Three-dimensional pseudo-continuous arterial spin-labelled perfusion imaging for diagnosing upper cervical lymph node metastasis in patients with nasopharyngeal carcinoma: a whole-node histogram analysis

AIM

To evaluate whole-node histogram parameters of blood flow (BF) maps derived from three-dimensional pseudo-continuous arterial spin-labelled (3D pCASL) imaging in discriminating metastatic from benign upper cervical lymph nodes (UCLNs) for nasopharyngeal carcinoma (NPC) patients.

MATERIALS AND METHODS

Eighty NPC patients with a total of 170 histologically confirmed UCLNs (67 benign and 103 metastatic) were included retrospectively. Pre-treatment 3D pCASL imaging was performed and whole-node histogram analysis was then applied. Histogram parameters and morphological features, such as minimum axis diameter (MinAD), maximum axis diameter (MaxAD), and location of UCLNs, were assessed and compared between benign and metastatic lesions. Predictors were identified and further applied to establish a combined model by multivariate logistic regression in predicting the probability of metastatic UCLNs. Receiver operating characteristic (ROC) curves were used to analyse the diagnostic performance.

RESULTS

Metastatic UCLNs had larger MinAD and MinAD/MaxAD ratio, greater energy and entropy values, and higher incidence of level II (upper jugular group), but lower BF10th value than benign nodes (all p<0.05). MinAD, BF10th, energy, and entropy were validated as independent predictors in diagnosing metastatic UCLNs. The combined model yielded an area under the curve (AUC) of 0.932, accuracy of 84.42 %, sensitivity of 80.6 %, and specificity of 90.29 %.

CONCLUSIONS

Whole-node histogram analysis on BF maps is a feasible tool to differentiate metastatic from benign UCLNs in NPC patients, and the combined model can further improve the diagnostic efficacy.

Bright white light emission from lanthanide oxide LaGdO3 for LED lighting by Bi3+ to Eu3+ energy transfer

Phosphors with intrinsic white light emission are of great potential in constructing high-quality white LEDs (WLEDs). In this work, we propose the use of energy transfer from Bi3+ to Eu3+ ions for white light emission. A unique Bi3+-activated phosphor LaGdO3 (LGO):Bi3+ was generated using the conventional high-temperature solid-state process. An energy transfer was established by introducing Eu3+ into the phosphor composition. The emission colour of LGO:Bi3+,Eu3+ phosphors changes from cyan to white to orange-red depending on the Bi3+/Eu3+ doping proportion. The energy transfer between the Bi3+ and Eu3+ ions results from the dipole-dipole interaction. The LGO:Bi3+,Eu3+ phosphors were combined with a near-ultraviolet chip to successfully create a single-component WLED device with a colour-rendering index of 92.4. Our work demonstrates the energy transfer as a route for single-component white light emission and makes LGO:Bi3+,Eu3+ phosphors one of the candidate materials for near-ultraviolet lighting.

MEMS Resonant Beam with Outstanding Uniformity of Sensitivity and Temperature Distribution for Accurate Gas Sensing and On-Chip TGA

Micromechanical resonators have aroused growing interest as biological and chemical sensors, and microcantilever beams are the main research focus. Recently, a resonant microcantilever with an integrated heater has been applied in on-chip thermogravimetric analysis (TGA). However, there is a strong relationship between the mass sensitivity of a resonant microcantilever and the location of adsorbed masses. Different sampling positions will cause sensitivity differences, which will result in an inaccurate calculation of mass change. Herein, an integrated H-shaped resonant beam with uniform mass sensitivity and temperature distribution is proposed and developed to improve the accuracy of bio/chemical sensing and TGA applications. Experiments verified that the presented resonant beam possesses much better uniformity of sensitivity and temperature distribution compared with resonant microcantilevers. Gas-sensing and TGA experiments utilizing the integrated resonant beam were also carried out and exhibited good measurement accuracy.

MiR-186-5p prevents hepatocellular carcinoma progression by targeting methyltransferase-like 3 that regulates m6A-mediated stabilization of follistatin-like 5

Background

Hepatocellular carcinoma (HCC) is a multistep process involving sophisticated genetic, epigenetic, and transcriptional changes. However, studies on microRNA (miRNA)'s regulatory effects of N6-methyladenosine (m6A) modifications on HCC progression are limited.

Methods

Cell Counting Kit-8 (CCK-8), clone formation, and Transwell assays were used to investigate changes in cancer cell proliferation, invasion, and migration. RNA m6A levels were verified using methylated RNA immunoprecipitation. Luciferase reporter assay was used to study the potential binding between miRNAs and mRNA. A mouse tumor transplant model was established to study the changes in tumor progression.

Results

Follistatin-like 5 (FSTL5) was significantly downregulated in HCC and inhibited its further progression. Additionally, methyltransferase-like 3 (METTL3) reduced FSTL5 mRNA stability in an m6A-YTH domain family 2(YTHDF2)-dependent manner. Functional experiments revealed that METTL3 downregulation inhibited HCC progression by upregulating FSTL5 in vitro and in vivo. Luciferase reporter assay verified that miR-186-5p directly targets METTL3. Additionally, miR-186-5p inhibits the proliferation, migration, and invasion of HCC cells by downregulating METTL3 expression.

Conclusions

The miR-186-5p/METTL3/YTHDF2/FSTL5 axis may offer new directions for targeted HCC therapy.

Differentiation of testicular seminomas from nonseminomas based on multiphase CT radiomics combined with machine learning: A multicenter study

BACKGROUND

Differentiating seminomas from nonseminomas is crucial for formulating optimal treatment strategies for testicular germ cell tumors (TGCTs). Therefore, our study aimed to develop and validate a clinical-radiomics model for this purpose.

METHODS

In this study, 221 patients with TGCTs confirmed by pathology from four hospitals were enrolled and classified into training (n = 126), internal validation (n = 55) and external test (n = 40) cohorts. Radiomics features were extracted from the CT images. After feature selection, we constructed a clinical model, radiomics models and clinical-radiomics model with different machine learning algorithms. The top-performing model was chosen utilizing receiver operating characteristic (ROC) curve analysis. Decision curve analysis (DCA) was also conducted to assess its practical utility.

RESULTS

Compared with those of the clinical and radiomics models, the clinical-radiomics model demonstrated the highest discriminatory ability, with AUCs of 0.918 (95 % CI: 0.870 - 0.966), 0.909 (95 % CI: 0.829 - 0.988) and 0.839 (95 % CI: 0.709 - 0.968) in the training, validation and test cohorts, respectively. Moreover, DCA confirmed that the combined model had a greater net benefit in predicting seminomas and nonseminomas.

CONCLUSION

The clinical-radiomics model serves as a potential tool for noninvasive differentiation between testicular seminomas and nonseminomas, offering valuable guidance for clinical treatment.

The prevalence and clinical correlates of suicide attempts in patients with bipolar disorder misdiagnosed with major depressive disorder: Results from a national survey in China

BACKGROUND AND AIM

Suicide is nearly always associated with underlying mental disorders. Risk factors for suicide attempts (SAs) in patients with bipolar disorder (BD) misdiagnosed with major depressive disorder (MDD) remain unelucidated. This study was to evaluate the prevalence and clinical risk factors of SAs in Chinese patients with BD misdiagnosed with MDD.

METHODS

A total of 1487 patients with MDD from 13 mental health institutions in China were enrolled. Mini International Neuropsychiatric Interview (MINI) was used to identify patients with BD who are misdiagnosed as MDD. The general sociodemographic and clinical data of the patients were collected and MINI suicide module was used to identify patients with SAs in these misdiagnosed patients.

RESULTS

In China, 20.6% of patients with BD were incorrectly diagnosed as having MDD. Among these misdiagnosed patients, 26.5% had attempted suicide. These patients tended to be older, had a higher number of hospitalizations, and were more likely to experience frequent and seasonal depressive episodes with atypical features, psychotic symptoms, and suicidal thoughts. Frequent depressive episodes and suicidal thoughts during depression were identified as independent risk factors for SAs. Additionally, significant sociodemographic and clinical differences were found between individuals misdiagnosed with MDD in BD and patients with MDD who have attempted suicide.

CONCLUSIONS

This study highlights the importance of accurate diagnosis in individuals with BD and provide valuable insights for the targeted identification and intervention of individuals with BD misdiagnosed as having MDD and those with genuine MDD, particularly in relation to suicidal behavior.

Structural and functional changes following brain surgery in pediatric patients with intracranial space-occupying lesions

We explored the structural and functional changes of the healthy hemisphere of the brain after surgery in children with intracranial space-occupying lesions. We enrolled 32 patients with unilateral intracranial space-occupying lesions for brain imaging and cognitive assessment. Voxel-based morphometry and surface-based morphometry analyses were used to investigate the structural images of the healthy hemisphere. Functional images were analyzed using regional homogeneity, amplitude of low-frequency fluctuations, and fractional-amplitude of low-frequency fluctuations. Voxel-based morphometry and surface-based morphometry analysis used the statistical model built into the CAT 12 toolbox. Paired t-tests were used for functional image and cognitive test scores. For structural image analysis, we used family-wise error correction of peak level (p < 0.05), and for functional image analysis, we use Gaussian random-field theory correction (voxel p < 0.001, cluster p < 0.05). We found an increase in gray matter volume in the healthy hemisphere within six months postoperatively, mainly in the frontal lobe. Regional homogeneity and fractional-amplitude of low-frequency fluctuations also showed greater functional activity in the frontal lobe. The results of cognitive tests showed that psychomotor speed and motor speed decreased significantly after surgery, and reasoning increased significantly after surgery. We concluded that in children with intracranial space-occupying lesions, the healthy hemisphere exhibits compensatory structural and functional effects within six months after surgery. This effect occurs mainly in the frontal lobe and is responsible for some higher cognitive compensation. This may provide some guidance for the rehabilitation of children after brain surgery.

