[Clinical characteristics and surgical management outcomes of glaucoma secondary to congenital ectropion uveae: a preliminary analysis of penetrating Schlemm's canaloplasty]

Objective: To investigate the clinical characteristics and treatment outcomes of glaucoma secondary to congenital ectropion uveae (CEU) using penetrating Schlemm's canaloplasty. Methods: This was a retrospective case series study. Medical records of patients diagnosed with glaucoma secondary to CEU and undergoing penetrating Schlemm's canaloplasty at the Eye Hospital of Wenzhou Medical University between August 2020 and December 2021 were collected. Clinical characteristics including the extent and location of iris ectropion, type of glaucoma, were analyzed. Follow-up visits were conducted at 1, 3, 6 months, and 1 year postoperatively. Visual acuity, intraocular pressure (IOP), anterior segment and fundus condition, filtering bleb morphology, use of IOP-lowering medications, ultrasound biomicroscopy results, and other indicators were analyzed to summarize surgical outcomes. Results: Six cases (6 eyes) of glaucoma secondary to CEU were included, all unilateral, with 3 left eyes and 3 right eyes; median age was 10.0 (5.3, 28.8) years; including 3 males and 3 females. Preoperative IOP was (31.7±10.0) mmHg (1 mmHg=0.133 kPa), and the preoperative number of IOP-lowering medications used was 2.0 (2.0, 3.2). The extent of iris ectropion in the 6 cases ranged from 270 ° to 360 °, with peripheral anterior synechiae corresponding to the location of iris ectropion, and angle closure with the degree of synechiae extending beyond Schwalbe's line. No surgical complications occurred in any of the 6 cases postoperatively. At 1 month postoperatively, the IOP was (16.4±3.2) mmHg, with a median of 0.0 (0.0, 1.5) medications used. At 3 months postoperatively, the IOP was (14.8±6.0) mmHg, with a median of 0.0 (0.0, 2.2) medications used. At 6 months postoperatively, the IOP was (18.1±6.1) mmHg, with a median of 0.0 (0.0, 0.5) medications used. Among them, 5 patients had a follow-up period of 1 year postoperatively, all achieving controlled IOP without the use of IOP-lowering medications, with an average IOP of (15.5±3.1) mmHg. No obvious filtering bleb formation was observed at the surgical site in all patients. Conclusions: Glaucoma secondary to CEU manifests primarily as closed-angle glaucoma, with a correspondence between the closure range of anterior iris adhesions in the angle and the extent of iris ectropion. Penetrating Schlemm's canaloplasty demonstrates favorable and stable efficacy for its treatment.

Initiating PeriCBD to probe perinatal influences on neurodevelopment during 3-10 years in China

Adverse perinatal factors can interfere with the normal development of the brain, potentially resulting in long-term effects on the comprehensive development of children. Presently, the understanding of cognitive and neurodevelopmental processes under conditions of adverse perinatal factors is substantially limited. There is a critical need for an open resource that integrates various perinatal factors with the development of the brain and mental health to facilitate a deeper understanding of these developmental trajectories. In this Data Descriptor, we introduce a multicenter database containing information on perinatal factors that can potentially influence children's brain-mind development, namely, periCBD, that combines neuroimaging and behavioural phenotypes with perinatal factors at county/region/central district hospitals. PeriCBD was designed to establish a platform for the investigation of individual differences in brain-mind development associated with perinatal factors among children aged 3-10 years. Ultimately, our goal is to help understand how different adverse perinatal factors specifically impact cognitive development and neurodevelopment. Herein, we provide a systematic overview of the data acquisition/cleaning/quality control/sharing, processes of periCBD.

Potential mechanism of biochar enhanced degradation of oxytetracycline by Pseudomonas aeruginosa OTC-T

Extensive use of oxytetracycline (OTC) and the generation of its corresponding resistance genes have resulted in serious environmental problems. Physical-biological combined remediation is an attractive method for OTC degradation because of its high remediation efficiency, stability, and environmental friendliness. In this study, an effective OTC-degrading strain identified as Pseudomonas aeruginosa OTC-T, was isolated from chicken manure. In the degradation experiment, the degradation rates of OTC in the degradation systems with and without the biochar addition were 92.71-100 % and 69.11-99.59 %, respectively. Biochar improved the tolerance of the strain to extreme environments, and the OTC degradation rate increased by 20.25 %, 18.61 %, and 13.13 % under extreme pH, temperature, and substrate concentration conditions, respectively. Additionally, the degradation kinetics showed that biochar increased the reaction rate constant in the degradation system and shortened the degradation period. In the biological toxicity assessment, biochar increased the proportion of live cells by 17.63 % and decreased the proportion of apoptotic cells by 58.87 %. Metabolomics revealed that biochar had a significant effect on the metabolism of the strains and promoted cell growth and reproduction, effectively reducing oxidative stress induced by OTC. This study elucidates how biochar affects OTC biodegradation and provides insights into the future application of biochar-assisted microbial technology in environmental remediation.

SiATG5-loaded cancer cell membrane-fused liposomes induced increased uptake of albumin-bound chemotherapeutics by pancreatic cancer cells

Chemotherapeutic efficacy for pancreatic cancer is severely compromised by limited drug availability to tumor cells. Herein, we constructed a cancer cell membrane-fused liposome containing a siATG5-loaded calcium phosphate (CaP) core, termed CLip@siATG5. Through cancer cell membrane camouflage, the liposomes evaded immune clearance, actively infiltrated tumor tissues, and were preferentially taken up by homotypic tumor cells. Then, siATG5 escaped from the endosomes and was liberated in the cytoplasm, mainly benefiting from CaP dissolution-induced endosome rupture and liposome disassembly in acidic endosomes. The released siATG5 silenced autophagy protein 5 (ATG5) to inhibit autophagy, starving tumor cells. An alternative nutrient procurement pathway, macropinocytosis, was then upregulated in the cells, leading to increased uptake of the albumin-bound chemotherapeutic agent (nanoparticle albumin-bound paclitaxel (Nab-PTX)). Finally, in a murine pancreatic cancer model, CLip@siATG5 combined with Nab-PTX exerted superior efficacy to a twofold dose of Nab-PTX while avoiding its toxicity. Overall, we justified enhancing chemotherapeutic delivery by modulating the pancreatic cancer cell metabolism, which will enlighten the development of more effective chemotherapeutic adjuvants for pancreatic cancer in the future.

Dipole-multipole plasmonic coupling between gold nanorods and titanium nitride nanoparticles for enhanced photothermal conversion

The plasmonic photothermal conversion efficiency can be enhanced by coupling among plasmonic atoms or plasmonic molecules due to the amplified local electric field and extinction cross-section. Recently, it has been theoretically proved that hybridization between dipolar modes and higher order modes can provide higher enhancement than that among dipolar modes in terms of both near- and far-field, which may lead to a higher photothermal conversion rate. In this work, we systematically investigated the photothermal conversion enhancement of plasmonic coupling between a dipolar mode of a titanium nitride nanoparticle (TiN NP) and a higher order mode of a gold nanorod (Au NR), which was compared to that of coupling among TiN NPs' dipolar modes. We evaluated the photothermal conversion efficiency of dipole-dipole coupling and dipole-multipole coupling in the nanocluster under the illumination of a monochromatic laser of 808 nm wavelength and simulated solar light, respectively. Both experimental tests and numerical simulations suggested that the plasmonic dipole-multipole coupling exhibited higher enhancement in photothermal conversion than dipole-dipole plasmonic coupling.

Neoadjuvant stereotactic ablative body radiotherapy combined with surgical treatment for renal cell carcinoma and inferior vena cava tumor thrombus: a prospective pilot study

BACKGROUND

Surgical treatment for renal cell carcinoma (RCC) and inferior vena cava (IVC) tumor thrombus (TT) is difficult, and the postoperative complication rate is high. This study aimed to explore the safety and oncologic outcomes of neoadjuvant stereotactic ablative body radiotherapy (SABR) combined with surgical treatment for RCC and IVC-TT.

METHODS

Patients with RCC and IVC-TTs were enrolled in this study. All patients received neoadjuvant SABR focused on the IVC at a dose of 30 Gy in 5 fractions, followed by 2 ~ 4 weeks of rest. Then, radical nephrectomy and IVC tumor thrombectomy were performed for each patient. Adverse effects, perioperative outcomes, and long-term prognoses were recorded.

RESULTS

From June 2018 to January 2019, 8 patients were enrolled-4 with Mayo grade II TT and 4 with Mayo grade III TT. Four (50%) patients had complicated IVC wall invasion according to CT/MRI. All patients received neoadjuvant SABR as planned. Short-term local control was observed in all 8 patients. Only Grade 1-2 adverse events were reported. In total, 3 (37.5%) laparoscopic surgeries and 5 (62.5%) open surgeries were performed. The median operation time was 359 (IQR: 279-446) min, with a median intraoperative bleeding volume of 750 (IQR: 275-2175) ml. The median postoperative hospital stay was 7 (5-10) days. With a 26-month (range: 5-41) follow-up period, the estimated mean overall survival was 30.67 ± 5.38 months.

CONCLUSIONS

This is the first preoperative radiotherapy study in Asia that focused on patients with TT. This study revealed the considerable safety of neoadjuvant SABR for RCC with IVC-TT.

