Search

BackgroundIncreasing evidence have highlighted the biological significance of mRNA N6-methyladenosine (m6A) modification in regulating tumorigenicity and progression. However, the potential roles of m6A regulators in tumor microenvironment (TME) formation and immune cell infiltration in liver hepatocellular carcinoma (LIHC or HCC) requires further clarification.MethodRNA sequencing data were obtained from TCGA-LIHC databases and ICGC-LIRI-JP databases. Consensus clustering algorithm was used to identify m6A regulators cluster subtypes. Weighted gene co-expression network analysis (WGCNA), LASSO regression, Random Forest (RF), and Support Vector Machine-Recursive Feature Elimination (SVM-RFE) were applied to identify candidate biomarkers, and then a m6Arisk score model was constructed. The correlations of m6Arisk score with immunological characteristics (immunomodulators, cancer immunity cycles, tumor-infiltrating immune cells (TIICs), and immune checkpoints) were systematically evaluated. The effective performance of nomogram was evaluated using concordance index (C‐index), calibration plots, decision curve analysis (DCA), and receiver operating characteristic curve (ROC).ResultsTwo distinct m6A modification patterns were identified based on 23 m6A regulators, which were correlated with different clinical outcomes and biological functions. Based on the constructed m6Arisk score model, HCC patients can be divided into two distinct risk score subgroups. Further analysis indicated that the m6Arisk score showed excellent prognostic performance. Patients with a high m6Arisk score was significantly associated with poorer clinical outcome, lower drug sensitivity, and higher immune infiltration. Moreover, we developed a nomogram model by incorporating the m6Arisk score and clinicopathological features. The application of the m6Arisk score for the prognostic stratification of HCC has good clinical applicability and clinical net benefit.ConclusionOur findings reveal the crucial role of m6A modification patterns for predicting HCC TME status and prognosis, and highlight the good clinical applicability and net benefit of m6Arisk score in terms of prognosis, immunophenotype, and drug therapy in HCC patients.

Abstracts: This study examines the impact of Confucian culture as an informal institution on the commercial credit financing of firms. Using A-share listed companies in Shanghai and Shenzhen, China, from 2006 to 2019, it finds that Confucian culture facilitates firms' access to business credit financing. In regions where Confucian values are strong, practicing the principles of “righteousness and profit” and “faith and righteousness,” for example, can help build a positive business reputation. This reputation improves stakeholder support and enables easier acquisition of business credit compared to firms in other areas. The study identifies three mechanisms by which Confucianism improves credit financing: enhancing internal controls, reducing corporate violations, and mitigating managers’ short-sightedness. This study adds to our understanding of corporate credit financing by delving into the role of Confucianism in traditional Chinese culture. It also provides empirical evidence for credit financing behavior in the Chinese context.

ABSTRACT Synergistic effects of phages in combination with antibiotics have received increasing attention. In this present study, we isolated a new phage pB3074 against clinically isolated multidrug-resistant Acinetobacter baumannii. Phage pB3074 combined with cell wall-targeting antibiotics could produce synergistic antibacterial effect in vitro bactericidal activities. Further research indicates that the bacteriophage dose is critical to synergistic antimicrobial effect of phage and antibiotic combination. Cefotaxime and meropenem were selected as the representative cell wall-targeting antibiotics for further synergistic antibacterial study. Results illustrated that phage pB3074 and cefotaxime or meropenem combination was very effective for the removal of mature biofilm and inhibition of biofilm formation. In a pig skin explant model, results also showed that phage pB3074 and cefotaxime or meropenem combination was very effective for the treatment of wound infection ex vivo. Subsequent studies showed that some extent recovery of drug sensitivity to cell wall-targeting antibiotics might be vital mechanism of synergistic antibacterial effect between bacteriophage pB3074 and these antibiotics. The existence of antibiotics could promote phage adsorption and proliferation, which might also be potential mechanism for synergistic antibacterial activities and have been observed in cefotaxime and meropenem application. In summary, results in the current study demonstrated that phage pB3074 has the potential to be developed as an antibacterial agent and combined application of phages and antibiotics might be a new choice for the treatment of current multidrug-resistant bacterial infections. IMPORTANCE Combined application of phages and antibiotics cannot only effectively inhibit the appearance of phage-resistant bacteria, but also reduce the effective use concentration of antibiotics, and even make some bacteria regain sensitivity to some resistant antibiotics. Therefore, phage-antibiotic combination (PAC) could improve the antibacterial activity of individual drug, providing a new choice for clinical treatment of multidrug-resistant bacterial infections.

