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It is well-established that the lack of accurate diagnostic modalities for prostate cancer (PCa) leads to overdiagnosis and overtreatments. Accordingly, this study aimed to assess the value of urine-derived exosomal prostate-specific membrane antigen (PSMA) as a biomarker for the diagnosis of PCa and clinically significant prostate cancer (csPCa).A total of 284 urine samples were collected from patients after the digital rectal examination (DRE). Urinary exosomes were extracted using commercial kits, and urine-derived exosomal PSMA was determined via enzyme-linked immunosorbent assay (ELISA). Evaluation of diagnostic accuracy of PSMA was performed via receiver operating characteristic (ROC) analysis, decision curve analysis (DCA), and waterfall plots.We found that urine-derived exosomal PSMA was significantly higher in PCa and csPCa than in benign prostatic hyperplasia (BPH) and BPH + non-aggressive prostate cancer (naPCa) groups (P 0.001). Furthermore, the urine-derived exosome PSMA yielded area under the ROC curve (AUC) values of 0.876 and 0.826 for detecting PCa and csPCa, respectively, suggesting better performance than traditional clinical biomarkers. Besides, when the cutoff value used corresponded to a sensitivity of 95%, urine-derived exosomal PSMA could avoid unnecessary biopsies in 41.2% of cases and missed only 0.7% of csPCa cases.Urine-derived exosomal PSMA exhibits a good diagnostic yield for detecting PCa and csPCa. Findings of the present study provide the foothold for future studies on cancer management and research in this patient population.

Increased plasma homocysteine (Hcy) levels have been widely documented in patients with overt hypothyroidism; however, the significance of Hcy level changes in patients with subclinical hypothyroidism (SCH) remains controversial. The aim of this meta-analysis was to determine the Hcy status in patients with SCH compared with euthyroid subjects. We searched PubMed, Embase, and Cochrane Library databases prior to December 2019 to identify eligible studies and assessed the quality of selected studies using the Newcastle-Ottawa Quality Assessment Scale. Publication bias was evaluated by Begg’s test and Egger’s test. Meta-regression analysis was conducted to investigate the source of heterogeneity. A likely source of heterogeneity was the year of the study. All statistical analyses were performed with RevMan 5.3 and Stata 12.0 software. Our meta-analysis of twelve observational studies with 684 patients showed that those with SCH aged between 18 and 65 years old were associated with a slightly increased plasma Hcy level compared with euthyroid controls. The pooled result of the weighted mean difference (WMD) of increased tHcy levels was 1.16 μmol/l (95% CI: 0.51, 1.82; p=0.0005). The Hcy level in patients with SCH aged between 18 and 65 years old is significantly increased compared to euthyroid controls.

Using Fiber as the based material for photocatalyst particles is favorable for their recovery, thereby avoiding the photocatalyst particles cause secondary pollution to water environment. In this work, the AgBr and Ag3PO4 photocatalyst particles were loaded onto the surface of chitosan fiber (CF) via chelation and in situ anion-exchange method. The photocatalytic results illustrated that the AgBr/Ag3PO4/CF composites displayed the best photocatalytic performance when the mass ratio of Ag3PO4 and AgBr onto the CF was approximately 1:0.15, their degradation rate can reach 98.1% for the methyl orange (MO) solution, this value far exceeded those of pure CF, AgBr/CF composites, and Ag3PO4/CF composites. Besides, the AgBr/Ag3PO4/CF composites also shown excellent durability, after the fifth cycle, they still maintained a decolorization rate of 86.4% for the MO solution, while the Ag3PO4/CF composites maintained a decolorization rate of only 70.7%. Based on these results, we consider that the AgBr/Ag3PO4/CF composites have high practical interest in environmental remediation.

