Sulfonated Microporous Polyxanthene Binder for High-Temperature Hydrogen Fuel Cells.

High-temperature proton exchange membrane fuel cells based on phosphoric acid-doped polybenzimidazole (PBI) materials face challenges of low power output and low Pt utilization due to the lack of suitable electrode binders. We have developed a sulfonated microporous polymer material (namely, SPX, i.e., sulfonated polyxanthene) with excellent chemical stability, to be used as the electrode binder. The rigid and contorted polymer structure of SPX reduces the adsorption of the ionomer on the Pt catalyst surface, prevents phosphoric acid loss, and promotes the rapid transport of reactant gases and water molecules within the catalyst layer. The cell performance is thereby significantly improved, with a Pt utilization reaching 42.51%, and a peak power density approaching 805 mW cm-2 at 180 °C, surpassing the performance of cells using PBI as a binder.

Enhanced Energy Storage in PVDF-Based Nanocomposite Capacitors through (00l)-Oriented BaTiO3 Single-Crystal Platelets.

Flexible nanocomposite dielectrics with inorganic nanofillers exhibit great potential for energy storage devices in advanced microelectronics applications. However, high loading of inorganic nanofillers in the matrix results in an inhomogeneous electric field distribution, thereby hindering the improvement of the energy storage density (Ue) of the dielectrics. Herein, we proposed a strategy that utilized (00l)-oriented barium titanate (BT) single-crystal platelets to fabricate trilayered nanocomposite dielectrics for energy storage applications. The trilayered nanocomposites consisted of two high-permittivity layers of (Ta2O5, Al2O3) codoped TiO2 nanoparticles (Ta-Al@TiO2 nps) dispersed in a poly(vinylidene fluoride) (PVDF) matrix to facilitate large electric displacement and a middle layer of (00l)-oriented BT single-crystal platelets to provide high breakdown strength. Hence, the trilayered PVDF/Ta-Al@TiO2 nps/BT single-crystal platelet nanocomposite film attains an outstanding Ue of 16.9 J cm-3 at 370 kV mm-1, which is ∼625% higher than that of the single-layer PVDF/Ta-Al@TiO2 nps film. Finite element simulation further clarified that the successive inner layer of highly (00l)-oriented BT single-crystal platelets could effectively restrain the propagation of electrical treeing in trilayered nanocomposites. This research offers an effective approach for developing flexible dielectric capacitors with an excellent energy storage performance.

A New Model for Predicting Nonsentinel Lymph Node Metastasis in Early-Stage Breast Cancer Using MMP15.

Background: In early-stage breast cancer (BC) patients, 40-70% of lymph node metastases are limited to the sentinel lymph nodes (SLNs). Patients at low risk for nonsentinel lymph node (NSLN) metastasis should be exempt from axillary lymph node dissection (ALND) or regional lymph node radiotherapy (RNI). Methods: The present study included 237 female early-stage BC patients with positive SLNs who received ALND. Based on the clinicopathological factors of the 158 patients in the training cohort, multivariate analysis was used to determine the independent risk factors for NSLN metastasis, which were used to establish the NSLN metastasis prediction model. The calibration and discrimination of this model were tested with the training and validation cohorts and compared to the Memorial Sloan Kettering Cancer Center (MSKCC) model. Results: Tumor size, neural invasion, lymphovascular invasion, expression of matrix metalloproteinase 15 (MMP15) in the cytoplasm, and the number of positive SLNs were statistically significant by multivariate analysis (P < 0.05), which were used to establish the new model. The MSKCC model was verified by the training cohort, and the area under the receiver-operating characteristic (ROC) curve was 0.733 (95% CI: 0.650-0.816), which was less than that of the new model (0.824; 95% CI: 0.760-0.889). The area under the ROC curve in the validation cohort for the new model was 0.773 (95% CI: 0.669-0.877), and the calibration performed well. The false-negative rates were 3.2%, 6.5%, and 14.5% for the predicted probability cut-offs of 50%, 60%, and 70%, respectively. Conclusions: The new model included five variables: tumor size, neural invasion, lymphovascular invasion, cytoplasmic MMP15 expression, and the number of positive SLNs. The model with a cut-off of 60% could accurately identify low-risk patients with NSLN metastasis.