Geochemical properties, heavy metals and soil microbial community during revegetation process in a production Pb-Zn tailings

Lead-zinc (Pb-Zn) tailings pose a significant environmental threat from heavy metals (HMs) contamination. Revegetation is considered as a green path for HM remediation. However, the interplay between HM transport processes and soil microbial community in Pb-Zn tailings (especially those in production) remain unclear. This study investigated the spatial distribution of HMs as well as the crucial roles of the soil microbial community (i.e., structure, richness, and diversity) during a three-year revegetation of production Pb-Zn tailings in northern Guangdong province, China. Prolonged tailings stockpiling exacerbated Pb contamination, elevating concentrations (from 10.11 to 11.53 g/kg) in long-term weathering. However, revegetation effectively alleviated Pb, reducing its concentrations of 9.81 g/kg. Through 16 S rRNA gene amplicon sequencing, the dominant genera shifted from Weissella (44%) to Thiobacillus (17%) and then to Pseudomonas (comprising 44% of the sequences) during the revegetation process. The structural equation model suggested that Pseudomonas, with its potential to transform bioavailable Pb into a more stable form, emerged as a potential Pb remediator. This study provides essential evidence of HMs contamination and microbial community dynamics during Pb-Zn tailings revegetation, contributing to the development of sustainable microbial technologies for tailings management.

Remote Control and Noninvasive Detection Enabled by a High-performance NIR pc-LED

In an increasing manner, near-infrared phosphor-converted light-emitting diodes (NIR pc-LEDs) are considered to be exemplary light sources owing to their notable attributes of elevated output power, economical nature, and exceptional portability. NIR phosphors are critical components of NIR pc-LEDs. Herein, we report a novel blue light excitable NIR phosphor CaLu2ZrScAl3O12:Cr3+ (CLZSA:Cr3+) as a crucial and efficient broadband NIR emitter. The CLZSA:Cr3+ phosphor displays an intense NIR broadband emission peaking at 776 nm and with a full width at half-maximum (fwhm) of 140 nm. The designed material also exhibits superior resistance to thermal quenching, as the intensity of emission at 423 K remains at 80% of that at room temperature. The constructed NIR pc-LED device based on CLZSA:Cr3+ demonstrates a high total output power of 68.4 mW at a drive current of 100 mA, along with a high photoelectric conversion efficiency of 23.0%. Impressively, the high-power NIR pc-LEDs are utilized as light sources for remote control and non-invasive detection, resulting in the excellent performance and remarkable achievement.

Ultrasound-based deep learning radiomics nomogram for risk stratification of testicular masses: a two-center study

OBJECTIVE

To develop an ultrasound-driven clinical deep learning radiomics (CDLR) model for stratifying the risk of testicular masses, aiming to guide individualized treatment and minimize unnecessary procedures.

METHODS

We retrospectively analyzed 275 patients with confirmed testicular lesions (January 2018 to April 2023) from two hospitals, split into training (158 cases), validation (68 cases), and external test cohorts (49 cases). Radiomics and deep learning (DL) features were extracted from preoperative ultrasound images. Following feature selection, we utilized logistic regression (LR) to establish a deep learning radiomics (DLR) model and subsequently derived its signature. Clinical data underwent univariate and multivariate LR analyses, forming the "clinic signature." By integrating the DLR and clinic signatures using multivariable LR, we formulated the CDLR nomogram for testicular mass risk stratification. The model's efficacy was gauged using the area under the receiver operating characteristic curve (AUC), while its clinical utility was appraised with decision curve analysis(DCA). Additionally, we compared these models with two radiologists' assessments (5-8 years of practice).

RESULTS

The CDLR nomogram showcased exceptional precision in distinguishing testicular tumors from non-tumorous lesions, registering AUCs of 0.909 (internal validation) and 0.835 (external validation). It also excelled in discerning malignant from benign testicular masses, posting AUCs of 0.851 (internal validation) and 0.834 (external validation). Notably, CDLR surpassed the clinical model, standalone DLR, and the evaluations of the two radiologists.

CONCLUSION

The CDLR nomogram offers a reliable tool for differentiating risks associated with testicular masses. It augments radiological diagnoses, facilitates personalized treatment approaches, and curtails unwarranted medical procedures.

Trajectories of social function in patients with first-episode schizophrenia: Analysis of data from a 10-year follow-up study

BACKGROUND

Patients with schizophrenia may have diverse functional outcomes. However, the long-term functional trajectories of patients with first-episode schizophrenia (FES) are unclear.

METHODS

We extracted data from the Chinese First-Episode Schizophrenia Trial, a 10-year prospective study of antipsychotic-naïve patients with FES. We applied K means cluster modelling to longitudinal data on the social function of patients with FES and examined associations of the empirically derived trajectories with baseline clinical characteristics of the 10-year follow-up.

OUTCOMES

Three distinct functional trajectories emerged: improving-favorable (39·3%), improving-poor (17·8%) and improving-stable (42·9%). All three trajectories demonstrated Personal and Social Performance (PSP) score improvement in the first six months. The improving-poor trajectory demonstrated PSP score decline during the second six months and thereafter, while PSP scores in the other two trajectories were mainly stable during the same period. Patients in the improving-favorable trajectory had higher baseline PSP scores than those in the improving-poor trajectory (OR=0·904 [0·852, 0·961], p < 0·05) and the improving-stable trajectory (OR=0·870 [0·825, 0·918], p < 0·001) and were more likely to be female than those in the improving-stable trajectory (OR=2·699 [1·030, 7·074], p < 0·05).

CONCLUSIONS

Patients with FES demonstrated varied long-term functional recovery profiles. The first year, especially the second half of the first year, is a key period for social function interventions that improve long-term functional outcomes. Male patients and patients with poor baseline function may particularly benefit from such interventions.

Adsorption of Polyetheramine-230 on Expansive Clay and Structure Properties Investigation

Polyetheramine (PEA) is a swelling inhibitor used to address engineering challenges arising from the interaction between montmorillonite (Mt) and water. This study comprehensively investigates the adsorption characteristics of PEA on three representative expansive clay samples: Na-Mt, Ca-Mt, and engineered expansive soil. Additionally, the desorption of exchangeable ions is examined. The findings reveal that a two-stage adsorption kinetic model and a pseudo-second-order kinetic model can properly describe the adsorption kinetics of PEA on expansive clays. PEA exhibits a strong capacity for ion exchange with sodium ions, while the exchange capacity for calcium ions is limited. Both protonated and non-protonated PEA contribute to rapid adsorption processes. The adsorption isotherms are well-fitted by the Langmuir and Freundlich models, with the Langmuir model being reasonable. At lower equilibrium concentrations, a higher proportion of the adsorption amount is attributed to ion exchange compared to higher equilibrium concentrations. Ion exchange emerges as the primary factor contributing to the adsorption of PEA on Na-Mt, whereas the adsorption of PEA on Ca-Mt and expansive soil is primarily attributed to physical adsorption by non-protonated PEA. X-ray diffraction results reveal significant intercalation effects of PEA as they penetrate the interlayer space and hinder interlayer ion hydration. Fourier transform infrared spectrum results demonstrate that the adsorption of PEA minimally impacts the framework of Mt structural units but primarily reduces the adsorbed water content. Clay-PEA composites exhibit a decreased affinity for water. Zeta potential experiments indicate that the adsorption of PEA significantly diminishes the surface potential of clay-PEA composite particles, effectively inhibiting their hydration dispersion.

Early life gut microbiome in children following spontaneous preterm birth and maternal preeclampsia

The early life microbiome plays an important role in developmental and long-term health outcomes. However, it is unknown whether adverse pregnancy complications affect the offspring's gut microbiome postnatally and in early years. In a longitudinal cohort with a five-year follow-up of mother-child pairs affected by preeclampsia (PE) or spontaneous preterm birth (sPTB), we evaluated offspring gut alpha and beta diversity as well as taxa abundances considering factors like breastfeeding and mode of delivery. Our study highlights a trend where microbiome diversity exhibits comparable development across adverse and normal pregnancies. However, specific taxa at genus level emerge with distinctive abundances, showing enrichment and/or depletion over time in relation to PE or sPTB. These findings underscore the potential for certain adverse pregnancy complications to induce alterations in the offspring's microbiome over the course of early life. The implications of these findings on the immediate and long-term health of offspring should be investigated in future studies.

Energy transfer and tunable emission in BaSrGd4O8:Bi3+,Eu3+ phosphors for warm WLED

In this work, a series of BaSrGd4O8:xBi3+ blue phosphors was synthesized employing the high-temperature solid-state method. Phase purity of the samples was verified by X-ray diffraction and Rietveld refinement. Time-resolved photoluminescence spectra revealed the existence of two distinct Bi sites. Subsequent optimization of dopant types and doping levels in the batch led to an almost twofold increase in quantum efficiency. The introduction of Eu3+ into the phosphors facilitated the construction of an energy transfer pathway. As the concentration of Eu3+ was increased, the emission color changed from blue to purple and finally to red. In addition, the thermal stability and potential applications of the phosphors were extensively investigated. Finally, two WLED devices were successfully fabricated with color rendering indices of 96.27 and 92.18, and correlated color temperatures of 5198 and 2475 K. This underscores the prospective application of these phosphors in the field of high-quality warm WLEDs.

