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Zhiwei Huang,1,* Jiatong Chen,1,* Shenglu Liu,1 Xin Xiang,2 Yang Long,3 Peng Tan,1,4 Wenguang Fu1,4 1Department of General Surgery (Hepatopancreatobiliary Surgery), The Affiliated Hospital, Southwest Medical University, Luzhou, 646000, People’s Republic of China; 2Department of General Surgery, The First People’s Hospital of Neijiang, Neijiang, 641000, People’s Republic of China; 3Department of Endocrinology and Metabolism, The Affiliated Hospital, Southwest Medical University, Luzhou, 646000, People’s Republic of China; 4Metabolic Hepatobiliary and Pancreatic Diseases Key Laboratory of Luzhou City, Academician (Expert) Workstation of Sichuan Province, Department of General Surgery (Hepatopancreatobiliary surgery), The Affiliated Hospital, Southwest Medical University, Luzhou, 646000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Peng Tan; Wenguang Fu, Department of General Surgery (Hepatopancreatobiliary Surgery), The Affiliated Hospital, Southwest Medical University, Luzhou, 646000, People’s Republic of China, Email tanpeng@swmu.edu.cn; fuwg@swmu.edu.cnBackground: Nonalcoholic steatohepatitis (NASH) has recently garnered increased attention due to immune infiltration. However, the role of membrane-associated protein 17 (MAP17) in NASH remains unclear, which prompted this study to explore its relationship with immune infiltration and its regulatory mechanisms.Methods: We employed weighted correlation network analysis (WGCNA) to construct a gene co-expression network aimed at identifying key genes associated with NASH progression. Our further analyses included differential expression evaluation, protein-protein interaction (PPI) network analysis, and Venn diagram analysis to discover novel targets. The CIBERSORT algorithm assessed the correlation between MAP17 and immune cell infiltration within the tumor microenvironment (TME), while the TIDE algorithm predicted responses to immunotherapy. Additionally, we conducted gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and gene set enrichment analysis (GSEA) to elucidate the mechanisms by which MAP17 operates. The expression of MAP17 was validated using liver tissues obtained from NASH patients and mice with diet-induced NASH or CCl4-induced liver fibrosis.Results: Our findings identified MAP17 as a novel target in the progression of NASH. Correlation analyses demonstrated a positive association between MAP17 and M1 macrophage infiltration, as well as a negative association with M2 infiltration. TIDE results positioned MAP17 as a potential biomarker for predicting responses to immune checkpoint blockade. Mechanistic studies revealed that MAP17 induced oxidative stress, which subsequently activated the p53, PI3K-AKT, and Wnt signaling pathways. Validation analyses confirmed that MAP17 levels significantly increased in liver tissues of mice with diet-induced NASH or CCl4-induced liver fibrosis, as well as in NASH patients.Conclusion: MAP17 is a novel biomarker linked to macrophage infiltration and immunotherapy responses in NASH patients. The oxidative stress induced by MAP17 activates the p53, PI3K-AKT, and Wnt pathways, all of which contribute to the progression of NASH.Keywords: NASH, MAP17, macrophage infiltration, immunotherapy response, oxidative stress

Jiabei Li,1,2 Wuchang Fu,3 Na Wang,1 Sisi Zeng,1 Xuechao Li,1 Jixiang Wan,1 Fangjun Wang1 1Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People’s Republic of China; 2Department of Anesthesiology, Meishan City People’s Hospital, Meishan, People’s Republic of China; 3Department of Anesthesiology, The Second Clinical Medical College of North Sichuan Medical College (Nanchong Central Hospital), Nanchong, People’s Republic of ChinaCorrespondence: Fangjun Wang, Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, No. 1 Maoyuan South Road, Nanchong, Sichuan, 637000, People’s Republic of China, Tel +86 13458253172, Email wfjlxy006@126.comPurpose: To determine the effect of dexmedetomidine on the ED50 and ED95 of sufentanil in patient-controlled intravenous analgesia (PCIA) after cesarean section.Patients and Methods: Parturients who underwent elective cesarean section (n = 80) were randomly assigned to either the sufentanil group (S group) or the dexmedetomidine-sufentanil combination group (DS group). Patients in the S group received a combination of sufentanil, 5 mg of tropisetron, and saline, whereas patients in the DS group were administered 1.5μg/kg of dexmedetomidine in addition to sufentanil, 5 mg of tropisetron, and saline. The ED50 and ED95 of sufentanil were determined by Dixon sequential method. We used probit regression to calculate the ED50, ED95, and 95% confidence intervals for sufentanil in each group.Results: The ED50 and ED95 for sufentanil in the S group were 1.634 (95% CI: 1.476– 1.810)μg/kg and 2.035 (95% CI: 1.841– 3.312)μg/kg, respectively. The ED50 and ED95 for sufentanil in the DS group were 1.275 (95% CI: 1.187– 1.353)μg/kg and 1.503 (95% CI: 1.406– 1.824)μg/kg. The VAS scores with rest at t5 and with movement at t4- t5 were lower in the DS group (P< 0.05). The t2-t5 Ramsay scores in the DS group were higher than those in the S group (P< 0.05). The doses of sufentanil and tramadol were markedly reduced in the DS group, while the onset of first lactation occurred significantly earlier in the DS group (P< 0.05). Compared with the S group, the DS group had a lower incidence of nausea, vomiting, and skin itching (P< 0.05), and lower frequency of patient-controlled analgesia (PCA) episodes (P< 0.05), and better postoperative pain satisfaction (P< 0.05).Conclusion: The 1.5μg/kg dexmedetomidine can significantly decrease the ED50 and ED95 of sufentanil in patient-controlled intravenous analgesia after cesarean section, provide good postoperative analgesia and sedation, and promote the earlier occurrence of first lactation.Keywords: dexmedetomidine, sufentanil, cesarean section, postoperative analgesia, ED50, ED95

