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Summary: Regulatory T cells (Treg) prevent the migration of effector T cells toward sites of inflammation, thereby limiting disease progression. We investigated this aspect of Treg function using psoriatic arthritis (PsA) as an exemplar of chronic inflammation. Patients with PsA had an increased Th17:Treg ratio which was reversed by anti-tumor necrosis factor (TNF) therapy. Utilizing an in vitro migration assay, Treg from patients with PsA treated with conventional therapy paradoxically boosted CCR6+ effector T-cell (a surrogate for Th17) migration toward CCL20. In contrast, Treg from patients with PsA treated with anti-TNF suppressed CCL20-driven effector T-cell migration. The boosting effect of TNF blockade upon Treg suppression of migration was accompanied by increased effector T-cell CCL20 production and enhanced interaction between Treg and effector T cells. This study provides mechanistic insight into Treg modulation of effector T-cell migration in patients with chronic inflammation and how this can be targeted by therapy.

BackgroundNon-infectious uveitis can cause chronic relapsing and remitting ocular inflammation, which may require high dose systemic immunosuppression to prevent severe sight loss. It has been classically described as an autoimmune disease, mediated by pro-inflammatory Th1 and Th17 T-cell subsets. Studies suggest that natural immunosuppressive CD4+CD25+FoxP3+ T-regulatory cells (Tregs) are involved in resolution of inflammation and may be involved in the maintenance of clinical remission.ObjectiveTo investigate whether there is a peripheral blood immunoregulatory phenotype associated with clinical remission of sight-threatening non-infectious uveitis by comparing peripheral blood levels of Treg, Th1, and Th17, and associated DNA methylation and cytokine levels in patients with active uveitic disease, control subjects and patients (with previously active disease) in clinical remission induced by immunosuppressive drugs.MethodsIsolated peripheral blood mononuclear cells (PBMC) from peripheral blood samples from prospectively recruited subjects were analyzed by flow cytometry for CD3, CD4, FoxP3, TIGIT, T-bet, and related orphan receptor γt. Epigenetic DNA methylation levels of FOXP3 Treg-specific demethylated region (TSDR), FOXP3 promoter, TBX21, RORC2, and TIGIT loci were determined in cryopreserved PBMC using a next-generation sequencing approach. Related cytokines were measured in blood sera. Functional suppressive capacity of Treg was assessed using T-cell proliferation assays.ResultsFifty patients with uveitis (intermediate, posterior, and panuveitis) and 10 control subjects were recruited. The frequency of CD4+CD25+FoxP3+ Treg, TIGIT+ Treg, and T-bet+ Treg and the ratio of Treg to Th1 were significantly higher in remission patients compared with patients with active uveitic disease; and TIGIT+ Tregs were a significant predictor of clinical remission. Treg from patients in clinical remission demonstrated a high level of in vitro suppressive function compared with Treg from control subjects and from patients with untreated active disease. PBMC from patients in clinical remission had significantly lower methylation levels at the FOXP3 TSDR, FOXP3 promoter, and TIGIT loci and higher levels at RORC loci than those with active disease. Clinical remission was also associated with significantly higher serum levels of transforming growth factor β and IL-10, which positively correlated with Treg levels, and lower serum levels of IFNγ, IL-17A, and IL-22 compared with patients with active disease.ConclusionClinical remission of sight-threatening non-infectious uveitis has an immunoregulatory phenotype characterized by upregulation of peripheral Treg, polarized toward T-bet and TIGIT. These findings may assist with individualized therapy of uveitis, by informing whether drug therapy has induced phenotypically stable Treg associated with long-term clinical remission.

Objective. This descriptive study aims to describe various anatomical morphological indicators of the triangular fibrocartilage complex (TFCC) in Vietnamese adults. Materials and methods. We analyzed 30 wrist joints from 15 fresh cadavers. To access the components of the TFCC, the wrist joints were dissected and measured, and anatomical morphological indices, including length, width, thickness, origin, and insertion, were recorded. Results. Nine of 30 articular discs had central tears. The average length of the articular disc was 10.05±2.26 mm, while the average width was 12.10±1.39 mm. The average thickness of the articular disk on the ulnar side was 1.56±0.42 mm, while the average thickness of the articular disk on the radial side was 2.63±1.04 mm. Most meniscus homologues (86.6%) were of the narrow opening type according to the Ishii classification, with a horizontal dimension of 6.98±2.05 mm, anteroposterior diameter of 8.94±2.46 mm, and thickness of 1.27±0.41 mm. The volar radioulnar ligament averaged 12.75±2.17 mm in length and 2.54±0.77 mm in width, while the dorsal radioulnar ligament averaged 12.82±2.63 mm in length and 2.37±0.65 mm in width. The ulnar collateral ligament averaged 13.59±2.79 mm in length, 3.75±0.80 mm in width, and 0.95±0.46 mm in thickness. The ulnolunate and ulnotriquetral ligaments had average lengths of 7.34±2.87 mm and 5.70±2.98 mm, widths of 3.93±1.55 mm and 4.87±1.06 mm, and thicknesses of 0.96±0.61 mm and 1.43±0.98 mm, respectively. Conclusions. There are no differences in the shape or structure of the adult Vietnamese TFCC. No significant differences were noted in any TFCC component according to wrist side or gender. [ABSTRACT FROM AUTHOR]