TRIAL REGISTRATION

This study was registered in the Chinese Clinical Trials Registry on 2018-03-08 (ChiCTR1800015118). For more information, please see the direct link ( https://www.chictr.org.cn/showproj.html?proj=25747 ).

The Application of CT Radiomics in the Diagnosis of Vein Wall Invasion in Patients With Renal Cell Carcinoma Combined With Tumor Thrombus

OBJECTIVE

The objective of this study was to explore the application of radiomics combined with machine learning to establish different models to assist in the diagnosis of venous wall invasion in patients with renal cell carcinoma and venous tumor thrombus and to evaluate the diagnostic efficacy.

MATERIALS AND METHODS

We retrospectively reviewed the data of 169 patients in Peking University Third Hospital from March 2015 to January 21, who was diagnosed as renal mass with venous invasion. According to the intraoperative findings, 111 patients were classified to the venous wall invasion group and 58 cases in the non-invasion group. ITK-snap was used for tumor segmentation and PyRadiomics 3.0.1 package was used for feature extraction. A total of 1598 features could be extracted from each CT image. The patients were divided into training set and testing set by time. The elastic-net regression with 4-fold cross-validation was used as a dimension-reduction method. After feature selection, a support vector machines (SVM) model, a logistic regression (LR) model, and an extra trees (ET) model were established. Then the sensitivity, specificity, accuracy, and the area under the curve (AUC) were calculated to evaluate the diagnostic performance of each model on the testing set.

RESULTS

Patients before September 2019 were divided into the training set, of which 88 patients were in the invasion group and 42 patients were in the non-invasion group. The others were in the testing set, of which 32 patients were in the invasion group and 16 patients were in the non-invasion group. A total of 34 radiomics features were obtained by the elastic-net regression. The SVM model had an AUC value of 0.641 (95% CI, 0.463-0.769), a sensitivity of 1.000, and a specificity of 0.062. The LR model had an AUC value of 0.769 (95% CI, 0.620-0.877), a sensitivity of 0.913, and a specificity of 0.312. The ET model had an AUC value of 0.853 (95% CI, 0.734-0.948), a sensitivity of 0.783, and a specificity of 0.812. Among the 3 models, the ET model had the best diagnostic effect, with a good balance of sensitivity and specificity. And the higher the tumor thrombus grade, the better the diagnostic efficacy of the ET model. In inferior vena cava tumor thrombus, the sensitivity, specificity, accuracy, and AUC of ET model can be improved to 0.889, 0.800, 0.857, 0.878 (95% CI, 0.745-1.000).

CONCLUSION

Machine learning combined with radiomics method can effectively identify whether venous wall was invaded by tumor thrombus and has high diagnostic efficacy with an AUC of 0.853 (95% CI, 0.734-0.948).

Factors predicting indistinct plane of surgical capsule in patients underwent HoLEP procedures

PURPOSE

To evaluate factors that effectively predict indistinct plane (IP) in patients who underwent holmium laser enucleation of the prostate (HoLEP).

METHODS

Data of 208 consecutive patients from our HoLEP database were reviewed and analyzed. IP was defined in 107 cases, as the plane could be identified only depending on endoscopic beak dissection rather than laser dissection in the initial stage of HoLEP, whereas the control group consisted of 101 cases. Variables including age, body mass index, prostatic volume (PV), intravesical prostatic protrusion, prostate-specific antigen, prostate-specific antigen density, bladder stones, urinary tract infection, microscopic hematuria, prior biopsy (PB), diabetes, hypertension, history of acute urinary retention, 5-alpha reductase inhibitor treatment, catheter dependency, residual urine, region, smoking, and alcohol consumption were compared between the two groups. The risk factors for predicting the presence of IP were determined using a multivariable binary logistic regression model using a forward selection approach with a focus on improvement in the area under the receiver operating characteristic curve (AUC).

RESULTS

The incidence of IP was 51.4% (107/208). PV (OR = 0.977, p < 0.001) and PB (OR = 0.297, p = 0.028) were identified as the independent predictors of capsule plane status. PV with a cutoff of 54 ml had the best predictive effectiveness for IP based on AUC (0.727; 95% CI 0.659-0.795). The specificity and sensitivity of this cutoff were 82.2% and 53.3%, respectively.

CONCLUSION

PV is the most reliable factor to predict IP during HoLEP procedures. There is a high possibility of IP in patients with a PV less than 54 ml.

Effect and influence mechanism of biofilm formation on the biological stability of reclaimed water

Microorganisms and sediments in reclaimed water adhere to the inner walls of pipes or water tanks, forming biofilms that support the continuous growth of microorganisms. These biofilms provide a protective barrier, shielding bacteria from disinfectants. This study investigated the impact of biofilms on bacterial growth and reproduction in reclaimed water and the factors limiting bacterial growth in reclaimed graywater (GMR) and reclaimed mixed wastewater (MWR). The results revealed that biofilm biomass gradually increased and reached a maximum value on Days 20-25, and the biomass of organisms continued to decrease after 40 days. Biofilms serve as a source of bacteria, continuously releasing them into reclaimed water systems. The presence of biofilms reduced the biological stability of the reclaimed water, leading to water quality deterioration. The concentration of assimilable organic carbon in the reclaimed water showed a positive correlation with the heterotrophic bacterial count and Escherichia coli levels in both the reclaimed water and biofilms. The threshold value of chlorine for inhibiting biofilms in reclaimed water was no <2 mg/L. High concentrations of free chlorine delayed the growth of biofilms but did not reduce the final biomass generated by the biofilms. Carbon was the limiting factor for the biological stability of reclaimed water, while nitrogen, phosphorus, and inorganic salts were not limiting factors. Thus, minimizing the concentration of organic matter in reclaimed water can reduce the nutrient sources available for biofilm formation. This study provides support for advancements in the wastewater reuse industry.

Prevention, incidence, and risk factors of chyle leak after radical nephrectomy and thrombectomy

BACKGROUND

To define the incidence and risk factors of chyle leak (CL) after radical nephrectomy and thrombectomy and to determine the impact of chyle leak on oncological outcomes.

PATIENTS AND METHODS

A total of 445 patients who underwent radical nephrectomy and thrombectomy between January 2014 and January 2023 were included. CL is defined as the drainage of chyle with a triglyceride level greater than 110 mg/dL after oral intake or enteral nutrition. Multivariate logistic regression analysis was performed to identify the risk factors of postoperative (CL). The Kaplan-Meier curves were used to compare overall survival and cancer-specific survival.

RESULTS

44 patients (9.9%) were diagnosed as (CL). All patients developed CL within 6 days after the operation with a median time of 3 days. In multivariate logistic regression analysis, Mayo grade and side were independent patient-related risk factors. In addition, operation approach, operation time, and number of lymph nodes harvested were independent surgery-related risk factors. Between the CL group and the non-CL group, neither overall survival nor cancer-specific survival showed statistical differences.

CONCLUSION

Based on this retrospective study of renal cell carcinoma and tumor thrombus patients in our center, we found that the risk factors were Mayo grade, side, operation approach, operation time, and number of lymph nodes harvested, and the occurrence of CL significantly prolonged hospital stay, but had no effect on long-term oncological outcomes.

Pulp waste extracted reinforced powder incorporated biodegradable chitosan composite film for enhancing red grape shelf-life

Chitosan (CS) is widely used as a natural biopolymer due to its semi-crystalline structure, good film-forming properties, and easy availability. CS-based composite films are widely used in industry, particularly in the food sector as active food packaging. Despite all of these advantages, their wide range of applications are constrained by poor mechanical properties. Therefore, this work introduced refined bamboo cellulose powder (RBCP), a reinforcing material that is extracted from waste bamboo pulp and applied to CS composite films to enhance their mechanical and physicochemical properties. The chemical composition and crystallinity properties of CS composite films with RBCP addition were observed by ATR-FTIR and XRD. The homogeneous and heterogeneous surfaces of the RBCP incorporated films before biodegradation and after biodegradation (20 days) were observed by scanning electron microscopy (SEM). The increase in reinforcing RBCP materials from 0.00 to 5.00 % resulted in an increase in tensile strength for CS/RBCP films from 2.9 to 8.3 MPa. The application of the CS/RBCP/5 composite film as red grapefruit storage was also investigated, which performed much better than commercial plastic and control CS films with 92.8 and 88.6 % viability of S. aureus and E. coli bacteria. Overall achieved properties demonstrated strong potential for usage as active packaging materials to preserve and lengthen the shelf life of red grapefruits.

The transformation of heavy metal speciation during rapid high-temperature aerobic fermentation of food waste and their potential mechanisms

In this study, the content changes of multiple trace heavy metals (HMs) in food waste using a new rapid high-temperature aerobic fermentation (RTAF) technology and their relationships with different physicochemical factors were researched. The results indicated that the content of HMs in the decomposed products met the industry standards for organic fertilizers (NY/T525-2021, China). Physicochemical factors played an important role in controlling the changes in HM content. The component evolution of dissolved organic matter was studied, and its influences on the transformation of HM speciation showed that the RTAF process converted proteins into humus-like substances. Redundancy analysis revealed that the main factors driving the speciation transformation of HMs were tyrosine-like substances or microbial-derived humus (C3), molecular weight of dissolved organic matter (SUVA254) and humification degree (E250/E365). The increase in humification degree contributed to passivating HMs. The correlation network analysis results showed that the exchangeable HMs (Exc-HMs) were related to Lactobacillus and Pediococcu. Additionally, the cytoskeleton, coenzyme transport and metabolic function of microorganisms affected the Exc-HM content. These research results can provide a scientific basis for the prevention and control of HM pollution during the treatment of food waste.

