Advances in research and application of artificial intelligence and radiomic predictive models based on intracranial aneurysm images.

Intracranial aneurysm is a high-risk disease, with imaging playing a crucial role in their diagnosis and treatment. The rapid advancement of artificial intelligence in imaging technology holds promise for the development of AI-based radiomics predictive models. These models could potentially enable the automatic detection and diagnosis of intracranial aneurysms, assess their status, and predict outcomes, thereby assisting in the creation of personalized treatment plans. In addition, these techniques could improve diagnostic efficiency for physicians and patient prognoses. This article aims to review the progress of artificial intelligence radiomics in the study of intracranial aneurysms, addressing the challenges faced and future prospects, in hopes of introducing new ideas for the precise diagnosis and treatment of intracranial aneurysms.

Perioperative chemotherapy with docetaxel plus oxaliplatin and S-1 (DOS) versus oxaliplatin plus S-1 (SOX) for the treatment of locally advanced gastric or gastro-esophageal junction adenocarcinoma (MATCH): an open-label, randomized, phase 2 clinical trial.

BACKGROUND: It remains unclear whether addition of docetaxel to the combination of a platinum and fluoropyrimidine could provide more clinical benefits than doublet chemotherapies in the perioperative treatment for locally advanced gastric/gastro-esophageal junction (LAG/GEJ) cancer in Asia. In this randomized, phase 2 study, we assessed the efficacy and safety of perioperative docetaxel plus oxaliplatin and S-1 (DOS) versus oxaliplatin plus S-1 (SOX) in LAG/GEJ adenocarcinoma patients. METHODS: Patients with cT3-4 Nany M0 G/GEJ adenocarcinoma were randomized (1:1) to receive 4 cycles of preoperative DOS or SOX followed by D2 gastrectomy and another 4 cycles of postoperative chemotherapy. The primary endpoint was major pathological response (MPR). RESULTS: From Aug, 2015 to Dec, 2019,154 patients were enrolled and 147 patients included in final analysis, with a median age of 60 (26-73) years. DOS resulted in significantly higher MPR (25.4 vs. 11.8%, P = 0.04). R0 resection rate, the 3-year PFS and 3-year OS rates were 78.9 vs. 61.8% (P = 0.02), 52.3 vs. 35% (HR 0.667, 95% CI: 0.432-1.029, Log rank P = 0.07) and 57.5 vs. 49.2% (HR 0.685, 95% CI: 0.429-1.095, Log rank P = 0.11) in the DOS and SOX groups, respectively. Patients who acquired MPR experienced significantly better survival. DOS had similar tolerance to SOX. CONCLUSIONS: Perioperative DOS improved MPR significantly and tended to produce longer PFS compared to SOX in LAG/GEJ cancer in Asia, and might be considered as a preferred option for perioperative chemotherapy and worth further investigation.

Toxic effects of combined exposure to homoyessotoxin and nitrite on the survival, antioxidative responses, and apoptosis of the abalone Haliotis discus hannai.

Homoyessotoxin (homo-YTX) and nitrite (NO2-N), released during harmful dinoflagellate cell lysis adversely affect abalones. However, their toxicity mechanisms in shellfish remain unclear. This study investigated the economic abalone species Haliotis discus hannai exposed to varying concentrations of homo-YTX (0, 2, 5, and 10 µg L-1) and NO2-N (0, 3, and 6 mg L-1) on the basis of their 12 h LC50 values (5.05 µg L-1 and 4.25 mg L-1, respectively) and the environmentally relevant dissolved concentrations during severe dinoflagellate blooms, including mixtures. The test abalones were exposed to homo-YTX and NO2-N for 12 h. The mortality rate (D), reactive oxygen species (ROS) levels, antioxidant defense capabilities, and expression levels of antioxidant-related, Hsp-related, and apoptosis-related genes in abalone gills were assessed. Results showed that the combined exposure to homo-YTX and NO2-N increased the D and ROS levels and upregulated B-cell lymphoma-2 (BCL2)-associated X (BAX) and caspase3 (CASP3) expression levels while reducing glutathione peroxidase (GPx) activity and GPx, CuZnSOD, and BCL2 expression levels. High concentrations of homo-YTX (10 µg L-1) and NO2-N (6 mg L-1) solutions and the combinations of these toxicants inhibited the activities of superoxide dismutase (SOD) and catalase (CAT) and downregulated the expression levels of MnSOD, CAT, Hsp70, and Hsp90. The ROS levels were negatively correlated with the activities of SOD, CAT, and GPx and the expression levels of MnSOD, CuZnSOD, CAT, GPx, Hsp70, Hsp90, and BCL2. These results suggest that homo-YTX, in conjunction with NO2-N, induces oxidative stress, disrupts antioxidant defense systems, and triggers caspase-dependent apoptosis in the gills of abalone. ROS-mediated antioxidative and heat-shock responses and apoptosis emerge as potential toxicity mechanisms affecting the survival of H. discus hannai due to homo-YTX and NO2-N exposure.