A critical review on the migration and transformation processes of heavy metal contamination in lead-zinc tailings of China

The health risks of lead-zinc (Pb-Zn) tailings from heavy metal (HMs) contamination have been gaining increasing public concern. The dispersal of HMs from tailings poses a substantial threat to ecosystems. Therefore, studying the mechanisms of migration and transformation of HMs in Pb-Zn tailings has significant ecological and environmental significance. Initially, this study encapsulated the distribution and contamination status of Pb-Zn tailings in China. Subsequently, we comprehensively scrutinized the mechanisms governing the migration and transformation of HMs in the Pb-Zn tailings from a geochemical perspective. This examination reveals the intricate interplay between various biotic and abiotic constituents, including environmental factors (EFs), characteristic minerals, organic flotation reagents (OFRs), and microorganisms within Pb-Zn tailings interact through a series of physical, chemical, and biological processes, leading to the formation of complexes, chelates, and aggregates involving HMs and OFRs. These interactions ultimately influence the migration and transformation of HMs. Finally, we provide an overview of contaminant migration prediction and ecological remediation in Pb-Zn tailings. In this systematic review, we identify several forthcoming research imperatives and methodologies. Specifically, understanding the dynamic mechanisms underlying the migration and transformation of HMs is challenging. These challenges encompass an exploration of the weathering processes of characteristic minerals and their interactions with HMs, the complex interplay between HMs and OFRs in Pb-Zn tailings, the effects of microbial community succession during the storage and remediation of Pb-Zn tailings, and the importance of utilizing process-based models in predicting the fate of HMs, and the potential for microbial remediation of tailings.

Crystal Field Engineering Yields New 3D Layered Solid Solution Phosphors (Ca/Sr)4MgAl2Si3O14:Eu2+ for White-Light-Emitting Diode Full-Spectrum Lighting

The cation-equivalent substitution strategy has the ability to manipulate the luminescence color of phosphors and enhance their overall luminescence performance. A series of novel yellow feldspar-type 3D layered phosphors (Ca1-ySry)4MgAl2Si3O14:xEu2+ were synthesized using a high-temperature solid-state reaction. The solid solution phosphors belong to a tetragonal crystal system with a space group of P4̅21m and cell parameters of a = b = 7.75407-7.91794 Å, c = 5.04299-5.22543 Å, and V = 303.166-327.602 Å3. Under near-ultraviolet (n-UV) excitation, the luminescence color of the phosphor undergoes modulation from yellow-green (530 nm) to blue (467 nm) as the Sr2+ ion substitution ratio increases. This modulation is attributed to the gradual decrease in crystal field splitting energy. Additionally, both the Stokes shift and the full width of the luminescence spectra decrease. Furthermore, there is an increase in the quantum yield (QY) from 45.50 to 60.73%. Finally, the fabricated white-light-emitting diode devices emitted warm white light and achieved high Ra (Ra = 94, 96.6, 92.7) and low correlated color temperature (CCT = 3486, 3430, 3788 K), indicating that the prepared solid solution phosphors can be used as candidate materials for WLED lighting.

Evolution characteristics of micromechanics provides insights into the microstructure of pharmaceutical tablets fabricated by bimodal mixtures

This research focuses on the evolution of mechanical behavior of bimodal mixtures undergoing compaction and diametrical compression. The clusters were built and discrete element method (DEM) was used to investigate the densification process and micromechanics of bimodal mixtures. Additionally, a more comprehensive investigate of the respective breakage of the bimodal mixtures has been carried out. On this basis, qualitative and quantitative analysis of the compressive force, force chain, contact bonds and density field evolution characteristics of the clusters are investigated during the compression process. The entire loading process of the clusters is divided into three stages: rearrangement, breakage and elastic-plastic deformation. Additionally, there are differences in the evolution of micromechanics behavior of different particles in the bimodal mixture, with pregelatinized starch breakage and deformation occurring before microcrystalline cellulose. With the tablet deformation, the fragmentation process of the tablet started at the point of contact and extended toward the center, and the curvature of the force chain increased. This approach may potentially hold a valuable new information relevant to important transformation forms batch manufacturing to advanced manufacturing for the oral solid dosage form.

Cardiovascular variations in patients with major depressive disorder versus bipolar disorder

BACKGROUND

Differentiating depression in major depressive disorder and bipolar disorder is challenging in clinical practice. Therefore, reliable biomarkers are urgently needed to differentiate between these diseases. This study's main objective was to assess whether cardiac autonomic function can distinguish patients with unipolar depression (UD), bipolar depression (BD), and bipolar mania (BM).

METHODS

We recruited 791 patients with mood disorders, including 191 with UD, 286 with BD, and 314 with BM, who had been drug free for at least 2 weeks. Cardiovascular status was measured using heart rate variability (HRV) and pulse wave velocity (PWV) indicators via finger photoplethysmography during a 5-min rest period.

RESULTS

Patients with BD showed lower HRV but higher heart rates than those with UD and BM. The PWV indicators were lower in the UD group than in the bipolar disorder group. The covariates of age, sex, and body mass index affected the cardiovascular characteristics. After adjusting for covariates, the HRV and PWV variations among the three groups remained significant. Comparisons between the UD and BD groups showed that the variable with the largest effect size was the frequency-domain indices of HRV, very low and high frequency, followed by heart rate. The area under the receiver operating characteristic curve (AUC) for each cardiovascular variable ranged from 0.661 to 0.714. The High-frequency index reached the highest AUC.

LIMITATIONS

Cross-sectional design and the magnitude of heterogeneity across participants with mood disorders limited our findings.

CONCLUSION

Patients with BD, but not BM, had a greater extent of cardiac imbalance than those with UD. Thus, HRV may serve as a psychophysiological biomarker for the differential diagnosis of UD and BD.

[Effect of recombinant human thrombin for hemostasis in liver resection: a randomized controlled phase Ⅲ clinical trial]

Objective: To evaluate the hemostatic efficacy, safety and immunogenicity of recombinant human thrombin in the treatment of liver wounds that still ooze after conventional surgical hemostasis. Methods: A multicenter, stratified randomized, double-blind, placebo-controlled phase Ⅲ trial with a planned enrollment of 510 subjects at 33 centers, with a 2∶1 randomization to the thrombin group versus the placebo group. An interim analysis will be conducted after approximately 70% of the subjects have completed the observation period. The primary efficacy endpoint was the rate of hemostasis within 6 minutes at the point of bleeding that could be evaluated. Safety analysis was performed one month after surgery, and the positive rates of anti-drug antibody (ADA) and neutralizing antibody were evaluated. Results: At the interim analysis, a total of 348 subjects had been randomized and received the study drug (215 were male and 133 were female). They were aged 19-69 (52.9±10.9)years. Among them, 232 were in the thrombin group and 116 were in the placebo group, with balanced and comparable demographics and baseline characteristics between the two groups. The hemostasis rate at 6 minutes was 71.6% (95%CI:65.75%-77.36%) in the thrombin group and 44.0% (95%CI: 34.93%-53.00%) in the placebo group, respectively (P<0.001). No grade≥3 drug-related adverse events and no drug-related deaths were reported from the study.No recombinant human thrombin-induced immunologically-enhanced ADA or immunologically-induced ADA was detected after topical use in subjects. Conclusion: Recombinant human thrombin has shown significant hemostatic efficacy and good safety in controlling bleeding during liver resection surgery, while also demonstrating low immunogenicity characteristics.

Does right hemisphere compensate for the left in school-age children with large left middle fossa arachnoid cysts?

BACKGROUND

To assess the cognitive function changes and brain network neuroplasticity in school-age children having large (diameter > 5 cm) left middle fossa arachnoid cyst (MFACs).

METHODS

Eleven patients and 22 normal controls (NC) between 6 and 14 years of age were included. The CNS Vital Signs (CNS VS) were administered for cognitive assessment. The differences of cognitive data and functional connectivity (FC) in resting-state functional magnetic resonance imaging (rs-fMRI) were compared between the patient group and the NC group. The correlations between the altered FC and cognitive data in the patient group were assessed.

RESULTS

Patient group had significantly poorer attention (including Complex Attention, Sustained Attention, Simple Attention, Cognitive Flexibility, and Executive Function) and memory function (Visual Memory and Working Memory) than the NC group (uncorrected p-value, p-unc < 0.05). Whole-brain local correlation (LCOR) analysis showed an extensively lower LCOR in the patient group (voxel threshold p-unc < 0.001, cluster-size threshold of false discovery rate adjusted p (p-FDR) < 0.001). Functional connectivity (FC) analysis showed that bilateral frontal and temporal lobes connectivity in the patient group was significantly lower than the NC group (p-FDR < 0.05). Seed-based FC analysis indicated that there was altered FC between the right temporal lobe and the left temporal-parietal/temporal-occipital area (p-FDR < 0.05). In the patient group, most of the altered FC had a negative correlation to the cognitive score, while the FC in the right temporal lobe-left temporal-occipital area positively correlated to Verbal/Visual Memory (r = 0.41-0.60, p-FDR < 0.05). In correlation analysis between clinical data and cognitive score, the only significant result was a low correlation between cyst size and Reaction Time (-0.30--0.36, P-FDR < 0.05).

CONCLUSIONS

School-aged children with large left MFAC showed significantly lower cognitive performance primarily in attention and memory domains. Distinct from neuroplasticity in a unilateral brain lesion, compensation in the healthy hemisphere in MFAC patients was sparse.