Abstract Background Timely detection of cerebral infarction is of vital importance in planning intervention effect of rapid rehabilitation. The clinical auxiliary diagnosis value of single biomarker, including small dense low-density lipoprotein concentration (sdLDLc), homocysteine concentration (HCYc) and high-density lipoprotein cholesterol concentration (HDLc) for cerebral infarction has been confirmed by many studies. Whether the use of three biomarkers in combination by calculating (sdLDLc*HCYc)/HDLc ratio could improve the diagnosis ability for primary cerebral infarction remains to be unclear. In the present study, we conducted a cross-sectional study to evaluate the value of (sdLDLc*HCYc)/HDLc ratio in clinical auxiliary diagnosis of primary cerebral infarction. Methods A total of 583 participants, including 299 healthy participants as control group and 284 participants diagnosed with first cerebral infarction as experiment group, were included in this respective study. The serum sdLDLc, HDLc and HCYc were measured by peroxidase method, enzyme‐linked immunosorbent assay and an enzymatic method, respectively. Results The average concentration of sdLDL and HCY (0.69 ± 0.29 mmol/L and 18.14 ± 6.62 μmol/L) in experiment group was significantly higher than those in the control group (0.55 ± 0.22 mmol/L and 10.77 ± 2.67 μmol/L, P

At present, scholars mainly study the relationship between nanobubbles and useful minerals, often ignoring the influence of bubbles on fine gangue minerals. When selecting nickel sulfide ore, scholars often faced with mudded and irrepressible serpentine, which seriously affects the quality of the concentrate. This mudded serpentine mineral often enters foam products with bubbles. In this study, the role of nanobubbles in the flotation behavior of hydrophilic serpentine was examined. Nanobubbles were successfully prepared via ultrasonic cavitation, with sizes ranging from 50 to 250 nm. The size and number of bubbles produced at 1 min and 2 min of sonication were significantly better than those of the prolonged test group, and it was found that longer sonication time did not produce better results. The stability of the nanobubbles produced via ultrasound was studied, and it was found that the nanobubbles were stable, with no change in size and only a slight decrease in number as the resting time increased. Nanobubbles were introduced into serpentine flotation, we found that the presence of nanobubbles significantly reduced the flotation recovery of serpentine. The presence of nanobubbles reduced the froth entrainment rate of microfine-grained serpentine, which in turn reduced its flotation rate. In the depressant group trials, it was found that the nanobubbles also reduced the amount of depressant. In short, the presence of nanobubbles can prevent the floating of fine hydrophilic gangues during flotation.

Abstract Background Rapid phage enumeration/quantitation and viable bacteria determination is critical for phage application and treatment of infectious patients caused by the pathogenic bacteria. Methods In the current study, a direct phage DNA detection-based Taqman qPCR methodology for quantification of phage P53 and rapid ultrasensitive identification of Acinetobacter baumannii (A. baumannii) was evaluated. Results The assay was capable of quantifying P53 phage DNA without DNA extraction and the detection limit of the assay was 550 PFU/mL. The agreement bias between the quantitative results of three different phage concentrations in this assay and double agar overlay plaque assay were under 3.38%. Through the built detection system, down to 1 log CFU/mL of viable A. baumannii can be detected within 4 h in A. baumannii spiked swab and bronchoalveolar lavage fluid samples. Compared with the Taqman qPCR that targets the conserved sequence of A. baumannii, the sensitivity of the assay built in this study could increase four orders of magnitude. Conclusions The methodology offers a valid alternative for enumeration of freshly prepared phage solution and diagnosis of bacterial infection caused by A. baumannii or other bacterial infection in complicated samples through switching to phages against other bacteria. Furthermore, the assay could offer drug adjustment strategy timely owing to the detection of bacteria vitality.

