Novel Bifunctionalization of Activated Methylene: Base-Promoted Trifluoromethylthiolation of ß-Diketones with Trifluoromethanesulfinyl Chloride.

A novel bifunctionalization of activated methylene was achieved successfully through the base-promoted trifluoromethylthiolation of ß-diketones or ß-ketoesters with trifluoromethanesulfinyl chloride. A series of α-trifluoromethylthiolated α-chloro-ß-diketones and α-chloro-ß-ketoesters were obtained in moderate to good yields under mild conditions. When ß-diketones containing a phenyl group with a hydroxyl or amino substituent at the ortho position were used as substrates, intramolecular trifluoromethylthiolation/cyclization reaction took place to give the corresponding cyclic products. Furthermore, the protocol could be extended to perfluoroalkylthiolation with the sodium perfluoroalkanesulfinate/POCl3 system. On the basis of experimental results, plausible mechanisms are proposed.

Indium-Mediated Intramolecular Reaction of N-(2-Iodobenzoyl)azabenzonorbornadienes: A General Access to Dihydrobenzo[c]phenanthridinones.

An efficient synthesis of dihydrobenzo[c]phenanthridinones was achieved by utilizing an indium(0)-mediated intramolecular cyclization reaction under ligand- and base-free conditions. A variety of functional groups were tolerated in the present protocol.

Iridium-catalyzed asymmetric hydrogenation of 2-pyridyl cyclic imines: a highly enantioselective approach to nicotine derivatives.

A highly efficient asymmetric hydrogenation of cyclic imines containing a pyridyl moiety was established by using iridium catalysts with chiral spiro phosphine-oxazoline ligands. This process will facilitate the development of new nicotine-related pharmaceuticals. The introduction of a substituent at the ortho position of the pyridyl ring to reduce its coordinating ability ensures the success of the hydrogenation and excellent enantioselectivity.

Chitosan-Polyethylene Glycol Inspired Polyelectrolyte Complex Hydrogel Templates Favoring NEO-Tissue Formation for Cardiac Tissue Engineering.

Neo-tissue formation and host tissue regeneration determine the success of cardiac tissue engineering where functional hydrogel scaffolds act as cardiac (extracellular matrix) ECM mimic. Translationally, the hydrogel templates promoting neo-cardiac tissue formation are currently limited; however, they are highly demanding in cardiac tissue engineering. The current study focused on the development of a panel of four chitosan-based polyelectrolyte hydrogels as cardiac scaffolds facilitating neo-cardiac tissue formation to promote cardiac regeneration. Chitosan-PEG (CP), gelatin-chitosan-PEG (GCP), hyaluronic acid-chitosan-PEG (HACP), and combined CP (CoCP) polyelectrolyte hydrogels were engineered by solvent casting and assessed for physiochemical, thermal, electrical, biodegradable, mechanical, and biological properties. The CP, GCP, HACP, and CoCP hydrogels exhibited excellent porosity (4.24 ± 0.18, 13.089 ± 1.13, 12.53 ± 1.30 and 15.88 ± 1.10 for CP, GCP, HACP and CoCP, respectively), water profile, mechanical strength, and amphiphilicity suitable for cardiac tissue engineering. The hydrogels were hemocompatible as evident from the negligible hemolysis and RBC aggregation and increased adsorption of plasma albumin. The hydrogels were cytocompatible as evident from the increased viability by MTT (>94% for all the four hydrogels) assay and direct contact assay. Also, the hydrogels supported the adhesion, growth, spreading, and proliferation of H9c2 cells as unveiled by rhodamine staining. The hydrogels promoted neo-tissue formation that was proven using rat and swine myocardial tissue explant culture. Compared to GCP and CoCP, CP and HACP were superior owing to the cell viability, hemocompatibility, and conductance, resulting in the highest degree of cytoskeletal organization and neo-tissue formation. The physiochemical and biological performance of these hydrogels supported neo-cardiac tissue formation. Overall, the CP, GCP, HACP, and CoCP hydrogel systems promise novel translational opportunities in regenerative cardiology.

RP11-40C6.2 Inactivates Hippo Signaling by Attenuating YAP1 Ubiquitylation in Hepatitis B Virus-associated Hepatocellular Carcinoma.