Biochar-assisted degradation of oxytetracycline by Achromobacter denitrificans and underlying mechanisms

Contamination of the environment with large amounts of residual oxytetracycline (OTC) and the corresponding resistance genes poses a potential threat to natural ecosystems and human health. In this study, an effective OTC-degrading strain, identified as Achromobacter denitrificans OTC-F, was isolated from activated sludge. In the degradation experiment, the degradation rates of OTC in the degradation systems with and without biochar addition were 95.01-100% and 73.72-99.66%, respectively. Biochar promotes the biodegradation of OTC, particularly under extreme environmental conditions. Toxicity evaluation experiments showed that biochar reduced biotoxicity and increased the proportion of living cells by 17.36%. Additionally, biochar increased the activity of antioxidant enzymes by 34.1-91.0%. Metabolomic analysis revealed that biochar promoted the secretion of antioxidant substances such as glutathione and tetrahydrofolate, which effectively reduced oxidative stress induced by OTC. This study revealed the mechanism at the molecular level and provided new strategies for the bioremediation of OTC in the environment.

Interfacial Polymerization Produced Magnetic Particles with Nano-Filopodia for Highly Accurate Liquid Biopsy in the PSA Gray Zone

Magnetic particles are leading separation materials for biological purification and detection. Existing magnetic particles, which almost rely on molecule-level interactions, however, often encounter bottlenecks in highly efficient cell-level separation due to the underestimate of surface structure effects. Here, immune cell-inspired magnetic particles with nano-filopodia (NFMPs) produced by interfacial polymerization for highly efficient capture of circulating tumor cells (CTCs) and further accurate clinical diagnosis of prostate cancer are reported . The unprecedented construction of nano-filopodia on polymer-based magnetic particles is achieved by introducing electrostatic interactions in emulsion interfacial polymerization. Due to the unique nano-filopodia, the NFMPs allow remarkably enhanced CTCs capture efficiency (86.5% ± 2.8%) compared with smooth magnetic particles (SMPs, 35.7% ± 5.7%). Under the assistance of machine learning by combining with prostate-specific antigen (PSA) and free to total PSA (F/T-PSA), the NFMPs strategy demonstrates high sensitivity (100%), high specificity (93.3%), and a high area under the curve (AUC) value (98.1%) for clinical diagnosis of prostate cancer in the PSA gray zone. The NFMPs are anticipated as an efficient platform for CTCs-based liquid biopsy toward early cancer diagnosis and prognosis evaluation.

Dose decision of HSK7653 oral immediate release tablets in specific populations clinical trials based on mechanistic physiologically-based pharmacokinetic model

HSK7653, an oral dipeptidyl peptidase-4 inhibitor administered every 2 weeks, is a candidate for the treatment of type 2 diabetes mellitus. The major elimination pathway of HSK7653 in vivo is renal excretion, and hepatic metabolism and fecal excretion of unchanged compound contribute less to the systemic clearance of HSK7653. Considering the disposition characteristics and the potential indication population of HSK7653, evaluating the HSK7653 exposure in patients with renal impairment and geriatric populations is a prerequisite for bringing more benefits to the patients. Here, a PBPK model was developed based on in vitro experimental results, such as dissolution, permeability, and metabolism, and the in vivo renal clearance, to evaluate the effects of physiological factors and food on HSK7653 exposure in specific populations, including adult and elder individuals with renal impairment and geriatric populations. Simulation results showed that the AUC of HSK7653 increased by 46%, 82%, and 129% in adult patients with mild, moderate, and severe renal impairment, and by 56%, 78%, and 101% in patients aged 65-75, 75-85 and 85-95 years, respectively. The AUC increased in the range of 62%-83%, 98%-133%, and 153%-195% in elderly patients (65-95 years) with mild, moderate, and severe renal impairment, respectively. Moreover, two different absorption model development methods (dissolution profile method and the diffusion layer model method) predicted that food had no effect on the exposure of the same simulated population. Since the predicted AUC of HSK7653 at the 10 mg dose in various specific populations was still within the relatively flat results of the exposure-response analysis, the 10 mg dose of HSK7653 was first used to explore the exposure in the renal impairment population (CTR20221952).

[Analysis of the relationship between embryo quality at different developmental stages and secondary sex ratio of single live births]

Objective: To investigate the effect of embryo quality at different developmental stages on the secondary sex ratio (SSR) of single live birth neonates. Methods: Data for patients with singleton live births after embryo transferred between January 2016 and January 2022 were retrospectively analyzed. The effect of embryo quality at different development stages on the SSR of 11 713 singleton live births were investigated. The association of SSR and embryo quality at different development stages was examined in univariate analysis and in a multivariate logistic regression model, after adjustment for confounders, using two models (Ⅰ and Ⅱ). Results: The age of both male and female, body mass index of both male and female, basal follicle stimulating hormone and estradiol, smoking of male, methods of insemination, methods of sperm extraction, types of transfer cycle and the number of embryo transferred were not related with SSR (all P>0.05). After adjustment for confounders, the probability of a male live birth was higher after transfer of good-quality blastula than after transfer of poorer-quality blastula (model Ⅰ: aOR=0.73, 95%CI: 0.65-0.82, P<0.001; model Ⅱ: aOR=0.73, 95%CI: 0.65-0.82, P<0.001). The quality of cleavage stage embryo was not associated with SSR (model Ⅰ: aOR=0.99, 95%CI: 0.87-1.13, P=0.937; model Ⅱ: aOR=0.99, 95%CI: 0.87-1.13, P=0.899). Conclusions: The SSR of singleton live births after embryo transfer is not correlated with the quality of cleavage stage embryo, but is correlated with the quality of blastula. Good-quality blastula transfer is more likely to result in a male live birth.

Pure Retroperitoneal Laparoscopic Peritoneum Incision Technique in Right Nephrectomy and Inferior Vena Cava Tumor Thrombectomy: A Novel Surgical Technique and Long-Term Outcomes from a Large Chinese Center

Purpose: To explore the safety and effectiveness of the Pure Retroperitoneal Laparoscopic Peritoneum Incision Technique (PREP-IT) in laparoscopic radical nephrectomy (LRN) and inferior vena cave (IVC) tumor thrombectomy for right renal-cell carcinoma (RCC) with level Mayo I to III venous tumor thrombus (VTT). Patients and Methods: From May 2015 to September 2020, 92 patients with right RCC and Mayo I to III VTT were retrospectively reviewed, including 57 patients who underwent retroperitoneal LRN and IVC thrombectomy using PREP-IT, and 35 patients who underwent open surgery. PREP-IT refers to dissecting the retroperitoneum and temporarily placing the right kidney into the abdominal cavity to enlarge the retroperitoneal workspace for a safer and faster IVC operation. Results: Compared with the open surgery group, the PREP-IT group had a larger tumor diameter, while a larger proportion of Mayo I tumor thrombus and smaller maximum tumor thrombus width. Two patients (3.5%) in the PREP-IT group had a history of abdominal surgery. No conversion to open surgery or standard laparoscopic surgery occurred in PREP-IT group. Laparoscopic surgery with PREP-IT was characterized by shorter operative time, less surgical blood loss, shorter postoperative hospital stay, and lower postoperative complication rate. With a 33-month (ranges: 2-86) follow-up time period, the estimated mean overall survival time was 57.2 ± 5.3 and 58.1 ± 71.5 months in the PREP-IT group and open surgery group, respectively. Log-rank test indicated no significant difference between the two groups in terms of overall survival and cancer-specific survival. Conclusions: The PREP-IT is relatively safe and feasible for retroperitoneal LRN with right renal tumor and IVC tumor thrombus, allowing for a large workspace and wide exposure for IVC operations.

Photochemical behaviors of dissolved organic matter in aquatic environment: Generation, characterization, influencing factors and practical application

Dissolved organic matter (DOM) widely exists in aquatic environment and plays a critical role in environmental photochemical reaction. The photochemical behaviors of DOM in sunlit surface waters have received widely attention because its photochemical effects for some coexisted substances in aquatic environment, especially for organic micropollutants degradation. Therefore, to gain a comprehensive understanding of the photochemical properties and environmental effects of DOM, we reviewed the influence of sources on the structure and composition of DOM with relevant identified techniques to analysis functional groups. Additionally, identification and quantification for reactive intermediates are discussed with a focus on influencing factors to produce reactive intermediates by DOM under solar irradiation. These reactive intermediates can promote the photodegradation of organic micropollutants in the environmental system. In future, attention should be paid to the photochemical properties of DOM and environmental effects in real environmental system and development of advanced techniques to study DOM.

Long-term outcomes after cytoreductive nephrectomy and thrombectomy of patients with metastatic renal cell carcinoma with venous tumor thrombus: a retrospective study from a large Chinese center

BACKGROUND

Targeted therapy combined with immunotherapy is the current first-line treatment for metastatic renal cell carcinoma (mRCC), but patients with tumor thrombus (TT) may suffer from lower limb edema or even sudden cardiac death, so the purpose of this study is to investigate the efficacy and safety of surgical treatment in patients with mRCC and TT and explore worse factors to affect the prognosis in this series of patients.

