Multi-Functional Actuators Made with Biomass-Based Graphene-Polymer Films for Intelligent Gesture Recognition and Multi-Mode Self-Powered Sensing.

Multi-functional actuation systems involve the mechanical integration of multiple actuation and sensor devices with external energy sources. The intricate combination makes it difficult to meet the requirements of lightweight. Hence, polypyrrole@graphene-bacterial cellulose (PPy@G-BC) films are proposed to construct multi-responsive and bilayer actuators integrated with multi-mode self-powered sensing function. The PPy@G-BC film not only exhibits good photo-thermoelectric (PTE) properties but also possesses good hydrophilicity and high Young's modulus. Thus, the PPy@G-BC films are used as active layers in multi-responsive bilayer actuators integrated with self-powered sensing functions. Here, two types of multi-functional actuators integrated with self-powered sensing functions is designed. One is a light-driven actuator that realizes the self-powered temperature sensing function through the PTE effect. Assisted by a machine learning algorithm, the self-powered bionic hand can realize intelligent gesture recognition with an accuracy rate of 96.8%. The other is humidity-driven actuators integrated a zinc-air battery, which can realize self-powered humidity sensing. Based on the above advantages, these two multi-functional actuators are ingeniously integrated into a single device, which can simultaneously perform self-powered temperature/humidity sensing while grasping objects. The highly integrated design enables the efficient utilization of environmental energy sources and complementary synergistic monitoring of multiple physical properties without increasing system complexity.

Total neoadjuvant therapy for locally advanced rectal cancer: a three-group propensity score matched study.

PURPOSE: Total neoadjuvant therapy (TNT) has emerged as a therapeutic approach for locally advanced rectal cancer (LARC). However, the optimal chemotherapy cycles within TNT remain uncertain. This study aimed to evaluate and compare the prognostic efficacy of varying cycles of chemotherapy during TNT for LARC. METHODS: Patients diagnosed with LARC (T3-4N0M0/T1-4N1-2M0), who underwent TNT or chemoradiotherapy followed by total mesorectal excision (TME) between 2015 and 2020, were retrospective included. Patients were categorized into three groups based on their neoadjuvant strategy: CRT (long-course chemoradiotherapy), STNT (long-course CRT with one to three cycles of chemotherapy), and LTNT (long-course CRT with four or more cycles of chemotherapy). Propensity score matching (PSM) based on gender, age, body mass index, tumor distance from the anal verge, clinical T stage, clinical N stage, and mesorectal fascia status was employed to reduce confounding bias. Primary endpoints were disease-free survival (DFS) and metastasis-free survival (MFS). RESULTS: The study comprised 372 patients, with 73 patients in each group after PSM. Compared with CRT, both STNT and LTNT demonstrated improved DFS (5-year rate: 59.7% vs. 77.8% vs. 76.5%, p = 0.027) and MFS (5-year rate: 65.1% vs. 81.3% vs. 81.4%, p = 0.030). There was no difference in DFS or MFS between STNT and LTNT. These favorable outcomes were consistent among subgroups defined by tumor distance from the anal verge ≥ 5 cm, clinical T3 stage, clinical N positive status, or involved mesorectal fascia. CONCLUSION: Compared to CRT, both STNT and LTNT demonstrated improved DFS and MFS outcomes. Notably, survival outcomes were similar between STNT and LTNT, suggesting that chemotherapy cycles in TNT may not significantly impact survival.

Three-Dimensional Multifrequency MR Elastography for Microvascular Invasion and Prognosis Assessment in Hepatocellular Carcinoma.

