sRNA expression profile of KPC-2-producing carbapenem-resistant Klebsiella pneumoniae: Functional role of sRNA51.

The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) has significant challenges to human health and clinical treatment, with KPC-2-producing CRKP being the predominant epidemic strain. Therefore, there is an urgent need to identify new therapeutic targets and strategies. Non-coding small RNA (sRNA) is a post-transcriptional regulator of genes involved in important biological processes in bacteria and represents an emerging therapeutic strategy for antibiotic-resistant bacteria. In this study, we analyzed the transcription profile of KPC-2-producing CRKP using RNA-seq. Of the 4693 known genes detected, the expression of 307 genes was significantly different from that of carbapenem-sensitive Klebsiella pneumoniae (CSKP), including 133 up-regulated and 174 down-regulated genes. Both the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment and Gene Ontology (GO) analysis showed that these differentially expressed genes (DEGs) were mainly related to metabolism. In addition, we identified the sRNA expression profile of KPC-2-producing CRKP for the first time and detected 115 sRNAs, including 112 newly discovered sRNAs. Compared to CSKP, 43 sRNAs were differentially expressed in KPC-2-producing CRKP, including 39 up-regulated and 4 down-regulated sRNAs. We chose sRNA51, the most significantly differentially expressed sRNA in KPC-2-producing CRKP, as our research subject. By constructing sRNA51-overexpressing KPC-2-producing CRKP strains, we found that sRNA51 overexpression down-regulated the expression of acrA and alleviated resistance to meropenem and ertapenem in KPC-2-producing CRKP, while overexpression of acrA in sRNA51-overexpressing strains restored the reduction of resistance. Therefore, we speculated that sRNA51 could affect the resistance of KPC-2-producing CRKP by inhibiting acrA expression and affecting the formation of efflux pumps. This provides a new approach for developing antibiotic adjuvants to restore the sensitivity of CRKP.

A morphology-based integrated teaching mode combining pathology and radiology with the aid of teaching media: A randomized controlled trial.

OBJECTIVE: The integration of curriculum is an important approach for enhancing medical education and facilitating interdisciplinary connections among students. This study aimed to develop a new morphological integrated teaching mode for undergraduate stomatology education by combining stomatological pathology and radiology courses with instructional media. METHODS: In total, 63 undergraduates were included in this study and divided into three groups: traditional (Group T; the control group) and two experimental groups: KoPa WiFi EDU (Group K), and KoPa WiFi EDU-cone beam computed tomography (CBCT) (Group K-C). All participants attended a 2-h lecture on periapical cysts and completed the first theoretical test. Subsequently, they underwent a 4-h experimental training session on the pathology and radiology of periapical cysts using different teaching methods. Following the training, participants completed the second theoretical test and underwent the first image-reading skill evaluation. After a 3-month period, participants completed the third theoretical test and underwent the second image-reading skill evaluation. The effectiveness of the teaching methods was assessed by analyzing the differences in theoretical test and experimental skill evaluation scores. RESULTS: There were no significant differences in the first theoretical outcomes among three groups (p > 0.05). However, the second theoretical scores, the first objective evaluation scores, and the first subjective evaluation scores were significantly higher in the integrated teaching mode (3D teaching mode with the KoPa WiFi EDU and CBCT: 89.29 ± 4.55, 81.00 ± 8.15, and 61.57 ± 5.52, respectively; 2D teaching mode with the KoPa WiFi EDU system: 80.43 ± 3.41, 73.00 ± 8.01, and 55.67 ± 5.66, respectively) than in the traditional teaching mode (72.57 ± 3.84, 69.38 ± 4.91, and 48.67 ± 5.54, respectively) (p < 0.05). Moreover, the long-term teaching effect of the integrated mode was better than that of the traditional mode (p < 0.05). CONCLUSIONS: The morphology-based integrated teaching mode combining pathology and radiology aroused student enthusiasm for learning, and resulted in enhanced learning outcomes in dental experimental education.

Study of Molecular Dimer Morphology Based on Organic Spin Centers: Nitronyl Nitroxide Radicals.

