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Background Hypertension and obstructive sleep apnea (OSA) often coexist, posing challenges in the management of blood pressure in these patients. A reliable and objective predictor is needed to anticipate the occurrence of hypertension and assess the status of blood pressure control in OSA patients, which would facilitate their blood pressure management. Objective To explore the correlation between red blood cell distribution width (RDW) and hypertension in patients with OSA. Methods A retrospective study was conducted at the Sleep Center of Peking University International Hospital, involving 510 patients who were diagnosed with OSA using polysomnography between January 2019 and September 2022. The derivation cohort comprised of 370 enrolled patients between January 2019 and December 2021, while the validation cohort included the remaining 140 patients enrolled between January and September 2022. Within the derivation cohort, patients were categorized into two groups based on their adherence to the definition of hypertension: hypertension group (n=211) and non-hypertension group (n=159). Subsequently, the hypertension group was further divided into two subgroups: blood pressure control subgroup (n=107) and blood pressure uncontrolled subgroup (n=104). The clinical characteristics and laboratory examination results of patients in the hypertension group and non-hypertension group, as well as those in the blood pressure control subgroup and blood pressure uncontrolled subgroup, were analyzed. Univariate and multivariate Logistic regression analyses were employed to investigate the predictors of hypertension in OSA patients and the status of blood pressure control in OSA patients with combined hypertension. The receiver operating characteristic (ROC) curve was plotted to evaluate the sensitivity and specificity of RDW in predicting the occurrence of hypertension among OSA patients, with its validity confirmed in the validation cohort. Results The multivariate Logistic regression analysis revealed that an increased BMI (OR=1.087, 95%CI=1.007-1.174, P=0.032), diabetes (OR=3.310, 95%CI=1.484-7.380, P=0.003), and a decreased RDW (OR=0.598, 95%CI=0.507-0.704, P

Background/Aim. High-grade glioma (HGG) is an interstitial cell-derived primary tumor of the nervous system. The current guidelines for the diagnosis and treatment of glioma recommend the maximum safe range of tumor resection for treatment methods. Adjuvant concurrent chemoradiotherapy is recommended after surgery, followed by six cycles of single-drug chemotherapy, temozolomide. Evaluation of the early efficacy of concurrent chemoradio-therapy after HGG surgery, especially for patients with a high risk of recurrence, is a crucial step in enhancing the treatment efficiency for patients diagnosed with HGG. In this study, we investigated the clinical utility of magnetic resonance (MR) spectroscopy (MRS) in assessing the early curing impact of concurrent chemoradiotherapy following HGG surgery. Methods. A total of 50 patients with incomplete resection or suspected residual postoperative HGG, treated in the radiotherapy department of our hospital between January 2016 and June 2021, were selected for routine concurrent chemoradiotherapy. Conventional MR imaging and MRS were performed one week prior to treatment and one month after treatment to assess changes in specific brain metabolites. All 50 patients were followed up for 6 to 12 months. Based on the follow-up results, the patients were divided into two groups: the tumor recurrence group and the tumor suppression group. One month after the end of the treatment, the differences in levels of brain metabolites between the two groups were analyzed using MRS. Results. The levels of N-acetylaspartate (NAA) and creatine (Cr) increased after radiotherapy, while choline (Cho) peak value, and Cho/Cr, NAA/Cr, and Cho/NAA ratios decreased compared to pre-treatment levels. There were statistically significant differences in the NAA peak value, and Cho/Cr, and Cho/NAA ratios in the tumor enhancement area before and after treatment (p < 0.05). There were also statistically significant differences in Cho/Cr ratio in the peritumoral edema area before and after treatment (p < 0.05). Conclusion. After concurrent chemoradiotherapy, MRS can be used to detect early metabolic changes in the tumor enhancement and peritumoral edema areas of HGG.

The modular multilevel converter (MMC) suffers from low output level and high harmonic distortion in medium-/low-voltage applications such as direct current (DC) distribution networks. In addition, the capacitor voltage of MMC is coupled with DC bus voltage in the traditional modulation method, leading to large fluctuations of capacitor voltages and deviation from the rated value under DC bus voltage margin. In order to solve the problems above, this paper proposes an improved nearest level control method, which can increase the output level of medium-/low-voltage MMCs by introducing a step wave correction. Based on the proposed modulation method, a capacitor voltage feedback control is thus proposed to limit the range of capacitor voltage fluctuations and improve equipment safety. The effectiveness of the proposed method is verified by MATLAB/Simulink simulation and real-time digital simulation system hardware-in-the-loop test.

Activating enhancer-binding protein 2 (AP-2) is a family of transcription factors (TFs) that play crucial roles in regulating embryonic and oncogenic development. In addition to splice isoforms, five major family members encoded by the TFAP2A/B/C/D/E genes have been identified in humans, i.e., AP-2α/β/γ/δ/ε. In general, the first three TFs have been studied more thoroughly than AP-2δ or AP-2ε. Currently, there is a relatively limited body of literature focusing on the AP-2 family in the context of gastroenterological research, and a comprehensive overview of the existing knowledge and recommendations for further research directions is lacking. Herein, we have collected available gastroenterological data on AP-2 TFs, discussed the latest medical applications of each family member, and proposed potential future directions. Research on AP-2 in gastrointestinal tumors has predominantly been focused on the two best-described family members, AP-2α and AP-2γ. Surprisingly, research in the past decade has highlighted the importance of AP-2ε in the drug resistance of gastric cancer (GC) and colorectal cancer (CRC). While numerous questions about gastroenterological disorders await elucidation, the available data undoubtedly open avenues for anti-cancer targeted therapy and overcoming chemotherapy resistance. In addition to gastrointestinal cancers, AP-2 family members (primarily AP-2β and marginally AP-2γ) have been associated with other health issues such as obesity, type 2 diabetes, liver dysfunction, and pseudo-obstruction. On the other hand, AP-2δ has been poorly investigated in gastroenterological disorders, necessitating further research to delineate its role. In conclusion, despite the limited attention given to AP-2 in gastroenterology research, pivotal functions of these transcription factors have started to emerge and warrant further exploration in the future. [ABSTRACT FROM AUTHOR]

