Search

Ruixue Zhang,1 Hui Xu,1 Xiaoxue Zhang,1 Hui Xiong,2 Fei Tang,3 Liping Lv,3 Xiangdong Mu,4 Wei Tian,5 Yueguang Cheng,6 JianRong Lu,6 Xiuhong Nie,7 Yang Guo,8 Yingying Liu,9 Zhi Zhang,10 Lianjun Lin1 1Department of Geriatrics, Peking University First Hospital, Beijing, People’s Republic of China; 2Department of Emergency, Peking University First Hospital, Beijing, People’s Republic of China; 3Department of Interventional Pulmonology, Anhui Province Chest Hospital, Hefei, People’s Republic of China; 4Department of Respiratory, Tsinghua Changgung Hospital, Beijing, People’s Republic of China; 5Department of Geriatrics, Jishuitan Hospital, Beijing, People’s Republic of China; 6Department of Emergency, Jingmei Group General Hospital, Beijing, People’s Republic of China; 7Department of Respiratory, Xuanwu Hospital, Beijing, People’s Republic of China; 8Department of Endoscopic Diagnosis &treatment, Beijing Chest Hospital, Capital Medical University, Beijing, People’s Republic of China; 9CapitalBio Technology Co., Ltd, Beijing, People’s Republic of China; 10Bio Biological Group Co., Ltd, Beijing, People’s Republic of ChinaCorrespondence: Lianjun Lin, Department of Geriatrics, Peking University First Hospital, No. 8 Xishiku Avenue, Beijing, 100034, People’s Republic of China, Email 06474@pkufh.comPurpose: The detection of pathogenic microorganisms plays a significant role in the diagnosis and management of pneumonia that are responsible for a substantial number of deaths worldwide. However, conventional microbiological tests (CMT) have low accuracy and are time-consuming. In this study, we aim to evaluate the clinical value of Chips for Complicated Infection Detection (CCID) in detecting pneumonia pathogens.Patients and Methods: This study was conducted at nine hospitals in China from January 2021 to September 2022. Respiratory samples from adult pneumonia patients were collected from each patient. CMT and CCID were performed in parallel to identify the pathogens.Results: A total of 245 patients were included, with 73% being elderly. CCID identified pathogenic microbes in 78.0% of patients and conventional microbiological tests (CMT) in 57.1% of the patients (p< 0.001). The overall positive and negative percent agreements between CCID and CMT for pathogen detection were 90.07% and 38.46%, respectively. 38.8% of patients were diagnosed with mixed infections with at least two pathogens by CCID. Bacterial infections identified by CCID accounted for 60.0% of 245 patients, with the top 3 being Pseudomonas aeruginosa, Klebsiella pneumoniae, and Enterococcus faecium, respectively. K. pneumoniae was the most common pathogen in elderly patients, with a significantly higher prevalence compared to non-elderly patients (p = 0.0011). Among the 197 patients who had used antibiotics before sample collection, the positive rate of CCID was significantly higher than that of CMT (p < 0.001).Conclusion: This study indicates that compared to CMT, this novel chip has significant advantages in detecting pathogens in pneumonia patients, especially in the elderly.Keywords: pneumonia, elderly, pathogens, chip, LAMP

Xue Yang,1,&ast; Man Wu,2,&ast; Tangzhiming Li,3,&ast; Jie Yu,4 Tian Fu,5 Guoping Li,6 Huanwen Xiong,7 Gang Liao,8 Sensen Zhang,9 Shaofeng Li,10 Zhonghua Zeng,11 Chun Chen,12 Benhui Liang,13,14 Zhiguo Zhou,15 Ming Lu16 1Shenzhen Institute of Respiratory Diseases, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, Shanghai Public Health Clinical Center Affiliated to Fudan University, Shanghai, People’s Republic of China; 3Department of Cardiology, Shenzhen Cardiovascular Minimally Invasive Medical Engineering Technology Research and Development Center, Shenzhen People’s Hospital (The Second Clinical Medical College, The First Affiliated Hospital, Southern University of Science and Technology, Jinan University), Shenzhen, Guangdong, People’s Republic of China; 4Department of Respiratory and Critical Care Medicine, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, People’s Republic of China; 5Department of Respiratory and Critical Care Medicine, Jining No 1. People’s Hospital, Jining, Shandong, People’s Republic of China; 6Department of Respiratory and Critical Care Medicine, Tongde Hospital of Zhejiang Hangzhou, Zhejiang, People’s Republic of China; 7Department of Respiratory and Critical Care Medicine, Gaoxin Branch of The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China; 8Department of Respiratory and Critical Care Medicine, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Shenzhen, Guangdong, People’s Republic of China; 9Department of Respiratory Medicine, The Third Central Hospital of Tianjin, Tianjin, People’s Republic of China; 10Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, People’s Republic of China; 11Department of Respiratory and Critical Care Medicine, The First People’s Hospital of Fuzhou, Jiangxi, People’s Republic of China; 12Cancer Center, Department of Pulmonary and Critical Care Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, People’s Republic of China; 13Department of Cardiology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 14Department of Structural Heart Disease, National Center for Cardiovascular Disease, China & State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Health Commission Key Laboratory of Cardiovascular Regeneration Medicine, National Clinical Research Center for Cardiovascular Diseases, Beijing, People’s Republic of China; 15Department of Pulmonary and Critical Care Medicine, The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, People’s Republic of China; 16Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhiguo Zhou, Department of Pulmonary and Critical Care Medicine, The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, People’s Republic of China, Email zhouzhiguo1217@163.com Ming Lu, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, People’s Republic of China, Email 602032934@qq.comIntroduction: C. psittaci pneumonia has atypical clinical manifestations and is often ignored by clinicians. This study analyzed the clinical characteristics, explored the risk factors for composite outcome and established a prediction model for early prediction of composite outcome among C. psittaci pneumonia patients.Methods: A multicenter, retrospective, observational cohort study was conducted in ten Chinese tertiary hospitals. Patients diagnosed with C. psittaci pneumonia were included, and their clinical data were collected and analyzed. The composite outcome of C. psittaci pneumonia included death during hospitalization, ICU admission, and mechanical ventilation. Univariate and multivariable logistic regression analyses were conducted to determine the significant variables. A ten-fold cross-validation was performed to internally validate the model. The model performance was evaluated using various methods, including receiver operating characteristics (ROC), C-index, sensitivity, specificity, positive/negative predictive value (PPV/NPV), decision curve analysis (DCA), and clinical impact curve analysis (CICA).Results: In total, 83 patients comprised training cohorts and 36 patients comprised validation cohorts. CURB-65 was used to establish predictive Model 1. Multivariate logistic regression analysis identified three independent prognostic factors, including serum albumin, CURB-65, and white blood cells. These factors were employed to construct model 2. Model 2 had acceptable discrimination (AUC of 0.898 and 0.825 for the training and validation sets, respectively) and robust internal validity. The specificity, sensitivity, NPV, and PPV for predicting composite outcome in the nomogram model were 91.7%, 84.5%, 50.0%, and 98.4% in the training sets, and 100.0%, 64.7%, 14.2%, and 100.0% in the validation sets. DCA and CICA showed that the nomogram model was clinically practical.Conclusion: This study constructs a refined nomogram model for predicting the composite outcome in C. psittaci pneumonia patients. This nomogram model enables early and accurate C. psittaci pneumonia patients’ evaluation, which may improve clinical outcomes.Keywords: Chlamydia psittaci pneumonia, nomogram, prediction model, composite outcome