In this work, in order to investigate the short-range interactions between molecules, the spin-magnetic unit nitronyl nitroxide (NN) was introduced to synthesize self-assembly single radical molecules with hydrogen bond donors and acceptors. The structures and magnetic properties were extensively investigated and characterized by UV-Vis absorption spectroscopy, electron paramagnetic resonance (EPR), and superconducting quantum interference devices (SQUIDs). Interestingly, it was observed that the single molecules can form two different dimers (ring-closed dimer and "L"-type dimer) in different solvents, due to hydrogen bonding, when using EPR to track the molecular spin interactions. Both dimers exhibit ferromagnetic properties (for ring-closed dimer, J/kB = 0.18 K and ΔES-T = 0.0071 kcal/mol; for "L"-type dimer, the values were J/kB = 9.26 K and ΔES-T = 0.037 kcal/mol). In addition, the morphologies of the fibers formed by the two dimers were characterized by transmission electron microscopy (TEM) and atomic force microscopy (AFM).

Gaps between current practice in perinatal depression screening and guideline recommendations: a systematic review.

OBJECTIVE: Screening for perinatal depression is recommended by many guidelines to reduce the disease burden, but current implementation practices require clarification. METHOD: Fifteen databases were searched for observational studies using a pre-tested search strategy. In addition, the websites of academic organizations were searched for guidelines, recommendations, and reports. Literature published between January 1, 2010, and December 19, 2021, in either English or Chinese, was included. The standard form of the Joanna Briggs Institute (JBI) was used to assess risk of bias of the included studies. RESULTS: The data analysis covered 103 studies, 21 guidelines, 11 recommendations, five position statements, three reports, two committee opinions, three consensuses, one consultation, and one policy statement. All but one guideline recommended that mothers be routinely screened for perinatal depression at least once during the perinatal period. In addition, 39 documents recommended that perinatal mothers at risk of perinatal depression be provided with or referred to counseling services. In original studies, however, only 8.7% of the original studies conducted routine screenings, and only one-third offered referral services after the screening process. The EPDS emerged as the most frequently used screening tool to measure perinatal depression. 32% (n = 33) of studies reported the technology used for screening. The most commonly used method was face-to-face interviews (n = 22). Screening personnel the agents conducting the screening comprised researchers (n = 26), nurses (n = 15), doctors (n = 11). CONCLUSIONS: A significant disparity was observed between the recommendations and implementation of perinatal depression screening, highlighting the need to integrate routine screening and referral processes into maternal care services.

Uniaxial-Oriented Chiral Perovskite for Flexible Full-Stokes Polarimeter.

Full-Stokes polarization detection, with high integration and portability, offers an efficient path toward next-gen multi-information optoelectronic systems. Nevertheless, current techniques relying on optical filters create rigid and bulky configurations, limiting practicality. Here, a flexible, filter-less full-Stokes polarimeter featuring a uniaxial-oriented chiral perovskite film is first reported. It is found that, the strategic manipulation of the surfactant-mediated Marangoni effect during blade coating, is crucial for guiding an equilibrious mass transport to achieve oriented crystallization. Through this approach, the obtained uniaxial-oriented chiral perovskite films inherently possess anisotropy and chirality, and thereby with desired sensitivity to both linearly polarized light and circularly polarized light vectors. The uniaxial-oriented crystalline structure also improves photodetection, achieving a specific detectivity of 5.23 × 1013 Jones, surpassing non-oriented devices by 10×. The as-fabricated flexible polarimeters enable accurate capture of full-Stokes polarization without optical filters, exhibiting slight detection errors for the Stokes parameters: ΔS1 = 9.2%, ΔS2 = 8.6%, and ΔS3 = 6.5%, approaching the detection accuracy of optics-filter polarimeters. This proof of concept also demonstrates applications in matrix polarization imaging.

Pediatric incarcerated inguinal hernia: Traditional open or laparoscopic-assisted approach?