Background and Aims: Chronic hepatitis caused by hepatitis B virus (HBV) infection is a leading cause of hepatocellular carcinoma (HCC). We investigated the roles of oncogenic HBV infection-associated long noncoding RNAs in HCC. Methods: Bioinformatics analysis of data from the Cancer Genome Atlas (TCGA) was performed to screen potential oncogenic HBV-related lncRNAs. Next, we assessed their expression in clinical samples and investigated their correlation with clinical characteristics. The detailed oncogenic effects were analyzed by performing in vitro and in vivo studies. Results: RP11-40C6.2, an HBV infection-related lncRNA, was identified by analysis of the TCGA-Liver Hepatocellular Carcinoma database. Gene Set Enrichment Analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of differentially expressed genes revealed a strong association of RP11-40C6.2 with the Hippo signaling pathway. RP11-40C6.2 was overexpressed in HCC patients with HBV infection compared to those without HBV infection. RP11-40C6.2 transcription showed a positive association with HBV-X protein (HBx), but not HBV core protein (HBc) expression, both of which are carcinogenic proteins. Luciferase gene reporter and ChIP assays revealed that YAP1/TAZ/TEADs complex enhanced RP11-40C6.2 transcription by binding to its promoter area. RP11-40C6.2 showed oncogenic characteristics in HCC cell lines and in animal models that were mediated via activation of YAP1. In vitro ubiquitylation assay revealed that RP11-40C6.2 can promote the stabilization of YAP1 by stopping phosphorylation at its s127 residue and further stopping its degradation through binding to 14-3-3. Conclusions: RP11-40C6.2 is an HBV infection-related lncRNA that exerts its oncogenic effects by targeting the Hippo signaling pathway.

Imaging features based on CT and MRI for predicting prognosis of patients with intrahepatic cholangiocarcinoma: a single-center study and meta-analysis.

BACKGROUND: To evaluate the prognostic role of imaging features based on CT and MRI in intrahepatic cholangiocarcinoma (ICC). METHODS: Two hundred and four patients from a single-center database who underwent radical ICC surgery from 2010 to 2019 were enrolled in the study. Cox proportional hazard model was used for survival analysis of imaging features. A meta-analysis was performed to determine imaging features that predict overall survival (OS) and event-free survival (EFS) in ICC. RESULTS: In the CT group of the retrospective cohort, tumor multiplicity, infiltrative tumor margin, lymph node metastasis, enhancement pattern in hepatic arterial phase and tumor necrosis correlated with poorer EFS and OS; moreover, enhancing capsules, high carcinoembryonic antigen levels contributed to poor OS. In the MRI group, tumor multiplicity and enhancement pattern were prognostic factors for OS; tumor multiplicity and enhancement pattern resulted in poor EFS. A total of 13 articles containing 1822 patients with ICC were enrolled in the adjusted hazard ratios meta-analysis. The results showed that enhancement pattern and infiltrative tumor margin were predictors of OS and EFS, whereas bile duct invasion was a predictor of OS. CONCLUSIONS: Arterial enhancement patterns and tumor margin status were associated with both OS and EFS of ICC patients following resection.

Evaluation of Hydraulic Conductivity Estimates from Various Approaches with Groundwater Flow Models.

Significant efforts have been expended for improved characterization of hydraulic conductivity (K) and specific storage (Ss ) to better understand groundwater flow and contaminant transport processes. Conventional methods including grain size analyses (GSA), permeameter, slug, and pumping tests have been utilized extensively, while Direct Push-based Hydraulic Profiling Tool (HPT) surveys have been developed to obtain high-resolution K estimates. Moreover, inverse modeling approaches based on geology-based zonations, and highly parameterized Hydraulic Tomography (HT) have also been advanced to map spatial variations of K and Ss between and beyond boreholes. While different methods are available, it is unclear which one yields K estimates that are most useful for high resolution predictions of groundwater flow. Therefore, the main objective of this study is to evaluate various K estimates at a highly heterogeneous field site obtained with three categories of characterization techniques including: (1) conventional methods (GSA, permeameter, and slug tests); (2) HPT surveys; and (3) inverse modeling based on geology-based zonations and highly parameterized approaches. The performance of each approach is first qualitatively analyzed by comparing K estimates to site geology. Then, steady-state and transient groundwater flow models are employed to quantitatively assess various K estimates by simulating pumping tests not used for parameter estimation. Results reveal that inverse modeling approaches yield the best drawdown predictions under both steady and transient conditions. In contrast, conventional methods and HPT surveys yield biased predictions. Based on our research, it appears that inverse modeling and data fusion are necessary steps in predicting accurate groundwater flow behavior.