Glioblastoma (GBM) is an aggressive primary brain tumor with unique immunity predominated by myeloid cells. GBM cells have been implicated to evade immune attack through hijacking myeloid-affiliated transcriptional programs to establish an immunosuppressive microenvironment. However, molecular features of immune-evading GBM cells in heterogeneous GBMs and their interactions with immune cells remain unclear. Herein, we employed single-cell RNA sequencing (scRNA-seq) and bulk RNA-seq data to develop an in silico method for delineating GBM immune signature and identifying new molecular subsets for immunotherapy. We identified a new GBM cell subset, termed TC-6, that harbored immune-invading signature and actively interacted with tumor-associated macrophages (TAMs) to orchestrate an immune-suppressive niche. Proinflammatory transcriptional factors STAT1, STAT2, IRF1, IRF2, IRF3, and IRF7 were identified as the core regulons defining TC-6 subsets. Further immune transcriptome analyses revealed three immune subtypes (C1, C2, and C3). C3 subtype GBMs were enriched with TC-6 cells and immunosuppressive TAMs, and exhibited an immunomodulatory signature that associated with reduced efficacy of anti-PD-1 treatment. Interferon-related DNA damage resistance signaling was upregulated in C3 GBMs, predicting shortened survival of GBM patients who received chemo-radiation treatment. Treatment of OSI-930 as a molecular agent targeting c-kit and VEGFR2 tyrosine kinases may compromise the immunomodulatory signature of C3 GBMs and synergize with chemo-radiation therapy. We further developed a simplified 11-gene set for defining C3 GBMs. Our work identified TC-6 subset as an immune-evading hub that creates an immunomodulatory signature of C3 GBMs, gaining insights into the heterogeneity of GBM immune microenvironment and holding promise for optimized anti-GBM immunotherapy.

Objective: To investigate the dynamic characteristics of serological antibodies against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is of much current significance. Methods: The dynamic changes and prevalence of immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies against SARS-CoV-2 were assessed from the time of symptom onset up to 210 days. Antibodies were detected using a chemiluminescence immunoassay. Results: The average titers and IgG/IgM positivity rates reached a peak within 30 days of symptom onset and then began to decline continuously. Between 180 and 210 days following symptom onset, the titers of IgG and IgM were 43.1 ± 27.0 AU/mL and 4.4 ± 5.2 AU/mL, respectively, while the respective positivity rates were 84.3% and 12.0%. Further statistical analyses revealed that the dynamic changes and prevalence of the SARS-CoV-2 IgG/IgM antibodies were related to age and disease severity, but not to sex. The dynamic changes and the prevalence were similar for both the IgM and the IgG antibodies. Even so, there was a more rapid rate of decline for the IgM antibodies. It was found that an IgG level of 16.33 ± 3.15 AU/mL may represent a threshold value that should act as an alert, as it may indicate that the IgG level will become undetectable within the next 30–60 days. Conclusion: The results provide important information concerning COVID-19 and may be of relevance for diagnosis, treatment, and vaccine development.

