Transcriptional profiling of Bulinus globosus provides insights into immune gene families in snails supporting the transmission of urogenital schistosomiasis

Schistosomiasis, urogenital and intestinal, afflicts 251 million people worldwide with approximately two-thirds of the patients suffering from the urogenital form of the disease. Freshwater snails of the genus Bulinus (Gastropoda: Planorbidae) serve as obligate intermediate hosts for Schistosoma haematobium, the etiologic agent of human urogenital schistosomiasis. These snails also act as vectors for the transmission of schistosomiasis in livestock and wildlife. Despite their crucial role in human and veterinary medicine, our basic understanding at the molecular level of the entire Bulinus genus, which comprises 37 recognized species, is very limited. In this study, we employed Illumina-based RNA sequencing (RNAseq) to profile the genome-wide transcriptome of Bulinus globosus, one of the most important intermediate hosts for S. haematobium in Africa. A total of 179,221 transcripts (N50 = 1,235) were assembled and the benchmarking universal single-copy orthologs (BUSCO) was estimated to be 97.7%. The analysis revealed a substantial number of transcripts encoding evolutionarily conserved immune-related proteins, particularly C-type lectin (CLECT) domain-containing proteins (n = 316), Toll/Interleukin 1-receptor (TIR)-containing proteins (n = 75), and fibrinogen related domain-containing molecules (FReD) (n = 165). Notably, none of the FReDs are fibrinogen-related proteins (FREPs) (immunoglobulin superfamily (IgSF) + fibrinogen (FBG)). This RNAseq-based transcriptional profile provides new insights into immune capabilities of Bulinus snails, helps provide a framework to explain the complex patterns of compatibility between snails and schistosomes, and improves our overall understanding of comparative immunology.

Associating Knee Osteoarthritis Progression with Temporal-Regional Graph Convolutional Network Analysis on MR Images

BACKGROUND

Artificial intelligence shows promise in assessing knee osteoarthritis (OA) progression on MR images, but faces challenges in accuracy and interpretability.

PURPOSE

To introduce a temporal-regional graph convolutional network (TRGCN) on MR images to study the association between knee OA progression status and network outcome.

STUDY TYPE

Retrospective.

POPULATION

194 OA progressors (mean age, 62 ± 9 years) and 406 controls (mean age, 61 ± 9 years) from the OA Initiative were randomly divided into training (80%) and testing (20%) cohorts.

FIELD STRENGTH/SEQUENCE

Sagittal 2D IW-TSE-FS (IW) and 3D-DESS-WE (DESS) at 3T.

ASSESSMENT

Anatomical subregions of cartilage, subchondral bone, meniscus, and the infrapatellar fat pad at baseline, 12-month, and 24-month were automatically segmented and served as inputs to form compartment-based graphs for a TRGCN model, which containing both regional and temporal information. The performance of models based on (i) clinical variables alone, (ii) radiologist score alone, (iii) combined features (containing i and ii), (iv) composite TRGCN (combining TRGCN, i and ii), (v) radiomics features, (vi) convolutional neural network based on Densenet-169 were compared.

STATISTICAL TESTS

DeLong test was performed to compare the areas under the ROC curve (AUC) of all models. Additionally, interpretability analysis was done to evaluate the contributions of individual regions. A P value <0.05 was considered significant.

RESULTS

The composite TRGCN outperformed all other models with AUCs of 0.841 (DESS) and 0.856 (IW) in the testing cohort (all P < 0.05). Interpretability analysis highlighted cartilage's importance over other structures (42%-45%), tibiofemoral joint's (TFJ) dominance over patellofemoral joint (PFJ) (58%-67% vs. 12%-37%), and importance scores changes in compartments over time (TFJ vs. PFJ: baseline: 44% vs. 43%, 12-month: 52% vs. 39%, 24-month: 31% vs. 48%).

DATA CONCLUSION

The composite TRGCN, capturing temporal and regional information, demonstrated superior discriminative ability compared with other methods, providing interpretable insights for identifying knee OA progression.

LEVEL OF EVIDENCE: 4

TECHNICAL EFFICACY

Stage 2.

BAF-Net: bidirectional attention-aware fluid pyramid feature integrated multimodal fusion network for diagnosis and prognosis

Objective. To go beyond the deficiencies of the three conventional multimodal fusion strategies (i.e. input-, feature- and output-level fusion), we propose a bidirectional attention-aware fluid pyramid feature integrated fusion network (BAF-Net) with cross-modal interactions for multimodal medical image diagnosis and prognosis.Approach. BAF-Net is composed of two identical branches to preserve the unimodal features and one bidirectional attention-aware distillation stream to progressively assimilate cross-modal complements and to learn supplementary features in both bottom-up and top-down processes. Fluid pyramid connections were adopted to integrate the hierarchical features at different levels of the network, and channel-wise attention modules were exploited to mitigate cross-modal cross-level incompatibility. Furthermore, depth-wise separable convolution was introduced to fuse the cross-modal cross-level features to alleviate the increase in parameters to a great extent. The generalization abilities of BAF-Net were evaluated in terms of two clinical tasks: (1) an in-house PET-CT dataset with 174 patients for differentiation between lung cancer and pulmonary tuberculosis. (2) A public multicenter PET-CT head and neck cancer dataset with 800 patients from nine centers for overall survival prediction.Main results. On the LC-PTB dataset, improved performance was found in BAF-Net (AUC = 0.7342) compared with input-level fusion model (AUC = 0.6825;p< 0.05), feature-level fusion model (AUC = 0.6968;p= 0.0547), output-level fusion model (AUC = 0.7011;p< 0.05). On the H&N cancer dataset, BAF-Net (C-index = 0.7241) outperformed the input-, feature-, and output-level fusion model, with 2.95%, 3.77%, and 1.52% increments of C-index (p= 0.3336, 0.0479 and 0.2911, respectively). The ablation experiments demonstrated the effectiveness of all the designed modules regarding all the evaluated metrics in both datasets.Significance. Extensive experiments on two datasets demonstrated better performance and robustness of BAF-Net than three conventional fusion strategies and PET or CT unimodal network in terms of diagnosis and prognosis.

5G NB-IoT System Integrated with High-Performance Fiber Sensor Inspired by Cirrus and Spider Structures

Real-time telemedicine detection can solve the problem of the shortage of public medical resources caused by the coming aging society. However, the development of such an integrated monitoring system is hampered by the need for high-performance sensors and the strict-requirement of long-distance signal transmission and reproduction. Here, a bionic crack-spring fiber sensor (CSFS) inspired by spider leg and cirrus whiskers for stretchable and weavable electronics is reported. Trans-scale conductive percolation networks of multilayer graphene around the surface of outer spring-like Polyethylene terephthalate (PET) fibers and printing Ag enable a high sensitivity of 28475.6 and broad sensing range over 250%. The electromechanical changes in different stretching stages are simulated by Comsol to explain the response mechanism. The CSFS is incorporated into the fabric and realized the human-machine interactions (HMIs) for robot control. Furthermore, the 5G Narrowband Internet of Things (NB-IoT) system is developed for human healthcare data collection, transmission, and reproduction together with the integration of the CSFS, illustrating the huge potential of the approach in human-machine communication interfaces and intelligent telemedicine rehabilitation and diagnosis monitoring.

Association between dietary patterns and cardiovascular diseases: A review

Cardiovascular disease (CVD), especially atherosclerosis, is the primary cause of global deaths. It accounts for millions of deaths annually. Even a small reduction in CVD through preventive treatment can have a substantial impact. Dietary patterns and substances are strongly linked to chronic diseases such as atherosclerosis, hypertension, heart failure, and type 2 diabetes. An unhealthy diet could lead to traditional risk factors such as LDL levels, TG levels, diabetes, and high blood pressure while accelerating atherosclerosis progression. Recent research has shown the potential of dietary interventions to prevent and treat cardiovascular disease, particularly through healthy dietary patterns such as the Mediterranean diet or DASH. In 2016, the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC) launched a new initiative aimed at enhancing the prevention and control of cardiovascular disease (CVD) by improving the management of CVD in primary care, including the optimization of dietary patterns. Here, this review summarizes several large cohort researches about the effects of dietary patterns on atherosclerosis, refines dietary components, and outlines some typical anti-atherosclerosis dietary agents. Finally, this review discusses recent mechanisms by which dietary interventions affect atherosclerosis progression.

Prognostic Value of a Combined Nomogram Model Integrating 3-Dimensional Deep Learning and Radiomics for Head and Neck Cancer

OBJECTIVE

The preoperative prediction of the overall survival (OS) status of patients with head and neck cancer (HNC) is significant value for their individualized treatment and prognosis. This study aims to evaluate the impact of adding 3D deep learning features to radiomics models for predicting 5-year OS status.

METHODS

Two hundred twenty cases from The Cancer Imaging Archive public dataset were included in this study; 2212 radiomics features and 304 deep features were extracted from each case. The features were selected by univariate analysis and the least absolute shrinkage and selection operator, and then grouped into a radiomics model containing Positron Emission Tomography /Computed Tomography (PET/CT) radiomics features score, a deep model containing deep features score, and a combined model containing PET/CT radiomics features score +3D deep features score. TumorStage model was also constructed using initial patient tumor node metastasis stage to compare the performance of the combined model. A nomogram was constructed to analyze the influence of deep features on the performance of the model. The 10-fold cross-validation of the average area under the receiver operating characteristic curve and calibration curve were used to evaluate performance, and Shapley Additive exPlanations (SHAP) was developed for interpretation.

