L2NLF: a novel linear-to-nonlinear framework for multi-modal medical image registration

In recent years, deep learning has ushered in significant development in medical image registration, and the method of non-rigid registration using deep neural networks to generate a deformation field has higher accuracy. However, unlike monomodal medical image registration, multimodal medical image registration is a more complex and challenging task. This paper proposes a new linear-to-nonlinear framework (L2NLF) for multimodal medical image registration. The first linear stage is essentially image conversion, which can reduce the difference between two images without changing the authenticity of medical images, thus transforming multimodal registration into monomodal registration. The second nonlinear stage is essentially unsupervised deformable registration based on the deep neural network. In this paper, a brand-new registration network, CrossMorph, is designed, a deep neural network similar to the U-net structure. As the backbone of the encoder, the volume CrossFormer block can better extract local and global information. Booster promotes the reduction of more deep features and shallow features. The qualitative and quantitative experimental results on T1 and T2 data of 240 patients' brains show that L2NLF can achieve excellent registration effect in the image conversion part with very low computation, and it will not change the authenticity of the converted image at all. Compared with the current state-of-the-art registration method, CrossMorph can effectively reduce average surface distance, improve dice score, and improve the deformation field's smoothness. The proposed methods have potential value in clinical application.

Regulation of Fluorescence and Self-assembly of a Salicylaldehyde Azine-Containing Amphiphile by Pillararene

Regulation of fluorescence and self-assembly of a salicylaldehyde azine-containing amphiphile by a water-soluble pillar[5]arene via host-guest recognition in water was realized. The fluorescence and the self-assembled aggregates of the bola-type amphiphile G can be tailored by adding different amounts of water-soluble pillar[5]arene (WP5). In addition, the emission property and self-assembly behavior of G and WP5 are responsive to pH conditions. Furthermore, the fluorescence emission property of G and the regulation by WP5 or pH conditions was applied as information encryption material, rewritable paper, and erasable ink. We believe that this fluorescence regulation strategy is promising for the construction of advanced fluorescent organic materials.

Quantitative analysis of six sesquiterpene glycosides from Dendrobium nobile Lindl. under different growth conditions by high-performance liquid chromatography coupled with triple quadrupole tandem mass spectrometry in MRM mode

INTRODUCTION

The sesquiterpene glycosides (SGs) from Dendrobium nobile Lindl. have immunomodulatory effects. However, there are no studies on the growth conditions affecting its contents and quantitative analysis methods.

OBJECTIVE

In the present study, a quantitative analysis method for six SGs from D. nobile was established. We explored which growth conditions could affect the contents of SGs, providing a basis for the cultivation and clinical application of D. nobile.

METHODS

Firstly, based on the optimization of mass spectrometry parameters and extraction conditions for six SGs in D. nobile, a method for the determination of the contents of six SGs was established using high-performance liquid chromatography coupled with triple quadrupole tandem mass spectrometry (HPLC-QqQ-MS/MS) in multiple reaction monitoring (MRM) mode. Then, the methodology of the established method was validated. Secondly, the established method was applied to determine the contents of six SGs from 78 samples of D. nobile grown under different growth conditions. Finally, chemometrics analysis was employed to analyze the results and select optimal growth conditions for D. nobile.

RESULTS

The results indicated significant variations in the contents of SGs from D. nobile grown under different growth conditions. The primary factors influencing SG contents included age, geographical origin, altitude, and epiphytic pattern.

CONCLUSION

Therefore, the established method for determining SG contents from D. nobile is stable. In particular, the SG contents were relatively high in samples of 3-year-old D. nobile grown at an altitude of approximately 500 m on Danxia rocks in Chishui, Guizhou.

Realization of Fine-Tuning the Lattice Thermal Conductivity and Anharmonicity in Layered Semiconductors via Entropy Engineering

Entropy engineering is widely proven to be effective in achieving ultra-low thermal conductivity for well-performed thermoelectric and heat management applications. However, no strong correlation between entropy and lattice thermal conductivity is found until now, and the fine-tuning of thermal conductivity continuously via entropy-engineering in a wide entropy range is still lacking. Here, a series of high-entropy layered semiconductors, Ni1- x(Fe0.25Co0.25Mn0.25Zn0.25)xPS3, where 0 ≤ x < 1, with low mass/size disorder is designed. High-purity samples with mixing configuration entropy of metal atomic site in a wide range of 0-1.61R are achieved. Umklapp phonon-phonon scattering is found to be the dominating phonon scattering mechanism, as revealed by the linear T-1 dependence of thermal conductivity. Meanwhile, fine tuning of the lattice thermal conductivity via continuous entropy engineering at metal atomic sites is achieved, in an almost linear dependence in middle-/high- entropy range. Moreover, the slope of the κ - T-1 curve reduces with the increase in entropy, and a linear response of the reduced Grüneisen parameter is revealed. This work provides an entropy engineering strategy by choosing multiple metal elements with low mass/size disorder to achieve the fine tuning of the lattice thermal conductivity and the anharmonic effect.

Synergistic Development of Natural Rubber/Butyl Rubber Composites for Improved Interfacial Bonding and Enhanced Shock-Absorbing Capabilities

Shock-absorbing materials play a vital role in various industrial sectors, including construction and transportation. Among these materials, natural rubber (NR) stands out due to its exceptional elastic and mechanical properties, coupled with its robust crack resistance. Nevertheless, with the rising demand for enhanced damping capacities, there is a need to further optimize the damping performance of NR. One direct approach is to blend it with high-damping rubber. Butyl rubber (IIR) is a prominent member of the high-damping rubber category. Integrating IIR effectively with the NR, however, presents challenges. These challenges arise from IIR's inherent characteristics, such as its low unsaturation, slower vulcanization rate, and restricted compatibility with NR. Addressing these challenges, our study employed isoprene and isobutene to synthesize a variant of butyl rubber with a higher degree of unsaturation-achieving an unsaturation level between 4 and 6 mol %. Notably, this heightened unsaturation significantly expedited the curing time of IIR and facilitated the concurrent vulcanization of both IIR and NR. Utilizing atomic force microscopy, we observed that the introduction of unsaturated double bonds ameliorated the compatibility between NR and IIR, leading to an interfacial region extending up to 1000 nm. Our tests using a dynamic mechanical analyzer and rubber processing analyzer demonstrated the material's damping temperature range. Furthermore, there was a noticeable rise in the loss factor (tan δ) at ambient temperature, which remains over 0.1 across both a frequency window of 0.2 to 5 Hz and a strain spectrum of 10 to 200%. This tan δ enhancement ensured the potential of these rubber composites for shock-absorbing applications.

Perfusion of hepatocellular carcinomas measured by diffusion-derived vessel density biomarker: Higher hepatocellular carcinoma perfusion than earlier intravoxel incoherent motion reports

Diffusion-derived vessel density (DVDD) is a physiological surrogate of the area of microvessels per unit tissue area. DDVD is calculated according to DDVD(b0b2) = Sb0/ROIarea0 - Sb2/ROIarea2, where Sb0 and Sb2 refer to the liver signal when b is 0 or 2 s/mm2 . Pathohistological studies and contrast-enhanced CT/MRI data showed higher blood volume in hepatocellular carcinoma (HCC) relative to native liver tissue. With intravoxel incoherent motion (IVIM) imaging, most authors paradoxically reported a decreased perfusion fraction of HCC relative to the adjacent liver. This study applied DDVD to assess the perfusion of HCC. MRI was performed with a 3.0-T magnet. Diffusion-weighted images with b-values of 0 and 2 s/mm2 were acquired in 72 HCC patients. Thirty-two patients had microvascular invasion (MVI(+)) and 40 patients did not have microvascular invasion (MVI(-)). Fifty-eight patients had Edmondson-Steiner grade I or II HCC, and 14 patients had Edmondson-Steiner grade III or IV HCC. DDVD measurement was conducted on the axial slice that showed the largest HCC size. DDVD(b0b2) T/L = HCC DDVD(b0b2)/liver DDVD(b0b2). DDVD(b0b2) T/L median (95% confidence interval) of all HCCs was 2.942 (2.419-3.522), of MVI(-) HCCs was 2.699 (2.030-3.522), of MVI(+) HCCs was 2.988 (2.423-3.990), of Edmondson-Steiner grade I/II HCCs was 2.873 (2.277-3.465), and of Edmondson-Steiner grade III/IV HCCs was 3.403 (2.008-4.485). DDVD(b0b2) T/L approximately agrees with contrast agent dynamically enhanced CT/MRI literature data, whereas it differs from earlier IVIM study results, where HCC perfusion fraction was paradoxically lower relative to native liver tissue. A weak trend was noted with MIV(+) HCCs had a higher DDVD(b0b2) T/L than that of MVI(-) HCCs, and a weak trend was noted with the poorly differentiated group of HCCs (Edmondson-Steiner grade III and IV) had a higher DDVD(b0b2) T/L than that of the better differentiated group of HCCs (Edmondson-Steiner grade I and II).

Grafted human-induced pluripotent stem cells-derived oligodendrocyte progenitor cells combined with human umbilical vein endothelial cells contribute to functional recovery following spinal cord injury

BACKGROUND

Spinal cord injury (SCI) is a devastating disease that causes extensive damage to oligodendrocytes and neurons leading to demyelination and axonal degeneration. In this study, we co-transplanted cell grafts containing oligodendrocyte progenitor cells (OPCs) derived from human-induced pluripotent stem cells (iPSCs) combined with human umbilical vein endothelial cells (HUVECs), which were reported to promote OPCs survival and migration, into rat contusion models to promote functional recovery after SCI.

