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Lijuan Chen,1,* Mingbo Liu,2,* Yunjuan Wang,3,4,* Wei Wei,1 Yaqiong Li,5 Yan Bai,1 Xuan Yu,1 Lei Jiao,6 Meiyun Wang1,4 1Department of Medical Imaging, Henan Provincial People’s Hospital & the People’s Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, People’s Republic of China; 2Department of Radiotherapy, Henan Provincial People’s Hospital & the People’s Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, People’s Republic of China; 3School of Life Sciences, Henan University, North Section of Jinming Avenue, Kaifeng, Henan, 475004, People’s Republic of China; 4Institute of Biomedicine, Henan Academy of Sciences, Zhengzhou, Henan, 450046, People’s Republic of China; 5Department of Pharmacy, Henan Provincial People’s Hospital & the People’s Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, People’s Republic of China; 6Institute of Molecular Metrology, College of Chemistry and Chemical Engineering, Qingdao University, Qingdao, Shandong, 266071, People’s Republic of China*These authors contributed equally to this workCorrespondence: Meiyun Wang, The Department of Medical Imaging, Henan Provincial People’s Hospital & the People’s Hospital of Zhengzhou University, No. 7, WeiWu Road, Zhengzhou, Henan, 450003, People’s Republic of China, Email mywang@zzu.edu.cnPurpose: Radiotherapy (RT) is currently recognized as an important treatment for glioblastoma (GBM), however, it is associated with several challenges. One of these challenges is the radioresistance caused by hypoxia, whereas the other is the low conversion efficiency of the strongly oxidized hydroxyl radical (•OH), which is produced by the decomposition of water due to high-energy X-ray radiation. These factors significantly limit the clinical effectiveness of radiotherapy.Results: To address these limitations, we developed a highly stable and efficient nanoplatform (MnO2/Pt@BSA). Compared to MnO2@BSA, this platform demonstrates high stability, a high yield of oxygen (O2), enhanced production of •OH, and reduced clearance of •OH. The system exhibited increased O2 production in vitro and significantly improved oxygen production efficiency within 100 s at the Pt loading of 38.7%. Furthermore, compared with MnO2, the expression rate of hypoxia-inducible factor (HIF-1α) in glioma cells treated with MnO2/Pt decreased by half. Additionally, the system promotes •OH generation and consumes glutathione (GSH), thereby inhibiting the clearance of •OH and enhancing its therapeutic effect. Moreover, the degradation of the nanoplatform produces Mn2+, which serves as a magnetic resonance imaging (MRI) contrast agent with a T1-weighted enhancement effect at the tumor site. The nanoplatform exhibited excellent biocompatibility and performed multiple functions related to radiotherapy, with simpler components. In U87 tumor bearing mice model, we utilized MnO2/Pt nanocatalysis to enhance the therapeutic effect of radiotherapy on GBM.Conclusion: This approach represents a novel and effective strategy for enhancing radiotherapy in gliomas, thereby advancing the field of catalytic radiotherapy and glioma treatment.Keywords: radiotherapy, glioblastoma, MnO2/Pt@BSA nanoplatform, nanocatalysis

Rongce Zhao,1,* Jing Zhou,2,* Zehao Zheng,1,* Xinhao Xiong,1 Qiaoxuan Wang,3 Shaohua Li,1 Wei Wei,1 Rongping Guo1 1Department of Liver Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China; 2Department of Pathology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China; 3Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Rongping Guo; Wei Wei, Department of Liver Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China, Email guorp@sysucc.org.cn; weiwei@sysucc.org.cnBackground: For patients with large unresectable hepatocellular carcinoma (HCC), the effectiveness of conventional transarterial chemoembolization (TACE) remains suboptimal, which necessitates the administration of substantial volumes of chemotherapy drugs and lipiodol, thereby increasing the risk of liver failure and other chemotherapy-related complications. Therefore, we devised a strategy of initial hepatic arterial infusion chemotherapy (HAIC) followed by sequential drug-eluting bead TACE (DEB-TACE). In our treatment design, a lower tumor burden after HAIC facilitated complete embolization of tumor vasculature, and the use of less amount of embolic agents reduced the incidence of liver failure and embolization syndromes.Methods: This retrospective study evaluated consecutive patients with unresectable large HCC with a maximum tumor diameter of ≥ 7 cm who received FOLFOX-HAIC combined with sequential DEB-TACE from April 2019 to February 2024. Efficacy was evaluated using the objective response rate (ORR), overall survival (OS), and progression-free survival (PFS); and safety was assessed using the frequency of key adverse events (AEs).Results: Among the 76 patients included, the median maximum tumor diameter was 12.4 cm (range, 7.0– 23.4 cm). The overall ORRs based on mRECIST and RECIST 1.1 criteria were 94.1% and 51.5%, respectively. The median OS was 28.1 months (95% CI, 22.7– 33.4), and the median PFS was 11.7 months (95% CI, 7.7– 15.8). All patients experienced AEs, but only 18.4% experienced grade 3 or 4 AEs, there was no treatment-related mortality.Conclusion: In this single-center, retrospective study, our results suggested that FOLFOX-HAIC with sequential DEB-TACE demonstrated promising efficacy and safety for patients with unresectable HCC with a maximum tumor diameter of ≥ 7 cm.Keywords: large unresectable hepatocellular carcinoma, hepatic arterial infusion chemotherapy, drug-eluting bead transarterial chemoembolization, sequential

Lin Zhu,1 Qian Zhang,1 Ke Ni,2 Xue-Jun Yang,1 Kai Jin,3 Wei Wei,4– 6 David A Preece,7,8 Bao-Ming Li,1,9 Xin-Lu Cai1,9 1Institute of Brain Science and Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, People’s Republic of China; 2Qiqihar Mental Health Center, Qiqihar, People’s Republic of China; 3The Fifth People’s Hospital of Lin’an District, Hangzhou, Zhejiang, People’s Republic of China; 4Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 5Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-Machine Integration, State Key Laboratory of Brain-Machine Intelligence, Zhejiang University, Hangzhou, People’s Republic of China; 6NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou, People’s Republic of China; 7School of Population Health and Curtin enAble Institute, Curtin University, Perth, WA, Australia; 8School of Psychological Science, The University of Western Australia, Perth, WA, Australia; 9Zhejiang Philosophy and Social Science Laboratory for Research in Early Development and Childcare, Hangzhou Normal University, Hangzhou, People’s Republic of ChinaCorrespondence: Xin-Lu Cai, Institute of Brain Science and Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, 311121, People’s Republic of China, Tel +86 571-28864320, Email caixinlu@hznu.edu.cnBackground: Abnormalities of regulating positive and negative emotion have been documented in patients with mental disorders. Valid and reliable psychological instruments for measuring emotion regulation across different valences are needed. The Perth Emotion Regulation Competency Inventory (PERCI) is a 32-item self-report measure recently developed to compressively assess emotion regulation ability across both positive and negative valences.Purpose: This study aimed to validate the Chinese PERCI in a large non-clinical sample and examine the clinical utility in patients with major depressive disorder (MDD).Methods: The Chinese PERCI was administered to 1090 Chinese participants (mean age = 20.64 years, 773 females). The factor structure, internal consistency, test-retest reliability, convergent validity, concurrent validity, and predictive validity were examined. Moreover, a MDD group (n = 50) and a matched healthy control group (n = 50) were recruited. Group comparisons and the linear discriminant analysis were conducted to assess the clinical relevance of the PERCI.Results: Confirmatory factor analysis supported the intended eight-factor structure of the PERCI in the Chinese population. The PERCI showed high internal consistency, test-retest reliability, as well as good convergent and concurrent validity. The MDD group had significantly higher PERCI scores than the healthy control group. Linear discriminant function comprised of the eight factors successfully distinguish patients with MDD from their matched controls.Conclusion: The Chinese version of the PERCI is a valid and reliable instrument to compressively measure emotion regulation across positive and negative valences in the general Chinese population and patients with depression.Plain Language Summary: The Perth Emotion Regulation Competency Inventory was designed to comprehensively assess emotion regulation ability across both positive and negative valences. This study provided the first translation and psychometric evaluation of the PERCI in the Chinese context. The findings support that the Chinese version of the PERCI is a reliable and valid measurement for assessing emotion regulation across positive and negative valences in research and clinical practice.Keywords: emotion regulation, reliability, validity, factor structure, depression

Xiong Zhang,1 Min Zhou,1 Xiaorong Jin,1 Yimei Zhang,1 Wei Wei,2 Yangjuan Bai,3 Fang Ma1 1Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People’s Republic of China; 2Digestive Surgery Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People’s Republic of China; 3Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People’s Republic of ChinaCorrespondence: Fang Ma, Department of Nursing, The First Affiliated Hospital of Kunming Medical University, 295#, Xichang Road, Kunming, 650032, Provence Yunnan, People’s Republic of China, Email rebeccamalei@126.comBackground: : Family coping, as an essential part of family management of patients with chronic heart failure (CHF), is an important component of CHF interventions, affecting the health of patients, family members, and the whole family. It is necessary to understand the current situation of family coping in patients with CHF to facilitate the development of family interventions for patients with CHF. This study aims to develop and validate a tool for assessing the family coping scale for patients with CHF.Methods: The semi-structured interviews, expert consensus meetings, expert consultations, and item analysis were used to develop the initial scale. We employed classical test theory and exploratory factor analysis to scrutinize and refine the items in the scale. To validate the scale, we used confirmatory factor analysis to assess structural validity. We assessed internal consistency, and split-half reliability to ensure the scale’s robustness and accuracy.Results: The FCS-CHF consisted of 24 items, including six dimensions: strategies for better management of CHF, psychological coping, substantial support by family members, emergency coping, overall heart failure awareness, and patients’ health behavior. The results of confirmatory factor analysis showed that the scale fitted the data with well construct validity. The results of the confirmatory factor analysis for the overall goodness of fit indices for the fitted model were found to be acceptable for the scale. The scale demonstrates good reliability and validity, meeting the requirements of psychometrics.Conclusions: The FCS-CHF developed in this study is considered reliable and valid, which can measure family coping in patients with CHF and provide a basis for developing family coping enhancement strategies.Keywords: chronic heart failure, family coping, scale development, reliability, validity

Baozhong Yang,1,* Wei Wei,1,2,* Jun Fang,1,2 Yating Xue,1,2 Jiacheng Wei1,2 1Department of Anaesthesiology, Taiyuan Central Hospital, Taiyuan, People’s Republic of China; 2School of Anesthesia, Shanxi Medical University, Shanxi, People’s Republic of China*These authors contributed equally to this workCorrespondence: Baozhong Yang, Email yangbz2000@163.comAbstract: More than half of people with diabetes experience neuropathic pain. Previous research has shown that diabetes patients’ neuropathic pain exhibits a circadian cycle, which is characterized by increased pain sensitivity at night. Additional clinical research has revealed that the standard opioid drugs are ineffective at relieving pain and do not change the circadian rhythm. This article describes diabetic neuropathic pain and circadian rhythms separately, with a comprehensive focus on circadian rhythms. It is hoped that this characteristic of diabetic neuropathic pain can be utilized in the future to obtain more effective treatments for it.Keywords: diabetic neuropathies, circadian rhythm, pain, chronotherapy, microglia, sex characteristics

Lianping Wang,1 Wengong Wei,2 Meiling Cai2 1Nursing Department, Qingpu Branch, Zhongshan Hospital, Fudan University, Shanghai, 201700, People’s Republic of China; 2Department of Obstetrics and Gynecology, Qingpu Branch, Zhongshan Hospital, Fudan University, Shanghai, 201700, People’s Republic of ChinaCorrespondence: Meiling Cai, Department of Obstetrics and Gynecology, Qingpu Branch, Zhongshan Hospital, Fudan University, Shanghai, 201700, People’s Republic of China, Tel +8618116016012, Email cai.meiling@qphospital.coBackground: Endometrial hyperplasia, characterized by excessive growth leading to endometrial thickening, is commonly observed in the premenopausal period. Its prevalence in postmenopausal women is approximately 15%, peaking between ages 50 and 60. This condition often manifests as abnormal uterine bleeding and can progress to malignancy, with varying risks depending on the type of hyperplasia.Purpose: This study aims to investigate the factors influencing endometrial thickness during the perimenopausal period and raise awareness among healthcare professionals about the importance of evaluating and caring for individuals with endometrial hyperplasia.Methods: Studies examining the association between various factors such as diabetes mellitus, hypertension, age, estrogen replacement therapy, anovulatory disorders, smoking, medications, genetic factors, and endocrine-related proteins and the development of endometrial hyperplasia were reviewed. The literature search encompassed relevant databases, including PubMed, Scopus, and Web of Science.Results: Research findings indicate significant associations between changes in gene expression of several factors and the development of endometrial hyperplasia. Notably, the risk of progression to cancer varies between non-atypical and atypical hyperplasia cases. Factors such as diabetes mellitus, hypertension, age, estrogen replacement therapy, anovulatory disorders, smoking, medications, Lynch syndrome, tamoxifen use, and alterations in gene expression of TNF-α, EGF, IGF-1, IGF-1R, and PTEN have been implicated in the pathogenesis of endometrial hyperplasia.Conclusion: This study underscores the importance of understanding the factors influencing endometrial thickness during the perimenopausal period. It emphasizes the pivotal role of healthcare professionals in evaluating and caring for individuals with this condition.Keywords: endometrial hyperplasia, premenopausal period, postmenopausal women, pathogenesis, malignancy risk