Yunfan He,1,2 Jun Liang,3– 5 Wenguang Fu,6 Yongcheng Liu,7 Fangyu Yang,8 Shunjing Ding,9 Jianbo Lei10– 12 1School of International Relations and Public Affairs, Fudan University, Shanghai, People’s Republic of China; 2National Institute of Intelligent Evaluation and Governance, Fudan University, Shanghai, People’s Republic of China; 3Department of AI and IT, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 4Center for Health Policy Studies, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 5Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 6Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, People’s Republic of China; 7Netease Group, Hangzhou, Zhejiang, People’s Republic of China; 8School of Nursing, Capital Medical University, Beijing, People’s Republic of China; 9Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China; 10Clinical Research Center, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China; 11School of Medical Informatics and Engineering, Southwest Medical University, Luzhou, Sichuan, People’s Republic of China; 12Center for Medical Informatics, Health Science Center, Peking University, Beijing, People’s Republic of ChinaCorrespondence: Jianbo Lei, Center for Medical Informatics, Peking University, Beijing, 100191, People’s Republic of China, Tel +86 (10) 8280-5901, Fax +86 (10) 8280-5900, Email jblei@hsc.pku.edu.cn Shunjing Ding, Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China, Email dsj6890@sina.comBackground: Online health-related misinformation poses a serious threat to public health. As the coronavirus disease 2019 (COVID-19) pandemic aggravated the spread of misinformation regarding COVID-19, relevant research has surged.Objective: To systematically summarize Chinese and English articles regarding health-related misinformation about COVID-19 on social media and quantitatively describe research progress.Methods: Using bibliometrics, we systematically analyzed and compared the characteristics of scientific articles in English and Chinese, examining article numbers, journals, authors, countries, institutions, funding, and research topics, and compared changes in popular research topics.Results: This study analyzed 1,294 articles, revealing a significant increase in article numbers and citations during the COVID-19 pandemic (1.94 times and 2.95 times, respectively, compared to pre-pandemic data). However, high-impact articles were scarce and the field lacked a core group of authors and collaborative networks. China had the largest number of papers (n=266) and funds (n=292), but articles in English exceeded by far those in Chinese (1,131 vs 163, respectively). Regarding article topics, the transformation from qualitative small-data analyses to quantitative empirical big-data research has been realized.Conclusion: With the maturity of natural language processing technology, in-depth mining of massive user-generated content has become a hot spot. The outbreak of the COVID-19 pandemic has prompted the research focus to shift from misinformation-related health problems to social problems involving the sources, content, channels, audiences, and effects of communication networks. Using artificial intelligence technology like machine learning to deeply mine large amounts of user-generated content on social media will be a future research hot spot.Keywords: misinformation, online health information, social media, COVID-19, Chinese, English

Xudong Che, Baixue Wu, Hongxia Zhang, Dengzhi Jiang, Wenqiao Fu, Zhaohui He Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of ChinaCorrespondence: Zhaohui He, Email geno_he@163.comBackground: Hemoglobin decrement is a common complication after aneurysmal subarachnoid hemorrhage (aSAH) and is associated with poor outcome. However, the mediating variables on the causal pathway between hemoglobin decrement and poor outcome in aSAH are not clear.Methods: This is a single-center retrospective observational study containing all consecutive patients with aSAH admitted to our hospital between January 1, 2019, and June 30, 2022. Hemoglobin decrement was defined as the hemoglobin at admission minus the minimum hemoglobin during hospitalization. Calculation of cutoff value using ROC curve Youden index. The main exposure of interest was a hemoglobin decrement greater than the cutoff value. The primary outcome was poor outcome at 3 months (mRS 4– 6).Results: A total of 480 patients with aSAH were included in the study, 414 (71.1%) had a favorable and 66 (28.9%) had a poor outcome at 3 months. The cut-off value for calculating the degree of hemoglobin decrease using the ROC curve was 12.5 g/l. Hemoglobin decrement greater than the cutoff value was significantly associated with pneumonia (OR 3.12; 95% CI 1.78– 5.57; p < 0.001), cerebral infarction (OR 3.06; 95% CI 1.80– 5.30; p < 0.001), and poor prognosis (OR 2.88; 95% CI 1.44– 5.92; p = 0.003) at 3 months. The mediation effect was significant for both pneumonia and cerebral infarction, with the average causal mediation effect (ACME) were 0.04 (95% CI 0.02– 0.08; p < 0.05) and 0.05 (95% CI 0.02– 0.08; p < 0.001), respectively.Conclusion: Hemoglobin decrement during hospitalization was significantly associated with poor prognosis after aSAH, and the increased risk of cerebral infarction and pneumonia might mediate this effect. Avoiding hemoglobin decrement greater than 12.5g/l may improve the prognosis of patients with aSAH.Keywords: aneurysmal subarachnoid hemorrhage, hemoglobin decrement, cerebral infarction, pneumonia

Mei Song, Meng Zhang, Jia Han, Wenjiang Fu Department of Infectious Diseases, Jiashan County First People’s Hospital, Jiashan, Zhejiang, 314100, People’s Republic of ChinaCorrespondence: Mei Song; Wenjiang Fu, Department of Infectious Diseases, Jiashan County First People’s Hospital, Jiashan, Zhejiang, 314100, People’s Republic of China, Email songmeiarticle@163.com; fwjtjh168@sina.comBackground: The present study aimed to construct and validate a nomogram based on clinical metrics to identify CPTB.Patients and Methods: The present study retrospectively recruited pulmonary tuberculosis (PTB) patients admitted to Jiashan County First People’s Hospital in China from November 2018 to September 2023. PTB patients were classified into the CPTB group and the non-CPTB group based on chest computed tomography findings, and were randomly allocated to the training set (70%) and the validation cohort (30%). The training set and validation set were used to establish and validate nomogram, respectively. Multivariate logistic regression analysis (MLSA) was used to identify the independent risk factors for CPTB in patients with PTB. Statistically significant variables in the MLSA were then used to construct a nomogram predicting CPTB in patients with PTB. The receiver operating characteristic (ROC) curve, calibration curve analysis (CCA), and decision curve analysis (DCA) were used for the evaluation of the nomogram.Results: A total of 293 PTB patients, including 208 in the training set (85 CPTB) and 85 in the validation set (33 CPTB\), were included in this study. Stepwise MLSA showed that sputum smear (≥ 2+), smoking(yes), glycosylated hemoglobin A1c(HbA1c), hemoglobin (HB), and systemic inflammatory response index (SIRI) were independent risk factors for the development of cavitation in patients with PTB. The nomogram identifying the high-risk CPTB patients was successfully established and showed a strong predictive capacity, with area under the curves (AUCs) of 0.875 (95% CI:0.806– 0.909) and 0.848 (95% CI:0.751– 0.946) in the training set and validation set respectively. In addition, the CCA and DCA corroborated the nomogram’s high level of accuracy and clinical applicability within both the training and validation sets.Conclusion: The constructed nomogram, consisting of sputum smear positivity, smoking, HbA1C, HB, and SIRI, serves as a practical and effective tool for early identification and personalized management of CPTB.Keywords: pulmonary tuberculosis, cavitation, nomogram