RESULTS

The TumorStage model, radiomics model, deep model, and the combined model achieved areas under the receiver operating characteristic curve of 0.604, 0.851, 0.840, and 0.895 on the train set and 0.571, 0.849, 0.832, and 0.900 on the test set. The combined model showed better performance of predicting the 5-year OS status of HNC patients than the radiomics model and deep model. The combined model was shown to provide a favorable fit in calibration curves and be clinically useful in decision curve analysis. SHAP summary plot and SHAP The SHAP summary plot and SHAP force plot visually interpreted the influence of deep features and radiomics features on the model results.

CONCLUSIONS

In predicting 5-year OS status in patients with HNC, 3D deep features could provide richer features for combined model, which showed outperformance compared with the radiomics model and deep model.

The genome and transcriptome of the snail Biomphalaria sudanica s.l.: immune gene diversification and highly polymorphic genomic regions in an important African vector of Schistosoma mansoni

BACKGROUND

Control and elimination of schistosomiasis is an arduous task, with current strategies proving inadequate to break transmission. Exploration of genetic approaches to interrupt Schistosoma mansoni transmission, the causative agent for human intestinal schistosomiasis in sub-Saharan Africa and South America, has led to genomic research of the snail vector hosts of the genus Biomphalaria. Few complete genomic resources exist, with African Biomphalaria species being particularly underrepresented despite this being where the majority of S. mansoni infections occur. Here we generate and annotate the first genome assembly of Biomphalaria sudanica sensu lato, a species responsible for S. mansoni transmission in lake and marsh habitats of the African Rift Valley. Supported by whole-genome diversity data among five inbred lines, we describe orthologs of immune-relevant gene regions in the South American vector B. glabrata and present a bioinformatic pipeline to identify candidate novel pathogen recognition receptors (PRRs).

RESULTS

De novo genome and transcriptome assembly of inbred B. sudanica originating from the shoreline of Lake Victoria (Kisumu, Kenya) resulted in a haploid genome size of ~ 944.2 Mb (6,728 fragments, N50 = 1.067 Mb), comprising 23,598 genes (BUSCO = 93.6% complete). The B. sudanica genome contains orthologues to all described immune genes/regions tied to protection against S. mansoni in B. glabrata, including the polymorphic transmembrane clusters (PTC1 and PTC2), RADres, and other loci. The B. sudanica PTC2 candidate immune genomic region contained many PRR-like genes across a much wider genomic region than has been shown in B. glabrata, as well as a large inversion between species. High levels of intra-species nucleotide diversity were seen in PTC2, as well as in regions linked to PTC1 and RADres orthologues. Immune related and putative PRR gene families were significantly over-represented in the sub-set of B. sudanica genes determined as hyperdiverse, including high extracellular diversity in transmembrane genes, which could be under pathogen-mediated balancing selection. However, no overall expansion in immunity related genes was seen in African compared to South American lineages.

CONCLUSIONS

The B. sudanica genome and analyses presented here will facilitate future research in vector immune defense mechanisms against pathogens. This genomic/transcriptomic resource provides necessary data for the future development of molecular snail vector control/surveillance tools, facilitating schistosome transmission interruption mechanisms in Africa.

An Innovative and Efficient Diagnostic Prediction Flow for Head and Neck Cancer: A Deep Learning Approach for Multi-Modal Survival Analysis Prediction Based on Text and Multi-Center PET/CT Images

Objective: To comprehensively capture intra-tumor heterogeneity in head and neck cancer (HNC) and maximize the use of valid information collected in the clinical field, we propose a novel multi-modal image-text fusion strategy aimed at improving prognosis. Method: We have developed a tailored diagnostic algorithm for HNC, leveraging a deep learning-based model that integrates both image and clinical text information. For the image fusion part, we used the cross-attention mechanism to fuse the image information between PET and CT, and for the fusion of text and image, we used the Q-former architecture to fuse the text and image information. We also improved the traditional prognostic model by introducing time as a variable in the construction of the model, and finally obtained the corresponding prognostic results. Result: We assessed the efficacy of our methodology through the compilation of a multicenter dataset, achieving commendable outcomes in multicenter validations. Notably, our results for metastasis-free survival (MFS), recurrence-free survival (RFS), overall survival (OS), and progression-free survival (PFS) were as follows: 0.796, 0.626, 0.641, and 0.691. Our results demonstrate a notable superiority over the utilization of CT and PET independently, and exceed the result derived without the clinical textual information. Conclusions: Our model not only validates the effectiveness of multi-modal fusion in aiding diagnosis, but also provides insights for optimizing survival analysis. The study underscores the potential of our approach in enhancing prognosis and contributing to the advancement of personalized medicine in HNC.

Efficacy and safety of hyperbaric oxygen therapy in acute ischaemic stroke: a systematic review and meta-analysis

OBJECTIVE

This study aims to evaluate the efficacy and safety of adjunctive hyperbaric oxygen therapy (HBOT) in acute ischaemic stroke (AIS) based on existing evidence.

METHODS

We conducted a comprehensive search through April 15, 2023, of seven major databases for randomized controlled trials (RCTs) comparing adjunctive hyperbaric HBOT with non-HBOT (no HBOT or sham HBOT) treatments for AIS. Data extraction and assessment were independently performed by two researchers. The quality of included studies was evaluated using the tool provided by the Cochrane Collaboration. Meta-analysis was conducted using Rev Man 5.3.

RESULTS

A total of 8 studies involving 493 patients were included. The meta-analysis showed no statistically significant differences between HBOT and the control group in terms of NIHSS score (MD = -1.41, 95%CI = -7.41 to 4.58), Barthel index (MD = 8.85, 95%CI = -5.84 to 23.54), TNF-α (MD = -5.78, 95%CI = -19.93 to 8.36), sICAM (MD = -308.47, 95%CI = -844.13 to 13227.19), sVCAM (MD = -122.84, 95%CI = -728.26 to 482.58), sE-selectin (MD = 0.11, 95%CI = -21.86 to 22.08), CRP (MD = -5.76, 95%CI = -15.02 to 3.51), adverse event incidence within ≤ 6 months of follow-up (OR = 0.98, 95%CI = 0.25 to 3.79). However, HBOT showed significant improvement in modified Rankin score (MD = 0.10, 95%CI = 0.03 to 0.17), and adverse event incidence at the end of treatment (OR = 0.42, 95%CI = 0.19 to 0.94) compared to the control group.

CONCLUSION

While our findings do not support the routine use of HBOT for improving clinical outcomes in AIS, further research is needed to explore its potential efficacy within specific therapeutic windows and for different cerebral occlusion scenarios. Therefore, the possibility of HBOT offering clinical benefits for AIS cannot be entirely ruled out.

A haplotype-like, chromosome-level assembled and annotated genome of Biomphalaria glabrata, an important intermediate host of schistosomiasis and the best studied model of schistosomiasis vector snails

Schistosomiasis is one of the world's most devastating parasitic diseases, afflicting 251 million people globally. The Neotropical snail Biomphalaria glabrata is an important intermediate host of the human blood fluke Schistosoma mansoni and a predominant model for schistosomiasis research. To fully exploit this model snail for biomedical research, here we report a haplotype-like, chromosome-level assembled and annotated genome of the homozygous iM line of B. glabrata that we developed at the University of New Mexico. Using multiple sequencing platforms, including Illumina, PacBio, and Omni-C sequencing, 18 sequence contact matrices representing 18 haploid chromosomes (2n = 36) were generated (337x genome coverage), and 96.5% of the scaffold sequences were anchored to the 18 chromosomes. Protein-coding genes (n = 34,559), non-coding RNAs (n = 2,406), and repetitive elements (42.52% of the genome) were predicted for the whole genome, and detailed annotations for individual chromosomes were also provided. Using this genomic resource, we have investigated the genomic structure and organization of the Toll-like receptor (TLR) and fibrinogen-domain containing protein (FReD) genes, the two important immune-related gene families. Notably, TLR-like genes are scattered on 13 chromosomes. In contrast, almost all (39 of 40) fibrinogen-related genes (FREPs) (immunoglobulin superfamily (IgSF) + fibrinogen (FBG)) are clustered within a 5-million nucleotide region on chromosome 13, yielding insight into mechanisms involved in the diversification of FREPs. This is the first genome of schistosomiasis vector snails that has been assembled at the chromosome level, annotated, and analyzed. It serves as a valuable resource for a deeper understanding of the biology of vector snails, especially Biomphalaria snails.

Corrigendum: Systematic review and meta-analysis of the efficacy and safety of electroacupuncture for poststroke dysphagia

[This corrects the article DOI: 10.3389/fneur.2023.1270624.].

Stress-only versus rest-stress SPECT MPI in the detection and diagnosis of myocardial ischemia and infarction by machine learning

BACKGROUND

Rest-stress SPECT myocardial perfusion imaging (MPI) is widely used to evaluate coronary artery disease (CAD). We aim to evaluate stress-only versus rest-stress MPI in diagnosing CAD by machine learning (ML).

METHODS

A total of 276 patients with suspected CAD were randomly divided into training (184 patients) and validation (92 patients) cohorts. Variables extracted from clinical, physiological, and rest-stress SPECT MPI were screened. Stress-only and rest-stress MPI using ML were established and compared using the training cohort. Then the diagnostic performance of two models in diagnosing myocardial ischemia and infarction was evaluated in the validation cohort.

RESULTS

Six ML models based on stress-only MPI selected summed stress score, summed wall thickness score of stress%, and end-diastolic volume of stress as key variables and performed equally good as rest-stress MPI in detecting CAD [area under the curve (AUC): 0.863 versus 0.877, P  = 0.519]. Furthermore, stress-only MPI showed a reasonable prediction of reversible deficit, as shown by rest-stress MPI (AUC: 0.861). Subsequently, nomogram models using the above-stated stress-only MPI variables showed a good prediction of CAD and reversible perfusion deficit in training and validation cohorts.