ABSTRACT Phage-antibiotic combination (PAC) therapy is a potential new alternative to treat infections caused by pathogenic bacteria, particularly those caused by antibiotic-resistant bacteria. In the present study, phage YC#06 against highly multidrug-resistant Acinetobacter baumannii 4015 was isolated, identified, and characterized. Compared with antibiotics alone, the time-kill experiments in vitro showed that YC#06 and antibiotic mixtures that include the chloramphenicol, imipenem, and cefotaxime combination could produce phage-antibiotic synergy (PAS), which reduced the ultimate effective concentration of antibiotics. No phage-resistant bacteria have been isolated during the whole time-kill experiments in vitro. Of note, PAS was dose dependent, requiring a moderate phage dose to achieve maximum PAS effect. In addition, PAS could effectively inhibit biofilm formation and remove mature biofilms in vitro. Furthermore, PAS between the combination of YC#06 and antibiotic mixtures in vivo was validated using a zebrafish infection model. Overall, the results of this study demonstrate that PAC could be a viable strategy to treat infection caused by high-level multidrug-resistant Acinetobacter baumannii or other drug-resistant bacteria through switching to other types of phage and antibiotic mixtures. IMPORTANCE The treatment of multidrug-resistant bacterial infection is an urgent clinical problem. The combination of bacteriophages and antibiotics could produce synergistic bactericidal effects, which could reduce the emergence of antibiotic resistance and antibiotic consumption in antibiotic-sensitive bacteria, restore efficacy to antibiotics in antibiotic-resistant bacteria, and prevent the occurrence of phage-resistant bacteria. Phage-antibiotic combination (PAC) might be a potential new alternative for clinical treatment of multidrug-resistant bacterial infections.

Cancer stem cells (CSCs) are a relatively rare subpopulation of tumor cell with self-renewal and tumorigenesis capabilities. CSCs are associated with cancer recurrence, progression, and chemoradiotherapy resistance. Establishing a reliable platform for CSC enrichment and study is a prerequisite for understanding the characteristics of CSCs and discovering CSC-related therapeutic strategies. Certain strategies for CSC enrichment have been used in laboratory, particularly fluorescence-activated cell sorting (FACS) and mammosphere culture. However, these methods fail to recapitulate the in vivo chemical and physical conditions in tumors, thus potentially decreasing the malignancy of CSCs in culture and yielding unreliable research results. Accumulating research suggests the promise of a biomaterial-based three-dimensional (3D) strategy for CSC enrichment and study. This strategy has an advantage over conventional methods in simulating the tumor microenvironment, thus providing a more effective and predictive model for CSC laboratory research. In this review, we first briefly discuss the conventional methods for CSC enrichment and study. We then summarize the latest advances and challenges in biomaterial-based 3D CSC platforms. Design strategies for materials, morphology, and chemical and physical cues are highlighted to provide direction for the future construction of platforms for CSC enrichment and study.

BackgroundPrimary liver cancer is still the most common lethal malignancy. The N-myc downstream-regulated gene family (NDRG1–4) is a group of multifunctional proteins associated with carcinogenesis. However, systematic evaluation of the diagnostic and prognostic values of NDRG1 or NDRG2 expression in liver cancer is poorly investigated.MethodThe gene expression matrix of liver hepatocellular carcinoma (LIHC) was comprehensively analyzed by the “limma” and “Dseq2” R packages. The Gene Ontology (GO) and Gene Set Enrichment Analysis (GSEA) were used to identify the biological functional differences. A single-sample GSEA (ssGSEA) was conducted to quantify the extent of immune cell infiltration. Finally, the clinical and prognostic information of LIHC patients was systematically investigated using Kaplan–Meier analysis and logistic and Cox regression analysis.ResultsCompared with normal tissues, NDRG1 expression was higher, whereas NDRG2 expression was lower in tumor tissues (P

Abstract A neuromorphic visual system integrating optoelectronic synapses to perform the in‐sensor computing is triggering a revolution due to the reduction of latency and energy consumption. Here it is demonstrated that the dwell time of photon‐generated carriers in the space‐charge region can be effectively extended by embedding a potential well on the shoulder of Schottky energy barrier. It permits the nonlinear interaction of photocurrents stimulated by spatiotemporal optical signals, which is necessary for in‐sensor reservoir computing (RC). The machine vision with the sensor reservoir constituted by designed self‐powered Au/P(VDF‐TrFE)/Cs2AgBiBr6/ITO devices is competent for both static and dynamic vision tasks. It shows an accuracy of 99.97% for face classification and 100% for dynamic vehicle flow recognition. The in‐sensor RC system takes advantage of near‐zero energy consumption in the reservoir, resulting in decades‐time lower training costs than a conventional neural network. This work paves the way for ultralow‐power machine vision using photonic devices.