Lina Zhang,1– 3,&ast; Ruibin Wu,2,3,&ast; Tenghui Ma,2,3 Wenwen Fu,2,3 Jiamin Chen,2,3 Lingling Li,2,3 Qing He2,3 1The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510080, People’s Republic of China; 2Department of Clinical Nutrition and Microbiome; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, People’s Republic of China; 3Key Laboratory of Human Microbiome and Chronic Diseases (Sun Yat-sen University), Ministry of Education, Guangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qing He, Email heqing5@mail.sysu.edu.cnObjective: To explore the active substances and targets of Danbie Capsules in Endometriosis therapy.Methods: This study was conducted through TCMSP and published literature screened and obtained 183 active substances of Danbie Capsules, combined and intersected with Endometriosis target genes collected and screened in the GEO database, obtained 24 target genes for Endometriosis treatment, and mapped the target network map of Danbie Capsules active substances against Endometriosis. The network was analyzed with the aid of Cytoscape version 3.9.1. With the aid of the platform of the STRING data analysis, PPI network analysis was conducted on 24 anti-Endometriosis targets of the Danbie Capsules.Results: The research results obtained three critical active substances, namely, Quercetin, β-sitosterol, and Luteolin. Seven critical targets were identified, and two representative genes (TP53 and AKT1) have been verified in Macromolecular docking and immunohistochemical verification.Conclusion: The active substances of Danbie Capsules in the treatment of Endometriosis are Quercetin, β-sitosterol and Luteolin, and the main targets are TP53 and AKT1.Keywords: danbie capsules, endometriosis, network pharmacology

Wanlan Fu,1 Yunxiang Cao,2 Jian Liu,2 Chuanbing Huang,2 Kaiyan Shu,1 Nanfei Zhu1 1First Clinical Medical College, Anhui University of Chinese Medicine, Hefei, Anhui, 230012, People’s Republic of China; 2Department of Rheumatology, First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui, 230031, People’s Republic of ChinaCorrespondence: Yunxiang Cao, Department of Rheumatology, First Affiliated Hospital of Anhui University of Chinese Medicine, 117 Meishan Road, Shushan District, Hefei, Anhui, 230031, People’s Republic of China, Tel +86-13514984395 ; +0551-62838591, Email cyx800805@163.comPurpose: This study probed the mechanism of action of Xinfeng Capsule (XFC) in myocardial injury in rats with adjuvant arthritis (AA) via the growth arrest-specific transcript 5 (GAS5)/microRNA-21 (miR-21)/Toll-like receptor 4 (TLR4) axis.Methods: Rats were injected with Freund’s complete adjuvant to establish a rat model of AA. Then, some modeled rats were given normal saline or drugs only, and some modeled rats were injected with adeno-associated viruses or necrosulfonamide (NSA; a pyroptosis inhibitor) before drug administration. Toe swelling and arthritis index (AI) were calculated. Pathological and morphological changes in synovial and myocardial tissues were analyzed with hematoxylin-eosin staining, and pyroptotic vesicles and the ultrastructural changes of myocardial tissues were observed with transmission electron microscopy. The serum levels of interleukin (IL)-1β, IL-18, IL-6, and tumor necrosis factor (TNF)-α were detected, and lactate dehydrogenase (LDH) release was measured in myocardial tissues, accompanied by the examination of GAS5, miR-21, TLR4, nuclear factor-kB (NF-κB) p65, nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3), Caspase-1, and Gasdermin D (GSDMD) expression in myocardial tissues.Results: After AA modeling, rats presented with significantly increased toe swelling and AI scores, synovial and myocardial tissue damage, elevated pyroptotic vesicles, and markedly enhanced serum levels of IL-1β, IL-18, IL-6, and TNF-α, accompanied by significantly diminished GAS5 expression, substantially augmented miR-21, TLR4, NF-κB p65, NLRP3, Caspase-1, and GSDMD expression, greatly increased LDH release in myocardial tissues. XFC treatment significantly declined toe swelling, AI scores, synovial and myocardial tissue damage, and the serum levels of IL-1β, IL-18, IL-6, and TNF-α in AA rats. Additionally, XFC treatment markedly elevated GAS5 expression and substantially lowered LDH release and miR-21, TLR4, NF-κB p65, NLRP3, Caspase-1, and GSDMD expression in myocardial tissues of AA rats. Moreover, the above effects of XFC in AA rats were further promoted by GAS5 overexpression or NSA treatment.Conclusion: XFC alleviated myocardial injury in AA rats by regulating the GAS5/miR-21/TLR4 axis and inhibiting pyroptosis and pro-inflammatory cytokine secretion.Keywords: adjuvant arthritis, myocardial injury, GAS5/miR-21/TLR4 axis, pyroptosis, Xinfeng Capsule