METHODS

OPCs were derived from iPSCs and identified by immunofluorescence at different time points. Functional assays in vitro were performed to evaluate the effect of HUVECs on the proliferation, migration, and survival of OPCs by co-culture and migration assay, as well as on the neuronal axonal growth. A combination of OPCs and HUVECs was transplanted into the rat contusive model. Upon 8 weeks, immunofluorescence staining was performed to test the safety of transplanted cells and to observe the neuronal repairment, myelination, and neural circuit reconstruction at the injured area; also, the functional recovery was assessed by Basso, Beattie, and Bresnahan open-field scale, Ladder climb, SEP, and MEP. Furthermore, the effect of HUVECs on grafts was also determined in vivo.

RESULTS

Data showed that HUVECs promote the proliferation, migration, and survival of OPCs both in vitro and in vivo. Furthermore, 8 weeks upon engraftment, the rats with OPCs and HUVECs co-transplantation noticeably facilitated remyelination, enhanced functional connection between the grafts and the host and promoted functional recovery. In addition, compared with the OPCs-alone transplantation, the co-transplantation generated more sensory neurons at the lesion border and significantly improved the sensory functional recovery.

CONCLUSIONS

Our study demonstrates that transplantation of OPCs combined with HUVECs significantly enhances both motor and sensory functional recovery after SCI. No significance was observed between OPCs combined with HUVECs group and OPCs-alone group in motor function recovery, while the sensory function recovery was significantly promoted in OPCs combined with HUVECs groups compared with the other two groups. These findings provide novel insights into the field of SCI research.

Individualized Use of 6-Mercaptopurine in Chinese Children with ALL: A Multicenter Randomized Controlled Trial

Continuous 6-mercaptopurine (6-MP) dose titration is necessary because of its narrow therapeutic index and frequently encountered dose-limiting hematopoietic toxicity. However, evidence-based guidelines for gene-based 6-MP dosing have not been established for Chinese children with acute lymphoblastic leukemia (ALL). This multicenter, randomized, open-label, active-controlled clinical trial randomly assigned Chinese children with low- or intermediate-risk ALL in a 1:1 ratio to receive TPMT-NUDT15 gene-based dosing of 6-MP (N = 44, 10 to 50 mg/m2 /day) or standard dosing (N = 44, 50 mg/m2 /day) during maintenance therapy. The primary end point was the incidence of 6-MP myelosuppression in both groups. Secondary end points included frequencies of 6-MP hepatotoxicity, duration of myelosuppression and leukopenia, event-free survival, and steady-state concentrations of active metabolites (6-thioguaninenucleotides and 6-methylmercaptopurine nucleotides) in erythrocytes. A 2.2-fold decrease in myelosuppression, the primary end point, was observed in the gene-based-dose group using ~ 50% of the standard initial 6-MP dose (odds ratio, 0.26, 95% confidence interval, 0.11 to 0.64, P = 0.003). Patients in the gene-based-dose group had a significantly lower risk of developing thiopurine-induced myelosuppression and leukopenia (P = 0.015 and P = 0.022, respectively). No significant differences were observed in the secondary end points of the incidence of hepatotoxicity and steady-state concentrations of active metabolites in erythrocytes between the two groups. TPMT- and NUDT15-based dosing of 6-MP will significantly contribute toward further reducing the incidence of leukopenia in Chinese children with ALL. This trial is registered at www.clinicaltrial.gov as #NCT04228393.

mTORC1 Mediates Biphasic Mechano-Response to Orchestrate Adhesion-Dependent Cell Growth and Anoikis Resistance

Cells constantly sense and respond to not only biochemical but also biomechanical changes in their microenvironment, demanding for dynamic metabolic adaptation. ECM stiffening is a hallmark of cancer aggressiveness, while survival under substrate detachment also associates with poor prognosis. Mechanisms underlying this, non-linear mechano-response of tumor cells may reveal potential double-hit targets for cancers. Here, an integrin-GSK3β-FTO-mTOR axis is reported, that can integrate stiffness sensing to ensure both the growth advantage endowed by rigid substrate and cell death resistance under matrix detachment. It is demonstrated that substrate stiffening can activate mTORC1 and elevate mTOR level through integrins and GSK3β-FTO mediated mRNA m6 A modification, promoting anabolic metabolism. Inhibition of this axis upon ECM detachment enhances autophagy, which in turn conveys resilience of tumor cells to anoikis, as it is demonstrated in human breast ductal carcinoma in situ (DCIS) and mice malignant ascites. Collectively, these results highlight the biphasic mechano-regulation of cellular metabolism, with implications in tumor growth under stiffened conditions such as fibrosis, as well as in anoikis-resistance during cancer metastasis.

Proportions of Pseudomonas aeruginosa and Antimicrobial-Resistant P aeruginosa Among Patients With Surgical Site Infections in China: A Systematic Review and Meta-analysis

Background

Pseudomonas aeruginosa is one of the most common pathogens in surgical site infections (SSIs). However, comprehensive epidemiological and antibiotic resistance details for P aeruginosa in Chinese SSIs are lacking. We evaluated the proportions and antimicrobial resistance of P aeruginosa among patients with SSIs in China.

Methods

Relevant papers from January 2010 to August 2022 were searched in databases including PubMed, Embase, Web of Science, China Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang, and Weipu. A meta-analysis was performed to analyze the proportions and 95% confidence interval (CIs) of P aeruginosa among patients with SSIs. Meta-regression analysis was used to investigate the proportion difference among different subgroups and antimicrobial resistance.

Results

A total of 72 studies met inclusion criteria, involving 33 050 isolated strains. The overall proportion of P aeruginosa among patients with SSIs was 16.0% (95% CI, 13.9%-18.2%). Subgroup analysis showed higher proportions in orthopedic (18.3% [95% CI, 15.6%-21.0%]) and abdominal surgery (17.3% [95% CI, 9.9%-26.2%]). The proportion in the central region (18.6% [95% CI, 15.3%-22.1%]) was slightly higher than that in other regions. Antibiotic resistance rates significantly increased after 2015: cefoperazone (36.2%), ceftriaxone (38.9%), levofloxacin (20.5%), and aztreonam (24.0%). Notably, P aeruginosa resistance to ampicillin and cefazolin exceeded 90.0%.

Conclusions

The proportion of P aeruginosa infection among patients with SSIs was higher than the data reported by the Chinese Antimicrobial Resistance Surveillance System, indicating rising antimicrobial resistance. The existing antimicrobial drug management plan should be strengthened to prevent a hospital epidemic of drug-resistant P aeruginosa strains.

Deep learning-based 3D brain multimodal medical image registration

Medical image registration is a critical preprocessing step in medical image analysis. While traditional medical image registration techniques have matured, their registration speed and accuracy still fall short of clinical requirements. In this paper, we propose an improved VoxelMorph network incorporating ResNet modules and CBAM (RCV-Net), for 3D multimodal unsupervised registration. Unlike popular convolution-based U-shaped registration networks like VoxelMorph, RCV-Net incorporates the convolutional block attention module (CBAM) during the convolution process. This inclusion enhances the feature map information extraction capabilities during training and effectively prevents information loss. Additionally, we introduce a lightweight and residual network module at the network's base, which enhances learning ability without significantly increasing training parameters. To evaluate the superiority of our registration model, we utilize evaluation metrics such as structural similarity (SSIM), peak signal-to-noise ratio (PSNR), and mean square error (MSE). Experimental results demonstrate that our proposed network structure outperforms current state-of-the-art methods, yielding better performance in multimodal registration tasks. Furthermore, generalization testing on databases outside of the training set has confirmed the optimal registration effectiveness of our model.

A novel and efficient murine model for investigating tendon-to-bone healing

BACKGROUND

Tendon-to-bone healing is a critical challenge in sports medicine, with its cellular and molecular mechanisms yet to be explored. An efficient murine model could significantly advance our understanding of this process. However, most existing murine animal models face limitations, including a propensity for bleeding, restricted operational space, and a steep learning curve. Thus, the need for a novel and efficient murine animal model to investigate the cellular and molecular mechanisms of tendon-to-bone healing is becoming increasingly evident.

METHODS

In our study, forty-four 9-week-old male C57/BL6 mice underwent transection and reattachment of the Achilles tendon insertion to investigate tendon-to-bone healing. At 2 and 4 weeks postoperatively, mice were killed for histological, Micro-CT, biomechanical, and real-time polymerase chain reaction tests.

RESULTS

Histological staining revealed that the original tissue structure was disrupted and replaced by a fibrovascular scar. Although glycosaminoglycan deposition was present in the cartilage area, the native structure had been destroyed. Biomechanical tests showed that the failure force constituted approximately 44.2% and 77.5% of that in intact tissues, and the ultimate tensile strength increased from 2 to 4 weeks postoperatively. Micro-CT imaging demonstrated a gradual healing process in the bone tunnel from 2 to 4 weeks postoperatively. The expression levels of ACAN, SOX9, Collagen I, and MMPs were detected, with all genes being overexpressed compared to the control group and maintaining high levels at 2 and 4 weeks postoperatively.

CONCLUSIONS

Our results demonstrate that the healing process in our model is aligned with the natural healing process, suggesting the potential for creating a new, efficient, and reproducible mouse animal model to investigate the cellular and molecular mechanisms of tendon-to-bone healing.