Intraoperative assessment of anastomotic blood supply using indocyanine green fluorescence imaging following esophagojejunostomy or esophagogastrostomy for gastric cancer.

Objective: This retrospective study aimed to evaluate the feasibility and safety of intraoperative assessment of anastomotic blood supply in patients undergoing esophagojejunostomy or esophagogastrostomy for gastric cancer using Indocyanine Green Fluorescence Imaging (IGFI). Materials and methods: From January 2019 to October 2021, we conducted a retrospective analysis of patients who had undergone laparoscopic gastrectomy for the treatment of gastric cancer. The patients were consecutively enrolled and categorized into two study groups: the Indocyanine Green Fluorescence Imaging (IGFI) group consisting of 86 patients, and the control group comprising 92 patients. In the IGFI group, intravenous administration of Indocyanine Green (ICG) was performed, and we utilized a fluorescence camera system to assess anastomotic blood supply both before and after the anastomosis. Results: The demographic characteristics of patients in both groups were found to be comparable. In the IGFI group, the mean time to observe perfusion fluorescence was 26.3 ± 12.0 seconds post-ICG injection, and six patients needed to select a more proximal resection point due to insufficient fluorescence at their initial site of choice. Notably, the IGFI group exhibited a lower incidence of postoperative anastomotic leakage, with no significant disparities observed in terms of pathological outcomes, postoperative recovery, or other postoperative complication rates when compared to the control group (p > 0.05). Conclusion: This study underscores the potential of IGFI as a dependable and pragmatic tool for the assessment of anastomotic blood supply following esophagojejunostomy or esophagogastrostomy for gastric cancer. The use of IGFI may potentially reduce the occurrence of postoperative anastomotic leakage.

Modulation of Electronic Synergy to Enhance the Intrinsic Activity of Fe5Ni4S8 Nanosheets in Restricted Space Carbonized Wood Frameworks for Efficient Oxygen Evolution Reaction.

Modulation of electronic structure and composition is widely recognized as an effective strategy to improve electrocatalyst performance. Herein, using a simple simultaneous carbonization and sulfidation strategy, NiFe double hydroxide-derived Fe5Ni4S8 (FNS) nanosheets immobilized on S-doped carbonized wood (SCW) framework by taking benefit of the orientation-constrained cavity and hierarchical porous structure of wood is proposed. Benefiting from the synergistic relationships between bimetal ions, the spatial confinement offered by the wood cavity, and the enhanced structural effects of the nanosheets array, the FNS/SCW exhibit enhanced intrinsic activity, increased accessibility of catalytically active sites, and convection-facilitated mass transport, resulting in an excellent oxygen evolution reaction (OER) activity and durability. Specifically, it takes a low overpotential of 230 mV at 50 mA cm-2 and potential increase is negligible (3.8%) at 50 mA cm-2 for 80 hours. Density functional theory (DFT) calculations further reveal that the synergistic effect of bimetal can optimize the electronic structure and lower the reaction energy barrier. The FNS/SCW used as the cathode of zinc-air battery shows higher power density and excellent durability relative to commercial RuO2, exhibiting a good application prospect. Overall, this research offers proposals for designing and producing effective OER electrocatalysts using sustainable resources.

Trimester-specific hemodynamics of per- and polyfluoroalkyl substances and its relation to lipid profile in pregnant women.

