Search

Purpose: The purpose of this study was to explore which therapeutic strategy is more beneficial for elderly esophageal cancer (EC) patients with distant metastasis, the treatment utilization status and the screening of factors related to prognosis, so as to better guide the treatment of these patients. Methods: Patients in the Surveillance Epidemiology and End Results (SEER) database were divided into chemoradiotherapy (Group A), chemotherapy (Group B), radiotherapy (Group C), and no treatment (Group D) according to different treatment methods. Propensity score matching (PSM) was performed to adjust for baseline differences between the two groups. Overall survival (OS) and esophageal cancer-specific survival (ECSS) was calculated using the Kaplan–Meier method and compared using the log-rank test. Results: A total of 7027 patients were included in this study, 5739 males (81.7%) and 1288 females (18.3%) with the median age was 70 (60–98). In the original cohort, the number of patients in the four groups was 2260 (Group A), 2087 (Group B), 945 (Group C) and 1735 (Group D), respectively. After PSM, there was no significant difference in mean OS (A vs B, 13.5 months VS 13.4 months, P = 0.511) and mean ECSS (A vs B, 15.6 vs 15.5 months, P = 0.374), while both OS (B vs C, 7 vs 3 months, P < 0.001) and ECSS (B vs C, 8 vs 3 months, P < 0.001) of chemotherapy alone were significantly better than those of radiotherapy alone. Subgroup analysis of patients older than 80 years showed that the median OS (A vs B, 7 vs 6 months) and median ECSS (A vs B, 8 vs 7 months) of Group A were significantly better than those of Group B (P < 0.05). In addition, all patients were randomly divided into a training set and a validation set with a ratio of 7:3. Based on the independent risk factors for OS, a nomogram model was constructed and validated. Conclusion: For elderly EC patients with distant metastasis, aggressive treatment was still necessary after a comprehensive assessment of the patient's physical condition, especially for patients over 80 years old, and chemoradiotherapy maybe still the first choice. In addition, a nomogram model was constructed to intuitively and accurately evaluate the prognosis of this population. [ABSTRACT FROM AUTHOR]

Background: Bacterial vaginosis (BV) is one of the most common infections among women of reproductive age and accounts for 15–50% of infections globally. The role played by folate in the pathogenesis and progression of BV is poorly understood. The aim of this study was to investigate the association between serum folate, red blood cell (RBC) folate, and BV in American women. Methods: 1,954 participants from the 2001-2004 National Health and Nutrition Examination Survey (NHANES) program were included in this study. Multiple logistic regression was used to analyze the association between serum folate, RBC folate, and BV, and covariates including race, age, education level, and body mass index were used to construct adjusted models. Stratified analysis was used to explore the stability of the above associations in different populations. Results: In the present cross-sectional study, we found that serum folate and RBC folate were inversely associated with the risk of BV. In the fully adjusted model, the risk of BV was reduced by 35% (OR=0.65, 95% CI: 0.51~0.83, p=0.0007) in the highest serum folate group and 32% (OR=0.68, 95% CI: 0.53~0.87, p=0.0023) in the highest RBC folate group compared to the lowest group. Conclusions: The results of this study indicated that serum folate and RBC folate were inversely associated with the risk of BV folate supplementation may play an important role in the prevention and management of BV. [ABSTRACT FROM AUTHOR]

Endoscopic papillectomy (EP) is an effective treatment for ampullary lesions but technically challenging because of anatomical specificities concerning the high rate of adverse events. Bleeding is one of the most feared complications and can be potentially life-threatening. To study the risk factors for bleeding after EP are presented with the goal of establishing preventive measures. A total of 173 consecutive patients with ampullary lesions undergone EP from January 2006 to October 2020 were enrolled in this study. They were divided into a bleeding group and a non-bleeding group depending on whether postoperative bleeding occurred. Related factors were analyzed by univariate and multivariate logistics regression. Postoperative bleeding was experienced in 33 patients (19.07%). Multivariate analysis also identified intraoperative bleeding (OR: 4.38, 95% CI: 1.87–11.15, p =.001) and endoscopic closure (OR: 0.25, 95% CI: 0.10–0.58, p =.001) as independent factors significantly associated with bleeding after EP. Lesion size (≥3 cm) was shown as an independent factor significantly associated with intraoperative bleeding (OR: 4.25, 95% CI: 1.21–16.44, p =.028). This retrospective evaluation found that endoscopic closure was associated with reduced risk and intraoperative bleeding with increased risk of bleeding after EP. Lesion size may indirectly influence the risk of postoperative bleeding by increasing the risk of intraoperative bleeding. [ABSTRACT FROM AUTHOR]