PATIENTS AND METHODS

A total of 85 mRCC patients with TT who received cytoreductive nephrectomy and thrombectomy at our medical center from 2014 to 2023 are included. All patients received postoperative systemic therapy. Overall survival (OS) is defined as the time from surgery to death due to any reason or the last follow-up. Kaplan-Meier analysis was performed to evaluate OS and differences among groups were tested by log-rank. Multivariable Cox proportional hazards analysis was performed to ascertain independent relationships between clinicopathological factors and OS.

RESULTS

The median age of patients was 58 years old. Eleven patients (12.9%) had no symptoms, 39 patients (45.9%) had local symptoms, 15 patients (17.6%) had systemic symptoms, and 20 patients (23.5%) had both. Mayo grade of TT was 0, 1, 2, 3, and 4 for 12, 27, 31, 7, and 8 patients respectively. Fifty-five patients had lung metastasis, 23 had bone metastasis, 16 had liver metastasis, 13 had adrenal metastasis, and 9 had lymph node metastasis. Of all patients, 17 patients had multiple metastases. The median operation time is 289 min and the median intraoperative hemorrhage is 800 ml. Twenty-eight patients experienced postoperative complications, 8 of which were serious complications of modified Clavien grade III or higher. The median OS of all patients was 33 months and median follow up time was 26 months. In multivariate analysis, systemic symptom (p = 0.00753), pathological type (p = 0.0166), sarcomatous degeneration (p = 0.0334), and perirenal fat infiltration (p = 0.0202) are independent predictors of OS.

CONCLUSION

Cytoreductive nephrectomy and thrombectomy is relatively safe and effective for patients with mRCC accompanied by TT. In this series of patients, the worse prognosis is associated with systemic symptoms, non-clear cell carcinoma, sarcomatous degeneration and perirenal fat infiltration.

ATAD2 promotes glycolysis and tumor progression in clear cell renal cell carcinoma by regulating the transcriptional activity of c-Myc

Clear cell renal cell carcinoma (ccRCC) is a common malignant tumor of the urogenital tract. Given that ccRCC is often resistant to radiotherapy and traditional chemotherapy, the clinical treatment of patients with ccRCC remains a challenge. The present study found that ATAD2 was significantly upregulated in ccRCC tissues. In vitro and in vivo experiments showed that the inhibition of ATAD2 expression mitigated the aggressive phenotype of ccRCC. ATAD2 was also associated with glycolysis in ccRCC. Interestingly, we found that ATAD2 could physically interact with c-Myc and promote the expression of its downstream target gene, thereby enhancing the Warburg effect of ccRCC. Overall, our study emphasizes the role of ATAD2 in ccRCC. The targeted expression or functional regulation of ATAD2 could be a promising method to reduce the proliferation and progression of ccRCC.

High-performance electrode of ZIF-67 metal-organic framework (MOF) loaded laser-induced graphene (LIG) composite for all-solid-state supercapacitor

This work demonstrates a facile and efficient methodology to synthesize a composite material of zeolitic imidazolate frameworks (ZIFs) and laser-induced graphene (LIG). This ZIF-67 loaded LIG composite (ZIF-67/LIG) has been adequately characterized for its morphology and structure, and its electrochemical performance has been specifically examined. As supercapacitors (SCs) electrode material, the ZIF-67/LIG composite exhibits superb electrochemical performance, owing to the inherent high porosity, abundant active sites, large specific surface area of ZIF-67, and the excellent conductive three-dimensional hierarchical porous network structure provided by LIG. In three-electrode system, ZIF-67/LIG composite electrode displays outstanding areal specific capacitance (C_A) of 135.6 mF cm^-2at a current density of 1 mA cm^-2with 1 M Na₂SO₄aqueous electrolyte, which is far greater than that of pristine LIG (7.7 mF cm^-2). Furthermore, the ZIF-67/LIG composite has been fabricated into an all-solid-state planar micro-supercapacitor (MSC). This ZIF-67/LIG MSC exhibits an impressiveC_Aof 38.1 mF cm^-2at a current density of 0.20 mA cm^-2, a good cycling stability of 80.3% capacitance retention after 3000 cycles, and a high energy density of 5.29μWh cm^-2at a power density of 0.1 mW cm^-2. All electrochemical results clearly manifest that as-prepared ZIF-67/LIG composite can be a candidate in energy storage field with exciting possibilities.

Effects of 12-week escitalopram treatment on resting-state functional connectivity of large-scale brain networks in major depressive disorder

In this study, the effects of antidepressants on large-scale brain networks and the neural basis of individual differences in response were explored. A total of 41 patients with major depressive disorder (MDD) and 42 matched healthy controls (HCs) were scanned by resting-state functional magnetic resonance imaging separately at baseline and after a 12-week follow-up. The patients with MDD received escitalopram for 12 weeks. After treatment, patients were classified into those with MDD in remission [MDDr, endpoint 17-item Hamilton Depression Rating Scale (HAMD) total score ≤7] and those in nonremission (MDDnr). The human Brainnetome Atlas was used to define large-scale networks and compute within- and between-network resting-state functional connectivity (rsFC). Results showed the decreased subcortical network (SCN)-ventral attention network (VAN) connectivity at baseline increased in patients with MDD after 12-week treatment, and it was comparable with that of HCs. This change was only observed in patients with MDDr. However, the decreased within-network rsFC in SCN and default mode network (DMN) persisted in all patients with MDD, including those with MDDr and MDDnr, after treatment. The strength of SCN-VAN connectivity at baseline was significantly negatively correlated with the reduction rate of HAMD score in all patients with MDD. Thus, SCN-VAN connectivity may be an antidepressant target associated with depressive state changes and a predictor of treatment response to serotonin reuptake inhibitors. The within-network rsFC in SCN and DMN may reflect a trait-like abnormality in MDD. These findings provide further insights into the mechanism of antidepressants and their individual differences in response. The trial name is "Appropriate technology study of MDD diagnosis and treatment based on objective indicators and measurement" (URL: http://www.chictr.org.cn/showproj.aspx?proj=21377; registration number: ChiCTR-OOC-17012566).

Durable Rapid Self-Disinfection, Reusable Protective Clothing Based on the Ag-Pd@MoS2 Nanozyme with Enhanced Triple-Mode Synergistic Antibacterial Effect

Personal protective clothing plays an important role in isolating microorganisms and harmful ultrafine dust, but it cannot quickly inactivate bacteria intercepted on the surface, making it a potential source of infection. However, spontaneous and durable rapid sterilization is a major challenge for commercial protective clothing. Herein, we exquisitely engineered a visible light-enhanced Ag-Pd@MoS₂ nanozyme-based fabric, named PVDF/Ag-Pd@MoS₂/PAN fabric (PAPMP fabric), with prominent triple-mode synergistic antibacterial effect through the replacement reaction, electrospinning technique, and vacuum filtration method. The modification of Ag-Pd greatly strengthened the absorption of MoS₂ nanosheets to the visible light spectrum (390-780 nm) and its corresponding catalytic performance. Meanwhile, the combination of MoS₂ nanosheets significantly enhanced the oxidase-like characteristics of Ag-Pd under sunlight irradiation, increasing the yield of surface-bound ¹O₂ ∼4.54 times in 5 min. In addition, the obtained Ag-Pd@MoS₂ nanozyme showed an excellent photo-to-thermal conversion property (36.12%), which enabled the sharp increase in the surface temperature of the PAPMP fabric to 62.8 °C in 1 min under a solar simulator (1 W/cm²). Correspondingly, the obtained PAPMP fabric exhibited excellent intrinsic antibacterial effect and greatly shortened the sterilization time from 4 h to only 5 min under sunlight stimulation. The rapid antibacterial effect of the fabric was attributable to the enhanced production rate of surface-bound reactive oxygen species and the increased temperature by solar irradiation. Notably, the fabric still maintained the efficient germicidal effect even after 30 washing cycles. In addition to high reusability, the fabric also had outstanding biological compatibility and water resistance. Our work provides a novel strategy to improve the inherent timely sterilization and heat preservation efficiency of protective clothing.

A Synergistic Combination of AuNRs and C Dots as a Multifunctional Material for Ice Recrystallization Inhibition and Rapid Rewarming

Robust platforms and advanced biocompatible materials having diverse performances are in tremendous demand for cryopreservation of biocells, which are greatly limited by the crystallization, formation, and growth of ice crystals. The fickle structure and the arduous extraction process of modern attainable antifreezing proteins cause fatal cryoinjury of the cells making it challenging to develop anti-icing materials. Thus, designing Au colloids is an effective way to combat cell-damaging concerns during the ice freezing-thawing process. Herein, we propose an emerging biomimetic hybrid nanomaterial (AuNR@SiO₂-CDs) prepared by combining the photoheating and rewarming controlling characteristics of carbon dots (CDs) and gold nanorods (AuNRs), respectively, via a SiO₂ scaffold that has an optimal aspect ratio of ∼4.4. The performance of the material is applied in the freezing and resuscitation of Hela cells. The typical linkage between the AuNR and CDs not only retains the stable structure but also possesses the symmetric functional characteristics of affirmative cryoprotectant materials and sustained low cytotoxicity of cell viability >90%. The cell recovery rate of the Hela cell is significantly improved to ∼60%, which is propped up to >4% higher by the laser irradiation dose. The above hybrid material is paving a path toward novel bionic antifreezing proteins and is envisioned for ice recrystallization inhibition and rapid rewarming.

