Life cycle assessment of post-combustion carbon capture and storage for the ultra-supercritical pulverized coal power plant

In this paper, different emerging post-combustion technologies, i.e., monoethanolamine (MEA), aqueous ammonia, pressure swing adsorption (PSA), temperature swing adsorption (TSA), membrane and calcium looping, were applied to an ultra-supercritical coal-fired power plant for carbon capture. A 'cradle-to-grave' life cycle assessment (LCA) was conducted to evaluate the technical performance and environmental impacts of the power plant with six emerging carbon capture technologies. Carbon capture significantly influences the impact categories directly associated with flue gas emission. The application of carbon capture reduced the GWP in the range of 49-75 %. TAP also reduced in the range of 18-51 %. However, the human toxicity potential, eutrophication potential, ecotoxicity potential and particulate matter formation potential increased due to energy and resource consumption in the upstream and downstream processes. For the life cycle water consumption potential, it decreased by 8 % with calcium looping, whereas it increased in the range of 36-75 % with other post-combustion technologies. The highest reduction in GWP and the least reduction in power efficiency was observed in calcium looping because of the high-temperature heat recovery from flue gas and elimination of complex solvent manufacturing. The plant with aqueous ammonia and membrane separation had the second and third highest reductions in GWP. In addition, the lowest values for TAP, FEP, and MEP were obtained in the membrane system. With MEA for CO2 capture, the total GWP value of the plant is slightly higher than these three technologies mentioned above, and the highest HTPc, FETP, and METP can be observed in this case. TSA and PSA have the most significant environmental impacts in most categories due to higher energy requirements.

Different extramedullary disease shown in chemokine receptor 4 targeted PET/CT with [68Ga]Ga-pentixafor in patients with Waldenström macroglobulinemia and smoldering disease

INTRODUCTION

It is important to distinguish Waldenström macroglobulinemia from smoldering Waldenström macroglobulinemia (sWM), because only patients with Waldenström macroglobulinemia require treatment, however the distinction can be clinically complex. The aim of this study is to investigate whether [68Ga]Ga-pentixafor PET/CT shows different characteristics in sWM and Waldenström macroglobulinemia patients and therefore can help to differentiate Waldenström macroglobulinemia and sWM.

RESULTS

Thirty-seven patients with newly diagnosed Waldenström macroglobulinemia and 11 sWM patients were analyzed [35 men and 13 women; 64.3 ± 10.7 (range, 29-87) years old]. The SUVmax of bone marrow disease, lymph nodes, and other extramedullary diseases on [68Ga]Ga-pentixafor were significantly higher than those on 2-[18F]FDG PET/CT (P < 0.05). On [68Ga]Ga-pentixafor PET/CT, patients with Waldenström macroglobulinemia had more lymph node regions involved, significantly higher incidence of involvement in more than three lymph node regions, larger nodal disease, and higher incidence of other extramedullary disease when compared with sWM patients (P < 0.05). Waldenström macroglobulinemia patients showed significantly higher total lesions uptake, total lesion volume, and SUVmax of extramedullary disease than sWM patients did (P < 0.05). None of the visual or semiquantitative indexes in 2-[18F]FDG PET/CT showed significant difference between Waldenström macroglobulinemia and sWM patients.

CONCLUSION

[68Ga]Ga-pentixafor PET/CT had better diagnostic performance than 2-[18F]FDG PET/CT in Waldenström macroglobulinemia. Patients with Waldenström macroglobulinemia presented with more extensive extramedullary disease shown in [68Ga]Ga-pentixafor PET/CT than sWM patients did.

Cations-Pillared and Polyaniline-Encapsulated Vanadate Cathode for High-Performance Aqueous Zinc-Ion Batteries

Layered vanadium-based oxides have emerged as highly promising candidates for aqueous zinc-ion batteries (AZIBs) due to their open-framework layer structure and high theoretical capacity among the diverse cathode materials investigated. However, the susceptibility to structural collapse during charge-discharge cycling severely hampers their advancement. Herein, we propose an effective strategy to enhance the cycling stability of vanadium oxides. Initially, the structural integrity of the host material is significantly reinforced by incorporating bi-cations Na+ and NH4 + as "pillars" between the V2O5 layers (NaNVO). Subsequently, surface coating with polyaniline (PA) is employed to further improve the conductivity of the active material. As anticipated, the assembled Zn//NaNVO@PA cell exhibits a remarkable discharge capacity of 492 mAh g-1 at 0.1 A g-1 and exceptional capacity retention up to 89.2 % after 1000 cycles at a current density of 5 A g-1. Moreover, a series of in-situ and ex-situ characterization techniques were utilized to investigate both Zn ions insertion/extraction storage mechanism and the contribution of polyaniline protonation process towards enhancing capacity.

[Dosimetric analysis of different optimization algorithms for three-dimensional brachytherapy for gynecologic tumors]

OBJECTIVE

To investigate the dosimetric difference between manual and inverse optimization in 3-dimensional (3D) brachytherapy for gynecologic tumors.

METHODS

This retrospective study was conducted among a total of 110 patients with gynecologic tumors undergoing intracavitary combined with interstitial brachytherapy or interstitial brachytherapy. Based on the original images, the brachytherapy plans were optimized for each patient using Gro, IPSA1, IPSA2 (with increased volumetric dose limits on the basis of IPSA1) and HIPO algorithms. The dose-volume histogram (DVH) parameters of the clinical target volume (CTV) including V200, V150, V100, D90, D98 and CI, and the dosimetric parameters D2cc, D1cc, and D0.1cc for the bladder, rectum, and sigmoid colon were compared among the 4 plans.

RESULTS

Among the 4 plans, Gro optimization took the longest time, followed by HIPO, IPSA2 and IPSA1 optimization. The mean D90, D98, and V100 of HIPO plans were significantly higher than those of Gro and IPSA plans, and D90 and V100 of IPSA1, IPSA2 and HIPO plans were higher than those of Gro plans (P < 0.05), but the CI of the 4 plans were similar (P > 0.05). For the organs at risk (OARs), the HIPO plan had the lowest D2cc of the bladder and rectum; the bladder absorbed dose of Gro plans were significantly greater than those of IPSA1 and HIPO (P < 0.05). The D2cc and D1cc of the rectum in IPSA1, IPSA2 and HIPO plans were better than Gro (P < 0.05). The D2cc and D1cc of the sigmoid colon did not differ significantly among the 4 plans.

CONCLUSION

Among the 4 algorithms, the HIPO algorithm can better improve dose coverage of the target and lower the radiation dose of the OARs, and is thus recommended for the initial plan optimization. Clinically, the combination of manual optimization can achieve more individualized dose distribution of the plan.

A novel perspective for exploring the relationship between cerebral small vessel disease and deep medullary veins with automatic segmentation

BACKGROUND

This study aimed to establish an intelligent segmentation algorithm to count the number of deep medullary veins (DMVs) and analyze the relationship between DMVs and imaging markers of cerebral small vessel disease (CSVD).

METHODS

DMVs on magnetic resonance imaging (MRI) of patients with CSVD were counted by intelligent segmentation and manual counting. The dice coefficient and intraclass correlation coefficient (ICC) were used to evaluate their consistency and correlation. Structural MR images were used to assess imaging markers and total burden of CSVD. A multivariate linear regression model was used to evaluate the correlation between the number of DMVs counted by intelligent segmentation and imaging markers of CSVD, including white matter hyperintensities of the presumed vascular origin, lacune, perivascular spaces, cerebral microbleeds, and total CSVD burden.

RESULTS

A total of 305 patients with CSVD were enrolled. An intelligent segmentation algorithm was established to calculate the number of DMVs, and it was validated and tested. The number of DMVs counted intelligently significantly correlated with the manual counting method (r = 0.761, P< 0.001). The number of smart-counted DMVs negatively correlated with the imaging markers and total burden of CSVD (P< 0.001), and the correlation remained after adjusting for age and hypertension (P< 0.05).