The objective of this study was to compare the safety and efficacy of laparoscopic-assisted surgery and traditional open surgery for pediatric incarcerated inguinal hernia. A total of 58 pediatric patients with indirect incarcerated inguinal hernia between January 2014 and January 2020 were included in this study. The patients were divided into 2 groups; observational group who underwent laparoscopic-assisted surgery (n = 36), and a control group who underwent traditional open surgery (n = 22). The overall operation time, intraoperative blood loss, postoperative recovery time, length of hospital stay, occurrence of postoperative scrotal or vulvar hematomas, incidence of postoperative surgical site infection, and hernia recurrence were analyzed and compared between the 2 groups. Compared with the control group, the operation time (38.28 ±â€…5.90) minutes, intraoperative blood loss (1.15 ±â€…0.54 mL), postoperative recovery time (8.39 ±â€…1.42 h), and length of hospital stay (1.64 ±â€…0.59) were significantly lower in the observational group (P < .05). There was no incidence of scrotal or vulvar hematoma or surgical site infection in the observation group, which was significantly lower than that in the control group (P < .05). However, no statistically significant difference was found in the rate of postoperative hernia recurrence between the 2 groups (P > .05). In conclusion, laparoscopic-assisted surgery appears to be a safe and effective alternative approach to traditional open surgery for the treatment of pediatric incarcerated inguinal hernia. Its advantages include reduced trauma, faster recovery, shorter hospital stays, and fewer complications.

Single-cell analysis of anti-BCMA CAR T cell therapy in patients with central nervous system autoimmunity.

Chimeric antigen receptor (CAR) T cell immunotherapy for the treatment of neurological autoimmune diseases is promising, but CAR T cell kinetics and immune alterations after treatment are poorly understood. Here, we performed single-cell multi-omics sequencing of paired cerebrospinal fluid (CSF) and blood samples from patients with neuromyelitis optica spectrum disorder (NMOSD) treated with anti-B cell maturation antigen (BCMA) CAR T cells. Proliferating cytotoxic-like CD8+ CAR T cell clones were identified as the main effectors in autoimmunity. Anti-BCMA CAR T cells with enhanced features of chemotaxis efficiently crossed the blood-CSF barrier, eliminated plasmablasts and plasma cells in the CSF, and suppressed neuroinflammation. The CD44-expressing early memory phenotype in infusion products was potentially associated with CAR T cell persistence in autoimmunity. Moreover, CAR T cells from patients with NMOSD displayed distinctive features of suppressed cytotoxicity compared with those from hematological malignancies. Thus, we provide mechanistic insights into CAR T cell function in patients with neurological autoimmune disease.

Correlation analysis of phosphorylation of myofibrillar protein and muscle quality of tilapia during storage in ice.

In this study, the correlation between protein phosphorylation and deterioration in the quality of tilapia during storage in ice was examined by assessing changes in texture, water-holding capacity (WHC), and biochemical characteristics of myofibrillar protein throughout 7 days of storage. The hardness significantly decreased from 471.50 to 252.17 g, whereas cooking and drip losses significantly increased from 26.5% to 32.6% and 2.9% to 9.1%, respectively (P < 0.05). Myofibril fragmentation increased, while myofibrillar protein sulfhydryl content and Ca2+-ATPase activity decreased from 119.33 to 89.29 µmol/g prot and 0.85 to 0.46 µmolPi/mg prot/h, respectively (P < 0.05). Correlation analysis revealed that the myofibrillar protein phosphorylation level was positively correlated with hardness and Ca2+-ATPase activity but negatively correlated with WHC. Myofibrillar protein phosphorylation affects muscle contraction by influencing the dissociation of actomyosin, thereby regulating hardness and WHC. This study provides novel insights for the establishment of quality control strategies for tilapia storage based on protein phosphorylation.

Genetic distribution, characterization, and function of Escherichia coli type III secretion system 2 (ETT2).

Many Gram-negative bacteria use type Ⅲ secretion system (T3SS) to inject effector proteins and subvert host signaling pathways, facilitating the growth, survival, and virulence. Notably, some bacteria harbor multiple distinct T3SSs with different functions. An extraordinary T3SS, the Escherichia coli Type III Secretion System 2 (ETT2), is widespread among Escherichia coli (E. coli) strains. Since many ETT2 carry genetic mutations or deletions, it is thought to be nonfunctional. However, increasing studies highlight ETT2 contributes to E. coli pathogenesis. Here, we present a comprehensive overview of genetic distribution and characterization of ETT2. Subsequently, we outline its functional potential, contending that an intact ETT2 may retain the capacity to translocate effector proteins and manipulate the host's innate immune response. Given the potential zoonotic implications associated with ETT2-carrying bacteria, further investigations into the structure, function and regulation of ETT2 are imperative for comprehensive understanding of E. coli pathogenicity and the development of effective control strategies.