CONCLUSION

Stress-only MPI demonstrated similar diagnostic performance compared with rest-stress MPI using 6 ML algorithms. Stress-only MPI with ML models can diagnose CAD and predict ischemia from scar.

Systematic review and meta-analysis of the efficacy and safety of electroacupuncture for poststroke dysphagia

Introduction

Optimal treatment strategies for post-stroke dysphagia (PSD) remain to be explored. Electroacupuncture (EA) has attracted widespread attention due to its simplicity, cheapness, and safety. However, the efficacy of EA in the treatment of PSD lacks high-level evidence-based medical support. This study aimed to systematically evaluate the clinical value of EA in the treatment of PSD.

Methods

A total of seven databases were searched for relevant literature. All randomized controlled trials (RCTs) on EA alone or EA combined with other interventions for the treatment of PSD were assessed using the modified Jadad scale. The studies with a score of ≥4 were included. The quality of the included studies was then assessed using the Cochrane Collaboration's tool. The meta-analysis was performed using Rev. Man 5.3 software.

Results

Twelve studies involving 1,358 patients were included in the meta-analysis. Meta-analysis results showed that the EA group was superior to the control group in terms of clinical response rate (OR = 2.63, 95% CI = 1.97 to 3.53) and videofluoroscopic swallowing study (VFSS) score (MD = 0.73, 95% CI = 0.29 to 1.16). There was no significant difference between the two groups in the standardized swallowing assessment (SSA) score (MD = -3.11, 95% CI = -6.45 to 0.23), Rosenbek penetration-aspiration scale (PAS) score (MD = -0.68, 95% CI = -2.78 to 1.41), Swallowing Quality of Life (SWAL-QOL) score (MD = 13.24, 95% CI = -7.74 to 34.21), or incidence of adverse events (OR = 1.58, 95% CI = 0.73 to 3.38).

Conclusion

This study shows that EA combined with conventional treatment or other interventions can significantly improve the clinical response rate and VFSS score in patients with PSD without increasing adverse reactions.Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=396840.

GCLR: A self-supervised representation learning pretext task for glomerular filtration barrier segmentation in TEM images

Automatic segmentation of the three substructures of glomerular filtration barrier (GFB) in transmission electron microscopy (TEM) images holds immense potential for aiding pathologists in renal disease diagnosis. However, the labor-intensive nature of manual annotations limits the training data for a fully-supervised deep learning model. Addressing this, our study harnesses self-supervised representation learning (SSRL) to utilize vast unlabeled data and mitigate annotation scarcity. Our innovation, GCLR, is a hybrid pixel-level pretext task tailored for GFB segmentation, integrating two subtasks: global clustering (GC) and local restoration (LR). GC captures the overall GFB by learning global context representations, while LR refines three substructures by learning local detail representations. Experiments on 18,928 unlabeled glomerular TEM images for self-supervised pre-training and 311 labeled ones for fine-tuning demonstrate that our proposed GCLR obtains the state-of-the-art segmentation results for all three substructures of GFB with the Dice similarity coefficient of 86.56 ± 0.16%, 75.56 ± 0.36%, and 79.41 ± 0.16%, respectively, compared with other representative self-supervised pretext tasks. Our proposed GCLR also outperforms the fully-supervised pre-training methods based on the three large-scale public datasets - MitoEM, COCO, and ImageNet - with less training data and time.

Optimal batch determination for improved harmonization and prognostication of multi-center PET/CT radiomics feature in head and neck cancer

Objective. To determine the optimal approach for identifying and mitigating batch effects in PET/CT radiomics features, and further improve the prognosis of patients with head and neck cancer (HNC), this study investigated the performance of three batch harmonization methods.Approach. Unsupervised harmonization identified the batch labels by K-means clustering. Supervised harmonization regarding the image acquisition factors (center, manufacturer, scanner, filter kernel) as known/given batch labels, and Combat harmonization was then implemented separately and sequentially based on the batch labels, i.e. harmonizing features among batches determined by each factor individually or harmonizing features among batches determined by multiple factors successively. Extensive experiments were conducted to predict overall survival (OS) on public PET/CT datasets that contain 800 patients from 9 centers.Main results. In the external validation cohort, results show that compared to original models without harmonization, Combat harmonization would be beneficial in OS prediction with C-index of 0.687-0.740 versus 0.684-0.767. Supervised harmonization slightly outperformed unsupervised harmonization in all models (C-index: 0.692-0.767 versus 0.684-0.750). Separate harmonization outperformed sequential harmonization in CT_m+clinic and CT_cm+clinic models with C-index of 0.752 and 0.722, respectively, while sequential harmonization involved clinical features in PET_rs+clinic model further improving the performance and achieving the highest C-index of 0.767.Significance. Optimal batch determination especially sequential harmonization for Combat holds the potential to improve the prognostic power of radiomics model in multi-center HNC dataset with PET/CT imaging.

The genome and transcriptome of the snail Biomphalaria sudanica s.l.: Immune gene diversification and highly polymorphic genomic regions in an important African vector of Schistosoma mansoni

Background

Control and elimination of schistosomiasis is an arduous task, with current strategies proving inadequate to break transmission. Exploration of genetic approaches to interrupt Schistosoma mansoni transmission, the causative agent for human intestinal schistosomiasis in sub-Saharan Africa and South America, has led to genomic research of the snail vector hosts of the genus Biomphalaria. Few complete genomic resources exist, with African Biomphalaria species being particularly underrepresented despite this being where the majority of S. mansoni infections occur. Here we generate and annotate the first genome assembly of Biomphalaria sudanica sensu lato, a species responsible for S. mansoni transmission in lake and marsh habitats of the African Rift Valley. Supported by whole-genome diversity data among five inbred lines, we describe orthologs of immune-relevant gene regions in the South American vector B. glabrata and present a bioinformatic pipeline to identify candidate novel pathogen recognition receptors (PRRs).

Results

De novo genome and transcriptome assembly of inbred B. sudanica originating from the shoreline of Lake Victoria (Kisumu, Kenya) resulted in a haploid genome size of ~944.2 Mb (6732 fragments, N50=1.067 Mb), comprising 23,598 genes (BUSCO=93.6% complete). The B. sudanica genome contains orthologues to all described immune genes/regions tied to protection against S. mansoni in B. glabrata. The B. sudanica PTC2 candidate immune genomic region contained many PRR-like genes across a much wider genomic region than has been shown in B. glabrata, as well as a large inversion between species. High levels of intra-species nucleotide diversity were seen in PTC2, as well as in regions linked to PTC1 and RADres orthologues. Immune related and putative PRR gene families were significantly over-represented in the sub-set of B. sudanica genes determined as hyperdiverse, including high extracellular diversity in transmembrane genes, which could be under pathogen-mediated balancing selection. However, no overall expansion in immunity related genes were seen in African compared to South American lineages.

Conclusions

The B. sudanica genome and analyses presented here will facilitate future research in vector immune defense mechanisms against pathogens. This genomic/transcriptomic resource provides necessary data for the future development of molecular snail vector control/surveillance tools, facilitating schistosome transmission interruption mechanisms in Africa.

Composite Hydrogels Based on Bacterial Cellulose and Poly-1-vinyl-1,2,4-triazole/Phosphoric Acid: Supramolecular Structure as Studied by Small Angle Scattering

New composite hydrogels (CH) based on bacterial cellulose (BC) and poly-1-vinyl-1,2,4-triazole (PVT) doped with orthophosphoric acid (oPA), presenting interpenetrating polymeric networks (IPN), have been synthesized. The mesoscopic study of the supramolecular structure (SMS) of both native cellulose, produced by the strain Komagataeibacter rhaeticus, and the CH based on BC and containing PVT/oPA complex were carried out in a wide range of momentum transfer using ultra- and classical small-angle neutron scattering techniques. The two SMS hierarchical levels were revealed from 1.6 nm to 2.5 μm for the objects under investigation. In addition, it was shown that the native BC had a correlation peak on the small-angle scattering curves at 0.00124 Å-1, with the correlation length ξ being equal to ca. 510 nm. This motive was also retained in the IPN. The data obtained allowed the estimation of the fractal dimensions and ranges of self-similarity and gave new information about the BC mesostructure and its CH. Furthermore, we revealed them to be in coincidence with Brown's BC model, which was earlier supported by Fink's results.

Electroacupuncture at HT5 + GB20 promotes brain remodeling and significantly improves swallowing function in patients with stroke

Background

This study compared the differences in the degree of brain activation, and swallowing function scales in patients with post-stroke dysphagia after treatment. We explored the mechanism of cortical remodeling and the improvement effect of electroacupuncture on swallowing function in patients and provided a theoretical basis for the clinical application of electroacupuncture.

Methods

Fifty patients with post-stroke dysphagia were randomized to the control or electroacupuncture group. The control group underwent conventional swallowing rehabilitation for 30 min each time for 12 sessions. In the electroacupuncture group, electroacupuncture was performed based on conventional swallowing rehabilitation for 30 min each time for 12 sessions. Cortical activation tests and swallowing function assessments were performed before and after treatment. Statistical analyses were used to investigate the differences within and between the two groups to explore the treatment effects.

Results

There were no statistical differences in clinical characteristics and baseline data between the two groups before treatment. Cortical activation and swallowing function were improved to different degrees in both groups after treatment compared with before treatment. After treatment, the electroacupuncture group showed higher LPM (t = 4.0780, p < 0.001) and RPM (t = 4.4026, p < 0.0001) cortical activation and tighter functional connectivity between RS1 and LM1 (t = 2.5336, p < 0.05), RM1 and LPM (t = 3.5339, p < 0.001), RPM and LM1 (t = 2.5302, p < 0.05), and LM1 and LPM (t = 2.9254, p < 0.01) compared with the control group. Correspondingly, the improvement in swallowing function was stronger in the electroacupuncture group than in the control group (p < 0.05).