CONCLUSIONS

The proposed intelligent segmentation algorithm, which was established to count DMVs, can provide objective and quantitative imaging information for the follow-up of patients with CSVD. DMVs are involved in CSVD pathogenesis and a likely new imaging marker for CSVD.

Comparison of neuroimaging features of histiocytic neoplasms with central nervous system involvement: a retrospective study of 121 adult patients

OBJECTIVES

To compare neuroimaging characteristics of three types of histiocytoses, namely Langerhans cell histiocytosis (LCH), Erdheim-Chester disease (ECD), and Rosai-Dorfman disease (RDD), with central nervous system (CNS) involvement.

METHODS

A total of 121 adult patients with histiocytoses (77 LCH, 37 ECD, and 7 RDD) and CNS involvement were retrospectively included. Histiocytoses were diagnosed based on histopathological findings combined with suggestive clinical and imaging features. Brain and dedicated pituitary MRIs were systematically analyzed for tumorous, vascular, degenerative lesions, sinus, and orbital involvement and for hypothalamic pituitary axis involvement.

RESULTS

Endocrine disorders, including diabetes insipidus and central hypogonadism, were more common in LCH patients than in ECD and RDD patients (p < 0.001). In LCH, tumorous lesions were mostly solitary (85.7%), located in the hypothalamic pituitary region (92.9%), and without peritumoral edema (92.9%), while in ECD and RDD, tumorous lesions were often multiple (ECD: 81.3%, RDD: 85.7%), their distribution was more widespread with meninges mostly involved (ECD: 75%, RDD: 71.4%), and they most likely presented with peritumoral edema (ECD: 50%, RDD: 57.1%; all p ≤ 0.020). Vascular involvement was an exclusive imaging characteristic of ECD (17.2%), which was not observed in LCH or RDD; this was also associated with a higher risk of death (p = 0.013, hazard ratio = 11.09).

CONCLUSION

The typical characteristic of adult CNS-LCH was endocrine disorders with radiological findings limited to the hypothalamic pituitary axis. The pattern of multiple tumorous lesions with predominant involvement of meninges was the main manifestation of CNS-ECD and CNS-RDD, while vascular involvement was pathognomonic for ECD and associated with poor prognosis.

CLINICAL RELEVANCE STATEMENT

Involvement of the hypothalamic-pituitary axis is the typical imaging characteristic of Langerhans cell histiocytosis. Multiple tumorous lesions, predominantly involving but not limited to meninges, occur in most Erdheim-Chester disease and Rosai-Dorfman disease patients. Vascular involvement occurs only in Erdheim-Chester disease patients.

KEY POINTS

• The different distribution patterns of brain tumorous lesions can help differentiate among LCH, ECD, and RDD. • Vascular involvement was an exclusive imaging finding of ECD and was associated with high mortality. • Some cases with atypical imaging manifestations were reported to further expand the knowledge on these diseases.

Reversible Multielectron Redox Chemistry in a NASICON-Type Cathode toward High-Energy-Density and Long-Life Sodium-Ion Full Batteries

Na-superionic-conductor (NASICON)-type cathodes (e.g., Na3 V2 (PO4 )3 ) have attracted extensive attention due to their open and robust framework, fast Na+ mobility, and superior thermal stability. To commercialize sodium-ion batteries (SIBs), higher energy density and lower cost requirements are urgently needed for NASICON-type cathodes. Herein, Na3.5 V1.5 Fe0.5 (PO4 )3 (NVFP) is designed by an Fe-substitution strategy, which not only reduces the exorbitant cost of vanadium, but also realizes high-voltage multielectron reactions. The NVFP cathode can deliver extraordinary capacity (148.2 mAh g-1 ), and decent cycling durability up to 84% after 10 000 cycles at 100 C. In situ X-ray diffraction and ex situ X-ray photoelectron spectroscopy characterizations reveal reversible structural evolution and redox processes (Fe2+ /Fe3+ , V3+ /V4+ , and V4+ /V5+ ) during electrochemical reactions. The low ionic-migration energy barrier and ideal Na+ -diffusion kinetics are elucidated by density functional theory calculations. Combined with electron paramagnetic resonance spectroscopy, Fe with unpaired electrons in the 3d orbital is inseparable from the higher-valence redox activation. More competitively, coupling with a hard carbon (HC) anode, HC//NVFP full cells demonstrate high-rate capability and long-duration cycling lifespan (3000 stable cycles at 50 C), along with material-level energy density up to 304 Wh kg-1 . The present work can provide new perspectives to accelerate the commercialization of SIBs.

[Characteristics of genioglossus neuromuscular activity in patients with obstructive sleep apnea during drug-induced sleep]

Objective: To analyze genioglossus (GG) activation responses to the negative pressure of upper airway cavity during awake and different sleep stages in patients with different obstructive sleep apnea (OSA) graduation. Methods: This prospective cohort study started from August 2019 to January 2021, recruited 42 male OSA patients aged from 21 to 59 (38.77±8.42) years. After completing whole night polysomnography (PSG) and upper airway CT, each subject underwent drug-induced sleep with simultaneous monitoring of genioglossal electromyography (GGEMG) and pressure of epiglottis (Pepi). Subjects were divided into three groups of mild OSA(7 males), moderate OSA(12 males), and severe OSA(23 males). The differences in upper airway CT measurements, parameters of GGEMG and Pepi during awake and induced sleep were compared. Statistical analysis was conducted by SPSS 21.0. Results: There was no significant difference in the GGEMG parameters between the mild and moderate groups. In wakefulness, the peak phasic GGEMG of the severe group was higher than the mild group (t=1.249, P=0.025), with no statistically difference in the corresponding Pepi. In the sleep onset, the GGEMG parameters and Pepi in severe group were higher than the other two groups. Linear regression analysis of the maximum GGEMG and maximum Pepi at the end of obstructive apnea (OA) in all moderate plus severe patients (n=35) was shown nonlinear correlation (r=0.28, P=0.694). The airway length of the glossopharyngeal cavity was linearly correlated with the maximum Pepi of OA (r=0.468, R2=0.219, P=0.005). Conclusions: The individual difference of GG activation in OSA patients is related to the severity of the disease (frequency of respiratory events) and negative pressure stimulation. In moderate and severe OSA patients, GG activity is not in harmony with the corresponding negative pressure stimulation, which may be one of the mechanisms leading to the aggravation of OSA.

Langerhans Cell Histiocytosis Showed Intense Uptake of 68 Ga-FAPI

ABSTRACT

A 23-year-old man was recently diagnosed with Langerhans cell histiocytosis (LCH). 68 Ga-FAPI PET/CT showed multiple lesions with intense FAPI uptake in the axial and appendicular skeleton with lytic or mixed bone destruction, consistent with osseous lesions of LCH. FAPI-avid foci around the right atrium and inferior vena cava, as well as micronodules and thin-walled cysts in the lungs, were also noted, possibly also involvement of LCH. This case suggested that 68 Ga-FAPI PET/CT may have the potential to be applied in evaluation of LCH.

Comparison between oral and enteral tube refeeding in hyperlipidemic acute pancreatitis

OBJECTIVE

Hyperlipidemic acute pancreatitis (HLAP) remains one of the major digestive emergencies with increasing health risks. Oral refeeding tolerant (ORT) and enteral tube feeding tolerant (ETFT) are commonly used for nutritional management in HLAP. However, the differences between ORT and ETFT are yet to be characterized.

PATIENTS AND METHODS

This study included consecutive patients admitted to the Ordos Central Hospital between January 2019 and April 2023, with predefined inclusion criteria.