Background: Hepatoid adenocarcinoma of the stomach (HAS) is an extremely rare and unique malignant gastric tumor with a significantly worse prognosis than non‐hepatoid adenocarcinoma of the stomach (non‐HAS). The present study explored the clinicopathological features of HAS and non‐HAS patients to provide insights into HAS treatment strategies. Methods: From December 26, 2023, we performed a comprehensive search of the PubMed, Web of Science, Cochrane Library, and Embase.com databases for relevant studies. Two authors independently screened the studies, evaluated their quality, extracted data, and performed the analyses. This study was registered with PROSPERO on January 2, 2024. Results: Nine retrospective studies were included for analysis after screening 833 articles. A total of 350 and 924 patients were enrolled in the HAS and non‐HAS groups, respectively. While no significant differences were observed in age, sex, tumor size, T3 or T4 stage, and N2 or N3 stage between the two groups, the HAS group exhibited higher rates of lymph node metastasis (OR = 1.93, 95% CI: 1.19–3.13, p = 0.007), liver metastasis (OR = 3.45, 95% CI: 2.26–5.28, p < 0.001), and vascular invasion (OR = 2.76, 95% CI: 2.05–3.71, p < 0.001). Additionally, the HAS group had lower 3‐year survival rates (HR = 2.35, 95% CI: 1.70–3.25, p < 0.001) and 5‐year survival rates (HR = 3.63, 95% CI: 1.49–8.88, p = 0.005), but lower rates of lymphatic permeation (OR = 0.68, 95% CI: 0.47–0.99, p = 0.040). Conclusion: Based on the current clinical evidence, patients with HAS present distinct clinicopathological features, greater invasiveness, and poorer prognosis than non‐HAS patients. Further research is warranted to develop optimal treatment strategies for HAS. [ABSTRACT FROM AUTHOR]

Shear localization is one of the most important failure mechanisms subjected to high-strain-rate deformation and has significant effects on the process, plastic deformation, and catastrophic failure of a material. Shear localization was observed in serrated chips produced during the high-speed cutting of the CoCrFeMnNi high-entropy alloy. Electron backscatter diffraction was performed to systematically investigate microstructural evolution during shear banding. The elongation and subdivision of the narrow grains were observed in the areas adjacent to the shear band. The microstructure inside the shear band was found to be composed of equiaxed ultrafine grains. The results reveal that grain subdivision and dynamic recrystallization might have significant roles in the microstructural evolution of shear bands. These results offer key insights into our understanding of shear localization and high-speed machining behavior for high entropy alloys. [ABSTRACT FROM AUTHOR]

China is a multi-ethnic country, and the prevalence of Helicobacter pylori (H. pylori) infection may be diverse among ethnics. This meta-analysis was conducted to compare the prevalence of H. pylori infection between Tibetans and Han ethnics. Ten studies that reported the prevalence of H. pylori infection between Tibetans and Hans in China were eligible. The pooled prevalence of H. pylori infection was 62.2% versus 55.3% among Tibetans and Hans, respectively. Tibetans had a higher risk of H. pylori infection than Hans (odds ratio [OR] = 1.38). In subgroup analysis, Tibetans with upper gastrointestinal symptoms (OR = 1.51), inhabiting in Tibet (OR = 1.51), or inhabiting in Northwestern region (OR = 1.15) had significantly higher risks of H. pylori infection. In addition, in the recent 10 years, Hans showed a decreased risk of H. pylori infection (OR = 1.81). Heterogeneity was common, while sensitivity analyses showed partially inconsistent results against main findings. This study demonstrated higher prevalence of H. pylori infection in Tibetans compared with Hans, especially in recent years, or in Tibet and northwest China, as well as symptomatic Tibetans. The results suggest tailored strategy and robustness need to be further considered for H. pylori screening and eradication among Tibetans. [ABSTRACT FROM AUTHOR]

Background. The impact of perioperative blood transfusion on the prognosis of gastric adenocarcinoma patients is still controversial. The aim of this study was to elucidate the impact of perioperative blood transfusion on postoperative complications and prognosis of patients who underwent gastrectomy for gastric adenocarcinoma with different levels of preoperative hemoglobin value (POHb). Method. From 2003 to 2011, 1199 patients who underwent curative gastrectomy were retrospectively enrolled and followed up to December 2014. Clinicopathological features and survival outcomes were compared between transfused and nontransfused patients. Results. In this study, transfused patients had more postoperative complications than nontransfused ones (P=0.002). In survival analysis, the difference was not significant between transfused and nontransfused patients with POHb between 70 and 100 g/L (P=0.191). However, in patients with POHb >100 g/L, transfused patients had significantly worse prognosis (P100 g/L and transfused patients had more postoperative complications; thus it is better to refrain from unnecessary perioperative blood transfusion especially intraoperative transfusion.