[Role of neoadjuvant rectal score in prognosis and adjuvant chemotherapy decision-making in locally advanced rectal cancer following neoadjuvant short-course radiotherapy and consolidation chemotherapy]

Objectives: To assess the prognostic impact of the neoadjuvant rectal (NAR) score following neoadjuvant short-course radiotherapy and consolidation chemotherapy in locally advanced rectal cancer (LARC), as well as its value in guiding decisions for adjuvant chemotherapy. Methods: Between August 2015 and August 2018, patients were eligible from the STELLAR phase III trial (NCT02533271) who received short-course radiotherapy plus consolidation chemotherapy and for whom the NAR score could be calculated. Based on the NAR score, patients were categorized into low (＜8), intermediate (8-16), and high (＞16) groups. The Kaplan-Meier method, log rank tests, and multivariate Cox proportional hazard regression models were used to evaluate the impact of the NAR score on disease-free survival (DFS). Results: Out of the 232 patients, 24.1%, 48.7%, and 27.2% had low (56 cases), intermediate (113 cases), and high NAR scores (63 cases), respectively. The median follow-up period was 37 months, with 3-year DFS rates of 87.3%, 68.3%, and 53.4% (P＜0.001) for the low, intermediate, and high NAR score groups. Multivariate analysis demonstrated that the NAR score (intermediate NAR score: HR, 3.10, 95% CI, 1.30-7.37, P=0.011; high NAR scores: HR=5.44, 95% CI, 2.26-13.09, P＜0.001), resection status (HR, 3.00, 95% CI, 1.64-5.52, P＜0.001), and adjuvant chemotherapy (HR, 3.25, 95% CI, 2.01-5.27, P＜0.001) were independent prognostic factors for DFS. In patients with R0 resection, the 3-year DFS rates were 97.8% and 78.0% for those with low and intermediate NAR scores who received adjuvant chemotherapy, significantly higher than the 43.2% and 50.6% for those who did not (P＜0.001, P=0.002). There was no significant difference in the 3-year DFS rate (54.2% vs 53.3%, P=0.214) among high NAR score patients, regardless of adjuvant chemotherapy. Conclusions: The NAR score is a robust prognostic indicator in LARC following neoadjuvant short-course radiotherapy and consolidation chemotherapy, with potential implications for subsequent decisions regarding adjuvant chemotherapy. These findings warrant further validation in studies with larger sample sizes.

[Mechanism of noise induced hidden hearing loss based on proteomics]

Objective: To explore the mechanism of noise-induced hidden hearing loss by proteomics. Methods: In October 2022, 64 SPF male C57BL/6J mice were divided into control group and noise exposure group with 32 mice in each group according to random sampling method. The noise exposure group was exposed to 100 dB sound pressure level, 2000-16000 Hz broadband noise for 2 h, and the mouse hidden hearing loss model was established. Auditory brainstem response (ABR) was used to test the change of hearing threshold of mice on the 7th day after noise exposure, the damage of basal membrane hair cells was observed by immunofluorescence, and the differentially expressed proteins in the inner ear of mice in each group were identified and analyzed by 4D-Label-free quantitative proteomics, and verified by Western blotting. The results were statistically analyzed by ANOVA and t test. Results: On the 7th day after noise exposure, there was no significant difference in hearing threshold between the control group and the noise exposure group at click and 8000 Hz acoustic stimulation (P>0.05) . The hearing threshold in the noise exposure group was significantly higher than that in the control group under 16000 Hz acoustic stimulation (P<0.05) . Confocal immunofluorescence showed that the basal membrane hair cells of cochlear tissue in noise exposure group were arranged neatly, but the relative expression of C-terminal binding protein 2 antibody of presynaptic membrane in middle gyrus and basal gyrus was significantly lower than that in control group (P<0.05) . GO enrichment analysis showed that the functions of differentially expressed proteins were mainly concentrated in membrane potential regulation, ligand-gated channel activity, and ligand-gated ion channel activity. KEGG pathway enrichment analysis showed that differentially expressed proteins were significantly enriched in phosphatidylinositol 3 kinase-protein kinase B (PI3K-Akt) signaling pathway, NOD-like receptor signaling pathway, calcium signaling pathway, etc. Western blotting showed that the expression of inositol 1, 4, 5-trisphosphate receptor 3 (Itpr3) was increased and the expression of solute carrier family 38 member 2 (Slc38a2) was decreased in the noise exposure group (P<0.05) . Conclusion: Through proteomic analysis, screening and verification of the differential expression proteins Itpr3 and Slc38a2 in the constructed mouse noise-induced hidden hearing loss model, the glutaminergic synaptic related pathways represented by Itpr3 and Slc38a2 may be involved in the occurrence of hidden hearing loss.

[Application and comparison of three occupational health risk assessment methods in an automobile manufacturing industry]

Objective: Three occupational health risk assessment methods were used to assess the occupational health risk of noise exposed posts in an automobile manufacturing enterprise. According to the results, the selection of risk assessment methods and risk management of such occupational noise enterprises were provided. Methods: Form April to November 2021, The occupational health field survey was carried out in an automobile manufacturing industry in Tianjin. The occupational health MES risk assessment method, occupational health risk index risk assessment method and Australian occupational hazard risk assessment method were used to evaluate the occupational health risk of noise-exposed posts in this enterprise, and the evaluation results of different methods were analyzed and compared. Results: The average value of L(Aeq, 8 h) in the four workshops of automobile manufacturing industry was 82.95 dB (A) , and the noise detection exceeding rate was 22.41% (26/116) . The LAeq, 8h and exceeding rate noise of welding workshop were higher than those of other workshops (χ(2)=23.56, 32.94, P<0.01) . The three occupational health risk assessment methods have the same risk assessment results for the four major workshops. The assembly and painting workshops are level 4 risk (possible risk) , and the stamping and welding workshops are level 3 risk (significant risk) . Conclusion: Occupational noise has certain potential hazards to workers in automobile manufacturing enterprises. Therefore, in the future work, corresponding organizational management measures should be taken to improve the working environment and reduce the actual exposure level of workers in order to protect the health of occupational workers.

A NiMOF integrated with conductive materials for efficient bifunctional electrocatalysis of urea oxidation and oxygen evolution reactions

The development of urea oxidation reaction (UOR) and oxygen evolution reaction (OER) bifunctional electrocatalysts has dual significance in promoting hydrogen energy production and urea-rich wastewater treatment. Herein, a carboxylated multi-walled carbon nanotube (MWCNT-COOH)-ferrocene carboxylic acid (Fc-COOH) modulated NiMOF hybrid material (MWCNT-NiMOF(Fc)) has been synthesized for dual electrocatalysis of the UOR and OER. The material characterization results indicated that MWCNT-COOH and Fc-COOH were integrated into the framework structure of the NiMOF. The direct interaction between the NiMOF and MWCNT/Fc facilitated electron transfer in the hybrid material and led to lattice strain, which improved the charge transfer kinetics, promoted the exposure of more unsaturated Ni sites, and increased the electrochemically active surface area. These factors together enhanced the electrocatalytic activity of MWCNT-NiMOF(Fc) towards the UOR and OER. Using a glassy carbon electrode as the substrate, MWCNT-NiMOF(Fc) exhibited low potential requirements, low Tafel slopes, and high stability. In overall urea and water splitting electrolysis cells, the excellent UOR and OER dual functional catalytic ability and enormous practical application potential of the MWCNT-NiMOF(Fc) modified foam nickel electrode were further demonstrated. On the basis of the above research, the influence of a KOH environment on urea electrolysis was further studied, and the urea electrolysis products were analyzed, promoting a more comprehensive understanding of the catalytic performance of MWCNT-NiMOF(Fc) for urea oxidation. This study provides a new approach for developing high-performance NiMOF-based electrocatalysts for challenging bifunctional UOR/OER applications, and has potential application value in hydrogen production from urea-containing wastewater electrolysis.