Per- and polyfluoroalkyl substances (PFAS) are persistent organic pollutants widely detected in blood from pregnant women, yet limited study evaluated the trimester-specific variance of serum PFAS, and even less is known for the window of vulnerability to lipids metabolism interrupting effects of PFAS during pregnancy. We quantified 16 legacy, 3 emerging PFAS, and lipid biomarkers in 286 serum samples from 118 pregnant women. All target PFAS, except perfluorotridecanoic acid (PFTrDA), in maternal serum showed moderate to low temporal irregular variability across gestation (average intraclass correlation coefficients ≥ 0.57), while the generalized estimating equations showed a significant declining trend in the serum levels during pregnancy (p for trend < 0.05). The decline of 6:2 chlorinated polyfluorinated ether sulfonate in maternal serum was the greatest with a change of - 21.63% from 1st to 2nd trimester, which indicated a possible higher accumulation of this emerging PFAS in fetal compartment. Multiple linear regression, multiple informant model and Bayesian kernel machine regression showed a higher vulnerability in the 1st trimester to effects of PFAS exposure on serum lipids of pregnant women. The results highlighted the importance of the study timing of PFAS exposure during pregnancy.

Dual-layer spectral-detector CT for predicting microsatellite instability status and prognosis in locally advanced gastric cancer.

OBJECTIVE: To construct and validate a prediction model based on dual-layer detector spectral CT (DLCT) and clinico-radiologic features to predict the microsatellite instability (MSI) status of gastric cancer (GC) and to explore the relationship between the prediction results and patient prognosis. METHODS: A total of 264 GC patients who underwent preoperative DLCT examination were randomly allocated into the training set (n = 187) and validation set (n = 80). Clinico-radiologic features and DLCT parameters were used to build the clinical and DLCT model through multivariate logistic regression analysis. A combined DLCT parameter (CDLCT) was constructed to predict MSI. A combined prediction model was constructed using multivariate logistic regression analysis by integrating the significant clinico-radiologic features and CDLCT. The Kaplan-Meier survival analysis was used to explore the prognostic significant of the prediction results of the combined model. RESULTS: In this study, there were 70 (26.52%) MSI-high (MSI-H) GC patients. Tumor location and CT_N staging were independent risk factors for MSI-H. In the validation set, the area under the curve (AUC) of the clinical model and DLCT model for predicting MSI status was 0.721 and 0.837, respectively. The combined model achieved a high prediction efficacy in the validation set, with AUC, sensitivity, and specificity of 0.879, 78.95%, and 75.4%, respectively. Survival analysis demonstrated that the combined model could stratify GC patients according to recurrence-free survival (p = 0.010). CONCLUSION: The combined model provides an efficient tool for predicting the MSI status of GC noninvasively and tumor recurrence risk stratification after surgery. CRITICAL RELEVANCE STATEMENT: MSI is an important molecular subtype in gastric cancer (GC). But MSI can only be evaluated using biopsy or postoperative tumor tissues. Our study developed a combined model based on DLCT which could effectively predict MSI preoperatively. Our result also showed that the combined model could stratify patients according to recurrence-free survival. It may be valuable for clinicians in choosing appropriate treatment strategies to avoid tumor recurrence and predicting clinical prognosis in GC. KEY POINTS: • Tumor location and CT_N staging were independent predictors for MSI-H in GC. • Quantitative DLCT parameters showed potential in predicting MSI status in GC. • The combined model integrating clinico-radiologic features and CDLCT could improve the predictive performance. • The prediction results could stratify the risk of tumor recurrence after surgery.

Comprehensive evaluation of perchlorate dietary exposure and health risks for Chinese adult males and breastfed infants.

Perchlorate is an environmental contaminant that has both natural and anthropogenic sources. Widespread contamination of various foods with perchlorate can be caused by water, soil, and fertilizer. Because of concerns about the health effects of perchlorate, attention has focused on its occurrence in food and potential human exposure. In this study, the dietary exposures of Chinese adult males and breastfed infants to perchlorate were evaluated using data from the sixth China Total Diet Study and the third National Breast Milk Monitoring Program conducted between 2016 and 2019. In the sixth China Total Diet Study, perchlorate was detected in 94.8 % of composite dietary samples (n = 288) from 24 provinces in China, while for the third National Breast Milk Monitoring, perchlorate was found in 100 % of pooled breast milk samples (n = 100) collected from 100 cities/counties in China. Vegetables were found to be the main source of dietary exposure for Chinese adult males. Furthermore, the concentrations in breast milk between urban (n = 34, mean: 38.6 µg/L) and rural (n = 66, mean: 59.0 µg/L) regions from 100 cities/counties in China were not significantly different. On average, the estimated daily intake of Chinese adult males (18-45 years) to perchlorate was 0.449 µg/kg bw/day, while that for breastfed infants (0-24 months) was 3.21-5.43 µg/kg bw/day. The exposure to perchlorate in breastfed infants was almost 10-fold greater than that of Chinese adult males.