TPM2 attenuates progression of prostate cancer by blocking PDLIM7-mediated nuclear translocation of YAP1

BACKGROUND

Prostate cancer (PCa) is a common malignant tumor of the genitourinary system. Clinical intervention in advanced PCa remains challenging. Tropomyosins 2 (TPM2) are actin-binding proteins and have been found as a biomarker candidate for certain cancers. However, no studies have explored the role of TPM2 in PCa and its regulatory mechanism.

METHODS

TPM2 expression was assessed in Gene Expression Omnibus (GEO) and the Cancer Genome Atlas (TCGA) PCa patient dataset. The effect of TPM2 on PCa progression was assessed in vitro and in vivo by quantifying proliferation, migration, invasion and tumor growth assays, and the mechanism of TPM2 in PCa progression was gradually revealed by Western blotting, immunoprecipitation, and immunofluorescence staining arrays.

RESULTS

TPM2 was found to be severely downregulated in tumor tissues of PCa patients compared with tumor-adjacent normal tissues. In vitro experiments revealed that TPM2 overexpression inhibited PCa cell proliferation, invasion and androgen-independent proliferation. Moreover, TPM2 overexpression inhibited the growth of subcutaneous xenograft tumors in vivo. Mechanistically, this effect was noted to be dependent on PDZ-binding motif of TPM2. TPM2 competed with YAP1 for binding to PDLIM7 through the PDZ-binding motif. The binding of TPM2 to PDLIM7 subsequently inhibited the nuclear transport function of PDLIM7 for YAP1. YAP1 sequestered in the cytoplasm phosphorylated at S127, resulting in its inactivation or degradation which in turn inhibited the expression of YAP1 downstream target genes.

CONCLUSIONS

This study investigated the role of TPM2, PDLIM7, and YAP1 in PCa progression and castration resistance. TPM2 attenuates progression of PCa by blocking PDLIM7-mediated nuclear translocation of YAP1. Accordingly, targeting the expression or functional modulation of TPM2, PDLIM7, or YAP1 has the potential to be an effective therapeutic approach to reduce PCa proliferation and prevent the progression of castration-resistant prostate cancer (CRPC).

Amygdala connectivity related to subsequent stress responses during the COVID-19 outbreak

Introduction

The amygdala plays an important role in stress responses and stress-related psychiatric disorders. It is possible that amygdala connectivity may be a neurobiological vulnerability marker for stress responses or stress-related psychiatric disorders and will be useful to precisely identify the vulnerable individuals before stress happens. However, little is known about the relationship between amygdala connectivity and subsequent stress responses. The current study investigated whether amygdala connectivity measured before experiencing stress is a predisposing neural feature of subsequent stress responses while individuals face an emergent and unexpected event like the COVID-19 outbreak.

Methods

Data collected before the COVID-19 pandemic from an established fMRI cohort who lived in the pandemic center in China (Hubei) during the COVID-19 outbreak were used to investigate the relationship between amygdala connectivity and stress responses during and after the pandemic in 2020. The amygdala connectivity was measured with resting-state functional connectivity (rsFC) and effective connectivity.

Results

We found the rsFC of the right amygdala with the dorsomedial prefrontal cortex (dmPFC) was negatively correlated with the stress responses at the first survey during the COVID-19 outbreak, and the rsFC between the right amygdala and bilateral superior frontal gyri (partially overlapped with the dmPFC) was correlated with SBSC at the second survey. Dynamic causal modeling suggested that the self-connection of the right amygdala was negatively correlated with stress responses during the pandemic.

Discussion

Our findings expand our understanding about the role of amygdala in stress responses and stress-related psychiatric disorders and suggest that amygdala connectivity is a predisposing neural feature of subsequent stress responses.

Preparation of a new biochar-based microbial fertilizer: Nutrient release patterns and synergistic mechanisms to improve soil fertility

The contradiction between population growth and soil degradation has been increasingly prominent, such that novel fertilizers (e.g., biochar and microbial fertilizers) should be urgently developed. Biochar is a promising fertilizer carrier for microbial fertilizers due to its porous structure. However, the preparation and mechanisms of the effects of biochar-based microbial fertilizers have been rarely investigated. In this study, biochar, Bacillus, and exogenous N-P-K fertilizers served as the raw materials to prepare biochar-based microbial fertilizers (BCMFs) by optimizing the preparation methods and the process parameters. Moreover, the release patterns of N-P-K were analyzed. A pot experiment was performed on pakchoi to examine the effect of the BCMFs and explore its synergistic effect on soil fertility. The results of this study indicated that adsorption by biochar maintained bacterial activity, whereas the granulation process reduced bacterial activity. The adsorption-granulation process increased the content of total nitrogen and organic matter in the soil while enhancing the slow-release effect of the BCMFs. The Elovich model was capable of describing the nitrogen release of the BCMFs, including the diffusion and chemical processes. As indicated by the result of the column leaching experiment, the BCMFs stopped nutrient leaching more significantly than the conventional fertilizers (CF), especially in stopping N and P leaching. The use of the BCMFs improved the available soil nutrients and soil quality while enhancing the abundance of bacteria correlated with carbon and nitrogen metabolism in the soil. Moreover, a 20 % reduction in the use of the BCMFs did not significantly affect the soil available N and P and the growth status of pakchoi. The result of redundancy analysis indicated that the cation exchange capacity (CEC), NH₄⁺-N, NO₃^--N, β-glucosidase (BG), urease (URE), and alkaline phosphatase (AlkP) were the six critical environmental factors for the microbial community structure and could explain 94.8 % of the variance. The BCMFs up-regulated the levels of the above six factors, especially CEC and BG, thus improving the soil quality and enhancing the soil fertility.

Case report and literature review: Primary leiomyosarcoma of the penis

Background

Leiomyosarcoma (LMS) is a malignant spindle-cell mesenchymal tumor originating from the smooth muscle cells, which mostly affects soft tissues and abdominopelvic organs over extremities. Primary LMS of the penis is a relatively uncommon mesenchymal tissue disease and a poorly understood condition.

Case Report

A 69-year-old man presented with a growing, painless mass protruding from the penis. The irregularly lobulated lump was roughly 3 cm × 2.5 cm, with a smooth surface, tough texture, distinct boundary, and no tenderness. It was determined to be a penile tumor during the preoperative radiological evaluation. The patient underwent resection of the penile mass, followed by extended resection in the second operation. The diagnosis of LMS was verified by pathological examination. During a 20-month follow-up, the patient made a smooth recovery and remained disease-free.

Conclusion

An immunohistochemical examination is essential for rendering this rare diagnosis. Radical excision of tumor lesions with negative cut margins is guaranteed to be the best treatment for primary penile LMS. Close follow-up should be provided due to the high rate of local recurrence.

[Analysis of pregnancy outcomes of single top-quality blastocyst transfer developed from cleavage embryos with different grading]

Objective: To explore the clinical outcomes of top-quality blastocysts transfer developed from cleavage embryos with different grading and determine whether the cleavage stage embryo morphology grading should be taken into consideration when transferring the embryo at the blastocyst stage. Methods: A number of 3 059 cycles were included with single top-quality blastocyst transfer dating from January 2017 to May 2021 in Henan Provincial People's Hospital. According to the number of cleavage sphere and degree of fragmentation, all cleavage stage embryos were divided into three groups: top D3 embryo (8 cells, ≤5% fragments)-TB group, suboptimal D3 embryo (8 cells, 5%<fragments≤10%; 7 cells or 9 cells, ≤10%)-TB group, and normal D3 embryo-TB group. Univariate analysis, multivariate logistic regression analysis and threshold effect analysis were performed on the data. Results: The clinical pregnancy rates of top D3 embryo-TB group(1 326 cycles), suboptimal D3 embryo-TB group (830 cycles) and normal D3 embryo-TB group (903 cycles) were 69.53%, 70.12% and 66.67%, respectively (P>0.05); and the early abortion rate were 10.74%, 12.54% and 12.62%, respectively (P>0.05). After adjusting for confounders, logistic regression showed that no significant associations were found between cleavage stage embryo morphology grading and clinical pregnancy rate (suboptimal D3 embryo-TB group: OR=1.02, 95%CI: 0.76-1.38, P=0.879; normal D3 embryo-TB group: OR=0.84, 95%CI: 0.61-1.14, P=0.262) and early abortion rate (suboptimal D3 embryo-TB group: OR=1.18, 95%CI: 0.77-1.82, P=0.445; normal D3 embryo-TB group: OR=1.26, 95%CI: 0.81-1.98, P=0.309). The results of threshold effect analysis showed that when a single top-quality blastocysts was transferred, the effect of age on the clinical pregnancy rate showed a curve relationship, when the age was≥33 years old, the clinical pregnancy rate decreased significantly with age increased (OR=0.89, 95%CI: 0.83-0.95, P=0.007); and there was no significant change in early abortion rate (OR=1.01, 95%CI: 0.97-1.06, P=0.628). Conclusions: Cleavage stage embryo grading is not found to correlate with clinical outcomes in single top-quality blastcyst tranfer. Therefore, when considering blastocyst transfer, its morphology at blastocyst stage is more relevant. The effect of age on pregnancy outcomes of single blastocyst transfer should be considered.