Long‐term abuse of ketamine causes ketamine‐induced cystitis. The functional alterations of bladder epithelial cells in microenvironment during cystitis remain poorly understood. Here, we explored extracellular vesicles (EV) alteration in ketamine‐induced toxicity. To simulate the high‐concentration ketamine environment in vivo, we established an in vitro model of high ketamine using human uroepithelial cells (SV‐HUC‐1). Cell viability and proliferation were assessed to evaluate the effects of various concentrations (0, 0.25, 0.5, 1, 2, 4 and 8 mmol/L) of ketamine on SV‐HUC‐1 cells. The cell supernatant cultured at a concentration (0, 1, 2, 4 mmol/L) of ketamine was selected for EV extraction and identified. Subsequently, we assessed different groups (ketamine, ketamine plus EV blocker, EV, EV plus extracellular vesicles blocker) of oxidative stress and expression of inflammation. Last, luciferase reporter assay was performed to study the transcriptional regulation of EV on the NF‐kB and P38 pathway. The results of our study suggested that treatment with 0, 1, 2 or 4 mmol/L ketamine altered the morphology and secretion capacity of extracellular vesicles. As the concentration of ketamine increased, the average particle size of EV decreased, but the crest size, particle concentration and EV protein increased. Moreover, after the addition of EV blocker, EV secreted at different concentrations were blocked outside the cell membrane, and the degree of oxidative stress decreased. Our study provided evidence that ketamine alters the secretion of EV by directly stimulating cells in inflammation microenvironment and EV play significant roles in intercellular signal communication and the formation of KIC.EV

Objective: The present study aimed to evaluate the association between hematocrit (HCT) levels and all-cause mortality in geriatric hip fractures. Methods: Older adult patients with hip fractures were screened between January 2015 and September 2019. The demographic and clinical characteristics of these patients were collected. Linear and nonlinear multivariate Cox regression models were used to identify the association between HCT levels and mortality. Analyses were performed using EmpowerStats and the R software. Results: A total of 2589 patients were included in this study. The mean follow-up period was 38.94 months. Eight hundred and seventy-five (33.8%) patients died due to all-cause mortality. Linear multivariate Cox regression models showed that HCT level was associated with mortality (hazard ratio [HR] = 0.97, 95% confidence interval [CI]: 0.96–0.99, p = 0.0002) after adjusting for confounding factors. However, the linear association was unstable and nonlinearity was identified. A HCT level of 28% was the inflection point for prediction. A HCT level of 28% was not a risk factor for mortality (HR = 0.99, 95% CI: 0.97–1.01, p = 0.3792). We found that the nonlinear association was very stable in the propensity score-matching sensitivity analysis. Conclusions: The HCT level was nonlinearly associated with mortality in geriatric hip fracture patients and could be considered a predictor of mortality in these patients. Registration: ChiCTR2200057323.

OBJECTIVE Little is known about the efficacy of using artificial intelligence to identify laryngeal carcinoma from images of vocal lesions taken in different hospitals with multiple laryngoscope systems. This multicenter study was aimed to establish an artificial intelligence system and provide a reliable auxiliary tool to screen for laryngeal carcinoma. Study Design: Multicentre case-control study Setting: Six tertiary care centers Participants: The laryngoscopy images were collected from 2179 patients with vocal lesions. Outcome Measures: An automatic detection system of laryngeal carcinoma was established based on Faster R-CNN, which was used to distinguish vocal malignant and benign lesions in 2179 laryngoscopy images acquired from 6 hospitals with 5 types of laryngoscopy systems. Pathology was the gold standard to identify malignant and benign vocal lesions. Results: Among 89 cases of the malignant group, the classifier was able to evaluate the laryngeal carcinoma in 66 patients (74.16%, sensitivity), while the classifier was able to assess the benign laryngeal lesion in 503 cases among 640 cases of the benign group (78.59%, specificity). Furthermore, the CNN-based classifier achieved an overall accuracy of 78.05% with a 95.63% negative prediction for the testing dataset. Conclusion: This automatic diagnostic system has the potential to assist clinical laryngeal carcinoma diagnosis, which may improve and standardize the diagnostic capacity of endoscopists using different laryngoscopes.