Psittacosis is a infectious disease caused by Chlamydia psittaci (C. psittaci), which presents as pneumonia in humans. The diagnosis of psittacosis is challenging, however, Metagenomic next-generation sequencing (MNGS) is very efficient. Herein we documented the clinical characteristics of two patients with severe C. psittaci pneumonia who were admitted to the Intensive Care Unit. C. psittaci nucleic acid sequences were detected by MNGS of bronchoalveolar lavage fluid from both patients. Doxycycline was administered and the treatment was effective. Implementation of MNGS is helpful for the early identification of pathogens, shortening the diagnosis and treatment time, and improving the prognosis of patients.

For facilitating theranostic nanoplatform with multimodal therapeutic ability, we develop the core-shell structured CDs@SiO2@TiO2 nanoplatforms (CST NPs). The designed CST NPs possess excellent photothermal effect and fluorescence resonance energy transfer (FRET) induced photodynamic property, which could achieve synergistic photothermal and photodynamic therapy. Meanwhile, the photothermal ability of CST NPs acts as a key role in the application of real-time photothermal imaging, benefitting for the diagnosis of tumor accurately. Moreover, the obtained CST NPs also exhibit outstanding sonodynamic effect with huge potential for sonodynamic therapy. Under the 650 nm laser irradiation, the synthesized CST NPs not only inhibit the growth of cancer cells in vitro, but also display precise photothermal imaging and photo-induced ablation to tumor in vivo. As a result, the prepared CST NPs may potentially serve as multifunctional nanoplatform for theranostic antitumor and pave the avenue for clinic cancer therapy. Keywords: Photothermal imaging, Photothermal therapy, Photodynamic therapy, Sonodynamic effect, Multimodal synergistic antitumor

Metal–organic frames (MOFs) have recently been used to support redox enzymes for highly sensitive and selective chemical sensors for small biomolecules such as oxygen (O2), hydrogen peroxide (H2O2), etc. However, most MOFs are insulative and their three-dimensional (3D) porous structures hinder the electron transfer pathway between the current collector and the redox enzyme molecules. In order to facilitate electron transfer, here we adopt two-dimensional (2D) metal–organic layers (MOLs) to support the HRP molecules in the detection of H2O2. The correlation between the current response and the H2O2 concentration presents a linear range from 7.5 μM to 1500 μM with a detection limit of 0.87 μM (S/N = 3). The sensitivity, reproducibility, and stability of the enzyme sensor are promoted due to the facilitated electron transfer.

Background: This paper reports two cases of anatomic urethroplasty (AU) using everted saphenous vein graft (eSVG) with long penile urethral strictures. The preliminary feasibility and safety of the operation are also analyzed. Methods: Two men with penile urethral strictures (5.5 cm and 5.0 cm) were treated with AU using eSVG. The highlight of this novel surgical technique was the anatomical repair of the layer of the narrowed urethral wall without affecting the continuity of the layer of corpus spongiosum. Moreover, the pre- and postoperative Urodynamics and Night Penis Tumescence and Rigidity test results were compared. Results: Complications, such as hematoma, urinary fistula, or urethral strictures, were not observed at 2 weeks postoperatively. At 6 months postoperatively, the urination status and urodynamic indexes of the patients had significantly improved compared with that preoperatively. There was no significant change in erection function before and after the operation. Conclusions: Repairing long penile urethral strictures with AU using eSVG is safe and feasible and can be used as an alternative treatment method.