Dual-Nanopipettes for the Detection of Single Nanoparticles and Small Molecules

Nanopore sensing is blooming due to its label-free and high sensitivity features. As a novel nanopore, a droplet is formed at the orifice of a dual-nanopipette, which allows for the translocation of analytes through the two channels at a relatively low speed and the promotion of signal-to-noise ratio. However, nanopore sensing based on the principle of current blockage requires the pore size to be comparable to that of the single entity, which poses a huge challenge for the direct detection of small molecules. In this work, gold nanoparticles (Au NPs) modified with sulfhydryl poly(ethylene glycol) (PEG-SH) or aptamers were detected successfully. The size difference of Au NPs and the interaction between Au NPs and dual-nanopipettes could be distinguished sensitively. Furthermore, Au NPs modified with designed aptamers will produce different blocking current after capturing the corresponding small molecules (e.g., dopamine and serotonin). Even non-electroactive ions, such as potassium ions, can also be detected, which is difficult to sense based on redox reactions, and further illustrates that the change of surface properties of nanoparticles is responsible for the detection. This work expands the application of nanopipette sensing for Au NPs and provides a universal platform for the small-molecule detection, which has the potential application in biosensing.

[The incidence and time distribution of early transient intraocular pressure elevation after penetrating canaloplasty]

Objective: To report the incidence and time distribution of early transient intraocular pressure (IOP) elevation after penetrating canaloplasty. Methods: Retrospective case series study. Data of patients treated by penetrating canaloplasty for glaucoma in the Eye Hospital of Wenzhou Medical University from June 2015 to March 2020 were collected. Early transient IOP elevation was defined as an increase of IOP to over 21 mmHg on the first week to the third month after surgery followed by a decrease to 21 mmHg or less within 3 months. Main outcome measures included IOP, quantity of medication use, the occurrence time and duration of IOP elevation. Generalized estimating equations were used for statistical analysis, and measurement data with non-normal distribution was represented as M (Q₁, Q₃). Results: A total of 277 patients (315 eyes) achieved 360-degree catheterization of the canal successfully, and 299 eyes (94.9%) completed the postoperative 6-month follow-up. Thirty-four eyes (10.8%) had persistently high IOP, so the surgical treatment failed in them. Consequently, 234 patients (265 eyes) were enrolled in the analyses, including 161 males (184 eyes) and 73 females (81 eyes). The median age was 42 (26, 54) years, the mean preoperative IOP was (37.7±11.1) mmHg, and the mean number of drugs used was 3 (2, 4). The incidence of early transient IOP elevation was 43.0% (114/265) in all enrolled eyes, 42.7% (35/82) in eyes with primary open angle glaucoma, 37.8% (17/45) in eyes with primary angle closure glaucoma, 27.7% (13/47) in eyes with congenital glaucoma and 53.8% (49/91) in eyes with secondary glaucoma. The IOP began to increase on the first to fourth week in 91.2% (104/114) of eyes with early transient IOP elevation and reached the peak [21.3 mmHg to 54.8 mmHg; mean, (32.4±8.2) mmHg] in 88.6% (101/114) on the first to fifth week after surgery. The IOP elevation lasted for no more than 4 weeks in 69.3% (79/114) of eyes. Conclusions: Over 40.0% of patients with penetrating canaloplasty may experience postoperative transient IOP elevation. The incidence is relatively high in secondary glaucoma but low in congenital glaucoma. Most of the elevations and peak IOP occur within 1-4 weeks after surgery.

Preliminary experience of oblique occlusion technique in robot-assisted infrahepatic inferior vena cava thrombectomy: step-by-step procedures and short term outcomes

Background

We aimed to compare the oncological outcomes between the oblique occlusion technique and the traditional technique for robot-assisted radical nephrectomy (RARN) with inferior vena cava (IVC) thrombectomy, and to explore the safety and effectiveness of the oblique occlusion technique.

Methods

Overall, 21 patients with renal cell carcinoma (RCC) and IVC tumor thrombus (TT) were admitted to our hospital from August 2019 to June 2020. All the patients underwent RARN with IVC thrombectomy, of which the IVC oblique occlusion technique was used in 11 patients and traditional occlusion technique was used in 10 patients. The oblique occlusion technique refers to oblique blocking from the upper corner of the right renal vein to the lower corner of the left renal vein using a vessel tourniquet or a vessel clamp (left RCC with IVCTT as an example).

Results

Compared with patients in the traditional group, those in the oblique group had lower serum creatinine at follow-up (3 month) (95 ± 21.1 vs. 131 ± 30.7 μmol/L, P = 0.03). There was no significant difference in operation time [149 (IQR 143–245) min vs. 148 (IQR 108–261) min, p = 0.86], IVC clamping time [18 (IQR 12–20) min vs. 20 (IQR 14–23) min, p = 0.41], and estimated intraoperative blood loss [300 (IQR 100–800) mL vs. 500 (IQR 175–738) mL, p = 0.51] between both groups. During a 16-month (range, 15–23 months) follow-up period, two cases progressed in the oblique group and three cases progressed in the traditional group.

Conclusions

The modified IVC oblique occlusion technique procedure is relatively safe and effective in RARN with IVC thrombectomy. The IVC oblique occlusion technique may play a role in the protection of renal function.

Breakage risk of different sacroiliac screws in unilateral sacral fractures a finite element analysis

Objective

To compare the breakage risk of lengthened sacroiliac screws and ordinary sacroiliac screws to treat unilateral vertical sacral fractures and provide a reference for clinical application.

Methods

A finite element model of Tile C pelvic ring injury (unilateral type Denis II fracture of the sacrum) was produced. The sacral fractures were fixed with a lengthened sacroiliac screw and ordinary sacroiliac screw in 6 types of models. The maximal von Mises stresses and stress distributions of the two kinds of screws when standing on both feet were measured and compared.

Results

The maximal von Mises stress of the lengthened screw was less than that of the ordinary screw. Compared with ordinary screw, the stress distribution in the lengthened screw was more homogeneous.

Conclusions

The breakage risk of screws fixed in double segments is lower than that of screws fixed in single segments, the breakage risk of lengthened screws is lower than that of ordinary screws, and the breakage risk of screws fixed in S2 segments is lower than that of screws fixed in S1 segments.

[Phacoemulsification combined with goniosynechialysis under a gonioscope in the treatment of angle-closure glaucoma: the effect of reopening the synechial anterior chamber angle]

A total of 170 consecutive patients (181 eyes) who were diagnosed with primary angle-closure glaucoma (PACG) and underwent phacoemulsification and intraocular lens implantation (PEI) combined with goniosynechialysis (GSL) with an instrument under a gonioscope in the Eye Hospital, Wenzhou Medical University from January 1, 2017 to December 31, 2019 were observed. Anterior chamber angle synechiae of 0 (0, 2) clock hour were released after PEI, while after combined goniosynechialysis, synechiae of 6 (3, 8) clock hours were further released. No matter in chronic PACG and acute PACG with cornea edema, the extent of anterior chamber angle synechiae was different before surgery and after PEI, and so was it in post-PEI and PEI-GSL prospectively (all P<0.01). Phacoemulsification alone can reopen the synechial anterior chamber angle in both chronic PACG and acute PACG in part, but not sufficiently. Combined goniosynechialysis under a gonioscope with an instrument is essential and effective.

Diagnosis and treatment strategies for intraoperative pulmonary embolism caused by renal tumor thrombus shedding

AIM

To provide an overview of techniques for prevention, immediate diagnosis, and treatment strategies of intraoperative pulmonary embolism caused by renal tumor thrombus shedding.

METHODS

A total of 290 patients admitted into our medical center from March 2015 to May 2021 were retrospectively analyzed. All patients underwent radical nephrectomy with tumor thrombectomy. Six patients were diagnosed as pulmonary embolism during the perioperative period, of which two patients had tumor thrombus shedding. One patient underwent thoracotomy and thrombectomy, one patient underwent interventional thrombectomy, and four patients underwent conservative treatment. All patients have gone through our diagnosis and strategy flow chart. Demographic data, tumor characteristics, tumor thrombus characteristics, and follow-up data were collected.

RESULTS

In the preoperative risk factor assessment, of the 253 patients who entered the follow-up, 163 were women, 48 were older than 60 years old, and 83 had a duration of more than 2 months. In addition, 27 patients had tumor thrombus with bland thrombus, and 43 patients had floating tumor thrombus. 78 patients underwent postoperative anticoagulation after evaluation. The average follow-up time was 23.3  ± $\pm $  8.6 months (range, 7-31 months). All patients were alive during the follow-up period.

CONCLUSION

For acute pulmonary embolism during nephrectomy and tumor thrombectomy, management strategies can be used to deal with intraoperative emergencies and provide reference.

Developmental differences of large-scale functional brain networks for spoken word processing

A dual-stream dissociation for separate phonological and semantic processing has been implicated in adults' language processing, but it is unclear how this dissociation emerges with development. By employing a graph-theory based brain network analysis, we compared functional interaction architecture during a rhyming and meaning judgment task of children (aged 8-12) with adults (aged 19-26). We found adults had stronger functional connectivity strength than children between bilateral inferior frontal gyri and left inferior parietal lobule in the rhyming task, between middle frontal gyrus and angular gyrus, and within occipital areas in the meaning task. Meanwhile, adults but not children manifested between-task differences in these properties. In contrast, children had stronger functional connectivity strength or nodal degree in Heschl's gyrus, superior temporal gyrus, and subcortical areas. Our findings indicated spoken word processing development is characterized by increased functional specialization, relying on the dorsal and ventral pathways for phonological and semantic processing respectively.