Impact of Platelets to Lymphocytes Ratio and Lymphocytes during Radical Concurrent Radiotherapy and Chemotherapy on Patients with Nonmetastatic Esophageal Squamous Cell Carcinoma.

Purpose: This study examined the importance of hematological parameters as prognostic markers for people with esophageal cancer receiving radical concurrent chemoradiation. Methods: 106 patients with esophageal cancer are included in this study. Cox regression analysis, Kaplan-Meier method, and chi-square test were used to analyze our data. Results: The median follow-up time for patients was 15.5 months (3-55). Univariate and multivariate analyses showed that age, the change of platelet-to-lymphocyte ratio (ΔPLR), and the change rate of circulating lymphocyte count (ΔCLC%) were independent influencing factors of OS and DFS. The patients were grouped according to the median of ΔPLR and ΔCLC%, and analysis showed that a higher ΔPLR and a higher ΔCLC% was related to poor OS and DFS (P < 0.001, P < 0.001 and P < 0.001, P < 0.001). By subgroup analysis, the OS of T1-4N1-2 were better in the low ΔPLR group than the high one (P = 0.03, P < 0.001, P = 0.001, P < 0.001, and P = 0.008). DFS of T3-4N1-2 in the low ΔPLR group were better than the high one (P < 0.001, P = 0.016 and P < 0.001, P = 0.022). For patients with T1-4N0-2, the OS in the low ΔCLC% group were better than in the high ΔCLC% group (P = 0.01, P < 0.001, P < 0.002, P = 0.012, P < 0.001, and P = 0.024). For T1-4N1-2, the DFS were better in the low ΔCLC% group than others (P = 0.042, P < 0.001, P < 0.001, P < 0.001, and P = 0.006). Conclusion: ΔPLR and ΔCLC% are independent factors of OS and DFS, and a lower ΔPLR and ΔCLC% are associated with a better OS and DFS. And T3-4N1-2 patients in the low ΔPLR group and low ΔCLC% group have greater survival benefit.

Chinese breast cancer patients with CYP2D6*10 mutant genotypes have a better prognosis with toremifene than with tamoxifen.

PURPOSE: To evaluate the prognosis of estrogen receptor-positive breast cancer patients with CYP2D6*10 mutant genotypes under tamoxifen or toremifen therapy. METHODS: Estrogen receptor-positive breast cancer patients were selected and CYP2D6*10 genotypes (C/C, C/T, and T/T) were determined by Sanger sequencing. Patients were divided into tamoxifen, toremifene, or tamoxifen + toremifene groups according to prior therapy. The correlation between CYP2D6*10 genotype and disease-free survival was analyzed. RESULTS: In total, 293 estrogen receptor-positive breast cancer patients treated with tamoxifen or toremifene between 2008 and 2017 were studied. Median follow-up was 39 months (10-141). Of these, 107 (36.52%), 112 (38.23%), and 74 (25.26%) patients had C/C, C/T, and T/T genotypes, respectively. Genotype was significantly associated with disease-free survival in tamoxifen patients. Patients with C/T and T/T genotypes showed worse disease-free survival than patients with a C/C genotype. Genotype and disease-free survival in toremifene and tamoxifen+toremifene patients were not correlated. Of patients with a C/T genotype, toremifene or tamoxifen+toremifene groups showed better disease-free survival than tamoxifen patients. Although disease-free survival of patients with a T/T genotype in the three groups was not statistically different, tamoxifen patients showed worse disease-free survival. There was no correlation between different treatments and disease-free survival in patients with a C/C genotype. Cox proportional hazard analysis revealed toremifene patients had a better prognosis than tamoxifen patients; toremifene was an independent protective factoremifene for disease-free survival. CONCLUSIONS: Tamoxifen was less effective in patients with CYP2D6*10 C/T and T/T genotypes. Estrogen receptor-positive breast cancer patients with a CYP2D6*10 mutation genotype have a better prognosis with toremifen than tamoxifen.