Cross-nanoflower CoS 2 on rGO nanosheets has been synthesized by simply controlling the pre-reaction step during hydrothermal route. Three-dimensional CoS 2 cross-nanoflowers of 150–200 nm in diameter are formed in-situ through self-assembling with rGO nanosheets reduced from GO (shorten as CoS 2 –NF/rGO-NS). From XRD, SEM, XPS and TEM analysis, these CoS 2 nanoflowers are composed of single crystal nano-slices of 20–30 nm in thickness and evenly distributed in the networks of flexible/conductive rGO nanosheets. Owing to both capacitive-controlled and diffusion-controlled mechanisms existing in the discharging/charging processes, CoS 2 –NF/rGO-NS composites show excellent rate performance and cycling stability as anode materials. According to DFT calculations/simulations, the corresponding diffusion barrier (E bar) is derived to be 0.47 eV along ⟨100⟩ diffusion direction for CoS 2 cross-nanoflower, indicating an effective lithium ion diffusion channel. Their enhanced electrochemical properties are therefore attributed to synergistic effects of two components: highly active/stable nanoflower-like CoS 2 –NF structure and flexible/conductive reduced graphene nanosheets (rGO-NS). Image 1 • 150–200 nm CoS 2 cross-nanoflower in-situ self-assembled on rGO nanosheet. • CoS 2 nanoflower composited of 20–30 nm single crystal nanochips in thickness. • CoS 2 nanochips provide a good Li+ diffusion channel along ⟨100⟩ by DFT calculations. • Advanced performance owing to highly active CoS 2 and pseudocapacitive effect by rGO. [ABSTRACT FROM AUTHOR]

Modified polyimides (MPIs) show great potential towards 5G communication applications, due to its excellent thermal stability, mechanical property and chemical stability as compared to most of polymers. Introducing fluoride groups or porous structure is favorable to ultra-low dielectric constant (Dk) and dielectric loss (Df). However, the cost of the fluorinated MPIs is high and their synthetic processes are complicated, and porous MPIs suffer poor mechanical properties. Also, increasing the fraction of free volume is a very effective way to lower Dk through introducing more ultra-low-Dk air component. However, most of this kind of MPIs lag far behind the fluorinated MPIs and the porous MPIs in terms of ultra-low Df, hindering the application of MPIs in high-speed communication devices. Thus, it is highly desirable to develop intrinsic ultra-low-Dk/Df MPIs at high frequency with less fluoric groups and nonporous structure. Herein, we introduce a facile and effective strategy to lower Dk and Df through introducing rigid and large sterically hindered aromatic groups into MPIs. On the one hand, their large steric hindrance effect leads to low Dk by increasing intrinsic free volume. On the other hand, the resulting highly stiff polymer chain and strong intermolecular interaction are favorable to reduce Df by inhibiting dipole orientations. Based on this strategy, the spirobifluorene groups are preferred. The as-prepared MPIs show excellent dielectric performance with low Dk of 2.74–2.76 and low Df of 0.00599 at 10 GHz, to some extent, exceeding the multiple fluorinated MPI with Dk/Df of 2.67/0.00663 at 10 GHz. [ABSTRACT FROM AUTHOR]

In this paper, a new aromatic diamine monomer 4,4′-(2,6-naphthalenediyl)bis[benzenamine]) (NADA) was synthesized and a series of modified PI films containing naphthalene ring structure obtained by controlling the molar ratio of NADA monomer, ternary polymerization with 4,4′-oxydianiline (ODA), and pyromellitic dianhydride (PMDA). The effects of the introduction of the naphthalene ring on the free volume and various properties of PI were investigated by molecular dynamic simulations. The results show that the comprehensive properties of the modified films are all improved to some extent, with 5% thermal weight loss temperature (Td5%) of 569 °C, glass transition temperature (Tg) of 381 °C, tensile strength of 96.41 MPa, and modulus of elasticity of 2.45 GPa. Dielectric property test results show that the dielectric constant (Dk) of the film at 1 MHz is reduced from 3.21 to 2.82 and dielectric loss (Df) reduced from 0.0091 to 0.0065. It is noteworthy that the PI-1 dielectric constant is reduced from 3.26 to 3.01 at 10 GHz with only 5% NADA doping, which is expected to yield the best ratio and provide the possibility of industrial production. [ABSTRACT FROM AUTHOR]