Conclusion

This study demonstrated that electroacupuncture based on conventional treatment activated more of the cerebral cortex associated with swallowing and promoted functional connectivity and remodeling of the brain. Accompanying the brain remodeling, patients in the electroacupuncture group also showed greater improvement in swallowing function.

Clinical trial registration

ClinicalTrials.gov, ChiCTR2300067457.

Electroacupuncture at HT5 + GB20 produces stronger activation effect on swallowing cortex and muscle than single points

Introduction

This study aimed to investigate the effects of electroacupuncture on cortical activation and swallowing muscle groups. The study examined brain activation in healthy subjects performing swallowing tasks during electroacupuncture. Additionally, the study analyzed electromyographic signals of swallowing muscle groups after electroacupuncture.

Methods

Twenty-seven healthy subjects were randomly separated into three groups. They underwent electroacupuncture at HT5 acupoint (HT5 group), or GB20 acupoint (GB20 group), or HT5 + GB20 acupoint (HT5 + GB20 group) for 30 min of intervention. Subjects performed a swallowing task while receiving electroacupuncture. Functional near-infrared spectroscopy (fNIRS) was used to detect cortical activation and functional connectivity (FC). The mean amplitude values of the swallowing muscle groups after electroacupuncture were also measured. Statistical analysis was used to investigate the differences between the three groups. The protocol was registered with the China Clinical Trials Registry with the registration number ChiCTR2300067457.

Results

Compared with the HT5 group, the HT5 + GB20 group showed higher cortical activation in the LM1 (t = 2.842, P < 0.05) and a tighter FC in the RM1 and LM1 (t = 2.4629, P < 0.05) with considerably increased mean amplitude values of the swallowing muscle groups (t = 5.2474, P < 0.0001). Increased FC was found in the HT5 + GB20 group compared to the GB20 group between the RM1 and RS1 (t = 2.9997, P < 0.01), RM1 and RPM (t = 2.2116, P < 0.05), RM1 and LM1 (t = 3.2078, P < 0.01), RPM and LM1 (t = 2.7440, P < 0.05). However, there were no statistically significant differences in cortical activation or mean amplitude values of swallowing muscle groups.

Conclusion

This study showed that electroacupuncture at HT5 + GB20 acupoints particularly engaged the cerebral cortex related to swallowing, resulting in tighter functional connectivity and higher amplitude values of swallowing muscle groups than electroacupuncture at single acupoints. The results may reveal the mechanism of electroacupuncture for post-stroke swallowing dysphagia.

Multimodality radiomics analysis based on [18F]FDG PET/CT imaging and multisequence MRI: application to nasopharyngeal carcinoma prognosis

OBJECTIVES

To determine whether radiomics models developed from 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) PET/CT combined with multisequence MRI could contribute to predicting the progression-free survival (PFS) of nasopharyngeal carcinoma (NPC) patients.

METHODS

One hundred thirty-two NPC patients who underwent both PET/CT and MRI scanning were retrospectively enrolled (88 vs. 44 for training vs. testing). For each modality/sequence (i.e., PET, CT, T1, T1C, and T2), 1906 radiomics features were extracted from the primary tumor volume. Univariate Cox model and correlation analysis were used for feature selection. A multivariate Cox model was used to establish radiomics signature. Prognostic performances of 5 individual modality models and 12 multimodality models (3 integrations × 4 fusion strategies) were assessed by the concordance index (C-index) and log-rank test. A clinical-radiomics nomogram was built to explore the clinical utilities of radiomics signature, which was evaluated by discrimination, calibration curve, and decision curve analysis (DCA).

RESULTS

The radiomics signatures of individual modalities showed limited prognostic efficacy with a C-index of 0.539-0.664 in the testing cohort. Different fusion strategies exhibited a slight difference in predictive performance. The PET/CT and MRI integrated model achieved the best performance with a C-index of 0.745 (95% CI, 0.619-0.865) in the testing cohort (log-rank test, p < 0.05). Clinical-radiomics nomogram further improved the prognosis, which also showed satisfactory discrimination, calibration, and net benefit.

CONCLUSIONS

Multimodality radiomics analysis by combining PET/CT with multisequence MRI could potentially improve the efficacy of PFS prediction for NPC patients.

KEY POINTS

• Individual modality radiomics models showed limited performance in prognosis evaluation for NPC patients. • Combined PET, CT and multisequence MRI radiomics signature could improve the prognostic efficacy. • Multilevel fusion strategies exhibit comparable performance but feature-level fusion deserves more attention.

Hydrogenative alkene perdeuteration aided by a transient cooperative ligand

Deuterogenation of unsaturated organic compounds is an attractive route for installing C(sp3)-D bonds, but the existing methods typically use expensive D2 and introduce only two deuterium atoms per unsaturation. Herein we report the hydrogenative perdeuteration of alkenes using readily available H2 and D2O instead of D2, catalysed by an acridanide-based ruthenium pincer complex and resulting in the incorporation of up to 4.9 D atoms per C=C double bond in a single synthetic step. Importantly, adding a catalytic amount of thiol, which serves as a transient cooperative ligand, ensures the incorporation of deuterium rather than protium by balancing the rates of two sequential deuteration processes. The current method opens an avenue for installing perdeuteroalkyl groups at specific sites from widely available alkenes under mild conditions.

Transfer learning-based attenuation correction for static and dynamic cardiac PET using a generative adversarial network

PURPOSE

The goal of this work is to demonstrate the feasibility of directly generating attenuation-corrected PET images from non-attenuation-corrected (NAC) PET images for both rest and stress-state static or dynamic [13N]ammonia MP PET based on a generative adversarial network.

METHODS

We recruited 60 subjects for rest-only scans and 14 subjects for rest-stress scans, all of whom underwent [13N]ammonia cardiac PET/CT examinations to acquire static and dynamic frames with both 3D NAC and CT-based AC (CTAC) PET images. We developed a 3D pix2pix deep learning AC (DLAC) framework via a U-net + ResNet-based generator and a convolutional neural network-based discriminator. Paired static or dynamic NAC and CTAC PET images from 60 rest-only subjects were used as network inputs and labels for static (S-DLAC) and dynamic (D-DLAC) training, respectively. The pre-trained S-DLAC network was then fine-tuned by paired dynamic NAC and CTAC PET frames of 60 rest-only subjects to derive an improved D-DLAC-FT for dynamic PET images. The 14 rest-stress subjects were used as an internal testing dataset and separately tested on different network models without training. The proposed methods were evaluated using visual quality and quantitative metrics.

RESULTS

The proposed S-DLAC, D-DLAC, and D-DLAC-FT methods were consistent with clinical CTAC in terms of various images and quantitative metrics. The S-DLAC (slope = 0.9423, R2 = 0.947) showed a higher correlation with the reference static CTAC as compared to static NAC (slope = 0.0992, R2 = 0.654). D-DLAC-FT yielded lower myocardial blood flow (MBF) errors in the whole left ventricular myocardium than D-DLAC, but with no significant difference, both for the 60 rest-state subjects (6.63 ± 5.05% vs. 7.00 ± 6.84%, p = 0.7593) and the 14 stress-state subjects (1.97 ± 2.28% vs. 3.21 ± 3.89%, p = 0.8595).

CONCLUSION

The proposed S-DLAC, D-DLAC, and D-DLAC-FT methods achieve comparable performance with clinical CTAC. Transfer learning shows promising potential for dynamic MP PET.

Global cluster analysis and network visualization in organoids in cancer research: a scientometric mapping from 1991 to 2021

Objective

In the last three decades, there has been a surge in research on cancer organoids using 3D culture technologies, which has resulted in the development of physiological human cancer models. This study aims to provide an overview of the global trends and frontiers in research on cancer organoids.

Methods

A total of 3189 publications on organoids in cancer research from 1991 to 2021 were collected from the Science Citation Index-Expanded (SCIE) of Web of Science (WoS). Bibliometric methods such as the R package "Bibliometrix," Citespace, and VOS viewer software were employed to investigate and visualize bibliographic coupling, co-citation, co-authorship, and co-occurrence trends, as well as publication trends in the field of organoids in cancer research.

Results

From 1991 to 2021, there has been a significant increase in publications on cancer organoids, with most articles being from North America, Eastern Asia, and Western Europe. The USA had the highest number of publications, citations, prolific authors, and research funding globally. Cancers was the journal with the most publications, while Nature had the best total link strength. Harvard University were the most contributive institutions. The global research in this field could be classified into five clusters: chemotherapy study, organoids for drug screening, different models, molecular mechanism study, and organoid construction. These areas are expected to remain hotspots for future research.

Conclusions

The number of publications on organoids in cancer research is expected to increase based on current global trends.

Identification of c.1495C > T mutation in SPAST gene in a family of Han Chinese with hereditary spastic paraplegia

BACKGROUND

Hereditary spastic paraplegia 4 (SPG4) caused by spastin (SPAST) gene mutations accounts for 40-45% of hereditary spastic paraplegia (HSP) cases. To search for more genetic evidences for the pathogenesis of HSP, the SPAST genotype and clinical phenotype of a Chinese Han SPG4 family were analysed in this study.

METHODS

The clinical data of the proband and his family members were collected. Whole genomic DNA was extracted from peripheral blood, and the gene detection and pathogenicity analysis of mutations were conducted using whole-exome sequencing technology. Suspected pathogenic mutations were identified. Verification within this family was conducted by Sanger sequencing.