Yujian Shao,1,2 Yonglu Chen,2 Mingyue Zhu,3 Yuanyuan Liu,2 Chen Fang,3 Minjun Wang,2 Peng Sun,3 Weiling Fu,2 Jing Huang,3 Shimei Sheng,2 Yanshan Huang2 1Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 2Department of Innovative Drug Discovery and Development, Zhejiang Doer Biologics Co., Ltd, Hangzhou, Zhejiang, People’s Republic of China; 3First Research Institute, Zhejiang Heze Pharmaceutical Technology Co., Ltd, Hangzhou, Zhejiang, People’s Republic of ChinaCorrespondence: Yanshan Huang, Department of Innovative Drug Discovery and Development, Zhejiang Doer Biologics Co., Ltd, Hangzhou, Zhejiang, People’s Republic of China, Email yanshanhuang@doerbio.comIntroduction: Diabetes and obesity are momentous risk factors threatening people’s lives and health. Currently available incretin analogue glucagon-like peptide 1 (GLP-1) possesses huge hypoglycemic effect with the unsatisfactory effect of weight loss. Co-agonists targeting GLP-1R plus glucagon receptor (GCGR) or gastric inhibitory polypeptide receptor (GIPR) show synergistic benefits in glycaemic control and weight loss. Here, we describe a novel dual GIP and GLP-1 receptor agonist, DR10627, and performed a preclinical assessment of it.Methods: The agonistic ability of DR10627 was indirectly assessed by inducing cAMP accumulation in Chinese hamster ovary (CHO) cells transfected with GLP-1R or GIPR in vitro. The plasma pharmacokinetics of DR10627 were analysed in cynomolgus monkeys. The OGTTs were performed in Sprague‑Dawley (SD) rats. The glucose lowering effects were evaluated by repeated administration of DR10627 in diabetic (db/db) mice for 4 weeks. The effects of anti-obesity and improving metabolism of DR10627 were evaluated by repeated administration of DR10627 in diet-induced obesity (DIO) mice for 57 days.Results: DR10627 had the capacity to activate both GLP-1R and GIPR in vitro. The terminal half-life of DR10627 was found to be approximately 4.19– 5.8 h in cynomolgus monkeys. DR10627 had a great improvement in oral glucose tolerance in SD rats. Moreover, DR10627 had a potent glucose-lowering effect in db/db mice, and the hypoglycemic effect of 18 nmol/kg DR10627 was better than that of 50 nmol/kg liraglutide. In addition, 10 and 30 nmol/kg DR10627 possessed the ability of potentiating the weight-loss, lipid-lowing efficacy and improving metabolism to a greater extent than 80 nmol/kg liraglutide.Conclusion: Preclinical assessment demonstrated that administration of DR10627 resulted in glucose lowering in SD rats and db/db mice, and substantial body weight reduction and metabolism improvement in DIO mice. DR10627 is a promising agent deserving further investigation for the treatment of type 2 diabetes and obesity.Keywords: glucagon-like peptide-1, gastric inhibitory polypeptide receptor, obesity, type 2 diabetes, inflammation

Wenxian Fu,1– 4 Xinyi Li,1– 4 Sifan Ji,1– 4 Tingting Yang,1,3– 5 Lu Chen,1,3– 5 Yaru Guo,1,3– 5 Kongliang He1– 5 1Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China; 2School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, People’s Republic of China; 3Anhui Mental Health Center, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China; 4Psychiatry Department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China; 5Psychological Counseling department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of ChinaCorrespondence: Kongliang He, Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China, Tel +8613966721862, Email hefei413@126.comObjective: Non-suicidal self-injury (NSSI) behavior is very common in adolescents with depression, and childhood trauma is considered one of the distal risk factors for its exacerbation. Rumination caused by adverse traumatic experiences, which can be transferred through NSSI behavior, can alleviate symptoms of depression in adolescents. The current research focuses on the relationship between the three, further exploring whether rumination is a mediator in the relationship between childhood trauma and NSSI behavior on the basis of previous studies, and provides some suggestions for future early intervention for adolescents with depression.Methods: A total of 833 adolescent patients with depression who met the DSM-5 criteria for depressive episode were recruited from 12 hospitals in China. The Chinese version of the Function Assessment of Self-mutilation, Childhood Trauma Questionnaire, and Rumination Inventory were used as research tools.Results: The scores of childhood trauma and rumination in adolescents with depression in the NSSI group were higher than those in the non-NSSI group. A Pearson’s correlation analysis showed that childhood trauma was positively correlated with rumination (r=0.165, P< 0.01), different types of childhood trauma were significantly positively correlated with rumination and its three factors, and these results were statistically significant. Rumination partially mediated the relationship between childhood trauma and NSSI behavior in depressed adolescent patients (effect size=0.002), and the effect in female participants (effect size=0.003), was greater than that in male participants (effect size=0.002).Conclusion: Childhood trauma and rumination were key factors for NSSI behavior in adolescents with depression. Childhood trauma not only has a direct effect on NSSI behavior in adolescent depression, but also plays an indirect effect on NSSI behavior through rumination.Keywords: adolescents, childhood trauma, rumination, non-suicidal self-injury

Tianli Zheng,1,2 Weiwei Fu,1,2 Shuang Jiang,3 Xiaodong Yang1,2 1School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China; 2Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, Jiangsu, People’s Republic of China; 3The Third Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, People’s Republic of ChinaCorrespondence: Xiaodong Yang, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, No. 88, Keling Road, Suzhou, Jiangsu Province, 215000, People’s Republic of China, Email xiaodong.yang@sibet.ac.cnPurpose: The prevalence of obesity and myopia in young people is increasing worldwide; however, the association between body mass index (BMI) and myopia remains controversial. This study aimed to assess the association between BMI and myopia in Chinese schoolchildren.Patients and Methods: In this study, the open data for analysis were obtained from DATADRYAD website (www.datadryad.org). A total of 3658 children were enrolled in this study. Logistic regression model was used to analyze the relationship between BMI and myopia.Results: Compared with individuals with lower BMI Q1 (less than 25 kg/m2), the adjusted odds ratios (ORs) for BMI and myopia were 2.15 (95% confidence interval [CI]: 1.62– 2.86) in Q2 (25.0– 29.9 kg/m2) and 2.39 (95% CI: 1.37– 4.18) in Q3 (30.0 kg/m2 or more). Moreover, the association between BMI and myopia exhibited an inverted L-shaped curve (nonlinear; p < 0.001). When the BMI was < 25 kg/m2, an increased BMI was significantly associated with a higher risk of myopia (OR = 1.244 [95% CI: 1.211– 1.277], p < 0.001). However, when the BMI was ≥ 25 kg/m2, the association lost its significance (OR = 1.063 [95% Cl: 0.964– 1.171], p = 0.219).Conclusion: This study found an inverted L-shaped association between BMI and myopia in Chinese schoolchildren. A higher BMI was associated with a higher risk of myopia reaching 25 kg/m2, after which an increase in BMI was no longer associated with an increased risk of myopia.Keywords: myopia, body mass index, cross-sectional, schoolchildren, logistic regression

