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Purpose: We explore a new approach to the study of cognitive effort involved in listening to speech by measuring the brain activity in a listener in relation to the brain activity in a speaker. We hypothesize that the strength of this brain-to-brain synchrony (coupling) reflects the magnitude of cognitive effort involved in verbal communication and includes both listening effort and speaking effort. We investigate whether interbrain synchrony is greater in native-to-native versus native-to-nonnative communication using functional near-infrared spectroscopy (fNIRS). Method: Two speakers participated, a native speaker of American English and a native speaker of Korean who spoke English as a second language. Each speaker was fitted with the fNIRS cap and told short stories. The native English speaker provided the English narratives, and the Korean speaker provided both the nonnative (accented) English and Korean narratives. In separate sessions, fNIRS data were obtained from seven English monolingual participants ages 20-24 years who listened to each speaker's stories. After listening to each story in native and nonnative English, they retold the content, and their transcripts and audio recordings were analyzed for comprehension and discourse fluency, measured in the number of hesitations and articulation rate. No story retellings were obtained for narratives in Korean (an incomprehensible language for English listeners). Utilizing fNIRS technique termed sequential scanning, we quantified the brain-to-brain synchronization in each speaker-listener dyad. Results: For native-to-native dyads, multiple brain regions associated with various linguistic and executive functions were activated. There was a weaker coupling for native-to-nonnative dyads, and only the brain regions associated with higher order cognitive processes and functions were synchronized. All listeners understood the content of all stories, but they hesitated significantly more when retelling stories told in accented English. The nonnative speaker hesitated significantly more often than the native speaker and had a significantly slower articulation rate. There was no brain-to-brain coupling during listening to Korean, indicating a break in communication when listeners failed to comprehend the speaker. Conclusions: We found that effortful speech processing decreased interbrain synchrony and delayed comprehension processes. The obtained brain-based and behavioral patterns are consistent with our proposal that cognitive effort in verbal communication pertains to both the listener and the speaker and that brain-to-brain synchrony can be an indicator of differences in their cumulative communicative effort.

Liubing Lan,1,2 Dandan Luo,1,2 Jianwen Lian,1 Lingna She,1,3 Bosen Zhang,1,3 Hua Zhong,1 Huaxian Wang,1 Heming Wu1 1Department of Prenatal Diagnostic Center, Meizhou People’s Hospital, Meizhou, People’s Republic of China; 2Department of Obstetrics, Meizhou People’s Hospital, Meizhou, People’s Republic of China; 3Department of Ultrasound, Meizhou People’s Hospital, Meizhou, People’s Republic of ChinaCorrespondence: Heming Wu, Department of Prenatal Diagnostic Center, Meizhou People’s Hospital, Meizhou, People’s Republic of China, Email wuheming1986@126.comObjective: Chromosomal microarray analysis (CMA) is a first-line test to assess the genetic etiology of fetal ultrasound abnormalities. The aim of this study was to evaluate the effectiveness of CMA in detecting chromosomal abnormalities in fetuses with ultrasound abnormalities, including structural abnormalities and non-structural abnormalities.Methods: A retrospective study was conducted on 368 fetuses with abnormal ultrasound who received interventional prenatal diagnosis at Meizhou People’s Hospital from October 2022 to December 2023. Samples of villi, amniotic fluid, and umbilical cord blood were collected according to different gestational weeks, and karyotype and CMA analyses were performed. The detection rate of chromosomal abnormalities in different ultrasonic abnormalities was analyzed.Results: There were 368 fetuses with abnormal ultrasound, including 114 (31.0%) with structural abnormalities, 225 (61.1%) with non-structural abnormalities, and 29 (7.9%) with structural combined with non-structural abnormalities. The detection rate of aneuploidy and pathogenic (P)/likely pathogenic (LP) copy number variations (CNVs) of CMA in fetuses with structural abnormalities was 5.26% (6/114), the detection rate of karyotype was 2.63% (3/114), and the additional diagnosis rate of CMA was 2.63%. In the fetuses with ultrasonic non-structural abnormalities, the detection rate of karyotype was 6.22% (14/225), the detection rate of aneuploidy and P/LP CNVs in fetuses with ultrasonic structural abnormalities was 9.33% (21/225), and the additional diagnosis rate of CMA was 3.11%. There was no significant difference in chromosome abnormality detection rate of CMA among structural abnormality, non-structural abnormality, and structural abnormality combined with non-structural abnormality groups (5.3%, 9.3%, and 13.8%, p = 0.241), also among multiple ultrasonic abnormality and single ultrasonic abnormality groups (14.8%, and 7.3%, p = 0.105).Conclusion: CMA can significantly improve the detection rate of genetic abnormalities in prenatal diagnosis of ultrasonic abnormal fetuses compared with karyotype analysis. CMA is a more effective tool than karyotyping alone in detecting chromosomal abnormalities in fetuses with ultrasound abnormalities.Keywords: chromosomal microarray analysis, copy number variation, abnormal ultrasound fetus, prenatal diagnosis