Min Fang,1,2 Wei Yin,3 Chunyan Qiu,4 Tao Song,2 Baihua Lin,2 Ying Wang,2 Hanchu Xiong,2 Shixiu Wu1 1Department of Radiation Oncology, The Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, Zhejiang, People’s Republic of China; 2Cancer Center, Department of Radiation Oncology, Zhejiang Provincial People’s Hospital(Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of China; 3Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang, People’s Republic of China; 4National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, People’s Republic of ChinaCorrespondence: Wei Yin, Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang, People’s Republic of China, Email hzyinwei@live.cn Shixiu Wu, Department of Radiation Oncology, The Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, Zhejiang, People’s Republic of China, Email wushixiu@yeah.netObjective: Immune cells play a key role in tumor microenvironment. The purpose of this study was to investigate the infiltration and clinical indication of immune cells including their combined prognostic value in microenvironment of triple negative breast cancer.Methods: We investigated 100 patients with triple negative breast cancer by Opal/Tyramide Signal Amplification multispectral immunofluorescence between 2003 and 2017 at Zhejiang Provincial people’s Hospital. Intratumoral and stromal immune cells of triple negative breast cancer were classified and quantitatively analyzed. Survival outcomes were compared using the Kaplan–Meier method and further analyzed with multivariate analysis.Results: Infiltration level of stromal B lymphocytes, stromal and intratumoral CD8+ T cells, stromal CD4+ T cells, stromal PD-L1 and intratumoral tumor associated macrophages 2 cells were shown as independent factors affecting disease-free survival and overall survival in univariate analysis. Stromal B lymphocytes, T stage, N stage and pathological type were independent predictive factors for both DFS and OS in multivariate analysis. We firstly found that patients with B lymphocytes-enriched subtypes have a better prognosis than those with T lymphocytes-enriched subtypes and tumor-associated macrophage-enriched subtypes.Conclusion: The present study identified a bunch of immune targets and subtypes, which could be exploited in future combined immunotherapy/chemotherapy strategies for triple negative breast cancer patients.Keywords: triple negative breast cancer, B lymphocytes, T lymphocytes, tumor associated macrophages, multispectral immunofluorescence, prognosis

Yuqi Li,1,2,&ast; Changjin Ji,1,2,&ast; Weiao Sun,1,2 Huahui Xiong,1,2 Zheng Li,3 Xiaoqing Huang,1,2 Tingting Fan,1,2 Junfang Xian,3 Yaqi Huang1,2 1School of Biomedical Engineering, Capital Medical University, Beijing, People’s Republic of China; 2Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, People’s Republic of China; 3Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yaqi Huang, School of Biomedical Engineering, Capital Medical University, Beijing, People’s Republic of China, Tel +86-10-83911809, Email yqhuang@ccmu.edu.cn Junfang Xian, Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China, Email cjr.xianjunfan@vip.163.comPurpose: Upper airway collapse during sleep in patients with obstructive sleep apnea (OSA) is a complex and dynamic phenomenon. By observing and analyzing the dynamic changes in the upper airway and its surrounding tissues during airway obstruction, we aim to reveal dynamic characteristics in different obstruction patterns, and the relationship between anatomical features during normal breathing and dynamic characteristics of airway obstruction.Patients and Methods: Dynamic MRI was performed in 23 male patients (age range 26– 63) with severe OSA diagnosed by overnight polysomnography, and obstruction events were identified from their images. Dynamic changes in parameters of the upper airway and surrounding tissues were measured to assess the key characteristics in different obstruction patterns.Results: We categorized airway obstruction into four types based on the obstruction location and motion characteristics of tissues during collapse, and detailed the alterations in the airway and surrounding tissues under each obstruction pattern. In all 112 obstruction events extracted from the dynamic images of 23 patients, type A (retropalatal obstruction caused by the soft palate separated from the tongue), BI, BII (both retropalatal obstructions caused by the soft palate attached to the tongue, and C (retropalatal and retroglossal obstruction caused by the soft palate and the tongue), accounted for 28.6%, 44.6%, 12.5%, and 14.3% respectively. In severe OSA patients with tongue and palatal obstruction related to type B or C, the more posterior hyoid position, shorter distance between tongue and uvula, and wider retropalatal space, the larger the tongue displacement and deformation during collapse, and the greater the reduction in airway space.Conclusion: There are multiple airway obstruction patterns, each with its own anatomical characteristics and behaviors during collapse. Hyoid position, tongue and uvula distance, and retropalatal space play an important role in airway collapse and should be paid more attention in the treatment of OSA.Keywords: airway obstruction patterns, obstruction location, tissue motion characteristics, hyoid position, retropalatal space

Qianqian Zhou,1 Shengru Zhou,1 Huizi Xiong,1 Jianqiu Yang,1 Ziliang Yang,2 Naihui Zhou,2 Jinzhu Mao,2 Min Li1,2 1Department of Dermatology, Dushu Lake Hospital Affiliated to Soochow University (Medical Center of Soochow University, Suzhou Dushu Lake Hospital), Suzhou, People’s Republic of China; 2Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of ChinaCorrespondence: Min Li, Department of Dermatology, Dushu Lake Hospital Affiliated to Soochow University (Medical Center of Soochow University, Suzhou Dushu Lake Hospital), No. 9, Chongwen Road, Suzhou, 215123, People’s Republic of China, Tel +86-18936140383, Email lm@suda.edu.cnIntroduction: Psoriasis is an immune-mediated chronic inflammatory skin disease. As our understanding of the pathogenesis of psoriasis has improved, biologic agents have become increasingly important in the treatment of psoriasis. However, the use of biologic agents is associated with cutaneous side effects. A new type of side effect called paradoxical reactions is an emerging threat arising from the increasing use of biologic agents.Case: Here, we present a case of paradoxical skin reactions – pyoderma gangrenosum (PG) and eczema – induced by biologic therapy. The case was successfully and eventually treated with baricitinib.Discussion: PG is a rare inflammatory disease characterised by painful and necrotic ulcerations containing neutrophils. It has been associated with autoimmune diseases such as inflammatory bowel disease (IBD). TNF (tumor necrosis factor) -α inhibitors can effectively treat refractory PG, while IL (interleukin) − 17A inhibitors may worsen IBD symptoms. The cause of PG in this case was believed to be secukinumab, not adalimumab. The patient was diagnosed with eczematous dermatitis due to TNF-α inhibitors, and baricitinib was added to treat eczematous dermatitis.Conclusion: Paradoxical reactions are unpredictable events that may occur during treatment with biologics at anytime. They need further research in order to formulate personalised treatment.Keywords: biology drugs, pyoderma gangrenosum, eczema, adalimumab, secukinumab, baricitinib

Zhi Qiang Luo,1,&ast; Biao Zhou,2,3,&ast; Hui Xiong1 1Department of Graduate School, Hunan University of Chinese Medicine, Changsha City, Hunan Province, People’s Republic of China; 2Department of Orthopedics, Xiangtan First People’s Hospital, Xiangtan City, Hunan Province, People’s Republic of China; 3Department of Orthopedics, Wangjing Hospital of Chinese Academy of Chinese Medical Science, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hui Xiong, Department of Graduate School, Hunan University of Chinese Medicine, Changsha City, Hunan Province, People’s Republic of China, Tel +86 13808456990, Email xh_hn@hnucm.edu.cn Biao Zhou, Department of Orthopedics, Xiangtan First People’s Hospital, Xiangtan City, Hunan, People’s Republic of China, Email ortho_zhou1986@163.comPurpose: Osteoarthritis (OA) is a common clinical disease characterized by the destruction of articular cartilage, subchondral ossification, cystic degeneration and osteophyte formation. Recently, more and more scholars draw attention to exosomes in the field of OA, and exciting breakthroughs have been achieved in recent years. However, bibliometric analysis of the literature in this research field is lacking. Considering its potential in treatment of OA, this article aimed to analyze the research status and identify future hotspots of exosomes in osteoarthritis in recent 10 years by bibliometrics tools.Methods: Relevant publications in this field from 2012 to 2022 was retrieved from the Web of Science core collection database (WOSSCC). And we used Vosviewers, CiteSpace, an online analysis platform and the R package “Bibliometrix” for bibliometric analysis.Results: A total of 484 publications (including 319 articles and 165 reviews) from 51 countries, 720 institutions, were included in this study. IRCCS Ist Ortoped Galeazzi, Shanghai Jiao Tong University, and Sun Yat-sen University are the leading research institutions in this field. International Journal of Molecular Sciences contributed the largest number of articles, and Osteoarthritis and Cartilage is the most co-cited journal. Of the 2664 scholars who participated in the study, Ragni E, De Girolamo L, Orfei CP, and Colombini A had the largest number of articles. Zhang, SP is the most co-cited author. “Mesenchymal stem cell”, “biomaterials”, “Inflammation” and “regenerative medicine” are the keywords in the research.Conclusion: This is the first bibliometric analysis of exosomes in osteoarthritis. We explored current research status in recent years and identified frontiers and hot spots in this research field. We highlight the significant roles of mesenchymal stem cell-derived exosomes (MSC-Exos) in the treatment of osteoarthritis, and identified exosomal biomaterials as frontier in this research domain, which can provide reference for the researchers who focus on this research field.Keywords: exosomes, osteoarthritis, bibliometric analysis, CiteSpace, VOSviewer, R package “bibliometrix&#x201D

