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Yu-qin Long,1,2 Xi-sheng Shan,1,2 Xiao-mei Feng,3 Hong Liu,4 Fu-hai Ji,1,2 Ke Peng1,2 1Departments of Anesthesiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People’s Republic of China; 2Institute of Anesthesiology, Soochow University, Suzhou, Jiangsu, People’s Republic of China; 3Department of Anesthesiology, University of Utah Health, Salt Lake City, UT, USA; 4Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, CA, USACorrespondence: Ke PengDepartment of Anesthesiology, First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, Jiangsu, 215006, People’s Republic of ChinaTel +86-159-6215-5989Email pengke0422@163.comPurpose: Patients undergoing major laparoscopic surgery often experience significant pain and postoperative nausea and vomiting (PONV). Deep neuromuscular block (NMB) improves surgical conditions and facilitates the application of low intra-abdominal pressure (IAP), which may be beneficial for these patients. This study is designed to determine the effects of deep NMB combined with low IAP, as compared to moderate NMB combined with standard IAP, on patients’ nociceptive recovery after major laparoscopic gastrointestinal surgery.Study Design and Methods: This single-center randomized controlled trial will include 220 patients scheduled for major laparoscopic gastrointestinal surgery (lasts for ≥ 90 minutes). Patients will be randomly assigned, with a 1:1 ratio, into a deep NMB + low IAP group (train of four = 0, post-tetanic count = 1– 3, IAP = 8 mmHg) and a moderate NMB + standard IAP group (train of four = 1– 3, IAP = 12 mmHg). If the surgical workspace is inadequate, the surgeons can request a step increase of 1 mmHg in IAP during 3-min intervals. The upper limit of IAP will be set at 15 mmHg. Postoperative recovery will be assessed using the postoperative quality recovery scale (PQRS). The primary outcome of this trial is the PQRS nociceptive recovery (including pain and PONV) at postoperative day (POD) 1. The secondary outcomes include recovery in other PQRS domains at POD 1, and recovery in all PQRS domains in a post-anesthesia care unit, at POD 3 in the surgical wards, at hospital discharge, and at postoperative 30 days. For the sample size estimation, 110 patients in each group (220 in total) would be needed to detect an absolute increase rate of 20% in the PQRS nociceptive domain in the deep NMB + low IAP group at POD 1.Discussion: This study investigates the effects of deep NMB combined with low IAP on postoperative PQRS nociceptive recovery in patients undergoing major laparoscopic gastrointestinal surgery. We expect that this deep NMB + low IAP strategy would improve postoperative pain and PONV following major laparoscopic gastrointestinal surgery.Keywords: major laparoscopic surgery, pneumoperitoneum pressure, neuromuscular block, postoperative quality recovery scale, randomized controlled trial

Wenqi Wang,* Xin Feng,* Yu Du, Cen Liu, Xinxin Pang, Kunxiu Jiang, Xirui Wang, Yonggang Liu School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, 102488, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yonggang Liu Email liuyg0228@163.comPurpose: Pinocembrin is a dihydroflavonoid, which is widely found in several plant species. Although pinocembrin has good pharmacological activity, it has poor water solubility and low bioavailability. Therefore, we have modified the structure of pinocembrin with a combination of different amino acids to solve this problem. Moreover, the effect of the antiaging activity of them has not been explored. We aim to investigate the effect of pinocembrin and its amino acid derivatives on the aging of Caenorhabditis elegans.Methods: Pinocembrin was spliced with different amino acids in order to obtain their corresponding derivatives. The preliminary research of pinocembrin and its amino acid derivatives on antiaging effect was studied by using the C. elegans model. Among all the compounds, the one shows the best antiaging effect was then studied on antiaging mechanism. The protective effect on nematodes under emergency conditions was explained by detecting the ROS content and sod-3p::GFP fusion protein expression in nematodes; the possible anti-aging mechanism of nematodes was determined by DAF-16 nuclear localization experiment and the survival curve of transgenic nematodes model under stress conditions.Results: Pb-3 showed the best effect on increasing tolerance to thermal and oxidative stress and reduce the accumulation of lipofuscin. In the assay of C. elegans, pb-3 reduced intracellular ROS accumulation. Application of pb-3 to the transgenic mutant TJ356 induced the translocation of the transcription factor DAF-16 from the cytosol to the nucleus, and modulated the expression of SOD-3 (downstream genes of daf-16), which regulates longevity in C. elegans. Moreover, pb-3 did not prolong the lifespan of daf-16, age-1, daf-2 and hsp16.2 mutants, suggesting that these genetic pathways are involved in mediating the antiaging effects of pb-3.Conclusion: The antioxidant and antiaging properties of pb-3 may involve in the DAF-16/FOXO transcription process. Pinocembrin amino acid derivatives might be a novel agent for antiaging therapy.Keywords: pinocembrin, antiaging, oxidative stress, amino acid derivatives, Caenorhabditis elegans, DAF-16/FOXO transcription factors