Wenying Yi,1,2 Haibo Wu,1,2 Weibin Fu,1,2 Huimei Feng,1,2 Jie Huang,1,2 Haijing Li,1,2 Zhen Song,1,2 Yuwei Chen,1,2 Yingjun Zheng,1,2 Shenglin She1,2 1Department of Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China; 2Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China Guangzhou Medical University, Guangzhou, People’s Republic of ChinaCorrespondence: Shenglin She, Department of Psychiatry, the Affiliated Brain Hospital of Guangzhou MedicalUniversity, No. 36 Mingxin Road, Liwan District, Guangzhou, People’s Republic of China, Tel +86-13825154669, Fax +86-20-82068107, Email shenglinshe@gzhmu.edu.cnBackground: To assess the prevalence and risk factors of NAFLD in non-obese patients with schizophrenia in a public psychiatric hospital in China.Methods: A total of 1,305 adult inpatients with schizophrenia in 2019 were included in this retrospective study. Body mass index (BMI) ≥ 25 kg/m2 was considered obese, and BMI < 25 kg/m2 was considered non-obese. We obtained the data from electronic records of the Affiliated Brain Hospital of Guangzhou Medical University.Results: A total of 1,045 non-obese patients and 260 obese patients were included in this study. The prevalence of NAFLD in non-obese patients was 25.0%, and it was much lower that in the obese patients (25.0% vs 64.6%, p < 0.001). Among the non-obese patients, there were significant differences in age, BMI, alanine aminotransferase (ALT), metabolic indices, and the prevalence of diabetes and hypertension between patients with NAFLD and patients without NAFLD. According to the results of binary logistic regression analysis, age, BMI, ALT, triglyceride (TG) and diabetes were significantly related to NAFLD among non-obese patients with schizophrenia. In contrast, HDL-C was was negatively associated with NAFLD among non-obese patients.Conclusion: This study suggested that NAFLD was common in patients with schizophrenia, even in non-obese patients with schizophrenia. In non-obese patients with schizophrenia, age, BMI, ALT, TG and diabetes are significantly associated with NAFLD. Moreover, HDL-C level was an independent protective factor against NAFLD. Given the adverse outcomes of NAFLD, it is necessary to increase awareness of NAFLD in patients with schizophrenia, especially in non-obese patients with schizophrenia.Keywords: schizophrenia, NAFLD, non-obese, obese, risk factors, China

Rui Zhao, Jing Zhao, Yichuan Song, Wenxuan Fu, Qingtao Wang, Rui Zhang Department of Clinical Laboratory, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Qingtao Wang; Rui Zhang, Department of Clinical Laboratory, Beijing Chao-yang Hospital, Capital Medical University, No. 8, Gongtinan Road, Chao-Yang District, Beijing, 100020, People’s Republic of China, Tel +86 1085231660, Email wqt36@163.com; zr189169@163.comPurpose: Outcomes after autologous stem cell transplantation (ASCT) are quite variable and difficult to predict. Second-generation flow, second-generation sequencing, and other tests are invasive and expensive for patients. In this study, we aimed to analyze laboratory data before and after transplantation to look for laboratory indicators that could predict disease progression in patients with newly diagnosed multiple myeloma (NDMM) patients underwent ASCT.Patients and Methods: Standard complete blood count (CBC) parameters, clinical biochemical, and immunological indicators on day -5 and day 90 after ASCT were obtained. Receiver-operating characteristic (ROC) curve was used to determine the cutoff values, we evaluated the predictive abilities of laboratory parameters for progression-free survival (PFS). Univariate and multivariate analyses were performed to evaluate the prognostic significance of variables associated with the PFS of 166 NDMM who underwent ASCT.Results: At day-5, a low absolute monocyte count (AMC, p=0.001), systemic inflammation response index< 1.56 (SIRI, P=0.03), serum calcium (p=0.02), and albumin (p=0.006) can predict for superior PFS. At Day +90, a high absolute neutrophil count (ANC, p = 0.008) and lymphocyte-to-monocyte ratio (LMR, p = 0.02), a low neutrophil-to-lymphocyte ratio (NLR, p =0.02) and SIRI< 0.41 (p=0.02) predicted for superior PFS.Conclusion: There are inflammation-related indicators derived from peripheral blood cell count (WBCC) – ANC, NLR, SIRI, and LMR - which can serve as potential biomarkers for predicting PFS of NDMM patients underwent ASCT.Keywords: multiple myeloma, autologous stem cell transplantation, SIRI, lymphocyte-to-monocyte ratio

Chunhui Shu,1,&ast; Jiaqiang Zhou,2,&ast; Hongqiong Yu,1 Weijing Fu,1 Jiayi Shen,1 Linchun Liang,3 Lisi Zheng,4 Lin Mao,5 Xuyan Fu,4 Tao Lv,4,6 Yunbo Chen4 1Department of Laboratory Medicine, Ningbo Mingzhou Hospital, Ningbo, People’s Republic of China; 2Department of Neurosurgery, Ningbo Mingzhou Hospital, Ningbo, People’s Republic of China; 3Department of Oncology, Ningbo Mingzhou Hospital, Ningbo, People’s Republic of China; 4State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of China; 5Department of Rehabilitation Medicine, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of China; 6Jinan Microecological Biomedicine Shandong Laboratory, Jinan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Tao Lv; Yunbo Chen, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of China, Tel/Fax +86 571-87236756, Email xifan_lvtao@163.com; chenyunbo@aliyun.comBackground: Clostridioides difficile is an important pathogen causing approximately 20– 30% of the cases-with antibiotic-associated diarrhea and 90% of those with Pseudomembranous enteritis. However, limited surveillance of C. difficile infections (CDI) in China is done at present, especially in terms of multi-hospital epidemiological reports.Methods: Between June 2020 and November 2020, we conducted a prospective study addressing antimicrobial susceptibility profiles and genomic epidemiology of C. difficile strains isolated from inpatients with diarrhea in seven tertiary hospitals in the same city.Results: In total, 177 strains of toxin-producing C. difficile were isolated, and the dominant toxin gene profiles were tcdA+tcdB+ (84.2%, 149/177) and tcdA-tcdB+ (15.8%, 28/177). Furthermore, 130 isolates were successfully analyzed for antimicrobial susceptibility phenotype in which the rates of resistance to clindamycin, erythromycin, levofloxacin, and moxifloxacin were higher than to other antibiotics. All strains were susceptible to metronidazole and vancomycin. Fluoroquinolone-associated mutations (such as gyrA) were the most frequently found ones in the analyzed genomes. Moreover, 24 different sequence types (STs) were identified in the 130 isolates, and the most prevalent types were ST3 (26.2%, 34/130) followed by ST54 (16.9%, 22/130) and ST2 (10%, 13/130). The so-called highly virulent strain ribotyping 027 (B1/NAP1/ST1) was not identified. In addition, we also compared single nucleotide polymorphisms (SNPs) among the isolates and carried out genomic epidemiological studies on the isolates. We found that ST3 and ST54 could cause transmission in both intra- and inter-hospital settings.Conclusion: Although it is the so-called hypervirulent epidemic strain, ribotyping 027 (ST1), was not detected. ST3 and ST54 can be transmitted through different hospitals. Therefore, it is necessary to conduct further molecular epidemiological monitoring of C. difficile and screening of patients admitted to key departments.Keywords: Clostridioides difficile infection, genomic analysis, toxin gene, antibiotic resistance, transmission