Zhiqiao Hu,&ast; Hao Zhang,&ast; Jiaqi Wang, Huan Xiong, Yunxiao Liu, Yihao Zhu, Zewen Chang, Hanqing Hu, Qingchao Tang Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qingchao Tang, Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Harbin, People’s Republic of China, Tel +86-13945052628, Email 13945052628@qq.comPurpose: To develop and validate the risk nomogram to predict the likelihood of postoperative anxiety and depression in colorectal cancer (CRC) patients.Methods: A total of 602 CRC patients from the Second Affiliated Hospital of Harbin Medical University were included in the study and divided into development set and validation set with the 2:1 ratio randomly. Logistic regression model was used to determine independent factors contributing to postoperative anxiety and depression, which were subsequently applied to build the nomogram for predicting postoperative anxiety and depression. The performance of the risk nomogram was appraised by the area under the receiver operating curve (AUC), calibration curves and decision curve analyses (DCA).Results: Gender, personal status, income, adjuvant therapy, the Eastern Cooperative Oncology Group Scale (ECOG) score, comorbidity, postoperative complications and stoma status were significant indicators for postoperative anxiety and depression. The AUCs for the development and validation sets were 0.792 and 0.812 for the postoperative anxiety nomogram and 0.805 and 0.825 for the postoperative depression nomogram. Additionally, calibration curves and decision curve analyses also determined the reliable clinical importance of the proposed nomogram.Conclusion: The current study constructed the risk nomogram for postoperative anxiety and depression and could help clinicians determine high-risk patients to some extent.Keywords: nomogram, colorectal cancer, postoperative, anxiety and depression

Mengqiu Zhong,&ast; Hanlin Xiong,&ast; Kebiao Zhang, Shimin Fu Department of Emergency, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Kebiao Zhang; Shimin Fu, Email zhangkebiao0537@163.com; fsm204472@hospital-cqmu.comBackground: Early in the pandemic, coronavirus disease 2019 (COVID-19) had been reported with significant impact on the stroke care pathway. Meanwhile, the mid/long-term consequence of treatment efficiency and effectiveness of the acute stroke pathway still remains unknown.Methods: A comprehensive retrospective analysis was conducted on the acute stroke care pathway parameters in a stroke unit in Chongqing, Southwest China. A total of 1492 patients were involved in this study, of whom 634 patients (42.5%) were included during the COVID-19 pandemic, 858 patients (57.5%) included during the similar period of 2019. We collected demographic and clinical characteristics, clinical outcome as the treatment efficiency and effectiveness indicators of the acute stroke pathway.Results: Compared to the same period in 2019, there were 2.8% fewer transient ischemic attack (TIA) patients, while 9.9% more acute ischemic stroke patients in 2020. In addition, patients had significantly higher National Institutes of Health Stroke Scale (NIHSS) scores (P = 0.002) and hospital mortality (P = 0.004) during the pandemic. The median door-CT time (P < 0.001) and emergency stay (P < 0.001) of acute stroke were also remarkably increased during the pandemic. The proportion of patients with intravenous thrombolysis (IVT) was significantly lower (P < 0.001), while the mechanical thrombectomy (MET) was remarkably higher (P = 0.042) in the pandemic group. Moreover, the IVT was significantly delayed during the pandemic (door-needle time: P = 0.001).Conclusion: The COVID-19 outbreak did not reduce the willingness of the acute stroke patient to seek medical help. Benefited from adjustments of stroke procedure in response to the COVID-19 pandemic, no significant reduction was observed in the reperfusion success of the acute stroke care pathway. However, more medical resources need to be invested into the acute stroke care pathway to prevent serious consequences of undiagnosed and untreated strokes.Keywords: COVID-19, acute stroke care pathway, intravenous thrombolysis, mechanical thrombectomy

Jin Wu,1– 3,&ast; Tianyi Zhang,1– 3,&ast; Haofeng Xiong,1– 4 Liujun Zeng,1– 3 Zijia Wang,1– 3 Ying Peng,1– 3 Weijun Chen,1– 3 Xin Hu,1– 3 Tong Su1– 3 1Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital of Central South University, Changsha, Hunan, 410008, People’s Republic of China; 2Research Center of Oral and Maxillofacial Tumor, Xiangya Hospital of Central South University, Changsha, Hunan, 410008, People’s Republic of China; 3Institute of Oral Cancer and Precancerous Lesions, Central South University, Changsha, Hunan, 410008, People’s Republic of China; 4Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, 410008, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Tong Su; Xin HuCenter Department of Oral and Maxillofacial Surgery, of Stomatology, Xiangya Hospital of Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, People’s Republic of ChinaEmail sutong@csu.edu.cn; huxin_666@qq.comObjective: Oral squamous cell carcinoma (OSCC) is the most frequent oral malignancy with a poor prognosis, in which tumor-infiltrating immune cells may play a critical role. Therefore, our study aims to screen potential immune cells and immune-related genes for predicting OSCC prognosis.Methods: A total of 310 OSCC patients with full transcriptional data and clinical characteristics were extracted from the TCGA database. Then, we obtained their abundance of tumor-infiltrating immune cells on TIMER 2.0 and analyzed them using xCell method. Univariate and multivariate Cox regressions were applied successively to identify the immune cells associated with overall survival of OSCC patients. Furthermore, we screened the prognostic genes that related to the identified immune cells and validated their expressions by immunohistochemistry.Results: CD4+ central memory T (TCM) cell was recognized as the sole independent immune cell correlated with OSCC prognosis (p = 0.0085). A novel nomogram based on CD4+ TCM cell abundance was established for predicting the prognosis of OSCC patients, with calibration plots showing good performance for 1-, 3-, 5-year overall survival. Thirty-four related prognostic genes were screened according to the differential abundance of CD4+ TCM cell infiltration. In immunohistochemistry analysis, DEFB1 showed a significant positive relationship with the density of CD4+ TCM cells (p = 0.0075).Conclusion: CD4+ central memory T cell was proposed as an independent prognostic biomarker for OSCC patients. DEFB1 might positively regulate the abundance of tumor-infiltrating CD4+ TCM cells, thus improving OSCC prognosis. Our findings may provide a new insight into better prognosis prediction and precise medicine for OSCC.Keywords: oral squamous cell carcinoma, CD4+ central memory T cell, DEFB1, prognosis biomarker