A radiomics model based on T2WI and clinical indexes for prediction of lateral lymph node metastasis in rectal cancer

OBJECTIVE

The aim of this study was to explore the clinical value of a radiomics prediction model based on T2-weighted imaging (T2WI) and clinical indexes in predicting lateral lymph node (LLN) metastasis in rectal cancer patients.

METHODS

This was a retrospective analysis of 106 rectal cancer patients who had undergone LLN dissection. The clinical risk factors for LLN metastasis were selected by multivariable logistic regression analysis of the clinical indicators of the patients. The LLN radiomics features were extracted from the pelvic T2WI of the patients. The least absolute shrinkage and selection operator algorithm and backward stepwise regression method were adopted for feature selection. Three LLN metastasis prediction models were established through logistic regression analysis based on the clinical risk factors and radiomics features. Model performance was assessed in terms of discriminability and decision curve analysis in the training, verification and test sets.

RESULTS

The model based on the combined T2WI radiomics features and clinical risk factors demonstrated the highest accuracy, surpassing the models based solely on either T2WI radiomics features or clinical risk factors. Specifically, the model achieved an AUC value of 0.836 in the test set. Decision curve analysis revealed that this model had the greatest clinical utility for the vast majority of the threshold probability range from 0.4 to 1.0.

CONCLUSION

Combining T2WI radiomics features with clinical risk factors holds promise for the noninvasive assessment of the biological characteristics of the LLNs in rectal cancer, potentially aiding in therapeutic decision-making and optimizing patient outcomes.

The consequences of laparoscopic fascial space priority approach to lateral lymph node dissection on urinary and sexual functionality

Introduction

In this prospective observational study, we aimed to evaluate the consequences of laparoscopic fascia space priority lymph node dissection on urination and sexual function.

Aim

To assess the consequences of laparoscopic lateral lymph node dissection (LLND) using the fascial space priority approach on urinary and sexual function in patients with advanced middle and low rectal cancer.

Material and methods

Consecutive patients undergoing laparoscopic LLND using the fascial space priority approach from December 2020 to November 2022 were identified from Tianjin Union Medical Center. Clinical data including patient characteristics, surgical details, and pathology were analysed. The urinary function was assessed by international prostate symptom score (IPSS) questionnaire and residual urine volume. The sexual function was investigated using the international index of erectile function (IIEF) questionnaire.

Results

A total of 51 patients, mean age 60.5 ±10.9 years, were identified. The lymph nodes were positive in 70.6% (36/51) of the patients. There was no significant difference between the preoperative IPSS score and that at 6 months (5.2 ±2.1 vs. 5.6 ±1.5; p = 0.16). And there was no significant difference between the residual urine volume and that at 6 months (9.5 ±10.6 vs. 8.6 ±6.3; p = 0.61). The IIEF score before the surgery showed no significant difference from that at 6 months after the surgery (21.1 ±2.2 vs. 20.6 ±2.3; p = 0.26).

Conclusions

Laparoscopic LLND using a fascial space priority approach can effectively protect the autonomic nerves. The procedure reduces short-term urination and sexual function, but it has little effect on long-term function.

Capping layer enabled controlled fragmentation of two-dimensional materials by cold drawing

Cold drawing, a well-established processing technique in the polymer industry, was recently revisited and discovered as an efficient material structuring method to create ordered patterns in composites consisting of both cold-drawable polymers and brittle target materials. Such a high-yield and low-cost manufacturing technique enables the large-scale fabrication of micro-ribbon structures for a wide range of functional materials, including two-dimensional (2D) layered materials. Compared to the abundant phenomenological results from experiments, however, the underlying mechanisms of this technique are not fully explored. Here, supported by experimental investigation, finite element calculations, and theoretical modeling, we systematically study the effect of a capping layer on the controlled fragmentation of 2D materials deposited on polymer substrates during the cold drawing. The capping layer is found to prevent the premature fracture of the 2D thin films during elastic deformation of the substrate, when a specific requirement proposed by the theoretical model is satisfied. Controlled fragmentation is enabled in the necking stage due to the protective effect of the capping layer, which also influences the size of the resulting fragments. Flexible and stretchable electrodes based on 2D material ribbons are fabricated to demonstrate the effectiveness of the proposed roadmap. This study gives an accurate understanding of interactions between 2D materials, polymer substrates, and capping layers during cold drawing, and offers guidance for potential applications such as flexible electronics.

[Interaction analysis of the influence of different factors and benzene exposure on workers' alanine aminotransferase]

Objective: To investigate the main factors that influence ALT abnormalities in workers exposed to benzene. Methods: In June 2022, data of 613 enterprises with benzene hazards and 585 enterprises with non-benzene hazards in Tianjin in 2021 were collected, and occupational health examination data of 13018 workers with benzene exposure and 13018 workers with non-benzene exposure were collected, and the region, enterprise type, industry classification and enterprise scale of the employer were analyzed. And occupational health examination data of workers with benzene exposure and non-benzene exposure. The effects of personal general situation, occupational history, enterprise information and benzene exposure on alanine aminotransferase were evaluated by additive interaction. Results: Compared with the group of non-benzene-exposed workers, the personal general conditions, occupational history, company information were higher in the benzene-exposed workers, and the differences were statistically significant (P<0.05). The quantitative analysis of additive interaction found that gender (RERI=2.632, 95%CI: 1.966-3.297; AP=0.383, 95%CI: 0.311-0.456; S=1.813, 95%CI: 1.530-2.149), age (RERI=1.142, 95%CI: 0.928-1.356; AP=0.462, 95% CI: 0.371-0.552; S=4.461, 95%CI: 1.800-11.053), length of service (RERI=-1.199, 95%CI: -1.653--0.745; AP=-0.456, 95%CI: -0.640--0.271; S=0.576, 95%CI: 0.479-0.693), region (RERI=0.421, 95% CI: 0.148-0.694; AP=0.161, 95%CI: 0.053-0.268; S=1.350, 95%CI: 1.057-1.726), industry classification (RERI=0.627, 95%CI: 0.345-0.910; AP=0.232, 95%CI: 0.132-0.332; S=1.584, 95%CI: 1.233-2.035) and benzene exposure had a statistically significant additive interaction with abnormal serum ALT. Conclusion: Emphasis should be placed on male workers under the age of 40 in the petrochemical industry, oil storage and transportation, and power production, so as to protect the health of workers more specifically and reduce the risk of disability due to disease.

Optimal biopsy site for the diagnosis of oral pemphigus vulgaris and mucous membrane pemphigoid: a systematic review and meta-analysis

The aim of this study was to critically evaluate the diagnostic yields of direct immunofluorescence (DIF) analysis on perilesional and normal-appearing mucosa biopsy samples, to determine the optimal biopsy site for patients presenting with oral pemphigus vulgaris (PV) or mucous membrane pemphigoid (MMP). Electronic databases and article bibliographies were searched in December 2022. The primary outcome was the rate of DIF positivity. Of 374 records identified after the elimination of duplicates, 21 studies with 1027 samples were ultimately included. Meta-analysis revealed a pooled DIF positivity rate of 99.6% (95% confidence interval (CI) 97.4-100.0%, I2 = 0%) for PV and 92.6% (95% CI 87.9-96.5%, I2 = 44%) for MMP for biopsies from perilesional sites, and of 95.4% (95% CI 88.6-99.5%, I2 = 0%) for PV and 94.1% (95% CI 86.5-99.2%, I2 = 42%) for MMP for biopsies from normal-appearing sites. For MMP, there was no significant difference in the rate of DIF positivity between the two biopsy sites (odds ratio 1.91, 95% CI 0.91-4.01, I2 = 0%). The results suggest that the perilesional mucosa remains the optimal biopsy site for DIF diagnosis of oral PV, while the normal-appearing mucosa biopsy is optimal for oral MMP.