Tidal channel meanders serve as stepping-stones to facilitate cordgrass landward spread by creating invasion windows

Understanding the mechanisms by which the geomorphic structures affect habitat invasibility by mediating various abiotic and biotic factors is essential for predicting whether these geomorphic structures may provide spatial windows of opportunity to facilitate range-expansion of invasive species in salt marshes. Many studies have linked geomorphic landscape features such as tidal channels to invasion by exotic plants, but the role of tidal channel meanders (i.e., convex and concave sides) in regulating the Spartina alterniflora invasion remains unclear. Here, we examined the combined effects of tidal channel meander-mediated hydrodynamic variables, soil abiotic stresses, and propagule pressure on the colonization of Spartina in the Yellow River Delta, China, by conducting field observations and experiments. The results showed that lower hydrodynamic disturbance, bed shear stress, and higher propagule pressure triggered by eddies due to the convex structure of channel meanders facilitated Spartina seedling establishment and growth, whereas the concave side considerably inhibited the Spartina invasion. Lower soil abiotic stresses also significantly promoted the invasibility of the channel meanders by Spartina. Based on these findings, we propose a conceptual framework to illustrate the effects of the meandering geomorphology of tidal channels on the mechanisms that might allow the landward spread of Spartina and related processes. Our results demonstrate that the meandering geomorphic structures of tidal channels could act as stepping-stones to significantly facilitate the landward invasion of Spartina along tidal channels. This implies that geomorphic characteristics of tidal channels should be integrated into invasive species control and salt marsh management strategies.

The association of normal-range serum phosphorus with immunoglobulin A nephropathy progression: a retrospective cohort study

PURPOSE

The relationship between serum phosphorus and immunoglobulin A (IgA) nephropathy progression remains uncertain, especially normal-range serum phosphorus. Therefore, we herein examined the relationship between the normal-range serum phosphorus and the progression of IgA nephropathy.

METHODS

One hundred sixty-two patients with primary IgA nephropathy were divided into three groups according to tertiles of baseline serum phosphorus (first tertile: 0.73-1.04 mmol/L; second tertile: 1.04-1.21 mmol/L; third tertile: 1.21-1.60 mmol/L). Estimated glomerular filtration rate (eGFR) was calculated using the chronic kidney disease epidemiology collaboration. The composite outcome was defined as a decrease of at least 50% in eGFR from baseline or end-stage kidney disease (ESKD). The association of serum phosphorus with IgA nephropathy progression was estimated using Cox proportional hazards models, adjusting for potential confounders.

RESULTS

During a median 16 month follow-up period, 15 patients reached a composite outcome. In the crude Cox proportional hazard model, baseline serum phosphorus as a continuous variable was associated with increased risk for adverse renal outcomes [hazard ratio (HR) = 63.510, 95% confidence interval (CI) = 3.953-1020.284, P = 0.003], and the high tertile of serum phosphorus group had an increased risk of the composite outcome by using the low tertile group as the reference (HR = 11.895, 95% CI = 1.522-92.993, P = 0.018). After adjustment for traditional risk factors, the high tertile of serum phosphorus group was significantly related to IgA nephropathy progression compared with the low tertile group (HR = 9.424, 95% CI = 1.019-87.165, P = 0.048).

CONCLUSIONS

Relatively higher serum phosphorus levels within the normal range were significantly associated with the progression of IgA nephropathy.

ACP-Mediated Phase Transformation for Collagen Mineralization: A New Understanding of the Mechanism

Despite significant efforts utilizing advanced technologies, the contentious debate surrounding the intricate mechanism underlying collagen fibril mineralization, particularly with regard to amorphous precursor infiltration and phase transformation, persists. This work proposes an amorphous calcium phosphate (ACP)-mediated pathway for collagen fibril mineralization and utilizing stochastic optical reconstruction microscopy technology, and has experimentally confirmed for the first time that the ACP nanoparticles can infiltrate inside collagen fibrils. Subsequently, the ACP-mediated phase transformation occurs within collagen fibrils to form HAP crystallites, and significantly enhances the mechanical properties of the mineralized collagen fibrils compared to those achieved by the calcium phosphate ion (CPI)-mediated mineralization and resembles the natural counterpart. Furthermore, demineralized dentin can be effectively remineralized through ACP-mediated mineralization, leading to complete restoration of its mechanical properties. This work provides a new paradigm of collagen mineralization via particle-mediated phase transformation, deepens the understanding of the mechanism behind the mineralization of collagen fibrils, and offers a new strategy for hard tissue repair.

Nanomedicine for Diagnosis and Treatment of Atherosclerosis

With the changing disease spectrum, atherosclerosis has become increasingly prevalent worldwide and the associated diseases have emerged as the leading cause of death. Due to their fascinating physical, chemical, and biological characteristics, nanomaterials are regarded as a promising tool to tackle enormous challenges in medicine. The emerging discipline of nanomedicine has filled a huge application gap in the atherosclerotic field, ushering a new generation of diagnosis and treatment strategies. Herein, based on the essential pathogenic contributors of atherogenesis, as well as the distinct composition/structural characteristics, synthesis strategies, and surface design of nanoplatforms, the three major application branches (nanodiagnosis, nanotherapy, and nanotheranostic) of nanomedicine in atherosclerosis are elaborated. Then, state-of-art studies containing a sequence of representative and significant achievements are summarized in detail with an emphasis on the intrinsic interaction/relationship between nanomedicines and atherosclerosis. Particularly, attention is paid to the biosafety of nanomedicines, which aims to pave the way for future clinical translation of this burgeoning field. Finally, this comprehensive review is concluded by proposing unresolved key scientific issues and sharing the vision and expectation for the future, fully elucidating the closed loop from atherogenesis to the application paradigm of nanomedicines for advancing the early achievement of clinical applications.

MRI-based automatic identification and segmentation of extrahepatic cholangiocarcinoma using deep learning network

BACKGROUND

Accurate identification of extrahepatic cholangiocarcinoma (ECC) from an image is challenging because of the small size and complex background structure. Therefore, considering the limitation of manual delineation, it's necessary to develop automated identification and segmentation methods for ECC. The aim of this study was to develop a deep learning approach for automatic identification and segmentation of ECC using MRI.

METHODS

We recruited 137 ECC patients from our hospital as the main dataset (C1) and an additional 40 patients from other hospitals as the external validation set (C2). All patients underwent axial T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), and diffusion-weighted imaging (DWI). Manual delineations were performed and served as the ground truth. Next, we used 3D VB-Net to establish single-mode automatic identification and segmentation models based on T1WI (model 1), T2WI (model 2), and DWI (model 3) in the training cohort (80% of C1), and compared them with the combined model (model 4). Subsequently, the generalization capability of the best models was evaluated using the testing set (20% of C1) and the external validation set (C2). Finally, the performance of the developed models was further evaluated.

RESULTS

Model 3 showed the best identification performance in the training, testing, and external validation cohorts with success rates of 0.980, 0.786, and 0.725, respectively. Furthermore, model 3 yielded an average Dice similarity coefficient (DSC) of 0.922, 0.495, and 0.466 to segment ECC automatically in the training, testing, and external validation cohorts, respectively.

CONCLUSION

The DWI-based model performed better in automatically identifying and segmenting ECC compared to T1WI and T2WI, which may guide clinical decisions and help determine prognosis.

Gastric cancer peritoneal metastasis related signature predicts prognosis and sensitivity to immunotherapy in gastric cancer

Gastric cancer peritoneal metastases (GCPM) is a leading cause of GC-related death. Early detection of GCPM is critical for improving the prognosis of advanced GC. Differentially expressed genes (DEGs) were identified in the GSE62254 database to distinguish between GCPM and non-GCPM. The gastric cancer peritoneal metastases signature (GCPMs) was developed using DEGs. We analysed the effectiveness of GCPMs as indicators for prognosis, chemotherapy, and immune therapy response in GC patients. Subsequently, we analysed the correlation between GCPMs and immune microenvironment as well as immune escape in GC patients. Random forest model and immunohistochemistry was utilized to identify the crucial genes that can aid in the diagnosis of GCPM. We identified five DEGs and utilized their expression to construct GCPMs. Patients with high GCPMs had a higher likelihood of a poor prognosis, while those with low GCPMs appeared to potentially benefit more from chemotherapy. GCPMs were a dependable marker for predicting the response to immunotherapy. Additionally, GCPMs was found to be significantly linked to stromal score and cancer-associated fibroblasts. SYNPO2 has been identified as the gene with the highest significance in the diagnosis of GCPM. Immunohistochemistry suggests that SYNPO2-positive expression in tumour cells, fibroblasts, inflammatory cell may be associated with promoting peritoneal metastasis in GC. GCPMs have shown to be a promising biomarker for predicting the prognosis and response of GC patients to chemotherapy and immunotherapy. The use of GCPMs for individual tumour evaluation may pave the way for personalized treatment for GC patients in the future.

RNF149 Promotes HCC Progression through Its E3 Ubiquitin Ligase Activity

Hepatocellular carcinoma (HCC) accounts for over 80% of cases among liver cancer, with high incidence and poor prognosis. Thus, it is of valuable clinical significance for discovery of potential biomarkers and drug targets for HCC. In this study, based on the proteomic profiling data of paired early-stage HCC samples, we found that RNF149 was strikingly upregulated in tumor tissues and correlated with poor prognosis in HCC patients, which was further validated by IHC staining experiments of an independent HCC cohort. Consistently, overexpression of RNF149 significantly promoted cell proliferation, migration, and invasion of HCC cells. We further proved that RNF149 stimulated HCC progression via its E3 ubiquitin ligase activity, and identified DNAJC25 as its new substrate. In addition, bioinformatics analysis showed that high expression of RNF149 was correlated with immunosuppressive tumor microenvironment (TME), indicating its potential role in immune regulation of HCC. These results suggest that RNF149 could exert protumor functions in HCC in dependence of its E3 ubiquitin ligase activity, and might be a potential prognostic marker and therapeutic target for HCC treatment.