This paper describes a new modeling framework for microscopic to reservoir-scale simulations of hydraulic fracturing and production. The approach builds upon a fusion of two existing high-performance simulators for reservoir-scale behavior: the GEOS code for hydromechanical evolution during stimulation and the TOUGH+ code for multi-phase flow during production. The reservoir-scale simulations are informed by experimental and modeling studies at the laboratory scale to incorporate important micro-scale mechanical processes and chemical reactions occurring within the fractures, the shale matrix, and at the fracture-fluid interfaces. These processes include, among others, changes in stimulated fracture permeability as a result of proppant behavior rear-rangement or embedment, or mineral scale precipitation within pores and microfractures, at µm to cm scales. In our new modeling framework, such micro-scale testing and modeling provides upscaled hydromechanical parameters for the reservoir scale models. We are currently testing the new modeling framework using field data and core samples from the Hydraulic Fracturing Field Test (HFTS), a recent field-based joint research experiment with intense monitoring of hydraulic fracturing and shale production in the Wolfcamp Formation in the Permian Basin (USA). Below, we present our approach coupling the reservoir simulators GEOS and TOUGH+ informed by upscaled parameters from micro-scale experiments and modeling. We provide a brief overview of the HFTS and the available field data, and then discuss the ongoing application of our new workflow to the HFTS data set.

Shouying Li,1,&ast; Jiaxin Feng,2,&ast; Haiyan Weng,1 Feng Zhao,3 Guohui Cui,1 Wenkui Fu,1 Xiaorong Lin,4 Hai Hu1,5 1Department of Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China; 2The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China; 3Research and Development Department, Guangzhou BioBlue Technology Co. Ltd, Guangzhou, People’s Republic of China; 4Diagnosis and Treatment Center of Breast Diseases, Shantou Central Hospital, Shantou, People’s Republic of China; 5Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiaorong Lin; Hai Hu, Email clarelynn_lin@163.com; huhai@mail.sysu.edu.cnPurpose: For better understanding of radiotherapy resistance and its potential mechanism.Methods: We established radioresistance cell lines of non-small cell lung cancer (NSCLC) followed by microarray analysis. 529 differentially expressed genes (DEGs) were then screened between radiation resistant cell lines compared with the sensitive cell lines. The biological functions and enrichment pathways of the above DEGs were identified using Kyoto Encyclopedia of Genes and Genomes (KEGG) and gene ontology (GO) enrichment analyses. Gene Set Enrichment Analysis (GSEA) revealed that the radiation resistance group had the most gene sets enriched in altered immune response, such as TNF signaling pathway, when compared to the radiation sensitive group. Protein-protein interaction (PPI) network was carried out through the STRING database, and then five hub genes (CXCL10, IFIH1, DDX58, CXCL11, RSAD2) were screened by Cytoscape software. RT-PCR confirmed the expression of the above hub genes. ChIP-X Enrichment Analysis showed that STAT1 might be the transcription factor of the above hub genes. Considering that PD-L1 could be activated by STAT1 in a variety of tumors and ultimately lead to immune exhaustion, RT-PCR and Western blot verified the expression level of PD-L1.Results: Five hub genes (CXCL10, IFIH1, DDX58, CXCL11, RSAD2) were screened and verified to be highly expressed in radioresistance group, STAT1 might be the transcription factor of the above hub genes. Our study found that the expression level of PD-L1 was increased after radiotherapy resistance.Conclusion: Although immune system activation occurs followed by radiation resistance, we hypothesized that the upregulation of PD-L1 expression caused by STAT1 activation might be one of the mechanisms of radiotherapy resistance.Keywords: NSCLC, radioresistance, DEGs, hub gene, STAT1

Jia Zhou,1,&ast; Yi Chen,1,&ast; Yi Xu,2,&ast; Bin Liao,3 Wenguang Fu4 1School of Humanities and Management Science, Southwest Medical University, Luzhou, SiChuan, 646000, People’s Republic of China; 2Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People’s Republic of China; 3Department of Cardiovascular Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, SiChuan, 646000, People’s Republic of China; 4Department of Hepatobiliary Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wenguang Fu, Department of Hepatobiliary Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China, Tel +86-13982770568, Email fuwg@swmu.edu.cn Bin Liao, Department of Cardiovascular Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, SiChuan, 646000, People’s Republic of China, Tel +86-0830-3162306, Email liaobin@swmu.edu.cnPurpose: This study explored the relationship between emotion and death-thought accessibility (DTA) in individuals experiencing true mortality salience (MS), specifically, patients with cancer.Patients and Methods: The study included 255 participants; among them, 132 patients had cancer and represented the MS group, and 123 had dental pain and served as a control group. Participants completed the Projective Diseases Attitude Assessment Questionnaire to induce priming, completed an affect scale, completed one of four calculation tasks as manipulation of cognitive load (all four were done over several sessions), and performed a Pinyin-Chinese characters exercise to measure DTA.Results: MS was associated with strong negative emotional arousal. When these negative emotions are generated, they enter an individual’s consciousness and activate proximal defense mechanisms. At this point, DTA can be measured. Patients with cancer had significantly higher levels of DTA in the high-frequency cognitive load condition than in the other three conditions (no task, simple delay task, and single cognitive load task). Patients with dental pain had significantly higher levels of DTA in the no task and simple delay conditions than in the single cognitive load or high-frequency cognitive load conditions. This study also found that negative experiences without MS (specifically, dental pain) are associated with higher levels of DTA.Conclusion: These findings suggest that in addition to death-related events, both negative and stress-inducing events can produce DTA.Keywords: mortality salience, cancer, terror management theory, proximal defense mechanisms