IntroductionImmune checkpoint inhibitors (ICIs) have transformed advanced gastric cancer treatment, yet patient responses vary, highlighting the need for effective biomarkers. Common markers, such as programmed cell death ligand-1 (PD-L1), microsatellite instability/mismatch repair (MSI/MMR), tumor mutational burden, tumor-infiltrating lymphocytes, and Epstein–Barr virus, face sampling challenges and high costs. This study seeks practical, minimally invasive biomarkers to enhance patient selection and improve outcomes.MethodsThis multicenter retrospective study analyzed 617 patients with advanced gastric or gastroesophageal junction cancer treated with programmed cell death protein-1 (PD-1)/PD-L1 inhibitors from January 2019 to March 2023. Clinical data and peripheral blood marker data were collected before and after treatment. The primary endpoints were overall survival (OS) and progression-free survival (PFS); the secondary endpoints included the objective response rate (ORR) and disease control rate (DCR). Least absolute shrinkage and selection operator (LASSO)-Cox and LASSO logistic regression analyses identified independent factors for OS, PFS, and ORR. Predictive nomograms were validated using receiver operating characteristic (ROC) curves, areas under the curve (AUCs), C-indices, and calibration curves, with clinical utility assessed via decision curve analysis (DCA), net reclassification improvement (NRI), and integrated discrimination improvement (IDI).ResultsOS-related factors included treatment line, T stage, ascites, pretreatment indirect bilirubin (pre-IBIL), posttreatment CA125, CA199, CA724, and the PLR. PFS-related factors included treatment lines, T stage, metastatic sites, pre-IBIL, posttreatment globulin (GLOB), CA125, and CA199 changes. ORR-related factors included treatment line, T stage, N stage, liver metastasis, pretreatment red cell distribution width-to-platelet ratio (RPR), CA125, and CA724 changes. The nomograms showed strong predictive performance and clinical utility.ConclusionsEarly treatment, lower T stage, the absence of ascites, and lower pre-IBIL, post-CA125, CA199, CA724, and PLR correlate with better OS. Factors for improved PFS include early treatment, lower T stage, fewer metastatic sites, and lower pre-IBIL, post-GLOB, and post-CA125 levels. Nomogram models can help identify patients who may benefit from immunotherapy, providing valuable clinical guidance.

High-flow priapism is a rare condition in the form of priapism unrelated to sexual stimulation. The disease causes a decline in quality of life and has the risk of causing long-term erectile dysfunction if not treated promptly. We report a case of a 48-year-old male patient with prolonged high-flow erection after trauma who received endovascular intervention with n-butyl-2 cyanoacrylate biological glue. Results after 40 days of intervention and use of sildenafil 25 mg/day, the patient has an erection and has normal sexual activity. Cavernous arteriovenous fistula causing priapism with high flow is a rare condition. Computed tomography helps supplement information about feeding vessels as well as accompanying injuries for comprehensive assessment before treatment. Currently, there are many treatment methods, but transcatheter arterial embolization is modality of choice for achieve clinical efficacy and can safely and flexibly reduce the risk of secondary erectile dysfunction.

Background: The anti-inflammatory effect of exercise may be an underlying factor in improving several autoimmune diseases. The aim of this systematic review was to examine the evidence on the role of exercise training in mitigating inflammation in adolescents and adults with autoimmune disease. Methods: PubMed, Web of Science, and Embase databases were systematically reviewed for related studies published between January 1, 2003, and August 31, 2023. All randomized and non-randomized controlled trials of exercise interventions with autoimmune disease study participants that evaluated inflammation-related biomarkers were included. The quality of evidence was assessed using the Tool for the assEssment of Study qualiTy and reporting in EXercise scale and Cochrane bias risk tool. Results: A total of 14,565 records were identified. After screening the titles, abstracts, and full texts, 87 were eligible for the systematic review. These studies were conducted in 25 different countries and included a total of 2779 participants (patients with autoimmune disease, in exercise or control groups). Overall, the evidence suggests that inflammation-related markers such as C-reactive protein, interleukin 6, and tumor necrosis factor α were reduced by regular exercise interventions. Regular exercise interventions combined with multiple exercise modes were associated with greater benefits. Conclusion: Regular exercise training by patients with autoimmune disease exerts an anti-inflammatory influence. This systematic review provides support for the promotion and development of clinical exercise intervention programs for patients with autoimmune disease. Most patients with autoimmune disease can safely adopt moderate exercise training protocols, but changes in inflammation biomarkers will be modest at best. Acute exercise interventions are ineffective or even modestly but transiently pro-inflammatory.