Yang Li,1,* Huihui Fan,2,* Wei Wei,3 Hanyu Zhu,4 Haifeng Wang,4 Dayao Lyu,1 Zengrui Zhang,1 Ying Tan1 1Department of Neurology, Huzhou Central Hospital, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, People’s Republic of China; 2Department of Ultrasound, Huzhou Central Hospital, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, People’s Republic of China; 3Department of Key Laboratory of Basic Research and Clinical Translation, Huzhou Central Hospital, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, People’s Republic of China; 4Department of Neurology, Medical School of Huzhou University, Huzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ying Tan, Email zzftyzhy@126.comIntroduction: The primary clinical manifestation of venous thrombosis is discomfort in the lower extremities. Some early Parkinson’s disease (PD) patients feel discomfort in the lower limbs. Venous thrombosis can risk lives by causing pulmonary embolism. This study examines the incidence of DVT in early PD patients and its correlation with different clinical and lab features.Methods: A cross-sectional study was conducted on 117 patients with early-stage PD. Ultrasonography was employed to detect the presence of DVT. Factors such as age, gender, body mass index, lifestyle habits (smoking and drinking), medical history (hypertension, diabetes, atrial fibrillation, and tumor), and other lab tests linked to thrombosis were analyzed.Results: In 117 patients, 11 (9.4%) had DVT, while 106 (90.6%) did not. There were no significant differences in gender, BMI, habits, medical history, or other thrombosis-related tests between both groups. However, DVT patients were older with higher d-dimer levels. They also showed an increased right substantia nigra ultrasound echo area, higher HY grades, higher UPDRS 3 scores, less improvement in UPDRS 3 scores and levodopa response.Discussion: The primary risk factors for lower extremity venous thrombosis were found to be age, d-dimer levels, and low-dose levodopa. Therefore, for elderly patients with early-stage PD, it is crucial to conduct d-dimer and lower extremity vascular ultrasound tests. The prevention of venous thrombosis in the lower extremities of early PD patients is of utmost importance.Keywords: deep vein thrombosis, early-stage, Parkinson’s disease, ultrasonography, risk

Qianfeng Li,1,* Bo Wang,2,* Jun Yang,3 Yuan Wang,1 Faliang Duan,1 Ming Luo,1 Chungang Zhao,4 Wei Wei,2 Lei Wang,3 Sha Liu2,5 1Department of Neurosurgery, Wuhan No.1 Hospital, Wuhan, People’s Republic of China; 2Brain Research Center, Zhongnan Hospital of Wuhan University, Wuhan, People’s Republic of China; 3Huanggang Central Hospital of Yangtze University, Huanggang, People’s Republic of China; 4Jilin Jianda Modern Agricultural Research Institute, Changchun, People’s Republic of China; 5Department of General Practice, Zhongnan Hospital of Wuhan University, Wuhan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lei Wang; Sha Liu, Email wanglei@hgyy.org.cn; sha.liu@whu.edu.cnBackground: Aging is recognized as the key risk for intracerebral hemorrhage (ICH). The detailed mechanisms of aging in ICH warrant exploration. This study aimed to identify potential aging-related genes associated with ICH.Methods: ICH-specific aging-related genes were determined by the intersection of differentially expressed genes (DEGs) between perihematomal tissues and corresponding contralateral parts of four patients with ICH (GSE24265) and 349 aging-related genes obtained from the Aging Atlas database. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Set Enrichment Analysis (GSEA) analyses were performed to identify the potential biological functions and pathways in which these ICH-specific aging-related genes may be involved. Then, PPI network was established to identify the hub genes of ICH-specific aging-related genes. Meanwhile, miRNA-mRNA and transcription factor (TF)-mRNA regulatory networks were constructed to further explore the ICH-specific aging-related genes regulation. The relationship between these hub genes and immune infiltration was also further explored. Additional single-cell RNA-seq analysis (scRNA-seq, GSE167593) was used to locate the hub genes in different cell types. Besides, expression levels of the hub genes were validated using clinical samples from our institute and another GEO dataset (GSE206971).Results: This study identified 24 ICH-specific aging-related genes, including 22 up-regulated and 2 down-regulated genes. The results of GO and KEGG suggested that the ICH-specific aging-related genes mainly enriched in immunity and inflammation-related pathways, suggesting that aging may affect the ich pathogenesis by regulating inflammatory and immune-related pathways.Conclusion: Our study revealed 24 ICH-specific aging-related genes and their functions highly pertinent to ICH pathogenesis, providing new insights into the impact of aging on ICH.Keywords: intracerebral hemorrhage, aging, immune infiltration, single-cell RNA sequencing, molecular docking

Wei Wei,1,2,* Haili Cao,2,* Di Shen,2 Xiyu Sun,2 Zhenzhen Jia,1 Mingzhen Zhang1 1School of Basic Medical Sciences, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, 710061, People’s Republic of China; 2Xi’an No.1 Hospital, Shaanxi Institute of Ophthalmology, Shaanxi Key Laboratory of Ophthalmology, Clinical Research Center for Ophthalmology Diseases of Shaanxi Province, First Affiliated Hospital of Northwestern University, Xi’an, Shaanxi, 710002, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhenzhen Jia; Mingzhen Zhang, Email jzz324716@stu.xjtu.edu.cn; mzhang21@xjtu.edu.cnPurpose: Dry eye disease (DED) is a multifactorial ocular surface disease with a rising incidence. Therefore, it is urgent to construct a reliable and efficient drug delivery system for DED treatment.Methods: In this work, we loaded C-dots nanozyme into a thermosensitive in situ gel to create C-dots@Gel, presenting a promising composite ocular drug delivery system to manage DED.Results: This composite ocular drug delivery system (C-dots@Gel) demonstrated the ability to enhance adherence to the corneal surface and extend the ocular surface retention time, thereby enhancing bioavailability. Furthermore, no discernible ocular surface irritation or systemic toxicity was observed. In the DED mouse model induced by benzalkonium chloride (BAC), it was verified that C-dots@Gel effectively mitigated DED by stabilizing the tear film, prolonging tear secretion, repairing corneal surface damage, and augmenting the population of conjunctival goblet cells.Conclusion: Compared to conventional dosage forms (C-dots), the C-dots@Gel could prolong exhibited enhanced retention time on the ocular surface and increased bioavailability, resulting in a satisfactory therapeutic outcome for DED.Keywords: dry eye disease, carbon dots nanozyme, thermosensitive in situ gel, composite ocular drug delivery system

Yuhua Wen,1,2,* Lianghe Lu,1,2,* Jie Mei,1,2 Yihong Ling,2,3 Renguo Guan,1,2 Wenping Lin,1,2 Wei Wei,1,2 Rongping Guo1,2 1State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People’s Republic of China; 2Department of Liver Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People’s Republic of China; 3Department of Pathology of Sun Yat-sen University Cancer Center, Guangzhou, 510060, People’s Republic of China*These authors contributed equally to this workCorrespondence: Rongping Guo; Wei Wei, Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People’s Republic of China, Email guorp@sysucc.org.cn; weiwei@sysucc.org.cnBackground: Microvascular invasion (MVI) is a significant pathological feature in hepatocellular carcinoma (HCC), adjuvant hepatic arterial infusion chemotherapy (a-HAIC) and adjuvant transcatheter arterial chemoembolization (a-TACE), are commonly used for HCC patients with MVI. This study aims to evaluate the efficacies of two adjuvant therapies after surgical treatment for HCC, compare them, and identify the significant factors.Methods: Clinical data from two randomized controlled trials involving HCC patients with MVI after surgical treatment were retrospectively reviewed. Propensity score matching (PSM) analysis was performed to balance baseline differences between patients who received a-HAIC or a-TACE, and control groups who underwent hepatectomy alone. Disease-free survival (DFS) and overall survival (OS) rates were compared.Results: In total of 549 patients were collected from two randomized controlled trials. Using the PSM and Kaplan-Meier method, the median DFS of the a-HAIC, a-TACE, and control groups was 63.2, 21.7, and 11.2 months (P

Shitong Su,1,2 Lianjing Liang,1 Lin Lü,1 Mingfeng Li,3 Xiaoling Zhang,4 Yongmei Jin,5 Wei Wei,1 Zhi Wan6 1Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China; 2Division of Head & Neck Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China; 3Department of Pathology, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China; 4Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China; 5Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China; 6Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of ChinaCorrespondence: Wei Wei, Chest Pain center, Department of Emergency Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu, 610041, People’s Republic of China, Email ww8075@126.com Zhi Wan, Rare Diseases Center, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu, 610041, People’s Republic of China, Email 456wz@163.comAbstract: Loeffler endocarditis, eosinophilic endocarditis or eosinophilic endomyocardial disease are conditions associated with hypereosinophilia and they affect the heart function. Loeffler endocarditis is a rare endomyocardial disorder thought to be caused by eosinophilic damage. The disorder is characterized by inflammatory infiltration, formation of thrombus within cardiovascular system, and ultimately fibrosis of the afflicted area. It can lead to multiple severe complications, including thromboembolic disease, thickening of fibrous tissue in the endocardium of ventricles, valve involvement, apical obliteration, and various heart disorders. Although early clinical intervention can lead to remission, the underlying mechanisms of the disorder remain unresolved. In the present article, we summarise the existing literature concerning Loeffler endocarditis based on PubMed, Web of Science, and other medical databases to conduct an in-depth review of the epidemiology, etiology, pathophysiological mechanisms, staging, diagnosis, treatment and prognosis of Loeffler endocarditis. Meanwhile, we provide novel patients data and clinical figures of Loeffler endocarditis to supplement the understanding of this cardiac disorder. The findings presented in this article provide a basis for further studies and can be used to improve management of the disorder.Keywords: Loeffler endocarditis, hypereosinophilia, eosinophils damage

Xu Su,1,* Yimei Zhang,1,* Huilin Zhou,1 Fang Ma,1 Xiaorong Jin,1 Yangjuan Bai,2 Wei Wei,3 Xiong Zhang,1 Min Zhou1 1Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China; 2Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China; 3Digestive Surgery Department, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China*These authors contributed equally to this workCorrespondence: Fang Ma, Department of Nursing, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, Kunming, 650032, People’s Republic of China, Email rebeccamalei@126.comPurpose: Studies had reported some influencing factors of health behavior among patients with coronary heart disease(CHD) after percutaneous coronary intervention(PCI). However, considering that human perceptions are complex, unrestricted and dynamically changing. A longitudinal qualitative study was conducted to explore the determinants of health-related behaviors of patients after PCI and dynamic changes of these determinants at the 1st, 3rd, and 6th months.Patients and Methods: Using purposive sampling, 18 patients undergoing PCI were interviewed. The conventional content analysis method was used to identify categories and subcategories. Semi-structured, face-to-face or telephone in-depth interviews were conducted at the cardiology unit of a tertiary referral hospital in Yunnan Province, China from March 2022 to January 2023.Results: Seven categories with some subcategories were constructed from the data, categorized into three domains. Firstly, individual factors include (i) Personal coping with healthy lifestyle requirements (tried but failed; I can do it), (ii) individual perception and feeling toward disease (knowing about the disease; belief of cure; fears of relapse), and (iii) personal benefits (improved health; meaning of life). Secondly, social factors include (i) social facilitators (family resources; healthcare support), (ii) social barriers (inconvenient medical care service; conflicting information). Finally, cultural factors include (i) way of living (dietary habits; key roles of yan (cigarette) and jiu (alcohol) in Chinese society), (ii) way of thinking (fatalism and Confucian familism).Conclusion: The determinants of health-related behaviors of patients after PCI are multifaceted and dynamic. Different interventions should be formulated to promote patients’ adherence to health behaviors. Moreover, priority should be given to the impact of traditional Chinese philosophy on the health behaviors of patients after PCI, and the health promotion program for these patients should be culturally sensitive. In addition, future research should further explore the determinants of health behaviors among diverse ethnic minorities after PCI, which has not been fully inquired in this study.Keywords: coronary heart disease, percutaneous coronary intervention, health behavior adherence, qualitative research, Chinese traditional culture