Dual-modular immunosensor for bongkrekic acid detection using specific monoclonal antibody.

Bongkrekic acid (BA) is a mitochondrial toxin that causes high mortality but is often mistakenly categorized as other food poisonings. The immunoassay of BA is still challenging since the specific antibody is unavailable. In this work, a monoclonal antibody specific to BA was first generated and a dual-modular immunosensor for on-site and laboratory detection was established. The antibody showed good affinity (Kd=0.33 µM) and sensitivity (IC50 =17.9 ng/mL in ELISA) with negligible cross-reactivity with common mycotoxins. In dual-modular conditions, fluorescence assay (FA) was conducted based on the inner filter effect of carbon dots (CDs) and oxidized 3,3',5,5'-tetramethylbenzidine (TMB), while the colorimetric assay (CA) was conducted using TMB2+-mediated rapid surface etching of gold nanostars (Au NSs). The proposed immunosensor showed good sensitivity and reproducibility to BA in food samples, with a limit of detection lower than 10 ng/mL and recovery ranging from 80.0% to 103.6%, which was in good consistence with that of standard LC-MS/MS. Overall, the proposed immunosensor is an ideal tool for screening BA contaminants in food with good sensitivity and high effectivity.

Single versus multiple hyperthermic intraperitoneal chemotherapy applications for T4 gastric cancer patients: Efficacy and safety profiles.

Objective: To explore the clinical safety and efficacy of single and multiple applications of lobaplatin-based hyperthermic intraperitoneal chemotherapy (HIPEC) for patients with T4 gastric cancer and to evaluate the impact of HIPEC on peritoneal metastasis. Materials and methods: We retrospectively reviewed prospectively collected data from T4 gastric cancer patients who underwent radical gastric resection plus HIPEC between March 2018 and August 2020 from the National Cancer Center and Huangxing Cancer Hospital. Patients who underwent radical surgery and HIPEC were divided into two groups: the single-HIPEC group (radical resection + a single application of intraoperative HIPEC with lobaplatin 50 mg/m2 at 43.0 ± 0.5°C for 60 min), and a multi-HIPEC group (two more HIPEC applications were performed after radical surgery). Results: A total of 78 patients were enrolled in this two-center study; among them, 40 patients were in the single-HIPEC group, and 38 patients were in the multi-HIPEC group. The baseline characteristics were well balanced between the two groups. There was no significant difference in the postoperative complication rates between the two groups (P > 0.05). Mild renal dysfunction, mild liver dysfunction, low platelet levels and low white blood cell levels were recorded in both groups, without significant differences between the two groups (P > 0.05). After a mean follow-up of 36.8 months, 3 (7.5%) patients in the single-HIPEC group and 2 (5.2%) patients in the multi-HIPEC group experienced peritoneal recurrence (P > 0.05). Both groups had comparable 3-year overall survival (OS) (51.3% vs. 54.5%, P = 0.558) and 3-year disease-free survival (DFS) rates (44.1% vs. 45.7%, P = 0.975). Multivariate analysis showed that an age > 60 years and low preoperative albumin levels were independent risk factors for postoperative complications. Conclusion: Single and multiple applications of HIPEC in patients with T4 gastric cancer were safe and feasible. Both groups had similar postoperative complication rates, 3-year OS rates and 3-year DFS rates. Special attention should be given to HIPEC for patients aged > 60 years and patients with low preoperative albumin levels.

THE REPORTING QUALITY OF SYSTEMATIC REVIEW ABSTRACTS IN LEADING GENERAL DENTAL JOURNALS: A METHODOLOGICAL STUDY.

OBJECTIVE: To assess the reporting quality of systematic review (SR) abstracts published in leading general dental journals according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Abstracts (PRISMA-A) guidelines, and to identify factors associated with overall reporting quality. METHODS: We identified SR abstracts published in 10 leading general dental journals and assessed their reporting quality. For each abstract, an overall reporting score (ORS, range: 0-13) was calculated. Risk ratio (RR) was calculated to compare the reporting quality of abstracts in Pre-PRISMA (2011-2012) and Post-PRISMA (2017-2018) periods. Univariable and multivariable linear regression analyses were performed to identify factors associated with reporting quality. RESULTS: A total of 104 eligible abstracts were included. The mean ORS was 5.59 (SD = 1.48) and 6.97 (1.74) respectively in the Pre- and Post-PRISMA abstracts, with statistically significant difference (mean difference = 1.38; 95% CI: 0.70, 2.05). Reporting of the exact P-value (B = 1.22; 95% CI: 0.45, 1.99) was a significant predictor of higher reporting quality. CONCLUSION: The reporting quality of SR abstracts published in leading general dental journals improved after the release of PRISMA-A guidelines, but is still suboptimal. Relevant stakeholders need to work together to enhance the reporting quality of SR abstracts in dentistry.