Quanrui Jiang, Xiang Feng, Dan Liu, Tao Li, Xiaoxia Kuang, Xiaowei Liu, Wu Li, Jiangshan Li College of Acupuncture & Moxibustion and Tui-Na, Hunan University of Chinese Medicine, Changsha, 410208, People’s Republic of ChinaCorrespondence: Jiangshan Li; Wu Li Tel +86-13707315642; +86-13574851647Email 292463008@qq.com; 272434694@qq.comObjective: To observe the effect of pressing intervention on the skeletal muscle repair of myofascial trigger points (MTrPs) in rats and explore the mechanism of pressing intervention on the deactivation of trigger points.Methods: Thirty SPF rats were randomly divided into blank group, model group and press group, with 10 rats in each group. The MTrPs models were established by blunt striking plus eccentric exercise, and then evaluated. The press group was given a pressing intervention with a self-made device for 14 days, and the rats in the other two groups were fed normally. Soft tissue tension (STT) D0.2 and pressure pain threshold (PPT) were measured before and after intervention. The skeletal muscle tissue at MTrPs was extracted and assessed by hematoxylin–eosin (HE) and Masson staining. The expression of collagen I, collagen III, α- smooth muscle actin (α-SMA), myosin heavy chain (MHC) and fibronectin (FN) were detected by Western Blotting. Enzyme linked immunosorbent assay (ELISA) was used to evaluate the expression of substance P (SP), 5-hydroxytryptamine (5-HT), cyclooxygenase 2 (COX-2) and prostaglandin E2 (PGE2).Results: (1) Compared with the blank group, the PPT and D0.2 reduced (P < 0.05) in the model group; while compared with the model group, the PPT and D0.2 increased (P < 0.05) in the press group. (2) Compared with the blank group, the model group showed obvious spontaneous potentials with higher amplitude and frequency, which were also much higher than those of the press group (P < 0.05). (3) The HE and Masson staining results showed evident fibrosis in the muscle tissue of the model group, with a larger area of collagen fibers relative to that of the press group (P < 0.05). (4) The amount of collagen I, collagen III, FN, α- SMA, SP, 5-HT, COX-2 and PGE2 increased and the content of MHC decreased (P < 0.05) in the model group, as compared to the blank group; while all the substances (P < 0.05), instead of MHC which increased (P < 0.05), in the press group were decreased as compared to the model group.Conclusion: Pressing intervention on the MTrPs in rats can alleviate chronic inflammation, inhibit fibrosis, promote skeletal muscle repair and relieve pain.Keywords: pressing, myofascial trigger points, skeletal muscle, chronic inflammation, fibrosis

To obtain high-quality two-dimensional (2D) materials from the bulky crystals, delamination under an externally controlled stimulus is crucial. Electrochemical exfoliation of layered materials requires simple instrumentation yet offers high-quality exfoliated 2D materials with high yields and features straightforward upscalability; therefore, it represents a key technology for advancing fundamental studies and industrial applications. Moreover, the solution processability of functionalized 2D materials enables the fabrication of (opto)electronic and energy devices via different printing technologies such as inkjet printing and 3D printing. This paper presents the electrochemical exfoliation protocol for the synthesis of black phosphorus (BP), one of the most promising emerging 2D materials, from its bulk crystals in a step-by-step manner, namely, cathodic electrochemical exfoliation of BP in the presence of N(C4H9)4∙HSO4 in propylene carbonate, dispersion preparation by sonication and subsequent centrifugation for the separation of flakes, and morphological characterization by scanning electron microscopy (SEM), atomic force microscopy (AFM), and transmission electron microscopy (TEM).

Yan Qu,1 Xien Feng,2 Jin’ning Liang,2 Junru Liu,3 Dong Gao2 1Department of Dermatology, The Affiliated Hospital of Weifang Medical University, Weifang, Shandong, 261031, People’s Republic of China; 2Department of Dermatology, Yantai Yuhuangding Hospital, Yantai, 264003, Shandong, People’s Republic of China; 3Department of Dermatology, Yantai Yuhuangding Hospital Laishan Branch, Yantai, 264003, Shandong, People’s Republic of ChinaCorrespondence: Dong Gao Email gaodong_yhd@163.comObjective: We aimed to investigate picosecond laser effects regarding rat tattoo removals. We systematically detected the metabolic pathways considering tattoo pigment particles in rat models.Materials and Methods: We employed fluorescein to mark the tattoo dye and utilized a pattern needle to prepare tattoo on rat so as to establish the tattoo removal effects of picosecond laser methods employing animal models. We applied a picosecond laser to process the tattoo and observed the effects along with metabolic pathways for tattoo removal via pathology and imaging approaches.Results: Based on the results of characterization, pathology and fluorescence, we discovered that the picosecond laser could effectively remove the pigment particles on rat skin, part of which would be metabolized out of the body through the circulatory system. After picosecond laser treatment, the fluorescence intensity of the rat skin engraved part was gradually weakened. At 8 h after the treatment, the metabolic organs had weak fluorescence, and there was no fluorescence in the metabolic organs at 12 h and 24 h after the treatment.Conclusion: The picosecond laser had perfect tattoo removal effects, which could be utilized as a reference for clinical tattoo removal.Keywords: tattoo, picosecond laser, pattern engraving, dye