RESULTS

Eight (4 males and 4 females) of 20 members in 4 generations had SPG4. All patients presented with the high feet arches (pes cavus), the abnormal gait, the active tendon reflexes of the upper limbs, the hyperreflexia of the lower limbs, and the positive ankle clonus and Babinski's signs bilaterally. In the proband, we found a heterozygous mutation c.1495C > T in SPAST gene, which was associated with the autosomal dominant SPG4. Both the daughters and granddaughters of the proband in this family were verified to carry this mutation. The clinical characteristics of the SPG4 patients in this family are in line with the simple type of HSP. Heterozygous c.1495C > T is a pathogenic mutation in this family.

CONCLUSION

In this study, we identified a c.1495C > T mutation in the SPAST gene in a Han Chinese family, enriching the mutation spectrum of SPG4.

Electrospun Nanofiber-Based Bioinspired Artificial Skins for Healthcare Monitoring and Human-Machine Interaction

Artificial skin, also known as bioinspired electronic skin (e-skin), refers to intelligent wearable electronics that imitate the tactile sensory function of human skin and identify the detected changes in external information through different electrical signals. Flexible e-skin can achieve a wide range of functions such as accurate detection and identification of pressure, strain, and temperature, which has greatly extended their application potential in the field of healthcare monitoring and human-machine interaction (HMI). During recent years, the exploration and development of the design, construction, and performance of artificial skin has received extensive attention from researchers. With the advantages of high permeability, great ratio surface of area, and easy functional modification, electrospun nanofibers are suitable for the construction of electronic skin and further demonstrate broad application prospects in the fields of medical monitoring and HMI. Therefore, the critical review is provided to comprehensively summarize the recent advances in substrate materials, optimized fabrication techniques, response mechanisms, and related applications of the flexible electrospun nanofiber-based bio-inspired artificial skin. Finally, some current challenges and future prospects are outlined and discussed, and we hope that this review will help researchers to better understand the whole field and take it to the next level.

Ethane Ammoxidation over Sn/H-Zeolite Catalysts: Toward the Factors Contributing to the Yield of Acetonitrile

Different Sn/H-zeolite (β, MOR, SSZ-13, FER, and Y zeolite) catalysts are prepared with the improved impregnation method. The effects of reaction temperature and the composition of the reaction gas (ammonia, oxygen, and ethane) on the catalytic reaction are investigated. Adjusting the fraction of ammonia and/or ethane in the reaction gas can effectively strengthen the ethane dehydrogenation (ED) route and ethylamine dehydrogenation (EA) route and inhibit the ethylene peroxidation (EO) route, whereas the adjustment of oxygen cannot effectively promote acetonitrile formation because it cannot avoid enhancing the EO route. By comparing the acetonitrile yields on different Sn/H-zeolite catalysts at 600 °C, it is revealed that the ammonia pool effect, the residual Brönsted acid in the zeolite, and the Sn-Lewis acid synergistically catalyze ethane ammoxidation. Moreover, a higher L/B ratio of the Sn/H zeolite is beneficial to the improvement of acetonitrile yield. With a certain application potential, the Sn/H-FER-zeolite catalyst shows an ethane conversion of 35.2% and an acetonitrile yield of 22.9% at 600 °C; although a similar catalytic performance was observed on the best Co-zeolite catalyst in literature, the Sn/H-FER-zeolite catalyst is more selective to ethene and CO than the Co catalyst. In addition, the selectivity to CO₂ is less than 2% of that on the Sn-zeolite catalyst. This may be attributed to the special 2D topology and pore/channel system of the FER zeolite, which guarantee an ideal synergistic effect of the ammonia pool, the residual Brönsted acid in the zeolite, and the Sn-Lewis acid for the Sn/H-FER-catalyzed ethane ammoxidation reaction.

[Efficacy and safety of modified Hartel approach in the treatment of primary trigeminal neuralgia with radiofrequency thermocoagulation]

Objective: To assess the efficacy and safety of modified Hartel approach in the treatment of primary trigeminal neuralgia with radiofrequency thermocoagulation. Methods: A total of 89 patients with primary trigeminal neuralgia in Nanjing Drum Tower Clinical College of Xuzhou Medical University from July 2021 to July 2022 were prospectively included, and were divided into experimental group (n=45, modified Hartel approach: selecting 2.0 cm lateral to and 1.0 cm below angulus oris as insertion point) and control group (n=44, traditional Hartel approach: selecting 2.5 cm lateral to the angulus oris as insertion point) according to the random number table method. There were 19 males and 26 females in the experimental group, and aged (67.6±8.8) years. Meanwhile, there were 19 males and 25 females in the control group, and aged (64.8±11.7) years. All the patients were treated by CT-guided radiofrequency thermocoagulation. The success rate of one-time puncture, number of punctures, the time of puncture, operation time, numerical rating scale (NRS) scores and complications were recorded and compared between the two groups. Results: The success rate of one-time puncture in experimental group was 64.4% (29/45), which was higher than that in control group 31.8% (14/44) (P<0.05). The number of punctures [M (Q₁, Q₃)], the time of puncture [M (Q₁, Q₃)] and operation time in the experimental group were 1 (1, 2), 218 (206, 378) s, (19.9±2.7) min, which were less than those of control group [2 (1, 3), 390 (231, 598) s, (27.0±3.9) min] (all P<0.05). The NRS scores [M (Q₁, Q₃)] of 1 day, 1 month and 3 months after surgery in the experimental group were 1 (1, 2), 1 (0, 2) and 1(0, 1), respectively, which were lower than the baseline level [6 (6, 7)] (all P<0.05). The NRS scores [M (Q₁, Q₃)] of 1 day, 1 month and 3 months after surgery in the control group were 1 (1, 2), 1 (0, 2) and 1 (0, 2), respectively, which were lower than the baseline level [6 (6, 7)] (all P<0.05). There was no statistically significant difference in the incidence of nausea and vomiting, facial numbness, and decreased masticatory muscle strength between the two groups (all P>0.05) In the experimental group, two patients had puncture needles into the oral cavity, with timely detection and replacement of puncture needles, and no infection occurred. There was no cerebrospinal fluid leakage and decreased corneal reflex in both groups. Conclusion: The modified Hartel approach can significantly improve the success rate of one-time puncture via foramen ovale, reduce the operation time and the incidence of postoperative facial swelling, which is a safe and effective puncture method.

A genome sequence for Biomphalaria pfeifferi, the major vector snail for the human-infecting parasite Schistosoma mansoni

BACKGROUND

Biomphalaria pfeifferi is the world's most widely distributed and commonly implicated vector snail species for the causative agent of human intestinal schistosomiasis, Schistosoma mansoni. In efforts to control S. mansoni transmission, chemotherapy alone has proven insufficient. New approaches to snail control offer a way forward, and possible genetic manipulations of snail vectors will require new tools. Towards this end, we here offer a diverse set of genomic resources for the important African schistosome vector, B. pfeifferi.

METHODOLOGY/PRINCIPAL FINDINGS

Based largely on PacBio High-Fidelity long reads, we report a genome assembly size of 772 Mb for B. pfeifferi (Kenya), smaller in size than known genomes of other planorbid schistosome vectors. In a total of 505 scaffolds (N50 = 3.2Mb), 430 were assigned to 18 large linkage groups inferred to represent the 18 known chromosomes, based on whole genome comparisons with Biomphalaria glabrata. The annotated B. pfeifferi genome reveals a divergence time of 3.01 million years with B. glabrata, a South American species believed to be similar to the progenitors of B. pfeifferi which undertook a trans-Atlantic colonization < five million years ago.

CONCLUSIONS/SIGNIFICANCE

The genome for this preferentially self-crossing species is less heterozygous than related species known to be preferential out-crossers; its smaller genome relative to congeners may similarly reflect its preference for selfing. Expansions of gene families with immune relevance are noted, including the FReD gene family which is far more similar in its composition to B. glabrata than to Bulinus truncatus, a vector for Schistosoma haematobium. Provision of this annotated genome will help better understand the dependencies of trematodes on snails, enable broader comparative insights regarding factors contributing to susceptibility/ resistance of snails to schistosome infections, and provide an invaluable resource with respect to identifying and manipulating snail genes as potential targets for more specific snail control programs.

Functional-structural sub-region graph convolutional network (FSGCN): Application to the prognosis of head and neck cancer with PET/CT imaging

BACKGROUND AND OBJECTIVE

Accurate risk stratification is crucial for enabling personalized treatment for head and neck cancer (HNC). Current PET/CT image-based prognostic methods include radiomics analysis and convolutional neural network (CNN), while extracting radiomics or deep features in grid Euclidean space has inherent limitations for risk stratification. Here, we propose a functional-structural sub-region graph convolutional network (FSGCN) for accurate risk stratification of HNC.

METHODS

This study collected 642 patients from 8 different centers in The Cancer Imaging Archive (TCIA), 507 patients from 5 centers were used for training, and 135 patients from 3 centers were used for testing. The tumor was first clustered into multiple sub-regions by using PET and CT voxel information, and radiomics features were extracted from each sub-region to characterize its functional and structural information, a graph was then constructed to format the relationship/difference among different sub-regions in non-Euclidean space for each patient, followed by a residual gated graph convolutional network, the prognostic score was finally generated to predict the progression-free survival (PFS).

RESULTS

In the testing cohort, compared with radiomics or FSGCN or clinical model alone, the model PETCT^Fea_CT^ROI + Cli that integrates FSGCN prognostic score and clinical parameter achieved the highest C-index and AUC of 0.767 (95% CI: 0.759-0.774) and 0.781 (95% CI: 0.774-0.788), respectively for PFS prediction. Besides, it also showed good prognostic performance on the secondary endpoints OS, RFS, and MFS in the testing cohort, with C-index of 0.786 (95% CI: 0.778-0.795), 0.775 (95% CI: 0.767-0.782) and 0.781 (95% CI: 0.772-0.789), respectively.