CS1 Expression Pattern in NK Cells and Correlated Factors in Plasma Cell dyscrasias: Implications for Elotuzumab Therapy and CAR-T Efficacy.

Treatment with elotuzumab alone has no discernible antitumor effect and progress in chimeric antigen receptor T cells (CAR-T) therapy targeting CS1 is relatively slow. A retrospective analysis was performed on 236 patients with multiple myeloma (MM) and 30 patients with other plasma cell dyscrasias (PCDs). CS1 expression in NK cells, lymphocytes, and monoclonal plasma cells was assessed using multiparameter flow cytometry. Furthermore, new explorations were undertaken regarding the antitumor applications of elotuzumab. Patients with MM had significantly higher CS1 expression levels in plasma cells than other patients with PCDs, with no significant differences between lymphocytes and NK cells. In both patients with MM and other PCDs, CS1 expression was significantly higher in plasma cells than in NK cells and lymphocytes. Univariate and multivariate analyses revealed a significant correlation between CS1 expression in plasma (r = 0.60; P < 0.001) and NK (r = 0.79; P < 0.001) cells. Factors such as cytogenetic abnormalities, disease progression, and survival were not associated with CS1 expression in NK cells. Moreover, this study showed that elotuzumab strongly increases the cytotoxicity of NK cells against non-plasma and plasma tumor cells independent of their CS1 expression level. This underscores the potential of elotuzumab in combination with NK cells as an effective therapeutic strategy against a broad spectrum of tumor types.

Case report: Light-chain amyloidosis responsive to selinexor in combination with daratumumab and dexamethasone (SDd) therapy.

The outcome of AL amyloidosis remains poor, particularly in patients with advanced organ involvement which takes long time to recovery. We conducted an observational study of two patients with AL amyloidosis treated with SDd regimen. Both patients successfully achieved significant hematological and organ responses without severe adverse events, and the time to organ response was remarkably shorter than previously reported. Notably, an over 15% reduction in interventricular septal thickness (IVST) was observed in patient#2 within 6 months. Up to now, SDd therapy has not been previously reported in AL amyloidosis and may be a promising option for these patients.

Mitral Geometry on the Mechanism of Left Ventricular Outflow Tract Obstruction in Hypertrophic Cardiomyopathy.

OBJECTIVE: The mechanism of left ventricular outflow tract obstruction (LVOTO) is complex in hypertrophic cardiomyopathy (HCM). We aimed to evaluate the impact of mitral valve geometry on LVOTO by echocardiography. MATERIALS AND METHODS: The study population comprised 177 consecutive patients with HCM. Morphological findings of left ventricular hypertrophy and LVOTO-related abnormalities were assessed by comprehensive transthoracic echocardiography. Aorto-mitral angle, mitral leaflet length, and coaptation height were measured and analyzed at rest. Multivariable stepwise forward logistic regression analysis was performed to identify geometric predictors of LVOTO. RESULTS: One hundred and thirty-seven patients had an LVOT gradient ≥ 30 mmHg. Multivariable logistic regression showed that aorto-mitral angle (OR 0.89, 95%CI 0.83-0.95, P<0.001), coaptation height (OR 1.96, 95%CI 1.41-2.72, P<0.001), and accessory mitral valve chordae tendineae (OR 13.1, 95%CI 4.32-39.95, P<0.001), were independently associated with LVOTO. ROC analysis showed that the area under the curve (AUC) of mitral coaptation height was higher (AUC=0.815) than the other two indicators (P<0.05). CONCLUSIONS: Mitral coaptation height, aorto-mitral angle, and accessory mitral valve chordae tendineae, were important predictors of SAM and LVOTO in HCM independent of septal hypertrophy.

Continuous flow synthesis of atom-precise platinum clusters.

Subnanometer clusters with precise atom numbers hold immense potential for applications in catalysis, as single atoms can significantly impact catalytic properties. Typically, inorganic clusters are produced using batch processes with high dilutions, making the scale-up of these processes time-consuming and its reproducibility challenging. While continuous-flow systems have been employed for organic synthesis and, more recently, nanoparticle preparation, these approaches have only rarely been applied to cluster synthesis. In a flexible, continuous flow synthesis platform, we integrate multiple continuous stirred tank reactors (CSTR) into a cascade to synthesize clusters with a precise number of atoms, demonstrating the potential of this approach for atom precise cluster synthesis and expanding the application of continuous-flow systems beyond organic synthesis.

