Immunohistochemical co-expression of PAX2 and CAIX predicts better prognosis in clear cell renal cell carcinoma after nephrectomy: A retrospective observational study.

Clear cell renal cell carcinoma (ccRCC) is a lethal malignancy with high metastatic probability. Paired box 2 gene product (PAX2) carbonic anhydrase IX were biomolecules closely linked with ccRCC development and outcomes of multiple malignancies. We aim to explore the role of immunohistochemical staining of PAX2 and CAIX to predict ccRCC prognosis after nephrectomy. Surgical specimens of patients who were pathologically diagnosed as ccRCC were reviewed. Expression levels of PAX2 and CAIX were assessed via immunohistochemical staining. Recurrence-free survival (RFS) and overall survival were compared among different phenotypes. Inverse probability of treatment weighting (IPTW) was used for adjustment of confounding factors. 56 patients were included. Patients with PAX2 and CAIX high-expression (the two-high group, n=8) had significantly longer RFS and OS than those of simultaneously down-expression (the two-low group, n=31). Median RFS was 38.4 (95% CI: 32.3-NA) for the two-high group and 14.8 (95% CI: 13.4-39.0) months for the two-low group (P=0.043). IPTW confirmed PAX2 and CAIX co-expression is associated with less recurrence risk HR: 0.39, 95% CI: 0.17-0.92, P=0.031). Co-expression of PAX2 and CAIX is associated better prognosis of ccRCC. We are looking for validation by large cohort studies.

Third Harmonic Generation in Thin NbOI2 and TaOI2.

The niobium oxide dihalides have recently been identified as a new class of van der Waals materials exhibiting exceptionally large second-order nonlinear optical responses and robust in-plane ferroelectricity. In contrast to second-order nonlinear processes, third-order optical nonlinearities can arise irrespective of whether a crystal lattice is centrosymmetric. Here, we report third harmonic generation (THG) in two-dimensional (2D) transition metal oxide iodides, namely NbOI2 and TaOI2. We observe a comparable THG intensity from both materials. By benchmarking against THG from monolayer WS2, we deduce that the third-order susceptibility is approximately on the same order. THG resonances are revealed at different excitation wavelengths, likely due to enhancement by excitonic states and band edge resonances. The THG intensity increases for material thicknesses up to 30 nm, owing to weak interlayer coupling. After this threshold, it shows saturation or a decrease, due to optical interference effects. Our results establish niobium and tantalum oxide iodides as promising 2D materials for third-order nonlinear optics, with intrinsic in-plane ferroelectricity and thickness-tunable nonlinear efficiency.

Engine combustion modeling method based on hybrid drive.

Accurate and comprehensive reconstruction of in-cylinder combustion process is essential for timely monitoring of engine combustion state. This article developed a method based on the zero-dimensional (0-D) physical model integrated with big data. The traditional 0-D prediction model based on cumulative fuel mass is improved, the factor of in-cylinder temperature is introduced to adjust the heat release rate, which solves the problem of difficulty in calibrating the heat release rate. Then, convolutional neural network-gated recurrent unit (CNN-GRU), as a deep neural network, including a special convolutional layer and a gated recurrent unit (GRU) neural network is designed for the parameters to be calibrated in the model. The 0-D predictive combustion model is constructed by combining the physical model with CNN-GRU, the combustion process is simplified and reconstructed. The fitting results show that the 0-D physical model based on improved cumulative fuel mass approach is an effective method to reflect the heat release law. Under non-calibration conditions, the root mean square error (RMSE) value of peak firing pressure (PFP) based on CNN-GRU prediction model is 0.5862. The prediction model is a promising method to realize online fitting and optimization of combustion process.

Terahertz spectral identification and low-frequency vibrational analysis of dinitrotoluene isomers.

Identifying dinitrotoluene (DNT) isomers has always been a challenging problem. In this study, five DNT isomers were investigated using terahertz time-domain spectroscopy (THz-TDS), which demonstrated significant spectral differences including variations in absorption positions and intensities. This suggests that THz-TDS is ideal for rapid identification of DNT isomers. We also employed density functional theory to further discuss the origin of these spectral differences. The results indicate that steric effects between substitute groups, rather than inter-molecular hydrogen bonding, lead to differences in low-frequency vibrations.