A series of pyrenyl-containing PDMAA copolymers were prepared by free radical copolymerization of dimethylacrylamide (DMAA) with pyrenebutanoyloxy ethyl methacrylate (PyBEMA). The structure of as-prepared copolymers was characterized by UV, FT-IR and 1H NMR spectroscopy. The effect of cyclodextrins (α-CD, β-CD and γ-CD) on the thermosensitivity and fluorescence of the copolymers in aqueous solutions were investigated. It was found that the as-prepared copolymers exhibit lower critical solution temperature (LCST)-type thermosensitivity. Cloud point (Tcp) decreases with the increasing molar content of PyBEMA unit in the copolymers. Tcp of the copolymers increases after the CD is added from half molar to equivalent amount relative to pyrenyl moiety, and that further adding twice equivalent CD results in a slight decrease in Tcp. The copolymers exhibit a pyrene emission located at 377 nm and a broad excimer emission centered at 470 nm. The copolymers in water present a stronger excimer emission (Intensity IE) relative to monomer emission (Intensity IM) than that in ethanol. The IE/IM values decrease after the addition of equivalent α-CD, β-CD and γ-CD into the copolymers in aqueous solution, respectively. The IE/IM values abruptly increase as the copolymers’ concentration is over 0.2 mg/L whether in ethanol solution or aqueous solution with or without CD, from which can probably be inferred that intra-polymeric pyrene aggregates dominate for solution concentration below 0.2 mg/L and inter-polymeric pyrene aggregates dominate over 0.2 mg/L. Furthermore, the formation of the CD pseudopolyrotaxanes makes it possible to form pyrene aggregates. For high concentration of 5 g/L, the copolymers and their inclusion complexes completely exhibit an excimer emission. The IE values abruptly increased as the temperature went up to Tcp, which indicates that the IE values can be used to research phase separation of polymers.

Gynura medica leaf extract contains significant amounts of flavonols and phenolic acids and exhibits powerful hypoglycemic activity against diabetic rats in vivo. However, the hypoglycemic active constituents that exist in the plant have not been fully elaborated. The purpose of this study is to isolate and elaborate the hypoglycemic activity compounds against inhibition the yeast α-glucosidase in vitro. Seven phenolic compounds including five flavonols and two phenolic acids were isolated from the leaf of G. medica. Their structures were identified by the extensive NMR and mass spectral analyses as: kaempferol (1), quercetin (2), kaempferol-3-O-β-D-glucopyranoside (3), kaempferol-3-O-rutinoside (4), rutin (5), chlorogenic acid (6) and 3,5-dicaffeoylquinic acid methyl ester (7). All of the compounds except 1 and 3 were isolated for the first time from G. medica. Compounds 1–7 were also assayed for their hypoglycemic activity against yeast α-glucosidase in vitro. All of the compounds except 1 and 6 showed good yeast α-glucosidase inhibitory activity with the IC50 values of 1.67 mg/mL, 1.46 mg/mL, 0.38 mg/mL, 0.10 mg/mL and 0.53 mg/mL, respectively.

A series of copolymers with an adamantyl side group (poly(NIPAM-co-AdMA) and poly(DMAM-co-AdMA)) were prepared by radical copolymerization of N-isopropylacrylamide (NIPAM) and N,N-dimethylacrylamide (DMAM) with a 2-methyl-2-adamantylmethacrylate (AdMA) monomer. The structure and composition of the as-synthesized copolymers were characterized by Fourier transform infrared (FT-IR) spectroscopy, proton nuclear magnetic resonance (1H NMR) spectroscopy, gel permeation chromatography (GPC), thermogravimetric analysis (TGA), and elemental analysis. Temperature and recognition dual responsivity of the copolymers was investigated by cloud point (Tcp) and dynamic light scattering (DLS), respectively. The results show that the as-synthesized copolymers are a kind of temperature-responsive polymer with a lower critical solution temperature (LCST). Tcp was approximately consistent with the critical temperature of intermolecular copolymer association (Tass) from DLS. For these copolymers, Tcp decreases with increasing content of AdMA unit in the copolymers. After the addition of β-cyclodextrins (β-CD), Tcp increases, and the increment of Tcp values gradually became large with increasing content of AdMA in the copolymers. It is host-guest molecular recognition of β-CD and adamantyl groups that endows the as-synthesized copolymers with recognition-tunable thermosensitivity.