Berry Curvature Dipole Induced Giant Mid-Infrared Second-Harmonic Generation in 2D Weyl Semiconductor

Due to its inversion-broken triple helix structure and the nature of Weyl semiconductor, 2D Tellurene (2D Te) is promising to possess a strong nonlinear optical response in the infrared region, which is rarely reported in 2D materials. Here, a giant nonlinear infrared response induced by large Berry curvature dipole (BCD) is demonstrated in the Weyl semiconductor 2D Te. Ultrahigh second-harmonic generation response is acquired from 2D Te with a large second-order nonlinear optical susceptibility (χ(2) ), which is up to 23.3 times higher than that of monolayer MoS2 in the range of 700-1500 nm. Notably, distinct from other 2D nonlinear semiconductors, χ(2) of 2D Te increases extraordinarily with increasing wavelength and reaches up to 5.58 nm V-1 at ≈2300 nm, which is the best infrared performance among the reported 2D nonlinear materials. Large χ(2) of 2D Te also enables the high-intensity sum-frequency generation with an ultralow continuous-wave (CW) pump power. Theoretical calculations reveal that the exceptional performance is attributed to the presence of large BCD located at the Weyl points of 2D Te. These results unravel a new linkage between Weyl semiconductor and strong optical nonlinear responses, rendering 2D Te a competitive candidate for highly efficient nonlinear 2D semiconductors in the infrared region.

[Construction of Tianjin occupational disease prevention and control ability assessment system based on Delphi method]

Objective: To establish a systematic, scientific, reasonable, feasible and reliable evaluation system for occupational disease prevention and control capability, in order to provide reference for occupational disease prevention and control work in Tianjin City. Methods: In August 2022, literature review was conducted to propose indicators for the evaluation system. Two rounds of anonymous consultation with occupational health experts were conducted using the Delphi method to form expert opinions. According to the boundary value method and expert opinions, eliminate, screen, and modify the evaluation system indicators to ultimately determine the system indicators. Use Cronbach's alpha to test the reliability of the system indicators and form a Tianjin occupational disease prevention and control capability evaluation system. Results: It showed that the effective response rates of the two rounds of consultation conducted by experts in this study were 92.3% and 100.0%, respectively. The expert authority coefficients were 0.84 and 0.82, respectively. The Kendall coordination coefficient was tested for differences, and the differences were statistically significant (P<0.05). The Tianjin occupational disease prevention and control capability evaluation system includes 7 primary indicators, 17 secondary indicators, and 54 tertiary indicators. The Cronbach's alpha of the primary, second, third level indicators and all indicators were 0.91, 0.98, 0.98, 0.98 (>0.7) . Conclusion: The preliminary evaluation system for occupational disease prevention and control capacity in Tianjin City has been established, providing a reference basis for the investigation of occupational disease prevention and control capacity in Tianjin City.

Prognostic Role and Time Varying Failure Hazard of Neoadjuvant Rectal (NAR) Scores in the Stellar Randomized Phase 3 Trial

PURPOSE/OBJECTIVE(S)

This study examined the prognostic role of the neoadjuvant rectal (NAR) score on disease-free survival (DFS) in the STELLAR phase III trial and assessed time-varying failure hazard.

MATERIALS/METHODS

The study included patients from the STELLAR trial who underwent total mesorecta excision and had calculable NAR scores. Chi-square tests were used to analyze the distribution of demographic information, treatment information, and NAR scores. Kaplan-Meier and Cox regression analyses assessed DFS, while smoothed hazard plots evaluated hazard variations.

RESULTS

Of 461 patients, 231 received total neoadjuvant therapy (TNT) and 229 received concurrent chemoradiotherapy (CRT). With a median follow-up of 37 months, 3-year DFS rates for low, intermediate, and high NAR scores were 86.2%, 72.671.8%, and 53.153.6%, respectively (P <0.001). In the TNT group, rates for the corresponding NAR score groups were 87.3%, 67.6%, and 52.4% while in the CRT group, rates were 84.7%, 76.0%, and 53.4% (both P <0.001). Multivariate analysis showed NAR scores as independent prognostic factors for DFS (intermediate vs. low, hazard ratio (HR) = 2.452.55, 95% confidence interval (CI): 1.347 - 4.4675, P <0.003; high vs. low, HR = 4.2668, 95% CI: 2.5133 - 8.727.79, P <0.001). The DFS hazardrisk rates for different NAR score groups initially increased and then decreased, peaking in the second year with rates of 5.04.6%, 11.62%, and 21.52% for low, intermediate, and high NAR scores, respectively. After the fourth year, the high NAR score still had a higher failure hazardrisk (12.5%), while the intermediate and low NAR score had a lower relapse hazardrisk (<3%).

CONCLUSION

The NAR score was a strong prognostic factor for DFS in the STELLAR trial, irrespective of TNT or CRT modalities. Hazard variations at different NAR score levels offer insights for personalized monitoring and warrant further investigation in clinical trials using NAR scores as endpoints. (NCT02533271).

An Analysis of the Gene Expression Associated with Lymph Node Metastasis in Colorectal Cancer

Objective

This study aimed to explore the genes regulating lymph node metastasis in colorectal cancer (CRC) and to clarify their relationship with tumor immune cell infiltration and patient prognoses.

Methods

The data sets of CRC patients were collected through the Cancer Gene Atlas database; the differentially expressed genes (DEGs) associated with CRC lymph node metastasis were screened; a protein-protein interaction (PPI) network was constructed; the top 20 hub genes were selected; the Gene Ontology functions and the Kyoto Encyclopedia of Genes and Genomes pathways were enriched and analyzed. The Least Absolute Shrinkage and Selection Operator (LASSO) regression method was employed to further screen the characteristic genes associated with CRC lymph node metastasis in 20 hub genes, exploring the correlation between the characteristic genes and immune cell infiltration, conducting a univariate COX analysis on the characteristic genes, obtaining survival-related genes, constructing a risk score formula, conducting a Kaplan-Meier analysis based on the risk score formula, and performing a multivariate COX regression analysis on the clinical factors and risk scores.

Results

A total of 62 DEGs associated with CRC lymph node metastasis were obtained. Among the 20 hub genes identified via PPI, only calcium-activated chloride channel regulator 1 (CLCA1) expression was down-regulated in lymph node metastasis, and the rest were up-regulated. A total of nine characteristic genes associated with CRC lymph node metastasis (KIF1A, TMEM59L, CLCA1, COL9A3, GDF5, TUBB2B, STMN2, FOXN1, and SCN5A) were screened using the LASSO regression method. The nine characteristic genes were significantly related to different kinds of immune cell infiltration, from which three survival-related genes (TMEM59L, CLCA1, and TUBB2B) were screened. A multi-factor COX regression showed that the risk scores obtained from TMEM59L, CLCA1, and TUBB2B were independent prognostic factors. Immunohistochemical validation was performed in tissue samples from patients with rectal and colon cancer.

Conclusion

TMEM59L, CLCA1, and TUBB2B were independent prognostic factors associated with lymphatic metastasis of CRC.

Mass Measurement of Upper fp-Shell N=Z-2 and N=Z-1 Nuclei and the Importance of Three-Nucleon Force along the N=Z Line

Using a novel method of isochronous mass spectrometry, the masses of ^{62}Ge, ^{64}As, ^{66}Se, and ^{70}Kr are measured for the first time, and the masses of ^{58}Zn, ^{61}Ga, ^{63}Ge, ^{65}As, ^{67}Se, ^{71}Kr, and ^{75}Sr are redetermined with improved accuracy. The new masses allow us to derive residual proton-neutron interactions (δV_{pn}) in the N=Z nuclei, which are found to decrease (increase) with increasing mass A for even-even (odd-odd) nuclei beyond Z=28. This bifurcation of δV_{pn} cannot be reproduced by the available mass models, nor is it consistent with expectations of a pseudo-SU(4) symmetry restoration in the fp shell. We performed ab initio calculations with a chiral three-nucleon force (3NF) included, which indicate the enhancement of the T=1 pn pairing over the T=0 pn pairing in this mass region, leading to the opposite evolving trends of δV_{pn} in even-even and odd-odd nuclei.