Endoscopic incision of rectal diverticulum: A case report.

A 70-year-old woman with a rectal diverticulum presented with anal pendant expansion and difficulty in defecation for more than 1 year. The patient was diagnosed with a rectal diverticulum by pelvic enhanced magnetic resonance imaging (MRI), computerized tomography (CT), rectal angiography, and colonoscopy. The endoscopic diverticulum incision procedure (EDIP) was implemented with this patient. At the 4-month follow-up, anal pendant expansion and difficulty in defecation were significantly relieved. Furthermore, colonoscopy proved that there were no vestigial feces in the diverticulum.

[Significance of Lymphocyte-to-Monocyte Ratio and Corrected Levels of Serum Calcium as Prognostic Markers in Patients with Newly Diagnosed Multiple Myeloma].

OBJECTIVE: To investigate the significance of peripheral blood lymphocyte to monocyte ratio (LMR) and corrected levels of serum calcium (cCa) as prognostic markers for the newly diagnosed multiple myeloma (MM) patients. METHODS: The clinical data of 114 newly diagnosed MM patients in the Second Affiliated Hospital of Kunming Medical University from January 2013 to March 2020 were retrospectively analyzed. Receiver operating characteristic (ROC) curve analysis was used to identify the optimal cutoff value, and the patients were divided into high LMR group and low LMR group (LMR≥3.35 and LMR < 3.35). Moreover, the patients were divided into four groups according to initial diagnosis LMR and LMR after four courses of treatment (LMR4): Group A (LMR≥3.35, LMR4≥3.35), Group B (LMR≥3.35, LMR4 < 3.35), Group C (LMR < 3.35, LMR4≥3.35), and group D (LMR < 3.35, LMR4 < 3.35). The simple prognosis model was established by combined with LMR and cCa, the patients were divided into Group a (no risk factor), group b (1 risk factor) and Group c (2 risk factors). Independent sample T-test, Pearson Chi-square test or Mann-Whitney U test were used to evaluate the differences between various parameters, and Kaplan-Meier method and Cox regression were used for survival analysis. RESULTS: The median follow-up time was 13.05（0.1-72.5）months. Survival analysis showed that the patients with low LMR predicted poor prognosis, the overall survival (OS) time of the patients with low LMR was significantly shorter (17 vs 50.5 months, P=0.006) than the patients with high LMR, the difference was also significant between group A and Group D (56.5 vs 30.5 months, P=0.043). The OS of the patients was also significantly shorter in the high cCa group (≥2.75 mmol/L) compared with normal group (8.5 vs 34 months, P=0.006). Multivariate survival analysis showed that LMR < 3.35 (P=0.028) and cCa≥2.75 mmol/L (P=0.036) were the independent risk factors affecting prognosis of MM patients. The comparison of risk factors showed that the median OS of Group a, b and c was 50, 20, and 8.5 months, respectively. The prognosis of the patients without risk factors was better than that of patients with 1-2 risk factors (Group a vs Group b, P < 0.0001; Group a vs Group c, P=0.002). CONCLUSION: LMR and cCa are the independent risk factors affecting the prognosis of newly diagnosed MM patients, and the development of a simple prognosis system combining them can quickly identify the prognosis of newly diagnosed MM patients.

Intraocular Lens with Mussel-Inspired Coating for Preventing Posterior Capsule Opacification via Photothermal Effect.

Phacoemulsification with implantation of intraocular lens (IOLs) has been widely applied as a standard treatment for cataract, which is the leading cause of vision impairment. However, it still remains a critical challenge to prevent posterior capsule opacification (PCO) in terms of postoperative visual quality. Herein, we report IOLs with mussel-inspired coatings for inhibiting lens epithelial cells and then preventing PCO through photothermal conversion effect. The mussel-inspired coatings are deposited on the nonoptical surface areas of IOLs, endowing the modified IOLs with efficient photothermal conversion property. The temperature can be facilely raised to 50-60 °C for the photothermal IOLs (PT-IOLs) by near-infrared (NIR) laser irradiation at a safe intensity of 0.3 W/cm2. These PT-IOLs display high capability of inhibiting lens epithelial cells (LECs) in vitro. Therefore, under routine NIR laser irradiation, New Zealand white rabbits implanted with the PT-IOLs demonstrate significantly lower evaluation of PCO (EPCO) scores than the control groups. The overall results indicate that our PT-IOLs provide a promising choice for the clinical prevention of PCO, thus opening a way to maintain the postoperative visual qualities for cataract patients.