Sleep-disordered breathing and risk of the breast cancer: A meta-analysis of cohort studies.

BACKGROUND: Sleep-disordered breathing (SDB) has been related to a higher risk of breast cancer whereas the results of previous studies are inconsistent. We, therefore, performed a meta-analysis to evaluate the association between SDB and subsequent risk of breast cancer in women. METHODS: Cohort studies that investigated the temporal relationship between SDB and breast cancer incidence were obtained via search of PubMed, Embase and Web of Science from inception to 30 January 2021. Only studies with multivariate analyses were included. A fixed or a randomised effect model was applied according to the heterogeneity. RESULTS: Eight cohort studies with 1 398 113 women were included. Pooled results with a randomised-effect model showed that compared with women without SDB at baseline, women with SDB had a significantly increased risk of breast cancer (risk ratio [RR]: 1.36, 95% confidence interval [CI]: 1.08 to 1.71, P = .01) with significant heterogeneity (P for Cochrane's Q test < .001, I2  = 95%). Subgroup analyses showed that SDB seemed to confer a more remarkably increased risk of breast cancer in elderly women (RR: 3.00, 95% CI: 1.33 to 6.76, P = .008) than that in non-elderly women (RR: 1.15, 95% CI: 1.02 to 1.29, P = .02; P for subgroup difference = .04). However, the association was not significantly affected by country of the study, study design, diagnostic strategy for SDB or adjustment of obesity (P for subgroup analyses all > .05). CONCLUSIONS: SDB may be an independent risk factor for breast cancer in women, particularly in elderly females.

Impact of Postmastectomy Radiotherapy on Locoregional Control and Disease-Free Survival in Patients with Breast Cancer Treated with Neoadjuvant Chemotherapy.

BACKGROUND: The impact of postmastectomy radiotherapy (PMRT) in patients receiving neoadjuvant chemotherapy (NAC) is unclear. The purpose of this study is to identify the patients who may benefit from PMRT. METHODS: We retrospectively analysed patients with clinical stage II-III breast cancer who underwent NAC and modified radical mastectomy at our centre from 2007 to 2015. We investigated the relationship amongst locoregional recurrence rate (LRR), disease-free survival (DFS), and clinical pathological characters. RESULTS: A total of 554 patients were analysed in this study. The median follow-up time was 65 months. Amongst the patients, 58 (10.5%) had locoregional recurrence, 138 (24.9%) had distant metastasis, and 72 (13.0%) patients died. The 5-year cumulative incidence of LRR and DFS was 9.2% and 74.2%, respectively. A total of 399 (72%) patients received PMRT and 155 (28%) did not. The 5-year LRR of the patients with PMRT (7.3% vs. 14.1%, P=0.01) decreased significantly. We found that PMRT was an independent prognostic factor of LRR and DFS. Patients with the persistent involvement of 1-3 lymph nodes (ypN1) and more than 4 positive lymph nodes (ypN2-3) had a better outcome after PMRT than those without. However, the LRR and DFS of patients with negative lymph nodes at the time of surgery (ypN0) and who received PMRT showed no significant benefits. Amongst all patients with the three molecular subtypes of breast cancer, patients with triple-negative breast cancer had the highest pathological complete response rate but the worst prognosis (P=0.001). CONCLUSION: Results showed that PMRT significantly reduced the LRR of patients with clinical stage II-III breast cancer after receiving NAC and mastectomy. YpN0 patients derived no local control or survival benefit after receiving PMRT, whereas those with ypN1 and ypN2-3 could obviously benefit from PMRT.