Defect Rich Structure Activated 3D Palladium Catalyst for Methanol Oxidation Reaction

Controlling the structure and properties of catalysts through atomic arrangement is the source of producing a new generation of advanced catalysts. A highly active and stable catalyst in catalytic reactions strongly depends on an ideal arrangement structure of metal atoms. We demonstrated that the introduction of the defect-rich structures, low coordination number (CN), and tensile strain in three-dimensional (3D) urchin-like palladium nanoparticles through chlorine bonded with sp-C in graphdiyne (Pd-UNs/Cl-GDY) can regulate the arrangement of metal atoms in the palladium nanoparticles to form a special structure. In situ Fourier infrared spectroscopy (FTIR) and theoretical calculation results show that Pd-UNs/Cl-GDY catalyst is beneficial to the oxidation and removal of CO intermediates. The Pd-UNs/Cl-GDY for methanol oxidation reaction (MOR) that display high current density (363.6 mA cm-2 ) and mass activity (3.6 A mgPd -1 ), 12.0 and 10.9 times higher than Pd nanoparticles, respectively. The Pd-UNs/Cl-GDY catalyst also exhibited robust stability with still retained 95 % activity after 2000 cycles. A defects libraries of the face-centered cubic and hexagonal close-packed crystal catalysts (FH-NPs) were synthesized by introducing chlorine in graphdiyne. Such defect-rich structures, low CN, and tensile strain tailoring methods have opened up a new way for the catalytic reaction of MOR.

Multienzyme-Mimicking LaCoO3 Nanotrigger for Programming Cancer-Cell Pyroptosis

Pyroptosis, a distinct paradigm of programmed cell death, is an efficient strategy against cancer by overcoming resistance to apoptosis. In this study, LaCoO3 (LCO) lanthanide-based nanocrystals with multienzyme characteristics are rationally designed and engineered to trigger the generation of cytotoxic reactive oxygen species (ROS) and the release of lanthanum ions, ultimately inducing lung cancer cell pyroptosis. The peroxidase- and oxidase-mimicking activities of LCO nanocrystals endow LCO with ROS production capacity in tumor tissues with an acidic pH and high hydrogen peroxide content. Concurrently, the LCO nanoenzyme exhibits catalase- and glutathione peroxidase-like activities, reversing the hypoxic microenvironment, destroying the activated antioxidant system of tumor cells, and amplifying the sensitivity of tumor cells to ROS. The use of ultrasound further accelerates the enzymatic kinetic rate. Most importantly, the La3+ ions released by LCO robustly destroy the lysosomal membrane, finally inducing canonical pyroptotic cell death, together with ROS. LCO-nanocrystal-triggered programmed cell pyroptosis amplifies the therapeutic effects both in vitro and in vivo, effectively restraining lung cancer growth and metastasis. This study paves a new avenue for the efficient treatment of lung cancer and metastasis through US-enhanced lanthanum-based nanoenzyme platforms and pyroptotic cell death.

Improving performance of medical image alignment through super-resolution

Medical image alignment is an important tool for tracking patient conditions, but the quality of alignment is influenced by the effectiveness of low-dose Cone-beam CT (CBCT) imaging and patient characteristics. To address these two issues, we propose an unsupervised alignment method that incorporates a preprocessing super-resolution process. We constructed the model based on a private clinical dataset and validated the enhancement of the super-resolution on alignment using clinical and public data. Through all three experiments, we demonstrate that higher resolution data yields better results in the alignment process. To fully constrain similarity and structure, a new loss function is proposed; Pearson correlation coefficient combined with regional mutual information. In all test samples, the newly proposed loss function obtains higher results than the common loss function and improve alignment accuracy. Subsequent experiments verified that, combined with the newly proposed loss function, the super-resolution processed data boosts alignment, can reaching up to 9.58%. Moreover, this boost is not limited to a single model, but is effective in different alignment models. These experiments demonstrate that the unsupervised alignment method with super-resolution preprocessing proposed in this study effectively improved alignment and plays an important role in tracking different patient conditions over time.

Tailored Dynamic Viscoelasticity of Polyurethanes Based on Different Diols

The development of damping and tire materials has led to a growing need to customize the dynamic viscoelasticity of polymers. In the case of polyurethane (PU), which possesses a designable molecular structure, the desired dynamic viscoelasticity can be achieved by carefully selecting flexible soft segments and employing chain extenders with diverse chemical structures. This process involves fine-tuning the molecular structure and optimizing the degree of micro-phase separation. It is worth noting that the temperature at which the loss peak occurs increases as the soft segment structure becomes more rigid. By incorporating soft segments with varying degrees of flexibility, the loss peak temperature can be adjusted within a broad range, from -50 °C to 14 °C. Furthermore, when the molecular structure of the chain extender becomes more regular, it enhances interaction between the soft and hard segments, leading to a higher degree of micro-phase separation. This phenomenon is evident from the increased percentage of hydrogen-bonding carbonyl, a lower loss peak temperature, and a higher modulus. By modifying the molecular weight of the chain extender, we can achieve precise control over the loss peak temperature, allowing us to regulate it within the range of -1 °C and 13 °C. To summarize, our research presents a novel approach for tailoring the dynamic viscoelasticity of PU materials and thus offers a new avenue for further exploration in this field.

Suppression of TGFβR-Smad3 pathway alleviates the syrinx induced by syringomyelia

BACKGROUND

Syringomyelia is a cerebrospinal fluid (CSF) disorder resulted in separation of pain and temperature, dilation of central canal and formation of syrinx in central canal. It is unclear about mechanisms of the dilation and syrinx formation. We aimed to investigate roles of ependymal cells lining central canal on the dilation, trying to reduce syrinx formation in central canal.

METHODS

We employed 78 Sprague-Dawley (SD) rats totally with syringomyelia to detect the contribution of ependymal cells to the dilation of central canal. Immunofluorescence was used to examine the activation of ependymal cells in 54 syringomyelia rat models. BrdU was used to indicate the proliferation of ependymal cells through intraperitoneal administration in 6 syringomyelia rat models. 18 rats with syringomyelia were injected with SIS3, an inhibitor of TGFβR-Smad3, and rats injected with DMSO  were used as control. Among the 18 rats, 12 rats were used for observation of syrinx following SIS3 or DMSO administration by using magnetic resonance imaging (MRI) on day 14 and day 30 under syringomyelia without decompression. All the data were expressed as mean ± standard deviation (mean ± SD). Differences between groups were compared using the two-tailed Student's t-test or ANOVA. Differences were considered significant when *p < 0.05.

RESULTS

Our study showed the dilation and protrusions of central canal on day 5 and enlargement from day 14 after syringomyelia induction in rats with activation of ependymal cells lining central canal. Moreover, the ependymal cells contributed to protrusion formation possibly through migration along with central canal. Furthermore, suppression of TGFβR-Smad3 which was crucial for migration reversed the size of syrnix in central canal without treatment of decompression, suggesting TGFβR-Smad3 signal might be key for dilation of central canal and formation of syrinx.

CONCLUSIONS

The size of syrinx was decreased after SIS3 administration without decompression. Our study depicted the mechanisms of syrinx formation and suggested TGFβR-Smad3 signal might be key for dilation of central canal and formation of syrinx.

The Biological Roles of Puccinia striiformis f. sp. tritici Effectors during Infection of Wheat

Puccinia striiformis f. sp. tritici (Pst) is the causative agent of wheat stripe rust, which can lead to a significant loss in annual wheat yields. Therefore, there is an urgent need for a deeper comprehension of the basic mechanisms underlying Pst infection. Effectors are known as the agents that plant pathogens deliver into host tissues to promote infection, typically by interfering with plant physiology and biochemistry. Insights into effector activity can significantly aid the development of future strategies to generate disease-resistant crops. However, the functional analysis of Pst effectors is still in its infancy, which hinders our understanding of the molecular mechanisms of the interaction between Pst and wheat. In this review, we summarize the potential roles of validated and proposed Pst effectors during wheat infection, including proteinaceous effectors, non-coding RNAs (sRNA effectors), and secondary metabolites (SMs effectors). Further, we suggest specific countermeasures against Pst pathogenesis and future research directions, which may promote our understanding of Pst effector functions during wheat immunity attempts.

Early prediction of MODS interventions in the intensive care unit using machine learning

Background

Multiple organ dysfunction syndrome (MODS) is one of the leading causes of death in critically ill patients. MODS is the result of a dysregulated inflammatory response that can be triggered by various causes. Owing to the lack of an effective treatment for patients with MODS, early identification and intervention are the most effective strategies. Therefore, we have developed a variety of early warning models whose prediction results can be interpreted by Kernel SHapley Additive exPlanations (Kernel-SHAP) and reversed by diverse counterfactual explanations (DiCE). So we can predict the probability of MODS 12 h in advance, quantify the risk factors, and automatically recommend relevant interventions.

Methods

We used various machine learning algorithms to complete the early risk assessment of MODS, and used a stacked ensemble to improve the prediction performance. The kernel-SHAP algorithm was used to quantify the positive and minus factors corresponding to the individual prediction results, and finally, the DiCE method was used to automatically recommend interventions. We completed the model training and testing based on the MIMIC-III and MIMIC-IV databases, in which the sample features in the model training included the patients' vital signs, laboratory test results, test reports, and data related to the use of ventilators.