Zu-Qin Yang,1 Jing-Yun Mai,2 Min-Li Zhu,2 Xiu-Man Xiao,2 Xiao-Xiao He,2 Shang-Qin Chen,2 Zhen-Lang Lin,2 Xing Feng1 1Department of Neonatology, Children’s Hospital of Soochow University, Suzhou, 215025, Jiangsu, People’s Republic of China; 2Department of Neonatology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027, People’s Republic of ChinaCorrespondence: Xing FengDepartment of Neonatology, Children’s Hospital of Soochow University, No. 92 Zhongnan Street, Wuzhong District, Suzhou, 215025, Jiangsu, People’s Republic of ChinaTel +86 0512 80692700Fax +86 0512 80693599Email fengxing1938@21cn.comBackground: Neonatal ventilator-associated pneumonia (NVAP) is one of the main infections acquired in hospitals, and soluble triggering receptors expressed on myeloid cells-1 (sTREM-1) are a TREM-1 subtype that can be released into the blood or bodily fluids during an infection.Methods: The patients included in the present study were divided into three groups: the NVAP group, the first control group, and the second control group (n = 20, each). Children requiring respiratory treatment were assigned to the NVAP group, newborns who received mechanical ventilation and had neonatal respiratory distress syndrome were assigned to the first control group, and newborns with normal X-ray and electrocardiogram results but no non-pulmonary infection was assigned to the second control group. The blood and bronchoalveolar lavage fluid (BALF) sTREM-1 levels in all newborns were analyzed.Results: The acute-phase blood and BALF sTREM-1 levels were significantly higher in the NVAP group than in the first control group, and the blood sTREM-1 expression level was lower in the second control group than in the NVAP group.Conclusion: The present results suggest that sTREM-1 might be a useful biomarker for NVAP prediction in the Department of Pediatrics.Keywords: pneumonia, neonatal ventilator-associated pneumonia, soluble TREM-1, neonate, C-reactive protein

Kairong Du,&ast; Wei Wu,&ast; Xiaobo Feng, Jianjuan Ke, Hengtao Xie, Yingying Chen Department of Anesthesiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei Province, Peoples Republic of China&ast;These authors contributed equally to this workCorrespondence: Hengtao Xie; Yingying ChenDepartment of Anesthesiology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei Province, Peoples Republic of ChinaTel +86-15342344235; +86-13476119947Email heng_823@163.com ; chenyingy@whu.edu.cnBackground: Puerarin, an active compound of radix puerariae, is a major compound used in Chinese herbal medicines and it has been well known for its pharmacological effects, including antioxidant, anti‑inflammatory, neuroprotective and cardioprotective properties. The aim of the present study was to determine the role of puerarin (Pue) in complete Freund’s adjuvant (CFA)-induced trigeminal neuralgia (TN) and the effects of this compound on Sirt1 activity and on the progression of CFA-induced TN.Methods: Mice were injected with CFA on the unilateral face to induce TN. A cell model of inflammation-associated TN was established by interleukin-1β (IL-1β; 10 ng/mL) and tumor necrosis factor-α (TNF-α; 50 ng/mL) stimulation of neurons. Reverse transcription-quantitative PCR and Western blot analyses were performed to analyze mRNA and protein expression levels in trigeminal ganglion and nerve cells. Terminal-deoxynucleotidyl transferase mediated nick end labeling (TUNEL) staining was used to determine nerve cell apoptosis following IL-1β/TNF-α or Pue treatment.Results: Pue is a conceivable Sirtuin1 (Sirt1) activator used for the prevention of trigeminal nerve injury that attenuates CFA-induced TN and inflammatory cytokine-evoked overactivation of neuronal inflammation and apoptosis. Treatment of mice with inflammatory cytokines induced upregulation of cleaved caspase-3 protein expression, which was neutralized by Pue supplementation. Both in vivo and in vitro experiments led to the conclusion that Pue modulated Sirt1 activation and repressed transforming growth factor-β 1 (TGF-β 1) protein expression and drosophila mothers against decapentaplegic homolog3 (Smad3) phosphorylation in order to exert neuroprotection.Conclusion: The findings suggested that Pue functioned as a potential Sirt1 activator to improve neuroinflammation-induced TN and neuronal apoptosis via the suppression of TGF-β 1/Smad3 activity. The pharmacological activity of Pue provides a new perspective for the effective prevention and treatment of TN.Keywords: apoptosis, inflammation, TGF-β 1/Smad3, trigeminal neuralgia, Sirt1

Xiuqun Gong,1,&ast; Zeyu Lu,2,&ast; Xiwu Feng,3,&ast; Kang Yuan,4 Mei Zhang,1 Xiaosi Cheng,1 Min Xue,1 Liang Yu,1 Jun Lu,5,6 Chuanqing Yu1 1Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology, First People’s Hospital of Huainan, Huainan, People’s Republic of China; 2College of Medicine, Anhui University of Science and Technology, Huainan, People’s Republic of China; 3Department of Cardiothoracic Surgery, First Affiliated Hospital of Anhui University of Science and Technology, First People’s Hospital of Huainan, Huainan, People’s Republic of China; 4Department of Neurology, Jinling Hospital, Nanjing Medical University, Nanjing, People’s Republic of China; 5Department of Medical Laboratory, College of Medicine, Anhui University of Science and Technology, Huainan, People’s Republic of China; 6Department of Clinical Laboratory, First Affiliated Hospital of Anhui University of Science and Technology, First People’s Hospital of Huainan, Huainan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jun LuDepartment of Medical Laboratory, College of Medicine, Anhui University of Science and Technology, 168 Taifeng Road, Huainan, 232001, Anhui Province, People’s Republic of ChinaTel + 86- 13855453149Email cfdxlujun@126.comChuanqing YuDepartment of Neurology, First Affiliated Hospital of Anhui University of Science and Technology, First People’s Hospital of Huainan, 203 Huaibin Road, Huainan, 232007, Anhui Province, People’s Republic of ChinaTel +86- 18949669880Email yuchuanqin1967@163.comObjective: Increased level of serum uric acid (UA) is often considered a risk factor for ischemic stroke. However, there are limited data on the association between UA and intracerebral hemorrhage (ICH). This study aimed to examine the connection between UA and early neurological deterioration (END) in patients with ICH.Methods: This is a prospective observational study. Patients with ICH were enrolled from January 2017 to December 2020. END was diagnosed as the Canadian Stroke Scale (CSS) score decreased ≥ 1 points between admission and 48 hours. UA was measured at admission. Multivariable logistic regression analysis was performed to explore the relationship between serum UA and END.Results: Of the 498 enrolled patients, 132 (26.5%) were developed with END. Patients with END had a significantly higher level of serum UA (332 vs 270 μmol/L, P < 0.001). Univariate logistic regression analysis indicated that patients with the highest quartile of UA level had an OR of 3.256 (95% CI: 1.849– 5.734, P < 0.001) for END compared with those with the lowest quartile of UA level. After adjusting for major confounders, the highest UA quartile remained as an independent predictor for END (OR = 2.282, 95% CI: 1.112– 4.685, P = 0.013).Conclusion: Higher serum UA level was independently associated with END in patients with ICH; therefore, intervention to lower UA level may be worth considering.Keywords: early neurological deterioration, intracerebral hemorrhage, uric acid