Yunxiao Liu, Hao Zhang, Mingyu Zheng, Chunlin Wang, Zhiqiao Hu, Yang Wang, Huan Xiong, BoYang Fan, Yuliuming Wang, Hanqing Hu, Qingchao Tang, Guiyu Wang Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of ChinaCorrespondence: Guiyu WangDepartment of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of ChinaTel +86-451-86296599Email guiywang@163.comPurpose: Distant metastasis (DM) is relatively rare in T1 colon cancer (CC) patients, especially in those with negative lymph node metastasis. The aim of this study was to explore the main clinical factors and build nomogram for predicting the occurrence and prognosis of DM in T1N0 colon cancer patients.Methods: Patients with T1N0 stage CC were collected from the Surveillance, Epidemiology, and End Result (SEER) database. All patients were divided into development and validation cohorts with the 3:1 ratio. Logistic regressions were performed to analyze the clinical risk factors for DM. Cox regression model was used to identify potential prognostic factors for patients with DM. The performance of nomogram was evaluated by concordance index (C-index), calibration curves, receiver operating characteristic (ROC) curves and decision curve analyses (DCAs). Based on cancer-specific survival (CSS), Kaplan–Meier curves were generated and analyzed using Log rank tests.Results: A total of 6770 patients were enrolled in this study, including 428 patients (6.3%) with DM. Age, size, grade, CEA were independent risk factors associated with DM. Age, grade, CEA, surgery and chemotherapy were independent prognostic factors for CSS. Nomograms were applied and C-index, calibration curves, ROC curves and DCA curves proved good discrimination, calibration and clinical practicability of the nomogram in predicting the occurrence and prognosis of DM in T1N0 CC patients. In the DM nomogram, the AUCs for development and validation cohort were 0.901 (95% CI = 0.879– 0.922) and 0.899 (95% CI=0.865– 0.940), respectively. The calibration curves (development cohort: S: p = 0.712; validation cohort: S: p = 0.681) showed the relatively satisfactory prediction accuracy. Similarly, the AUCs of the nomogram at 1-, 2-, and 3-year were 0.763 (95% CI=0.744– 0.782), 0.794 (95% CI=0.775– 0.813), and 0.822 (95% CI=0.803– 0.841) for the development cohort, and 0.785 (95% CI=0.754– 0.816), 0.748 (95% CI=0.717– 0.779) and 0.896 (95% CI=0.865– 0.927) for the validation cohort in the CSS nomogram. The C-indices of the development and validation cohort were 0.718 (95% CI=0.639– 0.737) and 0.712 (95% CI=0.681– 0.743).Conclusion: The population-based nomogram could help clinicians predict the occurrence and prognosis of DM in T1N0 CC patients and provide a reference to perform appropriate metastatic screening plans and rational therapeutic options for the special population.Keywords: T1N0 colon cancer, distant metastasis, nomogram, SEER

Qing-Yun Xie,1,&ast; Jie Yang,2,&ast; Ze-Hua Lei,1 Feng-Wei Gao,1 Bing Chen,1 Kang-Yi Jiang,1 Hui Xiong,1 Jie Yang1 1Department of Hepatobiliary Pancreatic Splenic Surgery, The People’s Hospital of Leshan, Leshan, Sichuan, 614000, People’s Republic of China; 2Diagnosis and Treatment Center of Hepatobiliary Pancreatic Splenic Systemic Disease in Leshan, The Second Batch of Hepatobiliary and Pancreatic ERAS Standard Wards of Hubei Chen Xiaoping Science and Technology Development Foundation, Leshan, Sichuan, 614000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ze-Hua LeiDepartment of Hepatobiliary Pancreatic Splenic Surgery, Leshan People’s Hospital of Sichuan Province, Leshan, Sichuan, 614000, People’s Republic of ChinaTel +86 833-2119894Email zehualeidr@outlook.comObjective: To explore the effects and value of establishing a multi-target nursing group (MTNG) for facilitating goal-oriented enhanced recovery after surgery (ERAS) using the LEER (“less pain”, “early movement”, “early return to a normal diet” and “reassurance”) model.Methods: The clinical data of 198 patients with hepatobiliary and pancreatic malignancies were retrospectively analyzed. The patients were divided into two groups: 91 cases were collected in a traditional group, which adopted traditional perioperative care, and 107 cases were collected in an MTNG group, which adopted MTNG measures. The differences in the clinical data including postoperative recovery, unplanned readmission rate, the implementation rate of nursing measures, the degree of a patient’s understanding of the disease, and patient compliance and satisfaction with nursing care during hospitalization were compared and analyzed between the two groups.Results: The MTNG group reflected a lower pain degree and hospitalization expenses (P < 0.05), earlier postoperative flatulence, earlier recommencing of a normal diet, and earlier postoperative ambulation (P < 0.05), together with a shorter postoperative indwelling catheter duration and length of hospital stay (P < 0.05). There were no significant differences in the incidence of postoperative complications and unplanned postoperative readmission rates between the two groups (P > 0.05). The implementation rate of nursing measures and the degree of patients understanding the disease, and patient compliance and satisfaction with nursing care were higher in the MTNG group (P < 0.05).Conclusion: The MTNG approach, based on ERAS with the LEER model, was conducive to the safe and rapid postoperative recovery of patients, the precise and efficient implementation of ERAS measures, the improvement of medical treatment satisfaction among patients.Keywords: LEER model, enhanced recovery after surgery, multi-target nursing

Jingcong Zhang,1,&ast; Haixia Xiong,2,&ast; Jie Chen,3 Qiuping Zou,4 Xiaoxing Liao,5 Yujie Li,6 Chunlin Hu6 1Department of Critical Care Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, People’s Republic of China; 2Department of Division of Nephrology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, People’s Republic of China; 3Department of Critical Care Medicine, the Dongguan People’s Hospital, Dongguan, Province Guangdong, 523059, People’s Republic of China; 4Department of Emergency Medicine the Dongguan People’s Hospital, Dongguan, Province Guangdong, 523059, People’s Republic of China; 5Department of Emergency Medicine, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518107, People’s Republic of China; 6Department of Emergency Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Chunlin Hu; Yujie LiDepartment of Emergency Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, People’s Republic of ChinaEmail huchunl@mail.sysu.edu.cn; yujieligd@163.comBackground and Objective: The role of percutaneous coronary intervention (PCI) after return of spontaneous circulation (ROSC) in patients with acute myocardial infarction (AMI) complicated by cardiac arrest (CA) is controversial. This study aimed to evaluate the effects of PCI on the in-hospital mortality after ROSC in patients with AMI complicated by CA.Methods: The clinical data of 66 consecutive patients with ROSC after CA caused by AMI from January 2006 to December 2015 at the First Affiliated Hospital of Sun Yat-sen University were collected. Among these patients, 21 underwent urgent PCI. We analyzed the clinical characteristics of the patients during hospitalization.Results: The patients who underwent PCI had a higher rate of ST-segment elevation, and their initial recorded heart rhythms were more likely to have a shockable rhythm. Further, they had a high PCI success rate of 100%. The in-hospital mortality in the patients who did not undergo PCI was significantly higher than that in the patients who underwent PCI (68.9% vs 9.5%, P< 0.05). Multivariate logistic regression analysis showed that cardiogenic shock (odds ratio [OR], 3.537; 95% CI, 1.047– 11.945; P=0.042) and Glasgow Coma Scale score of ≤ 8 after ROSC (OR, 14.992; 95% CI, 2.815– 79.843; P=0.002) were the independent risk factors for in-hospital mortality among the patients. Meanwhile, PCI was a protective factor against in-hospital mortality (OR, 0.063; 95% CI, 0.012– 0.318; P=0.001). After propensity matching analysis, the results still showed that PCI (OR, 0.226; 95% CI, 0.028– 1.814; P=0.0162) was a protective factor for in-hospital death.Conclusion: The patients with ROSC after CA caused by AMI who underwent PCI had a lower in-hospital mortality than those who did not undergo PCI.Keywords: percutaneous coronary intervention, cardiac arrest, in-hospital mortality, neurological performance