CONCLUSIONS

The proposed FSGCN can better capture the metabolic or anatomic difference/interaction among sub-regions of the whole tumor imaged with PET/CT. Extensive multi-center experiments demonstrated its capability and generalization of prognosis prediction in HNC over conventional radiomics analysis.

Prognostic value of 18F-FDG PET/CT-based radiomics combining dosiomics and dose volume histogram for head and neck cancer

OBJECTIVES

By comparing the prognostic performance of ¹⁸F-FDG PET/CT-based radiomics combining dose features [Includes Dosiomics feature and the dose volume histogram (DVH) features] with that of conventional radiomics in head and neck cancer (HNC), multidimensional prognostic models were constructed to investigate the overall survival (OS) in HNC.

MATERIALS AND METHODS

A total of 220 cases from four centres based on the Cancer Imaging Archive public dataset were used in this study, 2260 radiomics features and 1116 dosiomics features and 8 DVH features were extracted for each case, and classified into seven different models of PET, CT, Dose, PET+CT, PET+Dose, CT+Dose and PET+CT+Dose. Features were selected by univariate Cox and Spearman correlation coefficients, and the selected features were brought into the least absolute shrinkage and selection operator (LASSO)-Cox model. A nomogram was constructed to visually analyse the prognostic impact of the incorporated dose features. C-index and Kaplan-Meier curves (log-rank analysis) were used to evaluate and compare these models.

RESULTS

The cases from the four centres were divided into three different training and validation sets according to the hospitals. The PET+CT+Dose model had C-indexes of 0.873 (95% CI 0.812-0.934), 0.759 (95% CI 0.663-0.855) and 0.835 (95% CI 0.745-0.925) in the validation set respectively, outperforming the rest models overall. The PET+CT+Dose model did well in classifying patients into high- and low-risk groups under all three different sets of experiments (p < 0.05).

CONCLUSION

Multidimensional model of radiomics features combining dosiomics features and DVH features showed high prognostic performance for predicting OS in patients with HNC.

Unraveling the Structure and Reactivity Patterns of the Indole Radical Cation in Regioselective Electrochemical Oxidative Annulations

Oxidation-induced strategy for inert chemical bond activation through highly active radical cation intermediate has exhibited unique reactivity. Understanding the structure and reactivity patterns of radical cation intermediates is crucial in the mechanistic study and will be beneficial for developing new reactions. In this work, the structure and properties of indole radical cations have been revealed using time-resolved transient absorption spectroscopy, in situ electrochemical UV-vis, and in situ electrochemical electron paramagnetic resonance (EPR) technique. Density functional theory (DFT) calculations were used to explain and predict the regioselectivity of several electrochemical oxidative indole annulations. Based on the understanding of the inherent properties of several indole radical cations, two different regioselective annulations of indoles have been successfully developed under electrochemical oxidation conditions. Varieties of furo[2,3-b]indolines and furo[3,2-b]indolines were synthesized in good yields with high regioselectivities. Our mechanistic insights into indole radical cations will promote the further development of oxidation-induced indole functionalizations.

Upper limb intelligent feedback robot training significantly activates the cerebral cortex and promotes the functional connectivity of the cerebral cortex in patients with stroke: A functional near-infrared spectroscopy study

Background

Upper limb intelligence robots are widely used to improve the upper limb function of patients with stroke, but the treatment mechanism is still not clear. In this study, functional near-infrared spectroscopy (fNIRS) was used to evaluate the concentration changes of oxygenated hemoglobin (oxy-Hb) and deoxyhemoglobin (deoxy-Hb) in different brain regions and functional connectivity (FC) of the cerebral cortex in patients with stroke.

Method

Twenty post-stroke patients with upper limb dysfunction were included in the study. They all received three different types of shoulder joint training, namely, active intelligent feedback robot training (ACT), upper limb suspension training (SUS), and passive intelligent feedback robot training (PAS). During the training, activation of the cerebral cortex was detected by fNIRS to obtain the concentration changes of hemoglobin and FC of the cerebral cortex. The fNIRS signals were recorded over eight ROIs: bilateral prefrontal cortices (PFC), bilateral primary motor cortices (M1), bilateral primary somatosensory cortices (S1), and bilateral premotor and supplementary motor cortices (PM). For easy comparison, we defined the right hemisphere as the ipsilesional hemisphere and flipped the lesional right hemisphere in the Nirspark.

Result

Compared with the other two groups, stronger cerebral cortex activation was observed during ACT. One-way repeated measures ANOVA revealed significant differences in mean oxy-Hb changes among conditions in the four ROIs: contralesional PFC [F_{(2, 48)} = 6,798, p < 0.01], ipsilesional M1 [F_{(2, 48)} = 6.733, p < 0.01], ipsilesional S1 [F_{(2, 48)} = 4,392, p < 0.05], and ipsilesional PM [F_{(2, 48)} = 3.658, p < 0.05]. Oxy-Hb responses in the contralesional PFC region were stronger during ACT than during SUS (p < 0.01) and PAS (p < 0.05). Cortical activation in the ipsilesional M1 was significantly greater during ACT than during SUS (p < 0.01) and PAS (p < 0.05). Oxy-Hb responses in the ipsilesional S1 (p < 0.05) and ipsilesional PM (p < 0.05) were significantly higher during ACT than during PAS, and there is no significant difference in mean deoxy-Hb changes among conditions. Compared with SUS, the FC increased during ACT, which was characterized by the enhanced function of the ipsilesional cortex (p < 0.05), and there was no significant difference in FC between the ACT and PAS.

Conclusion

The study found that cortical activation during ACT was higher in the contralesional PFC, and ipsilesional M1 than during SUS, and showed tighter cortical FC between the cortices. The activation of the cerebral cortex of ACT was significantly higher than that of PAS, but there was no significant difference in FC. Our research helps to understand the difference in cerebral cortex activation between upper limb intelligent feedback robot rehabilitation and other rehabilitation training and provides an objective basis for the further application of upper limb intelligent feedback robots in the field of stroke rehabilitation.

Prognostic generalization of multi-level CT-dose fusion dosiomics from primary tumor and lymph node in nasopharyngeal carcinoma

PURPOSE

To investigate the prognostic performance of multi-level computed tomography (CT)-dose fusion dosiomics at the image-, matrix-, and feature-levels from the gross tumor volume (GTV) at nasopharynx and the involved lymph node for nasopharyngeal carcinoma (NPC) patients.

METHODS

Two hundred and nineteen NPC patients (175 vs. 44 for training vs. internal validation) were used to train prediction model, and 32 NPC patients were used for external validation. We first extracted CT and dose information from intratumoral nasopharynx (GTV_nx) and lymph node (GTV_nd) regions. Then, the corresponding peritumoral regions (RING_3 mm and RING_5 mm) were also considered. Thus, the individual and combination of intratumoral and peritumoral regions were as follows: GTV_nx, GTV_nd, RING_3 mm_nx, RING_3 mm_nd, RING_5 mm_nx, RING_5 mm_nd, GTV_nxnd, RING_3 mm_nxnd, RING_5 mm_nxnd, GTV + RING_3 mm_nxnd, and GTV + RING_5 mm_nxnd. For each region, 11 models were built by combining five clinical parameters and 127 features from: (1) dose images alone; (2-7) fused dose and CT images via wavelet-based fusion using CT weights of 0.2, 0.4, 0.6, and 0.8, gradient transfer fusion, and guided-filtering-based fusion (GFF); (8) fused matrices (sumMat); (9-10) fused features derived via feature averaging (avgFea) and feature concatenation (conFea); and finally, (11) CT images alone. The concordance index (C-index) and Kaplan-Meier curves with log-rank test were used to assess model performance.

RESULTS

The fusion models' performance was better than single CT/dose model on both internal and external validation. Models that combined the information from both GTV_nx and GTV_nd regions outperformed the single region model. For internal validation, GTV + RING_3 mm_nxnd GFF model achieved the highest C-index both in recurrence-free survival (RFS) and metastasis-free survival (MFS) predictions (RFS: 0.822; MFS: 0.786). The highest C-index in external validation set was achieved by RING_3 mm_nxnd model (RFS: 0.762; MFS: 0.719). The GTV + RING_3 mm_nxnd GFF model is able to significantly separate patients into high-risk and low-risk groups compared to dose-only or CT-only models.

CONCLUSION

Fusion dosiomics model combining the primary tumor, the involved lymph node, and 3 mm peritumoral information outperformed single-modality models for different outcome predictions, which is helpful for clinical decision-making and the development of personalized treatment.

A highly efficient needle-free-injection delivery system for mRNA-LNP vaccination against SARS-CoV-2

Despite the various vaccines that have been developed to combat the coronavirus disease 2019 (COVID-19) pandemic, the persistent and unpredictable mutations of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) require innovative and unremitting solutions to cope with the resultant immune evasion and establish a sustainable immune barrier. Here we introduce a vaccine-delivery system with a combination of a needle-free injection (NFI) device and a SARS-CoV-2-Spike-specific mRNA-Lipid Nanoparticle (LNP) vaccine. The benefits are duller pain and a significant increase of immunogenicity compared to the canonical needle injection (NI). From physicochemical and bioactivity analyses, the structure of the mRNA-LNP maintains stability upon NFI, contradictory to the belief that LNPs are inclined towards destruction under the high-pressure conditions of NFI. Moreover, mRNA-LNP vaccine delivered by NFI induces significantly more binding and neutralizing antibodies against SARS-CoV-2 variants than the same vaccine delivered by NI. Heterogeneous vaccination of BA.5-LNP vaccine with NFI enhanced the generation of neutralizing antibodies against Omicron BA.5 variants in rabbits previously vaccinated with non-BA.5-specific mRNA-LNP or other COVID-19 vaccines. NFI parameters can be adjusted to deliver mRNA-LNP subcutaneously or intramuscularly. Taken together, our results suggest that NFI-based mRNA-LNP vaccination is an effective substitute for the traditional NI-based mRNA-LNP vaccination.