Haiyan Ge,1,&ast; Xuanqi Liu,1,&ast; Wenchao Gu,2 Xiumin Feng,3,4 Fengying Zhang,5 Fengfeng Han,6 Yechang Qian,7 Xiaoyan Jin,8 Beilan Gao,9 Li Yu,10 Hong Bao,11 Min Zhou,12 Shengqing Li,13 Zhijun Jie,14 Jian Wang,15 Zhihong Chen,16 Jingqing Hang,5 Jingxi Zhang,3 Huili Zhu1 1Department of Respiratory and Critical Care Medicine, Huadong Hospital, Fudan University, Shanghai, People’s Republic of China; 2Department of Respiratory Medicine, Pudong New District People’s Hospital, Shanghai, People’s Republic of China; 3Department of Respiratory and Critical Care Medicine, Changhai Hospital Affiliated to Navy Military Medical University, Shanghai, People’s Republic of China; 4Department of Respiratory and Critical Care Medicine, Changji Branch of First Affiliated Hospital of Xinjiang Medical University, Xinjiang, People’s Republic of China; 5Department of Respiratory Medicine, Putuo District People’s Hospital, Shanghai, People’s Republic of China; 6Department of Respiratory Medicine, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; 7Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, People’s Republic of China; 8Department of Respiratory Medicine, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; 9Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, Shanghai, People’s Republic of China; 10Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 11Department of Respiratory Medicine Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, People’s Republic of China; 12Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 13Department of Respiratory and Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China; 14Department of Respiratory Medicine, Shanghai Fifth’s Hospital, Fudan University, Shanghai, People’s Republic of China; 15Department of Respiratory Medicine, Shanghai Ninth’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; 16Department of Respiratory and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Huili Zhu Email zhuhuili001@126.comJingxi Zhang Email jingxizhang2000@126.comBackground: Chronic obstructive pulmonary disease (COPD) often coexists with multiple comorbidities which may have a significant impact on acute exacerbations of patients. At present, what kind of comorbidities affects acute exacerbations and how comorbidities lead to poor prognosis are still controversial. The purpose of our study is to determine the impact of comorbidities on COPD exacerbation and establish an acute exacerbation risk assessment system related to comorbidities.Methods: A total of 742 COPD patients participated in the Shanghai COPD Investigation on Comorbidity Program (SCICP, ChiCTR2000030911). Finally, the baseline information of 415 participants and one-year follow-up data were involved in the analysis. We collected hemogram indices, pulmonary function tests and acute exacerbation of COPD with regular medical follow-up. Q-type cluster analysis was used to determine the clusters of participants. Receiver operating characteristic (ROC) analysis was constructed to assess the ability of indicators in predicting acute exacerbations.Results: Almost 65% of the population we investigated had at least one comorbidity. The distribution and incidence of comorbidities differed between exacerbation group and non-exacerbation group. Three comorbidity clusters were identified: (1) respiratory, metabolic, immune and psychologic disease (non-severe cases); (2) cardiovascular and neoplastic disease (severe cases); (3) less comorbidity. Different sub-phenotypes of COPD patients showed significant distinction in health status. Anxiety (OR=5.936, P=0.001), angina (OR=10.155, P=0.025) and hypertension (OR=3.142, P=0.001) were found to be independent risk factors of exacerbation in a year. The novel risk score containing BODEx and four diseases showed great prognostic value of COPD exacerbation in developing sample.Conclusion: Our study detailed the major interaction between comorbidities and exacerbation in COPD. Noteworthily, a novel risk score using comprehensive index – BODEx – and comorbidity parameters can identify patients at high risk of acute exacerbation.Keywords: chronic obstructive pulmonary disease, exacerbation, comorbidity, risk score