Xiyi Wang,1 Jing Shao,2 Aozhou Weng,1 Jiaqi Lian,1 Fule Weng,1 Qiong Fang,1 Yun Hu1 1School of Nursing, Shanghai Jiao Tong University, Shanghai, 200025, People’s Republic of China; 2Institute of Nursing Research and Department of Nursing of Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, People’s Republic of ChinaCorrespondence: Yun Hu, School of Nursing, Shanghai Jiao Tong University, Shanghai, 200025, People’s Republic of China, Email huyunsy@shsmu.edu.cnBackground: The nursing workforce faces substantial challenges, particularly in the aftermath of the COVID-19 era. Developing an effective strategy for workforce maintenance and the strategic deployment of nurses is crucial.Purpose: This study aimed to explore and categorize nurses’ personality traits, with a focus on analyzing differences in their perceptions of the nursing work environment.Participants and Methods: Between January 2023 and February 2023, a multi-center cross-sectional study was carried out involving nurses from 12 tertiary hospitals actively engaged in frontline COVID-19 response duties. Through cluster sampling, surveys were distributed among eligible nursing staff, comprising a general information questionnaire, the Chinese Big Five Personality Questionnaire-Short Form, subjective evaluations of emergency nursing management, and the Chinese Nursing Work Environment Scale for Public Health Emergencies. Various statistical analyses, such as descriptive analysis, cluster analysis, non-parametric tests, and general linear model analysis, were employed to investigate the correlation between personality types and the perception of nursing work environments.Results: The analysis encompassed 1059 valid questionnaires, reflecting the experiences of frontline nurses. The majority of these nurses possessed 1– 5 years of experience, held junior professional titles, volunteered for their roles, and served as attending nurses. Categorization based on personality traits revealed three groups: resilient (35.60%), ordinary (16.15%), and distressed (48.25%) types. Significantly distinct perceptions of nursing work environments emerged among these categories, with resilient and ordinary types expressing notably higher satisfaction compared to the distressed group (H value = 256.487, p < 0.001).Conclusion: This study illustrates the connection between nurses’ perceived working environment and their personality traits. Nursing managers should factor in nurses’ personality traits when choosing and deploying frontline responders during public health emergencies. Prioritizing resilient-type nurses and crafting a supportive work environment that aligns with nurses’ characteristics is indispensable for an effective emergency response.Keywords: workforce management, cross-sectional studies, human resources, health system

Haonan Guan,&ast; Guoyou Zhang,&ast; Qiqi Li, Jie Lian, Zhaoyang Dong, Lian Zhu, Kaiyan Xiao Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Kaiyan Xiao, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, People’s Republic of China, Tel +86 021 23271699, Fax +86 021 63136856, Email xky7026@163.comAbstract: Xanthomas are well-circumscribed skin lesions that are commonly seen in patients with familial hypercholesterolemia (FH). The aim of this report is to present a rare case of multiple large tuberous and tendinous xanthomas. A 17-year-old female patient in this report presented with multiple asymptomatic and papulo-nodular masses in both sides of palms, elbows, buttocks, knees, and Achilles tendons. Surgical removal of the masses was carried out in combination with lipid-lowering therapy. A following up of 3 months showed all wounds were healing well, and no recurrence of masses was observed. Therefore, for patients with xanthomas related with familial hypercholesterolaemia, lipid-lowering therapy has reportedly reduced the size of masses, but surgical treatment may be essential for large xanthomas caused pain or limitation of daily activities.Keywords: soft-tissue tumors, lipoprotein, atorvastatin, foam cells, lipid-lowering therapy

