Predictive value of immediate early response 5 like (IER5L) in the prognosis and immune checkpoint blockade therapy of non-small cell lung cancer patients.

BACKGROUND: Non-small cell lung cancer (NSCLC) is a malignancy with high mortality. Immediate early response 5 like (IER5L) has been found to associate with worse prognosis in colorectal cancer patients. However, its role in the prognosis prediction of NSCLC has remained largely unknown. METHODS: The IER5L expression in NSCLC and normal tissues was analyzed in two public cohorts: TCGA-LUAD-LUSC and GSE159857. Additionally, functional enrichment, survival analysis, CIBERSORT and tumor mutation burden (TMB) were investigated between low- and high-IER5L level groups. The in vitro IER5L mRNA and protein levels were determined using RT-qPCR and western blot, respectively. RESULTS: The data from TCGA-LUAD-LUSC and GSE159857 cohorts showed a high IER5L mRNA expression in NSCLC tissue samples compared to normal controls. The increased expression of IER5L in NSCLC cells were also validated by RT-qPCR and western blot analysis. Additionally, NSCLC patients with high-IER5L level had significantly worse prognosis and IER5L could be used as an independent prognostic factor for NSCLC patients. Meanwhile, patients in the high-IER5L group had higher TMB level. IER5L expression was negatively correlated with the proportion of Monocytes and T cells CD4 memory resting, and was positively related to the proportion of Tregs and M0 macrophages in tumor tissues. Besides, transcription factors TFAP4 and ZNF692 may bind to the promoter region of IER5L, and then modulate IER5L gene transcription, thereby affecting IER5L gene expression. Furthermore, GSEA results showed that IER5L gene was closely related to MAPK, PI3K-Akt, NF-kappaB signaling pathways in NSCLC. CONCLUSION: Collectively, high IER5L expression may be a promising unfavorable prognostic biomarker and therapeutic target for NSCLC patients.

The Application of Sesamoid Position in Diagnosing Thumb Metacarpophalangeal Joint Dorsal Dislocation: A Retrospective Study.

OBJECTIVES: The position of sesamoid of thumb metacarpophalangeal (MCP) joint changed clearly when the joint was dislocated dorsally. However, the significance of sesamoid location in diagnosing joint dislocation was unclear. The present study aimed to explore the positional relationship between sesamoid bone and thumb metacarpophalangeal joint in normal and dorsal dislocation joints. METHODS: Between January 2018 and August 2023, we collected 60 isometric plain films from sixty outpatients and reviewed 56 anisometric plain films from twenty-eight emergency patients with dorsal dislocation of thumb MCP joint at Tianjin Hospital, then took measurements on the hand X-ray images. The sesamoid length on its longitudinal axis was defined as DP, the distance between the distal edge of sesamoid and thumb MCP joint was defined as DJ, and the ratio of DJ and DP was R. An independent-samples t-test and paired-samples t-test was utilized to analyze difference among data groups. RESULTS: The 60 isometric images were from 30 male and 30 female outpatients with normal bone structure in their hands, and the 56 anisometric images of the 28 emergency patients included both preoperative and postoperative materials. Among the outpatients, the actual distance between the distal edge of sesamoid and thumb MCP joint space (DJ) was 2.09 mm and 1.40 mm in males and females, respectively. The authentic average length of sesamoid (DP) was 4.46 mm in males and 4.22 mm in females. The average value of R (the ratio of DJ and DP) in males and females was 0.49 and 0.34, respectively. There were gender-related statistical differences in DJ (p < 0.01) and R (p=0.01), but no statistical difference in DP (p > 0.05). For the 28 emergency patients, the mean value of R was -0.47 before joint reduction and 0.58 after joint reduction, with statistical difference between them (p < 0.01). CONCLUSIONS: There was significant difference in the relative position between sesamoid and thumb MCP joint when joint dislocation and joint reduction. The distal edge of sesamoid beyond thumb MCP joint could be an evidence in diagnosing joint dorsal dislocation. The distal edge of sesamoid below thumb MCP joint could be an evidence of joint reduction.

Study on the Adsorption Deformation of a Substrate via Spin Coating Based on the 3D-DIC Method and Its Effect on the Homogeneity of Perovskite Films.

The physical and chemical stability of perovskite films has always been a key issue for their industrialization, which has been extensively studied in terms of materials, environment, and encapsulation. Spin coating is one of the most commonly used methods for the preparation of perovskite films in research. However, little attention has been paid to the deformation state of the substrate when it is fixed by means of adsorption and its impact. In this work, the three-dimensional digital image correlation (3D-DIC) method and hyperspectral technology are used to acquire and analyze the adsorption deformation characteristics of the substrate during spin coating, as well as the resulting inhomogeneity. Plastic and four different thicknesses of float glass (0.2, 0.5, 0.7, 1.1 mm) were selected as substrates, and they were tested separately on two suction cups with different structures. The results show that the plastic and 0.2 mm specimens exhibit obvious strain localization behavior. The distribution and magnitude of the strain are affected by the size of the sucker structure, especially the width of the groove. For glass specimens, this effect shows a nonlinear decrease with increasing substrate thickness. Compared to the strain value, the irregularity of local deformation has a greater impact on the non-uniform distribution of materials. Finally, inhomogeneities in the perovskite films were observed through optical lens and hyperspectral data. Obviously, the deformation of the substrate caused by adsorption should attract the attention of researchers, especially for flexible or rigid substrates with low thickness. This may affect the centrifugal diffusion path of the precursor, causing microstructure inhomogeneity and residual stress, etc.