Identification of a five m6A-relevant mRNAs signature and risk score for the prognostication of gastric cancer.

Background: N6-methyladenosine (m6A) is the most abundant form of methylation modification in eukaryotic cell messenger RNA (mRNA). However, the role of m6A in gastric cancer (GC), which is one of the most common gastrointestinal malignancies, is unclear. In this study, m6A-relevant mRNA signatures and risk scores were determined to predict the prognosis of GC. Methods: The expression profiles and clinical information of 367 patients were downloaded from The Cancer Genome Atlas (TCGA). Cluster analysis and univariate Cox analysis were performed to identify the regulatory factors of RNA methylation associated with GC prognosis. A co-expression network was constructed using the WGCNA package in R. The correlations between module eigengenes and clinical traits were then calculated to identify the relevant modules. We used univariate Cox analysis to screen for genes that are significantly associated with prognosis in the module. We identified hub genes by least absolute shrinkage and selection operator (LASSO) and multivariate analysis and developed a Cox prognostic model. Finally, the hub gene expression values weighted by the coefficients from the LASSO regression were applied to generate a risk score for each patient, and receiver operating characteristic (ROC) and Kaplan-Meier curves were used to assess the prognostic capacity of the risk scores. The asporin (ASPN) gene in GC cell lines was verified via quantitative polymerase chain reaction (qPCR) and Western blot. Moreover, 5-ethynyl-2'-deoxyuridine (EdU) and transwell assays were applied to evaluate the effects of the proliferation, migration, and invasion abilities in GC cells after ASPN knockdown. Western blot verified the effects of ASPN on the phosphoinositide 3-kinase (PI3K)/serine/threonine kinase (AKT)/mechanistic target of rapamycin kinase (mTOR) pathway and epithelial-mesenchymal transition (EMT) pathway-related gene expression. Results: Our results indicated that AARD, ASPN, SLAMF9, MIR3117 and DUSP1 were hub genes affecting the prognosis of GC patients. Besides, we found that ASPN expression was upregulated in GC cells. The knockdown of ASPN expression suppressed GC cell proliferation, migration, and invasion by deactivating the PI3K/AKT/mTOR and EMT pathways, respectively. Conclusions: Our findings indicated that ASPN participates in the biological process of GC as an oncogene and may be a promising biomarker in GC.

[Panlong acupuncture combined with Xingnao Kaiqiao acupuncture for post-stroke fatigue: a randomized controlled trial].

OBJECTIVE: To observe the clinical effect of Panlong (dragon-like) acupuncture combined with Xingnao Kaiqiao (regaining consciousness and opening orifice) acupuncture on post-stroke fatigue. METHODS: Sixty patients with post-stroke fatigue were randomly divided into an observation group (30 cases, 1 case dropped off) and a control group (30 cases, 2 cases dropped off). The patients in the control group were treated with Xingnao Kaiqiao acupuncture at Neiguan (PC 6), Shuigou (GV 26), etc. for 30 min; based on the treatment of the control group, the patients in the observation group were treated with Panlong acupuncture at Jiaji (EX-B 2) of T1 to L5 for 15 min. The two groups were treated once a day, 6 times a week, for a total of 4 weeks. The scores of fatigue assessment instrument (FAI), energy of stroke-specific quality of life (SS-QOL), and modified Barthel index (MBI) in the two groups were compared before and after treatment, and the clinical efficacy was evaluated. RESULTS: Compared before treatment, the total score and each item score of FAI in the observation group were reduced after treatment (P<0.05), while the total score and FAI-1 and FAI-4 scores in the control group were reduced after treatment (P<0.05). The total score of FAI and FAI-1, FAI-2 and FAI-4 scores in the observation group were lower than those in the control group (P<0.05). After treatment, the SS-QOL energy scores and MBI scores of the two groups were increased compared before treatment (P<0.05), and the SS-QOL energy score in the observation group was higher than that in the control group (P<0.01). The total effective rate was 72.4% (21/29) in the observation group, which was better than 46.4% (13/28) in the control group (P<0.05). CONCLUSION: The Panlong acupuncture combined with Xingnao Kaiqiao acupuncture could effectively alleviate the fatigue symptoms and improve quality of life in patients with post-stroke fatigue.