Background: Lung cancer is the main cause of cancer-­related deaths worldwide, and the overall 5-year survival rate of non-small cell lung cancer (NSCLC) remained low. ­MicroRNAs had been confirmed to be an important regulator in tumor progression, and they could serve as either tumor promoters or suppressors in NSCLC. Objectives: To identify the novel cancer-specific biomarkers for NSCLC patients, which may be useful to monitor tumor progression and improve NSCLC patients’ survival. Method: The expression profile of miR-421 was analyzed in NSCLC samples using public datasets, including The Cancer Genome Atlas and GSE102286. The expression level of miR-421 was detected by reverse transcription-polymerase chain reaction. Cell proliferation and cell cycle were detected by Cell Counting Kit assay, flow cytometry assay, respectively. Kyoto Encyclopedia of Genes and Genomes analysis were applied to determine the biological roles of miR-421, based on the online DAVID system. Statistical comparisons between groups of normalized data were performed using t test or Mann-Whitney U test according to the test condition. Results: In this study, we focused on exploring the roles of miR-421 in NSCLC prognosis and growth. The present study for the first time showed that miR-421 was overexpressed in NSCLC and associated with a shorter overall survival time of patients with NSCLC. Bioinformatics analysis revealed miR-421 was involved in transcription, cell cycle, and insulin signaling pathway regulation. Furthermore, a gain of function assay showed that overexpression of miR-421 could promote NSCLC cell proliferation and cell cycle progression. Conclusions: Our findings suggest that miR-421 might be a promising prognostic and therapeutic target for NSCLC.

Objective To analyze the safety and efficacy of indocyanine green (ICG) fluorescence real-time imaging technology and digital ultrasound guidance technology for laparoscopic liver resection (LLR) of HCC at special location. Methods Twenty-four patients with hepatocellular carcinoma at special location were enrolled and equally divided into two groups: ICG fluorescent group received intravenous indocyanine green injection 2-3 days before operation, and then did fluorescent laparoscopic liver resection, while the normal control group were given general laparoscopic liver resection; meanwhile, the intraoperative and postoperative indexes including operative time, intraoperative bleeding, complications and length of hospital stay were analyzed to judge the clinical feasibility. Results Except 1 case treated with laparoscopic radiofrequency ablation because of the old age and illness factors and 1 case for conversion to laparotomy, all the rest were treated by LLR with ICG real-time images combined guidance of ultrasound in ICG fluorescent group, and all the patients but one who underwent conversion to laparotomy received general laparoscopic resection in the normal control group. There was no statistical difference between the two groups in terms of operative time [(215.0±35.8)min vs. (208.0±18.6)min, P=0.554]. As compared with the normal control group, the intraoperative bleeding volume significantly reduced [(255.0±19.4)ml vs. (230.0±17.5)ml, P=0.0032], and the hospital stay significantly shortened [(8.9±1.2)d vs. (10.6±1.6)d, P=0.0076], but there was no statistical differences between the two groups in R0 cutting edge and complications (P=0.308; P=0.173). Conclusion Laparoscopic liver resection using ICG fluorescence real-time imaging combined the digital imaging technology under ultrasound guidance is a safe and effective treatment approach for HCC at the special position, being worthy of further promotion clinically. DOI: 10.11855/j.issn.0577-7402.2019.04.12

Breast cancer is a major cause of morbidity worldwide and first-degree relatives of breast cancer survivors have a significantly higher risk of breast cancer that can be reduced by altering controllable risk factors. This study examined protective behavioral strategies used to cope with the risk in female first-degree relatives based on descriptions of their experiences, as well as their reason(s) for choosing a particular coping strategy.A total of 25 first-degree relatives of breast cancer survivors in 13 families were recruited for this descriptive qualitative study. Data were collected between January and November 2020 through individual interviews, and a thematic analysis was performed using MAXQDA software.Three themes under an overarching theme of 'competition with breast cancer risk' were identified: (1) protective behavioral strategies for coping with breast cancer risk (four coping types); (2) barriers and facilitators for behavior change (five unfavorable and favorable factors related to the type of coping); and (3) significant determinants of coping strategy types. Based on these three themes, we developed a Personal restrictions, Exposure hazards, Adverse circumstances, Coping ability, Endorsement from social network, and Significant determinants ('PEACE-S') scale model of first-degree relatives' strategies for coping with breast cancer risk.First-degree relatives present different risk coping strategies that are shaped by individual and external factors and specific determinants. Our results provide insights that can help healthcare professionals design targeted interventions based on first-degree relatives' individual circumstances to mitigate breast cancer risk in this group through the adoption of healthy lifestyle choices.