Results

The customizable model called SuperLearner, which integrated multiple machine learning algorithms, had the highest authenticity of screening, and its Yordon index (YI), sensitivity, accuracy, and utility_score on the MIMIC-IV test set were 0.813, 0.884, 0.893, and 0.763, respectively, which were all maximum values of eleven models. The area under the curve of the deep-wide neural network (DWNN) model on the MIMIC-IV test set was 0.960, and the specificity was 0.935, which were both the maximum values of all these models. The Kernel-SHAP algorithm combined with SuperLearner was used to determine the minimum value of glasgow coma scale (GCS) in the current hour (OR = 0.609, 95% CI   0.606-0.612), maximum value of MODS score corresponding to GCS in the past 24 h (OR = 2.632, 95% CI 2.588-2.676), and maximum score of MODS corresponding to creatinine in the past 24 h (OR = 3.281, 95% CI   3.267-3.295) were generally the most influential factors.

Conclusion

The MODS early warning model based on machine learning algorithms has considerable application value, and the prediction efficiency of SuperLearner is superior to those of SubSuperLearner, DWNN, and other eight common machine learning models. Considering that the attribution analysis of Kernel-SHAP is a static analysis of the prediction results, we introduce the DiCE algorithm to automatically recommend counterfactuals to reverse the prediction results, which will be an important step towards the practical application of automatic MODS early intervention.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40537-023-00719-2.

Non-Hermitian Topolectrical Circuit Sensor with High Sensitivity

Electronic sensors play important roles in various applications, such as industry and environmental monitoring, biomedical sample ingredient analysis, wireless networks and so on. However, the sensitivity and robustness of current schemes are often limited by the low quality-factors of resonators and fabrication disorders. Hence, exploring new mechanisms of the electronic sensor with a high-level sensitivity and a strong robustness is of great significance. Here, a new way to design electronic sensors with superior performances based on exotic properties of non-Hermitian topological physics is proposed. Owing to the extreme boundary-sensitivity of non-Hermitian topological zero modes, the frequency shift induced by boundary perturbations can show an exponential growth trend with respect to the size of non-Hermitian topolectrical circuit sensors. Moreover, such an exponential growth sensitivity is also robust against disorders of circuit elements. Using designed non-Hermitian topolectrical circuit sensors, the ultrasensitive identification of the distance, rotation angle, and liquid level is further experimentally verified with the designed capacitive devices. The proposed non-Hermitian topolectrical circuit sensors can possess a wide range of applications in ultrasensitive environmental monitoring and show an exciting prospect for next-generation sensing technologies.

The mechanism of whey protein and blueberry juice mixed system fermented with Lactobacillus inhibiting Escherichia coli during storage

The aim of this study was to identify the antimicrobial effect and mechanism of whey protein and blueberry juice mixed systems fermented with Lactobacillus against Escherichia coli during storage. The whey protein and blueberry juice mixed systems were fermented with L. casei M54, L. plantarum 67, S. thermophiles 99 and L. bulgaricus 134 and had different antibacterial activities against E. coli during storage. The antimicrobial activity of the mixed whey protein and blueberry juice mixture systems was the highest, with an inhibition zone diameter of approximately 230 mm, compared with the whey protein or blueberry juice systems alone. There were no viable E. coli cells 7 h after treatment with of the whey protein and blueberry juice mixed systems as determined by survival curve analysis. Analysis of the inhibitory mechanism showed that the release of alkaline phosphatase, electrical conductivity, protein and pyruvic acid contents, and aspartic acid transaminase and alanine aminotransferase activity in E. coli increased. These results demonstrated that these mixed systems fermented with Lactobacillus, especially those containing blueberries, could inhibit the growth of E. coli and even cause cell death by destroying the cell membrane and cell wall.

Home bias and employee social responsibility: Identification vs. benefit exchange

Employees, as the most valuable assets and critical sources of competitive advantage in enterprises, are among the important stakeholders in enterprises. Employee social responsibility (ESR) has been a continually important research interest in the field of enterprise social responsibility. However, in the literature, few studies explore how personal features affect employee social responsibility. Thus, sampling China's listed companies from 2006 to 2019, we investigate how the home bias of senior executives influences enterprises' employee social responsibility. We identify home bias based on whether a chairperson's or CEO's hometown matches the firm's registration place. Three main results are obtained. First, the home bias of both CEOs and chairpersons can improve the corporate fulfillment of employee social responsibility. Second, further cost-benefit analysis shows that this result is due to not only identification but also benefit exchange. Although senior executives' home bias significantly decreases employee turnover rate, enterprises absorb more employment, which significantly increases their redundant personnel costs. Therefore, firms should balance the potential benefits and costs incurred by home bias via trade-off. Third, in firms facing less market competition, firms with more governmental subsidies or state-owned firms, senior executives' home bias has a more significant promoting effect on the fulfillment of ESR, supporting the view of benefit exchange. Accordingly, by extending theories on the effects of senior executives' home bias and enriching the ESR literature, this paper has important practical value, our findings can guide and promote firms to perform ESR while actively complying with a national policy for stabilizing employment and ensuring people's well-being.

7,8-Dihydroxycoumarin Alleviates Synaptic Loss by Activated PI3K-Akt-CREB-BDNF Signaling in Alzheimer's Disease Model Mice

Alzheimer's disease (AD) is a progressive neurodegenerative disorder and is clinically characterized by the impairment of memory and cognition. Accumulation of β-amyloid (Aβ) in the brain is considered as a key process in the development of AD because it impairs the synapses' function to impair memory formation. Recent research studies have indicated that a group of edible plant-derived Thymelaeaceae compounds known as coumarin may exert particularly powerful actions on alleviating learning and memory impairment. 7,8-Dithydroxycoumarin (7,8-DHC), a bioactive component of coumarin derived from Thymelaeaceae, showed its function in neuroprotection before. In this study, we found that 7,8-DHC was able to mitigate Aβ accumulation via reducing the level of BACE1 and increasing the level of ADAM17 and ADAM10. More importantly, we found that 7,8-DHC could mitigate memory impairment, promote the dendrite branch density, and increase synaptic protein expression via activating PI3K-Akt-CREB-BDNF signaling. Hence, these results suggested that 7,8-DHC represented a novel bioactive therapeutic agent in mitigating Aβ deposition and synaptic loss in the process of treating AD.

Clinical Profiles and Genetic Spectra of 814 Chinese Children With Short Stature

CONTEXT

Data and studies based on exome sequencing for the genetic evaluation of short stature are limited, and more large-scale studies are warranted. Some factors increase the likelihood of a monogenic cause of short stature, including skeletal dysplasia, severe short stature, and small for gestational age (SGA) without catch-up growth. However, whether these factors can serve as predictors of molecular diagnosis remains unknown.

OBJECTIVE

We aimed to explore the diagnostic efficiency of the associated risk factors and their exome sequences for screening.

METHODS

We defined and applied factors that increased the likelihood of monogenic causes of short stature in diagnostic genetic tests based on next-generation sequencing (NGS) in 814 patients with short stature and at least 1 other factor.

RESULTS

Pathogenic/likely pathogenic (P/LP) variants in genes, copy number variations, and chromosomal abnormalities were identified in 361 patients. We found P/LP variants among 111 genes, and RASopathies comprised the most important etiology. Short stature combined with other phenotypes significantly increased the likelihood of a monogenic cause, including skeletal dysplasia, facial dysmorphism, and intellectual disability, compared with simple severe short stature (<-3 SD scores). We report novel candidate pathogenic genes, KMT2C for unequivocal growth hormone insensitivity and GATA6 for SGA.

CONCLUSION

Our study identified the diagnostic characteristics of NGS in short stature with different risk factors. Our study provides novel insights into the current understanding of the etiology of short stature in patients with different phenotypes.

Evaluating the variety of GNAS inactivation disorders and their clinical manifestations in 11 Chinese children

BACKGROUND

The GNAS gene on chromosome 20q13.3, encodes the alpha-subunit of the stimulatory G protein, which is expressed in most tissues and regulated through reciprocal genomic imprinting. Disorders of GNAS inactivation produce several different clinical phenotypes including pseudohypoparathyroidism (PHP), pseudopseudohypoparathyroidism (PPHP), progressive osseous heteroplasia (POH), and osteoma cutis (OC). The clinical and biochemical characteristics overlap of PHP subtypes and other related disorders presents challenges for differential diagnosis.

METHODS

We enrolled a total of 11 Chinese children with PHP in our study and analyzed their clinical characteristics, laboratory results, and genetic mutations.

RESULTS

Among these 11 patients, nine of them (9/11) presented with resistance to parathyroid hormone (PTH); and nine (9/11) presented with an Albright's hereditary osteodystrophy (AHO) phenotype. GNAS abnormalities were detected in all 11 patients, including nine cases with GNAS gene variations and two cases with GNAS methylation defects. These GNAS variations included an intronic mutation (c.212 + 3_212 + 6delAAGT), three missense mutations (c.314C > T, c.308 T > C, c.1123G > T), two deletion mutations (c.565_568delGACT*2, c.74delA), and two splicing mutations (c.721 + 1G > A, c.432 + 1G > A). Three of these mutations, namely, c.314C > T, c.1123G > T, and c.721 + 1G > A, were found to be novel. This data was then used to assign a GNAS subtype to each of these patients with six cases diagnosed as PHP1a, two cases as PHP1b, one as PPHP, and two as POH.