Xiangli Qing,1,2 Lin Wang,1 Shuangshuang Fang,1 Yanran Ban,1,3 Zhuotai Zhong,1 Weiqi Sun,1 Chenhui Zhang,4 Tao Zhang,1 Yang Yang,1 Wei Wei1 1Department of Gastroenterology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China; 2School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, People’s Republic of China; 3Graduate School of Beijing University of Chinese Medicine, Beijing, People’s Republic of China; 4Department of General Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, People’s Republic of ChinaCorrespondence: Wei Wei, Department of Gastroenterology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China, Email weiwei3816@mail.cintcm.ac.cnBackground: An unmet medical need for the treatment of inflammatory bowel disease (IBD) exists. A part of antidiabetic drugs had potential effects on IBD in various observational research.Objective: To investigate the potential of antidiabetic drugs on IBD.Methods: We undertook a summary-data-based Mendelian randomization (SMR) using the expression quantitative trait loci (eQTL) expressed in the blood or colon and a two sample Mendelian randomization (TSMR) utilizing single nucleotide polymorphism (SNP) of antidiabetic drug target genes mediated by blood glucose traits. Participants encompassed patients with IBD (25,042 cases/34,915 controls), UC (12,366 cases/33,609 controls), and CD (12,194 cases/28,072 controls). Data on eQTL in the blood or the colon were from the eQTLGen consortium (31,684 individuals) or GTEx Consortium V8, respectively. SMR was performed by SMR software (20,220,322); the primary method for TSMR was inverse-variance weighted (IVW) or Wald ratio through R studio (2023.06.0+421). Sensitivity analyses were carried out.Results: A 1-SD upper expression of the KCNJ11 gene (target gene of sulfonylureas) in the blood reduced the risk of CD (OR per 1-SD = 0.728, 95% CI = 0.586– 0.903, P = 0.004) according to the result of SMR. ABCC8 (target gene of sulfonylureas) expressed in the colon did not affect CD, UC, or IBD. T2D-mediated KCNJ11 has a protective effect on CD (OR = 0.475, 95% CI = 0.297– 0.761, P = 0.002). Gene predicted no relationship between T2D and CD.Conclusion: Sulfonylureas (SUs) may have side effects on CD. This work provides some suggestions for the selection of antidiabetic drugs in patients with CD.Keywords: antidiabetic drugs, inflammatory bowel disease, Mendelian randomization

Ling Wang,1,* Yuee Guan,2,* Xu Lin,3,* Jie Wei,4 Qinghuan Zhang,4 Limei Zhang,5 Jing Tan,1 Jie Jiang,1 Caiqin Ling,1 Lei Cai,1 Xiaobin Li,5 Xiong Liang,1 Wei Wei,6 Rui-Man Li7 1Department of Obstetrics, Zhuhai Hospital Affiliated with Jinan University (Zhuhai People’s Hospital), Zhuhai, 519000, People’s Republic of China; 2Department of Cardiology, Zhuhai Hospital Affiliated with Jinan University (Zhuhai People’s Hospital), Zhuhai, 519000, People’s Republic of China; 3Department of Gastrointestinal Surgery, Zhuhai Hospital Affiliated with Jinan University (Zhuhai People’s Hospital), Zhuhai, 519000, People’s Republic of China; 4Department of Clinical Laboratory, Zhuhai Hospital Affiliated with Jinan University (Zhuhai People’s Hospital), Zhuhai, 519000, People’s Republic of China; 5Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai Hospital Affiliated with Jinan University (Zhuhai People’s Hospital), Zhuhai, 519000, People’s Republic of China; 6Department of Cardiothoracic Surgery, Zhuhai Hospital Affiliated with Jinan University (Zhuhai People’s Hospital), Zhuhai, 519000, People’s Republic of China; 7Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, People’s Republic of China*These authors contributed equally to this workCorrespondence: Rui-Man Li; Wei Wei, Email hqyyck@126.com; Weiweidr001@163.comObjective: Escherichia coli is a common Gram-negative human pathogen. The emergence of E. coli with multiple-antibiotic-resistant phenotypes has become a serious health concern. This study reports the whole-genome sequences of third-generation cephalosporin-resistant (3GC-R) and multidrug-resistant (MDR) E. coli EC6868 and explores the acquired antibiotic-resistance genes (ARGs) as well as their genetic contexts.Methods: E. coli EC6868 was isolated from a vaginal secretion sample of a pregnant patient in China. The antimicrobial susceptibility was assessed, and whole-genome sequencing was conducted. The acquired ARGs, insertion sequence (IS) elements, and integrons within the genome of E. coli EC6868 were identified, and the genetic contexts associated with the ARGs were analyzed systematically.Results: E. coli EC6868 was determined to belong to ST69 and harbored a 144.9-kb IncF plasmid (pEC6868-1) with three replicons (Col156, IncFIBAP001918, and IncFII). The ESBL gene blaCTX-M-27 was located on the structure “∆ISEcp1-blaCTX-M-27-IS 903B”, which was widely present in the species of Enterobacteriales. Other ARGs carried by plasmid pEC6868-1 were mainly located on the 18.9-kb IS 26-composite transposon (five copies of intact IS 26 and one copy of truncated IS 26) composing of IS 26-mphA-mrx(A)-mphR(A)-IS 6100, ∆TnAs3-eamA-tet(A)-tetR(A)-aph(6)-Id-aph(3”)-Ib-sul2-IS 26, and a class 1 integron, which was widely present on IncF plasmids of E. coli, mainly distributed in ST131, ST38, and ST405. Notably, pEC6868 in our study was the first report on a plasmid harboring the 18.9-kb structure in E. coli ST69 in China.Conclusion: The 3GC-R E. coli ST69 strain with an MDR IncF plasmid carrying blaCTX-M-27 and other ARGs, conferring resistance to aminoglycosides, macrolides, sulfonamides, tetracycline, and trimethoprim, was identified in a hospital in China. Mobile genetic elements including ISEcp1, IS 903B, IS 26, Tn 3, IS 6100 and class 1 integron were found within the MDR region, which could play important roles in the global dissemination of these resistance genes.Keywords: Escherichia coli, vaginal secretion, plasmid, blaCTX-M-27, genetic context

Wenjun Liang,1 Angela TH Kwan,2 Huifang Ye,3 Mohammad Mofatteh,4 Mingzhu Feng,1 Jack Wellington,5 Pingzhong Fu,6 Wenlong Wei,1 Yu Sun,1 Jianhui Huang,7 Jie Luo,7 Yimin Chen,1 Shuiquan Yang,1 Sijie Zhou7 1Department of Neurology and Advanced National Stroke Center, Foshan Sanshui District People’s Hospital, Foshan, People’s Republic of China; 2Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; 3Department of Pharmacy, Foshan Sanshui District People’s Hospital, Foshan, People’s Republic of China; 4School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom; 5School of Medicine, Cardiff University, Cardiff, United Kingdom; 6Department of Radiology, Foshan Sanshui District People’s Hospital, Foshan, Guangdong Province, People’s Republic of China; 7Department of Surgery of Cerebrovascular Diseases, First People’s Hospital of Foshan, Foshan, Guangdong Province, People’s Republic of ChinaCorrespondence: Shuiquan Yang, Department of Neurology and Advanced National Stroke Center, Foshan Sanshui District People’s Hospital, Foshan, Guangdong Province, 528100, People’s Republic of China, Email yangshuiquan1969@126.com Sijie Zhou, Department of Neurosurgery, First People’s Hospital of Foshan, Foshan, Guangdong Province, 528000, People’s Republic of China, Email zhousijie91@163.comPurpose: In this study, we aimed to determine whether post-Alberta Stroke Project Early CT Changes Score (post-ASPECTS) in anterior stroke and post-(posterior circulation) PC-ASPECTS in posterior stroke on CT can predict post-endovascular thrombectomy (EVT) functional outcomes among patients with acute ischemic stroke (AIS) after EVT.Patients and Methods: A total of 247 consecutive patients aged 18 and over receiving EVT for LVO-related AIS were recruited into a prospective database. The data was retrospectively analyzed between March 2019 and February 2022 from two comprehensive tertiary care stroke centers: Foshan Sanshui District People’s Hospital and First People’s Hospital of Foshan in China. Patient parameters included EVT within 24 hr of symptom onset, premorbid modified Rankin scale (mRS) ≤ 2, presence of distal and terminal cerebral blood vessel occlusion, and subsequent 24– 72-hr post-stroke onset CT scan. Univariate comparisons were performed using the Fisher’s exact test or χ2 test for categorical variables and the Mann–Whitney U-test for continuous variables. Logistic regression analysis was performed to further analyze for adjusting for confounding factors. A p-value of ≤ 0.05 was statistically significant.Results: Overall, 236 individuals with 196 anterior circulation ischemic strokes and 40 posterior strokes of basilar artery occlusion were examined. Post-ASPECTS in anterior stroke and post-pc-ASPECTS as strong positive markers of favorable outcome at 90 days post-EVT; and lower rates of inpatient mortality/hospice discharge, 90-day mortality, and 90-day poor outcome were observed. Moreover, patients in the post-ASPECTS ≥ 7 cohort experienced shorter door-to-recanalization time (DRT), puncture-to-recanalization time (PRT), and last known normal-to-puncture time (LKNPT).Conclusion: Post-ASPECTS ≥ 7 in anterior circulation AIS and post-pc-ASPECTS ≥ 7 in posterior circulation can serve as strong prognostic markers of functional outcome after EVT.Keywords: endovascular therapy, thrombectomy, large vessel occlusion, cerebral ischemic stroke, ASPECTS

Ping Shao,1 Danyang Dong,1 Yong Huang,2 Yan Wang,1 Lian Pan,3 Qunshan Zhu,2 Zheng Wu,2 Fengjuan Jiang,4 Wei Wei2 1Department of Spleen and Stomach Diseases, Yixing Traditional Chinese Medicine Hospital, Wuxi, 214200, People’s Republic of China; 2Department of General Surgery, Jiangdu People’s Hospital Affiliated to Yangzhou University, Yangzhou, 225200, People’s Republic of China; 3Pathology Department, Yixing Traditional Chinese Medicine Hospital, Wuxi, 214200, People’s Republic of China; 4Department of Gastroenterology, Jiangdu People’s Hospital Affiliated to Yangzhou University, Yangzhou, 225200, People’s Republic of ChinaCorrespondence: Wei Wei, Email 18952531159@yzu.edu.cnBackground: Gastric cancer (GC) as is the second deadliest malignancy still lacks rapid, simple and economical detection and early clinical screening techniques. Surface-enhanced Raman spectroscopy (SERS) is a spectroscopic technique based on the surface plasmon resonance of precious metal nanoparticles, which can effectively detect low-abundance tumor markers. Combining SERS technology with sensors has high potential in the diagnosis and screening of GC.Methods: A novel Au/Si nano-umbrella array (Au/SiNUA) was prepared as a SERS substrate and the substrate was functionalized using the corresponding tumor marker aptamers for the detection of clinical biological samples using a one-step recognition release mechanism. Optimization of aptamer and complementary chain concentrations and detection time for optimal sensor preparation.Results: Au/SiNUA were tested to have good SERS enhancement activity. The proposed aptamer biosensor has good specificity and stability, with a low detection time of 18 min and a limit of detection (LOD) at the fM level, which is superior to most of the methods reported so far; and the accuracy of the clinical assay is comparable to that of the ELISA method. The expression levels of PDGF-B and thrombin in the serum of GC patients and healthy individuals can be effectively detected and differentiated.Conclusion: The ultrasensitive and specific aptamer biosensor is highly feasible for the diagnosis and screening of GC and has good application prospects.Keywords: surface-enhanced Raman scattering, gastric cancer, aptamer, biosensor, Au/SiNUA

Wei W, Mo X, Yan L, et al. Cancer Manag Res. 2020;12:15–30. We, the Editor and Publisher of the journal Cancer Management and Research have retracted the published article. Following publication, concerns were raised regarding the use of non-verifiable cell lines described in the article. The concerns related specifically to the use of cell lines which were found to be either contaminated, wrongly identified, improperly indexed, unavailable through external cell line repositories, and/or lacking publications describing their establishment. Overall, these concerns raised doubts about the validity of the findings described in the article. The corresponding author did not respond to our queries and was unable to provide information relating to the use of these cell lines or provide original data relating to the study. As verifying the validity of published work is core to the integrity of the scholarly record, the Publisher and Editor requested to retract the article and the corresponding author was notified of this decision. We have been informed in our decision-making by our editorial policies and COPE guidelines. The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as “Retracted”.