BACKGROUND: Pretreatment identification of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) is important when selecting treatment strategies. PURPOSE: To improve models for predicting MVI and recurrence-free survival (RFS) by developing nomograms containing three-dimensional (3D) MR elastography (MRE). STUDY TYPE: Prospective. POPULATION: 188 patients with HCC, divided into a training cohort (n = 150) and a validation cohort (n = 38). In the training cohort, 106/150 patients completed a 2-year follow-up. FIELD STRENGTH/SEQUENCE: 1.5T 3D multifrequency MRE with a single-shot spin-echo echo planar imaging sequence, and 3.0T multiparametric MRI (mp-MRI), consisting of diffusion-weighted echo planar imaging, T2-weighted fast spin echo, in-phase out-of-phase T1-weighted fast spoiled gradient-recalled dual-echo and dynamic contrast-enhanced gradient echo sequences. ASSESSMENT: Multivariable analysis was used to identify the independent predictors for MVI and RFS. Nomograms were constructed for visualization. Models for predicting MVI and RFS were built using mp-MRI parameters and a combination of mp-MRI and 3D MRE predictors. STATISTICAL TESTS: Student's t-test, Mann-Whitney U test, chi-squared or Fisher's exact tests, multivariable analysis, area under the receiver operating characteristic curve (AUC), DeLong test, Kaplan-Meier analysis and log rank tests. P < 0.05 was considered significant. RESULTS: Tumor c and liver c were independent predictors of MVI and RFS, respectively. Adding tumor c significantly improved the diagnostic performance of mp-MRI (AUC increased from 0.70 to 0.87) for MVI detection. Of the 106 patients in the training cohort who completed the 2-year follow up, 34 experienced recurrence. RFS was shorter for patients with MVI-positive histology than MVI-negative histology (27.1 months vs. >40 months). The MVI predicted by the 3D MRE model yielded similar results (26.9 months vs. >40 months). The MVI and RFS nomograms of the histologic-MVI and model-predicted MVI-positive showed good predictive performance. DATA CONCLUSION: Biomechanical properties of 3D MRE were biomarkers for MVI and RFS. MVI and RFS nomograms were established. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 2.

Effect of icariin on depressive behaviour in rat pups. Evidences for its mechanism of action by integrating network pharmacology, metabolomics and gut microbiota composition.

BACKGROUND: Prenatal stress (PS) can cause cognitive disorder and a range of psychological illnesses, including anxiety and depression. Icariin (ICA) has shown promising effects in improving PS-induced depressive behaviour. However, its mechanism of action remains unclear. PURPOSE: This study was performed to reveal the key targets, metabolites and gut microbiota for ICA in improving depressive behaviour in PS rat pups. METHODS: A prenatal restraint stress animal model was established for Sprague-Dawley (SD) rats in late pregnancy. Male pups were randomly divided into six groups: no stress group (NS), PS group, PS + saline group (PS_S), PS + high-dose ICA group (ICAH, 80 mg/kg*day), PS + low-dose ICA group (ICAL, 40 mg/kg*day) and PS + fluoxetine group (FLU, 10 mg/kg*day). The depressive behaviour of each group of rat pups was evaluated using open field test, forced swimming test and sucrose preference test. Different metabolites were identified using untargeted metabolomics of serum and faeces, and metabolic pathways were analyzed through MetaboAnalyst. Targets for ICA acting on depression were determined after network pharmacology was applied. An integrated network of network pharmacology and metabolomics were constructed using Cytoscape software, and molecular docking were performed to verify the interactions between ICA and key targets. Finally, gut microbiota of rat pups in each group were analyzed after 16S rDNA sequencing. RESULTS: PS could cause rat pups to exhibit depressive behaviour, and ICA could significantly improve this depressive behaviour. A total of 49 differential metabolites were found in serum and 23 differential metabolites were found in faeces, and 24 metabolites in serum and 6 metabolites in faeces could be reversed following ICA administration. Integrated analysis focused on five key targets (i.e. adenosyl homocysteinase; medium-chain specific acyl-CoA dehydrogenase, mitochondrial; thymidine phosphorylase; cGMP-specific 3',5'-cyclic phosphodiesterase and xanthine dehydrogenase/oxidase) and three metabolites (i.e. palmitoylcarnitine, methionine and hypoxanthine). Molecular docking indicated that ICA combined well with key targets. Gut microbiota analysis showed that g_Bacteroides, f_Bacteroidaceae and s_Lactobacillus reuteri were required for ICA to improve depressive behaviour. CONCLUSION: In this study, the antidepressant mechanism of ICA was clarified with a strategy of integrating metabolomics, network pharmacology and gut microbiota. ICA has a good effect on improving metabolism and increasing the abundance of probiotics in the intestine. The present research provided new insights into the anti-depressant mechanism of ICA.