Benjie Xu,&ast; Jiahao Zhu,&ast; Ren Wang, Xiangyi Pang, Xin Wang, Jie Lian, Haibo Lu Department of Outpatient Chemotherapy, Harbin Medical University Cancer Hospital, Harbin, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jie Lian; Haibo Lu, Harbin Medical University Cancer Hospital, No. 150 Haping Road, Nangang District, Harbin, Heilongjiang Province, 150081, People’s Republic of China, Tel +86 451 85718309, Email lianjie@hrbmu.edu.cn; luhaibo@hrbmu.edu.cnPurpose: The Nutritional Prognostic Score (NPS) is a composite indicator that effectively reflects the preoperative nutritional and inflammation status of patients. Its prognostic value has been extensively confirmed in various types of tumors. Our study aims to investigate the clinical implications of the NPS in the postoperative patients with cholangiocarcinoma (CCA).Patients and Methods: Data on clinicopathological characteristics were collected from CCA patients who underwent radical surgery between 2014 and 2019 at Harbin Medical University Cancer Hospital. NPS was calculated using relevant indicators to categorize the patients, and association of NPS with clinicopathological characteristics and survival outcomes were analyzed. To assess differences in survival rates between different groups, we utilized the Kaplan-Meier method. Independent prognostic risk factors were identified by Cox regression analysis. A CONomogram was created, and its accuracy in survival prediction was evaluated using receiver operating characteristic (ROC) curves. Independent verification was conducted in the validation group.Results: For this study, a cohort of 232 patients was enlisted and subsequently divided into training group (N=162) and validation group (N=70). An evident correlation was detected between NPS and preoperative malnutrition. Patients with higher NPS exhibited a worse overall survival (OS), with 5-year OS rates of 79.1%, 33.1%, and 10.6%. Multivariate analysis revealed that NPS was an independent risk factor for OS in resected CCA patients (P< 0.001). The NPS-based Nomogram was developed to accurately assess the risk of patients.Conclusion: The NPS was identified as a significant risk factor that impacts the prognosis of patients with resected CCA. In order to improve prognosis management, the NPS-based Nomogram has been demonstrated to be a precise and efficient tool.Keywords: Naples prognostic score, cholangiocarcinoma, nomogram, overall survival, real-world experience

Yilihamu Abulitifu,1 Jiangshan Lian,2 Munire Adilijiang,1 Lan Liu,1 Fengcong Zhao,1 Wen Qian,1 Yongping Zhang1 1Department of Infectious Diseases, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People’s Republic of China; 2Department of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of ChinaCorrespondence: Yongping Zhang, Department of Infectious Diseases, People’s Hospital of Xinjiang Uygur Autonomous Region, No. 91, Tianchi Road, Urumqi, Xinjiang, 830001, People’s Republic of China, Tel +86 13999233386, Fax +86 991 8563585, Email zhangyongping2@126.comPurpose: Patients with cirrhosis from genotype 3 (GT3) hepatitis C virus (HCV) infection are difficult to cure. This study investigated the effectiveness and safety of sofosbuvir-velpatasvir (SOF/VEL) with and without ribavirin (RBV) in patients with GT3 HCV-infection-related cirrhosis from Xinjiang, China.Patients and Methods: This study included 33 patients with GT3 HCV infected cirrhosis, who were treated with either SOF/VEL+RBV for 12 weeks (n = 27) or SOF/VEL alone for 24 weeks (n = 6) between January 2019 and June 2021. The primary endpoint was a sustained virological response at 12 weeks (SVR12), post-treatment. Secondary endpoints included changes from baseline in Child-Pugh-Turcotte scores, clinical results, hepatic-encephalopathy status, ascites, and gastrointestinal bleeding at 12 weeks, post-treatment.Results: Out of the 33 patients, 18 (54.6%) were diagnosed with GT3a, 15 (45.4%) with GT3b, 16 (48.5%) with compensated cirrhosis, and 17 (51.5%) with decompensated cirrhosis. SVR12 was 87.9% (compensated cirrhosis: 93.8%, decompensated cirrhosis: 82.4%). The Child-Pugh-Turcotte scores improved at 12 weeks (p < 0.05). Total bilirubin, albumin, and alanine transaminase levels, as well as hepatic-encephalopathy were significantly improved among patients with compensated and decompensated cirrhosis (p < 0.05). The blood cell count and serum creatinine levels did not deteriorate.Conclusion: SOF/VEL, with and without RBV, was effective, safe, and well-tolerated as a treatment for GT3 HCV associated cirrhosis.Keywords: hepatitis C, genotype 3, cirrhosis, sofosbuvir-velpatasvir, ribavirin