Wenjie Wei,* Renrui Luo,* Zhikui Chen, Jianbin He Department of Respiratory and Critical Care Medicine, Hunan University of Medicine General Hospital, Huaihua, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jianbin He, Department of Respiratory and Critical Care Medicine, Hunan University of Medicine General Hospital, Jinxi South Road 144, Hecheng District, Huaihua, 418000, People’s Republic of China, Email hjb0919@aliyun.comAbstract: In the available reports on clinical medicine, the infection sites of Mycobacterium porcinum include wounds, bone marrow, respiratory tract, and catheters. A 61-year-old woman was admitted to our hospital; her hilar and mediastinal lymph nodes were found to be enlarged during health examination, but there was no specific discomfort. Initially, she had undergone a mediastinal lymph node biopsy and pathology, but the diagnosis was not confirmed. However, 16S rRNA gene sequencing revealed M. porcinum infection of hilar and mediastinal lymph nodes. Subsequently, she was treated with clarithromycin, amikacin, imipenem, and tigecycline. After 2 months, chest computed tomography showed a significant reduction in lymph nodes. M. porcinum infection was considered to be the cause of disease.Keywords: Mycobacterium porcinum, hilar, mediastinal, lymph nodes, infection

Wen Wei,1,2,&ast; Chengwen Xie,3,&ast; Ronghua Cao,4,&ast; Yanwen Que,3 Xuejing Zhong,5 Zheyuan Chen,6 Fenyan Lv,6 Qianqian Kang,6 Ruiyu Lin,6 Baozhen Cao,7 Xiaomin Lai,7 Mei Tu1 1Department of Endocrinology, Fujian Longyan First Hospital, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, People’s Republic of China; 2Department of Endocrinology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, People’s Republic of China; 3Department of Ultrasonography, Fujian Longyan First Hospital, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, People’s Republic of China; 4Department of Nuclear Medicine, Fujian Longyan First Hospital, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, People’s Republic of China; 5Department of Science and Education, Fujian Longyan First Hospital, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, People’s Republic of China; 6Department of Endocrinology, Fujian Longyan First Hospital, Fujian Medical University, Fuzhou, 350004, People’s Republic of China; 7Department of Pulmonary and Critical Care Medicine, Fujian Longyan First Hospital, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Mei Tu, Department of Endocrinology, Fujian Longyan First Hospital, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, People’s Republic of China, Tel +86 5972958989, Fax +86 5972292374, Email tm13859596628@163.comObjective: This study aims to examine the clinical significance of ultrasound evaluation of the gastrocnemius muscle (GM) in identifying sarcopenia in patients with type 2 diabetes (T2D).Methods: One hundred and fifty-three patients with T2D were included in this study. We measured the appendicular skeletal muscle mass index (ASMI), handgrip strength, and 6-meter walking speed. The US-derived muscle thickness (MT), cross-sectional area (CSA), and shear wave ultrasound elastography (SWE) of GM were also measured. We assessed the correlations between clinical indicators and US features. The model for screening sarcopenia was established using stepwise logistic regression. Stepwise linear regression was used to identify a set of variables that jointly estimated ASMI. The model’s ability to identify sarcopenia and low muscle mass was assessed by receiver operating characteristic (ROC) curve analysis.Results: The prevalence of sarcopenia in this study was 24.2%. The CSA, MT and SWE values of the patients with sarcopenia were lower than those of patients without sarcopenia (all p < 0.05). ASMI was positively correlated with CSA (r = 0.56, p < 0.001) and MT (r = 0.39, p < 0.001). Handgrip strength was positively correlated with CSA (r = 0.45, p < 0.001), MT (r = 0.25, p < 0.001), and SWE (r = 0.26, p = 0.002). A diagnostic model for sarcopenia was established with a sensitivity of 81.1%, specificity of 75.0%, and an area under the curve (AUC) of 0.800. The estimated ASMI equation was developed and found to have a positive correlation with actual ASMI (r = 0.70, p < 0.001). It was also effective in diagnosing low muscle mass, with an AUC of 0.787 for males and 0.783 for females.Conclusion: Ultrasonographic assessment of the gastrocnemius muscle was found to be a useful and convenient method for detecting sarcopenia in patients with T2D.Keywords: sarcopenia, ultrasound, shear wave elastography, gastrocnemius muscle, T2D

Tianjun Wei,1,2 Wei Wei,2 Qiang Ma,2 Zhongbing Shen,2 Kebing Lu,2 Xiangming Zhu1,2 1School of Continuing Education, Anhui Medical University, Hefei, 230032, People’s Republic of China; 2Department of Ultrasound, The First Affiliated Hospital of Wannan Medical College, Wuhu, 241001, People’s Republic of ChinaCorrespondence: Xiangming Zhu, School of Continuing Education, Anhui Medical University, NO. 81 Meishan Road, Shushan District, Hefei City, Anhui Province, 230032, People’s Republic of China, Tel +86 553-5739808, Email xiangmingzhudr@yeah.netBackground and Objectives: Papillary thyroid carcinoma (PTC) is a prevalent histological type of thyroid cancer; however, noninvasive assessment of cervical lymph node metastasis (LNM) poses a challenge. This study aims to develop a novel clinical-radiomics nomogram that utilizes ultrasound (US) images to predict the presence of cervical LNM metastasis in patients with PTC.Methods: A total of 423 patients with PTC were recruited to participate in this study between January 2020 and December 2022, of which 282 were classified into the training group and 141 patients were classified into the validation set. Contrast-enhanced ultrasound (CEUS) and B-mode ultrasound (BMUS) images were subjected to radiomic analysis, leading to the extraction of 912 radiomic features. Thereafter, a radiomics score (Radscore) was developed to effectively integrate the information derived from BMUS and CEUS modalities. Univariate and multivariate backward stepwise logistic regression analysis techniques were used to construct the clinical and clinical-radiomics models, respectively.Results: The findings revealed that the clinical-radiomics nomogram incorporated age, sex, CEUS Radscore, and US-reported LNM as risk factors. The nomogram demonstrated good performance using data from the training (AUC = 0.891) and validation (AUC = 0.870) sets. The decision curve analysis implied that this nomogram exhibited good clinical utility, which was further supported by the results of the calibration curves and Hosmer-Lemeshow test.Conclusion: The CEUS Radscore-based clinical radiomics nomogram could serve as a valuable tool for predicting cervical LNM metastasis in patients with PTC, thereby tailoring individualized treatment strategies for them.Keywords: lymph node metastasis, radiomics, papillary thyroid carcinoma, contrast-enhanced ultrasound, B-mode ultrasound

Ziting Qu,1,&ast; Yanxun Han,2,&ast; Qingbo Zhu,1,&ast; Wenxi Ding,1 Yuyan Wang,1 Yan Zhang,1 Wei Wei,1 Yu Lei,1 Min Li,1 Yang Jiao,1 Kangsheng Gu,1,&ast; Yiyin Zhang1,&ast; 1Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China; 2Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Kangsheng Gu; Yiyin Zhang, Department of Oncology, The First Affiliated Hospital of Anhui Medical University, 218th Jixi Road, Hefei, Anhui, 230022, People’s Republic of China, Email gukangsheng@ahmu.edu.cn; zhangyiyin@ahmu.edu.cnBackground: Neutrophil extracellular traps (NETs) released by neutrophils are crucial for cancer development, metastasis, and can indicate gastric cancer (GC) patients’ prognosis. This study reveals the relevance of NETs-related genes to GC through transcriptome analysis.Methods: We obtained transcriptome sequencing data of GC from UCSC Xena and screened prognostic NETs-related genes by GEPIA2 database. The signature for NETs was subsequently created using the LASSO–Cox regression. The clinical value of model was further explored using the nomogram and was externally validated by the GEO database. After that, we employed GO, KEGG, and GSEA enrichment analyses to evaluate the bio-functional enrichment and related pathways. Additionally, ESTIMATE, MCP counter, and ssGSEA scores were used to investigate the immunological microenvironment of GC patients. Finally, in the external cohort, neutrophil elastase (NE)-DNA complexes were measured by ELISA, and the prognostic value of NE-DNA in GC was investigated using Cox analysis.Results: Seven NETs-associated genes (PDE4B, CD93, CTSG, IL6, ELANE, KCNJ15, and CRISPLD2) were filtered to establish the signature and participated in building the nomogram. In comparison to the high-risk group, the overall survival (OS) was much longer in the low-risk group (P=0.005). The validation cohort demonstrated the acceptable predictive ability of the nomogram. The signature was enriched in biological features such as extracellular matrix organization, epithelial-mesenchymal transition and inflammatory response. Moreover, there were substantial differences in immune cell infiltration across the different risk groups (p< 0.001), especially the high-risk group having more immune cells that are engaged in the antigen presentation process and associated functions. Finally, in the external cohort, NE-DNA levels were shown to be an independent factor affecting OS prognosis (p=0.006).Conclusion: Overall, this research identified a novel signature based on seven NETs-associated genes to predict prognosis and identify tumor microenvironment of GC. And high NE-DNA level may be a critical factor in the poor OS associated with NETs.Keywords: NETs, gastric cancer, gene signature, tumor microenvironment, prognosis

Ting Lan,1,&ast; Yang Zhao,1,2,&ast; Yu Du,1,3,&ast; Chunyi Ma,1 Rui Wang,1 Qianlei Zhang,1 Shanshan Wang,1 Wenxian Wei,4 Honghua Yuan,2 Qingli Huang1,2 1Medical Technology School of Xuzhou Medical University, Xuzhou City, Jiangsu, 221000, People’s Republic of China; 2Public Experimental Research Center of Xuzhou Medical University, Xuzhou City, Jiangsu, 221004, People’s Republic of China; 3Xuzhou Center for Disease Control and Prevention, Xuzhou City, Jiangsu, 221006, People’s Republic of China; 4Testing Center, Yangzhou University, Yangzhou City, Jiangsu, 225009, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Honghua Yuan, Public Experimental Research Center of Xuzhou Medical University, Tong Shan No. 209, Xuzhou, 221004, People’s Republic of China, Tel/Fax +86-516-83262091, Email XUYIyhh@xzhmu.edu.cn Qingli Huang, Medical Technology School, Public Experimental Research Center of Xuzhou Medical University, Tong Shan No. 209, Xuzhou, 221004, People’s Republic of China, Tel/Fax +86-516-83262091, Email qlhuang@xzhmu.edu.cnPurpose: A novel CYPA-targeted, SiO2 encapsulated Au star@AgAu yolk-shell nanostructure (YSNS) was synthesized and used for ovarian cancer early diagnosis and therapy.Methods: Diverse spectroscopic and microscopic methods were utilized to investigate the pattern of the yolk-shell nanostructure. In addition, in vitro and in vivo experiments were carried out.Results: It can be found that the ratio of HAuCl4 and AgNO3 played a critical role in the constitution of the yolk-shell nanostructure. The as-prepared yolk-shell nanostructure showed excellent SERS performance, which could be utilized as SERS substrate for specific sensitivity analysis of ovarian cancer markers cyclophilin A (CYPA) with detectable limit of 7.76&ast;10− 10 μg/mL. In addition, the as-prepared yolk-shell nanostructure possessed outstanding photothermal performance, which could be used as photothermal agent for ovarian cancer therapy. Experiments in vitro and in vivo proved that the as-prepared yolk-shell nanostructures are ideal candidate for early diagnosis and therapy for ovarian cancer in one platform.Conclusion: This work holds promise to offer a new method for the detection and therapy of ovarian cancer in the early stage.Graphical Abstract: Keywords: yolk-shell nanostructure, surface-enhanced Raman scattering, early diagnosis, cancer targeted therapy

Shirong Li,1,&ast; Wene Wei,1,&ast; Zhaorong Feng,1,&ast; Yingzhen Bian,1 Jinmiao Pan,1 Jinling Mai,1 Shufang Ning,1,2 Jinglei Huang,1 Xiangyang Gao,3,&ast; Litu Zhang1,2,&ast; 1Department of Research, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China; 2Department of Research, Guangxi Cancer Molecular Medicine Engineering Research Center, Nanning, People’s Republic of China; 3Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiangyang Gao; Litu Zhang, Email 13811130808@126.com; zhanglitu@gmail.comPurpose: In current studies, the role of serum Cytokeratin-19 fragments (CYFRA 21-1) in colorectal cancer (CRC) remains unclear. This study aimed to clarify the diagnostic and prognostic value of CYFRA 21-1 in CRC.Patients and Methods: Data were collected for 196 stage I–III CRC patients and 50 colorectal liver metastases (CRLM) patients between January 2018 and December 2019. The serum CYFRA 21-1 levels were measured using the chemiluminescent particle immunoassay (CMIA) kit in all objects and common biomarkers such as CA19-9, CEA, HSP90α, and AFP were measured in all colorectal cancer patients. We investigated the association between CYFRA 21-1 level and clinicopathological features. In addition, we evaluated the ability of serum CRFRA21-1 to differentiate CRLM from CRC. To assess the potential prognostic value, we used Cox proportional hazard model for univariate or multivariate analyses.Results: Serum CYFRA 21-1 was significantly elevated in CRLM patients compared to stage I–III CRC patients (5.85 ng/mL vs 2.29 ng/mL, p < 0.001). For all CRC patients cohort, stage I–III CRC patients cohort and CRLM patients cohort, the optimal cutoff levels of CYFRA 21-1 for overall survival (OS) were 3.47 ng/mL, 2.14 ng/mL and 7.63 ng/mL, respectively, and the optimal cutoff levels for progression-free survival (PFS) were 3.47 ng/mL, 2.56 ng/mL and 7.63 ng/mL, respectively. For CRLM patients, Kaplan–Meier analysis showed that patients with high CYFRA 21-1 level had poor OS. Multivariate analysis indicated that the CYFRA 21-1 level was an independent prognostic factor for PFS in stage I–III patients. And CYFRA 21-1 levels and age were independent prognostic factors for OS and PFS in CRLM patients.Conclusion: CYFRA 21-1 can better differentiate CRLM patients from the whole CRC patients and has unique prognostic value for CRLM patients.Keywords: colorectal cancer, colorectal liver metastases, CRLM, prognosis, cytokeratin-19 fragments, CYFRA21-1, overall survival, progression-free survival