Subregions of the fusiform gyrus are differentially involved in the attentional mechanism supporting visual mental imagery in depression.

BACKGROUND: Impaired visual mental imagery is an important symptom of depression and has gradually become an intervention target for cognitive behavioral therapy. METHODS: Our study involved a total of 25 healthy controls (HC) and 23 individuals with moderate depressive symptoms (MD). This study explored the attentional mechanism supporting visual mental imagery impairments in depression using the Vividness of Visual Imagery Questionnaire (VVIQ), attentional network test (ANT), and resting-state functional magnetic resonance imaging (rs-fMRI). The intrinsic activity of attention-related regions relative to those supporting visual mental imagery was identified in depression patients. In addition, a meta-analysis was used to describe the cognitive function related to this intrinsic activity. RESULTS: The global correlation (GCOR) of the right anterior fusiform gyrus (FG) was decreased in depression patients. Attention-related areas were concentrated in the right posterior FG; the anterior and posterior functional connectivity (FC) of the FG was decreased in depression patients. Graph theoretic analysis showed that the degree of the right anterior FG was decreased, the degree of the anterior insula was increased, and the negative connection between these two regions was strengthened in depression patients. In addition, the degree of the right anterior FG, the FC between the subregions of the right FG, and the FC between the right anterior FG and insula were correlated with VVIQ scores; however, this correlation was not significant in depression patients. The meta-analysis suggested that the changes in the anterior FG in depressed patients may stem from difficulties of semantic memory retrieval. CONCLUSION: The changed intrinsic activity of subregions of the FG relative to the semantic memory retrieval may be associated with visual mental imagery impairments in depression.

NSUN2 affects diabetic retinopathy progression by regulating MUC1 expression through RNA m5C methylation.

BACKGROUND: Diabetic retinopathy (DR) is the leading cause of blinding eye disease among working adults and is primarily attributed to the excessive proliferation of microvessels, which leads to vitreous hemorrhage and retinal traction, thereby significantly impairing patient vision. NSUN2-mediated RNA m5C methylation is implicated in various diseases, and in this investigation, we focused on elucidating the impact of NSUN2 on the regulation of the expression of the downstream gene MUC1, specifically through RNA m5C methylation, on the progression of DR. METHOD: Utilizing Microarray analysis, we examined patient vitreous fluid to pinpoint potential therapeutic targets for DR. Differential expression of NSUN2 was validated through qRT-PCR, Western blot, and immunofluorescence in human tissue, animal tissue, and cell model of DR. The relationship between NSUN2 and DR was explored in vitro and in vivo through gene knockdown and overexpression. Various techniques, such as MeRIP-qPCR and dot blot, were applied to reveal the downstream targets and mechanism of action of NSUN2. RESULTS: The levels of both NSUN2 and RNA m5C methylation were significantly elevated in the DR model. Knockdown of NSUN2 mitigated DR lesion formation both in vitro and in vivo. Mechanistically, NSUN2 promoted MUC1 expression by binding to the RNA m5C reader ALYREF. Knockdown of ALYREF resulted in DR lesion alterations similar to those observed with NSUN2 knockdown. Moreover, MUC1 overexpression successfully reversed a series of DR alterations induced by NSUN2 silencing. CONCLUSIONS: NSUN2 regulates the expression of MUC1 through ALYREF-mediated RNA m5C methylation, thereby regulating the progression of DR and providing a new option for the treatment of DR in the future.

An energy efficiency assessment of Yttrium-aluminum-garnet laser in vitro.

To study the effect range of the Nd:YAG laser through various levels of cloudy medium for targets with varying grayscale values in vitro. The coated paper cards with grayscale values of 0, 50, 100, and 150 were used as the laser's targets, which were struck straightly with varying energies using three burst modes (single pulse, double pulse, and triple pulse). Six filters (transmittances of 40, 50, 60, 70, 80, and 90) were applied to simulate various levels of cloudy refractive medium. Image J software was used to measure the diameters and regions of the laser spots. The ranges of the Nd:YAG laser spots increased with energy in the same burst mode (P < 0.05). Under the same amount of energy, the ranges of the Nd:YAG laser spot increased with the grayscale value of the targets (P < 0.05). The greater the transmittance of the filters employed, the larger the range of the Nd: YAG laser spots produced. Assuming that the total pulse energy is identical, the effect ranges of multi-pulse burst modes were significantly larger than those of single-pulse burst mode (P < 0.05). The effect range of a Nd:YAG laser grows with increasing energy and the target's grayscale value. A cloudy refractive medium has a negative impact on the effect range of the Nd: YAG laser. The single pulse mode has the narrowest and safest efficiency range.