Qingchao Tang,1 Yihao Zhu,1 Huan Xiong,1 Xiangzong Sheng,1 Zhiqiao Hu,1 Hanqing Hu,1 Rui Huang,1 Qian Zhang,1 Ziming Yuan,1 Lei Xie,2 Zhifeng Gao,1 Yuliuming Wang,1 Guiyu Wang,1 Xishan Wang3 1Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China; 2Heilongjiang Agricultural Reclamation General Hospital, Harbin, People’s Republic of China; 3Department of Colorectal Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of ChinaCorrespondence: Xishan WangDepartment of Colorectal Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Beijing, People’s Republic of ChinaTel +86 135 52367779Email wxshan1208@126.comGuiyu WangDepartment of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Harbin, People’s Republic of ChinaTel +86 451 86296599Email guiywang@163.comBackground: Natural orifice specimen extraction surgery (NOSES) has been successfully applied to the treatment of gastric, colorectal cancer (CRC). However, the development of NOSES is still in the exploratory stage, and there is still no strong evidence-based medical evidence.Patients and Methods: From January 2013 to June 2017, consecutive patients with colorectal cancer who underwent transluminal resection, anastomosis, and specimen extraction and those who underwent conventional laparoscopic resection were enrolled. Propensity score matching was used to align clinicopathological features between the two groups.Results: A total of 372 patients were eventually included in this study, 186 in each group. According to perioperative information and postoperative follow-up in both groups, the NOSES group had less blood loss (P = 0.011), shorter time to recovery of gastrointestinal function (P < 0.001), shorter postoperative hospital stay (P = 0.037). The NOSES group had fewer postoperative analgesics (P < 0.001), lower postoperative pain scores (P < 0.001), and lower incidence of postoperative complications (P = 0.017). Compared with the LA (laparoscopic) group, the NOSES group had better physical function (P< 0.05), role function (P< 0.001), emotional function (P< 0.001) and global health status than LA group, while symptoms such as pain (P< 0.001), insomnia (P< 0.001), constipation (P< 0.001) and diarrhea (P< 0.05) were less severe in the NOSES group. In addition, the NOSES group had higher body image scores. Overall survival (OS) and disease-free survival (DFS) were not significantly different between the two groups.Conclusion: For surgical treatment of colorectal cancer, NOSES has advantages in reducing postoperative pain, recovery of gastrointestinal function, postoperative quality of life, and improving patients’ satisfaction with abdominal wall aesthetics. There was no difference in long-term survival between NOSES and conventional laparoscopic surgery.Keywords: colorectal cancer, laparoscopic surgery, perioperative efficacy, natural orifice specimen extraction, survival

Jun Li,1,* Donggen Jiang,1,* Qian Zhang,2,* Shubin Peng,3 Guolong Liao,1 Xiangwei Yang,1 Jiani Tang,1 Haiyun Xiong,1 Jun Pang1 1Department of Urology, Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, People’s Republic of China; 2Department of Rehabilitation Medicine, Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, People’s Republic of China; 3Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jun Pang; Haiyun XiongDepartment of Urology, Seventh Affiliated Hospital, Sun Yat-Sen University, 628 Zhenyuan Road, Shenzhen 518107, People’s Republic of ChinaTel +86-18802044177; +86-18922869986Email pangjun2@mail.sysu.edu.cn; xionghy7@mail.sysu.edu.cnObjective: Renal cell carcinoma (RCC) displays an increasing incidence and mortality rate worldwide in recent years. More and more evidence demonstrated microRNAs function as positive or negative regulatory factors in many cancers, while the role of miR-301a in RCC is still unclear.Material and Methods: The expression and clinical significance of miR-301a were assessed via bioinformatic software on open microarray datasets of the Cancer Genome Atlas (TCGA) and then confirmed by quantitative real-time PCR (qRT-PCR) in RCC cell lines. Loss of function assays were performed in RCC cell lines both in vitro and in vivo. Cell Counting Kit-8 (CCK-8), flow cytometry, luciferase reporter assays, Western blotting, and immunohistochemistry were employed to explore the mechanisms of the effect of miR-301a on RCC.Results: By analyzing RCC clinical specimens and cell lines, we found a uniform increased miR-301a in expression in comparison with normal renal tissue or normal human proximal tubule epithelial cell line (HK-2). In addition, miR-301a upregulation correlated advanced stage and poor prognosis of clear cell RCC (ccRCC). Anti-miR-301a could inhibit growth and cell cycle G1/S transition in RCC cell lines. Moreover, we found that PTEN was identified as a direct target of miR-301a that might partially interrupt miR-301a-induced G1/S transition. Importantly, nude-mouse models revealed that knockdown of miR-301a delayed tumor growth.Conclusion: These results indicate that miR-301a functions as a tumor-promoting miRNA through regulating PTEN expression, representing a novel therapeutic target for RCC.Keywords: miR-301a, PTEN, renal cell carcinoma, proliferation, G1/S transition

Dan Zhang,1,2 Xiaojiao Li,1,2 Liang Lv,1 Jiayi Yu,1,2 Chao Yang,1,2 Hua Xiong,1,2 Ruikun Liao,1,2 Bi Zhou,1,2 Xianlong Huang,1 Xiaoshuang Liu,3 Zhuoyue Tang1,2 1Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, People’s Republic of China; 2Molecular and Functional Imaging Laboratory, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, People’s Republic of China; 3Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People’s Republic of ChinaCorrespondence: Zhuoyue TangDepartment of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, People’s Republic of ChinaEmail zhuoyue_tang@ucas.ac.cnObjective: The aim of this study was to explore and validate the diagnostic performance of whole-volume CT texture features in differentiating the common benign and malignant epithelial tumors of the parotid gland.Materials and Methods: Contrast-enhanced CT images of 83 patients with common benign and malignant epithelial tumors of the parotid gland confirmed by histopathology were retrospectively analyzed, including 50 patients with pleomorphic adenoma (PA) and 33 patients with malignant epithelial tumors. Quantitative texture features of tumors were extracted from CT images of arterial phase. The diagnostic performance of texture features was evaluated via receiver operating characteristic (ROC) curve and area under ROC curve (AUC). The specificity and sensitivity were respectively discussed by the maximum Youden’s index.Results: All the texture features were subject to normal distribution and homoscedasticity. Energy, mean, correlation, and sum entropy of epithelial malignancy group were significantly higher than those of PA group (P< 0.05). There were no statistically significant differences between PA group and epithelial malignancy group in uniformity, entropy, skewness, kurtosis, contrast, and difference entropy (P> 0.05). The AUC of each texture feature and joint diagnostic model was 0.887 (energy), 0.734 (mean), 0.739 (correlation), 0.623 (sum entropy), 0.888 (energy-mean), 0.883 (energy-correlation), 0.784 (mean-correlation). The diagnostic efficiency of energy-mean was the best. Based on the maximum Youden’s index, the specificity of energy-correlation was the highest (97%) and the sensitivity of energy was the highest (97%).Conclusion: Energy, mean, correlation, and sum entropy can be the effective quantitative texture features to differentiate the benign and malignant epithelial tumors of the parotid gland. With higher AUC, energy and energy-mean are superior to other indexes or joint diagnostic models in differentiating the benign and malignant epithelial tumors of the parotid gland. CT texture analysis can be used as a noninvasive and valuable means of preoperative assessment of parotid epithelial tumors without additional cost to the patients.Keywords: texture analysis, epithelial tumors, parotid gland

