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Sarcoma is a rare and an extremely aggressive form of cancer that originates from mesenchymal cells. Pyroptosis exerts a dual effect on tumours by inhibiting tumour cell proliferation while creating a microenvironment suitable for tumour cell development and proliferation. However, the significance of pyroptosis-related gene (PRG) expression in sarcoma has not yet been evaluated. Here, we conduct a retrospective analysis to examine PRG expression in 256 sarcoma samples from The Cancer Genome Atlas database. We identified the PRGs that had a significant correlation with overall patient survival in sarcoma by performing a univariate Cox regression analysis. Subsequently, we conducted a LASSO regression analysis and created a risk model for a six-PRG signature. As indicated from the Kaplan–Meier analysis, this signature revealed a significant difference between high- and low-risk sarcoma patients. A receiver operating characteristic curve analysis confirmed that this signature could predict overall patient survival in sarcoma patients with high sensitivity and specificity. Gene ontology annotation and Kyoto Encyclopaedia of Genes and Genomes pathway enrichment analyses revealed that five independent PRGs were closely associated with increased immune activity. Moreover, we also deciphered that increased number of immune cells infiltrated the tumour microenvironment in sarcoma. In brief, the PRG signature can effectively act as novel prognostic biomarker for sarcoma patients and is associated with the tumour immune microenvironment.

1.AbstractWhile there has been significant progress in molecular property prediction in computer-aided drug design, there is a critical need to have fast and accurate models. Many of the currently available methods are mostly specialists in predicting specific properties, leading to the use of many models side-by-side that lead to impossibly high computational overheads for the common researcher. Henceforth, the authors propose a single, generalist unified model exploiting graph convolutional variational encoders that can simultaneously predict multiple properties such as absorption, distribution, metabolism, excretion and toxicity (ADMET), target-specific docking score prediction and drug-drug interactions. Considerably, the use of this method allows for state-of-the-art virtual screening with an acceleration advantage of up to two orders of magnitude. The minimisation of a graph variational encoder’s latent space also allows for accelerated development of specific drugs for targets with Pareto optimality principles considered, and has the added advantage of explainability.

Squamous cell carcinoma of the head and neck (HNSCC) is the sixth most prevalent cancer worldwide, with an annual incidence of 600,000 new cases. Despite advances in surgery, chemotherapy, and radiotherapy, the overall survival for HNSCC patients has not been significantly improved over the past several decades. Fibroblast growth factor (FGF)/fibroblast growth factor receptor (FGFR) genomic alterations are frequently detected in HNSCC, including amplification, activating mutation, and chromosomal rearrangement. Among them, FGFR1 amplification, FGF amplifications, and FGFR3 mutations are the most prevalent. In addition, FGF/FGFR expression has also been observed in most HNSCCs. However, the prognostic value of FGF/FGFR aberrations remains unclear, especially for gene amplification and overexpression. Nonetheless, FGF/FGFR has been a promising target for HNSCC treatment, and recent preclinical studies demonstrate the potential of the combination treatment regimens involving FGFR inhibitors on HNSCC. Therefore, there are a number of FGFR inhibitors currently in clinical trials for the treatment of head and neck cancers.

The recently reported machine learning- or deep learning-based scoring functions (SFs) have shown exciting performance in predicting protein–ligand binding affinities with fruitful application prospects. However, the differentiation between highly similar ligand conformations, including the native binding pose (the global energy minimum state), remains challenging that could greatly enhance the docking. In this work, we propose a fully differentiable, end-to-end framework for ligand pose optimization based on a hybrid SF called DeepRMSD+Vina combined with a multi-layer perceptron (DeepRMSD) and the traditional AutoDock Vina SF. The DeepRMSD+Vina, which combines (1) the root mean square deviation (RMSD) of the docking pose with respect to the native pose and (2) the AutoDock Vina score, is fully differentiable; thus is capable of optimizing the ligand binding pose to the energy-lowest conformation. Evaluated by the CASF-2016 docking power dataset, the DeepRMSD+Vina reaches a success rate of 94.4%, which outperforms most reported SFs to date. We evaluated the ligand conformation optimization framework in practical molecular docking scenarios (redocking and cross-docking tasks), revealing the high potentialities of this framework in drug design and discovery. Structural analysis shows that this framework has the ability to identify key physical interactions in protein–ligand binding, such as hydrogen-bonding. Our work provides a paradigm for optimizing ligand conformations based on deep learning algorithms. The DeepRMSD+Vina model and the optimization framework are available at GitHub repository https://github.com/zchwang/DeepRMSD-Vina_Optimization.