Purpose Breast cancer affects survivors and their first-degree relatives. They face breast cancer together as a unit. This study aimed to explore the mutual support of breast cancer survivors and their first-degree relatives in their joint coping with breast cancer. Methods A qualitative case study with purposeful sampling was conducted. Ten breast cancer survivors and 21 of their first-degree relatives were recruited for in-depth interviews. Data were analyzed by thematic analysis using MAXQDA software. Results Three themes were extracted under the overarching theme “a shared journey to a better future”: 1. “Mutual support is needed as we are in the same boat,” suggesting mutual support in responding to breast cancer; 2. “We experience stormy and windy weather during our journey,” emphasizing challenges encountered in providing support; and 3. “Sunny and breezy days are a gift for both of us,” indicating they perceived reciprocity during the process of mutual support. Conclusions Mutual support was an important feature of breast cancer survivors and first-degree relatives coping with breast cancer and beneficial to both groups. However, significant challenges in supporting each other were reported, indicating the necessity of external support in coping with breast cancer. Health professionals should not ignore first-degree relatives of breast cancer survivors, and need to support both of these groups.

To analyze the changes in the gene expression profile of T cells in CML patients after TCRζ up-regulation expression, and to explore the molecular mechanism of T cell reactivation after transgenic up-regulation of TCRζ.The peripheral blood mononuclear cells(PBMCs) from 3 newly untreated chronic-stage CML patients were collected, and the CD3A total of 2248 differentially-expressed genes were obtained, including 553 up-regulated genes and 1695 down-regulated genes in experimental group as compared with those in control group (P0.05) . The GO and KEGG enrichment analyses showed that differentially expressed genes involved in the biological processes related to T cell immune function, such as TCR signaling pathway, T cell proliferation and activation. Some of core genes involved in promoting the TCR signaling pathway, T cell proliferation, activation and apoptosis pathways were significantly up-regulated, while some core genes involved in inhibiting T cell activation were significantly down-regulated.The molecular mechanism of the significantly improved T cell activation and proliferation ability in CML patients after TCRζ up-regulation may be related to the differential transcripts mediated signaling pathways of T cell activation, proliferation and apoptosis.慢性粒细胞白血病T细胞TCRζ链表达上调后全基因表达谱改变的分析.分析表达上调TCRζ后慢性粒细胞白血病（CML）患者T细胞基因表达谱的变化特点，探讨转基因上调TCRζ后T细胞活性恢复的分子机制.收集3例初发未治疗慢性期CML患者的外周血单个核细胞(PBMCs)，利用MACS法分选获得CD3共筛选出2 248个差异表达基因，其中553个基因表达上调，1 695个基因表达下调（P0.05）；GO功能注释分析和KEGG通路的富集分析结果显示，参与T细胞免疫功能相关的生物学过程，如TCR信号通路、T细胞增殖和活化等的差异表达基因发生显著富集；TCR信号通路，T细胞增殖、活化和凋亡通路中促进T细胞增殖活化的部分核心基因表达明显上调，而抑制T细胞活化的部分核心基因表达则明显下调.上调TCRζ后CML患者T细胞的活化和增殖能力明显改善，其分子机制可能与促进T细胞活化增殖的相关基因明显上调，抑制T细胞活化和促进细胞凋亡相关基因表达的下调有关.