An automatic segmentation method with self-attention mechanism on left ventricle in gated PET/CT myocardial perfusion imaging

OBJECTIVES

We aimed to propose an automatic segmentation method for left ventricular (LV) from 16 electrocardiogram (ECG) -gated ¹³N-NH₃ PET/CT myocardial perfusion imaging (MPI) to improve the performance of LV function assessment.

METHODS

Ninety-six cases with confirmed or suspected obstructive coronary artery disease (CAD) were enrolled in this research. The LV myocardial contours were delineated by physicians as ground truth. We developed an automatic segmentation method, which introduces the self-attention mechanism into 3D U-Net to capture global information of images so as to achieve fine segmentation of LV. Three cross-validation tests were performed on each gate (64 vs. 32 for training vs. validation). The effectiveness was validated by quantitative metrics (modified hausdorff distance, MHD; dice ratio, DR; 3D MHD) as well as cardiac functional parameters (end-systolic volume, ESV; end-diastolic volume, EDV; ejection fraction, EF). Furthermore, the feasibility of the proposed method was also evaluated by intra- and inter-observers with DR and 3D-MHD.

RESULTS

Compared with backbone network, the proposed approach improved the average DR from 0.905 ± 0.0193 to 0.9202 ± 0.0164, and decreased the average 3D MHD from 0.4611 ± 0.0349 to 0.4304 ± 0.0339. The average relative error of LV volume between proposed method and ground truth is 1.09±3.66%, and the correlation coefficient is 0.992 ± 0.007 (P < 0.001). The EDV, ESV, EF deduced from the proposed approach were highly correlated with ground truth (r ≥ 0.864, P < 0.001), and the correlation with commercial software is fair (r ≥ 0.871, P < 0.001). DR and 3D MHD of contours and myocardium from two observers are higher than 0.899 and less than 0.5194.

CONCLUSION

The proposed approach is highly feasible for automatic segmentation of the LV cavity and myocardium, with potential to benefit the precision of LV function assessment.

Zhongyong thinking (doctrine of the mean) and internet addiction: The mediation of maladaptive cognition and the moderation of subject

Based on the cognitive-behavioral model of pathological internet use, this study explored the relationship between zhongyong thinking (doctrine of the mean) and internet addiction, and examined the mediation of maladaptive cognition and the moderation of subject. Convenience sampling was used to select 1,518 college students for the questionnaire. The participants were 15-26 years old (M = 19.77; SD = 1.45), including 776 male and 742 female students. The results showed that zhongyong thinking was significantly negatively correlated with maladaptive cognition (r = -0.19, p < 0.001) and internet addiction (r = -0.14, p < 0.001). Maladaptive cognition was significantly positively correlated with internet addiction (r = 0.46, p < 0.001). After controlling for age, gender, zhongyong thinking negatively predicted internet addiction (B = -0.06, p < 0.05), maladaptive cognition positively predicted Internet addiction (B = 0.45, p < 0.001). Zhongyong thinking negatively predicted maladaptive cognition (B = -0.19, p < 0.001). Moreover, the bias-corrected bootstrapping mediation test indicated that the process by which zhongyong thinking predicted Internet addiction through maladaptive cognition was significant, indirect effect = -0.08, SE = 0.01, 95% CI = [-0.11, -0.06]. Subject has no moderating effect on the relationship between zhongyong thinking and maladaptive cognition. The interaction between zhongyong thinking and subject was not a significant predictor of maladaptive cognition (B = 0.05, p > 0. 05). The present results suggest that zhongyong thinking as a traditional Chinese wisdom can still play an important role in regulating young people's behavior in the digital age.

Radiomics prognostic analysis of PET/CT images in a multicenter head and neck cancer cohort: investigating ComBat strategies, sub-volume characterization, and automatic segmentation

PURPOSE

This study aimed to investigate the impact of several ComBat harmonization strategies, intra-tumoral sub-volume characterization, and automatic segmentations for progression-free survival (PFS) prediction through radiomics modeling for patients with head and neck cancer (HNC) in PET/CT images.

METHODS

The HECKTOR MICCAI 2021 challenge set containing PET/CT images and clinical data of 325 oropharynx HNC patients was exploited. A total of 346 IBSI-compliant radiomic features were extracted for each patient's primary tumor volume defined by the reference manual contours. Modeling relied on least absolute shrinkage Cox regression (Lasso-Cox) for feature selection (FS) and Cox proportional-hazards (CoxPH) models were built to predict PFS. Within this methodological framework, 8 different strategies for ComBat harmonization were compared, including before or after FS, in feature groups separately or all features directly, and with center or clustering-determined labels. Features extracted from tumor sub-volume clustering were also investigated for their prognostic additional value. Finally, 3 automatic segmentations (2 threshold-based and a 3D U-Net) were also compared. All results were evaluated with the concordance index (C-index).

RESULTS

Radiomics features without harmonization, combined with clinical factors, led to models with C-index values of 0.69 in the testing set. The best version of ComBat harmonization, i.e., after FS, for feature groups separately and relying on clustering-determined labels, achieved a C-index of 0.71. The use of features extracted from tumor sub-volumes further improved the C-index to 0.72. Models that relied on the automatic segmentations yielded close but slightly lower prognostic performance (0.67-0.70) compared to reference contours.

CONCLUSION

A standard radiomics pipeline allowed for prediction of PFS in a multicenter HNC cohort. Applying a specific strategy of ComBat harmonization improved the performance. The extraction of intra-tumoral sub-volume features and automatic segmentation could contribute to the improvement and automation of prognosis modeling, respectively.

Fragile Intermediate Identification and Reactivity Elucidation in Electrochemical Oxidative α-C(sp3)-H Functionalization of Tertiary Amines

The direct α-C(sp3)-H functionalization of widely available tertiary amines holds promise for the rapid construction of complex amine architectures. The activation of C(sp3)-H bonds through electron transfer and proton transfer...

Transcriptome Analysis of Traditional Chinese Medicine 'Kechuanning Plaster' in the Treatment of Asthma

BACKGROUND

Asthma is a severe chronic inflammatory airway disease. Kechuanning plaster has excellent efficacy in the treatment of asthma.

OBJECTIVE

The aim of this study was to analyze the molecular mechanisms of Kechuanning plaster in the treatment of asthma.

METHODS

An asthma model was constructed using Sprague Dawley rats. Differentially expressed genes (DEGs) were screened in three rat groups: the control (normal rats), model (asthma rats), and treatment (asthma rats treated with Kechuanning) groups. After enrichment analysis of the DEGs, the protein-protein interactions (PPIs) of the DEGs were analyzed, and transcription factors and microRNAs (miRNAs) that regulate DEGs were predicted. Finally, western blotting (WB) and immunohistochemical (IHC) analysis was performed to validate protein expression.

RESULTS

A total of 745 DEGs were identified and enriched in 93 Gene Ontology terms and 25 Kyoto Encyclopedia of Genes and Genomes pathways. A PPI network, consisting of 224 protein nodes and 368 edges, was constructed. The nuclear factor of activated T cells 2 (NFATc2) was predicted to have binding sites in 61 DEGs. The miRNA-target interaction network included 24 DEGs and 9 miRNAs. WB and IHC analysis demonstrated that the fatty acid-binding protein 5 (FABP5) and the chemokine (C-X-C motif) ligand 3 (CXCL3) had higher expression in the model group and lower expression in the control and treatment groups.

CONCLUSION

We concluded that FABP5, CXCL3, suppressor of cytokine signaling 3 (SOCS3), E1A binding protein P300 (EP300), NFATc2, microRNA 495 (miR-495), and miR-30 may play important roles in treating asthma.

Effects of filial piety belief on cyberbullying perpetration of Chinese university students

Cyberbullying has become a worldwide phenomenon. Although the topic has drawn decent academic attention and many studies have been conducted on Chinese samples, variable interests in these studies have not captured the thinking and behavioral characteristics of Chinese people. Based on the dual filial piety model and self-determination theory, this study examined the effect of filial piety belief on cyberbullying perpetration and tested the mediation of relatedness need satisfaction. A total of 856 university students completed the questionnaires, including dual filial piety scale, relatedness need satisfaction scale and cyberbullying perpetration scale. The regression results found that reciprocal filial piety negatively predicted and authoritarian filial piety positively predicted cyberbullying perpetration. The SEM results showed that reciprocal filial piety and authoritarian filial piety impacted cyberbullying perpetration through the mediating effect of relatedness need satisfaction. Reciprocal filial piety was positively while authoritarian filial piety negatively correlated with relatedness need satisfaction and relatedness need satisfaction was negatively correlated with cyberbullying perpetration. The results provide a new position to understand the effect of family factors on cyberbullying perpetration by placing the topic within traditional Chinese family value.

We can't afford the candy! The influence of parenting by lying about money on mobile phone addiction and the roles of anxiety and socioeconomic status among Chinese adolescents

BACKGROUND

Extant research has indicated that parenting practice, such as harsh parenting, rejection, and neglect increases the risk of mobile phone addiction. However, no research to date has examined the association between parenting by lying about money and adolescent mobile phone addiction.

OBJECTIVE

The current study used a survey to test whether parenting by lying about money may be associated with adolescent mobile phone addiction. The mediation of anxiety and moderation of socioeconomic status were also examined.

MATERIALS AND METHODS

We recruited 971 adolescents from five secondary schools in a city in central China. Of the participants, 448 (46.14%) were boys and 523 (53.86%) were girls (M age = 13.63, SD age = 1.01).