Long Non-Coding RNA as a Potential Biomarker for Canine Tumors.

Cancer is the leading cause of death in both humans and companion animals. Long non-coding RNA (lncRNA) plays a crucial role in the progression of various types of cancers in humans, involving tumor proliferation, metastasis, angiogenesis, and signaling pathways, and acts as a potential biomarker for diagnosis and targeted treatment. However, research on lncRNAs related to canine tumors is in an early stage. Dogs have long been considered a promising natural model for human disease. This article summarizes the molecular function of lncRNAs as novel biomarkers in various types of canine tumors, providing new insights into canine tumor diagnosis and treatment. Further research on the function and mechanism of lncRNAs is needed, which will benefit both human and veterinary medicine.

Nomogram predicting overall prognosis for invasive micropapillary carcinoma of the breast: a SEER-based population study.

OBJECTIVES: The prognosis of invasive micropapillary carcinoma (IMPC) of the breast is determined by many clinicopathological factors. This study aims to identify prognostic factors and develop reliable nomogram to predict the overall survival (OS) in patients with IMPC. DESIGN: Log-rank test and Cox proportional hazards analysis were used to identify variables and construct a nomogram based on the training cohort. C-index and calibration curves were performed to evaluate the performance of the model in the training cohort and validation cohorts. SETTING: We collected the patient data from the Surveillance, Epidemiology and End Results (SEER) database. This database holds data related to the cancer incidence from 18 population-based cancer registries in the USA. PARTICIPANTS: The SEER database was used to screen 754 eligible patients as the study cohort. The whole cohort was randomly divided into a training cohort (n=377) and a validation cohort (n=377). RESULTS: Age at diagnosis, hormone receptors, number of positive regional lymph nodes and clinical stage were independent prognostic factors for patients with IMPC. The calibration curves presented excellent consistency between the actual and nomogram-predict survival probabilities in the training and validation cohorts. The C-index values of the nomogram were 0.794 and 0.774 for OS in the training and validation cohorts, respectively. CONCLUSIONS: The novel nomogram provides new insights of the risk of each prognostic factor and can assist doctors in predicting the 1-year, 3-year and 5-year OS in patients with IMPC.

Non-destructive distinction of single seed for Medicago sativa and Melilotus officinalis by capillary electrophoresis with laser-induced fluorescence detection.

Flavonoids are a class of natural polyphenolic compounds with great health benefits, and the development of methods for their analysis is of continuing interest. In this work, apigenin, kaempferol and formononetin were selected as the typical representatives of flavone, flavonol and isoflavone, three subclasses of flavonoids. Fluorescence studies revealed that tetraborate complexation could significantly sensitize the weak intrinsic fluorescence of flavonoids in solution, with a maximum of 137-fold for kaempferol. Subsequently, an integrated strategy of derivatization and separation was proposed for the universal analysis of flavonoids by capillary electrophoresis (CE) with 405 nm laser-induced fluorescence (LIF) detection. Using a running buffer consisting of 20 mM sodium tetraborate, 10 mM SDS and 10% methanol (pH 8.5), the dynamic derivatization was realized in the capillary, and the baseline separation was achieved within 10 min, with the detection limits of 0.92-35.46 nM (S/N=3) for the total of 9 flavonoids. The developed CE-LIF method was employed to the quantitative analysis of some flavonoids in Medicago sativa (alfalfa) plants and granulated alfalfa with the recoveries of 80.55-94.25%. Combined with the principal component analysis, the developed method was successfully applied to the non-destructive distinction of single seed for alfalfa and Melilotus officinalis (sweet clover), two forage grass seeds with very similar apparent morphology. Furthermore, this method was used to continuously monitor the substance metabolism during the soaking process at the level of single seed.

Total neoadjuvant therapy versus chemoradiotherapy for locally advanced rectal cancer: Bayesian network meta-analysis.