Enhancing soil health and strawberry disease resistance: the impact of calcium cyanamide treatment on soil microbiota and physicochemical properties.

Introduction: Continuous strawberry cropping often causes soil-borne diseases, with 20 calcium cyanamide being an effective soil fumigant, pig manure can often be used as soil organic fertilizer. Its impact on soil microorganisms structure, however, remains unclear. Methods: This study investigated the effectiveness of calcium cyanamide and pig manure in treating strawberry soil, specifically against strawberry anthracnose. We examined the physical and chemical properties of the soil and the rhizosphere microbiome and performed a network analysis. Results: Results showed that calcium cyanamide treatment significantly reduces the mortality rate of strawberry in seedling stage by reducing pathogen abundance, while increasing actinomycetes and Alphaproteobacteria during the harvest period. This treatment also enhanced bacterial network connectivity, measured by the average connectivity of each Operational Taxonomic Unit (OTU), surpassing other treatments. Moreover, calcium cyanamide notably raised the levels of organic matter, available potassium, and phosphorus in the soil-key factors for strawberry disease resistance and yield. Discussion: Overall, applying calcium cyanamide to soil used for continuous strawberry cultivation can effectively decrease anthracnose incidence. It may be by changing soil physical and chemical properties and enhancing bacterial network stability, thereby reducing the copy of anthracnose. This study highlights the dual benefit of calcium cyanamide in both disease control and soil nutrient enhancement, suggesting its potential as a valuable tool in sustainable strawberry farming.

Cross-modal credibility modelling for EEG-based multimodal emotion recognition.

Objective.The study of emotion recognition through electroencephalography (EEG) has garnered significant attention recently. Integrating EEG with other peripheral physiological signals may greatly enhance performance in emotion recognition. Nonetheless, existing approaches still suffer from two predominant challenges: modality heterogeneity, stemming from the diverse mechanisms across modalities, and fusion credibility, which arises when one or multiple modalities fail to provide highly credible signals.Approach.In this paper, we introduce a novel multimodal physiological signal fusion model that incorporates both intra-inter modality reconstruction and sequential pattern consistency, thereby ensuring a computable and credible EEG-based multimodal emotion recognition. For the modality heterogeneity issue, we first implement a local self-attention transformer to obtain intra-modal features for each respective modality. Subsequently, we devise a pairwise cross-attention transformer to reveal the inter-modal correlations among different modalities, thereby rendering different modalities compatible and diminishing the heterogeneity concern. For the fusion credibility issue, we introduce the concept of sequential pattern consistency to measure whether different modalities evolve in a consistent way. Specifically, we propose to measure the varying trends of different modalities, and compute the inter-modality consistency scores to ascertain fusion credibility.Main results.We conduct extensive experiments on two benchmarked datasets (DEAP and MAHNOB-HCI) with the subject-dependent paradigm. For the DEAP dataset, our method improves the accuracy by 4.58%, and the F1 score by 0.63%, compared to the state-of-the-art baseline. Similarly, for the MAHNOB-HCI dataset, our method improves the accuracy by 3.97%, and the F1 score by 4.21%. In addition, we gain much insight into the proposed framework through significance test, ablation experiments, confusion matrices and hyperparameter analysis. Consequently, we demonstrate the effectiveness of the proposed credibility modelling through statistical analysis and carefully designed experiments.Significance.All experimental results demonstrate the effectiveness of our proposed architecture and indicate that credibility modelling is essential for multimodal emotion recognition.

LI-RADS version 2018 treatment response algorithm on extracellular contrast-enhanced MRI in patients treated with transarterial chemoembolization for hepatocellular carcinoma: diagnostic performance and the added value of ancillary features.