Prevalence and risk factors of erectile dysfunction in COVID-19 patients: a systematic review and meta-analysis

PURPOSE

Studies have found that erectile dysfunction (ED) may be a short-term or long-term complication in coronavirus disease 2019 (COVID-19) patients, but no relevant studies have completed a pooled analysis of this claim. The purpose of the review was to comprehensively search the relevant literature, summarize the prevalence of ED in COVID-19 patients, assess risk factors for its development, and explore the effect of the COVID-19 infection on erectile function.

METHODS

Medline, Embase, and the Cochrane Library was performed from database inception until April 14, 2022. Heterogeneity was analyzed by χ² tests and I² was used as a quantitative test of heterogeneity. Subgroup analyses, meta-regression, and sensitivity analyses were used to analyze sources of heterogeneity.

RESULTS

Our review included 8 studies, 4 of which functioned as a control group. There were 250,606 COVID-19 patients (mean age: 31-47.1 years, sample size: 23-246,990). The control group consisted of 10,844,200 individuals (mean age: 32.76-42.4 years, sample size 75-10,836,663). The prevalence of ED was 33% (95% CI 18-47%, I² = 99.48%) in COVID-19 patients. The prevalence of ED based on the international coding of diseases (ICD-10) was 9% (95% CI 2-19%), which was significantly lower than the prevalence of ED diagnosed based on the International Index of Erectile Function (IIEF-5) (46%, 95% CI 22-71%, I² = 96.72%). The pooling prevalence of ED was 50% (95% CI 34-67%, I² = 81.54%) for articles published in 2021, significantly higher than that for articles published in 2022 (17%, 95% CI 7-30%, I² = 99.55%). The relative risk of developing ED was 2.64 times in COVID-19 patients higher than in non-COVID-19 patients (RR: 2.64, 95% CI 1.01-6.88). The GRADE-pro score showed that the mean incidence of ED events in COVID-19 patients was 1,333/50,606 (2.6%) compared with 52,937/844,200 (0.4%) in controls; the absolute impact of COVID-19 on ED was 656/100,000 (ranging from 4/100,000 to 2352/100,000). Anxiety (OR: 1.13, 95% CI 1.03-1.26, I² = 0.0%) in COVID-19 patients was a risk factor for ED.

CONCLUSION

COVID-19 patients have a high risk and prevalence of ED, mainly driven by anxiety. Attention should be paid to patient's erectile functioning when treating COVID-19.

[Research progress of irradiation injuries anti-agents]

Irradiation injuries anti-agents refer to drugs that can inhibit the initial stage of radiation injuries, or reduce the development of radiation injuries and promote the recovery of injuries when used early after irradiation exposure. According to the mechanism of action and the time of intervention, the irradiation injuries anti-agents are divided into four categories: radioprotectors, radiomitigators, radiation therapeutics for external radiation exposure, and anti-agents for internalized radionuclides. In this paper, the research progress of irradiation injuries anti-agents in recent years is reviewed.

An electroactive metal-organic framework-based novel on-off ratiometric electrochemical platform for effective detection of lead ions

Metal-organic framework (MOF) materials exhibit unique advantages in adsorption, pre-enrichment and selective recognition of heavy metal ions due to their porous nature, tunable structure and ease of functionalization. However, due to the poor conductivity and electrochemical activity of most MOFs, their application in electrochemical sensing is limited. In this paper, an electroactive hybrid material rGO/UiO-bpy composed of UiO-bpy and electrochemically reduced graphene oxide (rGO) was prepared and has been successfully used in the electrochemical determination of lead ions (Pb²⁺). Interestingly, a reverse response relationship between the electrochemical signal of UiO-bpy and the concentration of Pb²⁺ was discovered in the experiment, which can be used to develop a novel on-off ratiometric sensing strategy for Pb²⁺ detection. To our knowledge, this is the first time that UiO-bpy has been used as both an improved electrode material for heavy metal ion detection and an internal reference probe for ratiometric analysis. This study is of great significance to expand the electrochemical application of UiO-bpy and develop innovative electrochemical ratiometric sensing strategies for Pb²⁺ determination.

UWB Frequency-Selective Surface Absorber Based on Graphene Featuring Wide-Angle Stability

In this paper, an ultra-wideband and polarization-insensitive frequency-selective surface absorber is presented with oblique incident stable behavior. Different from conventional absorbers, the absorption behavior is much less deteriorated with the increase in the incidence angle. Two hybrid resonators, which are realized by symmetrical graphene patterns, are employed to obtain the desired broadband and polarization-insensitive absorption performance. The optimal impedance-matching behavior is designed at the oblique incidence of electromagnetic waves, and an equivalent circuit model is used to analyze and facilitate the mechanism of the proposed absorber. The results indicate that the absorber can maintain a stable absorption performance with a fractional bandwidth (FWB) of 136.4% up to 40°. With these performances, the proposed UWB absorber could be more competitive in aerospace applications.

Unintrusive multi-cancer detection by circulating cell-free DNA methylation sequencing (THUNDER): development and independent validation studies

BACKGROUND

Early detection of cancer offers the opportunity to identify candidates when curative treatments are achievable. The THUNDER study (THe UNintrusive Detection of EaRly-stage cancers, NCT04820868) aimed to evaluate the performance of ELSA-seq, a previously described cfDNA methylation-based technology, in the early detection and localization of six types of cancers in the colorectum, esophagus, liver, lung, ovary and pancreas.

PATIENTS AND METHODS

A customized panel of 161,984 CpG sites was constructed and validated by public and in-house (cancer: n=249; non-cancer: n=288) methylome data, respectively. The cfDNA samples from 1,693 participants (cancer: n=735; non-cancer: n=958) were retrospectively collected to train and validate two multi-cancer detection blood test models (MCDBT-1/2) for different clinical scenarios. The models were validated on a prospective and independent cohort of age-matched 1,010 participants (cancer: n=505; non-cancer: n=505). Simulation using the cancer incidence in China was applied to infer stage-shift and survival benefits to demonstrate the potential utility of the models in the real world.

RESULTS

MCDBT-1 yielded a sensitivity of 69.1% (64.8%‒73.3%), a specificity of 98.9% (97.6%‒99.7%) and tissue origin accuracy of 83.2% (78.7%‒87.1%) in the independent validation set. For early stage (I‒III) patients, the sensitivity of MCDBT-1 was 59.8% (54.4%‒65.0%). In the real-world simulation, MCDBT-1 achieved the sensitivity of 70.6% in detecting the six cancers, thus decreasing late-stage incidence by 38.7%‒46.4%, and increasing 5-year survival rate by 33.1%‒40.4%, respectively. In parallel, MCDBT-2 was generated at a slightly low specificity of 95.1% (92.8%-96.9%) but a higher sensitivity of 75.1% (71.9%-79.8%) than MCDBT-1 for populations at relatively high risk of cancers, and also had ideal performance.

CONCLUSION

In this large-scale clinical validation study, MCDBT-1/2 models showed a high sensitivity, specificity, and accuracy of predicted origin in detecting six types of cancers.