RESULTS

A total of 335 HLAP patients were recruited according to the inclusion criteria. 268 patients were diagnosed with moderately severe acute pancreatitis (MSAP), of which 193 were in the OFT group and 75 in the ETFT group. In the ETFT group, abdominal pain and abdominal distension were significantly higher than that in the OFT group. No significant result was identified in the laboratory data. However, the OFT group showed a higher hospitalization and cost, as well as exocrine insufficiency and newly onset diabetes, than the ETFT group.

CONCLUSIONS

Based on the incidence of HLAP retrieved in this study, MSAP is the major type with increasing clinical value. From the nutritional management sense, patients who received OFT showed higher hospitalization and cost, as well as lower exocrine insufficiency and newly onset diabetes.

Identification of Excellent Prognosis IDH Wildtype Glioblastomas Using Genomic and Metabolic Profiling

PURPOSE/OBJECTIVE(S)

High grade gliomas (HGGs) are aggressive brain tumors with altered cellular metabolism. HGGs can carry mutations in the tricarboxylic acid (TCA) cycle enzyme isocitrate dehydrogenase 1 (IDH1), conferring distinct biology and improved patient prognosis compared to IDH wildtype (wt) tumors. Using metabolomic analyses of tumor tissue, we previously showed that IDH wt and IDH mutant (IDH mut) tumors have unique metabolomic signatures that correlate with different survival outcomes. Among this cohort of 69 HGG samples, we identified two unique patient tumors that metabolically clustered with IDH mut tumors, but lacked both the IDH mutation and its product 2-hydroxyglutarate. We aimed to discover unique mutations in these two tumors that may impart an IDH mutant-like phenotype in the absence of an IDH1 or IDH2 mutation.

MATERIALS/METHODS

Whole exome sequencing (WES) was performed on frozen tumor samples from two patients diagnosed as glioblastoma (GBM), IDH wt via Agilent v5 + IncRNA platform. Alignment to the hg38 genome and variant calling were completed using an accelerated implementation of GATK's BWA and MuTect2 algorithms from Sentieon. Variants were filtered based on supporting reads and variant allele thresholds, with synonymous variants and common SNPs removed. High-confidence variants were further filtered by membership in the four KEGG pathways associated with IDH1 and IDH2. Identified variants were corroborated with metabolomics data from the two unique IDH wt tumors compared with classical GBM IDH wt, oligodendrogliomas IDH mut and astrocytomas IDH mut to identify putative drivers of an IDH mutant-like metabolomic phenotype in these unique IDH wt tumors.

RESULTS

Despite the lack of an IDH mutation, one patient survived 45.6 months and the other patient remains alive at last follow up 64 months post diagnosis, much longer than the 16-18-month median survival typical of patients with GBM IDH wt. WES of outlier IDH wt tumor samples revealed 65 unique mutations in the queried KEGG pathways, of which 34 had a variant allele frequency > = 0.15. These variants were processed in Gprofiler, confirming expected enrichment of the carboxylic acid metabolic biologic process, a functional gene set consisting of TCA genes, among these variants (p = 0.002, 3.6-fold enrichment). Accordingly, metabolite levels of intermediates of the TCA cycle, including malate and isocitrate were decreased in the outlier tumor samples compared to classic GBMs IDH wt (p<0.001). Presence of genetic alterations in key variants of the carboxylic acid metabolic biologic process (including ME1, GYP4F3, PTGIS, PFKL, PSPH, AKR1A1, HK2, NOS1) correlated with improved overall survival among GBM patients in the TCGA (p = 0.04). Laboratory validation of these findings in preclinical GBM models is ongoing.

CONCLUSION

Disruption of the TCA cycle independent of an IDH mutation is associated with favorable survival in GBM. Pharmacologic inhibition of these pathways may be a promising strategy to improve GBM outcomes.

Performance of 68Ga-Labeled Fibroblast Activation Protein Inhibitor PET/CT in Evaluation of Erdheim-Chester Disease: A Comparison with 18F-FDG PET/CT

Erdheim-Chester disease (ECD) involves multiple organs and tissues and has diverse manifestations, which makes it difficult to distinguish lesions caused by ECD from those caused by other diseases. Variable degrees of fibrosis are present in ECD. Therefore, we conducted a prospective cohort study to explore the ability of 68Ga fibroblast activation protein inhibitor (68Ga-FAPI) PET/CT to detect lesions in ECD patients. Methods: Fourteen patients diagnosed with ECD, as confirmed by histology, were included in this study. For every patient, 68Ga-FAPI PET/CT and 18F-FDG PET/CT were conducted within 1 wk. The positive rate and SUVmax of the lesions in the involved organs were compared between the examinations. Results: The most commonly involved organs were bone (100%), heart (57.1%), lung (57.1%), kidney (42.9%), and peritoneum or omentum (35.7%); other common manifestations were intracranial infiltration (50%) and cutaneous infiltration (35.7%). 68Ga-FAPI PET/CT detected 64 of 67 lesions in 14 patients, whereas 18F-FDG PET/CT detected 51 of 67 lesions (P = 0.004). The SUVmax for 68Ga-FAPI PET/CT was significantly higher than the SUVmax for 18F-FDG PET/CT of the heart (4.9 ± 2.4 vs. 2.8 ± 1.2, respectively; P = 0.050), lung or pleura (6.8 ± 4.9 vs. 3.1 ± 1.3, respectively; P = 0.025), peritoneum or omentum (5.7 ± 3.6 vs. 2.8 ± 1.7, respectively; P = 0.032), and kidney or perinephric infiltration (4.9 ± 1.2 vs. 2.9 ± 1.1, respectively; P = 0.009). Conclusion: The detectivity of 68Ga-FAPI PET/CT is superior to that of 18F-FDG PET/CT. Moreover, 68Ga-FAPI PET/CT has a better image contrast and higher SUVmax for lesions in multiple organs including the heart, lungs, peritoneum, and kidneys. 68Ga-FAPI PET/CT is a promising tool to assess pathologic features and disease extent in ECD patients.

Characterizing Rosai-Dorfman disease with [18F]FDG PET/CT: a retrospective analysis of a single-center study

OBJECTIVES

Rosai-Dorfman disease (RDD) is a rare non-Langerhans cell histiocytic proliferative disorder. We performed a retrospective study to characterize the clinical and [18F]FDG PET/CT features of RDD.

METHODS

We retrospectively recruited 38 RDD patients with [18F]FDG PET/CT scan in our center. [18F]FDG PET/CT features were assessed, and clinical and follow-up data were recorded.

RESULTS

In the recruited patients, 20/38 (52.6%) patients had single-system disease, while others (18/38, 47.4%) had disease affecting multiple system. RDD most commonly involved the upper respiratory tract (47.4%), followed by cutaneous/subcutaneous lesion (39.5%), lymph node (36.8%), bone (31.6%), central nervous system (28.9%), and cardiovascular system (13.2%) in the recruited patients. In PET/CT, the RDD lesions were FDG-avid, and the SUVmax of the hottest lesion in an individual patient was positively correlated with C-reactive protein levels (r = 0.418, p = 0.014), and negatively correlated with hemoglobin levels (r =  -0.359, p = 0.036). The overall response rate of the first-line treatment was 80.8% in newly diagnosed RDD patients, and for patients with relapsed/progressive RDD, the overall response rate was 72.7%.

CONCLUSION

[18F]FDG PET/CT could be a useful tool for evaluating RDD.

KEY POINTS

• About half of the patients with Rosai-Dorfman disease had single-system disease, while others had disease affecting multiple system. Rosai-Dorfman disease most commonly involved the upper respiratory tract, followed by cutaneous/subcutaneous lesion, lymph node, bone, central nervous system, and cardiovascular system. • In [18F]FDG PET/CT, Rosai-Dorfman disease was usually hypermetabolic, and the SUVmax of the hottest lesion in an individual patient was positively correlated with C-reactive protein levels. • Rosai-Dorfman disease usually has a high overall response rate after treatment.