BACKGROUND: Total neoadjuvant therapy is a promising treatment for locally advanced rectal cancer, utilizing either short-course radiotherapy or long-course chemoradiotherapy, but their relative efficacy remains unclear. The aim of this Bayesian network meta-analysis was to investigate clinical outcomes amongst patients receiving total neoadjuvant therapy with short-course radiotherapy or long-course chemoradiotherapy, and those receiving long-course chemoradiotherapy alone. METHODS: A systematic literature search was performed. All studies that compared at least two of these three treatments for locally advanced rectal cancer were included. The primary endpoint was the pathological complete response rate, and survival outcomes were adopted as secondary outcomes. RESULTS: Thirty cohorts were included. Compared with long-course chemoradiotherapy, both total neoadjuvant therapy with long-course chemoradiotherapy (OR 1.78, 95 per cent c.i. 1.43 to 2.26) and total neoadjuvant therapy with short-course radiotherapy (OR 1.75, 95 per cent c.i. 1.23 to 2.50) improved the pathological complete response rate. Similar benefits were observed in the sensitivity and subgroup analyses, except for short-course radiotherapy with one to two cycles of chemotherapy. No significant differences in survival outcomes were found amongst the three treatments. Long-course chemoradiotherapy with consolidation chemotherapy (HR 0.44, 95 per cent c.i. 0.20 to 0.99) exhibited higher disease-free survival than long-course chemoradiotherapy alone. CONCLUSION: Compared with long-course chemoradiotherapy, both short-course radiotherapy with greater than or equal to three cycles of chemotherapy and total neoadjuvant therapy with long-course chemoradiotherapy can improve the pathological complete response rate, and long-course chemoradiotherapy with consolidation chemotherapy may lead to a marginal benefit in disease-free survival. The pathological complete response rate and survival outcomes are similar for total neoadjuvant therapy with short-course radiotherapy or long-course chemoradiotherapy.

Three-dimensional multifrequency magnetic resonance elastography improves preoperative assessment of proliferative hepatocellular carcinoma.

BACKGROUND: To investigate the viscoelastic signatures of proliferative hepatocellular carcinoma (HCC) using three-dimensional (3D) magnetic resonance elastography (MRE). METHODS: This prospective study included 121 patients with 124 HCCs as training cohort, and validation cohort included 33 HCCs. They all underwent preoperative conventional magnetic resonance imaging (MRI) and tomoelastography based on 3D multifrequency MRE. Viscoelastic parameters of the tumor and liver were quantified as shear wave speed (c, m/s) and loss angle (φ, rad), representing stiffness and fluidity, respectively. Five MRI features were evaluated. Multivariate logistic regression analyses were used to determine predictors of proliferative HCC to construct corresponding nomograms. RESULTS: In training cohort, model 1 (Combining cirrhosis, hepatitis virus, rim APHE, peritumoral enhancement, and tumor margin) yielded an area under the curve (AUC), sensitivity, specificity, accuracy of 0.72, 58.73%,78.69%, 67.74%, respectively. When adding MRE properties (tumor c and tumor φ), established model 2, the AUC increased to 0.81 (95% CI 0.72-0.87), with sensitivity, specificity, accuracy of 71.43%, 81.97%, 75%, respectively. The C-index of nomogram of model 2 was 0.81, showing good performance for proliferative HCC. Therefore, integrating tumor c and tumor φ can significantly improve the performance of preoperative diagnosis of proliferative HCC (AUC increased from 0.72 to 0.81, p = 0.012). The same finding was observed in the validation cohort, with AUC increasing from 0.62 to 0.77 (p = 0.021). CONCLUSIONS: Proliferative HCC exhibits low stiffness and high fluidity. Adding MRE properties (tumor c and tumor φ) can improve performance of conventional MRI for preoperative diagnosis of proliferative HCC. CRITICAL RELEVANCE STATEMENT: We investigated the viscoelastic signatures of proliferative hepatocellular carcinoma (HCC) using three-dimensional (3D) magnetic resonance elastography (MRE), and find that adding MRE properties (tumor c and tumor φ) can improve performance of conventional MRI for preoperative diagnosis of proliferative HCC.

High red blood cell distribution width is associated with the mortality of critically ill cancer patients: A propensity-matching study.