CONCLUSIONS

Evaluating patients with PTH resistance and AHO phenotype improved the genetic diagnosis of GNAS mutations significantly. In addition, our results suggest that when GNAS gene sequencing is negative, GNAS methylation study should be performed. Early genetic detection is required for the differential diagnosis of GNAS disorders and is critical to the clinician's ability to distinguish between heterotopic ossification in the POH and AHO phenotype.

In vivo development and single-cell transcriptome profiling of human brain organoids

OBJECTIVES

Human brain organoids can provide not only promising models for physiological and pathological neurogenesis but also potential therapies in neurological diseases. However, technical issues such as surgical lesions due to transplantation still limit their applications.

MATERIALS AND METHODS

Instead of applying mature organoids, we innovatively developed human brain organoids in vivo by injecting small premature organoids into corpus striatum of adult SCID mice. Two months after injection, single-cell transcriptome analysis was performed on 6131 GFP-labeled human cells from transplanted mouse brains.

RESULTS

Eight subsets of cells (including neuronal cells expressing striatal markers) were identified in these in vivo developed organoids (IVD-organoids) by unbiased clustering. Compared with in vitro cultured human cortical organoids, we found that IVD-organoids developed more supporting cells including pericyte-like and choroid plexus cells, which are important for maintaining organoid homeostasis. Furthermore, IVD-organoids showed lower levels of cellular stress and apoptosis.

CONCLUSIONS

Our study thus provides a novel method to generate human brain organoids, which is promising in various applications of disease models and therapies.

Assessment of Risk Factors for Drug Resistance of Dual Anti Platelet Therapy After PCI

Since aspirin and clopidogrel are the widely and conventionally used drugs to treat acute myocardial infarction after percutaneous coronary intervention (PCI), it is important to explore potential risk factors of their resistance. The platelet aggregation rate with arachidonic acid (AA, PAg-AA%) and adenosine diphosphate (ADP, PAg-ADP%) of 219 PCI patients were measured after standard treatment for 24 h. The disease history and laboratory data (before PCI) were obtained. We found 101 (46.12%) patients to be aspirin-resistant, and PAg-ADP% was the most prominent risk factor of aspirin resistance. Clopidogrel resistance was present in 157 of 219 patients. Patients in the clopidogrel-resistant group carried more CYP2C19*3 or *2, which was associated with higher clopidogrel resistance in this group (69.11%, 47/68) than in the control group (64.29%, 36/56). Platelet count (10⁹/L) and hemoglobin (g/L) were the prominent risk factors of clopidogrel resistance. Among the 219 patients, 98 showed dual antiplatelet drug resistance, for which platelet count (10⁹/L) and monocyte count (g/L) were the risk factors. Aspirin resistance was found to usually accompany clopidogrel resistance.

Piezo1 initiates platelet hyperreactivity and accelerates thrombosis in hypertension

BACKGROUND

Thrombosis is the pathological basis of cardiovascular and cerebrovascular diseases, which seriously threaten human life and health. Among them, nearly half of cardiovascular disease patients suffer from severe hypertension complications. Hypertension is thought to cause abnormal platelet activation and increases the risk of thrombosis, but the related mechanism is still vague.

OBJECTIVES

This study hypothesized that the abnormal hemodynamics of blood under hypertension might affect platelet function and accelerate thrombosis by activating mechanoreceptor Piezo1.

METHODS

To assess the activation effect of hypertension on mechanoreceptor Piezo1, we injected Piezo1 agonist Yoda1 and antagonist GsMTx-4 through the tail vein, then examined the platelet activation status and thrombosis.

RESULTS

Our results displayed that antagonist GsMTx-4 effectively inhibited calcium influx caused by hypertension and agonist Yoda1. Antithrombotic studies proved that the inhibition of Piezo1 effectively inhibited arterial thrombosis and reduced the infarct size of stroke in hypertensive mice.

CONCLUSIONS

Our study explains the activation of mechanoreceptor Piezo1 under hypertension is the key to abnormal platelet activation and thrombosis while providing novel platelet intervention strategies to prevent thrombosis.

A first principles investigation on the structural, mechanical, electronic, and catalytic properties of biphenylene

Recently, a new two-dimensional allotrope of carbon (biphenylene) was experimentally synthesized. Using first-principles calculations, we systematically investigated the structural, mechanical, electronic, and HER properties of biphenylene. A large cohesive energy, absence of imaginary phonon frequencies, and an ultrahigh melting point up to 4500 K demonstrate its high stability. Biphenylene exhibits a maximum Young's modulus of 259.7 N/m, manifesting its robust mechanical performance. Furthermore, biphenylene was found to be metallic with a n-type Dirac cone, and it exhibited improved HER performance over that of graphene. Our findings suggest that biphenylene is a promising material with potential applications in many important fields, such as chemical catalysis.

ZNF213 negatively controls triple negative breast cancer progression via Hippo/YAP signaling

Breast cancer is one of the most commonly diagnosed malignancies worldwide, while the triple negative breast cancer (TNBC) is the most aggressive and virulent subtype in breast cancers. Compared with luminal type breast cancers, which could be well controlled by endocrine treatment, TNBC is worse in prognosis and lack of effective targeted therapy. Thus, it would be interesting and meaningful to identify novel therapeutic targets for TNBC treatments. Recent genomic data showed the activation of Hippo/YAP signaling in TNBC, indicating its critical roles in TNBC carcinogenesis and cancer progression. Hippo/YAP signaling could subject to several kinds of protein modifications, including ubiquitination and phosphorylation. Quite a few studies have demonstrated these modifications, which controlled YAP protein stability and turnover, played critical role in Hippo signaling activation In our current study, we identified ZNF213 as a negative modifier for Hippo/YAP axis. ZNF213 depletion promoted TNBC cell migration and invasion, which could be rescued by further YAP silencing. ZNF213 knocking down facilitated YAP protein stability and Hippo target gene expression, including CTGF and CYR61. Further mechanism studies demonstrated that ZNF213 associated with YAP and facilitated YAP K48-linked poly-ubiquitination at several YAP lysine sites (K252, K254, K321 and K497). Besides, the clinical data showed that ZNF213 negatively correlated with YAP protein level and Hippo target gene expression in TNBC samples. ZNF213 expression correlated with good prognosis in TNBC patients. Our data provided novel insights in YAP proteolytic regulation and TNBC progression.

Comprehensive analysis of lncRNA biomarkers in kidney renal clear cell carcinoma by lncRNA-mediated ceRNA network

Introduction

Kidney renal clear cell carcinoma (KIRC) has a high incidence globally, and its pathogenesis remains unclear. Long non-coding RNA (lncRNA), as a molecular sponge, participates in the regulation of competitive endogenous RNA (ceRNA). We aimed to construct a ceRNA network and screened out possible lncRNAs to predict KIRC prognosis.

Material and methods

All KIRC data were downloaded from the TCGA database and screened to find the possible target lncRNA; a ceRNA network was designed. Next, GO functional enrichment and KEGG pathway of differentially expressed mRNA related to lncRNA were performed. We used Kaplan-Meier curve analysis to predict the survival of these RNAs. We used Cox regression analysis to construct a model to predict KIRC prognosis.

Results

In the KIRC datasets, 1457 lncRNA, 54 miRNA and 2307 mRNA were screened out. The constructed ceRNA network contained 81 lncRNAs, nine miRNAs, and 17 mRNAs differentially expressed in KIRC. Survival analysis of all differentially expressed RNAs showed that 21 lncRNAs, four miRNAs, and two mRNAs were related to the overall survival rate. Cox regression analysis was performed again, and we found that eight lncRNAs were related to prognosis and used to construct predictive models. Three lnRNAs from independent samples were meaningful.

Conclusion

The construction of ceRNA network was involved in the process and transfer of KIRC, and three lncRNAs may be potential targets for predicting KIRC prognosis.

Preliminary proposal: a classification system for reconstruction with autologous femoral head after periacetabular tumors resection

BACKGROUND

Although researchers have adopted various methods for the resection and reconstruction of periacetabular tumors, the total incidence rate of complications remains high. Aiming for preserving the acetabulum and reducing the risk of complications, we applied a surgery method using tumor-free autologous femoral head to reconstruct the defective acetabulum after resection of periacetabular tumors followed by performing a conventional total hip arthroplasty (THA). Moreover, we proposed a preliminary classification system for these surgery methods.

METHODS

We retrospectively reviewed 6 patients treated with acetabulum reconstruction combined with autologous femoral head following peri-acetabulum resection between April 2010 and May 2018. All patients were diagnosed as periacetabular tumors including chondrosarcoma (n = 5) and chondroblastoma (n = 1). Clinical data such as age, diagnosis, complications, local recurrence or metastasis, and function (Musculoskeletal Tumor Society 1993, MSTS93) were documented. The average time of follow-up was 62.5 months (range, 17 to 106 months).

RESULTS

A total of 5 patients survive with average MSTS93 score of 27.8 points (range, 26-30). One patient, suffering from multiple bone metastasis prior treatment, ended up dying. One who had received radiotherapy before surgery had poor incision healing. Further, a classification system was preliminary proposed in 2 patients involving the pubis (type A) and 4 patients involving ischium (type B).

CONCLUSIONS

Based on the results, we preliminary proposed a classification system for reconstruction with autologous femoral head after periacetabular low malignant tumors resection. The clinical results suggested that surgery methods involving pubis (type A) and ischium (Type B) are safe and feasible. However, further researches should be conducted to verify our classification system.