Design of a Low-Frequency Dielectrophoresis-Based Arc Microfluidic Chip for Multigroup Cell Sorting

Dielectrophoresis technology is applied to microfluidic chips to achieve microscopic control of cells. Currently, microfluidic chips based on dielectrophoresis have certain limitations in terms of cell sorting species, in order to explore a microfluidic chip with excellent performance and high versatility. In this paper, we designed a microfluidic chip that can be used for continuous cell sorting, with the structural design of a curved channel and curved double side electrodes. CM factors were calculated for eight human healthy blood cells and cancerous cells using the software MyDEP, the simulation of various blood cells sorting and the simulation of the joule heat effect of the microfluidic chip were completed using the software COMSOL Multiphysics. The effect of voltage and inlet flow velocity on the simulation results was discussed using the control variables method. We found feasible parameters from simulation results under different voltages and inlet flow velocities, and the feasibility of the design was verified from multiple perspectives by measuring cell movement trajectories, cell recovery rate and separation purity. This paper provides a universal method for cell, particle and even protein sorting.

Mitochondrial dysfunction in heart diseases: Potential therapeutic effects of Panax ginseng

Heart diseases have a high incidence and mortality rate, and seriously affect people's quality of life. Mitochondria provide energy for the heart to function properly. The process of various heart diseases is closely related to mitochondrial dysfunction. Panax ginseng (P. ginseng), as a traditional Chinese medicine, is widely used to treat various cardiovascular diseases. Many studies have confirmed that P. ginseng and ginsenosides can regulate and improve mitochondrial dysfunction. Therefore, the role of mitochondria in various heart diseases and the protective effect of P. ginseng on heart diseases by regulating mitochondrial function were reviewed in this paper, aiming to gain new understanding of the mechanisms, and promote the clinical application of P. ginseng.

The identification of sex-specific biomarkers in peripheral blood mononuclear cells from elderly individuals with ischemic stroke

OBJECTIVE

The aim of this study was to identify sex-specific biomarkers for ischemic stroke (IS) prophylaxis in elderly individuals.

MATERIALS AND METHODS

The GSE22255 dataset for elderly individuals with IS was retrieved from the gene expression omnibus database. Thereafter, gene ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed, as well as gene set enrichment analysis (GSEA). Furthermore, protein-protein interactions (PPIs) were explored using the STRING database, and to screen central genes from the Cytoscape PPI network, corresponding to peripheral blood samples from elderly individuals, we used the molecular complex detection plug-in and cytoHubba. Moreover, a Venn diagram was used to visualize the key genes common among elderly women and men with IS. Statistical analysis was also performed, and receiver operating characteristic (ROC) curves were constructed to evaluate the specificity and sensitivity of the prediction of IS in the elderly.

RESULTS

Compared with the healthy controls, in elderly women with IS, 511 biological process (BP) terms, 16 molecular function (MF) terms, and 34 KEGG terms were significantly enriched, whereas in the elderly men with IS, 681 BP terms, 12 MF terms, and 44 KEGG terms were enriched. The GSEA revealed 99 and 140 significantly enriched gene sets in elderly women and men with IS, respectively. Furthermore, in the PPI network, 10 hub genes for each sex with high specificity and sensitivity were identified using ROC curves.

CONCLUSIONS

Ten genes for each sex with significant differential expression were also identified in individuals with IS. The novel sex-specific gene targets may be promising diagnostic or prognostic markers and potential therapeutic targets for IS in the elderly.

New di-spirocyclic labdane diterpenoids from the aerial parts of Leonurus japonicus

Phytochemical investigation on the ethanol extract of a well-known medicinal herb Leonurus japonicus, led to the separation of 18 labdane type diterpenoids (1-18). Through comprehensive spectroscopic analyses and quantum chemical calculations, these compounds were structurally characterized as six new interesting 5,5,5-di-spirocyclic ones (1-6), two new (7 and 8) and six known (13-18) interesting 6,5,5-di-spirocyclic ones, a new rare 14,15-dinor derivative (9), and three new ones incorporating a γ-lactone unit (10-12). An in vitro neuroprotective assay in RSC96 cells revealed that compounds 7 and 12 exhibited neuroprotective activity in a concentration-dependent way, comparable to the reference drug N-acetylcysteine.

[Long-term mortality risk of valvular heart disease adults over 35 years old in Chinese communities]

Objective: To investigate the risk and influencing factors of long-term mortality of valvular heart disease (VHD) adults aged 35 years and over in Chinese communities. Methods: A cohort study was carried out. The data of the subjects who underwent echocardiography were collected from the Chinese Hypertension Survey between 2012 and 2015 and survival outcomes were followed up between 2018 and 2019. Kaplan-Meier survival curves were plotted and compared using log-rank test. Cox proportional hazards models were used to analyze the influence of VHD on mortality. Results: During an average follow-up time of (4.6±0.9) years, a total of 23 237 participants (10 881 males and 12 356 females) were pooled into the final analysis from 5 eastern, 5 central, and 4 western provinces, cities and autonomous regions in China, with a mean age of (56.9±13.2) years. Among the included participants, 1 004 had VHD (467 males and 537 females), with a mean age was of (68.1±12.6) years. In the Kaplan-Meier analysis, participants with VHD had a significantly increased risk of all-cause mortality (log-rank χ²=351.82, P<0.001) and cardiovascular mortality (log-rank χ²=284.14, P<0.001) compared with those without VHD. Multivariate Cox regression analysis showed that compared with those without VHD, the participants with rheumatic VHD had a 45% increased risk of all-cause mortality (HR=1.45, 95%CI: 1.12-1.89) and degenerative VHD increased the risk of cardiovascular mortality by 69% (HR=1.69, 95%CI: 1.19-2.38). The risk factors of cardiovascular mortality for VHD were age 55 years and over (55-<75 years: HR=4.93, 95%CI: 1.17-20.85;≥75 years: HR=11.92, 95%CI: 2.85-49.80) and diabetes mellitus (HR=1.71, 95%CI: 1.00-2.93). Conclusions: VHD is a risk factor of all-cause mortality and cardiovascular mortality among adults aged 35 years and over. Age 55 years and over and diabetes mellitus are adverse prognostic factors for patients with VHD.

A Review of Epidermal Flexible Pressure Sensing Arrays

In recent years, flexible pressure sensing arrays applied in medical monitoring, human-machine interaction, and the Internet of Things have received a lot of attention for their excellent performance. Epidermal sensing arrays can enable the sensing of physiological information, pressure, and other information such as haptics, providing new avenues for the development of wearable devices. This paper reviews the recent research progress on epidermal flexible pressure sensing arrays. Firstly, the fantastic performance materials currently used to prepare flexible pressure sensing arrays are outlined in terms of substrate layer, electrode layer, and sensitive layer. In addition, the general fabrication processes of the materials are summarized, including three-dimensional (3D) printing, screen printing, and laser engraving. Subsequently, the electrode layer structures and sensitive layer microstructures used to further improve the performance design of sensing arrays are discussed based on the limitations of the materials. Furthermore, we present recent advances in the application of fantastic-performance epidermal flexible pressure sensing arrays and their integration with back-end circuits. Finally, the potential challenges and development prospects of flexible pressure sensing arrays are discussed in a comprehensive manner.

Constructing Ionic Self-Concentrated Electrolyte via Introducing Montmorillonite Toward High-Performance Aqueous Zn-MnO2 Batteries

Aqueous zinc metal batteries are regarded as one of the most promising alternatives to lithium-ion batteries for large-scale energy storage due to the abundant zinc resources, high safety, and low cost. Herein, an ionic self-concentrated electrolyte (ISCE) is proposed to enable uniform Zn deposition and reversible reaction of MnO₂ cathode. Benefitting from the compatibility of ISCE with electrodes and its adsorption on the electrode surface for guidance, the Zn/Zn symmetrical batteries exhibit the long-life cycle stability with more than 5000 and 1500 h at 0.2 and 5 mA cm^-2 , respectively. The Zn/MnO₂ battery also exhibits a high capacity of 351 mA h g^-1 at 0.1 A g^-1 and can enable a stability over 2000 cycles at 1 A g^-1 . This work provides a new insight into electrolyte design for stable aqueous Zn-MnO₂ battery.