Terahertz spectral investigation of temperature induced polymorphic transformation of 2,2dinitroethylene-1,1-diamine.

The dynamic process of polymorphic transformations provides deep insights into the understanding of both the performance of explosives and its packing sensitivity. While terahertz spectroscopy is a sensitive tool that can be used to characterize its intermolecular forces. In this paper, terahertz time-domain spectroscopy (THz-TDS) is employed to investigate the polymorphic transformations of the explosive 2,2dinitroethylene-1,1-diamine (FOX-7) under a heating process. Solid-state density functional theory (DFT) uncovers the physical mechanisms that contribute to the polymorphic transformation. This is achieved by assessing the calculated spectra relative to the actual spectra from experiment. The results suggest that the THz spectral features that arise represent a redistribution of the intermolecular forces during the polymorphic transformations. This research will assist the understanding of the evolving properties of FOX-7, under external stimuli, which is vital knowledge for an explosive substance that can combust or detonate.

Substrate stiffness differentially impacts autophagy of endothelial cells and smooth muscle cells.

Stiffening of blood vessels is one of the most important characteristics in the process of many cardiovascular pathologies such as atherosclerosis, angiosteosis, and vascular aging. Increased stiffness of the vascular extracellular matrix drives artery pathology and alters phenotypes of vascular cell. Understanding how substrate stiffness impacts vascular cell behaviors is of great importance to the biomaterial design in tissue engineering, regenerative medicine, and medical devices. Here we report that changing substrate stiffness has a significant impact on the autophagy of vascular endothelial cells (VECs) and smooth muscle cells (VSMCs). Interestingly, our findings demonstrate that, with the increase of substrate stiffness, the autophagy level of VECs and VSMCs showed differential changes: endothelial autophagy levels reduced, leading to the reductions in a range of gene expression associated with endothelial function; while, autophagy levels of VSMCs increased, showing a transition from contractile to the synthetic phenotype. We further demonstrate that, by inhibiting cell autophagy, the expressions of endothelial functional gene were further reduced and the expression of VSMC calponin increased, suggesting an important role of autophagy in response of the cells to the challenge of microenvironment stiffness changing. Although the underlying mechanism requires further study, this work highlights the relationship of substrate stiffness, autophagy, and vascular cell behaviors, and enlightening the design principles of surface stiffness of biomaterials in cardiovascular practical applications.

Dynamic Porous Pattern through Controlling Noncovalent Interactions in Polyelectrolyte Film for Sequential and Regional Encapsulation.

Inspired by nature, many functional surfaces have been developed with special structures in biology, chemistry, and materials. Many research studies have been focused on the preparation of surfaces with static structure. Achieving dynamical manipulation of surface structure is desired but still a great challenge. Herein, a polyelectrolyte film capable of regional and reversible changes in the microporous structure is presented. Our proposal is based on the combination of azobenzene (Azo) π-π stacking and electrostatic interaction, which could be affected respectively by ultraviolet (UV) irradiation and water plasticization, to tune the mobility of polyelectrolyte chains. The porous patterns can be obtained after regional ultraviolet irradiation and acid treatment. Owing to the reversibility of Azo π-π stacking and electrostatic interaction, the patterns can be repeatedly created and erased in the polyelectrolyte film made by layer-by-layer (LbL) self-assembly of poly(ethyleneimine)-azo and poly(acrylic acid). Furthermore, through two rounds of porous pattern formation and erasure, different functional species can be loaded separately and confined regionally within the film, showing potential applications in the functional surface. This work highlights the coordination of two noncovalent interactions in thin films for regional and reversible controlling its structure, opening a window for more in-depth development of functional surfaces.

2D-Layered Ni-MgO-Al2 O3 Nanosheets for Integrated Capture and Methanation of CO2.