Breast cancer-related lymphedema (BCRL) is a major long-term complication for post-surgery breast cancer survivors. Although several risk factors have been identified, lifestyle characteristics have been neglected in previous studies. The aim of this study was to develop and validate a nomogram for estimating this population’s risk of developing lymphedema, taking into consideration their demographic, clinical, and personal lifestyle behaviors. In a cross-sectional study, we collected data from 775 post-operative breast cancer survivors who had attended a follow-up session in the recent 10 years (primary cohort). Lymphedema was assessed using the Norman telephone questionnaire, self-reported by patients. Multiple logistic regression was used to identify risk factors for lymphedema, including demographic, clinical, and lifestyle-related factors. A nomogram was constructed based on those factors and was validated using a separate group of 314 breast cancer patients (validation cohort). The factors independently associated with lymphedema were higher body mass index (BMI), modified radical mastectomy (MRM), postsurgical infection, chemotherapy, radiotherapy, exercise of the affected arm, and the active participation in physical activity (P

Aim To develop and implement a targeted psychological support scheme for frontline nurses involved in the management of coronavirus disease 2019 (COVID‐19). Background Nurses play a vital role in managing the ongoing COVID‐19 pandemic, while confronting enormous challenges and psychological problems. Methods Action research design was adopted to develop and provide a targeted psychological support scheme to 1,496 frontline nurses. Data regarding nurses’ feedback were collected from WeChat group chat, letters and comments on theme lectures. Subsequently, qualitative content analysis was conducted using MAXQDA. Results A targeted psychological support scheme was formed via three action cycles according to nurses’ needs. Frontline nurses received psychological assistance from a research team, which offered (1) a sense of belonging, (2) a sense of professional value and pride, and (3) a sense of being protected and confident. Conclusion The researchers successfully provided targeted psychological support to nurses, and nurses were motivated and became more confident when their needs were addressed. Implications for Nursing Management Nurses have various types of psychological needs, which could be addressed by targeted support. It is suggested that nurse managers should identify nurses’ needs in real time and provide appropriate support through multidisciplinary collaboration to improve their confidence and enhance their resilience.

Hepatocellular carcinoma (HCC) is a main cause of cancer-related deaths globally. Long non-coding RNAs (lncRNAs) play important roles in diverse cancers. LncRNA-UBE2R2-AS1 has been reported to promote apoptosis in glioma cell. However, the expressions, functions, and mechanisms of action of UBE2R2-AS1 in HCC are still unclear. UBE2R2-AS1 is increased in HCC tissues and cell lines. Increased expression of UBE2R2-AS1 is associated with large tumor size, multiple tumor number, advanced TNM stage, and poor survival of HCC patients. Functional experiments showed that knockdown UBE2R2-AS1 inhibited HCC growth and metastasis through in vitro and in vivo experiments. Regarding the mechanism, UBE2R2-AS1/miR-302b/EGFR established the ceRNA network involved in the modulation of cell progression of HCC cells via activation of PI3K-AKT signaling pathway. Overall, UBE2R2-AS1 may exhibit an oncogenic function in HCC via acting as a sponge for miR-302b to up-regulate EGFR, and may serve as a potential therapeutic target and a prognostic biomarker for HCC patients.

Recently, a novel plasmid-mediated tigecycline resistance mechanism, Tet(X4), has raised a global antimicrobial resistance concern (1, 2).….

Recently, a novel plasmid-mediated tigecycline resistance mechanism, Tet(X4), has raised a global antimicrobial resistance concern (1, 2).….

Purpose Breast cancer (BC) survivors have a lifelong risk of developing lymphedema . This study investigated the prevalence of BC-related arm lymphedema among Chinese BC survivors diagnosed in the last 10 years and examined the demographic and clinical variables as well as lifestyle factors associated with lymphedema status. Methods In this cross-sectional study, women with BC (N = 866) who had been diagnosed and followed up in the previous 10 years were recruited from the outpatient clinic of 4 general hospitals and one cancer association in China between August 2018 and October 2019. Lymphedema status was determined using the Norman telephone questionnaire as the patient-reported occurrence of hand/lower arm/upper arm swelling. Multiple logistic regression was used to identify risk factors for lymphedema. Results The median time from BC diagnosis was 4.0 years (interquartile range, 2.0–5.0 years). 81.4% of the patients had undergone mastectomy . The prevalence of arm lymphedema among BC survivors was 49.0%. Age ≥50 years, monthly income modified radical mastectomy , postsurgical wound infection, chemotherapy, and radiotherapy were associated with an increased risk of BC-related arm lymphedema, whereas exercise of the affected arm, engagement in active physical activity, and timely reporting of symptoms of infection to a physician decreased the risk (P Conclusions Arm lymphedema is a common complication for postoperative BC survivors within 10 years. It is essential to identify patients at risk of lymphedema based on demographic, clinical, and lifestyle factors and implement interventions targeting modifiable lifestyle behaviors-eg, active physical activity during the postoperative period .