Application and realization of Norland optical adhesive 73 novel photosensitive macromolecular material for the rapid preparation of periodically tunable nanoscale gratings

Periodically tunable nano-gratings have an irreplaceable role in spectral scanning and optical communication, but the performance of gratings manufactured from different materials varies considerably, and the development of superior materials has energized the preparation of high-precision devices. This paper presents a nanoscale preparation process based on Norland Optical Adhesive 73 (NOA73), which enables the rapid preparation of periodically tunable nano-gratings with up to 100% light transmission. The powerful fluidity and shear rate of NOA73 make it uniquely suited to the preparation of precision devices, allowing the production of up to dense grating structures and offering the possibility of making nanoscale gratings. This paper uses multi-angle hierarchical lithography, die stretching, and replication to achieve further improvements in accuracy and successfully prepare gratings with a period of 500 nm. The successful preparation of NOA73 nano-gratings demonstrates the practicality of NOA73 as a material for precision device fabrication.

Intrinsic morphology and spatial distribution of non-structural carbohydrates contribute to drought resistance of two mulberry cultivars

Drought is one of the most adverse environmental stresses limiting plant growth and productivity. However, the underlying mechanisms regarding metabolism of non-structural carbohydrates (NSC) in source and sink organs are still not fully elucidated in woody trees. Saplings of mulberry cv Zhongshen1 and Wubu were subjected to a 15-day progressive drought stress. NSC levels and gene expression involved in NSC metabolism were investigated in roots and leaves. Growth performance and photosynthesis, leaf stomatal morphology, and other physiological parameters were also analysed. Under well-watered conditions, Wubu had a higher R/S, with higher NSC in leaves than in roots; Zhongshen1 had a lower R/S with higher NSC in roots than leaves. Under drought stress, Zhongshen1 showed decreased productivity and increased proline, abscisic acid, ROS content and activity of antioxidant enzymes, while Wubu sustained comparable productivity and photosynthesis. Interestingly, drought resulted in decreased starch and slightly increased soluble sugars in leaves of Wubu, accompanied by notable downregulation of starch-synthesizing genes and upregulation of starch-degrading genes. Similar patterns in NSC levels and relevant gene expression were also observed in roots of Zhongshen1. Concurrently, soluble sugars decreased and starch was unchanged in roots of Wubu and leaves of Zhongshen1. However, gene expression of starch metabolism in roots of Wubu was unaltered, but in leaves of Zhongshen1 starch metabolism was more activated. These findings revealed that intrinsic R/S and spatial distribution of NSC in roots and leaves concomitantly contribute to drought resistance in mulberry.

Bing–Neel Syndrome and Coexisting Pituitary Macroadenoma in a Patient with Waldenström Macroglobulinemia Revealed by 18F-FDG and 68Ga-Pentixafor PET/CT

A 63-year-old man presenting with peripheral neuropathies was diagnosed of Waldenström’s macroglobulinemia, and Bing–Neel syndrome was subsequently confirmed via cerebrospinal fluid examinations. Besides involvement in bone marrow, lymph nodes, as well as the thoracic and sacral nerve root, 68Ga-Pentixafor PET/CT detected active tracer uptake in bilateral choroid plexus, which was negative in 18F-FDG PET/CT, possibly suggesting the involvement of Bing–Neel syndrome. The coexisting pituitary macroadenoma was FDG-avid but negative in 68Ga-Pentixafor PET/CT. After six cycles of chemotherapy, the follow-up PET/CT showed complete remission of the previous disease, including the high uptake of 68Ga-Pentixafor in choroid plexus. However, the hypermetabolic pituitary macroadenoma remained unchanged.

Neurological complications of COVID-19

Corona Virus Disease 2019 (COVID-19) has caused several pandemic peaks worldwide due to its high variability and infectiousness, and COVID-19 has become a long-standing global public health problem. There is growing evidence that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) frequently causes multi-organ injuries and more severe neurological manifestations. Therefore, increased awareness of possible neurological complications is beneficial in preventing and mitigating the impact of long-term sequelae and improving the prognostic outcome of critically ill patients with COVID-19. Here, we review the main pathways of SARS-CoV-2 neuroinvasion and the potential mechanisms causing neurological damage. We also discuss in detail neurological complications, aiming to provide cutting-edge basis for subsequent related basic research and clinical studies of diagnosis and treatment.

Report of consensus panel 1 from the 11th International Workshop on Waldenstrom's Macroglobulinemia on management of symptomatic, treatment-naïve patients

Consensus Panel 1 (CP1) of the 11th International Workshop on Waldenstrom's Macroglobulinemia (IWWM-11) was tasked with updating guidelines for the management of symptomatic, treatment-naïve patients with WM. The panel reiterated that watchful waiting remains the gold standard for asymptomatic patients without critically elevated IgM or compromised hematopoietic function. For first-line treatment, chemoimmunotherapy (CIT) regimens such as dexamethasone, cyclophosphamide, rituximab (DRC), or bendamustine, rituximab (Benda-R) continue to play a central role in managing WM, as they are effective, of fixed duration, generally well-tolerated, and affordable. Covalent BTK inhibitors (cBTKi) offer a continuous, generally well-tolerated alternative for the primary treatment of WM patients, particularly those unsuitable for CIT. In a Phase III randomized trial updated at IWWM-11, the second-generation cBTKi, zanubrutinib, was less toxic than ibrutinib and induced deeper remissions, thus categorizing zanubrutinib as a suitable treatment option in WM. While the overall findings of a prospective, randomized trial updated at IWWM-11 did not show superiority of fixed duration rituximab maintenance over observation following attainment of a major response to Benda-R induction, a subset analysis showed benefit in patients >65 years and those with a high IPPSWM score. Whenever possible, the mutational status of MYD88 and CXCR4 should be determined before treatment initiation, as alterations in these 2 genes predict sensitivity towards cBTKi activity. Treatment approaches for WM-associated cryoglobulins, cold agglutinins, AL amyloidosis, Bing-Neel syndrome (BNS), peripheral neuropathy, and hyperviscosity syndrome follow the common principle of reducing tumor and abnormal protein burden rapidly and deeply to improve symptoms. In BNS, ibrutinib can be highly active and produce durable responses. In contrast, cBTKi are not recommended for treating AL amyloidosis. The panel emphasized that continuous improvement of treatment options for symptomatic, treatment-naïve WM patients critically depends on the participation of patients in clinical trials, whenever possible.

Report of Consensus Panel 6 from the 11 th International Workshop on Waldenström's Macroglobulinemia on Management of Waldenström's Macroglobulinemia Related Amyloidosis

Consensus Panel 6 (CP6) of the 11th International Workshop on Waldenström's Macroglobulinemia (IWWM-11) was tasked with reviewing the state of the art for diagnosis, prognosis, and therapy of AL amyloidosis associated with Waldenström macroglobulinemia (WM). Since significant advances have been made in the management of AL amyloidosis an update for this rare disease associated with WM was necessary. The key recommendations from IWWM-11 CP6 included: (1) The need to improve the diagnostic process by recognizing red flags and using biomarkers and imaging; (2) The essential tests for appropriate workup; (3) The diagnostic flowchart, including mandatory amyloid typing, that improves the differential diagnosis with transthyretin amyloidosis; (4) Criteria for therapy response assessment; (5) State of the art of the treatment including therapy of wild type transthyretin amyloidosis associated with WM.