Spermatic cord anastomosing hemangioma mimicking a malignant inguinal tumor: A case report and literature review

Background

Anastomosing hemangioma (AH) is a rare vascular tumor and occurs in various organs. It is difficult to distinguish AH from malignant tumors even through multimodal imaging examination. AH located in the inguinal region is even rare. We present the diagnosis and treatment of a patient with spermatic cord AH in detail and conduct a literature review.

Case Report

An 84-year-old Chinese man had swelling pain in his right scrotum. A hard and fixed mass was palpable in the right inguinal region. Preoperative radiological examination considered it a neurogenic or vascular tumor. Malignant soft tissue sarcoma could not be excluded. He underwent radical inguinal right orchiectomy under intraspinal anesthesia. The diagnosis of spermatic cord AH was confirmed by pathological examination. The patient recovered uneventfully and remained disease-free during an 18-month follow-up.

Conclusion

Spermatic cord AH is quite rare and could be misdiagnosed as a malignant tumor. Pathological evidence might be necessary. The optimal choice of treatment should be determined through a comprehensive assessment of both tumor and patient factors.

A “3S+f” Nephrometry Score System to Predict the Clinical Outcomes of Laparoscopic Nephron-Sparing Surgery

Background

When we treat renal cell carcinoma by laparoscopic nephron-sparing surgery (NSS), it is essential to use an evaluation system to predict clinical outcomes. Hitherto, there are more than a dozen nephrometry score systems. In this study, through assessing the correlations between nephrometry score systems and clinical outcomes, we aim to provide a novel nephrometry score system—the “3S+f” score system—to simplify the evaluation of technical complexity of partial nephrectomy.

Methods

We retrospectively collected the data of 131 patients who underwent NSS, which was performed by a single surgeon (SZ) from January 2013 to July 2018 at Peking University Third Hospital. The “3S+f” score system contains four parameters: “size, side, site, and fat”, all of which can be obtained from preoperative imaging data. We evaluated the correlations between the “3S+f” score and clinical outcomes, and compared R.E.N.A.L. score and PADUA score.

Results

All the three nephrometry score systems were related to some clinical outcomes in univariate analyses. In multivariate regression models, the “3S+f” score, the R.E.N.A.L. score, and the PADUA score were significantly associated with operative time (p = 0.016, p = 0.035, and p = 0.001, respectively) and warm ischemia time (all p = 0.008, p < 0.001, and p < 0.001, respectively). “3S+f” was also significantly related to extubation time > 5 days (p = 0.018). In predicting operative time > 120 min and extubation time >5 days from ROC curves, the AUCs of the “3S+f” score (0.717 and 0.652, respectively) were larger than both the R.E.N.A.L (0.598 and 0.554, respectively) and PADUA (0.600 and 0.542, respectively) score systems.

Conclusion

A novel nephrometry score system—the “3S+f” score system—shows equivalent correlation and the ability in predicting clinical outcomes when compared to the R.E.N.A.L. score system and the PADUA score system, which can describe renal tumors.

A highly transparent and photothermal composite coating for effective anti-/de-icing of glass surfaces

Anti-/de-icing of glass surfaces is of great importance in present daily life. The long-standing challenge in this field is largely due to the lack of stable multifunctional coatings that can be conveniently and economically constructed on the glass surface, and more importantly, are capable of retaining the original transparency of glass ranging from the visible to the near infrared spectrum. Herein, a direct spraying sol method on the glass surface to prepare a highly transparent and photothermal composite coating is reported. Such multifunctional coating of Cu₇S₄ nanoparticles/organo-silicone sols has displayed a good photothermal conversion property and hydrophobic property and therefore yields excellent anti-icing and self-melting ice properties. The condensation time of water droplets can be extended to 86 s even at -10 °C, which is 3.42 times delayed relative to ordinary blank glass. And the adhesion strength of ice is largely reduced to 72 KPa, which is as low as ∼1/3 that of ordinary glass. Meanwhile, the subcooling of adhering droplets is reduced to -12 °C under one solar illumination condition and exhibits a rapid de-icing capability. More impressively, the prepared functional coating glass shows an outstanding transmittance of more than 75% in the visible region, while it is over the minimum glass transmittance limit allowed by Safety Standards for Glass (GB9656-2016, China). In addition, the multifunctional photothermal glass coating exhibits good physical/chemical stability, which facilitates the long-term application of the coating in different environments.

Micelle Dynamic Reconstruction to Effectively Modulate the Transmission of Smart Windows

Micelles are extremely dynamic equilibrium aggregates. The size and shape of micelles are subject to appreciable structural fluctuations with the introduction of foreign ions, temperature, etc. The highly dynamic character has for a long time hugely attracted the interest of researchers to investigate the mechanism of micellar structure change and the dependence of their optical properties on the structure change. Herein, taking the most common sodium dodecyl sulfate (SDS) as an example, the aggregation behavior of SDS with excess K⁺ and the effect of temperature on the K⁺/SDS mixed system were detailed and systematically investigated by combining with molecular dynamics simulations and experiments. The addition of K⁺ leads to a reconfiguration of the original micelle structure, resulting in a significant change in micelle size from the nanoscale up to the microscale. And simultaneously, temperature can induce a dynamic process of conjugation/deconjugation of K⁺/SDS micelles in the mixed solution, which is manifested macroscopically by the change of transmittance. Finally, a temperature-responsive smart gel was prepared by introducing K⁺/SDS into a polyacrylamide (PAM) gel, which showed an excellent tunable performance in transmittance (ΔT_550 nm = 60.1%, ΔT_808 nm = 42.72%). The designed smart window shows potential applications in room temperature control (Δt = 4.1 °C) and excellent stability over the course of 50 cycles.

Investigation of Plasmonic-Enhanced Solar Photothermal Effect of Au NR@PVDF Micro-/Nanofilms

Gold nanospheres (Au NSs) and gold nanorods (Au NRs) are traditional noble metal plasmonic nanomaterials. Particularly, Au NRs with tunable longitudinal plasmon resonance from the visible to the near-infrared (NIR) range were suitable for highly efficient photothermal applications due to the extended light-receiving range. In this work, we synthesized Au NRs and Au NSs of similar volumes and subsequently developed them into Au NR/poly(vinylidene fluoride) (PVDF) and Au NS/PVDF nanofilms, both of which exhibited excellent solar photothermal performance evaluated by solar photothermal experiments. We found that the Au NR/PVDF nanofilm showed a higher solar photothermal performance than the Au NS/PVDF nanofilm. Through detailed analysis, such as morphological characterization, optical measurement, and finite element method (FEM) modeling, we found that the plasmonic coupling effects inside the aggregated Au NR nanoclusters contributed to the spectral blue shifts and intensified the photothermal performance. As compared to Au NS/PVDF nanofilms, the Au NR/PVDF nanofilm exhibited a higher efficient light-to-heat conversion rate because of the extended light-receiving range and high absorbance, as a result of the strong plasmonic interactions inside nanoclusters, which was further validated by monochromatic laser photothermal experiments and FEM simulations. Our work proved that the Au NRs have huge potential for plasmonic solar photothermal applications and are envisioned for novel plasmonic applications.

A five-year review comparing 30-day mortality following intramedullary nailing versus sliding hip screw for trochanteric hip fractures

INTRODUCTION

Recent literature suggests that fixation of trochanteric hip fractures with intramedullary nailing carries a higher 30-day mortality than with sliding hip screw. The present study aims to verify whether this statement is reflected in our practice.

PATIENTS AND METHODS

Sliding hip screw and intramedullary nail fixation of trochanteric hip fractures were analysed over a 5-year period, between April 2011 and March 2016. Three investigators independently analysed 919 patients. Data collected included 30-day mortality, OTA classification of hip fracture and ASA grading. Inclusion and exclusion criteria were applied.

RESULTS

493 patients (66%) underwent sliding hip screw while 252 patients (34%) underwent intramedullary femoral nailing. AO/OTA classification was strongly associated with treatment group. It was found that 30-day mortality rate was 4.8% following intramedullary nailing compared to 6.1% with sliding hip screw. Multivariate logistic regression analysis found ASA grade, male gender and age to be associated with increased 30-day mortality with statistical significance. There was no statistically significant association between treatment group and 30-day mortality, nor between ASA grade and treatment group.

CONCLUSIONS

Both the lower 30-day mortality rate of 4.8% with intramedullary nailing and the higher rate of 6.1% with sliding hip screw fixation compare favourably with the mean 7.9% National 30-day mortality rate following hip fractures. The lower 30-day mortality in the intramedullary nailing group was not attributable to lower ASA grading nor due to simpler fracture configuration. ASA grade, male gender and age were shown to be statistically associated with increased 30-day mortality.

IMPLICATIONS

Previous studies may have deterred surgeons from choosing an intramedullary device. However, we hope this study assists surgeons to make an informed decision on the choice of implant particularly when an intramedullary device is required to provide a more stable construct.

Clinical Experience and Management Strategy of Retroperitoneal Tumor With Venous Tumor Thrombus Involvement

Background

This study aims to report the surgical management, complications, and outcomes for patients with retroperitoneal tumor and venous thrombus.