Causal relationship between bipolar disorder and inflammatory bowel disease: A bidirectional two-sample mendelian randomization study.

Background: Growing evidence suggests a bidirectional association between bipolar disorder (BD) and inflammatory bowel disease (IBD); however, observational studies are prone to confounding, making causal inference and directional determination of these associations difficult. Methods: We performed bidirectional two-sample Mendelian randomization (MR) and selected single nucleotide polymorphisms (SNPs) associated with BD and IBD as instrumental variables (IV). SNPs and genetic associations with BD and IBD were obtained from the latest genome-wide association studies (GWAS) in Europeans (BD: cases/controls: 20352/31358; IBD: 12882/21770; Crohn's disease (CD): 5,956/14927; ulcerative colitis (UC): 6968/20464). The inverse-variance-weighted method was the major method used in MR analyses. MR-Egger, weight mode, simple mode, and weighted median were used for quality control. Results: Genetically predicted BD (per log-odds ratio increase) was significantly positively associated with risk of IBD (OR: 1.18, 95% CI: 1.04-1.33), and UC (OR = 1.19, 95% CI: 1.05-1.35), but not CD (OR = 1.18, 95% CI: 0.95-1.48). The validation analysis found that combined OR of IBD, CD, and UC increased per log-OR of BD were 1.16(95% CI: 1.02-1.31), 1.20(95% CI: 0.98-1.48) 1.17(95% CI: 1.02-1.35), respectively. In contrast, no causal relationship was identified between genetically influenced IBD and BD. Conclusion: Our results confirm a causal relationship between BD and IBD, which may influence clinical decisions on the management of BD patients with intestinal symptoms. Although the reverse MR results did not support a causal effect of IBD on BD, the effect of the IBD active period on BD remains to be further investigated.

A comprehensive framework of the right posterior section for tailored anatomical liver resection based on three-dimensional simulation system.

Background: The anatomical right posterior sectionectomy (ARPS) is a technically challenging procedure. We aimed to develop and validate a novel framework of the right posterior section for a safe and tailored anatomical liver resection (ALR) based on a three-dimensional (3D) simulation system. Methods: 3D hepatectomy simulations of healthy participants who underwent contrast-enhanced computed tomography of the upper abdomen were retrospectively reviewed to develop the framework according to the relationship between the simulated plane determined by the right posterior portal pedicle (RPP) and the course of the right hepatic vein (RHV) trunk. The framework was validated in the practice of ARPS for hepatocellular carcinoma (HCC) prospectively. Results: Scans from 336 eligible participants were assessed. The framework was summarized into four types: normal, caudal-redundant, cranial-deficient, and combined types, accounting for 43.4% (146/336), 25.3% (85/336), 18.5% (62/336), and 12.8% (43/336) respectively. The caudal-redundant type was associated with the variable portal branches of the RPP or segment 6 branch across the ventral side of RHV. The mean aberrant volume proportion in type IIa was significantly greater than that in type IIb (P<0.001), which were 7.0%±3.5% and 4.4%±1.8% respectively. The cranial-deficient type was associated with the aberrant segment 7 portal pedicle originating from the right portal trunk or the dorsal portal branch of segment 8 crossing over to the RHV. The median aberrant volume proportion in type IIIa was significantly greater than that in type IIIb (P<0.001), which were 10.9% (8.5-13.3%) and 4.0% (3.0-6.1%), respectively. The combined type represented a combination of the caudal-redundant type and the cranial-deficient type. The framework provided instructions on tailored ARPS in 6 patients with HCC by maximizing lesion removal and functional liver remnant with favorable perioperative outcomes. Conclusions: Precise preoperative planning with an individualized surgical approach based on our framework allows safe anatomical liver resections for cases with lesions in the right posterior section.