Meilong Wu,1,2,&ast; Shizhong Yang,1,2,&ast; Xiaobin Feng,1,2 Chengquan Li,1,2 Xiangchen Liu,1,2 Zhenyu Zhang,1,2 Ying Xiao,1,3 Chuchu Liu,4 Jiahong Dong1,2 1School of Clinical Medicine, Tsinghua University, Beijing, 100084, People’s Republic of China; 2Hepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, People’s Republic of China; 3Department of pathology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, People’s Republic of China; 4Hepato-pancreato-biliary Surgery of Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, Xining, Qinghai, 810001, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jiahong DongHepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Changping District, Beijing, 102218, People’s Republic of ChinaTel/Fax +86-10-56118888Email dongjiahong@mail.tsinghua.edu.cnPurpose: Previous studies have shown that various preoperative inflammatory indicators can predict the prognosis of hepatocellular carcinoma (HCC), but the role of postoperative inflammatory indicators remains unclear. This study aimed to explore the prognostic value of postoperative inflammatory indicators and whether combining preoperative and postoperative inflammatory indicators can improve the predictive performance of the prognostic model.Patients and Methods: Eighty-eight patients with primary HCC were included in this study. A preoperative model, postoperative model, and combined model that integrated preoperative and postoperative inflammatory indicators were established. The prognostic value of the models was evaluated by the area under the curve of time-dependent receiver operating characteristic curves (td-AUC).Results: Multivariate analysis of preoperative and postoperative inflammatory indicators and clinicopathological indicators found that tumor number, alpha-fetoprotein (AFP) level, and the preoperative platelet-lymphocyte ratio (prePLR), preoperative prognostic nutritional index (prePNI), and postoperative neutrophil-lymphocyte ratio (postNLR) were independent prognostic factors for the disease-free survival. The prognostic efficacy of the postNLR at 2 years and 3 years was better than that of tumor number, AFP level, and the prePLR, and prePNI. The combined model had higher td-AUC values than the preoperative model, postoperative model, American Joint Committee on Cancer 8th edition stage, and Barcelona Clinic Liver Cancer stage at 2 years (0.814 vs 0.754, 0.765, 0.513 and 0.527, respectively), and 3 years (0.786 vs 0.749, 0.753, 0.509 and 0.529, respectively). The predictive performance of the combined model was better than that of the preoperative model, postoperative model, and traditional clinical stage.Conclusion: Postoperative inflammatory indicators were valuable prognostic indicators. The combination of preoperative and postoperative inflammatory indicators improved the predictive performance of the prognostic model. We should pay more attention to postoperative inflammatory indicators.Keywords: hepatocellular carcinoma, inflammation, postoperative, neutrophil-lymphocyte ratio, disease-free survival

Unlocking the mystery of the strange metal state has become the focal point of high-Tc research, not because of its importance for superconductivity, but because it appears to represent a truly novel phase of matter dubbed "quantum supreme matter."Detected originally through high magnetic field, transport experiments, signatures of this phase have now been uncovered with a variety of probes. Our high resolution optical data of the low-Tc cuprate superconductor, Bi2-xPbxSr2-yLayCuO6+δ allows us to probe this phase over a large energy and temperature window. We demonstrate that the optical signatures of the strange metal phase persist throughout the phase diagram. The strange metal signatures in the optical conductivity are twofold: (i) a low energy Drude response with Drude width on the order of temperature and (ii) a high energy conformal tail with a doping dependent power-law exponent. While the Drude weight evolves monotonically throughout the entire doping range studied, the spectral weight contained in the high energy conformal tail appears to be doping and temperature independent. Our analysis further shows that the temperature dependence of the optical conductivity is completely determined by the Drude parameters. Our results indicate that there is no critical doping level inside the superconducting dome where the carrier density starts to change drastically and that the previously observed "return to normalcy"is a consequence of the increasing importance of the Drude component relative to the conformal tail with doping. Importantly, both the doping and temperature dependence of the resistivity are largely determined by the Drude width.

Haijun Wan, Bosi Yuan, Kang Jiang, Juan Wei, Xiaoyue Feng, Bo Sun, Fangyu Wang Department of Gastroenterology, General Hospital of Eastern Theater Command, Nanjing City, Jiangsu Province, 210002, People’s Republic of ChinaCorrespondence: Fangyu WangDepartment of Gastroenterology, General Hospital of Eastern Theater Command, No. 305 East Zhongshan Road, Xuanwu District, Nanjing City, Jiangsu Province, 210002, People’s Republic of ChinaEmail fangyuwangnanjing@163.comPurpose: CircRNA CircRIMS has been characterized as an oncogenic circRNA in gastric cancer, while its role in other cancers is unknown. This study aimed to explore the role of CircRIMS in esophageal squamous cell carcinoma (ESCC).Patients and Methods: Tissues collected from 60 ESCC patients were subjected to extractions of total RNA and RT-qPCRs to analyze the differential expression of CircRIMS and miR-613. The 60 ESCC patients were followed up for 5 years to analyze the prognostic value of CircRIMS for ESCC. The interaction between CircRIMS and miR-613 was showed by luciferase activity assay and fluorescence in situ hybridization. The role of CircRIMS in regulating miR-613 expression and methylation was analyzed by overexpression experiments, RT-qPCRs and Western blot assay. The role of CircRIMS and miR-613 in regulating cell proliferation was analyzed using the BrdU assay. ESCC xenograft model was used to demonstrate the role of CircRIMS and miR-613 in vivo.Results: We found that CircRIMS was overexpressed in ESCC and predicted poor survival. In addition, miR-613 was under expressed in ESCC and inversely correlated with CircRIMS. In ESCC cells, CircRIMS overexpression decreased the expression of miR-613 and increased the methylation of miR-613 gene. Cell proliferation assay showed that CircRIMS overexpression reduced the inhibitory effects of miR-613 overexpression on cell proliferation. Animal experience finally illustrated that CircRNA CircRIMS downregulated miR-613 through methylation to promote tumor growth.Conclusion: Therefore, CircRIMS may downregulate miR-613 through methylation to increase cell proliferation in ESCC.Keywords: esophageal squamous cell carcinoma, CircRIMS, miR-613, proliferation, methylation