Abstract Background and objectives Colorectal mucinous adenocarcinoma (MAC) is a particular pathological type that has yet to be thoroughly studied. This study aims to investigate the characteristics of colorectal MAC-related genes in colorectal cancer (CRC), explore the role of MAC-related genes in accurately classifying CRC, and further construct a prognostic signature. Methods CRC samples were collected from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO). MAC-related differentially expressed genes (DEGs) were analyzed in TCGA samples. Based on colorectal MAC-related genes, TCGA CRC samples were molecularly typed by the non-negative matrix factorization (NMF). According to the molecular subtype characteristics, the RiskScore signature was constructed through univariate Cox, the least absolute shrinkage and selection operator (LASSO), and multivariate Cox regression analyses. Clinical significance in CRC of the RiskScore signature was analyzed. A nomogram was further built based on the RiskScore signature. Results From the colorectal MAC-related genes, three distinct molecular subtypes were identified. A RiskScore signature composed of six CRC subtype-related genes (CALB1, MMP1, HOXC6, ZIC2, SFTA2, and HYAL1) was constructed. Patients with high-RiskScores had the worse prognoses. RiskScores led to differences in gene mutation characteristics, antitumor drug sensitivity, and tumor microenvironment of CRC. A nomogram based on the signature was developed to predict the one-, three-, and five-year survival of CRC patients. Conclusion MAC-related genes were able to classify CRC. A RiskScore signature based on the colorectal MAC-related molecular subtype was constructed, which had important clinical significance for guiding the accurate stratification of CRC patients.

OBJECTIVE: Many clinical and imaging characteristics can influence the prognosis of multilevel cervical spondylotic myelopathy (M-CSM). This study investigated the factors that influence surgical outcomes among patients with M-CSM. PATIENTS AND METHODS: This prospective study included 30 patients who underwent surgical treatment for M-CSM from June 2019 to June 2021. RESULTS: The average age was 62.29 years, and the average follow-up time was 13.13 months. Preoperative, postoperative, and follow-up Modified Japanese Orthopaedic Association (mJOA) scores were 10.17, 13.53, and 16.17, respectively. The average postoperative and follow-up recovery rates were 45.46% and 76.69%, respectively. Patients older than 60 years (p = 0.04), male patients (p = 0.023), and smokers (p = 0.027) had lower preoperative mJOA scores than other groups. Patients with symptoms duration longer than 6 months had lower recovery rates (p = 0.021) than those with shorter symptom duration. Patients with intramedullary hyperintensity in ≤ 2 vertebra (p = 0.041) or anterior surgery (p = 0.022) had better postoperative recovery rates than their counterparts. A shorter period of hyperintensity in the intramedullary region on sagittal T2-weighted magnetic resonance imaging (T2W MRI) was significantly associated with faster discharge (p = 0.044). Patients with type 3 (discrete focal) hyperintensity in the intramedullary region on axial T2W MRI had a 6.75-fold increase in experiencing less than 50% postoperative recovery compared with other groups (odds ratio: 6.75, 95% confidence interval: 2.73-16.67). CONCLUSIONS: Good prognostic factors for a shorter recovery included hyperintensity in the intramedullary region for ≤ 2 levels, shorter period of hyperintensity in the intramedullary region on sagittal T2W MRI, and an anterior surgical approach. A duration of symptoms longer than 6 months and discrete hyperintensity in the intramedullary region on axial T2W MRI were poor prognostic indicators associated with a longer recovery period. [ABSTRACT FROM AUTHOR]

Due to the labor shortage, replacing manual topping with chemical topping has become an important practice in cotton-producing areas such as Xinjiang, China. Similarly, increasing planting density is a common strategy to enhance cotton yields. This study aimed to quantify the interactive effects of chemical topping and planting density on cotton growth and assimilate partitioning. To achieve this, a two-year (2020–2021) field experiment was conducted in Xinjiang, China. The main plots were assigned low (15 plants m−2) or high plant density (25 plants m−2), and the subplots were chemical topping using heavy amounts of mepiquat chloride (MC) or manual topping. The dynamics of dry matter accumulation and partitioning in cotton were well quantified using a beta-growth function with an overall nRMSE of 11.5%. Results indicated that chemical topping increased aboveground dry matter maximum by 4.88%, fruit dry matter maximum by 17.9% and seed cotton yield by 14.0% compared to manual topping. At low plant density, the partitioning index between vegetative and reproductive organs showed no significant differences. However, at high plant density, the time when 50% of assimilate partitioning to reproductive organs for chemical topping was 2.6 physiological days (under optimal temperature conditions) delayed than that for manual topping, resulting in a 2.7 physiological days delay in the time that fruits reached maximum growth rate. The results of the study suggest that applying chemicals for topping a little earlier in high-density planting could reduce the negative effects of delayed boll growth and promote carbon assimilate partitioning to fruit growth.