CO2 capture is an enabling technology for carbon conversion and storage; however, the high costs of the process have hindered its large-scale application so far. Therefore, new approaches for carbon abatement, particularly from diluted sources, are urgently needed. Herein, based on the adsorption and catalysis bifunctionality of 2D-layered Ni-O-Al2 O3 nanosheets, a two-step "capture and methanation" process is reported for the removal and utilization of CO2 , with no additional energy input for desorption being required. Continuous and nearly 100 % capture of CO2 was demonstrated at low temperatures (≤250 °C) and prolonged cycles. At isothermal conditions, the material could be fully regenerated with the production of methane, showing considerably higher time efficiency than temperature-swing and pressure-swing technologies. This strategy may pave a new way for CO2 reduction, providing a scalable connection between the power grid and the gas grid when H2 is used.

Impact of postoperative complications on long-term outcomes of patients following surgery for gastric cancer: A systematic review and meta-analysis of 64 follow-up studies.

Gastrectomy for cancer is a technically demanding procedure, with postoperative complications (POCs) reported to be in the range of 20%-46%. However, the effect of POCs on long-term survival of gastric cancer patients following surgery is far from conclusive. This systemic review aimed to determine the impact of postoperative complications (POCs) on the long-term survival of patients following surgery for gastric cancer. A systematic electronic search of PubMed and Scopus was performed from inception to June 26, 2018 to identify studies that described the relationship between POCs and long-term survival. Hazard ratios (HRs) for overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) from each study were combined using a random-effects model. Sixty-four eligible studies with reported results for 46198 gastric cancer patients were included. A meta-analysis found a statistically significant difference in OS, CSS and RFS between gastric patients with unspecific POCs and no POCs, POCs ≥ Clavien-Dindo grade (CD) 2 and < CD2, major POCs and minor POCs, infectious and non-infectious complications, anastomotic and non-anastomotic complications, and cardiopulmonary and non-cardiopulmonary complications. Subgroup and sensitivity analyses did not significantly change the summary of OS risk estimates between patients with POCs and without POCs. No significant publication bias was observed for the same outcome. The meta-analysis revealed that POCs were associated with worse survival among patients with resected gastric cancer, suggesting that treatment strategies aimed at minimizing POCs may improve oncological outcomes.

Facile and Rapid Preparation of Ag@ZIF-8 for Carboxylation of Terminal Alkynes with CO2 in Mild Conditions.

Metal-organic frameworks (MOFs) are promising hosts for catalytic active sites due to their adjustable porosity and framework chemistry. Strategies to improve synergistic effects between the installed sites and the parent MOF are highly desired. Herein, a facile and rapid method for the preparation of xAg@ZIF-8 materials was reported. The materials were systematically characterized and used as catalysts for carboxylation of terminal alkynes via direct insertion of CO2 to the C(sp)-H bond (CTACO2). It was found that the integrity of the ZIF-8 structure could be retained upon Ag loading, but short-range crystalline ordering was modified. Two types Ag species could be installed, namely, highly dispersed Ag(I) in the backbone (AgHD) and aggregated Ag(0) nanoparticles on the outer surface (AgNP). The AgNP sites are highly effective for the activation of terminal alkynes due to its high accessibility, while the AgHD-modified ZIF-8 framework worked as a CO2 reservoir with enhanced affinity. Combination of these factors translated to high activity in the CTACO2 process, the measured turnover frequency and time yield are among the highest among most heterogeneous catalysts.

Prognostic Nutritional Index Predicts Outcomes of Patients after Gastrectomy for Cancer: A Systematic Review and Meta-Analysis of Nonrandomized Studies.