[Gasless submental approach endoscopic removal of thyroglossal cyst]

Objective: To explore the safety and feasibility of gasless submental approach endoscopic removal of thyroglossal cyst. Methods: This work prospectively included the clinical data of 13 patients who underwent the gasless submental approach endoscopic removal of thyroglossal cyst at the Department of Otolaryngology, the First Affiliated Hospital of Chongqing Medical University from August 2021 to February 2022. The operative time, bleeding volumes, postoperative complications, subjective pain levels, satisfaction with incisional scars, neck and facial deformities, and recurrences were prospectively evaluated by visual analogue scale(VAS) score. Results: All of 13 patients were successfully treated using this new technique. The patients had a median age of 38 years, ranging from 24 to 59 years, comprising of 3 males and 10 females. The length of the submental incision was about 3 cm and the median of operation time was 135 minutes. Postoperative complications were minimal. The median volume of blood loss was 10 ml. Surgical site swelling existed in 1 case and dysphagia for more than 1 week occurred in 2 cases. Patients were discharged from the hospital with a median of 3 days after surgery. On a VAS of 0-10 scores, the pain had a median of 2 on the first day after surgery, and the satisfaction with incision scars and neck and facial deformities showed a median of 8 at 6 months after surgery. There were no recurrences during the follow-up period of 9-15 months. Conclusion: Gasless submental approach endoscopic removal of thyroglossal cyst may be a reliable new surgical method that is safe and has cosmetic advantages.

[Current status and research progress of occupational health monitoring in welding fume operations]

Welding operations are widely present in the manufacturing production process, involving a large number of occupational groups, and are the key occupations where work injuries and occupational diseases occur in China. For different welding processes and welding materials, the content and focus of occupational health monitoring are different. At present, the item of occupational health examination in welding operation is in poor consistency with the on-site exposure of occupational hazard factors, and it is mainly concentrated in the stage of disease development, which can not reflect the early health damage caused by welding dust exposure in time. The emergence of biomarkers of welding dust can make up for this defect. Therefore, it is of great significance to describe the current situation of occupational health monitoring of welding dust and summarize the research progress of related biomarkers for the early prevention of diseases caused by welding dust and the practice of occupational health monitoring.

[Analysis on disease burden and trend of occupational lung disease in Tianjin from 2010 to 2019 based on disability adjusted life years]

Objective: To analyze the level and trend of occupational pneumoconiosis disease burden in Tianjin from 2010 to 2019, and to provide scientific basis for making prevention and control countermeasures and suggestions. Methods: In June 2021, the data of occupational pneumoconiosis cases in Tianjin from 2010 to 2019 were selected from Follow-up survey of occupational pneumoconiosis patients in Tianjin and occupational "Health Hazardous Surveillance Information System", the subsystem of China Disease Control and Prevention Information System. Disability-adjusted life year (DALY) , years of life lost (YLL) and years lost due to disability (YLD) were used to comprehensively measure the disease burden of occupational pneumoconiosis by region, year, disease type, industry, sex and age; Kruskal-wallis H test was used for univariate analysis of DALY loss in pneumdo-niosis occupational. Results: A total of 43089 person-years of DALY due to pneumoconiosis in Tianjin from 2010 to 2019, of which the YLD accounted for about 2/3 (28277 person-years) , the YLL accounted for about 1/3 (14812 person-years) , and the average DALY was 7.34 person-years. The industrial distribution of pneumoconiosis burden in Tianjin was mainly concentrated in the manufacturing industry accounting for 90.6% of the whole industry. The disease types were mainly concentrated in silicosis, foundry pneumoconiosis, asbestosis and cement pneumoconiosis accounting for 34.4%, 16.9%, 13.3% and 10.5%, and the age distribution was mainly concentrated in the 50~<85 years old age group, accouling for 83.6%. The median DALY of occupational pneumoconiosis patients with different pneumoconiosis stages, disability grades and years of service exposed to dust were statistically significant (P<0.05) . Conclusion: The disease burden of occupational pneumoconiosis in Tianjin was still serious. It is necessary to take targeted intervention measures for key industries and population.

Stimulus-Responsive Metal-Organic Framework Signal-Reporting System for Photoelectrochemical and Fluorescent Dual-Mode Detection of ATP

Dual-mode bioanalysis integrating photoelectrochemical (PEC) and other modes is emerging and allows signal cross-checking for more reliable results. Metal-organic frameworks (MOFs) have been shown to be attractive materials in various biological applications. This work presents the utilization of MOF encapsulation and stimuli-responsive decapsulation for dual-mode PEC and fluorescence (FL) bioanalysis. Photoactive dye methylene violet (MV) was encapsulated in zeolitic imidazolate framework-90 (ZIF-90) to form an MV@ZIF-90 hybrid material, and MV could be released by adenosine triphosphate (ATP)-induced ZIF-90 disintegration. The released MV not only had FL emission but also had a sensitization effect on the ZnIn₂S₄ (ZnInS) photoanode. Based on the MV-dependent sensitization effect and FL emission characteristic, a dual-mode PEC-FL strategy was established for ATP detection with low detection limits, that is, 3.2 and 4.1 pM for PEC and FL detection, respectively. This study features and will inspire the construction and implementation of smart MOF materials for dual-mode bioanalysis.

[Analysis on individual dosage monitoring of some interventional radiology staffs in Tianjin City from 2016 to 2020]

Objective: To investigate the individual external dose level of some interventional radiology staffs from 2016 to 2020 in Tianjin City. Methods: All 2068 interventional radiology staffs who were included in the work of the Radiation Monitoring Project from 2016 to 2020 were selected as study subjects in March 2021. The individual dose monitoring results of interventional radiology staffs of different ages, working years, time and medical institutions were analyzed. Results: Among 2068 interventional radiology workers, 1406 (67.99%) were male and 662 (32.01%) were female. The age was 44.6 (39.2, 50.3) years, and the working years was 10.5 (4.3, 14.6) years. The annual effective doses per capita of 40-49 age group and ≥50 age group were higher than that of 30-39 age group (P<0.05) . The annual effective dose per capita of 5-9 working years was higher than that of <5 working years, and the annual effective dose per capita of 10-29 working years was higher than that of 5-9 working years (P<0.05) . The median per capita annual effective dose of the interventional radiology staffs was 0.164 mSv. There were 1976 interventional radiology staffs with an annual effective dose of <0.50 mSv/a (95.6%) . The collective dose distribution ration SR(0.5) was 41.1%. The difference of effective dose per capita in each year was statistically significant (H=19.23, P<0.05) . The per capita annual effective dose of interventional radiology staffs in tertiary medical institutions was higher than that in secondary medical institutions, and the difference was statistically significant (P<0.05) . Conclusion: The personal dose of interventional radiology staffs in Tianjin City is at a low level. It is necessary to emphasize the radiation hazard protection of interventional radiology staffs in tertiary medical institutions, 40-49 years old, ≥50 years old age groups and 5-9, 10-29 working years groups.

PIWI/piRNA-mediated regulation of signaling pathways in cell apoptosis

OBJECTIVE

This study aims to summarize the role of PIWIs/piRNAs in cell apoptosis through multiple signaling pathways. The PIWI-interacting RNAs (piRNAs) are among the small non-coding RNAs (sncRNAs) and are mainly expressed in germline cells. PIWI protein is the key to the biogenesis of piRNA. With the deepening of research in recent years, the PIWIs/piRNAs are expressed in a tissue-specific way in somatic cells outside the germline. In addition, researchers have found that the PIWIs/piRNAs play a regulatory role in cell apoptosis, proliferation, and necrosis by regulating key signaling pathways, such as PI3K/Akt signaling pathway, STAT signaling pathway, TGF-β signaling pathway, and Fas signaling pathway at the transcriptional or post-transcriptional level. However, the PIWIs/piRNAs' role in cell apoptosis and its underlying mechanisms are still not fully understood. This study reviews the regulatory functions of PIWIs/piRNAs in apoptosis from the perspective of the signal pathway.

MATERIALS AND METHODS

This study is a narrative review. PubMed and MEDLINE were used as the primary sources to search the following keywords: PIWI/piRNAs, signal pathway, pro-apoptotic, anti-apoptotic, and signaling pathway.