Enhanced energy storage density of all-organic fluoropolymer composite dielectric via introducing crosslinked structure.

Polymer-based dielectrics have been attracted much attention to flexible energy storage devices due to their rapid charge-discharge rate, flexibility, lightness and compactness. Nevertheless, the energy storage performance of these dielectric polymers was limited by the weak dielectric breakdown properties. Crosslinked structure has been proven efficient to enhance breakdown strength (E b) and charge-discharge efficiency (η) of polymer film capacitors. However, crosslinked networks usually lead to low electric displacement of dielectric capacitors, which greatly restrict their energy storage density (U d). In this work, we present a tri-layered composite via layer-by-layer casting technology, where crosslinked polyvinylidene fluoride (c-PVDF) was used as the inter-layer to offer high breakdown strength, and the outer ternary fluoropolymer layers with high dielectric constant could provide high electric displacement. The optimal tri-layered composites exhibit an ultrahigh discharge energy density of 18.3 J cm-3 and a discharge efficiency of 60.6% at 550 kV mm-1. This energy density is much higher than that of the PVDF terpolymer and commercially biaxially oriented polypropylene (BOPP, 1-2 J cm-3). The simulation results prove that the enhanced energy density originates from the effectively depressed charge transport in crosslinked structure at high applied electric field. Moreover, this work provides a feasible method for developing flexible all-organic high-energy-density composites for polymer capacitors.

MicroRNA-582-5p promotes triple-negative breast cancer invasion and metastasis by antagonizing CMTM8.

Triple-negative breast cancer (TNBC) commonly have aggressive properties. microRNA-582-5p (miR-582-5p) modulates the progression of several cancers. Yet, the role of miR-582-5p in TNBC progression is undetermined. In the current study, we investigated miR-582-5p expression levels and clinical significance in TNBC. The impact of miR-582-5p modulation on the biological behaviors of TNBC cells were measured. The downstream gene(s) regulated by miR-582-5p in TNBC was explored. We showed that compared to adjacent normal breast tissues, the miR-582-5p level was elevated in TNBC samples. The upregulation of miR-582-5p correlated with lymph node metastasis. Overexpression of miR-582-5p enhanced TNBC cell migration and invasion, whereas knockdown of miR-582-5p had an adverse impact on aggressive phenotype. In vivo xenograft mouse studies demonstrated that miR-582-5p overexpression accelerated TNBC growth and metastasis. Mechanistically, miR-582-5p selectively inhibited CMTM8, leading to a reduction of CMTM8 expression. CMTM8 showed suppressive effects on TNBC cell migration and invasion. Rescue experiments revealed that overexpression of CMTM8 impaired miR-582-5p-induced migration and invasion in TNBC cells. Overall, our data uncover an oncogenic role for miR-582-5p in TNBC metastasis through inhibition of CMTM8. We suggest miR-582-5p as a promising target for managing TNBC.

MicroRNA-125a-5p modulates radioresistance in LTEP-a2 non-small cell lung cancer cells by targeting SIRT7.