OBJECTIVE: The primary aim of this systematic review was to evaluate the survival predication value of preoperative prognostic nutritional index (PNI) in patients with gastric cancer. The second aim was to explore the relationship between preoperative PNI and clinicopathological features. METHODS: A systematic search of the electronic databases identified studies that investigated the association of preoperative PNI with short or long-term outcomes among patients after gastrectomy for cancer. Qualitative and quantitative analysis of results was conducted. RESULTS: Twenty-five studies with a total of 14,403 patients with gastric cancer met inclusion criteria for this review. Pooled analysis demonstrated that low preoperative PNI was associated with significantly reduced overall survival (HR 1.81, 95% CI: 1.56-2.09; P = 0.000), cancer-specific survival (HR 1.61, 95% CI: 1.24-2.10; P = 0.000), and recurrence-free survival (HR 1.82, 95% CI: 1.20-2.77; P = 0.005). In addition, risk of postoperative complications (POCs) and mortality was significantly higher in patients with lower preoperative PNI (RR 1.77, 95% CI: 1.44-2.17; P = 0.000 and RR 5.14, 95% CI: 2.23-11.79; P = 0.000, respectively). CONCLUSION: This study suggests that patients with low preoperative PNI may have a high incidence of POCs and poor prognosis following gastrectomy for cancer.

Rare acute abdominal condition caused by mesenteric fibromatosis perforation: A case report.

RATIONALE: Mesenteric fibromatosis is a rare benign neoplasm with a tendency to spread and recur locally, without metastasis. It may present with a wide spectrum of clinical features; however, onset as a perforation is extremely rare. PATIENT CONCERNS: The present patient was an 18-year-old female with a 10-hour history of increasing abdominal pain that arose suddenly with nausea and vomiting. She had experienced an appendectomy 2 years before this admission. DIAGNOSES: A gastrointestinal perforation was initially suspected on the basis of complaints and physical examination. The patient was thoroughly investigated for further diagnosis. Computed tomography showed a large well-defined intra-abdominal mass measuring 7.1 × 6.7 × 5.9 cm in the right lower quadrant, with adjacent small intestine compression and free intraperitoneal air. Then, the patient underwent a laparotomy. Finally, postoperative pathology and immunohistochemistry confirmed mesenteric fibromatosis, with a consecutive perforation from ileum to the bottom of tumor. INTERVENTIONS: The patient has been treated by a resection of the mass with the adhesive small intestine, without chemotherapy or radiotherapy postoperatively. OUTCOMES: The patient had an uneventful postoperative recovery. Three months after surgery, the patient reviewed the colonoscopy, no intestinal polyps were noted. The present case has been followed up for 17 months without tumor recurrence. LESSONS: Our case illustrates another possible cause of acute abdominal pain. Although rare, treating physicians should maintain a high suspicion index while managing a patient with an abdominal mass and pain. Close follow-up is essential because of the high incidence of local tumor recurrence.

Effect of Delay to Operation on Outcomes in Patients with Acute Appendicitis: a Systematic Review and Meta-analysis.

BACKGROUND: Many studies have investigated the association between time interval and incidence of complicated appendicitis and post-operative surgical site infection (SSI), but the results are controversial. METHODS: A systematic search of the electronic databases identified studies that investigated the association of appendectomy delay with complicated appendicitis and SSI among patients with acute appendicitis. Qualitative and quantitative meta-analysis of the results was conducted. RESULTS: Twenty-one studies were included in the final analysis. Meta-analysis showed no significant difference in complicated appendicitis incidence between patients in the 6-12 h, > 12 and < 6 h groups (OR 1.07, 95% CI 0.89-1.30, p = 0.47; OR 1.04, 95% CI 0.88-1.22, p = 0.64). Comparison of the 6-12 h category with the < 6 h category of in-hospital delay revealed significant associations between longer in-hospital delay and increased risk of post-operative SSI (OR 1.40, 95% CI 1.11-1.77, p = 0.004). Patients in the 24-48 h category had 1.99- and 1.84-fold (p < 0.05) higher odds of developing complicated appendicitis compared to patients in the < 24 h category for pre-hospital delay and total delay, respectively (OR 1.99, 95% CI 1.35-2.94, p = 0.0006; OR 1.84, 95% CI 1.05-3.21, p = 0.03). When pre-hospital and total delay time extended to more than 48 h, the odds of risk increased 4.62- and 7.57-fold, respectively (OR 4.62, 95% CI 2.99-7.13, p < 0.00001; OR 7.57, 95% CI 6.14-9.35, p = < 0.00001). CONCLUSION: Complicated appendicitis incidence was associated with overall elapsed time from symptom onset to admission or operation; short appendectomy in-hospital delay did not increase the risk of complicated appendicitis but was associated with a slightly increased risk of SSI. Prompt surgical intervention is warranted to avoid additional morbidity, enabling quicker recovery in this population.