Integration of circulating microRNAs and transcriptome signatures identifies early-pregnancy biomarkers of preeclampsia

BACKGROUND

MicroRNAs (miRNAs) have been implicated in the pathobiology of preeclampsia, a common hypertensive disorder of pregnancy. In a nested matched case-control cohort within the Vitamin D Antenatal Asthma Reduction Trial (VDAART), we previously identified peripheral blood mRNA signatures related to preeclampsia and vitamin D status (≤30 ng/mL) during gestation from 10 to 18 weeks, using differential expression analysis.

METHODS

Using quantitative PCR arrays, we conducted profiling of circulating miRNAs at 10-18 weeks of gestation in the same VDAART cohort to identify differentially expressed (DE) miRNAs associated with preeclampsia and vitamin D status. For the validation of the expression of circulating miRNA signatures in the placenta, the HTR-8/SVneo trophoblast cell line was used. Targets of circulating miRNA signatures in the preeclampsia mRNA signatures were identified by consensus ranking of miRNA-target prediction scores from four sources. The connected component of target signatures was identified by mapping to the protein-protein interaction (PPI) network and hub targets were determined. As experimental validation, we examined the gene and protein expression of IGF1R, one of the key hub genes, as a target of the DE miRNA, miR-182-5p, in response to a miR-182-5p mimic in HTR-8/SVneo cells.

RESULTS

Pregnant women with preeclampsia had 16 circulating DE miRNAs relative to normal pregnancy controls that were also DE under vitamin D insufficiency (9/16 = 56% upregulated, FDR < .05). Thirteen miRNAs (13/16 = 81.3%) were detected in HTR-8/SVneo cells. Overall, 16 DE miRNAs had 122 targets, of which 87 were unique. Network analysis demonstrated that the 32 targets of DE miRNA signatures created a connected subnetwork in the preeclampsia module with CXCL8, CXCL10, CD274, MMP9 and IGF1R having the highest connectivity and centrality degree. In an in vitro validation experiment, the introduction of an hsa-miR-182-5p mimic resulted in significant reduction of its target IGF1R gene and protein expression within HTR-8/SVneo cells.

CONCLUSIONS

The integration of the circulating DE miRNA and mRNA signatures associated preeclampsia added additional insights into the subclinical molecular signature of preeclampsia. Our systems and network biology approach revealed several biological pathways, including IGF-1, that may play a role in the early pathophysiology of preeclampsia. These pathways and signatures also denote potential biomarkers for the early stages of preeclampsia and suggest possible preventive measures.

Balloon-occluded retrograde transvenous obliteration and simultaneous endoscopic cyanoacrylate injection for treating gastric varices draining through gastrorenal shunts

BACKGROUND AND STUDY AIMS

Balloon-occluded retrograde transvenous obliteration-assisted endoscopic cyanoacrylate injection (E-BRTO) temporarily treats gastric fundic varices draining through gastrorenal shunts (GRS) occluding the GRS with a balloon, then endoscopically injecting cyanoacrylate. We retrospectively examined the safety, feasibility, and efficacy of E-BRTO.

PATIENTS AND METHODS

We enrolled 85 patients with hepatic cirrhosis plus gastric fundic varices with GRS; 34 underwent E-BRTO. The 51 patients who refused all secondary prophylactic treatments served as controls.

RESULTS

Finally, 33 of the 34 patients underwent successful E-BRTO without major adverse events. Gastric varices were eradicated from all 33 patients in the E-BRTO group; the average follow-up time was 161.0 (74.0) weeks (mean [SD]). Four end-point events (12%) were recorded during the follow-up period. In the control group, 33 patients (65%) suffered repeat variceal bleeding, resulting in seven deaths. The cumulative rebleeding rates of the E-BRTO group on the 6th, 24th, 48th, 96th, 144th, 192nd, 240th, and 288th week were 0%, 3%, 9%, 9%, 13%, 13%, 13%, and 13%, while the cumulative rebleeding rates of the control group in the same period were 10%, 20%, 35%, 46%, 55%, 65%, 76%, and 76%.

CONCLUSIONS

E-BRTO was safe, feasible, and well tolerated by patients with hepatic cirrhosis plus gastric fundic varices with GRS. Over the long-term follow-up period, the E-BRTO group demonstrated a lower rate of repeat bleeding than the control group.

Use of Real-World Evidence in a Virtual Bridging Analysis for a Human Epidermal Growth Factor Receptor 2-Targeted Antibody-Drug Conjugate in Gastric Cancer

This study bridged pharmacokinetic, efficacy, and safety clinical trial data from Japan to a Western population using real-world evidence (RWE) to investigate the antibody-drug conjugate trastuzumab deruxtecan (T-DXd) in the treatment of human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer. Using population pharmacokinetic and exposure-response (efficacy/safety) models, exposure-efficacy data from 117 patients and exposure-safety data from 158 patients in Japan who received T-DXd 6.4 mg/kg as second-line or later treatment were bridged to RWE including covariate information from 25 Western patients with HER2-positive gastric cancer who received second-line or later T-DXd treatment. Pharmacokinetic simulations indicated that intact T-DXd and released drug (DXd) steady-state exposures were comparable between Western patients and patients from Japan; the Western/Japan ratio of exposure medians ranged from 0.82 (T-DXd steady-state minimum concentration) to 1.18 (DXd steady-state maximum concentration). Exposure-efficacy simulations estimated a confirmed objective response rate of 28.6% (90% confidence interval, 20.8-38.4) in real-world Western patients versus 40.1% (90% confidence interval, 33.5-47.0) in patients from Japan, possibly because of checkpoint inhibitor use in 4% versus 30% of patients, respectively. Western patients had a higher estimated rate of serious adverse events than patients from Japan (42.2% vs 34.6%); however, the rate of interstitial lung disease was lower (less than 10%) in Western patients. Overall, T-DXd was predicted to have meaningful clinical activity and a manageable safety profile in Western patients with HER2-positive gastric cancer. Using RWE, bridging analysis supported US approval of T-DXd 6.4 mg/kg in advanced gastric cancer before a clinical trial was completed in Western patients.

Penta-SiCN monolayer as a well-balanced performance anode material for Li-ion batteries

Lithium-ion batteries (LIBs) remain irreplaceable for clean energy storage applications. The intrinsic metallic nature of penta-SiCN ensures its promising application in the electrodes of LIBs. Using first-principles calculations, we evaluate the performance of the intrinsic metallic penta-SiCN monolayer as the anode material for LIBs. Penta-SiCN exhibits a low diffusion energy barrier (0.107 eV) for Li atom migration on Si18C18N18, while the diffusion energy barrier for vacancy migration on Li17Si18C18N18 is only 0.006 eV. Additionally, penta-SiCN possesses a high theoretical capacity of 1485.98 mA h g-1, average open-circuit voltage of 0.97 V, and small volume expansion of 1%. Remarkably, penta-SiCN exhibits robust wettability towards the electrolytes (solvent molecules and metal salts) widely used in commercial LIBs, indicating the excellent compatibility in electrode applications. These intriguing theoretical findings make penta-SiCN a high performance anode material for LIBs.

Continuous suture technique increases the complete closure rate of colorectal mucosal defects after endoscopic resection: a single-blind, randomized controlled trial

BACKGROUND

Complete closure of mucosal defects after colorectal endoscopic submucosal dissection (ESD)/piecemeal endoscopic mucosal resection (p-EMR) procedures reduces postoperative adverse events, but the complete closure rate of the traditional method using only hemostatic clips is not satisfactory. Therefore, we invented a continuous suture technique using a barbed suture and clips to increase the complete closure rate of colorectal mucosal defects.

METHODS

Patients with a single large (≥ 2 cm) colorectal lesion were recruited. After completion of the ESD/p-EMR procedures, they were randomly allocated to the treatment group or control group. The mucosal defects of the treatment group were closed using barbed suture and clips, while the control group was closed using only clips.

RESULTS

From January 18, 2022 to April 13, 2022, a total of 62 patients with colorectal lesions were enrolled, with 31 patients in each group. Complete closure was achieved in 29 patients (93.5%) in the treatment group and 18 patients (58.1%) in the control group (P = 0.001). The median closure time was 13 min in the treatment group and 19 min in the control group (P < 0.001). The median closure speed was 6.4 cm2/10 min in the treatment group and 3.5 cm2/10 min in the control group (P = 0.008).

CONCLUSIONS

This study provided a clinically feasible continuous suture technique that was safe and effective for the complete closure of colorectal mucosal defects after endoscopic resection.

Ultrasensitive Bio-H2S Gas Sensor Based on Cu2O-MWCNT Heterostructures

Developing a respiratory analysis disease diagnosis platform for the H2S biomarker has great significance for the real-time detection of various diseases. However, achieving highly sensitive and rapid detection of H2S gas at the parts per billion level at low temperatures is one of the most critical challenges for developing portable exhaled gas sensors. Herein, Cu2O-multiwalled carbon nanotube (MWCNT) heterostructures with excellent gas sensitivity to H2S at room temperature and a lower temperature were successfully synthesized by a facile two-dimensional (2D) electrodeposition in situ assembly method. The combination of Cu2O and MWCNTs via the principle of optimal conductance growth not only reduced the initial resistance of the material but also provided an ideal interfacial barrier structure. Compared to the response of the pure Cu2O sensor, that of the Cu2O-MWCNT sensor to 1 ppm of H2S increased nearly 800 times at room temperature, and the response time decreased by more than 500 s. In addition to the excellent sensitivity with detection limits as low as 1 ppb, the Cu2O-MWCNT sensor was extremely selective with low-temperature adaptability. The sensor had a response value of 80.6 to 0.1 ppm of H2S at -10 °C, which is difficult to achieve with sensors based on oxygen adsorption/desorption mechanisms. The sensor was used for the detection of real oral exhaled breath, confirming its feasibility as a real-time disease monitoring sensor. The Cu2O-MWCNT heterostructures maximized the advantages of the individual components and laid the experimental foundation for future applications of highly sensitive portable breath analysis platforms for monitoring H2S.