[Prevalence of albuminuria and its association with cardiovascular diseases in Chinese residents aged over 35 years]

Objective: To investigate the prevalence of albuminuria in Chinese residents aged >35 years and its potential association with cardiovascular disease (CVD). Methods: A total of 34 647 Chinese subjects aged ≥35 years were selected by stratified multi-stage random sampling from 2012 to 2015. Data were collected through questionnaires, physical examinations, and laboratory tests. Albuminuria was categorized into 3 types according to urinary albumin-to- creatinine ratio: normal (<30 mg/g), microalbuminuria (MAU, 30-300 mg/g), and macroalbuminuria (≥300 mg/g). Measurement data were expressed as x¯±s, and t-tests were used for comparisons between indicators. Qualitative data were expressed as rate or constituent ratio, and the χ² test or Kruskal-Wallis test was used to examine differences. Logistic regression was used for multivariate analyses. SAS 9.4 software was used for statistical analyses, and P<0.05 was considered statistically significant. Results: The prevalence of abnormal albuminuria was 19.1%; the prevalence was 17.2% for MAU and lower in males (13.8%) than females (20.1%, P<0.01). The risk of CVD was higher among subjects with MAU (OR=1.23, 95%CI 1.12-1.35) and macroalbuminuria (OR=1.86, 95%CI 1.50-2.32). When MAU was complicated by hypertension and diabetes mellitus, the CVD risk was 1.76 times higher. Conclusions: The prevalence of MAU is high among Chinese subjects aged 35 years and over. Those with MAU have higher CVD risk, especially those with hypertension and diabetes mellitus.

68Ga-Pentixafor PET/CT May Fail to Detect Recurrent Multiple Myeloma with Extramedullary Disease

Two patients with a history of multiple myeloma experienced a recurrence of the disease.¹⁸F-FDG PET/CT revealed prominent extramedullary disease as well as multi-foci in the bone marrow, both with increased FDG uptake. However, on ⁶⁸Ga-Pentixafor PET/CT, all the myeloma lesions showed significantly lower tracer uptake in comparison with ¹⁸F-FDG PET. This false-negative result of recurrent multiple myeloma with extramedullary disease may be a potential limitation of ⁶⁸Ga-Pentixafor in assessing multiple myeloma.

Infrared Small Target Detection Based on Multiscale Kurtosis Map Fusion and Optical Flow Method

The uncertainty of target sizes and the complexity of backgrounds are the main reasons for the poor detection performance of small infrared targets. Focusing on this issue, this paper presents a robust and accurate algorithm that combines multiscale kurtosis map fusion and the optical flow method for the detection of small infrared targets in complex natural scenes. The paper has made three main contributions: First, it proposes a structure for infrared small target detection technology based on multiscale kurtosis maps and optical flow fields, which can well represent the shape, size and motion information of the target and is advantageous to the enhancement of the target and the suppression of the background. Second, a strategy of multi-scale kurtosis map fusion is presented to match the shape and the size of the small target, which can effectively enhance small targets with different sizes as well as suppress the highlighted noise points and the residual background edges. During the fusion process, a novel weighting mechanism is proposed to fuse different scale kurtosis maps, by means of which the scale that matches the true target is effectively enhanced. Third, an improved optical flow method is utilized to further suppress the nontarget residual clutter that cannot be completely removed by multiscale kurtosis map fusion. By means of the scale confidence parameter obtained during the multiscale kurtosis map fusion step, the optical flow method can select the optimal neighborhood that matches best to the target size and shape, which can effectively improve the integrity of the detection target and the ability to suppress residual clutter. As a result, the proposed method achieves a superior performance. Experimental results on eleven typical complex infrared natural scenes show that, compared with seven state-of-the-art methods, the presented method outperforms in terms of subjective visual effect, as well as some main objective evaluation indicators such as BSF, SCRG and ROC, etc.

Radiation-induced cancer after treatment for nasopharyngeal carcinoma: a study from a high prevalence area

BACKGROUND

Radiation-induced cancer (RIC) is a late complication in patients who have been treated for nasopharyngeal carcinoma (NPC). The comparison of index anatomic location, index histological type, and survival of RIC in patients with NPC after different radiotherapy modalities (intensity-modulated radiotherapy [IMRT], 3-dimensional conformal radiotherapy [3D-CRT], and conventional 2D radiotherapy) is currently unavailable.

METHODOLOGY

A total of 38,565 patients with NPC who received curative-intent radiotherapy at Sun Yat-sen University Cancer Center between January 1986 and December 2017 were reviewed. A total of 141 patients who developed RIC and fulfilled the study criteria were included. Categorical variables were compared by the chi-square test or Fisher's exact test. Kaplan-Meier curves were used to evaluate overall survival. Cox proportional hazards models were used to examine the independent significance of RIC treatment.

RESULTS

Among IMRT, 3D-CRT, and conventional 2D radiotherapy, the incidence of mandible RIC was higher in patients who received 3D-CRT (0.07%) than in those who received IMRT (0%). The proportion of mandible RICs was higher in patients who received 3D-CRT (16.667%) than in those who received IMRT (0%) and conventional 2D radiotherapy (3.529%). Regarding the histological type, the incidence of squamous cell carcinoma (SCC) was higher in patients who received conventional 2D radiotherapy (0.266%) than in those who received 3D-CRT (0.175%); patients who received IMRT had a higher proportion of SCC than those who received 3D-CRT/conventional 2D radiotherapy (86.4% vs. 41.7% vs. 74.2%); the incidence of sarcoma was higher in patients who received 3D-CRT (0.175%) than in those who received IMRT (0.025%); and the proportion of sarcoma was higher in patients who received 3D-CRT (41.667%) than in those who received IMRT (6.818%) and conventional 2D radiotherapy (17.647%). Patients who received surgery for RICs had better survival than those who received no surgery (64.49 vs. 12.42 months). In the univariate and multivariate analyses, surgery was an independent prognostic factor for overall survival.

CONCLUSIONS

Our results have implications for long-term follow-up of RIC, multidisciplinary management, and patient counseling of RIC after nasopharyngeal carcinoma treatment by treating clinicians.

Research progress on humanistic care ability and influencing factors of intern nursing students

This paper is dedicated to reviewing relative research on humanistic caring ability of intern nursing students and proposing strategies to improve humanistic caring ability. Firstly, current paper collected information from both domestic and foreign literature, and then scientific analysis, summary and overview of research results were conducted with regards to humanistic caring ability of interns nursing students. By analyzing the current situation of intern nursing students' humanistic caring ability, and factors that have influence on humanistic caring ability of intern nursing students, the present paper is determined to come up with feasible change methods and form strategic paths. At present, the humanistic care ability of intern nursing students is relatively low. Students, schools, hospitals, and the society all exert influence on the humanistic care ability of intern nursing students. Although scholars' research is different in topics or focus, the conclusions drawn from this research are highly consistent. Nursing humanistic care is the internal quality of nursing staff concerning morality, humanity, and integration of knowledge, concepts, and attitudes. Nursing humanistic care ability includes caring experience ability and caring behavior ability. The necessary psychological characteristics of personality are regarded as a special ability. It is of great significance to promote the quality of nursing and humanistic care ability of intern nursing students who serve as the backup force of nursing talent team. Meanwhile, it is imperative to strengthen the construction of intern nursing students' humanistic care ability.