Methods

We retrospectively analyzed 19 cases of retroperitoneal tumor with venous tumor thrombus from August 2015 to March 2021. A new tumor thrombus PUTH-RT grading system was proposed on the basis of the characteristics of the surgical techniques.

Results

Two cases of PUTH-RT-1a, two cases of PUTH-RT-1b, six cases of PUTH-RT-2, six cases of PUTH-RT-3, and three cases of PUTH-RT-4 were included. Surgeries were successfully performed in all 19 patients. Among them, five cases (26.3%) were operated via a completely laparoscopic approach and 13 cases (68.4%) via an open approach. One case (5.3%) was converted from laparoscopic to open approach. Five cases (26.3%) experienced postoperative complications. All patients were followed for a median of 14 months. Cancer-associated death occurred in three cases. Distant metastases occurred in seven cases.

Conclusions

We propose a new tumor thrombus grading system based on the anatomical characteristics of retroperitoneal tumors with venous tumor thrombus. Retroperitoneal tumor resection and removal of venous tumor thrombi are safe and effective for the treatment of such diseases.

Robot-Assisted Laparoscopic IVC Treatment Strategy in Retroperitoneal Tumors

Objectives

To show the practice of robot-assisted laparoscopic inferior vena cava (IVC) treatment strategies in patients with retroperitoneal tumors.

Patients and Methods

From October 2020 to July 2021, 17 patients with retroperitoneal tumors successfully underwent robot-assisted laparoscopic tumor resection with IVC management. The patient details, tumor characteristics, intraoperative data, pathological features and severe complications were assessed. The IVC treatment strategies were divided into 4 ways: ①local resection and primary repair of the IVC; ②IVC ligation; ③ IVC reconstruction by bovine pericardial grafts; and ④ IVC transection and anastomosis.

Results

In terms of IVC management, 5 cases had conventional total occlusion of the IVC and its branches, 3 cases had delayed occlusion of the proximal IVC technique, 2 cases had IVC resection by Satinsky clamp, 5 cases had IVC ligation, 1 case had IVC reconstruction by bovine pericardial grafts and 1 case had IVC transection and anastomosis. The median operation time was 151 min, and blood loss was 500 ml. There was no severe complication perioperatively. The follow-up time of 17 patients was 8 to 17 months (median: 12 months). No local recurrence or overall death was found during follow-up.

Conclusions

These robot-assisted laparoscopic IVC treatment strategies were considered to be safe and feasible in experienced centers, as well as helpful to completely remove the tumor for better oncological prognosis and restore the blood reflux of IVC as much as possible to ensure fewer postoperative complications.

Clinicopathological Features of Papillary Renal Cell Carcinoma With Venous Tumor Thrombus: Case Series from a Large Chinese Center

Background:

Few studies have reported the influence of the histological classification of type-2 papillary renal cell carcinoma (PRCC), which may differ from that of clear cell renal carcinoma (ccRCC), on the prognosis of renal cell carcinoma with tumor thrombus. We investigated the clinicopathological features and prognosis of type-2 PRCC associated with venous tumor thrombi (PRCC-TT).

Methods:

We retrospectively analyzed 163 patients with renal cell carcinoma with venous tumor thrombus (RCC-TT) admitted to Peking University Third Hospital between June 2016 and June 2020. Twenty-five patients had type-2 PRCC-TT and 138 had ccRCC combined with tumor thrombus; there were 125 males and 38 females. All the included patients underwent radical nephrectomy and thrombectomy under either complete laparoscopic surgery or open surgery. Univariate and multivariate Cox regression analysis were performed to evaluate the prognostic significance of each variable on cancer-specific survival (CSS). Cancer-specific survival was calculated from the date of surgery to death or the last follow-up using the Kaplan–Meier method.

Results:

The blood vessels of type-2 PRCC-TT presented on CT images were not as abundant as those of ccRCC-TT. Slight enhancement was observed in the corticomedullary phase. While wash-out symptoms were observed, contrast agent extinction was not obvious in the nephrographic and excretory phases. We compared the macroscopic and microscopic appearances of the 2 cohorts. Compared to the ccRCC-TT cohort, lymph node invasion was more prevalent in the PRCC-TT cohort (88.0% vs. 60.9%, P = .009). Multivariate analysis revealed that sarcomatoid differentiation, distant metastasis, and pathological type were the independent predictors of poor CSS. The Kaplan–Meier analysis showed that the CSS of type-2 PRCC-TT and ccRCC-TT were 23.5 and 38.4 months, respectively, with statistical significance (P = .002).

Conclusion:

Type-2 PRCC-TT varies with common ccRCC-TT in imaging manifestation and pathological characteristics. The prognosis of type-2 PRCC-TT patients was worse than that of ccRCC-TT patients.

Nomogram for predicting survival of renal cell carcinoma with tumor thrombus based on perioperative clinicopathological factors from a Chinese high-volume center

OBJECTIVES

To investigate perioperative clinicopathological predictors and establish a predictive nomogram for survival in patients with renal cell carcinoma and venous tumor thrombus undergoing nephrectomy and thrombectomy.

METHODS

Patients with renal cell carcinoma and venous tumor thrombus undergoing nephrectomy and thrombectomy were included in the study between January 2014 and June 2020. Cox regression analysis was used for univariate and multivariate survival analyses. A predictive nomogram for survival was established and internally validated using bootstrap resampling method.

RESULTS

A total of 228 patients were enrolled in this study. The median age was 60 years (interquartile range 53-66 years), consisting of 174 (76.3%) males and 54 (23.7%) females. The median follow-up time was 17.5 months (range 1-74 months), 26.8% (61 of 228) patients died of all causes. In multivariable analysis, hemoglobin less than the lower limit of normal (hazard ratio 1.73; 95% confidence interval 1.01-2.96; P = 0.045), sarcomatoid feature (hazard ratio 3.67; 95% confidence interval 1.97-6.82; P < 0.001), perirenal fat invasion (hazard ratio 1.80; 95% confidence interval 1.05-3.09; P = 0.033), histological subtype (hazard ratio 2.74; 95% confidence interval 1.39-5.41; P = 0.004), and metastasis at surgery (hazard ratio 1.71; 95% confidence interval 1.01-2.90; P = 0.047) were independently associated with overall survival. The result of internal validation presented that the predictive performance of the nomogram for survival measured by C-index was 0.77.

CONCLUSIONS

We developed a predictive nomogram with well-internal validation for survival in patients with renal cell carcinoma and venous tumor thrombus, which can greatly promote risk stratification and treatment planning.

Identification of KIF23 as a Prognostic Biomarker Associated With Progression of Clear Cell Renal Cell Carcinoma

About 3% of adult cancers are caused by renal cell carcinoma (RCC) and its pathogenesis remains elusive. Among RCC, clear cell renal cell carcinoma (ccRCC) is the predominant histological subtype. Resistance to conventional treatments leaves few treatment options for advanced ccRCC. Although the transcriptome profile of primary ccRCC has been comprehensively summarized, the transcriptome profile of metastatic ccRCC is still lacking. In this study we identified a list of metastasis-related genes and constructing a metastasis-associated prognostic gene signature. By analyzing data from GSE85258 and GSE105288 datasets, 74 genes were identified as metastasis-related genes. To construct prognostic features, we downloaded the expression data of ccRCC from the Cancer Genome Atlas (TCGA). Metastasis-associated genes were initially selected through the LASSO Cox regression analysis and 12 metastasis-related were included to construct prognostic model. Transcriptome profile, patient prognosis, and immune cell infiltration characteristics differed between low- and high-risk groups after grouping according to median risk score. Through explored the functions of differentially expressed genes (DEGs) between the two groups. Kinesin family member 23 (KIF23) was identified as a prognostic marker in ccRCC patients. Furthermore, inhibition of KIF23 expression reduced the proliferation, migration and invasion of ccRCC cells. We further demonstrated that KIF23 promote nuclear translocation of β-catenin in ccRCC cells, which provides novel insight into the functions and molecular machinery of KIF23 in ccRCC.

Plasmonic CuxS Nanocages for Enhanced Solar Photothermal Cell Warming

Highly efficient plasmonic photothermal nanomaterials are benefitial to the successful resuscitation of cells. Copper sulfide (Cu_xS) is a type of plasmonic solar photothermal semiconductor material that expands the light collecting range by altering its localized surface plasmonic resonance (LSPR) to the near- to mid-infrared (IR) spectral region. Particularly, nanocages (or nanoshells) have hybridized plasmon resonances as the result of superpositioned nanospheres and nanocavities, which extend their receiving range for the solar spectrum and increase light-to-heat conversion rate. In this work, for the first time, we applied colloidal hollow Cu_xS nanocages to revive cryopreserved HeLa cells via photothermal warming, which showed improved cell warming rate and cell viability after cell resuscitation. Moreover, we tested the photothermal performance of Cu_xS nanocages with concentrated light illumination, which exhibited extraordinary photothermal performance due to localized and enhanced illumination. We further quantified each band's contribution during the cell warming process via evaluating the warming rate of cryopreserved cell solution with illumination by monochromatic UV, visible, and NIR lasers. We studied the biosafety and toxicity of Cu_xS nanocages by analyzing the generated copper ion residue during cell warming and cell incubation, respectively. Our study shows that Cu_xS nanocages have huge potential for cell warming and are promising for vast range of applications, such as nanomedicine, life science, biology, energy saving, etc.