Jing Zhou,1 Miao Fu,2 Dehe Zhang,1 Yejin Xu,1 Jiangshan Lian,3 Hanglu Xu,1 Yang Zhang,1 Haijun Chen1 1Department of Infectious Disease, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, 321000, People’s Republic of China; 2Department of Clinical Laboratory, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, 321000, People’s Republic of China; 3State 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, Department of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People’s Republic of ChinaCorrespondence: Haijun Chen, Department of Infectious Disease, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, 365 Renmin East Road, Jinhua, Zhejiang, 32100, People’s Republic of China, Email jhchenhaijun@sina.comBackground: Although individuals infected with HIV for the first time manifest a series of acute syndromes, most patients show mild or no symptoms, which complicates the initial clinical diagnosis. Early diagnosis is important for effective prevention and management of patients. Metagenomic next-generation sequencing technology (mNGS) can rapidly detect a wide range of pathogenic microorganisms, even in atypical cases. However, to date, few studies have reported the application of mNGS to diagnose acute HIV infection with aseptic meningitis.Case Presentation: A 38-year-old man was admitted to the Department of Infectious Diseases due to repeated fever, headache, and scattered rashes on his limbs. Routine blood analysis revealed elevated absolute lymphocytes and monocytes. Moreover, monocytes were found to be significantly increased following a lumbar puncture and cerebrospinal fluid detection. mNGS results revealed the presence of the human immunodeficiency virus (HIV-1), with HIV RNA of 910 copies/mL in his cerebrospinal fluid. The HIV antigen/antibody test was negative. According to a study by Fie Big et al, a clear diagnosis of acute HIV infection at Fiebig stage I. The patient’s condition improved after treatment, and he was prescribed antiretroviral therapy (ART) after discharge.Conclusion: Aseptic meningitis is easily misdiagnosed during the initial stages of acute HIV infection. mNGS can be used to identify the pathogen early, rapidly, and accurately, thereby improving the treatment of acute HIV infections.Keywords: acute HIV infection, aseptic meningitis, Fiebig stage I, mNGS

Ye Tao,1,&ast; Xiaoli Li,2,&ast; Guang Yang,1 Lingling Wang,1 Junsong Lian,3 Zheng Chang1 1Central Medical District of Chinese PLA General Hospital, Beijing, People’s Republic of China; 2The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China; 3The Second Medical Center of Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Junsong LianThe Second Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, People’s Republic of ChinaEmail 148093109@qq.comZheng ChangCentral Medical District of Chinese PLA General Hospital Email cz780228@163.comObjective: This study aimed to explore the association between obstructive sleep apnea (OSA) and diabetes in a Chinese population based on a cross-sectional analysis of patient data from a large tertiary care hospital in China and analyses whether there are any gender differences in this association.Methods: A total of 794 (615 men and 179 women) inpatients were involved in this study. Polysomnography (PSG) was used to diagnose OSA, and overnight PSG testing was performed on each subject included in this study. All study subjects were also diagnosed with whether they had diabetes by an endocrinologist in the hospital.Results: After adjusting for sex, age, smoking status, alcohol consumption and body mass index (BMI) groups, the results showed that the number of apnea–hypopnea index (AHI) events was a risk factor for diabetes, with a 9% (95% CI: 1– 17%) increase in the risk of diabetes per unit increase, while subjects with higher (per unit increase) lowest oxygen saturation value monitored during the subject’s sleep (LSaO2) with a 13% (95% CI: 4– 22%) decrease in the risk of diabetes. Stratified analyses by gender, after adjustment, in men, OSA and its associated monitoring indicators were statistically significantly associated with diabetes [OR for severe OSA was 2.269 (95% CI: 1.164, 4.425), P=0.016, and OR for severe hypoxemia was 2.228 (95% CI: 1.145, 4.334), P=0.018], while not in women.Conclusion: Our study found a significant association between OSA and diabetes in a Chinese clinical-based population as well as a dose–response relationship between the severity of AHI and severe hypoxemia (LSaO2 < 80%) and blood glucose, the association has gender difference and was only present significant association in men, which demonstrated that diabetes prevention and blood glucose screening and management should be enhanced for Chinese men with OSA.Keywords: obstructive sleep apnea, diabetes, gender differences, glucose, Chinese