RESULTS

PIWIs/piRNAs modulated pro-apoptotic or anti-apoptotic effects in a variety of cells: PIWIs/piRNAs through PI3K/Akt signaling pathway, STAT signaling pathway, TGF-β signaling pathway, and Fas signaling pathway for pro-apoptotic or anti-apoptotic effects in cells.

CONCLUSIONS

Apoptosis is a basic biological phenomenon of cell death, and it also has a great significance and complex molecular biological mechanisms. PIWI/piRNAs are closely related to various types of diseases and play a pro-apoptotic or anti-apoptotic role through the following pathways: PI3K/Akt signaling, STAT signaling, TGF-β signaling, and Fas signaling pathways.

Quantitative Collateral Assessment on CTP in the Prediction of Stroke Etiology

BACKGROUND AND PURPOSE

Patients with stroke etiology of large-artery atherosclerosis were thought to have better collateral circulation compared with patients with other stroke etiologies. We aimed to investigate the association between stroke etiology and collateral circulation with a new quantitative collateral assessment method.

MATERIALS AND METHODS

This retrospective study reviewed data from consecutive patients with proximal anterior artery occlusion who underwent CTP before reperfusion therapy. CBF maps were derived from CTP. A new indicator, maximum CBF of collateral vessels within the Sylvian fissure (cCBF_max), was applied to quantitatively assess the collateral status. The relationship between collateral status and stroke etiology was investigated.

RESULTS

A total of 296 patients were finally analyzed. The median cCBF_max was significantly higher in patients with large-artery atherosclerosis than in those without it (92 [interquartile range, 65-123] mL/100 g/min versus 62 [interquartile range, 46-82] mL/100 g/min; P < .001). Multivariable analysis revealed that a higher cCBF_max score was independently associated with large-artery atherosclerosis etiology (OR, 1.010; 95% CI, 1.002-1.018; P = .017) after adjustment. The area under the curve, sensitivity, and specificity of the final model in predicting the etiology of large-artery atherosclerosis were 0.870, 89.7%, and 75.2%, respectively.

CONCLUSIONS

Patients with large-artery atherosclerosis had a more adequate collateral perfusion supply with the new quantitative collateral assessment. The new quantitative collateral measurement might contribute to the prediction of stroke etiology in the acute clinical scenario for patients with acute ischemic stroke.

[Value of dual-layer spectral detector CT in preoperative prediction of lymph node metastasis of gastric cancer]

Objective: To investigate the value of dual-layer spectral detector CT(SDCT) in preoperative prediction of lymph node (LN) metastasis of gastric cancer. Methods: From January 2019 to January 2021, the clinical and imaging data of 130 gastric cancer patients(93 males and 37 females, aged from 37 to 84 years)confirmed by pathology in the Zhongshan hospital of Xiamen University were retrospectively collected. According to the status of lymph node metastasis, those patients were divided into metastatic LNs group (n=104) and nonmetastatic LNs group (n=26). The maximum diameter of gastric cancer on spectral CT images, CT Values of lesions in 40, 50, 60, 70. KeV monoenergetic image of arterial and Venous phase (CT_{40 keV}, CT_{50 keV}, CT_{60 keV}, CT_{70 keV}), iodine concentration (IC) and effective atomic number (Z_eff) were measured, then the normalized IC(NIC) and spectral curve(K_(40-70)) value were calculated. The differences of each parameter derived from spectral CT between the two groups were compared, and a logistic regression model was constructed. The ROC curves and area under the curve (AUC) were conducted to evaluate the diagnostic performance of each parameter and Delong test was used to compare the difference of each AUC. Results: Compared to nonmetastatic LNs group, metastatic LNs group had higher maximum diameter of tumor, CT_{40 keV}, CT_{50 keV}, CT_{60 keV}, CT_{70 keV}, IC, NIC, Zeff, and K_(40-70) values on venous phase (the representative parameter is Z_eff: 8.4 (8.2, 8.5) vs 8.2 (8.1, 8.3)) (all P<0.05). The proportion of patients with lower histology differentiated degree, higher T grade and positive carcino embryonic antigen (CEA)were higher than that in nonmetastatic LNs (the representative parameter was CEA: 34.6%(36/104) vs 7.7%(2/26) (all P<0.05). The regression model constructed by CEA and Zeff had the highest predictive value in predicting metastatic LNs, with an AUC of 0.835(0.759-0.894), sensitivity and specificity of 83.65% and 73.08%, respectively. Conclusion: SDCT quantitative parameters on venous phase and CEA facilitate the accurate prediction of metastatic LNs in patients with gastric cancer, and the multi-parameter regression model has the highest diagnostic performance.

[Determination of phenyl glycidyl ether in workplace air by solvent desorption gas chromatography]

Objective: To establish a solvent desorption gas chromatographymethod for the determination of phenyl glycidyl ether (PGE) . Methods: From October to December 2020, PGE in the air of workplace was collected with carbon tube and desorbed by 25% acetone-carbon disulfide. The target toxicant was separated with the gas chromatography (GC) column and analyzed with flame ionization detector (FID), and quantified by peak area. Results: The linear range of PGE in the air of workplace was 10.0-1109.0 μg/ml, the linear equation was y=1.156x-4.328, with a correlation coefficient of 0.9997. The limit of detection was 3.0 μg/ml. The lower limit of quantification was 10.0 μg/ml. The intar-batch and inter-batch precisionswere 4.9%-6.4% and 6.2%-6.9%, respectively. The recovery rate was ranged from 97.2%-98.8%, the average collection efficiency was 100%, and the average extraction efficiency was 90.1%. The samples could be stored at 4 ℃ for 7 d. Conclusion: This method has high precision and good accuracy, and it is applicable for the determination of PGE in workplace air.

[Health hazards and hearing loss risk assessment of workers exposed to noise in an automobile manufacturing enterprise]

Objective: To investigate the current situation of occupational exposure to noise among noise workers in an automobile manufacturing enterprise in Tianjin, understand the impact of noise on workers＇ nervous system and hearing, and assess the risk of hearing loss among noise workers. Methods: In May 2021, 3516 workers in an automobile manufacturing enterprise were investigated by using a self-made questionnaire＂Noise Workers Questionnaire＂ and cluster sampling method. The occupational noise hygiene survey and occupational hazards detection were carried out in their workplaces. They were divided into noise exposure group and non-noise exposure group according to whether they were exposed to noise or not. The general characteristics, hearing and nervous system symptoms of the two groups of workers were compared, and the risk of hearing loss was assessed. Results: There were 758 workers in the noise exposure group, aged (26±5) years old, with a working age of 3.0 (2.0, 6.0) years exposed to noise. 2758 workers in the non-noise exposure group, aged (25±6) years old, with a working age of 2.0 (1.0, 4.0) years. There were statistically significant differences in the distribution of workers＇education level, working age and memory loss between the two groups (χ(2)=37.98, 38.70, 5.20, P<0.05). The workers in the noise exposure group showed a decreasing trend of insomnia, dreaminess, sweating and fatigue with the increase of working age (χ(2trend)=6.16, 7.99, P<0.05). The risk classification of binaural high-frequency hearing loss for workers in all noise positions until the age of 50 and 60 was negligible, the risk of occupational noise deafness was low for workers in stamping and welding noise positions until the age of 60. Conclusion: The occupational noise exposed to automobile manufacturing workers may cause certain harm to their nervous and auditory systems. Noise protection measures should be taken to reduce the risk of hearing loss and occupational noise deafness.