Measurement of the Positive Muon Anomalous Magnetic Moment to 0.20 ppm

We present a new measurement of the positive muon magnetic anomaly, a_{μ}≡(g_{μ}-2)/2, from the Fermilab Muon g-2 Experiment using data collected in 2019 and 2020. We have analyzed more than 4 times the number of positrons from muon decay than in our previous result from 2018 data. The systematic error is reduced by more than a factor of 2 due to better running conditions, a more stable beam, and improved knowledge of the magnetic field weighted by the muon distribution, ω[over ˜]_{p}^{'}, and of the anomalous precession frequency corrected for beam dynamics effects, ω_{a}. From the ratio ω_{a}/ω[over ˜]_{p}^{'}, together with precisely determined external parameters, we determine a_{μ}=116 592 057(25)×10^{-11} (0.21 ppm). Combining this result with our previous result from the 2018 data, we obtain a_{μ}(FNAL)=116 592 055(24)×10^{-11} (0.20 ppm). The new experimental world average is a_{μ}(exp)=116 592 059(22)×10^{-11} (0.19 ppm), which represents a factor of 2 improvement in precision.

Chinese herbal medicine combined with cognitive-behavioural therapy for avoidant paruresis: a controlled trial

Background

Avoidant paruresis is a common clinical condition in urology and psychosomatic medicine. However, it has limited treatment options that are safe and effective with few side effects.

Aims

Our study aimed to investigate the effectiveness and safety of the Chinese herbal Yangxin Tongquan decoction combined with cognitive-behavioural therapy (CBT) for avoidant paruresis.

Methods

Sixty-eight patients with avoidant paruresis were divided into a treatment group (33 patients) and a control group (35 patients). The control group was assigned 10 weeks of CBT and systematic desensitisation. In addition to CBT and systematic desensitisation, the treatment group was given the Chinese herbal Yangxin Tongquan decoction during the 10-week study. The Shy Bladder Syndrome Scale (SBS) and the Self-rating Anxiety Scale (SAS) were administered before and after treatment to measure any change.

Results

The overall efficacy in the treatment group (n=30) was 80.0% vs 62.5% in the control group (n=33). Comparing pretreatment and post-treatment measures, both groups showed improvement in SBS scores and SAS scores (treatment group: t(SBS) =8.397, p(SBS) <0.001, t(SAS) =8.216, p(SAS)<0.001; control group: t(SBS) =6.802, p(SBS) <0.001, t(SAS)=5.171, p(SAS) <0.001). Moreover, both groups' SBS and SAS scores changed significantly over time (SBS scores: Ftime =118.299, p<0.001; SAS scores: Ftime =92.114, p<0.001). However, the treatment group performed better than the control group (SBS scores: Ftime*group =5.709, p=0.020; SAS scores: Ftime*group =7.235, p=0.009).

Conclusions

The Chinese herbal Yangxin Tongquan decoction combined with cognitive-behavioural psychotherapy positively affects the treatment of avoidant paruresis without significant adverse effects.

USP1 promotes cholangiocarcinoma progression by deubiquitinating PARP1 to prevent its proteasomal degradation

Despite its involvement in various cancers, the function of the deubiquitinase USP1 (ubiquitin-specific protease 1) is unexplored in cholangiocarcinoma (CCA). In this study, we provide evidence that USP1 promotes CCA progression through the stabilization of Poly (ADP-ribose) polymerase 1 (PARP1), consistent with the observation that both USP1 and PARP1 are upregulated in human CCA. Proteomics and ubiquitylome analysis of USP1-overexpressing CCA cells nominated PARP1 as a top USP1 substrate. Indeed, their direct interaction was validated by a series of immunofluorescence, co-immunoprecipitation (CO-IP), and GST pull-down assays, and their interaction regions were identified using deletion mutants. Mechanistically, USP1 removes the ubiquitin chain at K197 of PARP1 to prevent its proteasomal degradation, with the consequent PARP1 stabilization being necessary and sufficient to promote the growth and metastasis of CCA in vitro and in vivo. Additionally, we identified the acetyltransferase GCN5 as acetylating USP1 at K130, enhancing the affinity between USP1 and PARP1 and further increasing PARP1 protein stabilization. Finally, both USP1 and PARP1 are significantly associated with poor survival in CCA patients. These findings describe PARP1 as a novel deubiquitination target of USP1 and a potential therapeutic target for CCA.

The Role of Radiation Therapy for Metastatic Cervical Cancer

PURPOSE/OBJECTIVE(S)

Survival rates for women with metastatic cervical cancer (CC) are low, with limited management options. Radiation therapy (RT) for metastatic disease has led to prolonged survival in other malignancies, however, the data are scarce in CC. Herein, we evaluated the effect of RT for metastatic CC.

MATERIALS/METHODS

A total of 58 patients with metastatic CC between September 2019 and January 2023 were retrospectively analyzed. All the patients were treated with platinum-based chemotherapy combined with targeted therapy or immunotherapy followed with or without RT (NRT). The recent efficacy, survival status and prognostic factors were analyzed statistically.

RESULTS

Objective response rate (ORR) was 63.6% with one complete and twenty partial responses in RT group (n = 33) and 40.0% with two complete and eight partial responses in NRT group (n = 25), respectively (p = 0.074). Disease control rate (DCR) of the RT and NRT groups were 79.4% vs 80.0%, respectively (p = 0.861). Median follow-up time was 17 months (3-39months). In RT group, 11(33.3%) patients experienced local regional or distant failure and 9 (27.3%) patients were dead. In NRT group, 15(60%) patients had progression and 8 (32%) patients dead. There was no significant difference between the two groups in overall survival (OS); however, RT group displayed superior progression-free survival (PFS) (1-year OS: 72.7% vs. 68.0%, p = 0.460; 1-year PFS: 66.7% vs. 40.0%, p = 0.039). The multivariate analysis showed that RT, immunotherapy, lymph node metastasis only relevant predictor of superior PFS but not OS. In subgroup analysis, patients treated with RT appeared to have a better PFS in some specific cohorts, such as age>45 years (72.0% vs 36.4% P = 0.015), squamous carcinoma histology (71.0% vs 40.9% P = 0.017), metastatic at diagnosis (75.0% vs 47.6% P = 0.012), non-targeted therapy (72.4% vs 43.8% P = 0.040). No significant increase in treatment-related toxicity was observed in the RT group compared with the NRT group.

CONCLUSION

RT provided superior PFS in metastatic CC patients compared to NRT, and well tolerated. Moreover, RT, immunotherapy, lymph node metastasis only were independent significant prognostic factors for PFS. Subgroup analysis showed that combination of RT and chemotherapy obtained favorable PFS in metastatic CC patients with age>45 years, squamous carcinoma histology, metastatic at diagnosis, non-targeted therapy. Studies with a larger sample size and longer follow-up are warranted.

Radiation Induced Lung Injury in Rats after Pre-Oxygenation Radiotherapy

PURPOSE/OBJECTIVE(S)

Deep inspiratory breath holding (DIBH) has been widely used during the radiotherapy of thoracic tumors. The main disadvantage of voluntary DIBH is the short duration of each breath hold. The hypocapnia induced by hyperoxia (oxygen concentration > 50%) pre-oxygenation (PreO2) combined with mechanical hyperventilation has been reported to prolong the duration of single breath hold, but its safety remains controversial, especially the sensitivity of lung tissue to radiation damage under hyperoxia exposure has not been elucidated. In this study, we aim to investigate the changes of radiation induced lung injury in rats after PreO2 radiation.

MATERIALS/METHODS

We evaluated the lung tissue of rats at different time points (48h, 2w, 4w, 8w, 12w) after thoracic radiation (15Gy single fraction to the right lung), and sequenced the transcriptome of lung tissue at 48 hours after irradiation. Rat cohorts (n = 7/group): 1. Control (Con); 2. Radiation group (RT); 3. Pre-oxygenation (oxygen concentration > 90%) for 8 hours before thoracic radiation (PreO2).

RESULTS

The inflammatory exudation emerged in the pulmonary interstitium at 48 hours, and reached the most serious alveolitis after four weeks of irradiation (the comparison of alveolitis scores in RT4w vs Con4w and PreO2(4w) vs Con4w, P<0.001) on hematoxylin-eosin staining. While the alveolitis scores in RT group and PreO2 group were not statistically different at each time point. Masson staining showed that the pulmonary fibrosis in the RT group and the PreO2 group reached an obvious pathological change at 12 weeks after irradiation, but the difference between the two groups was not significant. Transcriptome sequencing showed that the number of differential genes in PreO2 vs Con was 559 (302 up-regulated genes and 257 down-regulated genes). The GO enrichment analysis indicated that chromosome segregation was the most significant functional item with P value in the comparative analysis, and the KEGG enrichment analysis suggested that cell division was the most significant enrichment pathway of these differential genes. While there was a small quantity of differential genes in PreO2 vs RT group (3 up-regulated genes and 12 down-regulated genes). Pentose and glucuronate conversions were the most significant enrichment pathway of these differential genes.

CONCLUSION

This study demonstrated that PreO2 radiotherapy did not increase the severity of radiation induced lung injury in rats compared to conventional radiotherapy. Further study should be conducted to confirm these results and to investigate the regulatory mechanism of pneumonia caused by PreO2 radiotherapy.