The study evaluates chronic subdural hematoma (cSDH) middle meningeal artery (MMA) embolization efficacy and safety. A prospective interventional study was conducted in Viet Duc Hospital from November 2021 to April 2024. All consecutive cSDH MMA embolization patients were included. Clinical and imaging data were collected before and one month after treatment. The study included 31 42-cSDH patients. Of these, 25.8% had hematoma evacuation, 83.9% were treated with surgery and embolization, and 16.1% with embolization alone. 92.9% of procedures used polyvinyl alcohol particles. The success rate was 92.9% and complications 7.1%. Asymptomatic external carotid artery vasospasm and MMA rupture occurred. Functional improvement occurred in 91.7% of patients one month after treatment. Significantly lower mean modified Rankin Scale (mRS) score (0.2±0.7 vs. 1.7±0.9; P=0.000) and higher proportion of patients with ≤2 mRS score (95.8% vs. 74.1%) were observed after treatment. Hematoma thickness decreased significantly (P=0.00) from 21.5±7.9 mm to 8.3±4.1 mm. The midline shift decreased significantly from 7.4±5.0 mm to 0.7±1.2 mm (P=0.00). Just one patient (4.2%) needed surgery. MMA embolization alone or with surgery appears to treat cSDH safely and effectively.

Ling-Yun Bao,* Xin-Yue Dao,* Kun Du Department of Neonate, Kun Ming Children’s Hospital, Yunnan, 650021, People’s Republic of China*These authors contributed equally to this workCorrespondence: Kun Du, Department of Neonate, Kun Ming Children’s Hospital, No. 28 of Shulin Road, Yunnan, 650021, People’s Republic of China, Tel +86 15388843393, Email kdidljtdr_09@outlook.comAbstract: Neonatal respiratory distress syndrome (NRDS) is a common critical disease in neonates. Early diagnosis and timely treatment are crucial. Historically, X-ray imaging was the primary method for diagnosing NRDS. However, this method carries radiation exposure risks, making it unsuitable for dynamic lung condition monitoring. In addition, neonates who are critically ill require bedside imaging, but diagnostic delays are often unavoidable due to equipment transportation and positioning limitations. These challenges have been resolved with the introduction of lung ultrasound (LUS) in neonatal intensive care. The diagnostic efficacy and specificity of LUS for NRDS is superior to that of X-ray. The non-invasive, dynamic, and real-time benefits of LUS also allow for real-time monitoring of lung changes throughout treatment for NRDS, yielding important insights for guiding therapy. In this paper, we examine the ultrasonographic characteristics of NRDS and the recent progress in the application of ultrasound in the diagnosis and treatment of NRDS while aiming to promote wider adoption of this method.Keywords: dynamic monitoring, lung ultrasound, neonates, respiratory distress syndrome, NRDS, point of care ultrasound

Growth balance is very important for plants, which is the coordination of resource acquisition between the aboveground and belowground parts. Extensive research has focused on the aboveground portion, and less attention has been given to the root system. Furthermore, the specific regulatory mechanisms responsible for maintaining the growth balance between aboveground and belowground in crops are still unclear. We examined the root/shoot ratio and leaf area/root length ratio in 19 pima cotton (Gossypium barbadense) and 19 upland cotton (Gossypium hirsutum) accessions, and the effects of root traits on the growth balance were explored. The results indicated that growth balance could affect the biomass accumulation of cotton, and the root system was the core part of controlling growth balance. The difference was that the specific root length played a major role in pima cotton, while the root mass fraction was more important in upland cotton. Despite these differences, both types of cotton achieved similar resource acquisition capability through the synergistic effect of mass fraction and morphological characteristics of leaves and roots. Our study is the first to demonstrate that the root system dominates the growth balance in pima and upland cotton. Selecting accessions with similar phenotypes may represent a promising new direction for increasing the success probability of interspecific hybridization and introgression breeding. These findings expand our understanding of the resource acquisition and utilization of crops and provide a valuable perspective for ecological research and crop breeding.