Bismuth Subcarbonate Decorated Reduced Graphene Oxide Nanocomposite for the Sensitive Stripping Voltammetry Analysis of Pb(II) and Cd(II) in Water

In this paper, bismuth subcarbonate (BiO)2CO3-reduced graphene oxide nanocomposite incorporated in Nafion matrix ((BiO)2CO3-rGO-Nafion) was synthesized and further applied, for the first time, in the sensitive detection of Pb(II) and Cd(II) by square-wave anodic stripping voltammetry (SWASV). The as-synthesized nanocomposites were characterized by energy-dispersive spectroscopy (EDS), Raman spectroscopy, scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), cyclic voltammetry (CV), and electrochemical impedance spectroscopy (EIS). (BiO)2CO3 composite plays a key role in the improvement of the detection sensitivity, which can form multicomponent alloy with cadmium and lead. Additionally, the unique structure of rGO can enlarge the surface area and provide abundant active sites. Moreover, Nafion incorporation in the nanocomposite can effectively increase the adhesion and mechanical strength of the film, and further improve the preconcetration ability due to the cation-exchange capacity of its abundant sulfonate groups. As expected, the (BiO)2CO3-rGO/Nafion nanocomposite-modified glassy carbon electrode ((BiO)2CO3-rGO-Nafion/GCE) achieved low detection limits of 0.24 μg/L for Pb(II) and 0.16 μg/L for Cd(II), in the linear range of 1.0-60 μg/L, and showed some excellent performance, such as high stability, good selectivity, and sensitivity. Finally, synthetic water samples were prepared and further used to verify the practicability of the (BiO)2CO3-rGO-Nafion/GCE with satisfactory results.

Impact of infection in patients with non-ST elevation acute coronary syndrome undergoing percutaneous coronary intervention: insight from a multicentre observational cohort from China

OBJECTIVE

We aimed to describe the association between in-hospital infection and prognosis among patients with non-ST elevation acute coronary syndrome (NSTE-ACS) who received percutaneous coronary intervention (PCI).

DESIGN

This observational cohort originated from a database of patients with NSTE-ACS who underwent PCI from 1 January 2010 to 31 December 2014.

SETTING

Five centres in South China.

PARTICIPANTS

This multicentre observational cohort study consecutively included 8197 patients with NSTE-ACS who received PCI. Only patients with adequate information to diagnose or rule out infection were included. Patients were excluded if they were diagnosed with a malignant tumour, were pregnant or presented with cardiogenic shock at the index date. Patients were grouped by whether they had in-hospital infection or not.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was all-cause death and major bleeding during hospitalisation. The secondary outcomes included all-cause death and major bleeding during follow-up and in-hospital myocardial infarction.

RESULTS

Of the 5215 patients, 206 (3.95%) acquired infection. Patients with infection had a higher rate of in-hospital all-cause death and major bleeding (4.4% vs 0.2% and 16.5% vs 1.2%, respectively; p<0.001). After adjusting for confounders, infection remained independently associated with in-hospital and long-term all-cause death (OR, 13.19, 95% CI 4.59 to 37.87; HR, 2.03, 95% CI 1.52 to 2.71; p<0.001) and major bleeding (OR, 10.24, 95% CI 6.17 to 16.98; HR, 5.31, 95% CI 3.49 to 8.08; p<0.001). A subgroup analysis confirmed these results.

CONCLUSIONS

The incidence of infection is low during hospitalisation, but is associated with worse in-hospital and long-term outcomes.

[Autologous versus unrelated donor stem cell transplantation for adults with primary acute myeloid leukemia in first remission]

Objective: To compare differences of autologous and unrelated donor stem cell transplantation (auto-HSCT and URD-HSCT) for adults with primary acute myeloid leukemia (AML) in first complete remission (CR(1)) from a single center and to investigate the appropriate patients for the 2 types of transplant. Methods: In this retrospective investigation, we studied adults with primary AML who received auto-HSCT and URD-HSCT from March 2008 to November 2018. Overall survival (OS) , leukemia-free survival (LFS) , relapse, transplant-related mortality (TRM) , and hematopoietic reconstitution were compared along with the prognostic value of cytogenetics. Results: A total of 147 adult patients were enrolled in this study (n=87 for auto-HSCT and n=60 for URD-HSCT) . Baseline characteristics were comparable between the 2 groups. The accumulative neutrophil engraftment rate at +30 days was not statistically different between the 2 groups[92.6% (95% CI 86.9%-98.3%) vs 98.3% (95% CI 95.0%-100.0%) , P=0.270], whereas the accumulative platelet engraftment rate at +60 days was significantly lower in the auto-HSCT group[83.6% (95% CI 75.8%-91.4%) vs 93.3% (95% CI 87.0%-99.6%) , P<0.001]. In patients undergoing URD-HSCT, the accumulative incidences of acute GVHD (aGVHD) and grade Ⅱ-Ⅳ aGVHD were 56.7% (95% CI 43.0%-68.2%) and 16.7% (95% CI 8.5%-27.2%) , and the incidences of chronic GVHD (cGVHD) and extensive cGVHD were 33.3% (95% CI 21.7%-45.4%) and 15.0% (95% CI 7.3%-25.2%) , respectively. After a median follow-up of 53.8 (0.8-127.8) months, patients in the 2 groups demonstrated comparable OS and LFS at 5 years after transplant[71.7% (95% CI 61.7%-81.7%) vs 67.8% (95% CI 55.8%-79.8%) , P=0.556; 64.6% (95% CI 54.4%-74.8%) vs 68.1% (95% CI 56.3%-79.9%) , P=0.642]. Patients in the auto-HSCT group showed significantly higher incidence of relapse at 5 years after transplant[31.9% (95% CI 22.2%-42.1%) vs 15.1% (95% CI 7.4%-25.6%) , P=0.015] and significantly lower incidence of TRM[3.4% (95% CI 0.9%-8.9%) vs 16.7% (95% CI 8.5%-27.2%) , P=0.006] compared with the URD group. HLA mismatching had no effects on the incidences of hematopoietic reconstitution, GVHD, OS, LFS, relapse, and TRM. Patients of cytogenetically favorable and intermediate risk demonstrated comparable OS and LFS after auto-HSCT and URD-HSCT, while patients of poor risk had significantly higher relapse and lower LFS after auto-HSCT. Conclusions: In this study, adults with primary AML in CR(1) demonstrated relatively higher relapse but lower TRM after auto-HSCT, resulting in comparable survival to that of URD-HSCT. In the absence of matched sibling donors, patients of cytogenetically poor risk should receive URD-HSCT in order to achieve lower relapse and better survival.

Comparison of chest CT findings between COVID-19 pneumonia and other types of viral pneumonia: a two-center retrospective study

OBJECTIVES

To compare the pulmonary chest CT findings of patients with COVID-19 pneumonia with those with other types of viral pneumonia.

METHODS

This retrospective review includes 154 patients with RT-PCR-confirmed COVID-19 pneumonia diagnosed between February 11 and 20, 2020, and 100 patients with other types of viral pneumonia diagnosed between April 2011 and December 2020 from two hospitals. High-resolution CT (HRCT) of the chest was performed. Data on location, distribution, attenuation, maximum lesion range, lobe involvement, number of lesions, air bronchogram signs, Hilar and mediastinal lymph node enlargement, and pleural effusion were collected. Associations between imaging characteristics and COVID-19 pneumonia were analyzed with univariate and multivariate logistic regression models.

RESULTS

A peripheral distribution was associated with a 13.04-fold risk of COVID-19 pneumonia, compared with a diffuse distribution. A maximum lesion range > 10 cm was associated with a 9.75-fold risk of COVID-19 pneumonia, compared with a maximum lesion range ≤ 5 cm, and the involvement of 5 lobes was associated with an 8.45-fold risk of COVID-19 pneumonia, compared with a maximum lesion range ≤ 2. No pleural effusion was associated with a 3.58-fold risk of COVID-19 pneumonia compared with the presence of pleural effusion. Hilar and mediastinal lymph node enlargement was associated with a 2.79-fold risk of COVID-19 pneumonia.

CONCLUSION

A peripheral distribution, a lesion range > 10 cm, involvement of 5 lobes, presence of hilar and mediastinal lymph node enlargement, and no pleural effusion were significantly associated with 2019-novel coronavirus pneumonia.

KEY POINTS

• A peripheral distribution, a lesion range > 10 cm, involvement of 5 lobes, presence of hilar and mediastinal lymph node enlargement, and no pleural effusion were significantly associated with COVID-19 compared with other types of viral pneumonia.

Isolation and characterization of Bacillus subtilis strain 1-L-29, an endophytic bacteria from Camellia oleifera with antimicrobial activity and efficient plant-root colonization

Endophytic bacteria, which are common in plant tissues, may help to control plant pathogens and enhance plant growth. Camellia oleifera, an oil-producing plant, is widely grown in warm, subtropical, hilly regions in China. However, C. oleifera is strongly negatively affected by C. oleifera anthracnose, which is caused by Colletetrichum fructicola. To find a suitable biocontrol agent for C. oleifera anthracnose, 41 endophytes were isolated from the stems, leaves, and roots of C. oleifera. Bacterial cultures were identified based on analyses of 16S rDNA sequences; most strains belonged to the genus Bacillus. The antagonistic effects of these strains on C. fructicola were tested in vitro. In total, 16 strains inhibited C. fructicola growth, with B. subtilis strain 1-L-29 being the most efficient. Strain 1-L-29 demonstrated antagonistic activity against C. siamense, C. asianum, Fusarium proliferatum, Agaricodochium camellia, and Pseudomonas syringae. In addition, this strain produced indole acetic acid, solubilized phosphate, grew on N-free media, and produced siderophores. To facilitate further microecological studies of this strain, a rifampicin-resistant, green fluorescent protein (GFP)-labeled strain, 1-L-29gfp^r, was created using protoplast transformation. This plasmid had good segregational stability. Strain 1-L-29gfp^r was re-introduced into C. oleifera and successfully colonized root, stem, and leaf tissues. This strain remained at a stable concentration in the root more than 20 d after inoculation. Fluorescence microscopic analysis showed that strain 1-L-29gfp^r thoroughly colonized the root surfaces of C. fructicola as well as the root vascular tissues of Arabidopsis thaliana.