BACKGROUND: The red blood cell distribution width (RDW) is related to the mortality of patients with malignant tumors, but the relationship between RDW and the prognosis of cancer patients in the intensive care unit (ICU) has not been fully clarified. OBJECTIVES: To investigate the role of RDW in predicting the prognosis of critically ill cancer patients. MATERIAL AND METHODS: A propensity score matching (PSM) study was conducted using data from adult patients with cancer, admitted to the ICU from the Intensive Care Medical Information Market IV (MIMIC-IV, v. 1.4) database. The correlation between RDW and ICU all-cause mortality was evaluated using a logistic regression model; stratification factors were considered. Additionally, a receiver operating characteristic (ROC) curve analysis was performed to compare the prognostic values of various blood biomarkers. RESULTS: Overall, 4836 cancer patients were included. The optimal critical RDW value was 15%. The RDW levels were independently correlated with ICU mortality in critically ill cancer patients, with odds ratios (ORs) of 1.56 (1.12-2.18) in the original cohort, 1.64 (1.27-2.12) in the imputation cohort, 1.65 (1.22-2.24) in the matched cohort, and 1.55 (1.19-2.03) in the weighted cohort. The forecasted performance of RDW is better than other blood biomarkers with an area under the ROC curve (AUC) of 0.637 (0.591-0.683). CONCLUSIONS: The RDW has a prognostic value in critically ill cancer patients and a high RDW is independently associated with high mortality.

Siloxane-Modified UV-Curable Castor-Oil-Based Waterborne Polyurethane Superhydrophobic Coatings.

In recent years, superhydrophobic coatings with self-cleaning abilities have attracted considerable attention. In this study, we introduced hydroxyl-terminated polydimethylsiloxane (OH-PDMS) into castor-oil-based waterborne polyurethanes and synthesized silicone-modified castor-oil-based UV-curable waterborne polyurethanes (SCWPU). Further, we identified the optimal amount of OH-PDMS to be added and introduced different amounts of micro- and nanoscale heptadecafluorodecyltrimethoxysilane-modified SiO2 particles (FAS-SiO2) to prepare rough-surface SCWPU coatings with dense micro- and nanostructures, thus realizing waterborne superhydrophobic coatings. The results show that when the OH-PDMS content was 11 wt% and the total addition of FAS-SiO2 particles was 50% (with a 1:1:1 ratio of 100 nm, 1 µm, and 10 nm particles), the coatings exhibited a self-cleaning ability and superhydrophobicity with a contact angle of (152.36 ± 2.29)° and a roll-off angle of (4.9 ± 1.0)°. This castor-oil-based waterborne superhydrophobic coating has great potential for waterproofing, anti-fouling, anti-corrosion, and other applications.

Reduced tumor stiffness quantified by tomoelastography as a predicative marker for glypican-3-positive hepatocellular carcinoma.

Background: Glypican-3 (GPC3) expression is investigated as a promising target for tumor-specific immunotherapy of hepatocellular carcinoma (HCC). This study aims to determine whether GPC3 alters the viscoelastic properties of HCC and whether tomoelastography, a multifrequency magnetic resonance elastography (MRE) technique, is sensitive to it. Methods: Ninety-five participants (mean age, 58 ± 1 years; 78 men and 17 women) with 100 pathologically confirmed HCC lesions were enrolled in this prospective study from July 2020 to August 2021. All patients underwent preoperative multiparametric MRI and tomoelastography. Tomoelastography provided shear wave speed (c, m/s) representing tissue stiffness and loss angle (φ, rad) relating to viscosity. Clinical, laboratory, and imaging parameters were compared between GPC3-positive and -negative groups. Univariable and multivariable logistic regression were performed to determine factors associated with GPC3-positive HCC. The diagnostic performance of combined biomarkers was established using logistic regression analysis. Area-under-the-curve (AUC) analysis was done to assess diagnostic performance in detecting GPC3-positive HCC. Findings: GPC3-positive HCCs (n=72) had reduced stiffness compared with GPC3-negative HCCs (n=23) while viscosity was not different (c: 2.34 ± 0.62 versus 2.72 ± 0.62 m/s, P=0.010, φ: 1.11 ± 0.21 vs 1.18 ± 0.27 rad, P=0.21). Logistic regression showed c and elevated serum alpha-fetoprotein (AFP) level above 20 ng/mL were independent factors for GPC3-positive HCC. Stiffness with a cutoff of c = 2.8 m/s in conjunction with an elevated AFP yielded a sensitivity of 80.3%, specificity of 70.8%, and AUC of 0.80. Interpretation: Reduced stiffness quantified by tomoelastography may be a mechanical signature of GPC3-positive HCC. Combining reduced tumor stiffness and elevated AFP level may provide potentially valuable biomarker for GPC3-targeted immunotherapy.