Yi Liu,1,* Hua Xiong,2,3,* Xiaojiao Li,2,3 Dan Zhang,2,3 Chao Yang,2,3 Jiayi Yu,2,3 Ruikun Liao,2,3 Bi Zhou,2,3 Xianlong Huang,2,3 Zhuoyue Tang2,3 1Department of Radiology, Peking University First Hospital, Beijing 100034, People’s Republic of China; 2Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, People’s Republic of China; 3Molecular and Functional Imaging Laboratory, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhuoyue TangDepartment of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, No. 104 Pipashan Main Street, Yuzhong District, Chongqing 400014, People’s Republic of ChinaEmail zhuoyue_tang@ucas.ac.cnObjective: To investigate the baseline brain activity in neuromyelitis optica patients without brain lesion using the regional amplitude of low-frequency fluctuation (ALFF) and fractional amplitude of low-frequency fluctuation (fALFF) as indexes.Materials and methods: Forty-two patients of NMO with normal performance in conventional MRI and 42 healthy controls, matched in gender and age, were enrolled in this study. Resting-state functional magnetic resonance imaging (rs-fMRI) data acquired using the rs-fMRI Data Analysis Toolkit. The relationships between expanded disability states scale (EDSS) scores, abnormal baseline brain activity and disease duration were explored.Results: The left inferior temporal, left cerebellum_4_5, bilateral superior temporal pole, left caudate, right superior temporal, left middle frontal and left superior occipital showed significantly increased ALFF in the NMO. Regions of abnormal fALFF were similar to those of ALFF except that increased fALFF were also indicated in the right cerebellum crus2, right hippocampus, left parahippocampal gyrus and left supplementary motor area. Furthermore, a significant correlation between EDSS scores and ALFF/fALFF was noted in the left inferior temporal gyrus.Conclusion: Results confirmed the disturbances in NMO-related neural networks, which probably be related to spinal cord damage.Keywords: neuromyelitis optica, magnetic resonance imaging, resting-state functional magnetic resonance imaging, rs-fMRI

Mengqing Xiong,1 Weihua Hu,1 Minglin Dong,1 Meifang Wang,2 Junwen Chen,3 Hanzhong Xiong,4 Minhua Zhong,5 Yan Jiang,6 Dan Liu,6 Ke Hu1 1Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan 430060, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, People’s Republic of China; 3Department of Respiratory and Critical Care Medicine, Xiangyang Hospital, Hubei University of Medicine, Xiangyang 441000, People’s Republic of China; 4Department of Respiratory and Critical Care Medicine, Ezhou Central Hospital, Ezhou 436000, People’s Republic of China; 5Department of Respiratory and Critical Care Medicine, Xiaogan Central Hospital, Wuhan University of Technology, Xiaogan 432000, People’s Republic of China; 6Division of Respiratory Disease, The Fifth Hospital of Wuhan City, Wuhan 430050, People’s Republic of ChinaCorrespondence: Ke HuDepartment of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Zhangzhidong Road, No. 99, Wuhan 430060, People’s Republic of ChinaTel +86 189 7103 5988Fax +86 27 8804 2292Email huke-rmhospital@163.comObjective: To compare the performance of Epworth sleepiness scale (ESS), sleep apnea clinical score (SACS), Berlin questionnaire (BQ), and STOP-BANG questionnaire (SBQ) in screening for obstructive sleep apnea (OSA) in patients with chronic obstructive pulmonary disease (COPD).Methods: A total of 431 patients were analyzed. All subjects completed lung function test, ESS, SACS, BQ, and SBQ survey and overnight polysomnography (PSG). According to lung function and PSG results, participants were divided into COPD with OSA group (OVS, AHI ≥5) and without OSA group (AHI 2 was considered high risk of OSA; the sensitivity, specificity, and AUC were 92.8%, 40.6%, and 0.723 respectively, the odds ratio (OR) was 2.161. When AHI ≥15, AUC for SBQ was 0.737. In predicting severe OSA (AHI ≥30), the ROC curve showed cut-off point, sensitivity, specificity, and AUC for SBQ was >4, 66.1%, 82.1%, and 0.824 respectively; the positive and negative likelihood ratio was 3.70, 0.41 separately, the OR was 2.977.Conclusion: SBQ performed better than ESS, SACS, and BQ in predicting OSA in patients with COPD.Keywords: Berlin questionnaire, STOP-BANG questionnaire

Haijun Xiong,1 Jin Wang,1 Qian Ran,1 Guanhua Lou,1 Chengyi Peng,1 Qingxia Gan,1 Ju Hu,1 Jilin Sun,2 Renchuan Yao,3 Qinwan Huang1,4 1School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, People’s Republic of China; 2Sichuan Fuzheng Pharmaceutical Co. Ltd, Sichuan, People’s Republic of China; 3Sichuan Fermentation Traditional Chinese Medicine Engineering Research Center, Chengdu, People’s Republic of China; 4State Key Laboratory of Traditional Chinese Medicine Processing Technology, State Administration of Traditional Chinese Medicine, Chengdu 611137, People’s Republic of ChinaCorrespondence: Qinwan HuangCollege of Pharmacy, Chengdu University of Traditional Chinese Medicine, No. 1166, Liutai Road, Wenjiang District, Chengdu 611137, People’s Republic of ChinaTel +86 13982199974Fax +61800231Email hqwan2163@163.comAbstract: Obesity is a chronic metabolic disease caused by multiple factors and is considered to be a risk factor for type 2 diabetes, cardiovascular disease, hypertension, stroke and various cancers. Hesperidin, a flavanone glycoside, is a natural phenolic compound with a wide range of biological effects. Mounting evidence has demonstrated that hesperidin possesses inhibitory effect against obesity diseases. Our review discusses mechanisms of hesperidin in the treatment of obesity. Hesperidin regulates lipid metabolism and glucose metabolism by mediating AMPK and PPAR signaling pathways, directly regulates antioxidant index and anti-apoptosis, and indirectly mediates NF-κB signaling pathway to regulate inflammation to play a role in the treatment of obesity. In addition, hesperidin-enriched dietary supplements can significantly improve symptoms such as postprandial hyperglycemia and hyperlipidemia. Further clinical trials are also required for confirming lipid-lowering efficacy of this natural flavonoid and evaluating its safety profile.Keywords: citrus flavonoids, lipid metabolism, glucose metabolism, anti-oxidation, anti-inflammatory