A discussion is conducted on the problems of ideological and political education, rotation learning in departments, clinical and scientific research capabilities, paper writing, and improvement of the quality of papers encountered by professional master of clinical medicine in the “two-track integration” mode during the standardized training of resident doctors. On that basis, several methods are proposed in the present study (e.g., stressing ideological education for professional masters, coordinating learn of professional skills, enhancing paper writing ability and scientific research ability, organizing a professional team of tutors). On that basis, this study summarizes the problems and challenges exposed in training professional medical students, especially under “two-track integration” mode, seeks to propose a novel idea to serve better for the “two-track integration” educational mode, including provide solutions to help students establish learning goals, to enhance their writing ability, to narrow the bridge between teachers and students, etc. All of which, aims to optimize the training of professional masters of clinical medicine, and give some feasible suggestions for subsequent research. Hopefully, the suggestions and proposal in this study would draw attention and serve better to increase the education quality on professional medical students.

In this study, we investigated the application of mCherry, a fluorescent protein, to evaluate the inducible promoter rd29A in Arabidopsis under low temperature, using the Arabidopsis genome as a template to amplify this promoter by PCR. Overlapping extension PCR was used to ligate the rd29A promoter and the mCherry gene to initiate the expression of mCherry through construction of a pHDE-rd29A-mCherry plasmid. Competent Agrobacterium cells were transformed with the recombinant plasmid, and Agrobacterium-mediated transfect Arabidopsis to obtain the progeny which was identified containing rd29A-mCherry in the transformed plants. Positive transgenic T1 seeds were planted in 1/2MS medium, and the seedlings were subsequently cultured at 34, 24, 14, 4 and 0°C for 20 h. Expression of the mCherry gene was then determined using an inverted fluorescence microscope. The results showed that fluorescence intensity was significantly higher in seedlings grown at 4°C compared with those grown at other temperatures. Furthermore, the rd29A promoter was induced to express low-levels of mCherry expression. Quantitative PCR assay indicated that mCherry expression was high under the 4°C condition, which was consistent with the results obtained by microscopy. These findings indicate that mCherry can be used as an exogenous marker to investigate spatio-temporal promoter activation.

Osteoarthritis (OA) is a degenerative disease characterized by articular cartilage and/or chondrocyte destruction, and although it has long been considered as a primary disease, the importance of meniscus endothelial cell modulation in the subchondral microenvironment has recently drawn attention. Previous studies have shown that apelin could potentially inhibit cellular apoptosis; however, it remains unclear whether apelin could play a protective role in protecting the endothelium in the OA meniscus. In this study, with the advantages of single-cell RNA sequencing (scRNA-seq) data, in combination with flow cytometry, we identified two endothelial subclusters in the meniscus, featured by high expression of Homeobox A13 (HOXA13) and Ras Protein-Specific Guanine Nucleotide Releasing Factor 2 (RASGRF2), respectively. Compared with control patients, both subclusters decreased in absolute cell numbers and exhibited downregulated APJ endogenous ligand (APLN, coding for apelin) and upregulated apelin receptor (APLNR, coding apelin receptor). Furthermore, we confirmed that in OA, decreased endothelial cell numbers, including both subclusters, were related to intrinsic apoptosis factors: one more relevant to caspase 3 (CASP3) and the other to BH3-Interacting Domain Death agonist (BID). In vitro culturing of meniscal endothelial cells purified from patients proved that apelin could significantly inhibit apoptosis by downregulating these two factors in endothelial cell subclusters, suggesting that apelin could potentially serve as a therapeutic target for patients with OA.