Clinical characteristics and changing trajectories of esophageal cancer and gastric cancer in China from 2010 to 2019: An analysis of a hospital-based database of 24,327 patients.

Purpose: This analysis aimed to investigate the clinical characteristics and changing trajectories of gastric cancer (GC) and esophageal cancer (EC). Methods: We collected data from a large cancer hospital in Beijing, China, from 2010 to 2019. Joinpoint regression was used to analyze the trends of histological characteristics and comorbidities. Results: From 2010 to 2019, there were a total of 10,083 EC patients and 14,244 GC patients. Patients were mainly men and diagnosed at 55-64 years old. Metabolic comorbidity was the most common comorbidity, with hypertension being predominant. The percentages of stage I showed significant increases for EC [average annual percent change (AAPC): 10.5%] and GC (AAPC: 9.7%) patients. We also observed an increasing trend of EC and GC patients over 65 years old. For EC patients, esophageal squamous cell carcinoma (93.1%) remained as the prioritized subtype, and the middle third of the esophagus was the most common site. EC patients with three or more comorbidities increased from 0.1% to 2.2% (AAPC, 27.7%; 95% CI, 14.7% to 42.2%). For GC patients, adenocarcinoma accounts for 86.9% of the total cases, and cardia was the most common site. The ulcerative comorbidity rate decreased from 2.0% to 1.2% (AAPC, -6.1%; 95% CI, -11.6% to -0.3%). Conclusion: ESCC remained as the prioritized histological subtype, and the middle third of the esophagus was the most common site of EC. The majority of GC patients had adenocarcinoma, and the cardia was the most common site. There was an increasing trend of patients diagnosed at stage I. These findings provide scientific evidence to guide future treatment.

Antifungal Peptide SP1 Damages Polysaccharide Capsule of Cryptococcus neoformans and Enhances Phagocytosis of Macrophages.

Cryptococcus neoformans is a fungal pathogen which causes nearly half a million deaths worldwide each year. Under host-relevant conditions, it produces a characteristic polysaccharide capsule. The polysaccharide capsule is one of the main virulence factors of C. neoformans, which involves antiphagocytosis and immune responses of the host to cause a lack of an immune. Meanwhile, the polysaccharide capsule is a promising drug target because of the absence of analogs in the host. Here, we demonstrate that antifungal peptide SP1, which is derived from the N terminus of Saccharomyces cerevisiae GAPDH (glyceraldehyde-3-phosphate dehydrogenase), disrupts the polysaccharide capsule of C. neoformans H99. The mechanism is possibly due to the interaction of SP1 with glucuronoxylomannan (GXM). Disruption of the polysaccharide capsule enhances the adhesion and phagocytosis of C. neoformans H99 by macrophages and reduces the replication of C. neoformans H99 within macrophages. Additionally, SP1 exhibits antifungal activity against cryptococcal biofilms associated with the capsular polysaccharides. These findings suggest the potential of SP1 as a drug candidate for the treatment of cryptococcosis. IMPORTANCE C. neoformans is an opportunistic pathogen that causes invasive infections with a high mortality rate. Currently, the clinical drugs available for the treatment of cryptococcosis are limited to amphotericin B, azoles, and flucytosine. Amphotericin is nephrotoxic, and the widespread use of azoles and 5-flucytosine has led to a rapid development of drug resistance in C. neoformans. There is an urgent need to develop new and effective anticryptococcal drugs. Targeting virulence factors is a novel strategy for developing antifungal drugs. The antifungal peptide SP1 is capable of disrupting the polysaccharide capsule, which is a principal virulence factor of C. neoformans. Studying the mechanism by which SP1 damages the polysaccharide capsule and investigating the potential benefits of SP1 in removing C. neoformans from the host provides baseline data to develop a therapeutic strategy against refractory cryptococcal infections. This strategy would involve both inhibiting virulence factors and directly killing C. neoformans cells.

