Effect of Tea Polyphenols on Nuclear Factor Erythroid 2-related Factor 2 (NRF2) and Kelch-like ECH-associated Protein 1 (KEAP1) Gene Expression in Mice with Acute Cadmium Poisoning.

Background: Cadmium poisoning is mainly caused by inhalation of cadmium dust or cadmium compound dust, which greatly harms people's lives. Tea polyphenols extracted from green tea have wide biological properties, including anti-cardiovascular disease, anti-tumor, anti-inflammatory, and immune regulation. The transcription factor nuclear factor erythroid 2-related factor 2 (NRF2) and Kelch-like ECH-associated protein 1 (KEAP1) are involved in the regulation of cadmium-induced oxidative damage. However, whether tea polyphenols relieve acute cadmium poisoning via regulating NRF2 and KEAP1 gene expression remains unclear. Objective: To explore the influences of tea polyphenols on NRF2 and KEAP1 gene expression in mice with acute cadmium poisoning. Design: This is an animal experiment that adopts hematoxylin and eosin (HE) staining and immunohistochemistry (IHC) staining. Setting: This study was carried out in Zunyi Medical and Pharmaceutical College. Participants: Fifty specific pathogen-free (SPF) male Kunming mice aged 9 weeks, weighing 18-22 g were divided into five groups: normal group, model group, low-dose tea polyphenols group, middle-dose tea polyphenols group, and high-dose tea polyphenols group. Interventions: Tea polyphenols were administered intraastrically into mice with doses of 50 mg/kg, 100 mg/kg, and 200 mg/kg for 10 consecutive days, respectively. Observation indicators: (1) liver coefficient, (2) pathological liver injury, (3) liver function, (4) oxidative damage, and (5) NRF2 and KEAP1 gene expression. Results: The liver coefficient, pathological liver injury, serum aspartate transaminase and alanine transaminase levels of the model group were higher relative to the normal group (P < .05). Relative to the model group, different doses of tea polyphenols treatment significantly relieved liver coefficient, pathological liver injury, serum aspartate transaminase, and alanine transaminase levels (P < .05). Malondialdehyde content in liver tissues of the model group was significantly higher compared to the normal group, while glutathione together with glutathione peroxidase contents of the model group was lower (P < .05). Compared to the model group, malondialdehyde content in liver tissues declined while glutathione together with glutathione peroxidase contents were elevated after different doses of tea polyphenols treatment (P < .05). Relative to the normal group, NRF2 expression in the liver tissues of the model group was significantly lower, while KEAP1 expression was higher (P < .05). Relative to the model group, NRF2 expression in the liver tissues was elevated after treatment of different doses of tea polyphenols, while KEAP1 expression was declined (P < .05). Conclusion: Tea polyphenols can relieve liver injury in mice with acute cadmium poisoning by regulating NRF2 and KEAP1 expression. Our study might provide a promising treatment strategy for acute cadmium poisoning.

The effect of different flushing and locking techniques on catheter occlusion rates in central venous catheters: protocol for a multicentre, randomized controlled, parallel-group, open-label, superiority clinical trial.

BACKGROUND: Maintaining venous access is of great clinical importance. Running a slow continuous infusion to keep the vein open (KVO) is often used in peripheral intravenous catheters (PIVCs). Previous studies have compared the effects of intermittent flushing and continuous infusion via peripherally inserted central catheters (PICCs). In this study, we applied KVO to central venous catheters (CVCs) and compared the occlusion rate of this technique with that of the intermittent flushing technique. METHOD: This is a randomized controlled trial of 14 hospitals in China. A total of 250 patients will be recruited in this study, and they will be randomized at a 1:1 ratio. After study inclusion, patients who will undergo CVC insertion will receive intermittent flushing with prefilled saline syringes (control group) or KVO infusion with elastic pumps (test group). All the catheters will be checked for patency by scoping Catheter Injection and Aspiration (CINAS) Classification on Days 3 and 7. The primary outcome is the rate of catheter occlusion in 7 days. Patients will be followed up until 9 days after CVC insertion, catheter occlusion, or catheter removal. The secondary outcomes are the rate of catheter occlusion in 3 days, nurse satisfaction, cost-effectiveness, adverse event rate, catheter-related bloodstream infection rate, catheter-related thrombosis rate, extravasation rate, phlebitis rate, and catheter migration. DISCUSSION: We expect that the trial will generate findings that can provide an evidence-based basis for the improvement and optimization of clinical catheter flushing techniques. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2200064007. Registered on 23 September 2022. https://www.chictr.org.cn/showproj.html?proj=177311 .