• Using LPAs in TB detection. • Using LPAs in Drug-resistant TB detection. • LPAs detect TB and Drug-resistant TB correctly. • LPAs is a good method for TB diagnosis. Line probe assays (LPAs) are PCR-based assays used for the rapid diagnosis of Mycobacterium tuberculosis (MTB) and drug-resistant tuberculosis (DR-TB). But studies on its performance are insufficient. Thus, in this study, we conducted a systematic review and meta-analysis to evaluate the effect of LPAs in the detection of MTB and drug-resistant TB in comparison with the traditional culture and DST methods. A systemic literature search was conducted on the Web of Science, Embase, PubMed, the Cochrane Library, Scopus, and OVID databases. All the included studies were classified according to different detecting objects. Sensitivity, specificity, Positive Likely Ratio (PLR), Negative Likely Ratio (NLR), Diagnostic Odds Ratio (DOR), corresponding 95% confidence interval, Area Under Curve (AUC), Deeks' funnel plot, and Bivariate Boxplot was used to do the evaluation. 147 studies included 491 datasets, with 182,448 samples, were incorporated into our analysis. The sensitivity (95% CI), specificity (95% CI), PLR, NLR, DOR and AUC for MTB were 0.89 (0.86 to 0.92), 0.94 (0.90 to 0.97), 15.70, 0.11, 139 and 0.96, respectively; for rifampicin-resistant TB were 0.96 (0.95 to 0.97), 0.99 (0.98 to 0.99), 82.9, 0.04, 1994 and 1.00, respectively; for isoniazid-resistant TB were 0.91 (0.89 to 0.93), 0.99 (0.98 to 0.99), 83.4, 0.09, (0.99 to 1.00), 195.7, 0.07, 2783 and 1.00, respectively; for Multi-drug resistant TB (MDR-TB) were 0.93 (0.90 to 0.95), 1.00 (0.99 to 1.00), 195.7, 0.07, 2783 and 1.00, respectively; for extensively drug-resistant TB (XDR-TB) were 0.60 (0.33 to 0.82), 1.00 (0.95 to 1.00), 291.3, 0.4, 726 and 0.95, respectively; for (second-line drug-resistant TB) SLID-TB were 0.83 (0.78 to 0.87), 0.98 (0.97 to 0.99), 44.6, 0.17, 262 and 0.98, respectively. Sensitivity in pre-extensively drug-resistant TB (Pre-XDR-TB) was 0.67, specificity was 0.91. No publication bias existed according to Deeks' funnel plot. High diagnosis performance was confirmed in LPAs for the diagnosis of MTB and drug-resistant TB. LPAs might be a good alternative to culture and DST in detecting MTB, RR-TB, INH-TB, XDR-TB, SLID-TB, and MDR-TB. While more studies were still needed to explore the diagnosis performance of LPAs for Pre-XDR TB. [ABSTRACT FROM AUTHOR]

Background: Actinic keratosis (AK) is a precancerous disease, caused by ultraviolet radiation (UV). Objective: To analyze the clinical and pathological characteristics of AK in four areas with different ultraviolet radiation intensities. Methods: 1188 diagnosed AK patients, from January 2000 to July 2015, in dermatology department of four hospitals were collected. The UV intensity of hospital located cities from high to low is Kunming, Yinchuan, Shenyang and Nanjing. The information comes from medical records, and the pathological types and Keratinocyte Intraepithelial Neoplasia (KIN) grades were checked by two experienced pathologists. All information was conducted a retrospective multicenter research. Results: The patients were mainly middle‐aged and elderly female, which was in direct contrast to the majority of men in European. The age of onset in Kunming group was lower than that in Yinchuan Group (p = 0.013) and Nanjing Group (p < 0.01). The course of disease in Kunming group was significantly shorter than that in Nanjing Group (p < 0.001). The lesions were almost located in the exposed area. The proportion of unexposed areas in Shenyang group was significantly higher than that in other groups (p < 0.001). There were statistical differences in pathological morphological classification among the four groups. These differences were not affected by age and gender. The number of KIN III grade patients in Shenyang group was significantly higher than that in other three groups (p < 0.05). Conclusion: The Asian patients were mainly female. The clinical characteristics of AK are closely related to UV intensity, and environmental pollution, lifestyle, religious beliefs and other factors are also related. [ABSTRACT FROM AUTHOR]