One key task in virtual screening is to accurately predict the binding affinity ($\triangle$$G$) of protein-ligand complexes. Recently, deep learning (DL) has significantly increased the predicting accuracy of scoring functions due to the extraordinary ability of DL to extract useful features from raw data. Nevertheless, more efforts still need to be paid in many aspects, for the aim of increasing prediction accuracy and decreasing computational cost. In this study, we proposed a simple scoring function (called OnionNet-2) based on convolutional neural network to predict $\triangle$$G$. The protein-ligand interactions are characterized by the number of contacts between protein residues and ligand atoms in multiple distance shells. Compared to published models, the efficacy of OnionNet-2 is demonstrated to be the best for two widely used datasets CASF-2016 and CASF-2013 benchmarks. The OnionNet-2 model was further verified by non-experimental decoy structures from docking program and the CSAR NRC-HiQ data set (a high-quality data set provided by CSAR), which showed great success. Thus, our study provides a simple but efficient scoring function for predicting protein-ligand binding free energy., 7 pages, 4 figures, 1 table

Background. Increasing evidence demonstrated that long noncoding RNA (lncRNA) could affect inflammatory tumor immune microenvironment by modulating gene expression and could be used as a biomarker for HBC-related hepatocellular carcinoma (HCC) but still needs further research. The aim of the present study was to determine an lncRNA signature for the diagnosis of HBV-related HCC. Methods. HBV-related HCC expression profiles (GSE55092, GSE19665, and GSE84402) were abstracted from the GEO (Gene Expression Omnibus) data resource, and R package limma and RobustRankAggreg were employed to identify common differentially expressed genes (DEGs). Using machine learning, optimal diagnostic lncRNA molecular markers for HBV-related HCC were identified. The expression of candidate lncRNAs was cross-validated in GSE121248, and an ROC (receiver operating characteristic) curve of lncRNA biomarkers was carried out. Additionally, a coexpression network and functional annotation was built, after which a PPI (protein-protein interaction) network along with module analysis were conducted with the Cytoscape open source software. Result. A total of 38 DElncRNAs and 543 DEmRNAs were identified with a fold change larger than 2.0 and a P value < 0.05. By machine learning, AL356056.2, AL445524.1, TRIM52-AS1, AC093642.1, EHMT2-AS1, AC003991.1, AC008040.1, LINC00844, and LINC01018 were screened out as optional diagnostic lncRNA biosignatures for HBV-related HCC. The AUC (areas under the curve) of the SVM (support vector machine) model and random forest model were 0.957 and 0.904, respectively, and the specificity and sensitivity were 95.7 and 100% and 94.3 and 86.5%, respectively. The results of functional enrichment analysis showed that the integrated coexpressed DEmRNAs shared common cascades in the p53 signaling pathway, retinol metabolism, PI3K-Akt signaling cascade, and chemical carcinogenesis. The integrated DEmRNA PPI network complex was found to be comprised of 87 nodes, and two vital modules with a high degree were selected with the MCODE app. Conclusion. The present study identified nine potential diagnostic biomarkers for HBV-related HCC, all of which could potentially modulated gene expression related to inflammatory conditions in the tumor immune microenvironment. The functional annotation of the target DEmRNAs yielded novel evidence in evaluating the precise functions of lncRNA in HBV-related HCC.

Immune tolerance research is essential for kidney transplantation. Other than antibody and T cell-mediated immune rejection, macrophage-mediated innate immunity plays an important role in the onset phase of transplantation rejection. However, due to the complexity of the kidney environment as well as its diversity and low abundance, studies pertaining to monocyte/macrophages in kidney transplantation require further elucidation. In this study, kidney samples taken from healthy human adults and biopsy specimens from patients undergoing rejection following kidney transplantation were analysed and studied. By conducting a single-cell RNA analysis, the type and status of monocyte/macrophages in kidney transplantation were described, in which monocyte/macrophages were observed to form two different subpopulations: resident and infiltrating monocyte/macrophages. Furthermore, previously defined genes were mapped to all monocyte/macrophage types in the kidney and enriched the differential genes of the two main subpopulations using gene expression databases. Considering that various cases of rejection may be of the monocyte/macrophage type, the present data may serve as a reference for studies regarding immune tolerance following kidney transplantation.