Yuanming Cai,1,* Ruxue Jia,2,3,* Haozhe Xiong,4 Qun Ren,2,3 Weimin Zuo,2,3 Tingting Lin,2,3 Rong Lin,2 Yan Lei,2 Ping Wang,2 Huiyue Dong,2 Hu Zhao,2,3 Ling Zhu,3 Yunfeng Fu,3 Zhiyong Zeng,5 Wei Zhang,6 Shuiliang Wang2,31Undergraduate Grade 2015, The 5th Clinical Medical School of Xinjiang Medical University, Urumchi, People’s Republic of China; 2Department of Urology, The 900th Hospital of the Joint Logistics Team, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China; 3Fujian Key Laboratory of Transplant Biology, Affiliated Dongfang Hospital, Xiamen University School of Medicine, Fuzhou, Fujian, People’s Republic of China; 4Undergraduate Grade 2017, Department of Bioengineering, College of Life Science, Fujian Normal University, Fuzhou, Fujian, People’s Republic of China; 5Department of Thoracic Surgery, The 900th Hospital of the Joint Logistics Team, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China; 6Department of Emergency, The 900th Hospital of the Joint Logistics Team, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China*These authors contributed equally to this workBackground: Paclitaxel has shown significant anti-tumor activity against non-small cell lung cancer (NSCLC); however, resistance to paclitaxel frequently occurs and represents a significant clinical problem and its underlying molecular mechanism remains elusive.Methods: Long-term treatment of culture cell with paclitaxel was carried out to mimic the development of acquired drug resistance in NSCLC. Cell proliferation and clonogenic assay and apoptosis evaluation were carried out to determine the efficacy of paclitaxel on NSCLC cells. Western blot analyses were performed to determine the expression and activation of proteins. Apoptosis enzyme-linked immunosorbent assay was used to quantify cytoplasmic histone-associated DNA fragments. Microarray analyses were applied to explore both mRNA and miRNA expression profiles in NSCLC cells followed by integrative analysis. qRT-PCR was carried out to verify the differentially expressed mRNAs and miRNAs.Results: The expression of 652 genes was shown to be changed at least 2-fold in paclitaxel-resistant NSCLC (H460_TaxR) cells with 511 upregulated and 141 downregulated as compared with that in parental H460 cells. The differentially expressed genes were functionally enriched in regulating the cell proliferation, cell death, and response to endogenous stimulus, and clustered in pathways such as cancer and signaling by the G protein-coupled receptor (GPCR). Moreover, 43 miRNAs were shown to be differentially expressed in H460_TaxR cells with 15 upregulated and 28 downregulated as compared with parental H460 cells. A total of 289 pairs of miRNA-potential target gene were revealed in H460_TaxR cells by bioinformatics analysis. Furthermore, integrative analysis of miRNAs and gene expression profiles revealed that dysregulated miR-362-3p, miR-766-3p, and miR-6507-3p might confer paclitaxel resistance in NSCLC via targeting MAPT simultaneously.Conclusion: Our findings suggested that specific manipulation of MAPT-targeting miRNAs may be a novel strategy to overcome paclitaxel resistance in patients with NSCLC especially large-cell lung carcinoma.Keywords: integrative analysis, non-small cell lung cancer, paclitaxel-resistance, gene expression profile, miRNAs

Hua Xiong,1,2 Ping Yin,3 Xiaojiao Li,1,2 Chao Yang,1,2 Dan Zhang,1,2 Xianlong Huang,1,2 Zhuoyue Tang1,2 1Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, China; 2Molecular and Functional Imaging Laboratory, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, China; 3Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China Objective: To investigate the features of cerebral permeability and perfusion detected by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with Patlak model in relapsing–remitting multiple sclerosis (RRMS) and their correlations with Expanded Disability Status Scale (EDSS) scores and disease duration. Patients and methods: Twenty-seven RRMS patients underwent conventional MRI and DCE-MRI with 3.0 T magnetic resonance scanner were enrolled in the study. A Patlak model was used to quantitatively measure MRI biomarkers, including volume transfer constant (Ktrans), fractional plasma volume (Vp), cerebral blood flow (CBF), and cerebral blood volume (CBV). The correlations of MRI biomarkers with EDSS scores and disease duration were analyzed. Results: The MRI biomarkers Ktrans, Vp, CBF, and CBV of contrast-enhancing (CE) lesions were significantly higher (P0.05). Conclusion: Our study demonstrated the abnormalities of permeability and perfusion characteristics in multiple sclerosis (MS) lesions and NAWM regions by DCE-MRI with Patlak model. The Ktrans, Vp, CBF, and CBV of CE lesions were significantly higher than that of NE lesions, but these MRI biomarkers did not associate with the severity and duration of the disease. The skewness and kurtosis of Ktrans value in CE lesions were significantly higher than that in NE lesions, indicating that these parameters of Ktrans histogram can be used to distinguish the pathology of MS lesions. Keywords: dynamic contrast-enhanced magnetic resonance imaging, Patlak model, multiple sclerosis, permeability, perfusion, histogram

Heli Yang,1 Xiangdong Li,2 Jialun Shi,2 Hao Fu,1 Hao Yang,2 Zhen Liang,1 Hongchao Xiong,1 Hui Wang3 1Department of Thoracic Surgery I, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Haidian, Beijing, People’s Republic of China; 2Department of Cardiothoracic Surgery, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, People’s Republic of China; 3Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People’s Republic of China Introduction: This study aimed to develop a practical nomogram to predict prognosis in patients who are undergoing sublobar resection for stage IA non-small-cell lung cancer (NSCLC). Data from Surveillance, Epidemiology, and End Results (SEER) databases were used to construct the nomogram. Methods: Data from patients undergoing sublobar resection for stage IA NSCLC diagnosed between 2004 and 2014 were extracted from the SEER database. Factors that may predict the outcome were identified using the Kaplan–Meier method and the Cox proportional-hazards model. A nomogram was constructed to predict the 3- and 5-year overall survival (OS) and lung cancer-specific survival (LCSS) rates of these patients. The predictive accuracy of the nomogram was measured using the concordance index (C-index) and calibration curve. Results: A total of 4,866 patients were selected for this study. Using univariate and multivariate analyses, eight independent prognostic factors associated with OS were identified, including sex (P

Dan Zhang,1,2 Xiaojiao Li,2,3 Hua Xiong,2,3 Chao Yang,2,3 Fajin Lv,1 Xianlong Huang,2,3 Qi Li,1 Zhuoyue Tang,2,3 Tianyou Luo1 1Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China; 2Department of Radiology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, China; 3Molecular and Functional Imaging Laboratory, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, China Objectives: To characterize clinical, computed tomography (CT) and magnetic resonance imaging (MRI) features of tuberculosis (TB) of the parotid nodes. Materials and methods: CT (n=21) and MR (n=7) images, and clinical data from 25 patients with TB of the parotid nodes were retrospectively analyzed by two experienced radiologists who reached consensus. Results: Younger patients (aged

Yao Ma,1,* Xiang Tong,2,* Ying Liu,1 Sitong Liu,2 Hai Xiong,3 Hong Fan2 1The Center of Gerontology and Geriatrics, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China; 3Department of Gerontology, No 4 West China Teaching Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China *These authors contributed equally to this work Purpose: Angiotensin-converting enzyme (ACE) gene I/D polymorphism has been studied in relation to the susceptibility to COPD and COPD with pulmonary hypertension (PH) with inconclusive results. We performed the first comprehensive meta-analysis to evaluate accurately the association between the ACE gene polymorphism and the risk of COPD. Methods: Data were analyzed using odds ratios (ORs) and the corresponding 95% CIs to measure the strength of the models. Subgroup analyses were conducted by ethnicity and complication which referred to PH. Results: In total, 15 studies (2,635 participants) were included in our study, of which four studies (288 participants) were for PH subgroup. The overall analysis results indicated that the ACE gene polymorphism was not associated with COPD susceptibility in all gene models. However, the ethnic subgroup analysis results indicated that ACE gene polymorphism was associated with Asians’ susceptibility to COPD (DD+DI vs II, OR=1.47, P=0.019, 95% CI: 1.07–2.02). Further, the overall results of the present study detected no statistical significance between ACE gene polymorphism and the risk of COPD with PH, but the homozygote variant (DD) increased the risk of PH in Asian COPD patients (DD vs ID+II, OR=2.05, P=0.05, 95% CI: 1.00–4.19). Conclusion: The current study suggests that ACE polymorphism, particularly the homozygote variant (DD), might contribute to the risk of COPD and COPD with PH among Asians. Further studies with larger sample size and more ethnicities are expected to be conducted in the future to validate the results. Keywords: ACE, COPD, pulmonary hypertension, polymorphism, susceptibility, meta-analysis