Recent Progress on Phosphate Cathode Materials for Aqueous Zinc-Ion Batteries

Rechargeable zinc-ion batteries (ZIBs) are attractive for large-scale energy storage due to their superiority in resources, safety, and environmental friendliness. However, the lack of suitable ZIBs cathode materials limits their practical applications. In consideration of the excellent electrochemical performance of phosphate materials in monovalent ion (Li⁺ , Na⁺ ) batteries, they were also employed as ZIBs cathode materials recently and performed well with high potential. But they also suffer from low capacity and poor conductivity, and the energy storage mechanism is not clear yet. This Review provides a state-of-the art overview on the developments of phosphate cathode materials in ZIBs, including NASICON-type phosphates, fluorophosphates, olivine-structured, layered-structured, and novel-structured phosphate materials mainly. This study presents the reaction mechanism and electrochemical performance of phosphate cathode materials in aqueous ZIBs, and future research directions are discussed, which are intended to provide guidance for exploring high-potential cathode materials for ZIBs.

The clinical characteristic of alcohol-hyperlipidemia etiologically complex type of acute pancreatitis

OBJECTIVE

The aim of our study was to elucidate the clinical characteristics of alcoholic-hyperlipidemic etiologically complex acute pancreatitis.

PATIENTS AND METHODS

We reviewed complete data from 233 patients with acute pancreatitis treated in our hospital during the period January 2017-January 2022. They were divided into three groups according to etiology: alcoholic acute pancreatitis (AAP), hyperlipidemic acute pancreatitis (HLAP), and alcoholic-hyperlipidemic acute pancreatitis (AHAP). General clinical data, co-morbidities, laboratory results, imaging data, and disease severity were analyzed and compared between groups.

RESULTS

The proportion of male individuals in the AHAP group was significantly higher than that in the HLAP group (p<0.001). Age of onset was lower and the number of cases with antibiotic use was higher in the AHAP group than in the AAP group (p<0.05). Additionally, the average alcohol intake each time and weekly alcohol intake were also higher in the AHAP group than in the AAP group (p<0.05). Comparison of disease severity (moderate and severe acute pancreatitis, severe acute pancreatitis, and modified computed tomography severity index score) revealed the disease condition to be more severe in the AHAP group than in the AAP and HLAP groups (p<0.05). Accordingly, patients in the AHAP group had longer hospital stays than those in the other two groups (p<0.05). There were no significant differences in alcohol consumption, severity, or length of hospital stay in the AHAP group (p>0.05).

CONCLUSIONS

The clinical characteristics of patients in the AHAP, AAP and HLAP groups were different, and the patients in the AHAP group were more likely to have a moderate to severe disease course, with longer hospital stay. As a new AP classification concept, AHAP would offer high significance for diagnosis, treatment, and prognosis.

Structural characterization of polysaccharides recovered from extraction residue of ginseng root saponins and its fruit nutrition preservation performance

Polysaccharides recovered from extraction residue of ginseng root saponins, i.e., ginsenosides-extracting residue polysaccharides (GRP), were separated into two fractions, GRP-1 and GRP-2. Fourier infrared and nuclear magnetic resonance spectra, as well as high-performance liquid chromatography and gel permeation chromatography measurements, showed GRP-1 was composed of mainly starch-like glucans and GRP-2, relatively a smaller portion, was a mixture of heteropolysaccharides composed of starch-like glucans, rhamnogalacturonan-I pectin, and arabinogalactans, and they had similar molecular weights. These results proved that the structure of GRP was not destroyed and GRP still maintained strong antioxidant activities. In addition, GRP coating on surfaces of fruit slowed their deterioration and maintained their nutritional effects. Correlation and PCA analyses on various quality and antioxidant parameters supported the above findings and a possible mechanism in fruit preservation was then proposed. Knowing the structural features and bioactivities of GRP gives insights into its application. Specifically, GRP served as an environmentally friendly coating that can be used to preserve the nutrients and other quality indicators of strawberries and fresh-cut apples, paving the way for future new approaches to food preservation using polysaccharides or other natural products.

[Reconstruction of facial skin defects by the V-Y subcutaneous pedicle flap]

Objective: To investigate the method and efficacy of reconstruction of facial skin defects after removing the lesions by applying the V-Y subcutaneous pedicle flap. Methods: A retrospective analysis was performed on 23 patients with facial reconstruction by using V-Y subcutaneous pedicle flap in the Otolaryngology Department of Guangdong Integrated Traditional Chinese and Western Medicine Hospital from March 2012 to April 2021. Patient ages ranged from 45 to 85 years old, with a mean age of 66.5 years (14 males and 9 females). The facial lesion sites included cheek in 12 cases (nearly lower eyelid in 4 cases), nose in 4 cases, lips in 3 cases, temporal in 2 cases and mental region in 2 cases. The initial pathology included malignant tumors (7 cases of basal cell carcinoma (BCC), 2 cases of squamous cell carcinoma(SCC), and 1 case of malignant melanoma) and benign lesions (7 cases of keratoderma, 3 cases of intradermal nevus, 1 case of pilomatricoma, 1 case of cutaneous mixed tumor and 1 case of epidermal cyst). The V-Y subcutaneous facial pedicled flaps were designed reasonably after the facial lesions were excised. The advantages of blood supply, survival rate and adverse events of the flap were analyzed Chi-square test was used to compare the observation results of different types of patients. Results: The primary focus of 23 patients was excised surgically, and intraoperative frozen-section examinations were performed for obtaining margins negative as far as possible. One positive margin was still found in 1 patient after multiple resection in our group. The defect sizes were 14 mm×12 mm-59 mm×54 mm. All the flaps survived. The adverse events were slight necrosis of the epidermis at the junction or vicinity of the three arms of "Y" shaped in 4 cases, but the wounds finally recovered by wet compress and dressing change. There were no significant differences in the incidences of adverse events between double and single pedicle flaps (4/19 vs. 0/4), between benign and malignant lesions (4/13 vs. 0/10), and between patients with and without underlying diseases (1/6 vs. 3/17) (χ² values were 0.98, 3.56, 0.01, respectively, all P>0.05). There were no other major complications such as dehiscence, hematoma, eyelid ectropion and lip deformation. The patients with benign lesions were followed-up at least for 3 months, while those with malignant tumors were followed-up for 6-36 months postoperatively, without recurrence. Conclusions: V-Y subcutaneous facial pedicled skin flap may be a "no-easy-necrotic" local flap in the repair of small and medium-sized facial defects.

Elevated levels of active Transforming Growth Factor β1 in the subchondral bone relate spatially to cartilage loss and impaired bone quality in human knee osteoarthritis

OBJECTIVE

The association between the spatially distributed level of active TGFβ1 in human subchondral bone, and the characteristic structural and cellular parameters of human knee OA, was assessed.

DESIGN

Paired subchondral bone samples from 35 OA arthroplasty patients, (15 men and 20 women, aged 69 ± 9 years) were obtained from beneath macroscopically present (CA+) or denuded cartilage (CA-) to determine the concentration of active TGFβ1 (ELISA) and its relationship to bone quality (synchrotron micro-CT), cellularity, and vascularization (histology).

RESULTS

Bone samples beneath (CA-) regions had significantly increased concentrations of active TGFβ1 protein (mean difference: 26.4; 95% CI: [3.2, 49.7]), when compared to bone in CA + regions. Trabecular Bone below (CA-) regions had increased bone volume (median difference: 4.3; 96.49% CI: [-1.7, 17.8]), increased trabecular number (1.5 [0.006, 2.6], decreased trabecular separation (-0.05 [-0.1,-0.005]), and increased bone mineral density (394.5 [65.7, 723.3]) comparing to (CA+) regions. Further, (CA-) bone regions showed increased osteocyte density (0.012 [0.006, 0.018]), with larger osteocyte lacunae (39.8 [7.8, 71.7]) that were less spherical (-0.02 [-0.04, -0.003]), and increased bone matrix vascularity (12.4 [0.3, 24.5]) compared to (CA+). In addition, increased levels of active TGFβ1 related to increased bone volume (0.04 [-0.11, 0.9]), while increased OARSI grade associated with lacunar volume (-44.1 [-71.1, -17.2]), and orientation (2.7 [0.8, 4.6]).