Polyphenol-Assisted Exfoliation of Transition Metal Dichalcogenides into Nanosheets as Photothermal Nanocarriers for Enhanced Antibiofilm Activity.

Transition metal dichalcogenide (TMD) nanosheets have evoked enormous research enthusiasm and have shown increased potentials in the biomedical field. However, a great challenge lies in high-throughput, large-scale, and eco-friendly preparation of TMD nanosheet dispersions with high quality. Herein, we report a universal polyphenol-assisted strategy to facilely exfoliate various TMDs into monolayer or few-layer nanosheets. By optimizing the exfoliation condition of molybdenum disulfide (MoS2), the yield and concentration of as-exfoliated nanosheets are up to 60.5% and 1.21 mg/mL, respectively. This is the most efficient aqueous exfoliation method at present and is versatile for the choices of polyphenols and TMD nanomaterials. The as-exfoliated MoS2 nanosheets possess superior biomedical stability as nanocarriers to load antibiotic drugs. They show a high photothermal conversion effect and thus induce a synergetic effect of chemotherapy and photothermal therapy to harvest enhanced antibiofilm activity under near-infrared (NIR) light. All these results offer an appealing strategy toward the synthesis and application of ultrathin TMD nanosheets, with great implications for their development.

Anti-inflammatory furostanol saponins from the rhizomes of Smilax china L.

Seven new furostanol saponins (1-7), chongrenosides A-G, were isolated from the rhizomes of Smilax china L., together with nine known furostanol saponins (8-16). The structures of the new furostanol saponins (1-7) were elucidated by extensive spectroscopic data analyses (1D and 2D NMR, HRESIMS) and chemical evidence. Compounds 1-6 and 8-16 were evaluated for TNF-α mRNA expression inhibitory activity on LPS induced RAW264.7 cells. Of them, 1, 4, 6, and 11 inhibited the TNF-α mRNA expression by 88%, 87%, 67%, and 93%, respectively, at the concentration of 10 µM.

Dopamine-Triggered One-Step Polymerization and Codeposition of Acrylate Monomers for Functional Coatings.

Surface modification has been well recognized as a promising strategy to design and exploit diversified functional materials. However, conventional modification strategies usually suffer from complicated manufacture procedures and lack of universality. Herein, a facile, robust, and versatile approach is proposed to achieve the surface functionalization using dopamine and acrylate monomers via a one-step polymerization and codeposition process. The gel permeation chromatography, proton nuclear magnetic resonance, liquid chromatography-mass spectrometry, and UV-visible spectra results indicate that dopamine possesses the capability of triggering the polymerization of acrylate monomers into high-molecular-weight products, and the inherent adhesive ability of polydopamine can assist the polymerized products to deposit on various substrates. Besides, protein-resistant, antibacterial, and cell adhesion-resistant surfaces can be easily fabricated via the finely designed integration of corresponding acrylate monomers into the codeposition systems. This approach of in situ polymerization and codeposition significantly simplifies the fabrication process and provides more manifold choices for surface modification, which will open a new door for broadening the applications of polydopamine-based coatings.

Phenolic Compounds from the Rhizomes of Smilax china L. and Their Anti-Inflammatory Activity.

A new triflavanoid, kandelin B-5 (1), was isolated from the rhizomes of Smilax china L., together with six known phenylpropanoid substituted flavan-3-ols (2-7), nine flavonoids (8-16), two stilbenoids (17, 18), and two other compounds (19, 20). The structure of compound 1 was determined on the basis of 1D, 2D NMR and HR-ESI-MS data, as well as chemical method. Compounds 2-5, 8-12, 15, 17, and 19 were evaluated for anti-inflammatory activity. Only compounds 10, 15 and 17 showed slightly IL-1ß expression inhibitory activities on LPS induced THP-1 cells, with inhibition rate of 15.8%, 37.3%, and 35.8%, respectively, at concentration of 50 µg/mL.