Chunyuan Du,1,* Haibo Yan,2,* Jichao Liang,1 Ailing Luo,1 Lingqian Wang,1 Jing Zhu,1 Huayu Xiong,3 Yong Chen1 1Hubei Province Key Laboratory of Biotechnology of Chinese Traditional Medicine, Hubei Collaborative Innovation Center for Green Transformation of Bio-resources, Hubei University, Wuhan, 2Department of Internal Medicine, Shandong Medical College, Linyi, 3Ministry-of-Education Key Laboratory for the Synthesis and Application of Organic Functional Molecules, Hubei University, Wuhan, China *These authors contributed equally to this work Abstract: Efficient and safe nonviral gene delivery systems are a prerequisite for the clinical application of therapeutic genes. In this paper, polyethyleneimine-capped silver nanoclusters (PEI-AgNCs) were prepared for the purpose of microRNA (miRNA) delivery. The resultant PEI-AgNCs were characterized by a photoluminescence assay and transmission electron microscopy. A cytotoxicity assay showed that PEI-AgNCs exhibit relatively low cytotoxicity. Interestingly, PEI-AgNCs were confirmed to transfect miRNA mimics more effectively than PEI in HepG2 and 293A cells. In this regard, hsa-miR-21 or hsa-miR-221 mimics (miR-21/221m) were transported into HepG2 cells by using PEI-AgNCs. The miR-21/221 expression was determined post-transfection by quantitative real-time polymerase chain reaction. Compared with the negative control, PEI-AgNCs/miR-21/221m groups exhibited higher miR-21/221 levels. In addition, AgNCs endow PEI with stronger antibacterial activity, and this advantage provided PEI-AgNCs the potential to prevent bacterial contamination during the transfection process. Furthermore, we showed that PEI-AgNCs are viable nanomaterials for plain imaging of the cells by laser scanning confocal microscopy, indicating great potential as an ideal fluorescent probe to track the transfection behavior. These results demonstrated that PEI-AgNCs are promising and novel nonviral vectors for gene delivery. Keywords: gene delivery, silver nanoclusters, polyethylenimine, cell imaging, antibacterial activity

Cai Y, Jia R, Xiong H, et al. Cancer Manag Res. 2019;11:7391—7404. The authors have advised due to an error at the time of figure assembly, Figure 1D on page 7393 is incorrect. The correct Figure 1 is shown below. The authors apologize for this error and advise it does not affect the results of the paper. Read the original article

A key aspect of behavioral inhibition is the ability to wait before acting. Failures in this form of inhibition result in impulsivity and are commonly observed in various neuropsychiatric disorders. Prior evidence has implicated medial frontal cortex, motor cortex, orbitofrontal cortex (OFC), and ventral striatum in various aspects of inhibition. Here, using distributed recordings of brain activity [with local-field potentials (LFPs)] in rodents, we identified oscillatory patterns of activity linked with action and inhibition. Low-frequency (δ) activity within motor and premotor circuits was observed in two distinct networks, the first involved in cued, sensory-based responses and the second more generally in both cued and delayed actions. By contrast, θ activity within prefrontal and premotor regions (medial frontal cortex, OFC, ventral striatum, and premotor cortex) was linked with inhibition. Connectivity at θ frequencies was observed within this network of brain regions. Interestingly, greater connectivity between primary motor cortex (M1) and other motor regions was linked with greater impulsivity, whereas greater connectivity between M1 and inhibitory brain regions (OFC, ventral striatum) was linked with improved inhibition and diminished impulsivity. We observed similar patterns of activity on a parallel task in humans: low-frequency activity in sensorimotor cortex linked with action, θ activity in OFC/ventral prefrontal cortex (PFC) linked with inhibition. Thus, we show that δ and θ oscillations form distinct large-scale networks associated with action and inhibition, respectively.

Strong electron correlation can induce Mott insulating behaviour and produce intriguing states of matter such as unconventional superconductivity and quantum spin liquids. Recent advances in van der Waals material synthesis enable the exploration of Mott systems in the two-dimensional limit. Here we report characterization of the local electronic properties of single- and few-layer 1T-TaSe2 via spatial- and momentum-resolved spectroscopy involving scanning tunnelling microscopy and angle-resolved photoemission. Our results indicate that electron correlation induces a robust Mott insulator state in single-layer 1T-TaSe2 that is accompanied by unusual orbital texture. Interlayer coupling weakens the insulating phase, as shown by reduction of the energy gap and quenching of the correlation-driven orbital texture in bilayer and trilayer 1T-TaSe2. This establishes single-layer 1T-TaSe2 as a useful platform for investigating strong correlation physics in two dimensions.

As part of its Paris Agreement commitment, China pledged to peak carbon dioxide (CO2) emissions around 2030, striving to peak earlier, and to increase the non-fossil share of primary energy to 20% by 2030. Yet by the end of 2017, China emitted 28% of the world's energy-related CO2 emissions, 76% of which were from coal use. How China can reinvent its energy economy cost-effectively while still achieving its commitments was the focus of a three-year joint research project completed in September 2016. Overall, this analysis found that if China follows a pathway in which it aggressively adopts all cost-effective energy efficiency and CO2 emission reduction technologies while also aggressively moving away from fossil fuels to renewable and other non-fossil resources, it is possible to not only meet its Paris Agreement Nationally Determined Contribution (NDC) commitments, but also to reduce its 2050 CO2 emissions to a level that is 42% below the country's 2010 CO2 emissions. While numerous barriers exist that will need to be addressed through effective policies and programs in order to realize these potential energy use and emissions reductions, there are also significant local environmental (e.g., air quality), national and global environmental (e.g., mitigation of climate change), human health, and other unquantified benefits that will be realized if this pathway is pursued in China.

The O3-type layered Na(NixFeyMnz)O2 (0 < x, y, z < 1) cathode materials have attracted great interest in sodium ion batteries due to the abundance and cost of raw materials and their high specific capacities. However, the cycling stability and rate capability at high voltages (> 4.0 V) of these materials remain an issue. In this work, we successfully synthesized a Li-substituted layered-tunneled (O3-spinel) intergrowth cathode (LS-NFM) to address these issues. The remarkable structural compatibility and connectivity of the two phases were confirmed by X-ray diffraction (XRD), selected area electron diffraction (SAED), and high-resolution transmission electron microscopy (HRTEM). The LS-NFM electrode reached a discharge capacity of 96 mAh g-1 with a capacity retention of 86% after 100 cycles at a current rate of 100 mA g-1 in a voltage window of 2.0-4.2 V. Moreover, the LS-NFM cathode exhibited an enhanced rate capability in comparison to the undoped single-phased layered cathode (NFM). The enhanced rate capability of LS-NFM can be explained by the significantly increased effective Na+ diffusivity measured by the galvanostatic intermittent titration technique (GITT) compared to the undoped control NFM cathode, which can be ascribed to the improved charge transport kinetics through shortened diffusion path by direct connection between the 3D channels in the spinel phase and 2D channels in the layered phase. The results from ex situ hard/soft X-ray adsorption spectroscopy (XAS) suggest that the capacity of the LS-NFM cathode is mainly associated with the Ni2+/Ni4+ redox couple and slightly from the Fe3+/Fe4+ redox couple. The voltage profile of the LS-NFM cathode exhibits a reversible plateau above 4.0 V, indicating great stability at high voltages and structural stabilization by the spinel phase. In addition to the substitution of various transition metals, or the modification of the stoichiometry of each transition metal, this study provides a new strategy to improve electrochemical performance of layered cathode materials for sodium ion batteries.

Research in topological matter has expanded to include the Dirac and Weyl semimetals 1-10 , which feature three-dimensional Dirac states protected by symmetry. Zirconium pentatelluride has been of recent interest as a potential Dirac or Weyl semimetal material. Here, we report the results of experiments performed by in situ three-dimensional double-axis rotation to extract the full 4π solid angular dependence of the transport properties. A clear anomalous Hall effect is detected in every sample studied, with no magnetic ordering observed in the system to the experimental sensitivity of torque magnetometry. Large anomalous Hall signals develop when the magnetic field is rotated in the plane of the stacked quasi-two-dimensional layers, with the values vanishing above about 60 K, where the negative longitudinal magnetoresistance also disappears. This suggests a close relation in their origins, which we attribute to the Berry curvature generated by the Weyl nodes.