Lobaplatin-based prophylactic hyperthermic intraperitoneal chemotherapy for T4 gastric cancer patients: A retrospective clinical study.

Objective: To explore the clinical efficacy of lobaplatin-based prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) for patients with T4 gastric cancer after surgery and to evaluate its impact on survival. Materials and methods: Data on patients with T4 gastric cancer who underwent radical gastric resection between March 2016 and August 2017 were collected from the National Cancer Center and Huangxing Cancer Hospital. Enrolled patients were divided into two groups according to receiving or not receiving HIPEC. Results: A total of 106 patients were included in this study; among them, 51 patients underwent radical gastric resection plus prophylactic HIPEC, and 55 patients underwent radical gastric resection only. The baseline characteristics were well balanced between the two groups. The postoperative platelet counts in the HIPEC group were significantly lower than those in the non-HIPEC group (P < 0.05); however, we did not observe any occurrences of serious bleeding in the HIPEC group. There were no significant differences in the postoperative complication rates between the two groups (P > 0.05). The postoperative (1 month) CEA, CA19-9, and CA72-4 levels in the HIPEC group were significantly decreased in the HIPEC group (P < 0.05). At a median follow-up of 59.3 months, 3 (5.5%) patients in the HIPEC group experienced peritoneal recurrence, and 10 (18.2%) patients in the non-HIPEC group experienced peritoneal recurrence (P < 0.05). Both groups had comparable 5-year overall survival (OS) rates (41.1% HIPEC group vs. 34.5% non-HIPEC group, P = 0.118). The 5-year disease-free survival was significantly higher in the HIPEC group than in the non-HIPEC group (28.6% versus 39.7%, p = 0.046). Conclusions: Lobaplatin-based prophylactic HIPEC is feasible and safe for patients with T4 gastric cancer and does not increase postoperative adverse effects. The use of HIPEC showed a significant decrease in the incidence of local recurrence rates and blood tumor marker levels. The 5-year disease-free survival was significantly higher in the HIPEC group; however, the 5-year OS benefit was not found in T4 stage patients.

A case-control study of urinary concentrations of bisphenol A, bisphenol F, and bisphenol S and the risk of papillary thyroid cancer.

The incidence of thyroid cancer (TC), especially papillary thyroid cancer (PTC), has dramatically increased globally. Whereas some endocrine disruptors have been linked to neoplastic processes, the associations between human exposure to bisphenol analogs and the risk of TC remain unclear. This present case-control study examined the associations between the urinary concentrations of bisphenol A (BPA) and other bisphenols, namely bisphenol F (BPF) and bisphenol S (BPS), and the risk of PTC. After adjusting for confounders and creatinine standardization, significantly positive associations were observed for BPF (odds ratio [OR] = 1.80, 95% confidence interval [CI] = 1.27-2.54), but negative associations observed for BPA (OR = 0.38, 95% CI = 0.19-0.77) and BPS (OR = 0.63, 95% CI = 0.43-0.93), in the total population. However, after stratification by age and smoking, statistical significance was retained only in non-smoking women, suggesting the adverse effects of BPF exposure on PTC risk, especially in women. These findings require replication and confirmation in further research.

Measure on innovation efficiency of China's pharmaceutical manufacturing industry.

Pharmaceutical manufacturing industry is an important industry to ensure human life safety. The innovation efficiency is a significant factor to stimulate the development of pharmaceutical manufacturing industry. At present, there are few studies on the innovation efficiency of pharmaceutical manufacturing industry. To fill this gap, this paper estimates the innovation efficiency of China's pharmaceutical manufacturing industry in 23 provinces of China from 2010 to 2020 based on the super-network SBM model and Global-Malmquist index. The results show that: (1) From the perspective of efficiency of research and development stage (ERDS), the ERDS of China shows an increasing trend, with the most prominent growth in the western region. (2) From the perspective of efficiency of economic transformation stage (EETS), although there are fluctuations in the EETS, the overall development is good. The EETS of the central region and western region is better than that of the eastern region. (3) By comparing the efficiency of the two stages, it is found that the change direction of the efficiency of the two stages is not necessarily the same in some provinces.

On-line solid phase extraction-ultra high performance liquid chromatography-quadrupole/Orbitrap high resolution mass spectrometry determination of per- and polyfluoroalkyl substances in human serum.