RESULTS

The results of mediation analysis indicated that parenting by lying about money positively predicted mobile phone addiction (B = 0.144, p < 0.01); parenting by lying about money positively predicted anxiety (B = 0.126, p < 0.01) and mobile phone addiction (B = 0.107, p < 0.01). Anxiety positively predicted mobile phone addiction (B = 0.293, p < 0.01). Moreover, the bias-corrected bootstrapping mediation test indicated that the process by which parenting by lying about money predicted mobile phone addiction through anxiety was significant (indirect effect = 0.037, SE = 0.011, 95% CI = [0.017, 0.059]).

CONCLUSION

The current study suggests that parenting by lying about money may lead to mobile phone addiction through the mediation of anxiety. However, the effect was stronger for adolescents with higher level of socioeconomic status than their counterparts.

Compatibility between snails and schistosomes: insights from new genetic resources, comparative genomics, and genetic mapping

The freshwater snail Biomphalaria glabrata is an important intermediate host of the parasite Schistosoma mansoni that causes human intestinal schistosomiasis. To better understand vector snail biology and help advance innovative snail control strategies, we have developed a new snail model consisting of two homozygous B. glabrata lines (iM line and iBS90) with sharply contrasting schistosome-resistance phenotypes. We produced and compared high-quality genome sequences for iM line and iBS90 which were assembled from 255 (N50 = 22.7 Mb) and 346 (N50 = 19.4 Mb) scaffolds, respectively. Using F2 offspring bred from the two lines and the newly generated iM line genome, we constructed 18 linkage groups (representing the 18 haploid chromosomes) covering 96% of the genome and identified three new QTLs (quantitative trait loci), two involved in snail resistance/susceptibility and one relating to body pigmentation. This study provides excellent genomic resources for unveiling complex vector snail biology, reveals genomic difference between resistant and susceptible lines, and offers novel insights into genetic mechanism of the compatibility between snail and schistosome.

MRI Information-Based Correction and Restoration of Photoacoustic Tomography

As an emerging molecular imaging modality, Photoacoustic Tomography (PAT) is capable of mapping tissue physiological metabolism and exogenous contrast agent information with high specificity. Due to its ultrasonic detection mechanism, the precise localization of targeted lesions has long been a challenge for PAT imaging. The poor soft-tissue contrast of the PAT image makes this process difficult and inaccurate. To meet this challenge, in this study, we first make use of the rich and clear structural information brought about by another advanced imaging modality, Magnetic Resonance Imaging (MRI), to assist organ segmentation and correct for the light fluence attenuation of PAT. We demonstrate improved feature visibility and enhanced localization of endogenous and exogenous agents in the fluence corrected PAT images. Compared with PAT-based methods, the contrast-to-noise ratio (CNR) of our MRI-assisted method increases by 29.1% in live animal experiments. Furthermore, we show that the co-registered MRI image can also be incorporated into PAT image restoration, and achieves improved anatomical landscape and soft-tissue contrast (CNR increased by 25.36%) while preserving similar spatial resolution. This PAT-MRI combination provides excellent structural, functional and molecular images of the subject, and may enable more comprehensive analysis of various preclinical research applications.

Flexible Pressure Sensors with Combined Spraying and Self-Diffusion of Carbon Nanotubes

High-performance wearable sensors are required for applications in medical health and human-machine interaction, but their application has limited owing to the trade-off between sensitivity, pressure range, and durability. Herein, we propose the combined spraying and self-diffusion process of carbon nanotubes (CNTs) to balance and improve these parameters with the CNTs spontaneously diffusing into the film surface before the film curing. The obtained sensor not only achieves high sensitivity (155.54 kPa^-1) and ultrawide pressure detection range (0.1-500 kPa) but also exhibits exceptional durability (over 12,000 pressure cycles at a high pressure of 300 kPa). In addition, the sensor exhibits a fast response (25 ms), good stability, and full flexibility. This process is a general approach that may improve the performance of various types of thin film piezoresistive sensors. Besides, the fabricated sensors can be flexibly scaled into sensor arrays and communicate with smart devices to achieve wireless smart monitoring. At present, the sensor shows broad application prospects in the fields of intelligent medical health and motion sensing.

DeTransUnet: attenuation correction of gated cardiac images without structural information

Objective. Myocardial perfusion imaging (MPI) with positron emission tomography (PET) is a non-invasive imaging method, and it is of great significance to the diagnosis and prognosis of coronary heart disease. Attenuation correction (AC) for PET images is a necessary step for further quantitative analysis. In order not to use magnetic resonance (MR) or computed tomography (CT) images for AC, this work proposes DeTransUnet to obtain AC PET images directly from no-attenuation corrected (NAC) PET images. Approach. The proposed DeTransUnet is a 3D structure which combines the multi-scale deformable transformer layers and the 3D convolutional neural network (CNN). And it integrates the advantages of transformer with long-range dependence and CNN suitable for image calculation. The AC images using CT images for AC and scatter correction (SC) and are considered as training labels, while the NAC images are reconstructed without AC and SC. Standard uptake value (SUV) values are calculated for both NAC and AC images to exclude the influence of weight and injection dose. With NAC SUV images as the inputs of the DeTransUnet, the outputs of DeTransUnet are AC SUV images. Main results. The proposed DeTransUnet was performed on an MPI gated-PET dataset, and the results were compared with Unet2D and Unet2.5D. The metrics of the whole image and the left ventricular myocardium show that the proposed method has advantages over other deep learning methods. Significance. The proposed DeTransUnet is a novel AC framework that does not require CT or MR images. It can be used as an independent AC method on PET/MR instrument. In addition, when CT images contain defects or cannot be registered with PET images on PET/CT instrument, DeTransUnet is able to repair the defects and keep consistent with the NAC images.

Destructing surfactant network in nanoemulsions by positively charged magnetic nanorods to enhance oil-water separation

The separation of ultrafine oil droplets from wasted nanoemulsions stabilized with high concentration of surfactants is precondition for oil reuse and the safe discharge of effluent. However, the double barriers of the interfacial film and network structures formed by surfactants in nanoemulsions significantly impede the oil-water separation. To destroy these surfactant protective layers, we proposed a newly-developed polyethyleneimine micelle template approach to achieve simultaneous surface charge manipulation and morphology transformation of magnetic nanospheres to magnetic nanorods. The results revealed that positively charged magnetic nanospheres exhibited limited separation performance of nanoemulsions, with a maximum chemical oxygen demand (COD) removal of 50%, whereas magnetic nanorods achieved more than 95% COD removal in less than 30 s. The magnetic nanorods were also applicable to wasted nanoemulsions from different sources and exhibited excellent resistance to wide pH changes. Owing to their unique one-dimensional structure, the interfacial dispersion of magnetic nanorods was significantly promoted, leading to the efficient capture of surfactants and widespread destruction of both the interfacial film and network structure, which facilitated droplet merging into the oil phase. The easy-to-prepare and easy-to-tune strategy in this study paves a feasible avenue to simultaneously tailor surface charge and morphology of magnetic nanoparticles, and reveals the huge potential of morphology manipulation for producing high-performance nanomaterials to be applied in complex interfacial interaction process. We believe that the newly-developed magnetic-nanorods significantly contribute to hazardous oily waste remediation and advances technology evolution toward problematic oil-pollution control.

[Analysis of clinical features and surgical outcomes of petrous bone cholesteatomas]

Objective: To analyze the clinical features and surgical outcomes of petrous bone cholesteatomas (PBCs). Methods: Data from 39 PBCs patients treated in the Department of Otorhinolaryngology, Xijing Hospital from September 2011 to December 2017 were reviewed retrospectively, including 23 males, 16 femals, aged 12-71 years old, with the median age of 37. Clinical classifications, surgical methods, facial and hearing function, and intraoperative and postoperative complications were made summary analysis. Results: In this study, five patients were congenital PBCs and 34 patients were acquired PBCs. The common clinical symptoms were hearing loss (100%, 39/39), ear discharge/pus (89.7%, 35/39) and facial paralysis (46.2%, 18/39). According to Sanna's classification, 14 cases were supralabyrinthine, including three cases underwent transcochlear (TC) approach, six cases underwent transotic (TO) approach and five underwent translabyrinthine (TL) approach. 10 cases were infralabyrinthine, including eight cases underwent subtotal petrosectomy, one case underwent TO approach and one underwent TL approach.10 cases were massive, including seven cases underwent TC approach, three cases underwent TO approach. Five cases were infralabyrinthine-apical, including two cases underwent TC approach, two cases underwent TO approach, and one case underwent endoscope assisted infratemporal fossa type B. The degree of facial nerve (FN) dysfunction from high to low was massive (6/10), supralabyrinthine (8/14), infralabyrinthine-apical (2/5) and infralabyrinthine (2/10). 19 cases involved in facial nerve operation, three cases underwent FN decompression, four cases underwent FN rerouting, four cases underwent nerve grafting, and one case underwent facial-hypoglossal anastomosis. Preoperative FN involvement in 18 cases, and the FN function was improved in 14 cases after surgery. The improved rate of postoperative FN function was 77.8%. The bone conducted hearing retained 50.0% (14/28) postoperatively. Five cases with cerebrospinal fluid leak were managed by inserting free muscle plugs and cavity obliteration. Two cases with the cholesteatomas matrix involved the sigmoid sinus and the jugular bulb, and occlusion of the sigmoid sinus was performed. Postoperatively, two patients presented with synkinesis. The patients were followed up for 40 to 115 months, and there was no recurrence. Conclusions: There are no specific clinical manifestations for PBCs, thus, it is difficult in early diagnosis and treatment. According to Sanna's classification, preoperative FN and hearing function, the best surgical approach should be selected with minimal recurrences and perioperative morbidity.