Yunfang Luo,1,* Fang Yu,1,* Xianjing Feng,1 Di Liao,1 Yuanlin Ying,1 Xi Li,1 Qin Huang,1 Zeyu Liu,1 Minping Wei,1 Tingting Zhao,1 Lin Zhang,1 Ruxin Tu,1 Jian Xia1– 3 1Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 2Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, People’s Republic of China; 3National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jian XiaDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of ChinaTel +86 731 84327216Fax +86 731 84327401. Email xjian1216@csu.edu.cnPurpose: Previous studies have shown a rising incidence of early-onset symptomatic intracranial atherosclerosis (sICAS), which has brought a severe economic burden to social development. This study aimed to evaluate the molecular biomarkers associated with early-onset sICAS and to seek possible intervention strategies for early prevention.Patients and Methods: We consecutively recruited patients with sICAS and divided them into two groups based on age: early-onset sICAS group as age ≤ 60 years old and late-onset sICAS group as age > 60 years old. We collected and compared the demographic data and laboratory results of each group. A bivariate logistic regression model was applied to evaluate the independent molecular biomarkers of early-onset sICAS.Results: A total of 1007 subjects with sICAS were enrolled in this study, comprising 519 patients in the early-onset sICAS group and 488 patients in the late-onset sICAS group. Bivariate logistic regression analysis demonstrated an increased level of white blood cell, platelet, albumin globulin ratio, free triiodothyronine, and a decreased level of total bile acid, urea nitrogen, high-density lipoprotein, homocysteine, and fibrinogen in the early-onset sICAS group when compared to the late-onset group.Conclusion: Our study showed the relevance between early sICAS and circulating levels of different molecular biomarkers. Detection of these related molecular biomarkers may provide a simple way for early sICAS preventions in the future.Keywords: ischemic stroke, symptomatic intracranial atherosclerosis, molecular biomarkers

Xinwei Li,1,* Xuechao Feng,2,* Weilong Xiao,1 Hui Zhou3 1College of Education and Human Development, Zhejiang Normal University, Jinhua, 321004, People’s Republic of China; 2Yuxiu Secondary School, Changyi, 261300, People’s Republic of China; 3Jinhua Advanced Research Institute, Jinhua, 321004, People’s Republic of China*These authors contributed equally to this workCorrespondence: Weilong XiaoCollege of Education and Human Development, Zhejiang Normal University, Jinhua, 321004, People’s Republic of ChinaEmail xwl743@163.comHui ZhouJinhua Advanced Research Institute, Jinhua, 321004, People’s Republic of ChinaEmail zhouhui102@163.comIntroduction: Mobile phones bring convenience to people’s lives, but also affect their physical and mental health (especially in college students). Previous studies have revealed that mobile phone addiction is positively related to loneliness. This study further explored the mediating effects of boredom proneness and self-control on the relationship between loneliness and mobile phone addiction.Methods: A cross-sectional design was conducted in the present study. The investigation employed the Chinese version of the UCLA Loneliness Self-report Scale, Boredom Proneness Scale-Short Form, the Chinese version of the Self-control scale, and the Mobile Phone Addiction Index. Out of 1122 college students, 1078 completed the questionnaire survey and became our final subjects. PROCESS macro of SPSS 21 was used to conduct explore the mediating roles of boredom proneness and self-control in the relationship between loneliness and mobile phone addiction.Results: Loneliness, boredom proneness, and mobile phone addiction were significantly and positively correlated with each other, as well as significantly negatively correlated with self-control. Boredom proneness and self-control, when operating in parallel, partially mediated the relationship between loneliness and mobile phone addiction. By contrast, when occurring sequentially, they fully mediated the relationship between loneliness and mobile phone addiction.Conclusion: Mobile phone addiction among lonely college students can be eliminated by exercising self-control and alleviating boredom proneness.Keywords: loneliness, boredom proneness, self-control, mobile phone addiction, college students