Patterned Aluminum/Polydimethylsiloxane-Laminated Film for a Solvent-Driven Soft Actuator with Programmable and Multistable Shape Morphing.

Recently, soft actuators capable of deforming in predictable ways under external stimuli have attracted increasing attention by showing great potential in emerging industries. However, limited efforts are being spent on the untethered actuators with multistable deformations. Also, there is a lack of mechanically guiding design principles for multistable structures. Here, the patterned aluminum/polydimethylsiloxane (Al/PDMS)-laminated films with surface wrinkles are fabricated by magnetron sputtering the Al layer on the PDMS substrate. By tuning the geometric parameters and surface constraints of the patterned Al/PDMS-laminated films, a series of solvent-driven actuators with multiform stable configurations (such as monostable arc, multistable cylinder, and monostable/bistable spiral) are proposed. The deformation mechanism is revealed using a linear elastic theory. Combined with the finite element analysis method, the deformations of Al/PDMS-laminated films with different surface constraints and geometric configurations are visually predicted. Besides, we modulate the deformation of different parts of the Z-shaped actuators by tuning the surface constraints in different regions of the Z-shaped Al/PDMS bilayer films to achieve multiple stable deformations in a single actuator. The concept offers a huge design scope for reconfigurable soft robots. Finally, two bionic applications are proposed to demonstrate the practical applications of the soft solvent-driven actuator based on the patterned Al/PDMS films in artificial muscles and bionic robotics. This work provides a strategy for the design and fabrication of programmable and controllable soft actuators, laying the foundation for a wide range of applications in smart materials.

Correlation analysis of structural and biomechanical properties of hepatocellular carcinoma tissue.

It is known that biomechanical and structural properties of tumor tissues are potential biomarkers for the diagnosis and prognosis of tumors such as Hepatocellular carcinoma (HCC). Although there are many studies on the characterization of biomechanical properties of HCC at the cellular level, limited information is known from in vitro studies. Here, tissue samples from 14 patients diagnosed with HCC were analyzed. Indentation tests showed the instantaneous shear modulus and long-term shear modulus of the HCC tissue were 1.19 ± 0.86 kPa and 0.29 ± 0.25 kPa, respectively. The volume fraction of collagen fibers estimated by analyzing the histology images was positively correlated with either instantaneous shear modulus (r = 0.64, p = 0.016) or long-term shear modulus (r = 0.76, p = 0.002). Diffusion-weighted images with 13b-values were also collected and the diffusivity from Intravoxel Incoherent Motion (IVIM) and Diffusion Kurtosis Imaging (DKI) models were 1.09 ± 0.47 ∙ 10-3 mm2/s and 2.06 ± 0.83∙10-3 mm2/s, respectively. Significant positive correlations were observed between long-term shear modulus and the diffusivity estimated from IVIM (r = 0.600, p = 0.026). The shifted apparent diffusion coefficient (ADC) estimated based on b = 600 and 2000 s/mm2 was negatively correlated with both instantaneous shear modulus (r = -0.745, p = 0.003) and long-term shear modulus (r = -0.591, p = 0.029). In addition, the diffusivity and non-Gaussian Kurtosis parameters estimated at different b values showed a significant negative correlation (r = -0.675, p = 0.010). Results revealed the close relationships between the structural and biomechanical properties of HCC tissue. The interrelation of diffusion and biomechanical properties are not only crucial for HCC characterization but could also provide helpful information for HCC diagnosis and prognosis.

Surgical Treatment of Bilateral Chronic Subdural Hematoma.