[Research advances in photoactivatable CRISPR gene editing technology].

Since the emergence of CRISPR/Cas9, gene editing technologies have attracted increasing attention, in particular type II systems, in which nucleases consist of only a single protein. The effectors include type II Cas9, type V Cas12 and type VI Cas13, which allow precise genomic DNA or RNA editing. Catalytically inactive CRISPR/Cas9 can also be used as a platform to recruit effectors such as transcription factors, epigenetic factors, and/or base modification enzymes to target gene loci. On the other hand, optogenetics offers spatial, temporal, and reversible control of biological processes. CRISPR and optogenetics can enable precise gene editing in vitro and in vivo at the spatiotemporal level, which has a broad applicability in biology and medicine. This article has provided a review for the research advance in photoactivatable CRISPR systems, with details for the design and application of such tools and a discussion over the limitations of the current methods, which may shed light on this emerging field.

Application of WALANT technique for repairing finger skin defect with a random skin flap.

BACKGROUND: Wide-awake local anesthesia no tourniquet (WALANT) technique has emerged among hand surgeons with other indications. Surgeries involving pedicled flap and revascularization are no longer used as contraindications. The present study aimed to evaluate the feasibility and merits of the WALANT technique in random skin flap surgery. METHODS: From May 2018 to March 2019, 12 patients with finger skin defects repaired with random skin flaps were reviewed. Abdominal skin flaps or thoracic skin flaps were used to cover the wound. Both the fingers and the donor sites were anesthetized by the WALANT technique. A 40-mL conventional volume consisted of a mixture of epinephrine and lidocaine. A volume of 5 mL was injected at the distal palmar for nerve block, the other 5 mL was injected around the wound for hemostasis, and the remaining was injected at the donor site of flaps for both analgesia and hemostasis. Baseline data with respect to sex, age, side, type of finger, donor sites, flap size, dosage of anesthetics, usage of finger tourniquet, intraoperative and postoperative pain, hemostasis effect, operation time, Disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) score, and hospitalization expense, were collected. RESULTS: All patients tolerated the procedure, and none of them needed sedation. Single finger skin defect in 8 patients and double finger skin defect occurred in 4 patients; 5 patients were repaired by abdominal skin flaps, and 7 patients were repaired by thoracic skin flaps. The good surgical field visibility was 91.7%. All flaps survived adequately, without necrosis, pulling fingers out, and other complications. The average visual analog scale (VAS) score of the maximal pain was 1.1 in fingers vs. 2.1 in donor sites during the operation. On postoperative day one, the average VAS score of the maximal pain in fingers and donor sites was 1.3 and 1.1, respectively. The average hospitalization expense before reimbursement of the whole treatment was 11% less expensive compared to the traditional method. The average QuickDASH score was 9.1. CONCLUSIONS: Under wide-awake anesthesia, patients have the ability to control their injured upper extremities consciously, avoiding the complications due to pulling flap pedicles. With the merits of safety, painlessness, less bleeding, and effectivity, the WALANT technique in random skin flaps is feasible and a reliable alternative to deal with finger skin defect.

Local ectopic implantation for salvaging an amputated thumb: an anatomical study and a case report.

Relatively few cases of the ectopic implantation of an amputated thumb have been reported. The majority of ectopic sites are far from the original anatomic site, and anastomosis of the artery cannot be avoided in the secondary replantation surgery, which increases the failure rate. We conducted an anatomic study to investigate the possibility of performing local ectopic implantation of an amputated thumb at the wrist level such that an arterial pedicled thumb could be harvested in the secondary surgery. Thirty radial arteries were dissected from the point 3 cm proximal to the radial styloid to the point at which they passed over the radial styloid. Each branch with a diameter >0.8mm was selected. The mean number of branches was 3.2 > ± 1.37, and the mean diameter was 1.09 ± 0.83 mm. The mean diameter of the ulnar digital artery in the thumb was 1.08 ± 0.15 mm at the metacarpophalangeal joint level. Following anatomic research, an amputated thumb was ectopically implanted locally and replanted during a secondary operation without anastomosis of the artery. The amputated thumb survived, and its function was partially restored. In conclusion, the branches of the radial artery that have a similar diameter to the ulnar digital artery of the thumb can always be located at the wrist level. Local ectopic implantation is feasible and can help prevent the need for anastomosis of the artery during the secondary replantation surgery.