The dual transition metals CoS 2 –SnO 2 @ reduced graphene oxide heterostructure quantum dots (shorten as CoS 2 –SnO 2 @rGO QDs) is intentionally synthesized by hydrothermal method. The compositions, grain sizes and contents of the synthesized CoS 2 –SnO 2 @rGO QDs are identified and calculated from XRD pattern. The layered structures and crystal sizes (<10 nm) of CoS 2 –SnO 2 heterostructure quantum dots are confirmed by TEM high-resolution image. Moreover, the CoS 2 –SnO 2 @rGO QDs deliver higher specific capacity of 940.4, 781.9, 673.8, 506.6 and 303.1 mAh g−1 at 0.2, 0.5, 1.0, 2.0 and 4.0 A g−1, respectively, and remained 521.4 mAh g−1 (300 cycles) with 98.9% Coulomb efficiency under 1.0 A g−1 cycling. The DFT (density functional theory) calculation results suggest that the Li ions should diffuse through two possible paths with relatively lower E bar values of 0.519 and 0.566 eV in CoS 2 –SnO 2 @rGO QDs. Combining with XRD, XPS, TEM and DFT calculation, we therefore assign the excellent electrochemical performances of CoS 2 –SnO 2 @rGO QDs to its highly active CoS 2 –SnO 2 interfaces for electrode reactivity enhancement, to the characteristic heterointerfaces for "extra" Li+ ions storage/release, and to super conductive/layered rGO network for better ionic/electronic transport. The successful synthesis of CoS 2 –SnO 2 @rGO QDs may provide a strategy for dual/multi-transition metal heterojunction to enhance lithium-ion battery electrode materials. [Display omitted] • Grains of SnO 2 and CoS 2 in SnO 2 –CoS 2 @rGO QDs are ∼3.5 and ∼11.9 nm, respectively. • SnO 2 –CoS 2 @rGO QDs remains ∼521.4 mAh/g under 1.0 A/g after 300 cycles. • E bar of SnO 2 –CoS 2 heterointerface for Li are 0.519 and 0.566 eV by DFT calculation. [ABSTRACT FROM AUTHOR]

• The changes in the surface properties of N-MXene have been studied in detail. • The wrinkled/flexible N-MXene is firstly introduced to enhance NCM811 cathode. • More extra capacity is provided for NCM811 by wrinkled/flexible/layered N-MXene. • Irreversible Mn/Co/Ni migration is prohibited by N-MXene from DFT simulation. In this work, the wrinkled, flexible, and layered nitrogen-doped Ti 3 C 2 T x (shorten as N-MXene) is synthesized by using cyanamide as N-dopants. The changeable (002) plane spacing and the attached functional groups of N-MXene are detected by XRD and XPS analyses in details, respectively. The microscopic morphology of N-MXene is characterized by SEM and TEM, which demonstrates its wrinkled and flexible characteristics. When the wrinkled N-MXene being added into the LiNi 0.8 Co 0.1 Mn 0.1 O 2 (NCM811) as conductive additive, the attained electrodes obtain enhanced electrochemical performances at the appropriate weight ratio (namely 2.5-N-MXene with 2.5 wt.%). The 2.5-N-MXene delivers "extra" capacity of 226.9 mAh/g at 0.1 C (20 mA/g) current density. The "extra" capacity is assigned to Li ions intercalation/extraction from the wrinkled/flexible/layered N-MXene. Moreover, based on the analyses of CV and dQ/dV curves, the wrinkled/flexible N-MXene additive could effectively inhibit the phase transition of M↔H2 of NCM811 and alleviate the volume change of the particles in the circulation. From DFT simulation, the N-MXene is more capable of preventing Ni/Co/Mn from dissolving and migrating to the negative electrode to form dendrites through adsorption. Therefore, the N-MXene should be a very competitive conductive agent to improve the mechanical and electrochemical properties of high nickel cathode materials. [Display omitted] [ABSTRACT FROM AUTHOR]