Deep Learning-Based Multi-Modality Segmentation of Primary Gross Tumor Volume in CT and MRI for Nasopharyngeal Carcinoma

PURPOSE/OBJECTIVE(S)

The delineation of primary gross tumor volume (GTV) of nasopharyngeal carcinoma (NPC) is an essential step for radiotherapy planning. In clinical practice, radiation oncologists manually delineate the GTV in planning CT with the help of diagnostic MRI. This is because NPC tumors are closely adjacent to many important anatomic structures, and CT and MRI provide complementary strength to accurately determine the tumor extension boundary. Manual delineation is time-consuming with the potential registration errors between MRI and CT decreasing the delineation accuracy. In this study, we propose a fully automated GTV segmentation method based on CT and MRI by first aligning MRI to CT, and then, segmenting the GTV using a multi-modality deep learning model.

MATERIALS/METHODS

We collected 104 nasopharyngeal carcinoma patients with both planning CT and diagnostic MRI scans (T1 & T2 phases). An experienced radiation oncologists manually delineated the GTV, which was further examined by another senior radiation oncologist. Then, a coarse to fine cross-modality registration from MRI to CT was conducted as follows: (1) A rigid transformation was performed on MRI to roughly align MRI to CT with similar anatomic position. (2) Then, the region of interest (RoI) on both CT and rigid-transformed MRI were cropped. (3) A leading cross-modality deformable registration algorithm, named DEEDS, was applied on the cropped MRI and CT RoIs to find an accurate local alignment. Next, using CT and registered MRI as the combined input, a multi-modality deep segmentation network based on nnUNet was trained to generate the GTV prediction. 20% patients were randomly selected as the unseen testing set to quantitatively evaluate the performance.

RESULTS

The quantitative NPC GTV segmentation performance is summarized in Table 1. The deep segmentation model using CT alone achieved reasonable high performance with 76.6% Dice score and 1.34mm average surface distance (ASD). When both CT and registered MRI were used, the segmentation model further improved the performance by 0.9% Dice score increase and 11% relative ASD error reduction, demonstrating the complementary strength of CT and MRI in determining NPC GTV. Notably, the achieved 77.5% Dice score and 1.19mm ASD by the multimodality model is among the top performing results reported in recent automatic NPC GTV segmentation using either CT or MRI modality.

CONCLUSION

We developed a fully automated multi-modal deep-learning model for NPC GTV segmentation. The developed model can segment the NPC GTV in high accuracy. With further optimization and validation, this automated model has potential to standardize the NPC GTV segmentation and significantly decrease the workload of radiation oncologists in clinical practice.

HSDL2 knockdown promotes the progression of cholangiocarcinoma by inhibiting ferroptosis through the P53/SLC7A11 axis

BACKGROUND

Human hydroxysteroid dehydrogenase-like 2 (HSDL2), which regulates cancer progression, is involved in lipid metabolism. However, the role of HSDL2 in cholangiocarcinoma (CCA) and the mechanism by which it regulates CCA progression by modulating ferroptosis are unclear.

METHODS

HSDL2 expression levels in CCA cells and tissues were determined by quantitative real-time polymerase chain reaction (qRT-PCR), western blotting, and immunohistochemistry. The overall survival and disease-free survival of patients with high vs. low HSDL2 expression were evaluated using Kaplan-Meier curves. The proliferation, migration, and invasion of CCA cells were assessed using Cell Counting Kit-8, colony formation, 5-ethynyl-2'-deoxyuridine DNA synthesis, and transwell assays. The effect of p53 on tumor growth was explored using a xenograft mouse model. The expression of SLC7A11 in patients with CCA was analyzed using immunofluorescence. Ferroptosis levels were measured by flow cytometry, malondialdehyde assay, and glutathione assay. HSDL2-regulated signaling pathways were analyzed by transcriptome sequencing. The correlation between p53 and SLC7A11 was assessed using bioinformatics and luciferase reporter assays.

RESULTS

HSDL2 expression was lower in primary human CCA tissues than in matched adjacent non-tumorous bile duct tissues. HSDL2 downregulation was a significant risk factor for shorter overall survival and disease-free survival in patients with CCA. In addition, HSDL2 knockdown enhanced the proliferation, migration, and invasion of CCA cells. The transcriptome analysis of HSDL2 knockdown cells showed that differentially expressed genes were significantly enriched in the p53 signaling pathway, and HSDL2 downregulation increased SLC7A11 levels. These findings were consistent with the qRT-PCR and western blotting results. Other experiments showed that p53 expression modulated the effect of HSDL2 on CCA proliferation in vivo and in vitro and that p53 bound to the SLC7A11 promoter to inhibit ferroptosis.

CONCLUSIONS

HSDL2 knockdown promotes CCA progression by inhibiting ferroptosis through the p53/SLC7A11 axis. Thus, HSDL2 is a potential prognostic marker and therapeutic target for CCA.

An efficient blue-excitable broadband Y3ScAl4O12:Ce3+ garnet phosphor for WLEDs

Most commercial phosphor-converted white light-emitting diodes (pc-WLEDs) are manufactured with blue LED chips and yellow-emitting Y3Al5O12:Ce3+ (YAG:Ce3+) garnet phosphor, but the lack of blue-green light in the spectrum results in a low color rendering index (CRI). In this paper, we synthesized Y3ScAl4O12:Ce3+ (YSAG:Ce3+) by replacing Al3+ in YAG:Ce3+ with Sc3+. The introduction of Sc3+ with a larger ionic radius through a cation substitution strategy causes lattice expansion, elongation of the Y-O bond, and ultimately a decrease in Ce3+ 5d level crystal field splitting. As a consequence, the emission spectrum undergoes a blue-shift of 10 nm. Furthermore, the YSAG:Ce3+ phosphor exhibits good thermal stability, and its emission intensity at 423 K is about 58% of that at 303 K. Moreover, the analysis of Eu3+ emission spectra demonstrates that the introduction of Sc3+ resulted in a slight reduction of the dodecahedral lattice symmetry. YSAG:Ce3+ effectively compensates for the lack of the blue-green region, and WLEDs with high color rendering index (90.1), low color temperature (4566 K) and high luminous efficiency (133.59 lm W-1) were prepared using the combination of YSAG:0.08Ce3+, CaAlSiN3:Eu2+ and 450 nm blue chips. These findings indicate that YSAG:Ce3+ garnet phosphor has potential to be used in high quality WLEDs.

Heart rate variability in patients with psychiatric disorders from adolescence to adulthood

OBJECTIVE

Age is associated with changes in autonomic nervous system activity. These changes are assessed using heart rate variability(HRV) indicators; however, the effect of age on HRV in patients with psychiatric disorders remains unclear. Our study aimed to explore this effect and determine its variance across different lifespans.

METHOD

Consecutive patients(N = 3315), comprising 1833 patients with psychotic disorders, 1040 with mood disorders, and 442 with anxiety disorders, were recruited. The patients were divided into four age groups: adolescence(10-24 years), early adulthood(25-39 years), middle adulthood(40-59 years), and late adulthood(60+ years). HRV indicators were measured during a 5-min rest period.

RESULTS

The heart rate and HRV indices were higher in the adolescent and early adulthood groups than they were in the middle and late adulthood groups(increased HRV is beneficial for health, while reduced HRV is detrimental). Age and all the HRV indices were negatively correlated(r-values 0.153-0.350, p < 0.001), with these correlation patterns being more evident in the adolescent and early adulthood groups than in the middle and late adulthood groups. Stratified by sex, the low-frequency/high-frequency ratio was higher in men than in women across most age groups(p < 0.05), except the late adulthood group(p = 0.085). Stratified by diagnosis, most HRV variables(except very low-frequency) were lower in the psychotic disorder group than they were in the mood and anxiety disorder groups, especially in middle and late adulthood patients. After adjusting for confounders, the HRV variables were significantly associated with age, while older age was associated with lower HRV.

CONCLUSIONS

These results indicate that the substantial reduction in HRV with age in patients with psychiatric disorders. The association remains significant after correction for sex, heart rate, and diagnoses; this may prove useful to clinical practice and further research.

Psychiatric emergency department visits during the coronavirus disease-2019 pandemic

Background

Previous research has demonstrated the negative impact of the coronavirus disease-2019 (COVID-19) pandemic on mental health.

Aims

To examine changes in the Chinese psychiatric emergency department (PED) visits for mental health crises that occurred during the pandemic.

Methods

Before and during the COVID-19 pandemic, PED visit counts from the largest psychiatric hospital in China between 2018 and 2020 were investigated. Electronic medical records of 2020 PED visits were extracted during the COVID-19 pandemic period and compared for the same period of 2018 and 2019.

Results

Overall, PED visits per year increased from 1,767 in 2018 to 2210 (an increase of 25.1%) in 2019 and 2,648 (an increase of 49.9%) in 2020. Compared with 2 years before the epidemic, during the COVID-19 pandemic, the proportion of PED visits among patients with stress disorders, sleep disorders, and anxiety disorders increased significantly. In terms of the distribution of demographic characteristics, age shows a younger trend, while the gender difference is not significant.

Conclusion

These findings suggest that PED care-seeking increases during the COVID-19 pandemic, highlighting the need to integrate mental health services for patients with stress, sleep, anxiety, and obsessive-compulsive disorders during public health crises.