Yong Yang, Wenwen Wei, Ting Wang School of Educational Science, Xinyang Normal University, Xinyang, Henan, People’s Republic of ChinaCorrespondence: Yong Yang, School of Educational Science, Xinyang Normal University, Room 517, Xinyang, Henan, 464000, People’s Republic of China, Email yangyongseeklight@m.scnu.edu.cnPurpose: The continuing global spread of COVID-19 has seriously jeopardized human mental health. How to reduce the damage of COVID-19 pandemic to people’s mental health is a current research hotspot. The purpose of this study was to explore the influence mechanism of perceived vulnerability to disease on anxiety level during the COVID-19 pandemic.Methods: A total of 1085 Chinese subjects were investigated by using the Fear of COVID-19 Scale, Perceived Vulnerability to Disease Scale, Trust in the Government Measure Scale and Anxiety Scale, which was conducted by an online survey using snowball sampling technique. Hayes PROCESS macro for SPSS was used to test the hypothesized mediating effects of fear of COVID-19 and rust in the government measure in the relationship between perceived vulnerability to disease (PVD) and anxiety.Results: (1) the PVD significantly positively predicts anxiety level (0.001); (2) Fear of COVID-19 (p< 0.001) and trust in the government (p< 0.001) mediated the relationship between PVD and anxiety level respectively; (3) PVD could also indirectly predict anxiety level through the chain-mediated role of the fear of COVID-19 and the trust in the government measure (p< 0.001).Conclusion: Our findings shed light on a correlation between perceived vulnerability to disease and anxiety. This study emphasizes the value of trust in the government in facing public stress events. Moreover, this study provides some implications for how to prevent or reduce public anxiety in an epidemic setting.Keywords: COVID-19 pandemic, fear of COVID-19, perceived vulnerability to disease, anxiety, trust in the government measure

Ke-Fan Zhang,1,&ast; Chuan-Xin Shi,1,&ast; Si-Yu Chen,2,&ast; Wei Wei1 1Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China; 2Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wei Wei, Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China, Email kevinwei@njmu.edu.cnAbstract: Fournier’s gangrene (FG) is a life-threatening and special form of necrotizing fasciitis, characterized by occult onset, rapid progress and high mortality, occurring mainly in men over 50 years of age. Risk factors of FG include diabetes, HIV infection, chronic alcoholism and other immunosuppressive state. FG was previously considered as an idiopathic disease, but in fact, three quarters of the infections originated from the skin, urethra and gastrointestinal tract. Initial symptoms of FG are often inconsistent with severity and can progress promptly to fatal infection. Although the treatment measures of FG have been improved in recent years, the mortality does not seem to have decreased significantly and remains at 20% – 30%. The time to identify FG and the waiting period before surgical debridement are directly related to the prognosis. Therefore, in addition to the combination of intensive fluid resuscitation and broad-spectrum antibiotics, treatment of FG should particularly emphasize the importance of early surgical debridement assisted with fecal diversion and skin reconstruction when necessary. This paper is to briefly summarize the progress in the definition, epidemiology, clinical manifestations, diagnosis, treatment and prognosis of Fournier’s gangrene in recent years, more importantly, illustrates the importance of multidisciplinary cooperation in the management of FG.Keywords: Fournier’s gangrene, necrotizing fasciitis, lethal infection, surgical debridement, multidisciplinary cooperation

Qiang Lai,1– 3 Wei Wei,1– 3 Yarong He,1– 3 Tao Cheng,1– 3 Tianyong Han,1– 3 Yu Cao1– 3 1Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 3Disaster Medical Center, Sichuan University, Chengdu, Sichuan, People’s Republic of ChinaCorrespondence: Yu Cao, Emergency Department, West China Hospital of Sichuan University, 37 Guoxue Lane, Wuhou District, Chengdu, 610041, Sichuan, People’s Republic of China, Email yuyuer@126.comObjective: To establish a rapid and concise prognosis scoring system for pancreatitis in the emergency department based on bedside arterial blood gas analysis (ABG).Methods: A single-center, retrospective cohort study was used to establish the new scoring system, and a validation group was used to verify it. The primary endpoint was 60-day death, and secondary endpoints were 28-day death, admission to the intensive care unit (AICU), requirement for mechanical ventilation (MV) and persistent organ failure (POF). Receiver operating characteristic (ROC) curves was drawn to validate the predictive value of the new scoring system. The performance of the new scoring system was compared with that of conventional predictive scoring.Results: 443 patients were in the derivation group and 217 patients in the validation group, of which 27 and 25 died during follow-up. A total of 443 patients in the derivation group, 27 of whom died during the follow-up period. Multivariate regression analysis showed that mental status, hematocrit (HCT), base excess (BE) and Serum ionic calcium (Ca2+) were independent risk factors for 60-day mortality of pancreatitis, and they were used to create a new scoring system (MHBC). In the derivation and validation, the ability of MHBC (AUC= 0.922, 0.773, respectively) to predict 60-day mortality from pancreatitis was no less than that of APACHE II (AUC= 0.838, 0.748, respectively) and BISAP (AUC= 0.791, 0.750, respectively), while, MHBC is more quickly and concisely than APACHE II and BISAP. Compared with MHBC less than or equal to 2, when MHBC is greater than 2, the 28-day mortality, 60-day mortality and the incidence of AICU, MV and POF increased significantly (P < 0.001).Conclusion: The MHBC can quickly and concisely evaluate the 60-day mortality, 28-day mortality, and the incidence of AICU, MV and POF of patients with acute pancreatitis in the emergency department.Keywords: acute pancreatitis, prognosis, emergency department, arterial blood gas analysis, ABG

Yi-Bo Zhao, Wei Wei, Xiao-Xi Lin, Yan-Fen Chai, Heng Jin Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, 300000, People’s Republic of ChinaCorrespondence: Heng Jin; Yan-Fen Chai, Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, 300000, People’s Republic of China, Email hengjin@tmu.edu.cn; chaiyanfen2012@126.comAbstract: Acute kidney injury (AKI) is a clinical syndrome in which kidney function declines sharply due to various reasons. Although the morbidity and mortality of AKI are high, the mechanism of occurrence and development of AKI has not been fully elucidated, and precise prevention and treatment measures are lacking. Epigenetics is a branch of genetics that provides a new perspective to explore the pathophysiology of AKI and renal repair. A large amount of literature shows that the methylation mechanism of H3 in histones is closely related to the development of kidney diseases. The sorting out of histone H3 methylation mechanism in AKI and kidney repair can help understand the pathophysiological process of the disease more deeply. It may also provide new ideas for diagnosing and treating of the disease.Keywords: kidney, Acute kidney injury, histone methylation, epigenetic

Hang Zhou,1 Fang Ma,2 Yi Zhang,2 Youqin Tan,2 Yangjuan Bai,3 Qiulan Hu,4 Wei Wei,5 Yanjiao Wang1 1Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China; 2Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China; 3Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China; 4ICU in Geriatric Department, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China; 5Neurosurgery Department, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of ChinaCorrespondence: Yanjiao Wang, Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, 295#, Xichang Road, Kunming, People’s Republic of China, Tel +86-138-889-29699, Email mayuwyj1974@126.com Correspondence: Fang Ma, Department of Nursing, The First Affiliated Hospital of Kunming Medical University, 295#, Xichang Road, Kunming, People’s Republic of China, Tel +86-159-251-89957, Email rebeccamalei@126.comPurpose: To explore perceptions of antipsychotics associated side-effects among family caregivers of patients with schizophrenia.Patients and Methods: A descriptive qualitative study was applied in a tertiary referral hospital in China. Purposeful sampling of 18 family caregivers of patients with schizophrenia were interviewed about their perceptions towards antipsychotics related side effects.Results: According to content analysis, three themes emerged from the data: (a) nightmare in the treatment with the categories of sleep disturbances; physical impairment; appearance impairment; (b) opposite attitudes toward side-effect with the categories of being vigilant; do not care; (c) diverse ways of coping side-effects with the categories of asking for help from professionals; self-determined; try any quack’s prescription.Conclusion: The side effects of antipsychotics not only damage the health of patients, but also increase the burden and stress of caregivers. However, caregivers have different attitudes and coping styles about the side effects of antipsychotics. Health professionals should be aware of the influence of individual background and cultural factors on caregivers’ attitudes towards drug side effects. Furthermore, health professionals should also provide caregivers with knowledge about drug side effects, coping skills, and appropriate management strategies to promote health outcomes for people with schizophrenia.Keywords: schizophrenia, family caregivers, antipsychotics, drug side effects, content analysis

Hengqing Cui,1,&ast; Yidan Su,1,&ast; Wei Wei,2,&ast; Fei Xu,3 Jie Gao,2 Wenjun Zhang2 1Department of Burns and Plastic Surgery, Shanghai Changzheng Hospital, Shanghai, 200003, People’s Republic of China; 2Changhai Clinical Research Unit, Shanghai Changhai Hospital, Naval Medical University, Shanghai, 200433, People’s Republic of China; 3Department of Plastic Surgery, Naval Medical Center, Naval Medical University, Shanghai, 200052, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wenjun Zhang, Department of Burns and Plastic Surgery, Shanghai Changzheng Hospital, Shanghai, 200001, People’s Republic of China, Tel +86 21 81885775, Fax +86 21 81886000, Email gift1013@163.com Jie Gao, Changhai Clinical Research Unit, Shanghai Changhai Hospital, Naval Medical University, Shanghai, 200433, People’s Republic of China, Tel +86 21 81871290, Fax +86 21 81871290, Email gaojiehighclea@163.comAbstract: Hypoxia can aggravate the conditions of many oxygen-deficiency-aggravated diseases (ODAD), such as cancer, ischemic heart disease, and chronic wounds. Photosynthetic microalgae can alleviate the hepatotoxicity of the local microenvironment by producing oxygen. In addition, microalgae extracts have antitumor, anti-inflammatory, antibacterial, and antioxidant effects. These properties make them attractive candidates for developing methods to treat ODAD. Although researchers have exploited the advantages of microalgae and developed a variety of microalgae-based biomaterials to treat ODAD, a comprehensive review of this topic has not been presented previously. Therefore, in this review, we summarize the development and progress made in the field of developing microalgae-based biomaterials toward the treatment of ODAD. The challenges and prospects of this field are also discussed.Keywords: chronic wounds, tumors, ischemic heart disease, hypoxia, oxygen generation

Wei Wei,1,2,&ast; Yongli Pan,2,3,&ast; Xinyu Yang,4 Zhonglun Chen,1 Yue Heng,1 Bufan Yang,1 Mingjun Pu,1 Jiacai Zuo,1 Zhuhong Lai,5 Yufeng Tang,1 Wenqiang Xin2,4 1Department of Neurology, Mianyang Central Hospital, Mianyang, Sichuan, People’s Republic of China; 2Department of Neurology, University Medical Center of Göttingen, Georg-August-University of Göttingen, Göttingen, Lower Saxony, Germany; 3Department of Neurology, Weifang Medical University, Weifang, Shandong, People’s Republic of China; 4Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China; 5Department of Cardiology, Mianyang Central Hospital, Mianyang, Sichuan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wenqiang Xin, Department of Neurosurgery, Tianjin Medical University General Hospital, Anshan Road No. 154, Tianjin, 300052, People’s Republic of China, Tel +86– 18526201182, Fax +86– 2260362062, Email xinwenqiangdr@126.com Wei Wei, Department of Neurology, Mianyang Central Hospital, Changjia Lane No. 12, Mianyang, 621000, People’s Republic of China, Tel +86– 15983634286, Fax +86-8162222566, Email weiwei1990sci@163.comAbstract: Eukaryotic cells release different types of extracellular vesicles (EVs), including exosomes, apoptotic bodies and microvesicles. EVs carry proteins, lipids and nucleic acids specific to cells and cell states. Autophagy is an intracellular degradation process, which, along with EVs, can significantly affect the development and progression of neurological diseases and, therefore, has been the hotspot. Generally, EVs and autophagy are closely associated. EVs and autophagy can interact with each other. On the one hand, the level of autophagy in target cells is closely related to the secretion and transport of EVs. In another, the application of EVs provides a great opportunity for adjuvant treatment of neurological disorders, for which autophagy is an excellent target. EVs can release their cargos into target cells, which, in turn, regulate the autophagic level of target cells through autophagy-related proteins directly and the non-coding RNA, signal transducer and activator of transcription 3 (STAT3), phosphodiesterase enzyme (PDE) 1-B, etc. signaling pathways indirectly, thus regulating the development of related neurological disorders.Keywords: extracellular vesicle, autophagy, neurological disorders, non-coding RNA, STAT3, PDE1-B