Chunliu Ning,1 Tengfei Zhao,1 Zechen Wang,1 Delong Li,1 Yurong Kou,2 Shaohui Huang1 1Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, Liaoning, People’s Republic of China; 2Department of Oral Biology, School of Stomatology, China Medical University, Shenyang, Liaoning, People’s Republic of China Background: The purpose of this research was to determine whether neck dissection is necessary for the adenoid cystic carcinoma (ACC) of head and neck. Materials and methods: This article screened the abstract and full-text papers that investigated salivary gland primary ACC of head and neck. Two independent reviewers searched for articles published before October 2017 in three databases (Web of Science, PubMed, and Ovid), having no limits in date and language. Statistical data were analyzed statistically by Review Manager 5.3. Results: In total, 18 studies involving 2993 patients were included in the analysis. Of the 2993 patients, 473 patients had cervical lymph node metastasis, with a merge frequency of 16% (95% CI: 13–19). Among included articles, only 4 involved cervical lymph node occult metastases, with a merge frequency of 14% (95% CI: 9–20). There were 5 articles containing minor salivary glands (MiSGs) involving 370 patients of which 92 patients had cervical lymph node metastases and the merge frequency was 25% (95% CI: 11–38). Moreover, there were 4 studies on major salivary glands involving 904 patients of which 158 patients had cervical lymph node metastases and the merge frequency was 17% (95% CI: 15–20). Conclusion: Elective neck dissection is unnecessary for all patients with salivary gland ACC of head and neck. Moreover, compared with major salivary glands, MiSGs have a higher cervical lymph node metastases rate in ACC. The overall cervical lymph node metastases rate of MiSGs is 25%, which is enough to attract our attention. Therefore, we suggest that neck dissection might be applied to ACC of MiSGs. Keywords: adenoid cystic carcinoma, rates of cervical metastases and occult metastases, elective neck dissection, meta-analysis

A novel series of boron-containing compounds were designed, synthesized and evaluated as multi-target-directed ligands against Alzheimer's disease. The biological activity results demonstrated that these compounds possessed a significant ability to inhibit self-induced Aβ aggregation (20.5–82.8%, 20 μM) and to act as potential antioxidants (oxygen radical absorbance capacity assay using fluorescein (ORAC-FL) values of 2.70–5.87). In particular, compound 17h is a potential lead compound for AD therapy (IC(50) = 3.41 μM for self-induced Aβ aggregation; ORAC-FL value = 4.55). Compound 17h also functions as a metal chelator. These results indicated that boron-containing compounds could be new structural scaffolds for the treatment of AD.

Mitochondria and lysosomes at some pH values can be potential areas for cellular component recycling, virus dissemination and inflammatory response. These actions are closely related to mitochondrial elimination and autophagy in the processes of cell growth and apoptosis; though there are enormous differences in the pH values and functions between them, lysosomes present near mitochondria and mitolysosomes are difficult to distinguish from mitochondria by a single fluorescent probe. To distinguish these organelles, pH fluorescent probes have been designed to indicate pH changes and localization of mitochondrion or lysosome in living cells. While these probes address tracer ability, they do not enable the targeting of mitochondrion and lysosome for pH monitoring simultaneously. Towards this end, we report the development of Rh-BMDZ, a single rhodamine spirolactam fluorescent probe, for the differentiation and pH monitoring of mitochondria and lysosomes. The probe employs benzimidazole, the presence of which decreases the alkalinity and nucleophilicity of the spiro-N atom, thus allowing for the monitoring of mitochondrial pH by exhibiting varying fluorescence intensities based on pH. Additionally, the alkalescent benzimidazole can also attract Rh-BMDZ into lysosomes and emit strong fluorescence in the lysosomal pH range of 4.0–5.5. Owing to the unique 1H-benzo[d]-imidazole structure and properties, Rh-BMDZ with neutral pKa (6.9) shows distinct fluorescence changes in the pH range from 5.0 to 8.0. Consequently, Rh-BMDZ can simultaneously localize and accumulate in mitochondria and lysosomes, thus facilitating discrimination between mitochondria and lysosomes according to its fluorescence intensity. These excellent properties make Rh-BMDZ a promising probe for simultaneous tracking and pH monitoring of mitochondria and lysosomes in the biomedical and biological fields.