OBJECTIVE: Although the application of transcranial Doppler (TCD) ultrasonography in clinical diagnosis of cerebral vasospasm is popular in clinical practice in Vietnam, available evidence of the predictive value of vasospasm on TCD in the literature was mostly reported from large institutions in developed countries. Hence, this study was conducted to evaluate the value of TCD ultrasonography in the diagnosis of vasospasm in patients with subarachnoid hemorrhage (SAH) in Vietnam. PATIENTS AND METHODS: This is a prospective observational study of all aneurysmal SAH patients consecutively admitted to a single center between 2008 and December 2011. TCD and 64-slice computed tomographic angiography (CTA) were used to cerebral vasospasm in SAH patients. RESULTS: 316 patients were analyzed (mean age = 52.97±12.27 years, 52.2% males). There were statistically significant difference rates of the cerebral vasospasm by Hunt and Hess Classification and Fisher classification (p <0.01). The proportion of the patients with cerebral vasospasm who were diagnosed exactly by TCD was 95.2%, while the proportion of the patients without cerebral vasospasm diagnosed exactly was 91.5%. TCD predictive diagnostic value was the highest, with the sensitivity of 0.95 (95% CI: 0.91-0.98), specificity of 0.91 (95% CI: 0.85-0.96), positive predictive value of 0.94 (5% CI: 0.90-0.97) and negative predictive value of 0.93 (95 CI: 0.87-0.97). Hemiplegia was the clinical symptom with the highest diagnostic value with the sensitivity of 0.34 (95% CI: 0.27-0.41), specificity of 0.92 (95% CI: 0.86-0.96), positive predictive value of 0.86 (95% CI: 0.76-0.93) and negative predictive value of 0.49 (95% CI: 0.41- 0.54). CONCLUSIONS: Evidence of vasospasm diagnosis on TCD ultrasonography was found with high accuracy. Current study enables to suggest the wide application of TCD in Vietnam health facilities from central to grassroots levels instead of the CTA use. [ABSTRACT FROM AUTHOR]

Abatract: Objectives: Recently, there has been extensive research on dual immunotherapy for advanced or metastatic non-small cell lung cancer (NSCLC), yet a comprehensive evaluation is lacking. This study aimed to rank the available treatment options and assess the efficacy and safety of dual immunotherapy regimens through the implementation of a Bayesian network meta-analysis (NMA). Materials and methods: A thorough search was conducted to recognize eligible randomized controlled trials (RCTs) on March 20, 2023. Overall survival (OS), progression-free survival (PFS), treatment-related adverse events (TRAEs) and grade ≥3 TRAEs were evaluated to identify the efficacy and safety of dual immunotherapy regimens. The surface under the cumulative ranking curve (SUCRA) and P score were employed to rank the treatments. Results: Eleven clinical trials involving six different regimens were included in this study. The combination of anti-programmed cell death protein 1/programmed cell death ligand 1 (PD-1/PD-L1) antibodies with anti-T-cell immunoglobulin and ITIM domain (TIGIT) antibodies emerged as the most promising regimen for improving OS and PFS, followed by anti-PD-1/PD-L1 + anti-cytotoxic T lymphocyte antigen 4 (CTLA-4) + chemotherapy treatment and anti-PD-1/PD-L1 + anti-CTLA-4 treatment. The forest plots demonstrated that these three regimens were all superior to chemotherapy. The above results were observed in both unselected treatment line and first-line settings. The least likely to be associated with TRAEs and grade ≥3 TRAEs were respectively anti-CTLA-4 treatment and anti-PD-1/PD-L1 + anti-TIGIT treatment, with anti-PD-1/PD-L1 + anti-CTLA-4 + chemotherapy treatment to be the worst. Conclusions: This NMA validated the promising efficacy and safety of dual immunotherapy in advanced or metastatic NSCLC. Among them, anti-PD-1/PD-L1 + anti-TIGIT regimen emerges as a highly potential therapeutic approach. Ongoing research efforts should focus on improving treatment regimens, identifying biomarkers, and managing TRAEs to optimize the patient benefits of dual immunotherapy.

The physicochemical properties, fatty acid composition and volatile aroma compounds of cold-pressed passion fruit seed oils were analyzed. The oils were rich in linoleic acid, oleic acid and volatile compounds. A total of 108 volatile compounds including 17 aldehydes, 23 alcohols, 21 esters, 19 ketones, 6 acids, 9 alkenes, 5 pyrazines and 8 others were identified using HS-GC-IMS. The significant differences of volatile compounds in the purple and yellow passion fruit seed oils were observed via the GalleryPlot graph and distinguished by principal component analysis. The results showed that acids, alcohols, esters and ketones were major aromatic compounds in purple passion fruit seed oils, which contribute to flavors such as flowery, fruity, creamy, yogurt. Whereas the contents of aldehydes, pyrazines, alkenes were higher in yellow passion fruit seed oils, which contributes to fatty and nutty odors. The findings filled in our understanding of volatilization characteristics in passion fruit seed oils.