BACKGROUND: The Liver Imaging Reporting and Data System (LI-RADS) Treatment Response Algorithm (TRA) (LI-RADS TRA) is used for assessing response of HCC to locoregional therapy (LRT), however, the value of ancillary features (AFs) for TACE-treated HCCs has not been extensively investigated on extracellular agent MRI (ECA-MRI). PURPOSE: To evaluate the diagnostic performance of LI-RADS v2018 TRA on ECA-MRI for HCC treated with transarterial chemoembolization (TACE) and the value of ancillary features. METHODS: This retrospective study included patients who underwent TACE for HCC and then followed by hepatic surgery between January 2019 and June 2023 with both pre- and post-TACE contrast-enhanced MRI available. Two radiologists independently evaluated the post-treated lesions on MRI using LI-RADS treatment response (TR) (LR-TR) algorithm and modified LR-TR (mLR-TR) algorithm in which ancillary features (restricted diffusion and intermediate T2-weighted hyperintensity) were added, respectively. Lesions were categorized as complete pathologic necrosis (100%, CPN) and non-complete pathologic necrosis (< 100%, non-CPN) on the basis of surgical pathology. The diagnostic performance in predicting viable and non-viable tumors based on LR-TR and mLR-TR algorithms was compared using the McNemar test. Interreader agreement was calculated by using Cohen's weighted and unweighted κ. RESULTS: A total of 61 patients [mean age 59 years ± 10 (standard deviation); 47 men] with 79 lesions (57 pathologically viable) were included. For non-CPN prediction, the sensitivity, specificity of LR-TR viable and mLR-TR viable category were 75% (43 of 57), 82% (18 of 22) and 88% (50 of 57), 77% (17 of 22), respectively, the sensitivity of mLR-TR was significantly higher than that of LR-TR (P = 0.016) without difference in specificity (P = 1.000). Interreader agreement for LR-TR and mLR-TR category was moderate (k = 0.50, 95% confidence interval 0.33, 0.67, k = 0.42, 95% confidence interval 0.20, 0.63). The sensitivity of both LR-TR and mLR-TR algorithms in predicting viable tumors between conventional TACE (cTACE) and drug-eluting beads TACE (DEB-TACE) did not have significant difference (cTACE: 76%, 89% vs. DEB-TACE: 73%, 82%). CONCLUSIONS: On ECA-MRI, applying ancillary features to LI-RADS v2018 TRA can improve the sensitivity in predicting pathologic tumor viability in patients treated with TACE for hepatocellular carcinoma with no significant difference in specificity.

Molecular characteristics and multivariate survival analysis of 43 patients with locally advanced or metastatic esophageal squamous cell carcinoma.

Background: Esophageal cancer (EC) is an aggressive malignant tumor with poor prognosis and high incidence. It is the sixth leading cause of cancer-related death in the world, and the 5-year overall survival (OS) rate is only 12-20%. The rapid development of next-generation sequencing (NGS) has provided powerful help for the treatment and management of EC patients. Methods: Tumor tissue and blood samples of 43 Chinese patients with nonsurgical esophageal squamous cell carcinoma (ESCC) were sequenced using a 425 gene-panel. Genomic profiling was explored and and the Cox proportional hazards model was used to analyze the correlations between gene or signaling pathway alterations and prognosis. Results: In this study, the most common mutated genes were TP53 (90.5%), CCND1 (45.2%), FGF19 (38.1%), NOTCH1 (26.2%), PI3KCA (21.4%) and CDKN2A (19%). Among these mutations, PI3KCA and NOTCH1 showed mutual exclusion to some extent. In the univariate model, mutations in NOTCH1, CBLB and TSC2 genes and tumor mutation burden (TMB) ≥7 were independent biomarkers of OS. NOTCH1 (P=0.007, HR =2.87), CBLB (P=0.011, HR =4.68) and TSC2 (P=0.024, HR =3.7) were significantly associated with poorer OS, and patients with TMB ≥7 had longer OS (P=0.151, HR =0.31). In addition, patients who carried alteration in NOTCH signaling pathway had reduced OS (P=0.014, HR =2.54). Conclusions: NOTCH1, CBLB and TSC2 alterations were found to be potential indicators of poor prognosis in patients with ESCC. TMB was also positively correlated with the OS of ESCC patients, providing valuable insights for their treatment strategies.