Wei Wei,1– 3 Yujie Zhang,1,2 Runqing Li,4 Yameng Cao,1,2 Xiangji Yan,1,2 Yana Ma,1,2 Yuanyuan Zhang,1,2 Mei Yang,1,2 Mingzhen Zhang1,2 1School of Basic Medical Sciences, Xi’an Key Laboratory of Immune Related Diseases, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 2Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 3Xi’an No.1 Hospital, Shaanxi Institute of Ophthalmology, Shaanxi Key Laboratory of Ophthalmology, Clinical Research Center for Ophthalmology Diseases of Shaanxi Province, First Affiliated Hospital of Northwestern University, Xi’an, Shaanxi, People’s Republic of China; 4Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of ChinaCorrespondence: Mei Yang; Mingzhen Zhang, Email yangmeimei528@stu.xjtu.edu.cn; mzhang21@xjtu.edu.cnBackground: Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) of unknown aetiology affecting the colon and rectum. Pterostilbene (PS) has been reported as an effective antioxidant and anti-inflammatory agent in preclinical IBD models. However, the therapeutic outcomes of PS are limited by potential side effects associated with the systemic exposure and the modest bioavailability afforded by its oral administration. These issues can be improved with the use of intelligent responsive nanoparticles with the ability of lysosome escape, given their high drug delivery capacity and reducing the side effects.Materials and Methods: Herein, the hyaluronic acid (HA)-modified L-arginine CO2 nanoparticles (HA-L-Arg-CO2@NPs) loaded with PS (HA-PS@NPs) are constructed. Under lysosomal pH conditions, HA-PS@NPs liberate CO2 and generate a pH-activated nano-bomb effect to augment the cytosolic delivery of PS.Results: HA-L-Arg-CO2@NPs show great biocompatibility and the excellent ability to target the colon. Using lipopolysaccharide-induced inflammation in vitro, the prominent anti-inflammatory effect of HA-L-Arg-CO2@NPs and HA-PS@NPs is observed. Further, orally administered HA-L-Arg-CO2@NPs and HA-PS@NPs via the colon-targeted chitosan/alginate (CA) hydrogel downregulate pro-inflammatory cytokines and reduce intestinal permeability, yielding significant outcomes in alleviating the symptoms of UC.Conclusion: This pH-activated “nano-bomb” carrier with therapeutic effect can be exploited as efficient oral drug carriers for UC treatment.Keywords: ulcerative colitis, pterostilbene, nano-bomb effect, L-arginine, oral administration

Recent decades have witnessed a tremendous growth in the number of Earth observation satellites (EOSs), which presents a huge challenge for mission planning. For the EOSs with optical sensors particularly, the observation mission is significantly influenced by the uncertainty of cloud coverage, which has been identified as the most dominant factor for the invalidation of remote sensing images. To overcome this uncertainty, uncertainty programming methods, namely, chance constraint programming (CCP), stochastic expectation model, and robust optimization, are put forth. Despite their success, these approaches are limited in that they simplified the complex cloud coverage uncertainty, which may be different from the true cloud conditions, and they did not take the true cloud information into consideration. Motivated by these recent trends toward Big Data of satellite cloud images and machine learning for spatiotemporal prediction, this article explores a dynamic replanning scheme for multiple EOSs based on cloud forecasting. Specifically, we propose a new approach mainly in the following three steps: first, proactive scheduling based on a CCP is implemented and uploaded via ground control; second, cloud forecasting can be continuously conducted relying on the predictive recurrent neural network and the latest satellite cloud image; and third, mission replanning can be conducted according to the initial schedule and relatively accurate cloud information. Simulation results show that the cloud forecasting method is effective, and the replanning approach presents highly efficient and accurate scheduling results.

Yongli Pan,1,2,* Ting Wang,3,* Zhiqiang Zhao,4,* Wei Wei,2,5,* Xinyu Yang,6 Xianbin Wang,7 Wenqiang Xin2,6 1Department of Neurology, Weifang Medical University, Weifang, Shandong, People’s Republic of China; 2Georg-August-University of Göttingen, Göttingen, Lower Saxony, Germany; 3Department of Radiology, The Second Affiliated Hospital of Baotou Medical College, Baotou, 014030, People’s Republic of China; 4Department of Neurosurgery, Heji Hospital affiliated Changzhi Medical College, Shanxi, People’s Republic of China; 5Department of Neurology, Mianyang Central Hospital, Mianyang, Sichuan, People’s Republic of China; 6Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China; 7Department of Emergency Medicine, The Second Affiliated Hospital of Baotou Medical College, Baotou, 014030, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wenqiang XinDepartment of Neurosurgery, Tianjin Medical University General Hospital, Anshan Road No. 154, Tianjin, 300052, People’s Republic of ChinaTel +86– 18526201182, Fax +86– 2260362062, Email xinwenqiangdr@126.com Xianbin WangDepartment of Emergency Medicine, The Second Affiliated Hospital of Baotou Medical College, Baotou, 014030, People’s Republic of ChinaEmail wangxianbin198006@163.comAbstract: Nuclear paraspeckle assembly transcript 1 (Neat1) located at chromosome 11 is a long non-coding RNA that is widely expressed in mammalian cell types, and which is overexpressed in several inflammation-related disorders. Inflammation implies a plethora of mutual interactions between both soluble factors and cells due to various stimuli including tissue injury. Although there is no doubt that inflammation is critically involved in multiple biological and pathological processes alike, the precise mechanisms being involved are still open for debate. In this context, the role of Neat1 as a regulator of inflammation, microglial activation, and lipid accumulation under various inflammatory conditions remains elusive. Herein, we review the regulation of Neat1 and how it modulates the expression of its target genes. Thereafter, we will review the impact of Neat1 on inflammation by activating or inhibiting various signaling pathways, such as microRNAs, AKT, TLR4, TRAF6, and NF-κB.Keywords: Neat1, inflammation, microglia, lipids, microRNA, NF-κB

Xiaoling Liu,1,2,&ast; Junhua Mai,1,&ast; Chaoyang Meng,1 Aldona J Spiegel,3 Wei Wei,2 Haifa Shen1 1Department of Nanomedicine, Houston Methodist Academic Institute, Houston, TX, 77030, USA; 2Department of Breast and Thyroid Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong, 518036, People’s Republic of China; 3Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine, Houston, TX, USA&ast;These authors contributed equally to this workCorrespondence: Haifa ShenDepartment of Nanomedicine, Houston Methodist Academic Institute, Houston, TX, 77030, USATel +1 713-441-7321Email HaifaShen@gmail.comBackground: Abdominal flaps are routinely performed in clinic after primary mastectomy of breast cancer. However, cancer patients can still develop cancer recurrence and metastasis after surgery. In this study, we evaluated the feasibility of concurrent abdominal flap reconstruction and vaccine inoculation in the tissue for prevention and treatment of HER2-positive breast cancer.Methods: A murine model of metastatic HER2-positive breast cancer was generated by inoculating HER2-expressing TUBO tumor cells into both the mammary gland fat pad and left ventricle. Mammary gland fat pad with primary tumor was resected by mastectomy, and superficial inferior epigastric (SIE) vessel-based abdominal flap was performed for abdominal reconstruction. During the surgery, mice also received a single intra-flap treatment of a microparticulate-based cancer vaccine. Popliteal (Pop) and inguinal (Ing) lymph nodes (LN) were collected at different time points after vaccination, and activation of dendritic cells and T lymphocytes was evaluated with flow cytometry. ELISpot was also performed to measure HER2-specific T cells in splenocytes. In addition, infiltration of CD3+ T cells in brain metastatic nodules was analyzed with immunohistochemistry.Results: Flow cytometry detected increased number of activated dendritic cells in lymph nodes in mice treated with cancer vaccine. ELISpot revealed abundant IFN-γ-expressing T cells in the spleen. Mice treated with abdominal flap-embedded cancer vaccine extended median survival by 9 days over the control group (p< 0.05).Conclusion: Abdominal flap-embedded cancer vaccine effectively stimulated systemic immune response and inhibited tumor progression in a murine model of HER2-positive breast cancer.Keywords: silicon microparticle, cancer vaccine, peddled flap-based reconstruction, breast cancer, HER2

Weichi Wei,1 Xin Peng,2 Xuan Su3 1Acupuncture and Rehabilitation Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China; 2The Eighth Clinical School of Medicine, Guangzhou University of Chinese Medicine, Foshan, People’s Republic of China; 3The Ninth People’s Hospital of Nanhai District, Foshan, People’s Republic of ChinaCorrespondence: Xuan Su, Email suxuan2022@126.com

Dechao Feng,&ast; Facai Zhang,&ast; Ling Liu,&ast; Qiao Xiong, Hang Xu, Wuran Wei, Zhenghua Liu, Lu Yang Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhenghua Liu; Lu YangDepartment of Urology, Institute of Urology, West China Hospital, Sichuan University, 37 Guoxue Xiang, Chengdu, 610041, Sichuan, People’s Republic of ChinaTel +86 28-8542-2444Fax +86 28-85422451Email zhliu@scu.edu.cn; wycleflue@163.comBackground: There is a surprising paucity of studies investigating the potential mechanism of SKA3 in the progression and prognosis of kidney renal papillary cell carcinoma (KIRP).Methods: We used TCGA and other databases to analyze the expression, clinical value, and potential mechanisms of SKA3 in KIRP patients. We also explored therapeutic agents for KIRP through GSCALite.Results: SKA3 mRNA expression was significantly upregulated and the area under the curve was 0.792 (95% CI 0.727– 0.856). Increased SKA3 expression was related to shorter overall survival, disease-specific survival and progression-free survival. Hub genes in protein–protein interactions were CDK1, CDC20, CCNB1, CCNA2, BUB1, AURKB, BUB1B, PLK1, CCNB2, and MAD2L1, which were differentially expressed and also associated with KIRP prognosis. Gene-set enrichment analysis indicated that E2F targets, epithelial–mesenchymal transition, glycolysis, the WNT signaling pathway, and other pathways were highly enriched upon SKA3 upregulation. Gene-set variation analysis of SKA3 and its ten hub genes showed that the significant correlation of cancer-related pathways included the cell cycle, DNA damage, hormone androgen receptor, hormone estrogen receptor, PI3K/Akt, and Ras/MAPK. In addition, we found that MEK inhibitors, ie, trametinib, selumetinib, PD0325901, and RDEA119, may be feasible targeting agents for KIRP patients.Conclusion: SKA3 might contribute to poor prognosis of KIRP through cell cycle, DNA damage, hormone androgen receptor, hormone estrogen receptor, PI3K/Akt, and RAS/MAPK. SKA3 potentially serves as a prognostic biomarker and target for KIRP.Keywords: spindle and kinetochore–associated complex subunit 3, kidney renal papillary cell carcinoma, biomarker, enrichment analysis, targeted therapy

Wenbin Wei,1 Youxin Chen,2 Bojie Hu,3 Mingwei Zhao,4 Mei Han,5 Hong Dai,6 Harvey S Uy,7 Michelle Y Chen,8 Kate Wang,8 Jenny Jiao,8 Jean Lou,8 Xiao-Yan Li8 1Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Peking Union Medical College Hospital, Beijing, People’s Republic of China; 3Tianjin Medical University Eye Hospital, Tianjin, People’s Republic of China; 4Peking University People’s Hospital, Beijing, People’s Republic of China; 5Tianjin Eye Hospital, Tianjin, People’s Republic of China; 6Beijing Hospital, Beijing, People’s Republic of China; 7Peregrine Eye and Laser Institute, Makati City, Philippines; 8Allergan, an AbbVie company, Irvine, CA, USACorrespondence: Wenbin WeiBeijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang, Dongcheng District, Beijing, 100730, People’s Republic of ChinaEmail tr_weiwenbin@163.comPurpose: To evaluate the safety and efficacy of dexamethasone intravitreal implant 0.7 mg (DEX) compared with laser photocoagulation in patients with diabetic macular edema (DME).Patients and Methods: This Phase 3, multicenter, randomized, efficacy evaluator–masked, parallel-group, 12-month clinical study enrolled adults in China and the Philippines with reduced visual acuity secondary to fovea-involved DME in the study eye. Participants were randomized 1:1 to study eye treatment with laser photocoagulation every 3 months as needed (n = 139) or DEX every 5 months (n = 145). The main efficacy measures were best-corrected visual acuity (BCVA), central retinal thickness (CRT), and leakage area. The primary endpoint was the average change in BCVA from baseline over 12 months (area-under-the-curve method). Preplanned subgroup analyses evaluated outcomes in Chinese patients.Results: Mean average change in BCVA from baseline during the study (letters) was 4.3 with DEX (n = 145) versus 1.4 with laser (n = 127) overall (P = 0.001) and 4.6 with DEX (n = 129) versus 0.6 with laser (n = 113) in Chinese patients (P < 0.001). At Month 12, mean change in CRT from baseline was − 209.5 μm with DEX versus − 120.3 μm with laser (P < 0.001) and mean change in total leakage area from baseline was − 8.367 mm2 with DEX versus − 0.637 mm2 with laser (P < 0.001). The most common treatment-emergent adverse events in the DEX group were increased intraocular pressure and cataract.Conclusion: DEX administered every 5 months provided significantly greater improvement in BCVA, CRT, and total leakage area compared with laser treatment. DEX demonstrated an acceptable safety profile, consistent with an intraocular corticosteroid, and similar to that reported in completed global registration studies.Keywords: central retinal thickness, corticosteroid, dexamethasone, diabetic retinopathy, drug delivery device, laser photocoagulation, randomized controlled trial, macular edema, visual acuity