[Noise exposure and its impact on health in an auto parts manufacturing enterprise]

Objective: To learn about the noise exposure and health status of workers and analyze factors that may affect the health outcomes of workers in an auto manufacturing enterprise in Tianjin City. Methods: In September 2020, occupational hygiene survey, noise exposure level detection and occupational health examination data collection were carried out in an auto parts manufacturing enterprise. Chi square test and unconditional logistic regression analysis were used to analyze the health effects of noise exposure and hearing loss of 361 noise exposure workers. Results: The rates of over-standard noise exposure, hearing loss and hypertension were 69.39% (34/49) , 33.24% (120/361) and 11.36% (41/361) , respectively. There were upward trends on age and noise-working years for hearing loss and hypertension rates (χ(2)=-5.95, -6.16, -2.81, -2.74, P<0.05) . Unconditional logistic regression analysis showed that age>35 years old, noise exposure length of service >10 years and noise L(EX, 8 h)>85 dB (A) were risk factors for hearing loss (OR=3.57, 95%CI: 1.09, 11.75; OR=4.05, 95%CI: 1.97, 8.25; OR=1.75, 95%CI: 1.00, 3.05; P=0.036, 0.001, 0.047) . Conclusion: This company has a high rate of job noise exceeding the standard, and noise-exposed workers have more serious hearing loss. Age, noise exposure and high noise exposure are risk factors for hearing loss.

[Effect of miR-204 targeted regulation of DVL3 gene in silica-induced mouse lung epithelial cells]

Objective: To construct a recombinant lentiviral vector for mouse miR-204 overexpression, and to verify the targeted regulation of miR-204 and DVL3 in silica (SiO(2)) -induced mouse lung epithelial cells (MLE-12 cells) . Methods: In October 2019, the pre-miR-204 gene was amplified from the mouse genome by the polymerase chain reaction (PCR) method. After sequencing, the amplified product was cloned into the pLenti-CMV-EGFP lentiviral vector. The positive clones were identified by PCR screening and sequencing. The miR-204 overexpressed lentiviral vector was transfected into 293T cells, and lentiviral packaging and titer determination were performed. The experiment was divided into SiO(2) control group, virus control group, and miR-204 virus group, and the expressions of miR-204 and DVL3 gene were detected by real-time PCR. Results: The miR-204 lentiviral expression vector Lv-miR-204-5p was constructed and identified correctly by PCR and sequencing, and a virus dilution with a titer of 9.57×10(8) IU/ml was obtained. The results of real-time PCR showed that the expression of miR-204 in MLE-12 cells of the miR-204 virus group was higher than that of SiO(2) control group and virus control group, and the expression of DVL3 gene was lower than that of SiO(2) control group and virus control group, the differences were statistically significant (P<0.05) . Conclusion: Overexpression of miR-204 by lentiviral vector may inhibit the expression of DVL3 gene in silica-induced mouse lung epithelial cells.

Fascial space priority approach for laparoscopic total pelvic exenteration in patients with locally advanced rectal cancer

BACKGROUND

Total pelvic exenteration (TPE) with intent to achieve a pathological R0 resection is now considered as the only chance of a long-term survival for locally advanced rectal cancer (LARC) invading into adjacent organs. Lately, laparoscopic total pelvic exenteration (LTPE) is performed and achieved in several specialized centers and showed a promising application prospect. Although this is universally realized by surgeons, there are only few specialized centers to perform this complex surgery, due to concerns about the high morbidity and mortality. The techniques associated need to be disclosed and facilitated.

OBJECTIVE

The aim of this article is to introduce a fascial space priority approach for laparoscopic TPE step by step (with video).

METHODS

We describe here a fascial space priority approach for LTPE in highly selected patients with locally advanced rectal cancer. The main principle of this approach is that all of the pelvic organs are considered as a whole, the non-vascular spaces surrounding it are separated in the first place, the vascular pedicle and nerve pedicle of pelvic organs can be isolated and then transected precisely. Meanwhile, the associated key landmarks of this approach are disclosed (see the video).

RESULTS

The ureterohypogastric nerve fascia (UHGNF) and the vesicohypogastric fascia (VHGF) are two vital embryological planes on the lateral compartment of pelvis. The spaces on either side of them together with the retrorectal space, the space of Retzius, are all non-vascular spaces, and dissection of these spaces in LTPE surgery can be achieved simply and practicably. The ureter, the umbilical artery, the arcus tendinous fasciae pelvis (ATFP), piriformis and the puboprostatic ligament (PPL) are all important landmarks during surgery. Step-by-step illustration with precise anatomical landmarks in the present video may lead to less intraoperative blood loss and complications.

CONCLUSIONS

LTPE with fascial space priority approach might be a standard surgical procedure for total pelvic exenteration with clear anatomy and reduced blood loss.

Lipid accumulation product is a reliable indicator for identifying metabolic syndrome: the China Multi-Ethnic Cohort (CMEC) Study

BACKGROUND

Previous studies have shown that lipid accumulation product (LAP) was associated with the risk of cardiometabolic disease. It is not clear whether LAP could be used as a marker to identify metabolic syndrome (MetS) among Chinese ethnic groups.

AIM

To assess the reliability of LAP as a maker to identify MetS among Dong adults.

DESIGN

Population-based cross-sectional study.

METHOD

We included 6494 Dong individuals (1403 patients) aged 30-79 years from southwest China. MetS was established by Chinese Diabetes Society. Logistic regression model was utilized to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Receiver operating characteristic (ROC) curve was utilized to calculate area under the ROC curve (AUC) and 95% CIs to obtain the identification ability for MetS.

RESULTS

The risk of MetS was increased with per 5 units increase of LAP (OR 1.37 [95% CI, 1.34-1.39]). Similar results were found in subgroup analyses and sensitivity analyses. Clustered metabolic risk associated with per 5 units increase of LAP was observed for people with 1 (OR 1.59 [95% CI, 1.53-1.65]), 2 (2.15 [2.06-2.24]), 3 (2.59 [2.48-2.71]), 4 (2.81 [2.69-2.95]) and 5 (3.03 [2.87-3.21]) MetS components. LAP presented higher AUC (0.915 [95% CI, 0.907-0.923]) than other included obesity indices (P < 0.05).

CONCLUSION

These data support evidence that LAP was related to the risk of MetS, had a high AUC and could be a reliable index for identifying MetS patients among Dong adults in Chinese.

Diagnostic Value of Sylvian Fissure Hyperechogenicity in Fetal SAH

BACKGROUND AND PURPOSE

Fetal SAH is an intracranial malformation. The typical diagnostic features of fetal SAH in ultrasound have not been reported. This study aimed to evaluate the diagnostic value of Sylvian fissure hyperechogenicity by prenatal ultrasound in fetuses with SAH.

MATERIALS AND METHODS

The features on ultrasound and MR imaging of 10 fetuses with SAH were reviewed and summarized. The diagnostic value of the Sylvian fissure in fetal SAH by prenatal ultrasound was evaluated.

RESULTS

The typical and most obvious manifestations of SAH during the prenatal period were hyperechogenicity in the subarachnoid cavity, especially in the Sylvian fissure; all 10 cases (10/10) had such manifestations. Other manifestations included a hyperecho in other sulci (6/10), especially in the subfrontal sulcus, superior temporal sulcus, or parieto-occipital sulcus; a hyperecho in the cisterns (8/10), especially in the suprasellar cistern, posterior cranial fossa, cisterna ambiens, or quadrigeminal cistern; and a hyperecho around the anterior and posterior longitudinal fissures (2/10). Combined hemorrhage in the parenchymal layer or ventricles (9/10) was found. In addition, Doppler ultrasound showed that the peak flow velocity in the MCA increased in 6 cases (6/10).

CONCLUSIONS

The homogeneous hyperechogenicity of the Sylvian fissure is an important clue for detecting and diagnosing fetal SAH by prenatal ultrasound. A diagnostic approach has been proposed for fetal SAH, which has great significance in further prognosis.