The intractable issues of silicon anodes hinder its wide application in high-capacity Li-ion batteries. Binders are proven to be one of the effective ways to enhance the electrochemical performance of Si anodes. Inspired by mussels, the water soluble binder carboxymethyl cellulose (CMC) is modified through amidation reaction, and the dopamine moieties are successfully introduced into the polymer backbone of CMC. The dopamine-modified CMC (CMC-DOP) is confirmed by liquid 1H nuclear magnetic resonance (1H NMR) spectroscopy, Fourier transform infrared (FTIR) spectroscopy and X-ray photoelectron spectroscopy (XPS) techniques. The CMC-DOP with polar catechol groups and affluent anchoring points exhibits higher adhesive force and superior electrochemical performance. The Si @ CMC-DOP electrode delivers a high initial specific capacity of 3418.2 mAh g−1 and maintains satisfactory capacity of 1650.6 mAh g−1 after 200 cycles. Furthermore, the tight wrapping/coating effect of CMC-DOP binder can effectively protect the active material from exposure to electrolyte, and reduce the decomposition of electrolyte as well as the massive formation of solid electrolyte interface (SEI) layers. The Si electrode with CMC-DOP binder shows slight polarization and intact structure in long-term cycling.

A novel six-membered rhodamine-based fluorescent probe (6G-ClO) was developed from 2-formyl rhodamine (6G-CHO) and used for hypochlorite detection in water and HUVEC cells. Different from planar penta cycle of rhodamine spirolactam, there was a twist six-membered spirocyclic hydrazone in 6G-ClO optimized by Gaussian software at DFT/B3LYP/6-31G(d) level. The high selectivity, high sensitivity and fast response of 6G-ClO towards ClO− would be attributed to the twist six-membered spirocycle. Test-strip prepared with 6G-ClO was successfully used to semi-quantitatively indicate the concentration of ClO− in water. 6G-ClO can also quantitatively detect the concentration of ClO− in tap water and swimming pool water. The detection limit of 6G-ClO was as low as 12 nM. The co-localization staining of HUVEC cells further verified that 6G-ClO could specifically accumulate in lysosomes and capture exogenous/endogenous ClO− in living lysosomes. 6G-ClO would be a practical probe for real-time monitoring of ClO− in the biological and real water samples.

Rhodamine derivatives and analogues have been widely used for different super-resolution imaging techniques, including photoactivated localization microscopy (PALM). Among them, rhodamine spirolactams exhibit great superiority for PALM imaging due to a desirable bright-dark contrast during the photochromic switching process. Although considerable attention has been paid to the chemical modifications on rhodamine spirolactams, the on-time of photochromic switching, one of the key characteristics for PALM imaging, has never been optimized in previous developments. In this study, we proposed that simply installing a carboxyl group close to the lactam site could impose an intramolecular acidic environment, stabilize the photoactivated zwitterionic structure, and thus effectively increase the on-time. On the basis of this idea, we have synthesized a new rhodamine spirolactam, Rh-Gly, that demonstrated considerably longer on-time than the other tested analogues, as well as an enhancement of single-molecule brightness, an improvement on signal-to-noise ratio and an enlargement of total collected photons of a single molecule before photobleaching. Finally, super-resolution images of live cell mitochondria stained with Rh-Gly have been obtained with a good temporal resolution of 10 s, as well as a satisfactory localization precision of ∼25 nm. Through self-labeling protein tags, Rh-Gly modified with a HaloTag ligand enabled super-resolution imaging of histone H2B proteins in live HeLa cells; through immunostaining antibodies labeled with an isothiocyanate-substituted Rh-Gly, super-resolution imaging of microtubules was achieved in fixed cells. Therefore, our simple and effective strategy provides novel insight for developing further enhanced rhodamine spirolactams recommendable for PALM imaging.

Objective To examine the practical effect of inter-professional education and situational simulation teaching implemented in surgical nursing practice teaching. Methods On the whole, 100 undergraduate nursing students in the operating room of the hospital of the authors from May 2019 to August 2020 were selected. These students fell to two groups with the random number table method. The control received the regular teaching, and the research group were given the interprofessional education and context. The Simulation teaching was conducted to compare the theoretical knowledge, skill level, various abilities of the two groups of students, as well as the satisfaction of the operating room doctors to the nursing cooperation of the interns. Results The research group achieved higher theoretical knowledge and a higher skill level than the control (p < 0.05); the various abilities of the research group were higher than those of the control (p < 0.05); the operating room doctors of the research group were more satisfied with the nursing cooperation of interns, as compared with those of the control (p < 0.05). Conclusion In the surgical nursing practice teaching, the inter-professional education and the situational simulation teaching have significant effects and are worth clinical applications.