Quanhong Chu,1 Lin Liao,2 Wenxin Wei,1 Ziming Ye,1 Li Zeng,1 Chao Qin,1 Yanyan Tang1 1Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 2Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of ChinaCorrespondence: Yanyan TangDepartment of Neurology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning, 530021, Guangxi, People’s Republic of ChinaEmail yuji0301@126.comPurpose: Venous thromboembolism (VTE) is a common complication of intracerebral hemorrhage (ICH) patients in intensive care unit (ICU), but anticoagulation therapy of ICH patients with VTE remains controversial. We aim to explore the risk factors and prognosis of anticoagulation therapy in ICH patients with VTE.Patients and Methods: Medical records of ICH patients were collected from the Medical Information Mart for Intensive Care III (MIMIC-III version 1.4) database. The risk factors and prognosis of anticoagulation therapy in ICH patients with VTE were assessed by multivariable logistic regression analysis and Kaplan–Meier survival analysis, respectively.Results: A total of 848 ICH patients were included in our study, of whom 69 ICH patients with VTE were screened, including 58 patients with deep vein thrombosis (DVT), 12 patients with pulmonary embolism (PE), and 1 patient with DVT and PE. In the multivariable logistic regression analysis, malignancy (odds ratio (OR): 4.262, 95% confidence interval (CI): 2.263– 8.027, P=0.000), pulmonary circulation disease (OR: 28.717, 95% CI: 9.566– 86.208, P=0.000), coagulopathy (OR: 2.453, 95% CI: 1.098– 5.483, P=0.029), age > 60 years old (OR: 2.138, 95% CI: 1.087– 4.207, P=0.028) and hospitalization time > 16 days (OR: 2.548, 95% CI: 1.381– 4.701, P=0.003) were independent risk factors for VTE in ICH patients. Kaplan–Meier survival analysis and log-rank test found that, compared to non-anticoagulation group, anticoagulation group had higher cumulative survival rates during hospitalization, 28-day, 3-month, 1-year, and 4-year after admission, respectively.Conclusion: Malignancy, pulmonary circulation disease, coagulopathy, age > 60 years old and hospitalization time > 16 days were independent risk factors for VTE in ICH patients, and anticoagulation therapy for VTE in ICH patients may be safe and effective. These findings need to be verified by more high-quality and well-designed randomized controlled trials.Keywords: intracerebral hemorrhage, venous thromboembolism, risk factors, anticoagulation, prognosis

Pengyu Huang,&ast; Shengrong Du,&ast; Yunhong Lin,&ast; Zhiqing Huang, Haiyan Li, Gangxin Chen, Suzhu Chen, Qingfen Chen, Lincui Da, Hang Shi, Wei Wei, Lei Yang, Yan Sun, Beihong Zheng Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350001, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yan Sun; Beihong Zheng Email sunyan62@163.com; zhengbeihong2010@163.comObjective: It is well known that circRNAs are closely involved in the progression of various diseases. However, their functions and potential regulatory mechanisms in polycystic ovary syndrome (PCOS) remain largely unknown. In the present study, our aim was to investigate the potential diagnostic value of circRNAs in PCOS.Methods: The circRNA dataset GSE145296, mRNA dataset GSE155489 and miRNA GSE138572 were downloaded from Gene Expression Omnibus (GEO) database. Then, differentially expressed genes (DEGs) were identified. Based on the potential interactions, a network of cirRNA-related competing endogenous RNAs (ceRNAs) was constructed. Biological functions were predicted by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. For further validation, qRT-PCR method was used to detect the expression level of the candidate circRNAs. Then, receiver operating characteristics (ROC) were constructed to evaluate the diagnostic value of the three differentially expressed circRNA (DE-circRNA).Results: We constructed a network of cirRNA-related ceRNA network. Hsa_circ_0075691, hsa_circ_0075692 and hsa_circ_0085997 were validate to be dysregulated in PCOS.Conclusion: Hsa_circ_0075691, hsa_circ_0075692 and hsa_circ_0085997 may be potential diagnostic biomarkers of PCOS, but their specific regulatory mechanisms still need to be further studied.Keywords: polycystic ovary syndrome, circRNA, biomarkers, bioinformatics

Yongli Pan,1,&ast; Qingzheng Jiao,2,&ast; Wei Wei,3,&ast; Tianyang Zheng,4,&ast; Xinyu Yang,5 Wenqiang Xin5 1Department of Neurology, Weifang Medical University, Weifang, Shandong, People’s Republic of China; 2Second Department of Internal Medicine, Gucheng County Hospital, Gucheng, Hebei, People’s Republic of China; 3Department of Neurology, Mianyang Central Hospital, Mianyang, Sichuan, People’s Republic of China; 4Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin, People’s Republic of China; 5Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wenqiang XinDepartment of Neurosurgery, Tianjin Medical University General Hospital, Anshan Road No. 154, Tianjin, 300052, People’s Republic of ChinaTel +86– 185 26201182Fax +86– 22 60362062Email xinwenqiangdr@126.comAbstract: As a crucial kind of pervasive gene, long noncoding RNAs (lncRNAs) are abundant and key players in brain function as well as numerous neurological disorders, especially ischemic stroke. The mechanisms underlying ischemic stroke include angiogenesis, autophagy, apoptosis, cell death, and neuroinflammation. Inflammation plays a vital role in the pathological process of ischemic stroke, and systemic inflammation affects the patient’s prognosis. Although a great deal of research has illustrated that various lncRNAs are closely relevant to regulate neuroinflammation and microglial activation in ischemic stroke, the specific interactional relationships and mechanisms between lncRNAs and neuroinflammation have not been described clearly. This review aimed to summarize the therapeutic effects and action mechanisms of lncRNAs on ischemia by regulating inflammation and microglial activation. In addition, we emphasize that lncRNAs have the potential to modulate inflammation by inhibiting and activating various signaling pathways, such as microRNAs, NF‐κB and ERK.Keywords: ischemic stroke, long noncoding RNA, microglia, neuroinflammation

Qingshan Huang,1 Lijun Xie,2 Liyan Huang,2 Weili Wei,2 Haiying Li,2 Yunfang Zhuang,2 Xinxiu Liu,2 Shuqiang Chen,2 Sufang Zhang2 1Musculoskeletal Tumor Center, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China; 2Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People’s Republic of ChinaCorrespondence: Sufang ZhangDepartment of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People’s Republic of ChinaTel/Fax +86-591-87981961Email zsufang@fjmu.edu.cnQingshan HuangMusculoskeletal Tumor Center, Peking University People’s Hospital, Beijing, 100044, People’s Republic of ChinaTel/Fax +86-10-88324471Email hqingshan@pku.edu.cnBackground: High-resolution ultrasound is the first choice for the diagnosis of thyroid nodules, but it is still difficult to distinguish between follicular thyroid carcinoma (FTC) and follicular adenoma (FA). Our research aimed to develop and validate an ultrasonic diagnostic model for differentiating FTC from FA.Methods: This study retrospectively analyzed 196 patients who were diagnosed as FTC (n=83) and FA (n=113). LASSO regression analysis was used to screen clinical and ultrasonic features. Multivariate logistic regression analysis was used to establish the ultrasonic diagnostic model of FTC. Nomogram was used for the visualization of diagnostic models. C-index, ROC, and calibration curves analysis were used to evaluate the accuracy of the diagnostic model. Decision curve analysis (DCA) was used to evaluate the net benefits of the ultrasonic diagnostic model for FTC diagnosis under different threshold probabilities. The bootstrap method was used to verify the ultrasonic diagnostic model.Results: After Lasso regression analysis, 10 clinical and ultrasonic features were used to construct the ultrasonic diagnostic model of FTC. The C-index and AUC of the model were 0.868 and 0.860, respectively. DCA showed that the ultrasonic model had good clinical application value. The C-index in the validation group was 0.818, which was close to the C-index in the model.Conclusion: Ultrasonic diagnostic model constructed with 10 clinical and ultrasonic features can better distinguish FTC from FA.Keywords: follicular thyroid carcinoma, follicular adenoma, diagnostic, ultrasonic

Jie Mei,1,2,&ast; Xu-Qi Sun,3,&ast; Wen-Ping Lin,1,2,&ast; Shao-Hua Li,1,2 Liang-He Lu,1,2 Jing-Wen Zou,1,2 Wei Wei,1,2 Rong-Ping Guo1,2 1Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China; 2State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People’s Republic of China; 3Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Rong-Ping Guo; Wei Wei Email guorp@sysucc.org.cn; weiwei@sysucc.org.cnBackground: Inflammatory response is related to cancer progression and patient survival. However, the value in predicting survival in hepatocellular carcinoma (HCC) patients who received anti-PD-1 therapy has not been elucidated. This study aimed to compare the predictive ability of inflammation-based scores for the prognosis of HCC patients after anti-PD-1 therapy.Methods: A total of 442 patients who received anti-PD-1 therapy were included in the study. Representative inflammation-based prognostic scores, including the platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-C-reactive protein (CRP) ratio (LCR), lymphocyte-to-monocyte ratio (LMR), systemic immune inflammation index (SII), CRP-to-albumin ratio (CAR), prognostic nutritional index (PNI), Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), and prognostic index (PI), were assessed for prediction accuracy using Kaplan–Meier survival curves, time-dependent receiver operating characteristic (ROC) and Harrell’s concordance index (C-index) analyses.Results: All the inflammation-based prognostic scores exhibited good discriminatory ability in overall survival (OS) (all P < 0.01), while the PNI score was a unique independent predictor for OS in multivariate analysis (hazard ratio, 1.770; confidence interval, 1.309– 2.393; P < 0.001). The areas under the ROC curves at 6, 12, 18 and 24 months and the C-index (0.65) demonstrated that the predictive accuracy of the PNI score was superior to that of the other inflammation-based scores.Conclusion: The PNI score is a discriminatory prognostic indicator for OS in HCC patients with anti-PD-1 therapy and is superior to the other inflammation-based prognostic scores in terms of predictive ability.Keywords: inflammation-based score, hepatocellular carcinoma, anti-PD-1 therapy, overall survival, prognostic nutritional index

Haozhang Huang,1,2,* Ziling Mai,1,3,* Liling Chen,4,* Qiang Li,1 Shiqun Chen,1 Kunming Bao,4 Ronghui Tang,5 Wen Wei,4 Yaren Yu,6 Zhidong Huang,1 Wenguang Lai,1,3 Bo Wang,1 Ning Tan,1– 3 Jiyan Chen,1– 3 Jin Liu,1 Yong Liu1– 3 1Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of China; 2The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, People’s Republic of China; 3Guangdong General Hospital, Affiliated with South China University of Technology, Guangzhou, 510515, People’s Republic of China; 4Department of Cardiology, Longyan First Hospital Affiliated with Fujian Medical University, Longyan, 364000, People’s Republic of China; 5Yunnan Fuwai Cardiovascular Hospital, Department of Ultrasound Imaging, Yunnan, 650000, People’s Republic of China; 6The First People’s Hospital of Foshan, Foshan, Guangdong Province, 528000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yong Liu; Jin LiuDepartment of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of ChinaTel +86 2083827812-10528Fax +86 2083851483Email liuyong@gdph.org.cn; ljaw397017568@163.comPurpose: Hypochloremia is a predictor for short-term mortality in patients with cardiovascular disease, but its association with coronary artery disease (CAD) is still unclear. We aimed to assess the impact of hypochloremia on all-cause mortality (short-and long-term) among patients with CAD.Patients and Methods: Based on the registry at Guangdong Provincial People’s Hospital in China, we analyzed data of 49,025 hospitalized patients who underwent coronary angiography (CAG) and were diagnosed with CAD from January 2007 to December 2018. To assess the association between hypochloremia and the study endpoints, a logistic-regression model (for 30-day all-cause mortality) and a Cox regression model (for long-term all-cause mortality) were fitted.Results: Overall, 4.4% of the study population showed hypochloremia (< 98 mmol/L). During a median follow-up of 5.2 (3.1– 7.8) years, a total of 6486 (13.2%) patients died. Patients with hypochloremia were generally older and at risk for diabetes, cardiorenal dysfunction, and morbidity than those without hypochloremia. After adjustment for confounders, hypochloremia remained a significant predictor of mortality risk (30-day all-cause death: adjusted odds ratio [aOR], 1.99; 95% confidence interval, 1.08– 3.18; P=0.017 and long-term all-cause death: adjusted hazard ratio [aHR], 1.32; 95% confidence interval, 1.19– 1.47; P< 0.001).Conclusion: Hypochloremia is mildly common in patients with CAD and is associated with increased short-and long-term mortality. Meanwhile, it is necessary to further investigate effective and preventive measures and the potential mechanisms of hypochloremia in patients with CAD.Keywords: hypochloremia, coronary artery disease, prevalence, short- and long-term mortality