Metformin Suppresses Hepatocellular Carcinoma through Regulating Alternative Splicing of LGR4.

Methods: First, the expression of LGR4 in HCC tumor tissues and cell lines was detected by western blotting and immunofluorescence. The ability of cell proliferation, migration, and invasion was detected with CCK8, wound-healing, and transwell assays when overexpressing LGR4 or treating with metformin. The ß-catenin expression was detected by immunofluorescence. In order to investigate novel AS-associated LGR4, we discarded LGR4 isoforms from GSO databases. We used siRNA to knock down the specific isoform to check the cell proliferation, migration, and invasion when treated with metformin. Results: The level of LGR4 expression was higher in HCC cell lines and tumor tissues. The HCC cell proliferation, migration, and invasion were increased when overexpressing LGR4, which could be reduced by metformin treatment. The GEO database (GSE190076) showed that LGR4 had switching properties in HCC cell lines treated with metformin. We used siRNA to knock down the specific isoform, and the result showed that the specific isoform siRNA could promote the inhibition of cell invasion caused by metformin treatment. Conclusions: LGR4 could promote the ability of cell proliferation, migration, and invasion in HCC, which could be reduced by metformin through alternative splicing.

CircMYH9 increases KPNA2 mRNA stability to promote hepatocellular carcinoma progression in an EIF4A3-dependent manner.

Hepatocellular carcinoma (HCC) is the most commonly diagnosed cancer worldwide with a high incidence of recurrence and metastasis; however, the molecular mechanisms underlying HCC development remain to be fully understood. In this study, we identified circMYH9 as an important regulator of HCC. Overexpression of circMYH9 induced, while knockdown of circMYH9 inhibited, the proliferation, migration, and invasion of HCC cells. Mechanistically, circMYH9 bound to eukaryotic translation initiation factor 4A3 (EIF4A3) and increased karyopherin subunit alpha 2 (KPNA2) mRNA stability. circMYH9 knockdown in HCC cells reduced the stability of KPNA2 mRNA. Importantly, circMYH9 regulation of HCC required the activity of KPNA2. In support with this, circMYH9 level was positively correlated with the expression of KPNA2 in HCC patient samples. Taken together, our study was the first to uncover the oncogenic role of circMYH9 in HCC and further elucidated the functional mechanism of circMYH9 by interacting with EIF4A3 to increase KPNA2 mRNA stability. Our findings might provide a novel potential target for the diagnose and treatment of HCC.

Surgical Strategy for Resecting Hepatocellular Carcinoma in the Caudate Lobe: Isolated or Combined Lobectomy? A Single-Center Study and Meta-Analysis.

BACKGROUND: Resection of hepatocellular carcinoma (HCC) originating in the caudate lobe remains challenging, while the optimal extent of resection is debated. We aimed to evaluate the relative benefits of combined caudate lobectomy (CCL) versus isolated caudate lobectomy (ICL) for caudate HCC. METHODS: Patients who underwent curative-intent resection for caudate HCC between January 2010 and December 2018 were identified from a single-center database. Surgical outcomes of the two strategy groups were analyzed before and after propensity score matching. A systematic review with meta-analysis was also performed to compare outcomes of CCL versus ICL for caudate HCC. RESULTS: A total of 28 patients were included: 11 in the CCL and 17 in the ICL group. Compared with ICL, the CCL group contained patients with larger tumors and a higher incidence of vascular invasion. After propensity score matching, 6 pairs of patients were selected. In the well-matched cohort, CCL demonstrated significantly improved recurrence-free survival (RFS) (P = 0.047) compared with ICL; no significant differences were noted for overall survival (OS), operation time, blood loss and morbidity rate. A total of 227 patients from nine eligible studies and ours were involved in the systematic review. Meta-analysis revealed that CCL provided better RFS (hazard ratio 0.54, 95% confidence interval 0.31-0.92) than ICL; no significant differences were observed in OS, operation time, blood loss and morbidity rate. CONCLUSION: CCL confers superior RFS over ICL without compromise of perioperative outcomes and should be prioritized for patients with caudate HCC when feasible, especially for those with large-sized tumors.

Effect of Electro-acupuncture on Vasomotor Symptoms in Rats with Acute Cerebral Infarction Based on Phosphatidylinositol System.