Influence of different infill materials on the performance of geocell-reinforced cohesive soil beds

This paper presents a comprehensive study on the numerical and parametric study of geocell-reinforced cohesive soil beds, focusing on different infill materials. The numerical calculations were validated against model test results using FLAC^3D software. Subsequently, the verified model was expanded to the geocell-reinforced cohesive soil beds. Six cases were simulated to investigate the reinforced performance, including pressure-settlement responses, bearing capacity improvement factor, settlement reduction percentage, and surface deformation. The numerical findings emphasize that the significance of superior geocell reinforcement should not overshadow the consideration of soil infill's mechanical properties. In the case of cohesive soil as the infill material, the poor improvement in geocell-reinforced performance may be attributed to its low modulus and cohesion. Parametric studies suggest that geocells significantly impact reinforced performance when the infill material consists of foundation soil with a higher modulus and lower cohesion. Further, according to this numerical study, cohesionless soil with a modulus of 20 MPa and friction of 40° is the optimum infill soil in pockets to reinforce cohesive soil beds.

Construction and evaluation of prognostic models of ECMO in elderly patients with cardiogenic shock based on BP neural network, random forest, and decision tree

OBJECTIVE

To analyze the predictive effect of a back propagation (BP) neural network, random forest (RF) and decision tree model on the prognosis of elderly patients with cardiogenic shock after extracorporeal membrane oxygenation (ECMO).

METHODS

This is a retrospective analysis of the clinical data of elderly patients with cardiogenic shock (258 cases) who underwent ECMO in People's Hospital of Guangxi Zhuang Autonomous Region from January 2016 to January 2022. All patients were followed up for 6 months after ECMO treatment. The prognosis was evaluated, and the prognostic factors were analyzed. BP neural network, RF and decision tree were used to establish predictive models, and the predictive performance of the models was evaluated.

RESULTS

Among the 258 elderly patients with cardiogenic shock, 52 (20.16%) died 6 months after the ECMO treatment. Based on BP neural network, RF, and decision tree, predictive models for the prognosis and death of elderly patients with cardiogenic shock were constructed. A test set was used to predict the performance of the three models. The results showed that the predictive performances of the three models were all more than 80.00%. The accuracy, sensitivity, and specificity of the RF model were 0.987, 1.000, and 0.929 respectively, which were higher than those of the decision tree model. The area under the receiver operating characteristic curve (AUC) of the RF model was 1.000, which was higher than 0.916 for the decision tree model. DeLong test showed that there was a significant difference in the AUC of the RF model compared to the decision tree test set (D=-2.063, P=0.042 < 0.05).

CONCLUSION

The predictive performance is good in all the three models, which have a high application value for prognosis of ECMO in elderly patients with cardiogenic shock. In clinical practice, predictive models should be selected according to the actual situation, so clinicians and patients can make decisions.

Application of mesohepatectomy with caudate lobectomy for the treatment of type III-IV hilar cholangiocarcinoma: a single-center retrospective study

BACKGROUND

The main surgical procedure for Bismuth‒Corlette III-IV hilar cholangiocarcinoma (HCCA) is hemihepatectomy/extended hemihepatectomy. However, many patients have no opportunity for surgery due to having an insufficient remnant liver volume. Preservation of more liver volume on the premise of ensuring R0 resection is the goal. Mesohepatectomy with caudate lobectomy may be a new method to meet these requirements.

METHODS

The clinical data of 41 patients with Bismuth‒Corlette III-IV HCCA, including 18 patients who underwent mesohepatectomy with caudate lobectomy (the mesohepatectomy group) and 23 patients who underwent hemihepatectomy or extended hemihepatectomy (the hemihepatectomy group), were analyzed retrospectively. The perioperative indicators and prognostic survival time between the two groups were analyzed.

RESULTS

The mesohepatectomy group was compared with the hemihepatectomy group, and the operation time was 7.95 ± 1.2 vs. 7.15 ± 1.5 h (P > 0.05); the intraoperative blood loss was 600.0 ± 153.4 vs. 846.1 ± 366.8 mL (P < 0.05); the postoperative hospital stay was 9.9 ± 2.2 vs. 13.8 ± 3.0 days (P < 0.05); and the R0 resection rate was 100% vs. 87.0% (P > 0.05). The postoperative complications of the two groups included bile leakage (22.2% vs. 21.7%), pleural effusion (11.1% vs. 8.7%), and fever (16.7% vs. 8.7%), with no significant differences in the incidences (P > 0.05). The 1-, 3-, and 5-year survival rates of the two groups were 87.5%, 55.7%, 27.8% and 83.5%, 56.1%, 24.5%, respectively, with no significant differences (P > 0.05).

CONCLUSIONS

Mesohepatectomy with caudate lobectomy can preserve more functional liver volume while ensuring the bile duct margin. It can be applied as the surgical treatment of Bismuth‒Corlette III-IV HCCA.

Prognostic model for hepatocellular carcinoma based on anoikis-related genes: immune landscape analysis and prediction of drug sensitivity

Background

Hepatocellular carcinoma (HCC) represents a complex ailment characterized by an unfavorable prognosis in advanced stages. The involvement of immune cells in HCC progression is of significant importance. Moreover, metastasis poses a substantial impediment to enhanced prognostication for HCC patients, with anoikis playing an indispensable role in facilitating the distant metastasis of tumor cells. Nevertheless, limited investigations have been conducted regarding the utilization of anoikis factors for predicting HCC prognosis and assessing immune infiltration. This present study aims to identify hepatocellular carcinoma-associated anoikis-related genes (ANRGs), establish a robust prognostic model for HCC, and delineate distinct immune characteristics based on the anoikis signature. Cell migration and cytotoxicity experiments were performed to validate the accuracy of the ANRGs model.

Methods

Consensus clustering based on ANRGs was employed in this investigation to categorize HCC samples obtained from both TCGA and Gene Expression Omnibus (GEO) cohorts. To assess the differentially expressed genes, Cox regression analysis was conducted, and subsequently, prognostic gene signatures were constructed using LASSO-Cox methodology. External validation was performed at the International Cancer Genome Conference. The tumor microenvironment (TME) was characterized utilizing ESTIMATE and CIBERSORT algorithms, while machine learning techniques facilitated the identification of potential target drugs. The wound healing assay and CCK-8 assay were employed to evaluate the migratory capacity and drug sensitivity of HCC cell lines, respectively.

Results

Utilizing the TCGA-LIHC dataset, we devised a nomogram integrating a ten-gene signature with diverse clinicopathological features. Furthermore, the discriminative potential and clinical utility of the ten-gene signature and nomogram were substantiated through ROC analysis and DCA. Subsequently, we devised a prognostic framework leveraging gene expression data from distinct risk cohorts to predict the drug responsiveness of HCC subtypes.

Conclusion

In this study, we have established a promising HCC prognostic ANRGs model, which can serve as a valuable tool for clinicians in selecting targeted therapeutic drugs, thereby improving overall patient survival rates. Additionally, this model has also revealed a strong connection between anoikis and immune cells, providing a potential avenue for elucidating the mechanisms underlying immune cell infiltration regulated by anoikis.

Two-dimensional (n = 1) ferroelectric film solar cells

Molecular ferroelectrics that have excellent ferroelectric properties, a low processing temperature, narrow bandgap, and which are lightweight, have shown great potential in the photovoltaic field. However, two-dimensional (2D) perovskite solar cells with high tunability, excellent photo-physical properties and superior long-term stability are limited by poor out-of-plane conductivity from intrinsic multi-quantum-well electronic structures. This work uses 2D molecular ferroelectric film as the absorbing layer to break the limit of multiple quantum wells. Our 2D ferroelectric solar cells achieve the highest open-circuit voltage (1.29 V) and the best efficiency (3.71%) among the 2D (n = 1) Ruddlesden-Popper perovskite solar cells due to the enhanced out-of-plane charge transport induced by molecular ferroelectrics with a strong saturation polarization, high Curie temperature and multiaxial characteristics. This work aims to break the inefficient out-of-plane charge transport caused by the limit of the multi-quantum-well electronic structure and improve the efficiency of 2D ferroelectric solar cells.

Context-aware deep network for coronary artery stenosis classification in coronary CT angiography

Automatic coronary artery stenosis grading plays an important role in the diagnosis of coronary artery disease. Due to the difficulty of learning the informative features from varying grades of stenosis, it is still a challenging task to identify coronary artery stenosis from coronary CT angiography (CCTA). In this paper, we propose a context-aware deep network (CADN) for coronary artery stenosis classification. The proposed method integrates 3D CNN with Transformer to improve the feature representation of coronary artery stenosis in CCTA. We evaluate the proposed method on a multicenter dataset (APOLLO study with NCT05509010). Experimental results show that our proposed method can achieve the accuracy of 0.84, 0.83, and 0.86 for stenosis diagnosis on the lesion, artery, and patient levels, respectively.

Colloid driven low supersaturation crystallization for atomically thin Bismuth halide perovskite

It is challenging to grow atomically thin non-van der Waals perovskite due to the strong electronic coupling between adjacent layers. Here, we present a colloid-driven low supersaturation crystallization strategy to grow atomically thin Cs₃Bi₂Br₉. The colloid solution drives low-concentration solute in a supersaturation state, contributing to initial heterogeneous nucleation. Simultaneously, the colloids provide a stable precursor source in the low-concentration solute. The surfactant is absorbed in specific crystal nucleation facet resulting in the anisotropic growth of planar dominance. Ionic perovskite Cs₃Bi₂Br₉ is readily grown from monolayered to six-layered Cs₃Bi₂Br₉ corresponding to thicknesses of 0.7, 1.6, 2.7, 3.6, 4.6 and 5.7 nm. The atomically thin Cs₃Bi₂Br₉ presents layer-dependent nonlinear optical performance and stacking-induced second harmonic generation. This work provides a concept for growing atomically thin halide perovskite with non-van der Waal structures and demonstrates potential application for atomically thin single crystals' growth with strong electronic coupling between adjacent layers.