Laparoscopic donor nephrectomy (LDN) is increasingly popular because of its advantages over open surgery. Chyle leak after donor nephrectomy is a rare but potentially lethal complication if not treated appropriately. We describe a case of a 43-year-old female patient with no remarkable history who presented a chyle leak on day 2 after right transperitoneal LDN. Since conservative treatment failed, the patient underwent magnetic resonance imaging (MRI) and intranodal lipiodol lymphangiography, which confirmed the chyle leak from the right lumbar lymph trunk into the right renal fossa. The chyle leak was percutaneously embolized twice, on postoperative day (POD) 5 and POD 10, by a mixture of N-butyl-2-cyanoacrylate and lipiodol. The drainage fluid decreased significantly after the second embolization. The subhepatic drainage tube was withdrawn on POD 14, and the patient was discharged on POD 17. MRI lymphangiography and intranodal lipiodol lymphangiography effectively identified the chyle leak point. Percutaneous embolization seems to be a safe, effective method for treating high-output chyle leaks.

Summary: Background: The increasing incidence of multidrug-resistant Gram-negative bacteria causing ventilator-associated pneumonia (VAP) is a global concern. A better understanding of the epidemiology of VAP in Southeast Asia is essential to optimise treatments and patient outcomes. Methods: VAP epidemiology in an intensive care unit in Vietnam was investigated. A prospective cohort study was conducted. Patients who were ventilated for >48 hours, diagnosed with VAP, and had a positive respiratory culture between October 2015 and March 2017 were included. Whole-genome sequencing (WGS) was performed on Acinetobacter baumannii isolates. Results: We identified 125 patients (137 episodes) with VAP from 1,699 admissions. Twelve patients had 2 VAP episodes. The median age was 60 years (interquartile range: 48–70), and 68.8% of patients were male. Diabetes mellitus was the most frequent comorbidity (N=35, 28%). Acinetobacter baumannii was most frequently isolated in the first VAP episode (N=84, 67.2%) and was multiply resistant to meropenem, levofloxacin, and amikacin. The 30-day mortality rate was 55.2% (N=69) and higher in patients infected with A. baumannii (N=52, 65%). WGS results suggested a complex spread of multiple clones. Conclusions: In an intensive care unit in Vietnam, VAP due to A. baumannii had a high mortality rate, and A. baumannii and K. pneumoniae were multidrug resistant, with carbapenem resistance of 97% and 70%, respectively.

Abstract Background There are limited reports on nanoparticle albumin bound‐paclitaxel (nab‐paclitaxel) regimens as second‐ or third‐line treatments for advanced esophageal squamous cell carcinoma (ESCC). Additionally, its safety and efficacy in ESCC patients after failure of first‐line programmed cell death protein‐1 (PD‐1) blockade plus chemotherapy have not been reported. In this study, we aimed to assess the efficacy and tolerability of nab‐paclitaxel regimens as second‐ or later‐line treatment in advanced ESCC. Methods We retrospectively reviewed clinical data of advanced ESCC patients who participated in a randomized phase III clinical study and received serplulimab or placebo plus chemotherapy at our institution, and consecutive patients who received subsequent nab‐paclitaxel‐based regimens as second‐ or later‐line treatment were included for data collection and analysis. Results A total of 39 patients were included, 25 (64.1%) received serplulimab plus chemotherapy and 14 (35.9%) received chemotherapy alone as first‐line treatment. Treatment strategies included nab‐paclitaxel monotherapy (7/39, 17.9%), or in combination with other chemotherapy (19/39, 48.7%), with anti‐PD‐1 antibodies (12/39, 30.8%) or with nimotuzumab (1/39, 2.6%). Overall, the objective response rate (ORR) and disease control rate (DCR) were 33.3% (13/39) and 61.5% (24/39), respectively. With a median follow‐up of 9.7 months, the median progression‐free survival and median overall survival were 5.0 and 7.9 months, respectively. The most common adverse events were neuropathy peripheral (30.8%), anemia (30.8%), neutrophil count decreased (23.1%), and nausea (20.5%). Conclusions Nab‐paclitaxel‐based regimen could be a safe and effective option as second‐ or later‐line treatment in patients with advanced ESCC, regardless of their previous exposure to PD‐1 inhibitors.