Graphite-like carbon nitride (g-C3N4) based heterostrutures has attracted intensive attention due to their prominent photocatalytic performance. Here, we explore the g-C3N4/SnS2 coupling effect on the electronic structures and optical absorption of the proposed g-C3N4/SnS2 heterostructure through performing extensive hybrid functional calculations. The obtained geometric structure, band structures, band edge positions and optical absorptions clearly reveal that the g-C3N4 monolayer weakly couples to SnS2 sheet, and forms a typical van der Waals heterojunction. The g-C3N4/SnS2 heterostructure can effectively harvest visible light, and its valence band maximum and conduction band minimum locate in energetically favorable positions for both water oxidation and reduction reactions. Remarkably, the charge transfer from the g-C3N4 monolayer to SnS2 sheet leads to the built-in interface polarized electric field, which is desirable for the photogenerated carrier separation. The built-in interface polarized electric field as well as the nice band edge alignment implys that the g-C3N4/SnS2 heterostructure is a promising g-C3N4 based water splitting photocatalyst with good performance.

Codoping is an effective method to improve the photoelectrochemical performance of anatase TiO2. In this work, through performing extensive hybrid density functional theory calculations, we explore the (Zn + S) and (Cd + S) codoping effects on the electronic structures and photocatalytic activities of anatase TiO2. Theoretical results clearly reveal that the coupling of the incorporated S dopant with the second-nearest neighboring O atom assisted by the acceptor metals leads to the fully occupied and delocalized intermediate bands within the band gap, which originate from the S O antibonding states (π∗). This kind of metal-assisted S O coupling can not only effectively reduce the band gap of TiO2, but also prevent the recombination of the photogenerated carriers. Moreover, the visible light absorption of anatase TiO2 is significantly enhanced via codoping, and both the reduction and oxidation potentials of water lie within the band gap of the (Zn + S) and (Cd + S) codoped anatase TiO2, which are desirable for photocatalytic water splitting. These theoretical findings imply that the metal-assisted S O coupling is an effectively approach to engineer the band structures and the visible light photoelectrochemical performance of semiconductors photocatalysts.

The rare earths are important modifier in copper alloy. This paper did research about the effect of Ce on microstructures and mechanical properties of HMn64-8-5-1.5 brass. The addition of Ce can refine the matrix grain of as-cast and extruded HMn64-8-5-1.5 brass, reduce the size and quantity of big hard phase , and contribute to the extraction of tiny hard phase, such as Mn5Si3 phase. When given tensile stress, hard phases can produce crack initiations. The addition of rare earth Ce can increase the number of hard phase and thus produce more crack initiations, so that the mechanical properties of HMn64-8-5-1.5 brass can be reduced.

Aldehyde dehydrogenase 2 (aldh2) serves an important role in the development of organ injury. Therefore, the present study investigated the effects of aldh2 on the oxidative stress response in a mouse model of ketamine-induced cystitis (KIC). A total of 60 8-week-old male Institute of Cancer Research wild-type (WT) mice and 45 aldh2 knock-out (KO) mice were randomized to receive low-dose ketamine (30 mg/kg), high-dose ketamine (60 mg/kg) or normal saline (controls). At 4, 8 and 12 weeks post-injection, bladder tissues were harvested and used to investigate the protective mechanisms of aldh2 on bladder function. The results demonstrated that aldh2 KO mice exhibited significant weight loss following chronic ketamine injection compared with that in WT mice. Furthermore, ketamine treatment increased the urination rate (P

This study investigated the efficiency and mechanisms of Cd