Chen-Hao Zhang,1,&ast; Xiao-Lan Su,2,&ast; Yi-Ying Liu,1 Long Lin,1 Yin-Chun Wang,1 Xiao-Dong Li,1 Jin-Ze Zhang,1 Wei Wei2 1Department of Emergency, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, 100102, People’s Republic of China; 2Department of Gastroenterology, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, 100102, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Chen-Hao ZhangDepartment of Emergency, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, 100102, People’s Republic of ChinaTel +86 136 7139 3316Email zhangch_dr@163.comWei WeiDepartment of Gastroenterology, Wangjing Hospital of China Academy of Chinese Medical Sciences, No. 6 of Wangjing Zhonghuan South Street, Chaoyang District, Beijing, 100102, People’s Republic of ChinaTel +86 13601233816Email weiweigrt@163.comBackground: To investigate the effects of Chinese herbal medicine in tonifying qi and attaining hemostasis caused by the metabolism of the drug clopidogrel and as a result of platelet and gastric mucosa injury in an ischemia-reperfusion rat model.Methods: A pharmacokinetic model was established to record the drug metabolism parameters of clopidogrel metabolites. Then, absorption of the drug was compared with approaches using the traditional Chinese medicine (TCM) approach of tonifying qi and establishing hemostasis, to using the drug pantoprazole and applying these approaches in combination with clopidogrel. Intragastric administration was performed, and all indicators were tested.Results: The area under the curve (AUC; 0–T, 300.342 ± 35.832 mg/L&ast; h; AUC 0–∞, 320.462 ± 40.213 mg/L&ast; h), the plasma peak concentration (30.622 ± 9.917 mg/L&ast;), and the peak time and half-life (7.954 ± 1.121 h) in the clopidogrel and the TCM groups were higher than those in the clopidogrel and pantoprazole groups. In terms of antiplatelet aggregation, compared with model group, the platelet aggregation rate induced by arachidonic acid (AA) and adenosine diphosphate (ADP) was significantly decreased by the TCM approach of tonifying qi and stopping bleeding (p < 0.05). The ADP, thromboxane A2, GPII B/Pa-A, CD62P and platelet factor 4 content in the TCM yiqi decoction and hemostasis approach were significantly decreased (p < 0.01). Compared with the clopidogrel group, the gastrin and motilin in the serum, the cyclooxygenase (COX)-1 and prostaglandin E2 in gastric tissue, and expression of vascular endothelial growth factor messenger ribonucleic acid in the serum were all significantly increased using TCM approach to protect against gastric mucosal injury (p < 0.05).Conclusion: TCM invigorating qi and hemostasis has an inhibitory effect on platelet activation. It can reduce the local inflammatory reaction at the same time as protecting gastric mucosa.Keywords: supplementing qi and hemostasis herbs, proton pump inhibition, antiplatelet effect, gastric mucosal protection, traditional Chinese medicine

Xiuli Wang,1,2,&ast; Cui Fang,1,2,&ast; Xiaoxi Liu,1,&ast; Wei Wei,3 Mengfan Zhang,2,4 Shuang Chen,2,4 Fuping Shi1 1Department of Neurology, Affiliated Hospital of Hebei University, Baoding, People’s Republic of China; 2School of Clinical Medicine, Hebei University, Baoding, People’s Republic of China; 3Department of Radiology, Hebei Province Veterans Hospital, Baoding, People’s Republic of China; 4Department of Internal Medicine, Affiliated Hospital of Hebei University, Baoding, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Fuping ShiDepartment of Neurology, Affiliated Hospital of Hebei University, No. 212 East Yuhua Road, Baoding, Hebei, 071000, People’s Republic of ChinaTel +86 132 7321 0990Email sfp-1000@163.comPurpose: Post-stroke depression (PSD) is one of the emotional disorders after the onset of stroke. Many studies have indicated that inflammatory processes can promote the occurrence and development of PSD. The purpose of our study was to explore the potential relationship between PSD and two inflammatory biomarkers: inducible nitric oxide synthase (iNOS) and macrophage inflammatory protein 1α (MIP-1α).Methods: In total, 80 patients diagnosed with depression after the first-ever acute ischemic stroke were enrolled in PSD group consecutively. During the same period, 40 non-depressed patients following the first-ever acute ischemic stroke and 40 healthy control subjects were recruited as non-PSD group and normal group, respectively. All participants have performed serum iNOS and MIP-1α level examination with enzyme-linked immunosorbent assay (ELISA). The severity of depressive symptoms was evaluated by the 24-item Hamilton Depression Scale (HAMD-24).Results: Serum iNOS and MIP-1α levels were significantly higher in PSD group than those in non-PSD and normal groups (P < 0.001). Serum iNOS and MIP-1α levels of PSD patients with varying degrees of depression were significantly different, serum iNOS and MIP-1α levels became higher as the depressive symptoms became more severe (P < 0.05). There was a positive correlation between the elevated levels of iNOS, MIP-1α and HAMD scores (r = 0.262, 0.209, P < 0.05). Logistic regression analysis showed that both serum iNOS and MIP-1α levels were independently associated with PSD (OR = 2.790, 95% CI: 0.712– 10.933, P < 0.05 and OR = 1.922, 95% CI: 0.648– 9.815, P < 0.05, respectively) after adjustment for possible relevant confounders.Conclusion: High serum levels of iNOS and MIP-1α were found to be associated with the development of PSD and closely related to its severity.Keywords: post-stroke depression, inducible nitric oxide synthase, macrophage inflammatory protein 1α, HAMD scores

Jiawei Li,1 Guobin Zhong,1 Keqiong Wang,1 Wei Kang,2 Wei Wei1 1Department of Breast Surgery, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, People’s Republic of China; 2Dominant Cultivation Discipline of Guangxi Medical University Cancer Hospital (Medical Imaging Department), Guangxi Key Clinical Specialty (Medical Imaging Department), Nanning, Guangxi, People’s Republic of ChinaCorrespondence: Wei Wei; Wei Kang Email 605347565@qq.com; xuanbingche0313@126.comBackground: Breast-conserving surgery plus postoperative radiotherapy is the standard surgical treatment mode for early breast cancer. Currently, there are no clear predictive indicators to determine whether a patient can choose breast-conserving surgery, which mainly depends on the surgeon’s clinical experience and subjective judgment. Cone-beam breast computed tomography (CBBCT) reconstructs the breast 3D image from three mutually perpendicular angles, helping surgeons to locate and accurately measure the volume of the tumor, mammary gland, and breast. We used CBBCT to retrospectively measure the tumor-to-gland volume ratio and tumor-to-breast volume ratio in breast cancer cases. Then, we analyzed the correlation between the surgical methods and ratios in breast cancer patients.Methods: We collected 100 patients undergoing breast-conserving surgery as the study group, and 100 patients undergoing mastectomy as the control group. All patients chose the surgical approach after comprehensive consideration of examination results and assessment of patient condition. Patients underwent CBBCT examination before surgery. We retrospectively measured the volume of tumor, mammary glands and breast, then calculated tumor-to-gland and tumor-to-breast volume ratios.Results: Tumor volume and the ratios of the two groups statistically differed (P < 0.001), while the mammary gland and breast volume did not (P > 0.05). The average tumor-to-gland volume ratio was 4.32% in the study group and 10.74% in the control group, and the average tumor-to-breast volume ratio was 0.74% in the study group and 1.36% in the control group. In breast-conserving surgery, the 95% reference range of tumor-to-gland ratio is (0, 12.90%), and the 95% reference range of tumor-to-breast ratio is (0, 2.17%).Conclusion: The tumor-to-gland volume ratio and tumor-to-breast volume ratio measured using CBBCT are correlated with the choice of surgical methods (breast-conserving surgery or mastectomy) for breast cancer patients. This can be used as possible predictor of breast-conserving surgery to help surgeons.Keywords: breast cancer, cone-beam breast computed tomography, CBBCT, tumor-to-gland volume ratio, tumor-to-breast volume ratio, breast-conserving surgery

Sufang Zhang,1,* Liyan Huang,1,* Qingshan Huang,2,* Weili Wei,1 Lijun Xie,1 Jinshu Zeng,1 Qiuyang Gu,1 Ling Chen,1 Shuqiang Chen1 1Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People’s Republic of China; 2Musculoskeletal Tumor Center, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shuqiang ChenDepartment of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People’s Republic of ChinaTel/Fax +86-591-87981961Email chenshu0518@163.comPurpose: Ultrasonography as the first choice for thyroid nodules is still difficult to distinguish between solid follicular thyroid neoplasm (FTN) and solid nodular goiter (NG). We tried to investigate the value of relative size (M/S, M: the maximum diameter of target nodule, S: the maximum diameter of the largest of the remaining nodules) that may help to differentiate FTN from NG.Methods: T test and chi-square test were used to retrospectively analyze the differences of the clinical and ultrasonographic characteristics between FTN and NG in 422 cases in our hospital. T test was used to analyze the difference of M/S value in the two kinds of nodules. ROC was used to evaluate the accuracy of M/S value in distinguishing the two.Results: There were statistically significant differences in age, echogenicity, calcification, peripheral halo and blood supply between the two. The M/S value is not only significantly different in the two kinds of nodules but also can be used as a quantitative indicator to guide ultrasound diagnosis. ROC analysis showed that the cutoff point and AUC of M/S value were 1.94 and 0.709, respectively.Conclusion: In the ultrasound diagnosis of multiple thyroid nodules, the M/S value can better distinguish FTN and NG. We need to be aware of FTN when the M/S value of the nodule is greater than 2.Keywords: follicular thyroid neoplasm, nodular goiter, size, ultrasonography

Yunchao Wang,1 Ning Dai,1 Wei Wei,2 Chunyan Jiang1 1Department of Internal Medicine and Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Clinical Epidemiology and EBM, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Chunyan JiangDepartment of Internal Medicine and Geriatrics, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong’an Road, Xicheng District, Beijing, 100050, People’s Republic of ChinaTel + 86 10 63137648Fax + 86 10 63138795Email chunyan_jiang@ccmu.edu.cnPurpose: This retrospective observational study investigated the efficacy and safety of vancomycin to treat patients aged 80 years and older. In particular, the associations between vancomycin trough concentration (VTC) and treatment outcomes or nephrotoxicity were explored.Patients and Methods: Patients aged ≥ 80 years had received ≥ 3 vancomycin treatments and ≥ 1 detection of VTC. Treatment outcomes were defined as success or failure. Nephrotoxicity was considered an increase in serum creatinine ≥ 44.2 mmol/L, or 50% above baseline, for ≥ 2 consecutive days. Univariate and multivariate analyses were performed to identify risk factors for treatment failure and nephrotoxicity.Results: Of 349 patients, 120 (34.4%) experienced treatment failure. For patients with VTCs at < 10, 10– 15, 15– 20, and ≥ 20 μg/mL, the clinical response rates were, respectively, 77.8, 77.0, 80.5, and 61.0%; the 30-day mortality rates were 2.8, 15.0, 15.3, and 37.8%; and the rates of persistent bacteremia were 16.7, 12.4, 11.9, and 11.0%. The multivariate analysis indicated that blood urea nitrogen ≥ 11 g/dL and heart failure were independently associated with treatment failure; but not VTC (P = 0.004, 0.016, 0.828, respectively). During vancomycin treatment, 42 (12.0%) patients experienced nephrotoxicity with recovery time 7.5 ± 4.5 days. Fewer than half of patients with nephrotoxicity recovered after suspending vancomycin application. The variables found independently associated with increased nephrotoxicity were: VTC ≥ 15 μg/mL; treatment duration ≥ 15 d; and concomitant aminoglycosides administration (P = 0.024, 0.035, 0.029).Conclusion: In patients aged 80 years and older, elevated VTC level was not associated with favorable treatment outcomes. Patients with VTC ≥ 20 μg/mL appear to suggest a worsened prognosis compared with lower VTCs. The risk of nephrotoxicity increases with elevated VTC, longer treatment time, and concomitant aminoglycoside administration.Keywords: elderly, vancomycin trough concentration, outcome, nephrotoxicity

Qian Wang,1,* Jingyan Yang,1,* Jost B Jonas,2 Xuehui Shi,1 Shouling Wu,3 Shuohua Chen,4 Yanni Yan,1 Wenjia Zhou,1 Li Dong,1 Wenbin Wei,1 Ya Xing Wang5 1Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karis-University, Mannheim, Germany; 3Cardiology Department, Kailuan General Hospital, Tangshan, People’s Republic of China; 4Health Care Center, Kailuan Group, Tangshan, People’s Republic of China; 5Beijing Institute of Ophthalmology and Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wenbin WeiBeijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Xiang, Dong Cheng District, Beijing, 100730, People’s Republic of ChinaTel +86-10-58269516Fax +86-10-6512 5617Email weiwenbintr@163.comPurpose: To investigate the prevalence of retinal vein occlusions (RVOs) and associated factors in a Chinese population.Patients and Methods: The cross-sectional community-based Kailuan Eye Study included individuals who participated in the Kailuan Study. RVOs were diagnosed on the fundus photographs. Estimated cerebrospinal fluid pressure (eCSFP) was calculated as “eCSFP=0.44*Body Mass Index+0.16*Diastolic Blood Pressure-0.18*Age”.Results: The study included 12,499 participants with a mean age of 52.9± 13.1 years. The overall prevalence of RVO was 120/12,499 or 0.96%, with branch RVOs observed in 116/12,499 individuals and central RVOs in 4/12,499 individuals. RVOs started at the optic disc in 19 participants (15.8% of all RVOs), and in 101 (84.2%) individuals arterio-venous crossings outside the optic disc. In multivariable analysis, a higher RVO prevalence was associated with older age (P< 0.001), higher eCSFP (P< 0.001), and higher fasting serum glucose concentration (P< 0.001). Differentiating between RVOs at arterio-venous crossings and RVOs at the optic disc revealed that the prevalence of both RVO types was associated with higher eCSFP (P< 0.001 and P=0.004, respectively) after adjusting for age and fasting serum glucose concentration.Conclusion: In this adult Chinese population recruited on a community basis, the prevalence of any RVO (mean: 0.96) was associated with older age, higher eCSFP and higher fasting serum glucose concentration. Higher eCSFP may play an etiologic role in RVOs.Keywords: retinal vein occlusion, blood pressure, arterial hypertension, glaucoma, intraocular pressure, cerebrospinal fluid pressure