Scoping review update on somatic symptom disorder that includes additional Chinese data

Somatic symptom disorder (SSD) is a new diagnosis introduced into the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is expected to solve the diagnostic difficulties of patients with medically unexplained symptoms. Based on the previous work, this review aims to comprehensively synthesise updated evidence related to SSD from recent years in English publications and, more extensively, from data published in Chinese language journals. The scoping review update was based on an earlier scoping review and included Chinese language publication data from China National Knowledge Internet (CNKI), WANFANG and WEIPU between January 2013 and May 2022 and data from PubMed, PsycINFO, and Cochrane Library between June 2020 and May 2022. Initially, 2 984 articles were identified, of which 63 full texts were included for analysis. In China, SSD is mainly applied in scientific research, but it also shows good predictive validity and clinical application potential. The mean frequency of SSD was 4.5% in the general population, 25.2% in the primary care population and 33.5% in diverse specialised care settings. Biological factors, such as brain region changes and heart rate variability, are associated with the onset of SSD. Psychological impairment related to somatic symptoms is the best predictor of prognosis. While adolescent SSD was significantly associated with family function, SSD overall is associated with an increased dysfunction of cognition and emotion, decreased quality of life, and high comorbidity with anxiety and depressive disorders. Further research is needed on suicide risk and cultural and gender-related issues. Updating the data of Chinese language studies, our research enriches the evidence-based findings related to the topics addressed in the text sections of the SSD chapter of DSM-5. However, research gaps remain about SSD reliability, population-based prevalence, suicide risk, and cultural and gender-related issues.

Homologous post-treatment strategy enabling phase-pure α-FAPbI3 films

Formamidinium lead triiodide (FAPbI3) is considered as the prospective light-absorbing layer on account of the close-to-ideal bandgap of the α-phase, wide optical absorption spectrum and good thermal stability. Therefore, how to realize δ to α-phase transition to obtain phase-pure α-FAPbI3 without additives is important for FAPbI3 perovskite films. Herein, a homologous post-treatment strategy (HPTS) without additives is proposed to prepare FAPbI3 films with pure α-phase. The strategy is processed along with dissolution and reconstruction process during the annealing. The FAPbI3 film has tensile strain with the substrate, and the lattice keeps tensile, and the film maintains in an α/δ hybrid phase. The HPTS process releases the tensile strain between the lattice and the substrate. The process of strain release realizes the phase transition from δ to α-phase during this process. This strategy can accelerate the transformation from hexagonal δ-FAPbI3 to cubic α-FAPbI3 at 120℃. As a result, the acquired α-FAPbI3 films exhibit better film quality in optical and electrical properties, accordingly achieving device efficiency of 19.34% and enhanced stability. This work explores an effective approach to obtain additive-free and phase-pure α-FAPbI3 films through a homologous post-treatment strategy to fabricate uniform high-performance α-FAPbI3 perovskite solar cells.

Coaxial radiography guided puncture technique for percutaneous transforaminal endoscopic lumbar discectomy: A randomized control trial

BACKGROUND

The coaxial radiography-guided puncture technique (CR-PT) is a novel technique for endoscopic lumbar discectomy. As the X-ray beam and the puncturing needle are maintained in a parallel and coaxial direction, the X-ray beam can be used to guide the trajectory angle, facilitating the choice of the puncture site and providing real-time guidance. This puncture technique offers numerous advantages over the conventional anterior-posterior and lateral radiography-guided puncture technique (AP-PT), especially in cases of herniated lumbar discs with a hypertrophied transverse process or articular process, high iliac crest, and narrowed intervertebral foramen.

AIM

To confirm whether CR-PT is a superior approach to percutaneous transforaminal endoscopic lumbar discectomy compared to AP-PT.

METHODS

In this parallel, controlled, randomized clinical trial, herniated lumbar disc patients appointed to receive percutaneous endoscopic lumbar discectomy treatment were recruited from the Pain Management Department of the Affiliated Hospital of Xuzhou Medical University and Nantong Hospital of Traditional Chinese Medicine. Sixty-five participants were enrolled and divided into either a CR-PT group or an AP-PT group. The CR-PT group underwent CR-PT, and the AP-PT group underwent AP-PT. The number of fluoroscopies during puncturing, puncture duration (min), surgery duration (min), VAS score during puncturing, and puncture success rate were recorded.

RESULTS

Sixty-five participants were included, with 31 participants in the CR-PT group and 34 in the AP-PT group. One participant in the AP-PT group dropped out due to unsuccessful puncturing. The number of fluoroscopies [median (P25, P75)] was 12 (11, 14) in the CR-PT group vs 16 (12, 23) in the AP-PT group, while the puncture duration (mean ± SD) was 20.42 ± 5.78 vs 25.06 ± 5.46, respectively. The VAS score was 3 (2, 4) in the CR-PT group vs 3 (3, 4) in the AP-PT group. Further subgroup analysis was performed, considering only the participants with L5/S1 segment herniation: 9 patients underwent CR-PT, and 9 underwent AP-PT. The number of fluoroscopies was 11.56 ± 0.88 vs 25.22 ± 5.33; the puncture duration was 13.89 ± 1.45 vs 28.89 ± 3.76; the surgery duration was 105 (99.5, 120) vs 149 (125, 157.5); and the VAS score was 2.11 ± 0.93 vs 3.89 ± 0.6, respectively. All the above outcomes demonstrated statistical significance (P < 0.05), favoring the CR-PT treatment.

CONCLUSION

CR-PT is a novel and effective technique. As opposed to conventional AP-PT, this technique significantly improves puncture accuracy, shortens puncture time and operation time, and reduces pain intensity during puncturing.

Primary suture for patients of bile duct stones after laparoscopic biliary tract exploration: a retrospective cohort study

There are still many physicians who are reluctant to use primary biliary suture in Laparoscopic common bile duct exploration (LCBDE) for fear of more complications. We compare and analyze the clinical effectiveness of bile duct primary suture with three laparoscopic ports and indwelling T-tube drainage (with four laparoscopic ports) in patients with choledocholithiasis after LCBDE. Clinical data of 135 patients with common bile duct (CBD) stone were compared, including general conditions, postoperative hospital stay, postoperative complications, hospitalization costs, postoperative follow-up and other indicators. Forty-eight patients underwent primary suture of bile duct (group A) and 87 were treated with external T-tube drainage (group B). There were no significant differences between the two groups neither relating to the age, gender, BMI, diameter of CBD, number of stones, preoperative bilirubin value, number of previous surgeries in preoperative, nor the operation time, residual stones, the number of cases converted from laparoscopic conversion to laparotomy. The postoperative complications like fever, bleeding, incision infection, bile duct stricture has no differences between two group. The incidence of bile leakage (p = 0.008) and postoperative electrolyte disturbance (p = 0.001) were slightly lower in group A. There were fewer postoperative complications in group A vs group B (p = 0.04). Patients in group A experienced shorter postoperative hospital stay (p < 0.001), earlier postoperative extubation (p < 0.001), lower total hospitalization costs (p = 0.03), and earlier postoperative recovery (p = 0.000). Primary suture of CBD is a safe and effective method for some patients after LCBDE.

Strategic interaction in environmental regulation and sulfur dioxide emissions: Evidence from China

Environmental regulation is the central government's main instrument for pollution control, but its actual implementation effect directly depends on the level of enforcement by local governments. Using panel data of 30 regions in Mainland China from 2004 to 2020 and a spatial Durbin model, we investigated the effects of strategic interaction among local governments in environmental regulation on sulfur dioxide (SO₂) emissions. We found a "race to the top" behavior in the enforcement of environmental regulation among China's local governments. The enhancement of environmental regulation in a region or in its adjacent regions can significantly reduce SO₂ emissions in that region, indicating that joint environmental governance can achieve considerable pollution control effects. Furthermore, influence mechanism analysis shows that the emission reduction effect of environmental regulation is primarily achieved through green innovation and finance. In addition, we found that environmental regulation has a significant negative impact on SO₂ emissions in low-energy-consuming regions, but not in high-energy-consuming regions. Our findings indicate that China should continue to implement and deepen the green performance appraisal system for local governments and improve the efficiency of environmental regulations in high-energy-consuming regions.

Expression and Correlation Research of MicroRNA10a-5p and PIK3CA in Middle Ear Cholesteatoma

BACKGROUND

This study aimed to examine the roles of miR-10a-5p and phosphatidylinositol-4,5-bisphosphonate 3-kinase catalytic subunit α in the pathogenesis of middle ear cholesteatoma.

METHODS

We enrolled 27 patients with middle ear cholesteatoma and collected samples of intraoperative cholesteatoma and normal posterior ear skin tissues. The mRNA expression levels of miR-10a-5p and PIK3CA were detected using real-time quantitative polymerase chain reaction. PIK3CA protein expression was measured by immunohistochemistry and western blotting.

RESULTS

Middle ear cholesteatoma tissues showed significantly lower miR-10a-5p expression levels and significantly higher PIK3CA expression levels than normal posterior ear skin tissues (both P < .05). Furthermore, the miR-10a-5p and PIK3CA expression levels were significantly negatively correlated in middle ear cholesteatoma tissues (r = -0.926, P < .001).

CONCLUSION

Low miR-10a-5p expression levels in middle ear cholesteatoma tissues may inhibit the growth and proliferation of cholesteatoma, whereas high PIK3CA expression level may promote its growth and proliferation. In addition, miR-10a-5p may affect the proliferation and differentiation of cholesteatoma by negatively regulating its target gene, PIK3CA.