Jie Shen,1,2,* Yiling Wu,3,* Xiaoshuang Feng,1,2,* Fei Liang,4 Miao Mo,1,2 Binxin Cai,3 Changming Zhou,1,2 Zezhou Wang,1,2 Meiying Zhu,3 Guoxiang Cai,2,5 Ying Zheng1,2 1Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China; 2Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China; 3Department of Noninfectious Chronic Disease Control and Prevention, Songjiang District Center for Disease Control and Prevention, Shanghai, People’s Republic of China; 4Department of Biostatistics, Zhongshan Hospital Fudan University, Shanghai, People’s Republic of China; 5Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ying ZhengDepartment of Cancer Prevention, Fudan University Shanghai Cancer Center, No. 270 Dong’An Road, Shanghai, 200032, People’s Republic of ChinaEmail zhengying@fudan.edu.cnObjective: To identify people with high-risk early colorectal neoplasm is highly desirable for pre-selection in colorectal cancer (CRC) screening in low-resource countries. We aim to build and validate a risk-based model so as to improve compliance and increase the benefits of screening.Patients and Methods: Using data from the Shanghai CRC screening cohort, we conducted a population-based nested case–control study to build a risk-based model. Cases of early colorectal neoplasm were extracted as colorectal adenomas and stage 0-I CRC. Each case was matched with five individuals without neoplasm (controls) by the screening site and year of enrollment. Cases and controls were then randomly divided into two groups, with two thirds for building the risk prediction model and the other one third for model validation. Known risk factors were included for risk prediction models using logistic regressions. The area under the receiver operating characteristic curve (AUC) and Hosmer–Lemeshow chi-square statistics were used to evaluate model discrimination and calibration. The predicted individual risk probability was calculated under the risk regression equation.Results: The model incorporating age, sex, family history and lifestyle factors including body mass index (BMI), smoking status, alcohol, regular moderate-to-intensity physical activity showed good calibration and discrimination. When the risk cutoff threshold was defined as 17%, the sensitivity and specificity of the model were 63.99% and 53.82%, respectively. The validation data analysis also showed well discrimination.Conclusion: A risk prediction model combining personal and lifestyle factors was developed and validated for high-risk early colorectal neoplasm among the Chinese population. This risk-based model could improve the pre-selection for screening and contribute a lot to efficient population-based screening in low-resource countries.Keywords: cancer prevention, colorectal cancer, risk model, screening

Xiaomeng Zhao,1,* Nan Ye,1,* Xueke Feng,1 Haiyan Ju,1 Ruixia Liu,1 Wenyu Lu1– 3 1School of Chemical Engineering and Technology, Tianjin University, Tianjin, the People’s Republic of China; 2Key Laboratory of System Bioengineering, Tianjin University, Tianjin, the People’s Republic of China; 3Collaborative Innovation Center of Chemical Science and Engineering, Tianjin University, Tianjin, the People’s Republic of China*These authors contributed equally to this workCorrespondence: Wenyu Lu No. 135, Yaguan Road, Haihe Education Park, Jinnan District, Tianjin, the People’s Republic of ChinaTel +86-22-85356523Fax +86-22-27400973Email wenyulu@tju.edu.cnPurpose: The purpose of this study was to investigate the relationship between microRNA-29b-3p (miR-29b-3p) and myc-associated zinc finger protein (MAZ) expression and the effects of this interaction on the proliferation, migration, and invasion of gastric cancer cells.Methods: qPCR and Western blots were used to detect the expression of miR-29b-3p and MAZ. The dual luciferase reporter gene system was used to explore whether MAZ is the target of miR-29b-3p. Cell function experiments and a mouse tumorigenesis model were used to determine the effects of miR-29b-3p overexpression and MAZ depletion on proliferation, migration, and invasion in gastric cancer cell lines and on tumor growth.Results: The expression level of miR-29b-3p was low and the expression level of MAZ was high in gastric cancer cells compared with normal human gastric mucosal epithelial cells. MAZ was the target gene of miR-29b-3p. The upregulation of miR-29b-3p reduces the expression of MAZ. Overexpression of miR-29b-3p and downregulation of MAZ inhibited the proliferation and migration of cancer cells and induced apoptosis by controlling the expression of autophagy-related proteins. MiR-29b-3p mimics inhibit tumor growth in mice.Conclusion: MiR-29b-3p inhibits the migration and invasion of gastric cancer cells by regulating the autophagy-related protein MAZ.Keywords: gastric cancer, microRNA, autophagy, migration, invasion

Xuan Feng,1,2 Feng Xue,3 Guihua He,4 Suiping Huang,4 Qing Ni1,3 1Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225001, Jiangsu, People’s Republic of China; 2Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, 225001, Jiangsu, People’s Republic of China; 3Department of Surgery, Affiliated Hospital of Yangzhou University, Yangzhou, 225000, Jiangsu, People’s Republic of China; 4Department of Gastroenterology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510120, People’s Republic of ChinaCorrespondence: Suiping Huang; Qing Ni Email gzdoctorhsp@126.com; nqingnn@163.comPurpose: Banxia xiexin decoction (BXXX) is a classical Chinese herbal compound for the treatment of gastrointestinal diseases. Its ingredients are also considered helpful for cancer rehabilitation. Here, we will explore the regulatory mechanism of BXXX acting on PD-L1 in gastric cancer (GC).Methods: GC samples and the general baseline data of the patients were collated. Immunohistochemical (IHC) detected the expression of programmed cell death-ligand 1(PD-L1), hypoxia-inducible factor-1 (HIF-1), epidermal growth factor receptor (EGFR), interferon-γ receptor (IFNGR) and Toll-like receptor 4 (TLR4). ELISA detected the expressions of EGF, IFNG and IL-6 in serum samples. Network tools were used to analyze the potential molecules of BXXX. In the cell experiment, CCK-8 detected the cell proliferation. Tunel detected the apoptosis. Western blot detected the expression of related proteins. In animal experiments, the tumor volume of GC-bearing mice was observed. Expression of EGF, IFNG and IL-6 in the serum of tumor-bearing GC mice were detected by ELISA. Western blot detected the expression of related proteins.Results: The expressions of PD-L1, HIF-1, EGFR, IFNGR and TLR4 in the tissues of GC patients were significantly increased, and the expressions of EGF, IFNG and IL-6 in serum were increased. The molecular results of the network tools showed that BXXX and its main components have a targeting effect on the key molecules of each pathway in the PD-L1 regulatory network. Cell experiments showed that BXXX can inhibit the expression of PD-L1, HIF-1, EGFR and TLR4, but has no significant effect on the expression of IFNGR, thus inhibiting the proliferation and promoting the apoptosis of GC cells. The results were consistent with the animal experiments on tumor-bearing gastric cancer mice.Conclusion: BXXX inhibited the expression of PD-L1 through multi-target and multi-pathway regulation of major oncogenes in GC, thus effect cell proliferation and apoptosis.Keywords: banxia xiexin decoction, gastric cancer, PD-L1, multi-target and multi-pathway