Background: Chronic subdural hematoma (CSDH) is one of the common clinical intracranial hemorrhagic disorders, accounting for 16%-20% of bilateral CSDH. At present, the surgical treatment of bilateral CSDH mainly includes drilling drainage and neuroendoscopic assistance. The main objective of this paper was to compare the effects of two surgical methods on CSDH. Methods: 153 patients who were diagnosed with CSDH were included in this study. 79 patients were treated with bilateral drilling drainage, and the other 74 patients were treated with neuroendoscope-assisted drainage. The clinical data of the two groups were compared, and the surgical indexes, neurological function, cure rate, and recurrence rate of the two groups were compared. The operation indexes of patients include operation time, postoperative hematoma volume, hospital stay, extubation time, misplacement of drainage tube, recurrence, and hematoma clearance rate. Results: All patients underwent CT examination one day after operation. The CT imaging detection of the two groups was generally good. The cranial CT was reexamined before discharge. The bilateral hematoma disappeared in 114 patients, the unilateral hematoma disappeared in 29 patients, a small amount of compensatory crescent very low-density shadow subdural effusion was observed on the other side, and a small amount of compensatory crescent very low-density shadow subdural effusion was observed on both sides in 10 patients. There was no space occupying effect and intracranial gas disappeared. Compared with neuroendoscopic assisted drainage, the operation time of drilling drainage patients was significantly shorter. The extubation time, drainage tube dislocation, recurrence rate, postoperative hematoma volume, and hematoma clearance rate of patients receiving neuroendoscopic assisted drainage were significantly better than those receiving drilling drainage. The Markwalder score and hospital stay between the two groups were not significant. Conclusions: Drilling drainage and neuroendoscopic assisted surgery have good therapeutic effects on bilateral CSDH. The operation time of drilling drainage is shorter. Neuroendoscopic assisted surgery has more advantages in extubation time, misplacement of drainage tube, recurrence, postoperative hematoma volume, and hematoma clearance rate.

Tomoelastography based on multifrequency MR elastography predicts liver function reserve in patients with hepatocellular carcinoma: a prospective study.

BACKGROUND: Estimating liver function reserve is essential for preoperative surgical planning and predicting post-hepatectomy complications in patients with hepatocellular carcinoma (HCC). We investigated hepatic viscoelasticity quantified by tomoelastography, a multifrequency magnetic resonance elastography technique, to predict liver function reserve. METHODS: One hundred fifty-six patients with suspected HCC (mean age, 60 ± 1 years; 131 men) underwent preoperative tomoelastography examination between July 2020 and August 2021. Sixty-nine were included in the final analysis, and their 15-min indocyanine green retention rates (ICG-R15s) were obtained to determine liver function reserve. Tomoelastography quantified the shear wave speed (c, m/s), which represents stiffness, and loss angle (φ, rad), which represents fluidity. Both were correlated with the ICG-R15. A prediction model based on logistic regression for major hepatectomy tolerance (ICG-R15 ≥ 14%) was established. RESULTS: Patients were assigned to either the ICG-R15 < 14% (n = 50) or ICG-R15 ≥ 14% (n = 19) group. Liver c (r = 0.617) and φ (r = 0.517) were positively correlated with the ICG-R15 (both p < 0.001). At fibrosis stages F1-2, φ was positively correlated with the ICG-R15 (r = 0.528; p = 0.017), but c was not (p = 0.104). At stages F3-4, c (r = 0.642; p < 0.001) and φ (r = 0.377; p = 0.008) were both positively correlated with the ICG-R15. The optimal cutoffs of c and φ for predicting ICG-R15 ≥ 14% were 2.04 m/s and 0.79 rad, respectively. The area under the receiver operating characteristic curve was higher for c (0.892) than for φ (0.779; p = 0.045). CONCLUSIONS: Liver stiffness and fluidity, quantified by tomoelastography, were correlated with liver function and may be used clinically to noninvasively assess liver function reserve and stratify treatments.

Added Value of Viscoelasticity for MRI-Based Prediction of Ki-67 Expression of Hepatocellular Carcinoma Using a Deep Learning Combined Radiomics (DLCR) Model.