Role of BP230 autoantibodies in bullous pemphigoid

Bullous pemphigoid (BP) is an autoimmune disease associated with subepidermal blistering due to autoantibodies directed against BP180 and BP230. BP180 is currently considered as the major pathogenic autoantigen. However, previous clinical findings suggested that anti-BP230 autoantibodies alone can cause skin lesions in animal models and many BP patients. The characteristics of BP230 and the pathogenic roles of anti-BP230 antibodies have been proposed. First, at the molecular level, BP230 mediates the attachment of keratin intermediate filaments to the hemidesmosomal plaque and interacts with other constituents of hemidesmosomes. Second, the presence of BP230 autoantibodies may correlate with specific clinical features of BP. The immunoglobulin (Ig)G autoantibodies from BP patients react mainly against the C-terminus of BP230, while the IgE autoantibodies are still inconclusive. Third, in vivo, autoantibodies against BP230 involved in the disease may not only induce the inflammatory response but also impair the structural stability of hemidesmosomes. This article reviews recently published work about the role of BP230 and its antibodies, including IgG and IgE, aiming to find clues of its clinical association and lay the foundation for the research on the pathogenicity of antibodies against BP230.

A nanocomposite prepared from bifunctionalized ionic liquid, chitosan, graphene oxide and magnetic nanoparticles for aptamer-based assay of tetracycline by chemiluminescence

A nanocomposite was prepared from a bifunctionalized ionic liquid, chitosan on magnetic nanoparticle-modified graphene oxide (IL/Chit@MGO). It was used in a chemiluminescencc (CL) assay for tetracycline. The materials were characterized by Fourier transform infrared spectroscopy, scanning electron microscopy, X-ray powder diffraction, nitrogen adsorption-desorption isotherm, vibrating sample magnetometry and zeta potentials. Subsequently, a tetracycline-binding aptamer (TC-Apt) acting as a recognition element, and G-quadruplex DNAzyme (G-DNAzyme) acting as a signal amplification component were modified on IL/Chit@MGO. So, the bifunctional G-DNAzyme/TC-Apt/IL/Chit@MGO was prepared. The IL/Chit@MGO is found to possess excellent loading capability for TC-Apt. This is attributed to the large specific surface and abundant charge on the surface of IL/Chit@MGO. The composite was used to construct a CL assay for tetracycline. Tetracycline binds to TC-Apt and causes the release of the G-DNAzyme. The latter catalyzes the CL of luminol-H₂O₂ CL system at pH 7.4. Under optimized conditions, the blue CL at the emission wavelength of 425 nm increases linearly in the 0.16 pM to 2.0 nM concentration range, and the detection limit is 21 fM (at 3σ). The assay is selective, reproducible and stable. The assay was applied to tetracycline detection in practical samples. The apparent recoveries are 98.0% to 101.3% for the milk sample and 97.0% to 102.2% for the water sample. Graphical abstractG-quadruplex DNAzyme (G-DNAzyme) and tetracycline aptamer (TC-Apt) bifunctionalized ionic liquid/chitosan@magnetic graphene oxide (IL/Chit@MGO) was prepared. The nanocomposite was used to construct a chemiluminescence (CL) assay for tetracycline.

Clinical evaluation of deep brain stimulation of nucleus accumbens/anterior limb of internal capsule for opioid relapse prevention: protocol of a multicentre, prospective and double-blinded study

INTRODUCTION

Deep brain stimulation (DBS) is a new potential surgical treatment for opioid dependence. However, the implement of DBS treatment in addicted patients is currently controversial due to the significant associated risks. The aim of this study was mainly to investigate the therapeutic efficacy and safety of bilateral DBS of nucleus accumbens and the anterior limb of the internal capsule (NAc/ALIC-DBS) in patients with refractory opioid dependence (ROD).

METHODS AND ANALYSIS

60 patients with ROD will be enrolled in this multicentre, prospective, double-blinded study, and will be followed up for 25 weeks (6 months) after surgery. Patients with ROD (semisynthetic opioids) who meet the criteria for NAc/ALIC-DBS surgery will be allocated to either the early stimulation group or the late stimulation group (control group) based on the randomised ID number. The primary outcome was defined as the abstinence rate at 25 weeks after DBS stimulation on, which will be confirmed by an opiate urine tests. The secondary outcomes include changes in the Visual Analogue Scale (VAS) score for craving for opioid drugs, body weight, as well as psychological evaluation measured using the 17-item Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Pittsburgh Sleep Quality Index, Fagerstrom test for nicotine dependence assessment, social disability screening schedule, the Activity of Daily Living Scale, the 36-item Short Form-Health Survey and safety profiles of both groups.

ETHICS AND DISSEMINATION

The study received ethical approval from the medical ethical committee of Tangdu Hospital, The Fourth Military Medical University, Xi'an, China. The results of this study will be published in a peer-reviewed journal and presented at international conferences.

TRIAL REGISTRATION NUMBER

NCT03424616; Pre-results.

Integration of homogeneous structural region identification and rock mass quality classification

In rock engineering projects, professionals assess the overall rock mass qualities using a sole value. However, the true qualities of partial rock masses are incompatible with such a value. To address this problem, the idea of regionally classifying rock mass qualities is proposed and the associated procedure presented. To achieve this goal, the probabilistic and deterministic joints within the study area were determined, and a three-dimensional joint network model was created. Then, the three-dimensional joint network model was discretized into interlocking subdomains, and the modified blockiness index (MBi ) was used to finely identify the homogeneous structural regions, together with the k-means algorithm and the sum of squared errors (SSE). A synthetic model comprising homogeneous structural regions was developed and validated with respect to the extracted cross-sections. Next, an improved rock mass rating system (RMRmbi ) was introduced, and the viability of RMRmbi was supported through a significant amount of theoretical cases and several real cases. Finally, visualization of regional RMRmbi classification results was performed. Results show that: (i) the homogeneous structural regions are finely demarcated in three dimensions, and (ii) the proposed idea can overcome the problem of rock mass quality classification using the conventional approach often leading to 'overgeneralization'.

Molecular characterization and expression of six heat shock protein genes in relation to development and temperature in Trichogramma chilonis

Trichogramma is a kind of egg parasitoid wasp that is widely used to control lepidopterous pests. Temperature is one of the main factors that determines the various life activities of this species, including development, reproduction and parasitism efficiency. Heat shock proteins (HSPs) are highly conserved and ubiquitous proteins that are best known for their responsiveness to temperature and other stresses. To explore the potential role of HSPs in Trichogramma species, we obtained the full-length cDNAs of six HSP genes (Tchsp10, Tchsp21.6, Tchsp60, Tchsp70, Tchsc70-3, and Tchsp90) from T. chilonis and analyzed their expression patterns during development and exposure to temperature stress. The deduced amino acid sequences of these HSP genes contained the typical signatures of their corresponding protein family and showed high homology to their counterparts in other species. The expression levels of Tchsp10, Tchsp21.6 and Tchsp60 decreased during development. However, the expression of Tchsc70-3 increased from the pupal stage to the adult stage. Tchsp70 and Tchsp90 exhibited the highest expression levels in the adult stage. The expression of six Tchsps was dramatically upregulated after 1 h of exposure to 32 and 40°C but did not significantly change after 1 h of exposure to 10 and 17°C. This result indicated that heat stress, rather than cold stress, induced the expression of HSP genes. Furthermore, the expression of these genes was time dependent, and the expression of each gene reached its peak after 1 h of heat exposure (40°C). Tchsp10 and Tchsp70 exhibited a low-intensity cold response after 4 and 8 h of exposure to 10°C, respectively, but the other genes did not respond to cold at any time points. These results suggested that HSPs may play different roles in the development of this organism and in its response to temperature stress.

Design of limited-stop service based on the degree of unbalance of passenger demand

This paper presents a limited-stop service for a bus fleet to meet the unbalanced demand of passengers on a bus route and to improve the transit service of the bus route. This strategy includes two parts: a degree assessment of unbalanced passenger demand and an optimization of the limited-stop service. The degree assessment of unbalanced passenger demand, which is based on the different passenger demand between stations and the unbalance of passengers within the station, is used to judge whether implementing the limited-stop service is necessary for a bus route. The optimization of limited-stop service considers the influence of stop skipping action and bus capacity on the left-over passengers to determine the proper skipping stations for the bus fleet serving the entire route by minimizing both the waiting time and in-vehicle time of passengers and the running time of vehicles. A solution algorithm based on genetic algorithm is also presented to evaluate the degree of unbalanced passenger demand and optimize the limited-stop scheme. Then, the proper strategy is tested on a bus route in Changchun city of China. The threshold of degree assessment of unbalanced passenger demand can be calibrated and adapted to different passenger demands.