The Martian magnetotail is largely controlled by the solar wind (SW) and is modulated by variations in the upstream drivers. However, due to the limitations of single‐spacecraft observations, the effects of SW variations on the Martian magnetotail have not been fully understood so far. Here, using Tianwen‐1 and MAVEN data, we report for the first time the rapid response of Martian magnetotail to the SW disturbance. In our study, Tianwen‐1 detected the flapping of Martian magnetotail, while MAVEN monitored disturbances in the upstream SW. The results indicate that a 20% increase (or decrease) in SW dynamic pressure and a 30° (or 50°) rotation of interplanetary magnetic field clock angle could cause the Martian magnetotail to swing rapidly. These two SW disturbances could lead to oscillations of the Martian magnetotail. This study reveals the importance of joint observations for studying the interaction between the SW and Mars. Plain Language Summary: Mars lacks an intrinsic global magnetic field and as a result solar wind (SW) interacts directly with its ionosphere and atmosphere, leading to a high dependence of the Martian induced magnetosphere on SW conditions. Understanding the interaction between the SW and Mars can provide critical information for studies of planetary evolution, especially the effect of the SW on the Martian magnetotail. In previous studies, using single satellite observations, we limit ourselves to studying some local physical processes or statistical properties. Here, based on the joint measurements by Tianwen‐1 and MAVEN, we observed the rapid response of Martian magnetotail to the SW disturbance, finding that a 20% increase (or decrease) in SW dynamic pressure and a 30° (or 50°) rotation of IMF clock angle could cause the Martian magnetotail to swing rapidly. These two SW disturbances could lead to oscillations of the Martian magnetotail. These results can help us understand the SW interaction with the Martian induced magnetosphere. Key Points: We report for the first time the rapid response of Martian magnetotail to the solar wind (SW) disturbance by using Tianwen‐1 and MAVEN dataA 20% increase (or decrease) in PSW and a 30° (or 50°) rotation of interplanetary magnetic field clock angle could cause the Martian magnetotail to swingThese two SW disturbances could lead to oscillations of the Martian magnetotail [ABSTRACT FROM AUTHOR]

Magnetic holes (MHs) are transient magnetic structures responsible for energy conversion in space plasma. Using single-spacecraft measurements from Mars Atmosphere and Volatile EvolutioN (MAVEN), the existence of MHs on Mars has been confirmed. However, due to the limitations of single-spacecraft observations, significant uncertainty also arises on the identification of the spatial scale and 3D geometry of MHs. In this study, we report a series of MHs successively detected by Tianwen-1 near the high-latitude magnetopause and by the MAVEN spacecraft near the subsolar magnetopause. The large separation between Tianwen-1 and MAVEN (∼4 R M) suggests these MHs are macroscale structures extending along the axial direction. Additionally, we observe whistler waves generated by electron perpendicular anisotropy in one of the macroscale MHs. This study is the first joint observation of Martian MHs, shedding light on the research of transient magnetic structures on Mars. [ABSTRACT FROM AUTHOR]

Danni Zheng,1,&ast; Weida Fu,1,&ast; Lingli Jin,1,&ast; Xiaofang Jiang,2 Wenjie Jiang,1 Yaoyao Guan,3 Rutian Hao1 1Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 2Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 3Department of Plastic Surgery, Sir Run-Run Hospital Affiliated to Zhejiang University, Hangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yaoyao Guan, 3 Qingchun East Road, Jianggan District, Hangzhou, Zhejiang, People’s Republic of China, Tel +86 571-86006618, Fax +86 571-86044817, Email gyykq748@163.com Rutian Hao, South White Elephant Warm hospital first New Area, Ouhai District, Wenzhou, Zhejiang, People’s Republic of China, Tel +86 577 5557, Fax +86 577-55578033, Email hrtwenzhou@163.comPurpose: To explore the mechanism of AP1S1 in breast cancer.Methods and Results: In different datasets, we found that AP1S1 is more highly expressed in breast tumors, which was furthermore verified in our local cohort.Immune infiltration analysis showed that AP1S1 was related to a variety of immune cells. The higher AP1S1 expression was negatively correlated with a variety of immune infiltrating cells, suggesting that AP1S1 may affect cellular immunity.Clinical analysis showed that patients with higher AP1S1 expression had higher estrogen receptor gene expression and were more prone to distant metastasis and lymph node metastasis.The overall survival rate, disease-specific survival rate, and progression-free interval time were worse in the group with higher AP1S1 expression. AP1S1 may be a potential oncogene of breast cancer, and overexpression is related to the poor prognosis of breast cancer.Therefore, a nomogram was constructed, along with correlated gene analysis and functional analysis to further explore the carcinogenic mechanism, practical clinical issues, and value of AP1S1.Conclusion: AP1S1 is a potential oncogene of breast cancer.Keywords: breast cancer, AP1S1, immune infiltration, prognosis, oncogene