The dramatic volume change and electrode pulverization hinder the practical utilization of silicon-based anodes for lithium-ion batteries. Studies show that binders can be an effective approach to solve these issues. Herein, the natural vegetable gum-guar gum (GG) is modified through carboxymethylation method. The carboxymethyl guar gum (CMGG) exhibits rapid water solubility, excellent thermal stability, high viscosity and robust adhesion. When it is applied as a binder for silicon anodes, the CMGG possessing affluent hydroxyl and carboxyl groups can effectively accommodate the significant volume variations of silicon particles through the formation of intensive hydrogen bonds. The Si @ CMGG electrode not only retains a high reversible capacity of 1865 mAh g−1 after 200 cycles with a capacity decay rate of 0.12% for each cycle, but also holds a capacity of 1287.1 mAh g−1 after 100 cycles with high mass loading of 1.15 mg cm−2. Furthermore, the CMGG binder can promote the lithium-ion transport like guar gum and reduce the electrode polarization, which is helpful in maintaining the electrochemical stability of Si anodes at high current density.

Image super-resolution is an essential technology for improving user quality of experience of internet videos. As the state-of-the-art deep learning-based super-resolution technology, the enhanced super-resolution generative adversarial networks (ESRGAN) has the best performance in the perceptual quality of reconstructed images, and the efficient sub-pixel convolutional neural network (ESPCN) has the best real-time performance. This work proposes real-time super-resolution generative adversarial network (RTSRGAN). RTSRGAN takes the advantages of ESRGAN and ESPCN so as to simultaneously satisfy the demands on the real-time performance and the resulting pleasant artifacts of super-resolution at the client side. Our experimental studies demonstrate our proposed RTSRGAN can be used for super-resolution at the client side to enhance the real-time performance as well as ensure the image perceptual quality.We also find that RTSRGAN is suitable for restoring imageswith regularly changing texture featureswithout requiring training for individual image categories.

Flexible actuators composed of twisted and coiled polymers (TCPs) can provide excellent performance such as high power-to-weight ratios for robotic hands. This paper presents a systematic methodology for the kinematic design of the TCP-actuated finger mechanism. The finger mechanism has a redundant serial-parallel hybrid topology, which is designed for grasping in space. The local and global performance evaluation indices concerning the dexterity and the extreme value of the velocity are first proposed for the optimal design of mechanism dimensions. Moreover, the flexibility matrix, mapping the stiffnesses of flexible elements including active TCP actuators and passive springs into the end-effector's stiffness, is established, and thus the extreme value of the deformation is obtained as the optimization objective function. Therefore, optimal passive stiffness coefficients are achieved by the genetic algorithm. Finally, the prototype of three-fingered robotic hand with the proposed finger mechanism and the control strategy based on TCP power-strain model were developed. Comparisons of experimental and theoretical data validated the kinematic design of the finger mechanism.

Parotidectomy is the most classic and unequivocal intervention for parotid neoplasm. The operative outcomes and postoperative complications of parotidectomy between harmonic scalpel and electrocautery gained more prominence in physician. In spite of much research work within the past years, there was an obvious lack of randomized controlled trial to resolve this question. Hence, a quantitative and qualitative meta-analysis was essential to evaluate the differences in these two types of hemostasis method.The major electronic databases, including Pubmed, Embase, Cochrane library, Google Scholar, China National Knowledge Infrastructure and Chinese Scientific and Technological Journal databases were using the key words "electrocautery", "electrocoagulation", "harmonic scalpel", "ultrasonic scalpel", "ultrasonic dissector", "parotidectomy" and "parotid surgery". 9 articles were included in our systematic review and meta-analysis. The operative time, intraoperative blood loss, hospital stay, salivary fistula and transient facial nerve paralysis were the outcome measures. Odds ratios (ORs) with 95% confidence intervals (CIs) were employed to evaluate the effect size for categorical outcomes and mean differences (MDs) with 95% confidence intervals (CIs) for continuous outcomes.In our meta-analysis, there was a significant reduction in operation time [mean difference: -20.97; 95%CI=(-24.02,-17.92); P 0.00001], intraoperative blood loss [mean difference: -20.75, 95%CI=(-22.32,-19.18); P 0.00001], hospital stay [mean difference: -0.83; 95%CI=(-1.10,-0.57); P 0.00001], salivary fistula [ORs: 0.30, 95%CI=(0.08,1.14)] and transient facial nerve paralysis [OR:0.33, 95%CI=(0.19,0.58),P = 0.0001] in harmonic scalpel group compared with electrocautery group.This meta-analysis indicated that compared with electrocautery, harmonic scalpel (HS)was transcendent in the aspects of operative time, intraoperative blood loss, hospital stay, salivary fistula and transient facial nerve paralysis. The harmonic scalpel, as an efficient and useful instrument, was advocated in parotidectomy.