Solid-Ionic Memory in a van der Waals Heterostructure

Defect states dominate the performance of low-dimensional nanoelectronics, which deteriorate the serviceability of devices in most cases. But in recent years, some intriguing functionalities are discovered by defect engineering. In this work, we demonstrate a bifunctional memory device of a MoS₂/BiFeO₃/SrTiO₃ van der Waals heterostructure, which can be programmed and erased by solely one kind of external stimuli (light or electrical-gate pulse) via engineering of oxygen-vacancy-based solid-ionic gating. The device shows multibit electrical memory capability (>22 bits) with a large linearly tunable dynamic range of 7.1 × 10⁶ (137 dB). Furthermore, the device can be programmed by green- and red-light illuminations and then erased by UV light pulses. Besides, the photoresponse under red-light illumination reaches a high photoresponsivity (6.7 × 10⁴ A/W) and photodetectivity (2.12 × 10¹³ Jones). These results highlighted solid-ionic memory for building up multifunctional electronic and optoelectronic devices.

[Induction of peripheral blood mononuclear cells to hepatocyte-like cells and preliminary study of cell response to injury under the effect of acetaminophen]

Objective: To establish a method for the induction of peripheral blood mononuclear cells to hepatocyte-like cells, and preliminarily investigate cell response to injury under the effect of acetaminophen (APAP). Methods: The surface marker CD45 of peripheral blood mononuclear cells wase detected cells by using flow cytometry and immunofluorescence methods. The cellular morphology of induced hepatocyte-like cells was observed under an inverted microscope. Real-time fluorescent quantitative PCR (RT-PCR) was used to detect the expression level of hepatocyte-specific genes, such as cytochrome (CY) P1A2, CYP3A4, CYP2C9, albumin (ALB), alpha-fetoprotein (AFP), and hepatocyte nuclear factor (HNF)4α mRNA. Immunofluorescence method was used to detect intracellular hepatocyte markers AFP, HNF4α, and ALB expression at the protein level. Biochemical analyzer was used to detect hepatocyte-specific secretory functions of AFP, ALB, and urea. Luciferase chemiluminescence method was used to detect the activity of key drug metabolizing enzyme CYP3A4. Colorimetric assay was used to detect the effect of the drug acetaminophen on hepatocyte-like cells, and alanine aminotransferase (ALT) was used as an indicator of liver cell injury. The statistical differences between the data were compared with t-test and rank-sum test. Results: The positive expression rate of CD45 cell surface markers isolated from peripheral blood mononuclear cells was about 98%, and hepatocyte-like cell morphology changes appeared on 15th day of induction. Compared with isolated mononuclear cells, CYP1A2, CYP3A4, CYP2C9, ALB, AFP and HNF4α mRNA was markedly elevated. The expression level of AFP, ALB and HNF4α protein were equally increased, and the secretory function of AFP, ALB and urea were enhanced. Compared with primary hepatocytes, CYP1A2, CYP2C9, AFP, HNF4α mRNA, and CYP3A4 mRNA did not decrease. The expression levels of AFP, ALB, and HNF4α proteins in the cells did not decrease, and the secretory function of AFP, ALB, and urea did not decrease. In addition, the CYP3A4 enzyme activity produced by hepatocyte-like cells was similar to that of primary hepatocytes. Compared with hepatocyte-like cells incubated without APAP, hepatocyte-like cells incubated with APAP had higher ALT level. Under the effect of APAP, the ALT level of hepatocyte-like cells was higher than isolated mononuclear cells. Conclusion: Peripheral blood mononuclear cells can be induced into hepatocyte-like cells with partial characteristics of hepatocytes, including the activity of CYP3A4, a key enzyme of hepatocyte drug metabolism. Additionally, preliminarily ALT secretory features reflect the hepatocytes injury under the effect of acetaminophen.

Laparoscopic Pelvic Exenteration with Bladder Sparing for Men with Locally Advanced Rectal Cancer (with Video)

OBJECTIVE

The aim of this article was to introduce a fascial space priority approach for laparoscopic pelvic exenteration (PE) with bladder-sparing for men with locally advanced rectal cancer.

METHODS

We present a video of bladder-sparing laparoscopic PE with fascial space priority approach in a 70-year old man. The systematic de-arterialization of the prostate on the basis of complete separation of the avascular lateral pelvic spaces is introduced in detail.

RESULTS

The operation time was 360 min and the estimated intraoperative blood loss was 50 mL. The postoperative course was uneventful and the patient was discharged on postoperative day 14. Histopathological examination showed all margins to be tumor-free.

CONCLUSIONS

Bladder-sparing laparoscopic PE using a fascial space priority approach is a feasible and safe procedure that can be performed in well-selected patients following neoadjuvant chemoradiotherapy. Extensive multivisceral resection is possible without a permanent stoma.

[Research progress on the human health risks assessment of radionuclides in water environment]

The quality of the water environment is one of the most important factors that can directly affect the health of human beings and other non-human species. The levels of the radionuclides in water environment are the key indicator while assessing the quality of water environment. Recently, with the development of the nuclear energy in China, the public people have paid a focus attention on the levels and the health risks of the radionuclides. This paper introduced the sources, the health effects, the health risk assessment methods and the current status of the health risk assessment study about the radionuclides, in order to provide basis for the health risk assessment of radionuclides in water environment and the protection of human health.

Controlled Synthesis of MoxW1-xTe2 Atomic Layers with Emergent Quantum States

Recently, new states of matter like superconducting or topological quantum states were found in transition metal dichalcogenides (TMDs) and manifested themselves in a series of exotic physical behaviors. Such phenomena have been demonstrated to exist in a series of transition metal tellurides including MoTe₂, WTe₂, and alloyed Mo_xW_1-xTe_2. However, the behaviors in the alloy system have been rarely addressed due to their difficulty in obtaining atomic layers with controlled composition, albeit the alloy offers a great platform to tune the quantum states. Here, we report a facile CVD method to synthesize the Mo_xW_1-xTe₂ with controllable thickness and chemical composition ratios. The atomic structure of a monolayer Mo_xW_1-xTe₂ alloy was experimentally confirmed by scanning transmission electron microscopy. Importantly, two different transport behaviors including superconducting and Weyl semimetal states were observed in Mo-rich Mo_0.8W_0.2Te₂ and W-rich Mo_0.2W_0.8Te₂ samples, respectively. Our results show that the electrical properties of Mo_xW_1-xTe₂ can be tuned by controlling the chemical composition, demonstrating our controllable CVD growth method is an efficient strategy to manipulate the physical properties of TMDCs. Meanwhile, it provides a perspective on further comprehension and sheds light on the design of devices with topological multicomponent TMDC materials.

Sonographic findings of immunoglobulin G4-related sialadenitis and differences from Sjögren's syndrome

OBJECTIVE

To evaluate ultrasonic features of the major salivary glands in patients with immunoglobulin G₄-related sialadenitis (IgG₄-RS) and to explore the differences between IgG₄-RS and Sjögren's syndrome (SS).

METHOD

We conducted the study in 150 patients with IgG₄-RS and 100 patients with SS. Ultrasonographic variables of the static images of major salivary glands were analysed. An experienced radiologist scored the confidence rating regarding the presence of the characteristic imaging findings using a five-grade rating system. Ultrasonography scores between IgG₄-RS and SS were compared.

RESULTS

The major salivary glands were significantly larger in patients with IgG₄-RS than in the SS group. The main features of ultrasonography of the salivary glands in IgG₄-RS were various hypoechoic lesions and increased colour Doppler signalling. In contrast, the major salivary glands in SS exhibited hyperechoic lines and/or spots and obscuration of the gland configuration. The scores of the summarized sonographic characteristics also showed statistically significant differences between the IgG₄-RS and SS groups.

CONCLUSION

This study revealed different ultrasonic features of the major salivary glands in patients with IgG₄-RS and SS. The scored sonographic features were helpful in differentiating IgG₄-RS from SS. Consequently, we suggest that ultrasonography of major salivary glands could be a useful imaging procedure in the evaluation of patients suspected of having IgG₄-RS.