Weida Fu,&ast; Shurong Zheng,&ast; Jieyu Zhou, Kangkang Lu, Yiqiao Lu, Guilong Guo Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Guilong Guo, Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China, Tel/Fax +86-13867709361, Email guoguilong@sina.comAbstract: Male breast carcinoma metastatic to the choroid is very rare and often related to poor prognosis. Herein, we report the findings in a Chinese male breast cancer patient who developed choroidal metastasis, and give opinions on systemic treatments. A 45-year-old Chinese male represented with difficulty breathing and visual impairment in the left eye 6 years after his breast cancer surgery and postoperative adjuvant treatment. PET/CT revealed multi-organs metastasis of the patient. The IHC indicated the lung lesion to be originated from the breast (ER+/PR+/HER2-). Eye examination provided evidence for breast cancer choroidal metastasis. Two cycles of TX (docetaxel + capecitabine) followed by two courses of GP (gemcitabine + cis-platinum) were applied as salvage chemotherapy. Metastases in his lung and bone remained stable. As for choroidal metastasis, a regimen of CDK4/6 inhibitor (Palbociclib) plus fulvestrant was recommended to the patient, which led to a good response. Notably, CDK4/6 inhibitor combined with endocrine therapy may be considered as an effective treatment for hormonal receptor-positive breast cancer patients with choroidal metastasis. We recommend that eye examination should not be neglected in breast cancer patients.Keywords: choroidal metastasis, male breast cancer, systemic therapy, CDK4/6 inhibitor, case report

Di Zhang, Yi Li, Heping Li, Weifeng Fu, Jing Zeng, Xi Zeng Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou City, Henan Province, People’s Republic of ChinaCorrespondence: Xi ZengDepartment of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Huiji District, Zhengzhou City, Henan Province, People’s Republic of China, Tel +861 359 250 5588, Email zengxikangfu@126.comPurpose: This study investigated the factors that influence the prognosis of swallowing function rehabilitation therapy in patients with dysphagia after medullary infarction.Patients and Methods: This retrospective study was conducted using the clinical data of 51 patients who were diagnosed with dysphagia after medullary infarction and hospitalized at our institution between January 2019 and January 2021. As per the water swallow test (WST) grade at 1 month after rehabilitation treatment, patients were classified into the good prognosis group and the poor prognosis group. Univariate analysis as well as univariate and multivariate logistic regression analysis were used to analyze factors that influence the prognosis of swallowing function rehabilitation therapy in patients with dysphagia after medullary infarction. Receiver operating characteristic (ROC) curves were then used to test the predictive ability of the significant parameters to predict the prognosis of the rehabilitation therapy in these patients.Results: Univariate analysis and univariate logistic regression analysis showed that previous stroke (odds ratio [OR] = 1.361), dysarthria (OR = 3.771), disease course (OR = 1.112), National Institutes of Health Stroke Scale (NIHSS) score at admission (OR = 2.596), and infarct site (OR = 11.071) were all significantly correlated with the prognosis of swallowing function rehabilitation therapy in patients with dysphagia after medullary infarction (P < 0.05). Multivariate logistic regression analysis showed that dysarthria (OR = 5.519, 95% confidence interval (CI) 1.413– 21.566), infarct site (OR = 18.634, 95% CI 1.696– 204.73), and the NIHSS score (OR = 1.001, 95% CI 1.536– 4.820) were independent influencing factors of the prognosis of swallowing function rehabilitation therapy in these patients. The ROC curve showed that the area under the curve for the combined prediction of the three indicators was 0.943.Conclusion: The NIHSS score, dysarthria, and infarct site are independent influencing factors for the prognosis of swallowing function rehabilitation therapy in patients with dysphagia after medullary infarction.Keywords: medullary infarction, dysphagia, rehabilitation, prognosis, influencing factors

Hao Ren,1,2,&ast; Jie Liu,1,3,&ast; Jiwei Zhang,4 Baixi Zhuang,5 Weiguo Fu,6 Danming Wu,7 Feng Wang,8 Yu Zhao,9 Pingfan Guo,10 Wei Bi,11 Shenming Wang,12 Wei Guo1,3 1Medical School of Chinese PLA, Beijing, 100853, People’s Republic of China; 2Department of Vascular Surgery, Dalian Municipal Central Hospital, Dalian, 116033, People’s Republic of China; 3Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China; 4Department of Vascular Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200120, People’s Republic of China; 5Department of Vascular Surgery, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100080, People’s Republic of China; 6Department of Vascular Surgery, Zhongshan Hospital Fudan University, Shanghai, 200032, People’s Republic of China; 7Department of Vascular Surgery, The People’s Hospital of Liaoning Province, Shenyang, 110016, People’s Republic of China; 8Department of Interventional Therapy, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, People’s Republic of China; 9Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400042, People’s Republic of China; 10Department of Vascular Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People’s Republic of China; 11Department of Vascular Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050073, People’s Republic of China; 12Department of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510055, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wei GuoDepartment of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, 100853, People’s Republic of ChinaTel +86-10-66938049Fax +86-10-66938149Email Guoweiplagh@sina.comObjective: To evaluate the long-term outcomes after drug-coated balloon (DCB) angioplasty dissection in patients with complex femoropopliteal artery disease.Methods: Two hundred patients with femoropopliteal peripheral artery disease were enrolled in the AcoArt I trial and randomly assigned to either the DCB or percutaneous transluminal angioplasty (PTA) group. A total of 86 patients with post-balloon angioplasty dissection were reanalyzed. The primary endpoint was clinically driven target lesion revascularization (CD-TLR) over five years. Kaplan–Meier curve estimates were used to evaluate the association between the treatment and CD-TLR. Interaction and stratified analyses were also performed.Results: Over five years, patients treated with DCB angioplasty demonstrated an acceptable effect with a numerically higher but not statistically significant rate of freedom from CD-TLR compared with those treated by PTA (Kaplan–Meier estimate of 77.6% vs 64.4%; log-rank P = 0.08). Among the patients who underwent TLR, the mean time from intervention to TLR in the DCB group was significantly prolonged compared to the PTA group (P < 0.001). The stratified analysis showed that the Rutherford classification played an interactive role in the association between the DCB angioplasty and low CD-TLR rate at five years. No significant difference in the all-cause mortality was found in the patients with post-balloon angioplasty dissection between the two treatment groups.Conclusion: The five-year follow-up outcomes of the post-balloon angioplasty dissection in the AcoArt I trial demonstrated that DCB angioplasty is more trustworthy than PTA, with a higher rate of freedom than CD-TLR and sustained improvement in clinical symptoms. However, the all-cause mortality rate in patients with femoropopliteal lesions is similar after both DCB angioplasty and PTA.Clinical Trial Registration: http://www.clinicaltrials.gov.Unique Identifier: NCT01850056.Keywords: balloon angioplasty, dissection, femoropopliteal artery disease, long-term outcomes, drug-coated balloon, percutaneous transluminal angioplasty