Weifeng Xu,* Haiwang Guan,* Da Gao, Zicheng Wang, Yanna Ba, Hao Yang, Wenjun Shen, Jiangfang Lian, Jianqing Zhou Department of Cardiology, Ningbo Medical Center Lihuili Hospital, Ningbo 315040, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jiangfang Lian; Jianqing ZhouDepartment of Cardiology, Ningbo Medical Center Lihuili Hospital, Ningbo, People’s Republic of ChinaTel +86 13566305960; +86 13780084909Email hjmpin@163.com; 741710363@qq.comIntroduction: Lipoprotein(a) (Lp(a)) is associated with the severity of coronary lesions evaluated using Syntax score in patients with stable coronary artery disease (CAD). However, the effect of low-density lipoprotein cholesterol (LDL-C) levels on the association of Lp(a) levels with Syntax score remains unclear.Methods: A total of 646 patients with stable CAD were enrolled in the present study. Lp(a) levels were measured with an AU5800 Chemistry Analyzer. Syntax scores were calculated by two advanced interventional cardiologists. SPSS 22.0 was used for statistical analyses.Results: The concentration of Lp(a) ranged from 1 to 192 mg/dL. Pearson’s correlation analysis showed a positive correlation between Syntax score and the level of Lp(a) (r = 0.108, p = 0.006). The LDL-C ≥ 100 mg/dL group presented with a higher Lp(a) level, 16 (9– 29) vs 13 (7– 24). Pearson’s correlation analysis identified a correlation between Lp(a) level and Syntax score (r = 0.249, p < 0.001) only in the LDL-C ≥ 100 mg/dL group. Multivariate logistic regression analysis revealed the positive predictive value of an Lp(a) level > 30 mg/dL for a Syntax score ≥ 23 only in the LDL-C ≥ 100 mg/dL group, adjusted odds ratio 2.895, p = 0.010. A receiver operating characteristic curve analysis confirmed the predictive value of Lp(a) levels for a Syntax score ≥ 23 in the LDL-C ≥ 100 mg/dL group with a cutoff value for Lp(a) > 30 mg/dL.Discussion: The association between Lp(a) level and Syntax score was only maintained in the LDL-C ≥ 100 mg/dL group. An Lp(a) level > 30 mg/dL was an independent predictor of a Syntax score ≥ 23 only in the LDL-C ≥ 100 mg/dL group. The effect of LDL-C levels on the association of Lp(a) levels with Syntax score requires further investigations.Keywords: lipoprotein(a), low-density lipoprotein cholesterol, stable coronary artery disease, syntax score