Mei Er Tu He Ta Mi Shi,1,* Ning Wang,1,* Qing Yao,1 Shuang-Shuang Dong,1 Xiao Feng,1 Jin Zhao,1 Hong Zou,1 Li-Juan Pang,1 Yan Qi1,2 1Department of Pathology, Shihezi University School of Medicine and the First Affiliated Hospital to Shihezi University School of Medicine, Shihezi, Xinjiang, 832002, People’s Republic of China; 2Department of Pathology, Central People’s Hospital of Zhanjiang and Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yan Qi; Li-Juan PangDepartment of Pathology, Shihezi University School of Medicine and The First Affiliated Hospital to Shihezi University School of Medicine, North 2 Road, Shihezi, Xinjiang, 832002, People’s Republic of ChinaTel +86 150 09932652Email qiyanyan-1998@163.com; ocean123456@163.comAbstract: Phyllodes tumors (PTs) account for less than 1% of breast tumors, and malignant PTs account for even less. Here, we described an unusual case of malignant PT with mixed liposarcoma (myxoid liposarcoma [MLP] and pleomorphic liposarcoma [PLP]). A 52-year-old woman discovered a small lump in her left breast. Twenty years later, the lump suddenly grew within 1 month. Mammography showed space-occupying lesions of the left breast. Histologically, the tumor was characterized by hypercellular stroma covering the epithelium and protrusion of the myoepithelium into the cyst to form a lobulated structure; regions of loose mucus and hypercellular structures alternated. A region of peripheral benign fibroadenoma was also observed, and many stellate and spindle cells or signet ring-like cells were identified in loose areas. Some areas showed a characteristic thin branching vascular pattern. In the cell-rich area, adipocytes and odd megakaryocytes were observed. Atypical mitotic figures were observed in the cell-rich and mucus areas (16 mitoses/10 high-power fields [HPF] and 2 mitoses/10 HPF, respectively). In the immunohistochemical analysis, a small number of tumor cells were positive for AE1/3 and vimentin, whereas all cells were negative for cytokeratin 34βE12, E-cadherin, p63, estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and S-100, ruling out the possibility of metaplastic carcinoma. Interestingly, cyclin-dependent kinase 4, mouse double minute 2 (MDM2), and p16 were strongly positive in both loose mucus and cell-rich areas. However, the fluorescence in situ hybridization test results showed that MDM2 was not amplified. Combined with morphological characteristics, these findings supported that the tumor was a mixed malignant PT with MLP and PLP. Our patient did not receive radiation therapy, and after 47 months of follow-up, no recurrence or metastasis occurred. This case report serves to expand the morphologic spectrum of mixed malignant PT with liposarcoma.Keywords: malignant phyllodes tumor, breast cancer, mixed liposarcoma

Peng Qi,1 Xin Feng,2 Jun Lu,1 Junjie Wang,1 Shen Hu,1 Daming Wang2 1Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 2Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China; Graduate School of Peking Union Medical College, Beijing, People’s Republic of ChinaCorrespondence: Daming WangGraduate School of Peking Union Medical College, No. 9 Dongdansantiao, Dongcheng District, Beijing, 100730, People’s Republic of ChinaTel +86 10-85136281Fax +86 10-85132621Email daming2000@263.comObjective: It remains unclear whether irregular morphological features of intracranial aneurysms (IAs) are associated with atherosclerosis. We investigated the effect of cerebrovascular atherosclerosis stenosis (CAS) on irregular morphology of IAs.Patients and Methods: This single-center case-control study included consecutive patients with IAs at our institution from September 2011 to September 2018. Cases were patients with irregular IAs, and age- and location-matched controls were patients with regular IAs. Conditional logistic regression models were used to assess the relationship between angiographic variables of CAS and aneurysmal irregularity.Results: A total of 140 cases of irregular IAs and 140 controls were included in the analysis. Sixteen patients with irregular IAs (11.4%) and eleven patients with regular IAs (7.9%) had > 50% parent artery stenosis; however, the differences were not statistically significant between these two groups. In addition, no significant between-group differences were observed in distributions of the cerebrovascular stenosis, number of arterial stenoses, and location of the stenosis. In the final adjusted conditional logistic regression model, only aneurysm size (≥ 7 mm) was significantly associated with irregular IA morphology (P = 0.022). Moreover, 89 cases of irregular IAs and 89 controls were included in the analysis of unruptured IAs (UIAs). In the final adjusted conditional logistic regression model, only aneurysm size (≥ 7 mm) was significantly associated with irregular UIA morphology (P = 0.020).Conclusion: Our findings indicate that the morphological irregularity of unruptured intracranial aneurysms is more related with aneurysm size rather than cerebrovascular atherosclerosis. Further studies are needed to use prospective data to identify causative factors responsible for aneurysmal irregularity.Keywords: atherosclerotic stenosis, intracranial aneurysms, irregular morphology, risk factors, aneurysm size