OBJECTIVE: To investigate the effect of electro-acupuncture (EA) on vasomotor symptoms in rats with acute cerebral infarction, by observing the changes in the expression of factors related to the phosphatidylinositol (PI) system. METHODS: Forty-two Wistar rats were randomly divided into 3 groups by a random number table: the control group (n=6), the model group (n=18) and the EA group (n=18). The EA group was given EA treatment at Shuigou (GV 26) instantly after modeling with middle cerebral artery occlusion (MCAO) method, while the model and control groups were not given any treatment. The degrees of neurological deficiency were evaluated using neurological severity scores (NSS) and the brain blood flow was evaluated by a laser scanning confocal microscope. Western blot analysis was conducted to detect the expression levels of G-protein subtype (Gq) and calmodulin (CaM). Competition for protein binding was conducted to detect the expression level of inositol triphosphate (IP3). Thin layer quantitative analysis was conducted to detect the expression level of diacylglycerol (DAG). The expression level of intracellular concentration of free calcium ion ([Ca2+]i) was detected by flow cytometry. RESULTS: The NSS of the model group was significantly higher than the control group at 3 and 6 h after MCAO (P<0.01), while the EA group was significantly lower than the model group at 6 h (P<0.01). The cerebral blood flow in the model group was significantly lower than the control group at 1, 3 and 6 h after MCAO (P<0.01), while for the EA group it was remarkably higher than the model group at the same time points (P<0.01). The expressions of Gq, CaM, IP3, DAG and [Ca2+]i in the model group were significantly higher than the control group (P<0.05 or P<0.01), and those in the EA group were significantly lower than the model group at the same time points (P<0.05 or P<0.01). CONCLUSION: EA treatment at GV 26 can effectively decrease the over-expression of related factors of PI system in rats with acute cerebral infarction, improve cerebral autonomy movement, and alleviate cerebral vascular spasm.

CircASPH Promotes Hepatocellular Carcinoma Progression Through Methylation and Expression of HAO2.

CircRNAs have been reported to be related to hepatocellular carcinoma (HCC) development. Limited studies have revealed the expression profile of circRNAs in tumor and para-tumor normal samples in HCC patients. We found that circASPH was significantly increased in HCC tumor samples and that the level of circASPH was closely related to the overall survival of HCC patients. Mechanistically, circASPH could regulate the methylation of the promoter and expression of hydrocyanic oxidase 2 (HAO2) to promote HCC progression by acting as a sponge for miR-370-3p, and miR-370-3p could target DNMT3b and increase the 5mC level. In summary, our study determined that circASPH could regulate the methylation and expression of HAO2 and it could be considered an important epigenetic regulator in HCC progression.

Development and Application of Medicine-Engineering Integration in the Rehabilitation of Traumatic Brain Injury.

The rapid progress of the combination of medicine and engineering provides better chances for the clinical treatment and healthcare engineering. Traumatic brain injury (TBI) and its related symptoms have become a major global health problem. At present, these techniques has been widely used in the rehabilitation of TBI. In this review article, we summarizes the progress of the combination of medicine and industry in the rehabilitation of traumatic brain injury in recent years, mainly from the following aspects: artificial intelligence (AI), brain-computer interfaces (BCI), noninvasive brain stimulation (NIBS), and wearable-assisted devices. We believe the summary of this article can improve insight into the combination of medicine and industry in the rehabilitation of traumatic brain injury.

Machine Learning to Improve Prognosis Prediction of Early Hepatocellular Carcinoma After Surgical Resection.