Abstract Background The addition of immune checkpoint inhibitors to perioperative chemotherapy in operable gastric or gastroesophageal junction (GEJ) cancer has become one of the research hotspots, while reliable biomarkers for efficacy are lacking. We conducted a phase 1 trial to assess the safety and efficacy of LP002, an anti‐PD‐L1 antibody, plus chemotherapy as perioperative treatment in patients with gastric or GEJ cancer. Methods We enrolled patients with resectable and PD‐L1 positive gastric or GEJ cancers. Eligible patients received three preoperative and six postoperative cycles of intravenous LP002 with cisplatin and 5‐fluorouracil, repeated every 2 weeks. The primary endpoint was safety. Secondary endpoints included rate of margin‐free (R0) resection and pathological complete response (pCR). We also characterized changes in the tumor immune microenvironment using multiplex immunofluorescence (MIF) staining and next‐generation sequencing (NGS) with pre‐ and post‐treatment tumor samples. Results Thirty patients were enrolled, of whom 28 had GEJ cancer. With a median follow‐up of 7.9 months, all patients completed preoperative treatment, and 27 patients underwent surgery. Twenty‐four patients underwent R0 resection. Six patients (20.0%) had Mandard tumor regression grade (TRG) 1–3, including one achieving pCR. Twenty‐seven patients had treatment‐related adverse events (TRAEs), while grade 3–4 TRAEs were observed in 11 patients. No treatment‐related deaths occurred. MIF staining revealed that TRG 1–3 group was associated with a higher density of PD‐L1+/CD68+ cells in the pre‐treatment tumor parenchyma than TRG 4–5 group (p = 0.048). NGS studies with paired pre‐ and post‐treatment tumor samples revealed the disappearance of pre‐existing mutations, the emergence of new mutations, and variations in the abundance of mutations after preoperative LP002 and chemotherapy. Meanwhile, tumor mutational burden decreased in patients with TRG 1–3 (p = 0.0313). Conclusions LP002 plus cisplatin and 5‐fluorouracil are safe in patients with gastric or GEJ cancer, and patient selection via appropriate biomarkers is needed in the future.

The atomic pathway in the photoinduced ultrafast structural phase transition of VO2 has been a controversial problem for a long time. Here the authors, using MeV ultrafast electron diffraction, show that the melting of V-V dimers and the transformation of crystal symmetry are two processes with different timescales.

Abstract Background Lymph node (LN) metastasis is crucial in determining the prognosis and treatment options for colon cancer patients. Our work was to study whether the lymph nodes beyond D3 station in transverse colon cancer, especially 206 LN, should be dissected. Methods A total of 225 patients within our department were reviewed. The primary and secondary endpoints were overall survival (OS) and disease‐free survival (DFS). We employed Propensity score weighting (PSW) for weighing participants to balance observed confounders between the 206D+ group and the 206D− group. Results The rate of metastasis in station 206 was 9.3%. Only T stage (OR, 3.009; 95% CI, 1.018–8.892), N stage (OR, 9.818; 95% CI, 1.158–83.227), and M stage (OR, 26.126; 95% CI, 1.274–535.945) were an independent risk factor for 206 station metastasis in multivariate logistic analysis. The 206D+ group had a similarly survival than the 206D− group (3‐year DFS, 89.6% v 85.9%; p = 0.389; 3‐year OS, 94.6% v 85.3% p = 0.989). PSW further verified it. Metastasis of 206 station LN is not an independent prognostic factor, but a predictive factor of DFS. Conclusion Station 206 LN positive is a predictive factor for DFS. Only the patient with T1‐3, N+ who is at a high risk of 206 station LN metastases should consider dissecting 206 station LN.

Abstract Ultrashort laser pulses have been utilized to dynamically drive phase transitions in correlated quantum materials. Of particular interest is whether phases not achievable in thermal equilibrium can be induced in complex oxides with intricately coupled lattice, electron and spin degrees of freedom. Here, we tracked atomic motions in LaMnO3 following photoexcitation with MeV ultrafast electron diffraction (MeV-UED) technique. We found that the light excited state exhibits numerous signatures different from thermal equilibrium ones, including nearly conserved Bragg intensities, strongly suppressed La cation and oxygen anion displacements, and the long-range lattice orthorhombicity evolution. Furthermore, using first-principles calculations, we predict that the ferromagnetic ordering and conductivity are both enhanced upon laser excitation due to the reduction of the lattice orthorhombicity. This work benefits from recent advance in fabrication of membrane films with high epitaxial quality and in MeV-UED with large momentum space access and high temporal resolution.

The spatial-temporal evolution principle of the temperature field in a high-temperature geothermal highway tunnel is investigated, which aims to shed light on the thermal damage prevention for the high-temperature geothermal tunnels. Taking the Nige Tunnel, a high-temperature geothermal tunnel of Jianshui (Gejiu) to Yuanyang expressway in Yunnan Province as the research case, the temperature fields of air, lining and surrounding rock covering all the thermal damage grade sections are monitored. Furthermore, the numerical simulation is conducted to simulate the temperature field of the tunnel. The results show that 1) the temporal curve of air temperature inside the tunnel shows a slowly decreasing trend with the decrease of air temperature outside the tunnel. In contrast, the temporal curve of secondary lining shows a rapid increase-rapid decrease-stable-slow decrease trend. The temperature of surrounding rock experienced two stages of natural and slow decline. 2) In the spatial dimension, the temperature in the tunnel is distributed in an “n” shape along the longitudinal direction of the tunnel, and the temperature contour of the surrounding rock is parabolic, with the centerline located at the breakthrough point during the tunnel construction. As time progresses, the region where the temperature field of the surrounding rock decreases gradually develops to the interior. 3) The effect of the sprayed thermal insulation layer is significant: the temperature difference of secondary lining and initial support could reach 20.1 °C; the temperature inside the tunnel then reduces to the standard value. 4) There is no thermal insulation layer in the cable trench of the Nige Tunnel, and the “thermal bridge effect” appears. The cable trench needs a targeted design, and the research of electromechanical heat resistance should be paid more attention.