CONCLUSION

Increased concentration of active TGFβ1 in the subchondral bone of human knee OA associates spatially with impaired bone quality and disease severity, suggesting that TGFβ1 is a potential therapeutic target to prevent or reduce human OA disease progression.

Non-Destruction Evaluation Method for Long-Term Oxidation Behavior of SiC/SiC Composites with Different Preforms in Wet Oxygen

The implementation of SiC fiber reinforced SiC/SiC composites to aero-engine hot components has attracted wide attention, due to their many excellent properties. Along these lines, in order to predict the oxidation behavior of the material in extreme environments and to explore the effect of different preforms on the oxidative behavior of the composites, four SiC/SiC composites, with different preforms, were oxidized under environmental conditions of pressure of 12 kPa H₂O:8 kPa O₂:80 kPa Ar, at 1400 °C temperature. Moreover, the morphology and defect distribution of the samples were characterized by carrying out scanning electron microscopy, and micro-computed X-ray tomography measurements. Furthermore, the relation between the micro- and macro-scales was established, so as to be able to predict the oxidation behavior of the composites; not only the quantitative relationship between the mass change rate and the defect volume change rate, but also the combination of micro-computed X-ray images.

[Investigation on status of dyslipidemia in Chinese females aged 35 years or above]

Objective: To investigate the prevalence, awareness, treatment and control status of dyslipidemia among females aged ≥35 years old across China. Methods: Participants were selected by stratified multistage random sampling method in the "Twelfth Five-Year Plan" National Science and Technology Support Project "Survey on the Prevalence of Important Cardiovascular Diseases and Key Technology Research in China" project. This study is a retrospective, cross-sectional study. A total of 17 418 females aged 35 years and over were included in the current study. The basic information such as age, medical history and menopause was collected by questionnaire. The blood lipid parameters were derived from clinical laboratory examinations. The prevalence of dyslipidemia and the rate of awareness, treatment, and control of dyslipidemia were analyzed in females aged 35 years and over. Results: The age of participants was (56.2±13.0) years old, and the prevalence of dyslipidemia was 33.1% (5 765/17 418). The prevalence rates of high total cholesterol, hypertriglyceridemia, low HDL-C and high LDL-C were 9.7% (1 695/17 418), 11.1% (1 925/17 418), 10.9% (1 889/17 418) and 7.3% (1 262/17 418), respectively. The prevalence of dyslipidemia increased with age and the prevalence of dyslipidemia in women who were not married, Han, menarche age>16 years, obesity, central obesity, alcohol consumption, diabetes, hypertension and family history of cardiovascular disease were higher than those without such characteristics (P<0.05). There were 10 432 (59.9%) menopausal females in this cohort and prevalence of dyslipidemia of these participants was 38.8% (4 048/10 432), which was higher than that of non-postmenopausal females (24.6%, 1 717/6 986) (P<0.05). The awareness rates, treatment rates and control rates of dyslipidemia were 33.9% (1 953/5 765), 15.1% (870/5 765) and 2.5% (143/5 765) respectively among females aged 35 years and over in China. Conclusion: The prevalence of dyslipidemia in Chinese females aged 35 years and over is high, and its awareness, treatment, and control rates need to be optimized.

[Construction of a nomogram model for predicting 2-year survival rate of small cell lung cancer based on more comprehensive variables]

Objective: To construct a novel prognostic nomogram model based on more comprehensive variables for patients with small-cell lung cancer (SCLC). Methods: The data of 722 patients with SCLC confirmed by pathology in Affiliated Cancer Hospital of Shanxi Medical University from January 2015 to December 2018 were retrospectively analyzed [including 592 males and 130 females, aged from 23 to 82(61±9) years]. A random seed count of 133 was used to divide those patients into training set (n=422) and validation set (n=300). Kaplan-Meier was used for survival curves analysis and univariate Log-rank test was used for evaluating the influence of clinical variables on the prognosis of sclc, variables with P<0.05 in univariate analysis were included in a multivariate Cox regression model. The nomogram was constructed based on the variables which P<0.05 in multivariate analysis. Receiver operating characteristic (ROC) curve, calibration by Integrated Brier score (IBS) and clinical net benefit by decision curve analysis (DCA) were used to evaluate model discriminative power, prediction error value, and clinical net benefit, and compared with the American Joint Committee on Cancer 8th TNM. Results: Male, abnormal monocyte (MON) counts, abnormal neuron specific enolase (NSE), abnormal cytokeratin 19 fragment (Cyfra211), M1a stage, M1b stage, M1c stage, radiotherapy (RT), chemotherapy ≥4 cycles and prophylactic cranial irradiation (PCI) were prognostic factors for SCLC[HR(95%CI)=1.39(1.00-1.92), 1.29(1.02-1.63), 1.41(1.11-1.80), 2.02(1.48-2.76), 1.09(0.77-1.55), 1.44(0.94-2.22), 2.01(1.49-2.71), 0.75(0.57-0.98), 0.40(0.31-0.51)and 0.42(0.26-0.68), respectively, all P<0.05]. The area under ROC curve (AUC) of the nomogram in training set and validation set were 0.814(95%CI: 0.765-0.862)and 0.787 (95%CI: 0.725-0.849), which were higher than TNM [0.616(95%CI: 0.558-0.674) and 0.648(95%CI: 0.581-0.715)].The calibration curve showed a good correlation between the nomogram prediction and actual observation for the 2-year overall survival (OS). IBS indicted a lower prediction error rate (training set: 0.132 vs 0.169; validation set: 0.138 vs 0.169). DCA showed a wider threshold range than TNM (training set: 0.01-0.96 vs 0.01-0.85, validation set: 0.01-0.94 vs 0.01-0.86) and a greater improvement of the clinical net benefit (in training set the nomogram had a greater clinical benefit than TNM in the range of 0.19-0.96, and remained in validation set in the range of 0.19-0.94). Conclusion: The established nomogram model for predicting 2-year OS in patients with SCLC based on 8 variables, including gender, MON, NSE, Cyfra211, M stage, RT, CT cycles and PCI can be used for an more accurately prognosis prediction and reference for therapeutic regimen selection.

Distinct Mutation Landscapes Between Acute Myeloid Leukemia With Myelodysplasia-Related Changes and De Novo Acute Myeloid Leukemia

OBJECTIVES

To explore the distinct mutation profiles between acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) and de novo AML and their relationships with prognosis.

METHODS

Next-generation sequencing of 42 myeloid neoplasm-related genes in 293 newly diagnosed patients with AML.

RESULTS

Eighty-four patients had AML-MRC, and 161 patients had de novo AML. The mutation rates of ASXL1 (25% vs 8.7%, P = .001), NRAS (17.9% vs 8.1%, P = .022), PTPN11 (11.9% vs 5%, P = .048), SETBP1 (6% vs 0.6%, P = .033), SRSF2 (11.9% vs 5.6%, P = .08), TP53 (16.7% vs 1.2%, P < .001), and U2AF1 (17.9% vs 7.5%, P = .014) in AML-MRC were higher than those in de novo AML, while the rates of FLT3-ITD (3.6% vs 15.5%, P = .005), KIT (0% vs 6.2%, P = .046), WT1 (3.6% vs 9.9%, P = .077), NPM1 (1.2% vs 21.7%, P < .001), and CEBPA (4.8% vs 24.2%, P < .001) mutation were lower. The appearance of ASXL1, TP53, U2AF1, SRSF2, and SETBP1 mutation could predict AML-MRC-like features in de novo AML, which was related to older age (60 vs 51 years, P = .001), low WBC counts (4.7 × 109/L vs 11.6 × 109/L, P = .001), and inferior outcomes (median overall survival, 15 months vs not reached, P = .003).

CONCLUSIONS

The presence of AML-MRC-related mutations can reveal a subset of patients with de novo AML similar to patients with AML-MRC.