A rapid, high-performance, and accurate on-line TurboFlow ultra high performance liquid chromatography-quadrupole/Orbitrap high resolution mass spectrometry method was developed for the analysis of 46 per- and polyfluoroalkyl substances (PFAS), including 17 perfluoroalkylcarboxylic acids, 15 perfluoroalkylsulfonates, 3 fluorinated telomer sulfonates, 2 perfluoroalkyl unsaturated carboxylates, 2 perfluorooctanesulfonamidoacetic acid, 3 perfluorooctanesulfonamides, hexafluoropropylene oxide-dimer acid, ammonium 4,8-dioxa-3H-perfluorononanoate, 6:2 chlorinated polyfluorinated ether sulfonate (Cl-PFESA), and 8:2 Cl-PFESA, in human serum. The TurboFlow column, mobile phase, sample injection volume, loading flow rate, and elution time were optimized. The linearities of matrix calibration curves, method limits of quantification, accuracy and precision were investigated for method validation. Serum samples (50 µL) were precipitated with acetonitrile and directly injected into the system. The method showed good linearity (R2 > 0.99), satisfactory recoveries (matrix-spiked recoveries range: 68.9%-115.7%), good precision (relative standard deviation ranges: 1.2%-12.1%) and a low method limit of quantification (0.1-1 ng mL-1). The developed method is rapid, accurate and convenient for large-scale biomonitoring of PFAS in humans. Fifty real serum samples from China were analyzed and the results showed that br-perfluorooctanesulfonate (PFOS) accounted for approximately 30% of the ∑PFOS in serum, which suggested there was high exposure to 6:2 Cl-PFESA.

Effect of therapeutic versus prophylactic anticoagulation therapy on clinical outcomes in COVID-19 patients: a systematic review with an updated meta-analysis.

BACKGROUND: Previous studies demonstrate a reduced risk of thrombosis and mortality with anticoagulant treatment in patients with COVID-19 than in those without anticoagulation treatment. However, an open question regarding the efficacy and safety of therapeutic anticoagulation (T-AC) versus a lower dose, prophylaxis anticoagulation (P-AC) in COVID-19 patients is still controversial. METHODS: We systematically reviewed currently available randomized clinical trials (RCTs) and observational studies (OBs) from January 8, 2019, to January 8, 2022, and compared prophylactic and therapeutic anticoagulant treatment in COVID-19 patients. The primary outcomes were risk of mortality, major bleeding, and the secondary outcomes included venous and arterial thromboembolism. Subgroup analysis was also performed between critically ill and non-critically ill patients with COVID-19 and between patients with higher and lower levels of D-dimer. Sensitivity analysis was performed to decrease the bias and the impact of population heterogeneity. RESULTS: We identified 11 RCTs and 17 OBs fulfilling our inclusion criteria. In the RCTs analyses, there was no statistically significant difference in the relative risk of mortality between COVID-19 patients with T-AC treatment and those treated with P-AC (RR 0.95, 95% CI, 0.78-1.15, P = 0.60). Similar results were also found in the OBs analyses (RR 1.21, 95% CI, 0.98-1.49, P = 0.08). The pooling meta-analysis using a random-effects model combined with effect sizes showed that in the RCTs and OBs analyses, patients with COVID-19 who received T-AC treatment had a significantly higher relative risk of the major bleeding event than those with P-AC treatment in COVID-19 patients (RCTs: RR 1.76, 95% CI, 1.19-2.62, P = 0.005; OBs: RR 2.39, 95% CI, 1.56-3.68, P < 0.0001). Compared with P-AC treatment in COVID-19 patients, patients with T-AC treatment significantly reduced the incidence of venous thromboembolism (RR 0.51, 95% CI, 0.39-0.67, P<0.00001), but it is not associated with arterial thrombosis events (RR 0.97, 95% CI, 0.66-1.42, P = 0.87). The subgroup analysis of OBs shows that the mortality risk significantly reduces in critically ill COVID-19 patients treated with T-AC compared with those with P-AC treatment (RR 0.58, 95% CI, 0.39-0.86, P = 0.007), while the mortality risk significantly increases in non-critically ill COVID-19 patients treated with T-AC (RR 1.56, 95% CI, 1.34-1.80, P < 0.00001). In addition, T-AC treatment does not reduce the risk of mortality in COVID-19 patients with high d-dimer levels in RCTs. Finally, the overall sensitivity analysis after excluding two RCTs studies remains consistent with the previous results. CONCLUSIONS: In our integrated analysis of included RCTs and OBs, there is no significant difference between the mortality of T-AC and P-AC treatment in unselected patients with COVID-19. T-AC treatment in COVID-19 patients significantly reduced the incidence of venous thromboembolism but showed a higher risk of bleeding than those with P-AC treatment. In addition, P-AC treatment was superior to T-AC treatment in non-critically ill COVID-19 patients, the evidence supporting the necessity for T-AC treatment in critically ill COVID-19 patients came only from OBs. TRIAL REGISTRATION: Protocol registration: The protocol was registered at PROSPERO (CRD42021293294).