BACKGROUND: Micro(mi)RNAs are a series of 20-24 nt non-coding small-molecule single-stranded RNAs that are believed to be closely related to tumor occurrence, development and other biological processes. MicroRNA-125a modulates radiochemotherapy sensitivity. However, the mechanism by which miRNA-125a regulates radiation resistance by lung cancer cells is yet to be elucidated. OBJECTIVE: The present study was designed to explore the biological role of miR-125a in regulating radioresistance in non-small cell lung carcinoma (NSCLC). METHODS AND RESULTS: The expression of miR-125a was assessed by quantitative real-time PCR in the human lung cancer cell lines, A549 and LTEP-a2. Notably, we found that miRNA-125a-5p regulated lung cancer radiosensitivity. We found that miRNA-125a-5p was more highly expressed in LTEP-a2 cells, which showed radiosensitivity compared to A549 cells with lower expression of miRNA-125a-5p. In addition, we up-regulated or down-regulated miR-125a-5p expression using an miR-125a-5p mimic or inhibitor, respectively, to reverse radioresistance. Flow cytometry revealed that the mimic increased the apoptotic rate as well as the expression of the apoptosis-related protein, cleaved poly ADP-ribose polymerase (PARP). Gene detection by luciferase reporter showed that sirtuin (SIRT)7 is a direct target of miR-125a-5p. Inhibiting SIRT7 using a small interfering RNA (siSIRT) abrogated resistance to radiation. In addition, the overexpression of SIRT7 decreased radiation-induced cell apoptosis. CONCLUSION: Our results indicated that the miR-125a level varies in NSCLC cell lines with different radiosensitivities. We demonstrated that miR-125a-5p upregulated SIRT7 and further upregulated apoptosis in lung cancer cells to increase their radiosensitivity. Our findings provide new directions for improving radiosensitivity in malignant lung tumors.

LncRNA LINC00963 Promotes Tumorigenesis and Radioresistance in Breast Cancer by Sponging miR-324-3p and Inducing ACK1 Expression.

Upregulation of long non-coding RNA LINC00963 has been observed in several cancer types. In this study, we analyzed the clinical and biological significance of LINC00963 in breast cancer. The key microRNA (miR) mediating the action of LINC00963 was identified. We show that LINC00963 upregulation is correlated with aggressive parameters of breast cancer. Silencing of LINC00963 suppresses the proliferation and tumorigenesis of breast cancer cells, whereas LINC00963 overexpression exerts an opposite effect. Knockdown of LINC00963 enhances DNA damage and oxidative stress and sensitizes breast cancer cells to radiation. Mechanistically, LINC00963 antagonizes the repressive activity of miR-324-3p on ACK1 expression. Clinically, there is a negative correlation between miR-324-3p and LINC00963 expression in breast cancer tissues. Overexpression of LINC00963 or ACK1 rescues the inhibitory effects of miR-324-3p on breast cancer cell proliferation and radiosensitivity. In addition, knockdown of ACK1 attenuates LINC00963-dependent breast cancer growth and tumorigenesis. Taken together, LINC00963 promotes tumorigenesis and radioresistance in breast cancer through interplay with miR-324-3p and derepression of ACK1. LINC00963 may represent a potential target for the treatment of breast cancer.

[Reparation of deep burn wounds with different kinds of skin flaps in patients with electrical injury].

OBJECTIVE: To sum up the clinical experience in the reparation of burn wounds with different types of skin flaps in patients with severe electrical injury. METHODS: Free skin flap, axile island flap with vascular pedicle and muscular skin flap were employed to repair 64 wounds in 49 cases. RESULTS: Skin flap necrosis happened in 2 cases, congestion and necrosis at the edge of skin flaps in 4 cases, and complete survival of the skin flaps and primary healing of the wounds in the remaining cases. CONCLUSION: Reparation of wounds with proper skin flaps according to the degree of the electrical injury is effective and reliable, which might be beneficial to the prevention of necrobiosis and the infection in deep tissue.

[The reverse medialis pedis flap for coverage of forefoot skin defects].

OBJECTIVE: To study a new method to repair forefoot skin defects. METHODS: Based on anatomical studies, a reverse medialis pedis flap was designed for coverage of forefoot skin defect. The flap was based on the distal end of the medial plantar artery and had distal anastomosis with the lateral plantar artery and dorsal metatarsal artery. RESULTS: The flap was used clinically in 6 cases. The size of the flap ranged from 4 x 3 cm to 11 x 9 cm. The pedicle of the flap was 6 to 11 cm. All flaps survived completely. The aesthetic and functional results were satisfactory after 6-24 months follow-up. CONCLUSION: The flap is one of the best choices for repairing of forefoot skin defects.