Background: Increasing evidence have highlighted the biological significance of mRNA N6-methyladenosine (m6A) modification in regulating tumorigenicity and progression. However, the potential roles of m6A regulators in tumor microenvironment (TME) formation and immune cell infiltration in liver hepatocellular carcinoma (LIHC or HCC) requires further clarification. Method: RNA sequencing data were obtained from TCGA-LIHC databases and ICGC-LIRI-JP databases. Consensus clustering algorithm was used to identify m6A regulators cluster subtypes. Weighted gene co-expression network analysis (WGCNA), LASSO regression, Random Forest (RF), and Support Vector Machine-Recursive Feature Elimination (SVM-RFE) were applied to identify candidate biomarkers, and then a m6Arisk score model was constructed. The correlations of m6Arisk score with immunological characteristics (immunomodulators, cancer immunity cycles, tumor-infiltrating immune cells (TIICs), and immune checkpoints) were systematically evaluated. The effective performance of nomogram was evaluated using concordance index (C-index), calibration plots, decision curve analysis (DCA), and receiver operating characteristic curve (ROC). Results: Two distinctm6A modification patterns were identified based on 23m6A regulators, which were correlated with different clinical outcomes and biological functions. Based on the constructed m6Arisk score model, HCC patients can be divided into two distinct risk score subgroups. Further analysis indicated that the m6Arisk score showed excellent prognostic performance. Patients with a high m6Arisk score was significantly associated with poorer clinical outcome, lower drug sensitivity, and higher immune infiltration. Moreover, we developed a nomogram model by incorporating the m6Arisk score and clinicopathological features. The application of the m6Arisk score for the prognostic stratification of HCC has good clinical applicability and clinical net benefit. Conclusion: Our findings reveal the crucial role of m6A modification patterns for predicting HCC TME status and prognosis, and highlight the good clinical applicability and net benefit of m6Arisk score in terms of prognosis, immunophenotype, and drug therapy in HCC patients. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction: The buried penis, if not treated before adolescence, will lead to psychological and physical disorders in adulthood. Therefore, early surgical intervention is necessary. At present, the common surgical methods include the penile corpus fixation, the Johnson's operation, the Devine's method, the modified Devine's method, Shiraki's method, etc. However, we found that these traditional surgeries showed various postoperative complications, such as long-term prepuce edema, avascular necrosis of skin flaps, stenotic prepuce, scarring, and poor appearance. This video shows the main technical steps of our innovative surgical procedure “Six Stitch” (SS) method for the buried penis. Materials and Methods: The designation of the so-called SS method was based on the total knots made (six knots were made for the SS procedure). After the crura penis was fully exposed via a longitudinal incision at the penoscrotal junction, at the 2 o'clock position (around the penis), the superficial layer of albuginea of the crura penis was sutured to the prepubic ligament with 2-0 non-absorbable sutures to prevent the retraction of the penis (the 1st knot). The same procedure was used for the 10 o'clock position (the 2nd knot); At the 2 o'clock position, the skin and subcutaneous tissue at the pubic mound were sutured to the prepubic ligament to reconstruct the appearance of dorsum penis (the 3rd knot). The same procedures were used for the 10 o'clock position (the 4th knot). At the 5 o'clock position, the ventral albuginea was sutured to the tunica dartos and subcutaneous tissue at the penoscrotal junction to reconstruct the penoscrotal angle (the 5th knot). The same procedures were used for the 4 o'clock position (the 6th knot). Finally, the gloved prepuce was reset and circumcision was conducted if the redundant prepuce existed. Results: We have done a total of 64 cases of SS procedures for concealed penis; mean length improvement was 3.8 ± 0.5 cm, with a satisfying 95 percent (61 / 64), which was much longer than the outcome of the above-mentioned methods. Mean operative time was 62.3 ± 12.1 minutes, and there was no serious intraoperative or postoperative complication (only 2 presented scar hyperplasia at the incision site). Conclusions: In conclusion, after the SS procedure, patients with buried penis can acquire an almost 4 cm improvement of penile length and covert incision at the midline of the scrotum, with an acceptable and low incidence of adverse events. This safe and effective procedure may be a viable option for the surgical management of pediatric and adult buried penis.