Hexin Lin,1,2,* Jiabian Lian,3,4,* Lu Xia,4,5,* Guoxian Guan,2 Jun You1,4 1Department of Gastrointestinal Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, People’s Republic of China; 2Department of Colorectal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China; 3Department of Laboratory Medicine, Xiamen Key Laboratory of Genetic Testing, The First Affiliated Hospital of Xiamen University, Xiamen, People’s Republic of China; 4School of Clinical Medicine, Fujian Medical University, Fuzhou, People’s Republic of China; 5Laboratory of Cancer Center, The First Affiliated Hospital of Xiamen University, Xiamen, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jun YouDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, 55 Zhenhai Road, Xiamen, Fujian 361000, People’s Republic of ChinaTel +86-13906051681Email junyou_fahxm@163.comBackground: Chromobox 3 (CBX3) is a member of the chromobox family proteins, which plays a critical role in tumor progression, but the exact function of CBX3 in gastric cancer remains unknown. The current research mainly investigates the underlying mechanisms and clinical value of CBX3 in gastric cancer.Methods: Gene expression cohorts from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) were analyzed to assess the effect of CBX3 in gastric cancer. CBX3 expression was further determined by immunohistochemistry (IHC). The function of CBX3 on proliferation, migration and the cell cycle was explored via colony-forming, cell cycle and transwell assays, respectively. Moreover, RNA sequencing (RNA-seq) in AGS cells and two cohorts was utilized to explore the specific mechanism of CBX3.Results: CBX3 expression was upregulated in human gastric cancer tissues and the expression level was closely associated with adverse signs. Knockdown of CBX3 in gastric cancer cells significantly inhibited the malignant phenotype. In addition, RNA-seq analysis revealed that CBX3 regulates genes related to the cell cycle, mismatch repair and immune-related pathways. Furthermore, the expression of CBX3 was significantly and inversely related to the abundance of tumor-infiltrating lymphocytes (TILs), PDCD1 and PDCD1LG2 expression and immunotherapy responses. Moreover, CBX3 influences the effectiveness of chemotherapy, thereby impacting the prognosis of gastric cancer patients.Conclusion: CBX3 contributes to gastric cancer progression and is associated with chemotherapy and immunotherapy response. CBX3 may serve as a new diagnostic biomarker and potential target for immunotherapy and chemotherapy in gastric cancer.Keywords: chromobox 3, gastric cancer, tumorigenesis, survival, chemotherapy, immunotherapy

Hongwei Li,1,* Weili Wang,1,* Xiaotang Yang,1 Jianhong Lian,2 Shuangping Zhang,3 Jianzhong Cao,1 Xiaqin Zhang,1 Xin Song,1 Sufang Jia,1 Ruiqi Xue4 1Department of Radiotherapy, Shanxi Medical University, Shanxi Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China; 2Department of Chemotherapy, Shanxi Medical University, Shanxi Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China; 3Department of Surgery, Shanxi Medical University, Shanxi Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China; 4Shanxi Medical University, Shanxi Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiaotang YangDepartment of Radiology, Shanxi Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of ChinaTel +86 351-4651153Email yangxt210@126.comPurpose: Several studies have explored the correlation between the neutrophil-to-lymphocyte ratio (NLR) and the prognosis of patients with lung cancer. However, little is known about the correlation between the pretreatment NLR and the prognosis of patients with brain metastases from non–small cell lung cancer (NSCLC)-harboring mutations in the epidermal growth factor receptor (EGFR) gene. We sought to evaluate the predictive values in brain metastasis from lung adenocarcinoma with EGFR mutations.Methods: We retrospectively examined 133 patients with brain metastases (BMs) from lung adenocarcinoma with EGFR mutations. NLR was calculated using N/L, where N and L, respectively, refer to peripheral blood neutrophil (N) and lymphocyte (L) counts. The cut-off value of NLR was assessed by the area under the curve (AUC). The Log rank test and Cox proportional hazard model were used to confirm the impact of NLR and other variables on survival.Results: An NLR value equal to or less than 2.99 was associated with prolonged survival in this cohort of patients in both variable and multivariable analysis.Conclusion: We concluded that NLR is an independent prognostic factor in BMs from lung adenocarcinoma with EGFR mutations. This could serve as a useful prognostic biomarker and could be incorporated in the clinical prognostic index specific to patients with BMs.Keywords: neutrophil-to-lymphocyte ratio, brain metastases, non–small cell lung cancer, EGFR mutations

We evaluated the degree to which relative growth rate (RGR) of saplings and large trees is related to seven functional traits that describe physiological behavior and soil environmental factors related to topography and fertility for 57 subtropical tree species in Dinghushan, China. The mean values of functional traits and soil environmental factors for each species that were related to RGR varied with ontogenetic stage. Sapling RGR showed greater relationships with functional traits than large-tree RGR, whereas large-tree RGR was more associated with soil environment than was sapling RGR. The strongest single predictors of RGR were wood density for saplings and slope aspect for large trees. The stepwise regression model for large trees accounted for a larger proportion of variability (R 2 = 0.95) in RGR than the model for saplings (R 2 = 0.55). Functional diversity analysis revealed that the process of habitat filtering likely contributes to the substantial changes in regulation of RGR as communities transition from saplings to large trees. © 2014 Springer-Verlag Berlin Heidelberg.