p53 mutations are prevalent in human cancers; approximately half of patients with esophageal cancer present these mutations. Mutant p53 (mutp53) exerts oncogenic functions that promote malignant tumor progression, invasion, metastasis, and drug resistance, resulting in poor prognosis. Some small molecules have been shown to mitigate the oncogenic function of mutp53 by restoring its wild-type activity. Although these molecules have been evaluated in clinical trials, none have been successfully used in the clinic. Here, we investigated the antitumor effects of phenethyl isothiocyanate (PEITC) in p53-mutant esophageal squamous cell carcinoma (ESCC) and elucidated its mechanism to identify new therapeutic strategies. We observed that p53R248Q is a DNA contact mutation and a structural mutation and that PEITC can restore the activity of p53R248Qin vitro and in vivo, further clarifying the antitumor activity of PEITC in cancers with different types of p53 mutations. PEITC can inhibit ESCC growth, induce apoptosis, and arrest cell cycle progression and has a preferential selectivity for ESCC with p53 mutations. Mechanistic studies showed that PEITC induced apoptosis and arrested cells at G2/M transition in cells expressing the p53R248Q mutant by restoring the wild-type conformation and transactivation function of p53; these effects were concentration dependent. Furthermore, PEITC inhibited the growth of subcutaneous xenografts in vivo and restored p53 mutant activity in xenografts. According to these findings, PEITC has antitumor effects, with its ability to restore p53R248Q activity being a key molecular event responsible for these effects.

Abstract A compact damping ring with a limited circumference of about 160 m is proposed for producing kilowatt-level coherent EUV radiation. The electron bunch in the storage ring is modulated by a 257 nm wavelength seed laser with the help of the angular-dispersion-induced micro-bunching method (Feng and Zhao in Sci Rep 7:4724, 2017), coherent radiation at 13.5 nm with an average power of about 2.5 kW can be achieved with the state-of-the-art accelerator and laser technologies.

The relationship between the charge density wave and excitonic correlations in a layered compound 1T-TiSe2 has remained controversial. Here, the authors observe a photo-induced dimensional crossover of the charge density wave and conclude that excitonic correlations are responsible for its out-of-plane phase coherence.

Objectives: Studies have revealed that a relatively high incidence of severe infection and mortality in COVID-19 patients is attributed to healthcare-associated infections (HAIs). We implemented a study in 2 field hospitals dedicated to COVID-19 treatment in Da Nang, Vietnam (July–August 2020), and Ho Chi Minh City, Vietnam (August–October 2021), to identify pathogens, risk factors, and outcomes associated with HAIs. Methods: We applied a prospective study tool to estimate HAI incidence among 1,454 patients. HAIs are diagnosed and ascertained using surveillance criteria established by the US Centers for Disease Control and Prevention. All patients hospitalized for COVID-19 for at least 2 days were enrolled in this assessment of HAI risks, pathogens, and outcomes. Results: Among 1,454 sampled patients, 391 patients had 423 HAIs (27.1%). The highest proportion occurred in ICUs, with 422 HAI patients (34.1%). Pneumonia (n = 331, 78.3%) and bloodstream infections (n = 55, 13.1%) were the most common HAIs. Multidrug-resistant (MDR) bacteria, such as Klebsiella pneumonia (27.9%) and Acinetobacter baumannii (25.3%), were the most commonly isolated organisms. Ventilators and central venous catheters were independently associated with HAIs. Regarding the mortality rates, 55% of deaths occurred in intensive care units. Patients with HAIs (70.3%) were twice as likely to die compared to patients without HAIs (38.8%). HAIs leading to septic shock caused almost triple mortality (n = 58, 90.6%) compared with non-HAI patients (n = 412, 38.8%). HAIs prolonged hospital stay: 24.7 days for patients with HAIs and 19.1 days for patients without HAIs (P < .001). Conclusions: Patients with COVID-19–related critical illnesses are at high risk of HAIs from multidrug-resistant (MDR) bacteria. HAIs prolong hospitalization, whereas HAIs with septic shock almost tripled mortality. Guidelines and procedures to prevent and control HAIs caused by MDR bacteria as well as training and monitoring on aseptic-compliant techniques during invasive clinical procedures are needed.