Yurong Kou,1,* Tengfei Zhao,2,* Shaohui Huang,2 Jie Liu,3 Weiyi Duan,2 Yunjing Wang,2 Zechen Wang,2 Delong Li,2 Chunliu Ning,2 Changfu Sun2 1Department of Oral Biology, School of Stomatology, China Medical University, Shenyang, Liaoning, People’s Republic of China; 2Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Shenyang, Liaoning, People’s Republic of China; 3Centre of Science Experiment, China Medical University, Shenyang, Liaoning, People’s Republic of China *These authors contributed equally to this work Purpose: The aim of this study was to clarify whether level IIb dissection should be performed or avoided in the treatment of oral squamous cell carcinoma by meta-analysis.Materials and methods: Articles that were published before June 2017 were searched electronically in four databases (Web of Science, PubMed, Ovid and China National Knowledge Infrastructure) without any date or language restrictions by two independent reviewers. Abstracts and full-text papers which investigated the cervical metastases to level IIb from primary head and neck cancers and were deemed potentially relevant were screened. Data were analyzed using RevMan 5.3.Results: Four hundred and fifty-five abstracts and 129 full-text papers were screened, and 22 studies were included in the analysis. Among the 2001 patients included, 112 patients had level IIb metastases, the pooled frequency of which was 6% (95% confidence interval [CI]: 4.0–7.0). Among the 400 patients with tongue squamous cell carcinoma from 12 studies, 37 patients had level IIb metastases, the pooled incidence of which was 7% (95% CI: 5.0–10.0). Metastases to level IIb always went together with level IIa, and only three patients were found to have isolated level IIb metastases without involving the other levels.Conclusion: Due to the low frequency of level IIb nodal metastases in oral squamous cell carcinoma patients and rare occurrence of isolated level IIb, level IIb dissection could be avoided when the primary lesions were in early stages (T1 and T2), with the exception of tongue cancer. It is recommended to dissect level IIb tongue cancers without considering the stages of primary lesions and the lymph nodes status. It is also suggested that level IIb dissection should be performed in patients preoperatively or intraoperatively found with multilevel neck metastasis, especially level IIa metastasis. Keywords: level IIb, meta-analysis, neck dissection, oral squamous cell carcinoma, submuscular recess

We report for the first time the intrinsically three-dimensional (3D) geometry of the magnetic reconnection process induced by ballooning instability in a generalized Harris sheet. The spatial distribution and the structure of the quasi-separatrix layers, as well as their temporal emergence and evolution, indicate that the associated magnetic reconnection can only occur in a 3D geometry, which is irreducible to that of any two-dimensional reconnection process. Such a finding provides a new perspective to the long-standing controversy over the substorm onset problem and elucidates the combined roles of reconnection and ballooning instabilities. It also connects to the universal presence of 3D reconnection processes previously discovered in various natural and laboratory plasmas.

Because of the complexity of Alzheimer's disease (AD), the multi-target-directed ligand (MTDL) strategy is expected to provide superior effects for the treatment of AD, instead of the classic one-drug-one-target strategy. In this context, we focused on the design, synthesis and evaluation of homoisoflavonoid derivatives as dual acetyl cholinesterase (AChE) and monoamine oxidase (MAO-B) inhibitors. Among all the synthesized compounds, compound 10 provided a desired balance of AChE and hMAO-B inhibition activities, with IC50 value of 3.94 and 3.44 μM, respectively. Further studies revealed that compound 10 was a mixed-type inhibitor of AChE and an irreversible inhibitor of hMAO-B, which was also confirmed by molecular modeling studies. Taken together, the data indicated that 10 was a promising dual functional agent for the treatment of AD.