This study aimed to explore the added value of viscoelasticity measured by magnetic resonance elastography (MRE) in the prediction of Ki-67 expression in hepatocellular carcinoma (HCC) using a deep learning combined radiomics (DLCR) model. This retrospective study included 108 histopathology-proven HCC patients (93 males; age, 59.6 ± 11.0 years) who underwent preoperative MRI and MR elastography. They were divided into training (n = 87; 61.0 ± 9.8 years) and testing (n = 21; 60.6 ± 10.1 years) cohorts. An independent validation cohort including 43 patients (60.1 ± 11.3 years) was included for testing. A DLCR model was proposed to predict the expression of Ki-67 with cMRI, including T2W, DW, and dynamic contrast enhancement (DCE) images as inputs. The images of the shear wave speed (c-map) and phase angle (φ-map) derived from MRE were also fed into the DLCR model. The Ki-67 expression was classified into low and high groups with a threshold of 20%. Both c and φ values were ranked within the top six features for Ki-67 prediction with random forest selection, which revealed the value of MRE-based viscosity for the assessment of tumor proliferation status in HCC. When comparing the six CNN models, Xception showed the best performance for classifying the Ki-67 expression, with an AUC of 0.80 ± 0.03 (CI: 0.79-0.81) and accuracy of 0.77 ± 0.04 (CI: 0.76-0.78) when cMRI were fed into the model. The model with all modalities (MRE, AFP, and cMRI) as inputs achieved the highest AUC of 0.90 ± 0.03 (CI: 0.89-0.91) in the validation cohort. The same finding was observed in the independent testing cohort, with an AUC of 0.83 ± 0.03 (CI: 0.82-0.84). The shear wave speed and phase angle improved the performance of the DLCR model significantly for Ki-67 prediction, suggesting that MRE-based c and φ-maps can serve as important parameters to assess the tumor proliferation status in HCC.

Orchestration of ethylene and gibberellin signals determines primary root elongation in rice.

Primary root growth in cereal crops is fundamental for early establishment of the seedling and grain yield. In young rice (Oryza sativa) seedlings, the primary root grows rapidly for 7-10 days after germination and then stops; however, the underlying mechanism determining primary root growth is unclear. Here, we report that the interplay of ethylene and gibberellin (GA) controls the orchestrated development of the primary root in young rice seedlings. Our analyses advance the knowledge that primary root growth is maintained by higher ethylene production, which lowers bioactive GA contents. Further investigations unraveled that ethylene signaling transcription factor ETHYLENE INSENSITIVE3-LIKE 1 (OsEIL1) activates the expression of the GA metabolism genes GIBBERELLIN 2-OXIDASE 1 (OsGA2ox1), OsGA2ox2, OsGA2ox3, and OsGA2ox5, thereby deactivating GA activity, inhibiting cell proliferation in the root meristem, and ultimately gradually inhibiting primary root growth. Mutation in OsGA2ox3 weakened ethylene-induced GA inactivation and reduced the ethylene sensitivity of the root. Genetic analysis revealed that OsGA2ox3 functions downstream of OsEIL1. Taken together, we identify a molecular pathway impacted by ethylene during primary root elongation in rice and provide insight into the coordination of ethylene and GA signals during root development and seedling establishment.

Highly Expressed CYBRD1 Associated with Glioma Recurrence Regulates the Immune Response of Glioma Cells to Interferon.

Invasiveness, resistance to treatment, and recurrence of gliomas are significant hurdles to successful treatment regimens. Data sets from Gene Expression Omnibus (GEO), CGGA-RNAseq, and The Cancer Genome Atlas Glioblastoma Multiforme (TCGA-GBM) were analyzed, and an increased expression of Cytochrome B Reductase 1 (CYBRD1) was identified and could be associated with aggravated clinical outcomes. Gene ontology (GO) enrichment analysis indicated that CYBRD1 co-expressed genes are enriched during an immune response. CYBRD1 overexpression in glioma cell lines is enhanced, whereas CYBRD1 silencing attenuated the aggressiveness of glioma cells. In IFN-α-treated glioma cells, IFN-α suppressed the viability and migratory ability and invasive ability of glioma cells, whereas CYBRD1 overexpression attenuated the antitumor effects of IFN-α. CYBRD1 could potentially serve as a biomarker for glioma recurrence. CYBRD1 overexpression enhances glioma cell aggressiveness and attenuates glioma cell response to IFN-α.