Protective effects of female reproductive factors on gastric signet-ring cell carcinoma.

BACKGROUND: The overall incidence of gastric cancer is higher in men than women worldwide. However, gastric signet-ring cell carcinoma (GSRC) is more frequently observed in younger female patients. AIM: To analyze clinicopathological differences between sexes in GSRC, because of the limited evidence regarding association between sex-specific differences and survival. METHODS: We reviewed medical records for 1431 patients who received treatment for GSRC at the Cancer Hospital, Chinese Academy of Medical Sciences between January 2011 and December 2018 and surveyed reproductive factors. Clinicopathological characteristics were compared between female and male patients. Cox multivariable model was used to compare the mortality risks of GSRC among men, menstrual women, and menopausal women. RESULTS: Of 1431 patients, 935 patients were male and 496 were female (181 menstrual and 315 menopausal). The 5-year overall survival in male, menstrual female and menopausal female groups was 65.6%, 76.5% and 65%, respectively (P < 0.01). Menstruation was found to be a protective factor (hazard ratio = 0.58, 95% confidence interval: 0.42-0.82). CONCLUSION: The mortality risk of GSRC in menstrual women was lower than that in men. This study identified the protective effects of female reproductive factors in GSRC.

Quantitative Dynamic-Enhanced MRI and Intravoxel Incoherent Motion Diffusion-Weighted Imaging for Prediction of the Pathological Response to Neoadjuvant Chemotherapy and the Prognosis in Locally Advanced Gastric Cancer.

Background: This study aimed to explore the predictive value of quantitative dynamic contrast-enhanced MRI (DCE-MRI) and intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) quantitative parameters for the response to neoadjuvant chemotherapy (NCT) in locally advanced gastric cancer (LAGC) patients, and the relationship between the prediction results and patients' prognosis, so as to provide a basis for clinical individualized precision treatment. Methods: One hundred twenty-nine newly diagnosed LAGC patients who underwent IVIM-DWI and DCE-MRI pretreatment were enrolled in this study. Pathological tumor regression grade (TRG) served as the reference standard of NCT response evaluation. The differences in DCE-MRI and IVIM-DWI parameters between pathological responders (pR) and pathological non-responders (pNR) groups were analyzed. Univariate and multivariate logistic regressions were used to identify independent predictive parameters for NCT response. Prediction models were built with statistically significant quantitative parameters and their combinations. The performance of these quantitative parameters and models was evaluated using receiver operating characteristic (ROC) analysis. Clinicopathological variables, DCE-MRI and IVIM-DWI derived parameters, as well as the prediction model were analyzed in relation to 2-year recurrence-free survival (RFS) by using Cox proportional hazards model. RFS was compared using the Kaplan-Meier method and the log-rank test. Results: Sixty-nine patients were classified as pR and 60 were pNR. Ktrans, kep, and ve values in the pR group were significantly higher, while ADCstandard and D values were significantly lower than those in the pNR group. Multivariate logistic regression analysis demonstrated that Ktrans, kep, ve, and D values were independent predictors for NCT response. The combined predictive model, which consisted of DCE-MRI and IVIM-DWI, showed the best prediction performance with an area under the curve (AUC) of 0.922. Multivariate Cox regression analysis showed that ypStage III and NCT response predicted by the IVIM-DWI model were independent predictors of poor RFS. The IVIM-DWI model could significantly stratify median RFS (52 vs. 15 months) and 2-year RFS rate (72.3% vs. 21.8%) of LAGC. Conclusion: Pretreatment DCE-MRI quantitative parameters Ktrans, kep, ve, and IVIM-DWI parameter D value were independent predictors of NCT response for LAGC patients. The regression model based on baseline DCE-MRI, IVIM-DWI, and their combination could help RFS stratification of LAGC patients.