BACKGROUND: Improved prognostic prediction is needed to stratify patients with early hepatocellular carcinoma (EHCC) to refine selection of adjuvant therapy. We aimed to develop a machine learning (ML)-based model to predict survival after liver resection for EHCC based on readily available clinical data. METHODS: We analyzed data of surgically resected EHCC (tumor≤5 cm without evidence of extrahepatic disease or major vascular invasion) patients from the Surveillance, Epidemiology, and End Results (SEER) Program to train and internally validate a gradient-boosting ML model to predict disease-specific survival (DSS). We externally tested the ML model using data from 2 Chinese institutions. Patients treated with resection were matched by propensity score to those treated with transplantation in the SEER-Medicare database. RESULTS: A total of 2778 EHCC patients treated with resection were enrolled, divided into 1899 for training/validation (SEER) and 879 for test (Chinese). The ML model consisted of 8 covariates (age, race, alpha-fetoprotein, tumor size, multifocality, vascular invasion, histological grade and fibrosis score) and predicted DSS with C-Statistics >0.72, better than proposed staging systems across study cohorts. The ML model could stratify 10-year DSS ranging from 70% in low-risk subset to 5% in high-risk subset. Compared with low-risk subset, no remarkable survival benefits were observed in EHCC patients receiving transplantation before and after propensity score matching. CONCLUSION: An ML model trained on a large-scale dataset has good predictive performance at individual scale. Such a model is readily integrated into clinical practice and will be valuable in discussing treatment strategies.

The efficacy and safety of controlled low central venous pressure for liver resection: a systematic review and meta-analysis.

BACKGROUND: Application of controlled low central venous pressure (LCVP) in liver resection growing in popularity, but its efficacy and safety are still controversial. Our objectives were to assess and compare the efficacy, feasibility, and safety of controlled LCVP in patients undergoing liver resection. METHODS: The PubMed, Cochrane library, and EMBASE databases were systematically searched for all the relevant studies regardless of study design. We evaluated the methodological quality of the included studies and excluded studies of poor quality. Moreover, we applied a systematic review and meta-analysis by using RevMan 5.3 software to compare the efficacy and safety of LCVP vs. standard CVP for liver resection. Outcomes included operation time, blood loss, blood infusion, fluid infusion, urinary volume, postoperative complication rates, and hospital stay. RESULTS: In total, 10 studies, involving 324 patients undergoing liver resection with controlled LCVP, were identified. Meta-analysis displayed that blood loss in the LCVP group was dramatically less than that in the control group (standard CVP group, mean difference (MD): -581.68; 95% CI: -886.32 to -277.05; P=0.0002). Moreover, blood transfusion in the LCVP group was also markedly less than that in the control group (MD: -179.16; 95% CI: -282.00 to -76.33; P=0.0006). However, there was no difference between LCVP group and control group in operation time (MD: -16.24; 95% CI: -39.56 to 7.09; P=0.17), fluid infusion (MD: -287.89; 95% CI: -1,054.47 to 478.69; P=0.46), urinary volume (MD: -26.88; 95% CI: -87.14 to 33.37; P=0.38), ALT (MD: -58.66; 95% CI: -153.81 to 36.50; P=0.23), TBIL (MD: -0.32; 95% CI: -3.93 to 3.28; P=0.86), BUN (MD: -0.13; 95% CI: -0.73 to 0.47; P=0.67), CR (MD: 1.87; 95% CI: -4.90 to 8.63; P=0.59), postoperative complication rates (MD: 0.62; 95% CI: 0.44 to 0.90; P=0.01) and hospital stay (MD: -0.61; 95% CI: -1.68 to 0.46; P=0.26). CONCLUSIONS: Compared with the control, controlled LCVP showed comparable efficacy and safety for the treatment during liver resection.

Effects of PEDOT:PSS:GO composite hole transport layer on the luminescence of perovskite light-emitting diodes.

Perovskite light-emitting diodes (PeLEDs) employing CH3NH3PbBr3 as the emission layer (EML) and graphene oxide (GO) doped PEDOT:PSS as the hole transport layer (HTL) were prepared and characterized. GO doped in PEDOT:PSS can lead to the increased work function of HTL and lower the hole injection barrier at the HTL/CH3NH3PbBr3 interface, which facilitates the hole injection. Meanwhile, the optimized GO amount in PEDOT:PSS can help to reduce the quenching of luminescence occurring at the interface between HTL and perovskite. The luminance and current efficiency reach the maximum values of 3302 cd m-2 and 1.92 cd A-1 in PeLED with an optimized GO ratio (0.3), which increase by 43.3% and 73.0% in comparison with the undoped device, respectively. The enhanced luminescence of PeLEDs was caused by the combined effects of enhanced hole injection efficiency and the suppressed exciton quenching occurring at the HTL/EML interface. These results indicate that the introduction of traditional two-dimensional materials is a reasonable method for designing the structure of PeLEDs.