A Pump-Free Strategy for the Controllable Generation of Alginate Microgels as Cellular Microcarriers.

Microgels are advanced scaffolds for tissue engineering due to their proper biodegradability, good biocompatibility, and high specific surface area for effective oxygen and nutrient transfer. However, most of the current monodispersed microgel fabrication systems rely heavily on various precision pumps, which highly increase the cost and complexity of their downstream application. In this work, we developed a simple and facile system for the controllable generation of uniform alginate microgels by integrating a gas-shearing strategy into a glass microfluidic device. Importantly, the cell-laden microgels can be rapidly prepared in a pump-free manner under an all-aqueous environment. The three-dimensional cultured green fluorescent protein-human A549 cells in alginate microgels exhibited enhanced stemness and drug resistance compared to those under two-dimensional conditions. The pancreatic cancer organoids in alginate microgels exhibited some of the key features of pancreatic cancer. The proposed microgels showed decent monodispersity, biocompatibility, and versatility, providing great opportunities in various biomedical applications such as microcarrier fabricating, organoid engineering, and high-throughput drug screening.

Enhanced hypoglycemic effects of konjac glucomannan combined with Polygonatum cyrtonema Hua polysaccharide in complete nutritional liquid diet fed type 2 diabetes mice.

In our aging society, dysphagia and malnutrition are growing concerns, necessitating intervention. Liquid nutrition support offers a practical solution for traditional dietary issues, but it raises a key issue: the potential for post-meal glucose spikes impacting efficacy. This study examined the effects of supplementation of Polygonatum cyrtonema Hua polysaccharide (PCP), konjac glucomannan (KGM) and their combination on acute phase postprandial glycemic response and long-term glucose metabolism in T2DM mice on a complete nutritional liquid diet. KGM was more effective in reducing postprandial glucose response, while PCP was more prominent in ameliorating long-term glucose metabolism. The KGM-PCP combination demonstrated superior outcomes in fasting blood glucose, insulin, and glucose homeostasis. PCP and KGM also influenced the composition and abundance of the gut microbiome, with the H-PCP group showing optimal performance. Moreover, the KGM-PCP combination improved body weight, lipid homeostasis, and liver health the most. PCP potentially regulates glycemia through metabolic pathways, while KGM improves glycemic metabolism by reducing postprandial glucose levels in response to viscous intestinal contents. This research identifies the structure, viscosity properties, and hypoglycemic effects of KGM and PCP in complete nutritional liquid diet fed T2DM mice, enabling their strategic utilization as hypoglycemic components in nutritional administration and glycemic regulation.

SMMF: a self-attention-based multi-parametric MRI feature fusion framework for the diagnosis of bladder cancer grading.

Background: Multi-parametric magnetic resonance imaging (MP-MRI) may provide comprehensive information for graded diagnosis of bladder cancer (BCa). Nevertheless, existing methods ignore the complex correlation between these MRI sequences, failing to provide adequate information. Therefore, the main objective of this study is to enhance feature fusion and extract comprehensive features from MP-MRI using deep learning methods to achieve an accurate diagnosis of BCa grading. Methods: In this study, a self-attention-based MP-MRI feature fusion framework (SMMF) is proposed to enhance the performance of the model by extracting and fusing features of both T2-weighted imaging (T2WI) and dynamic contrast-enhanced imaging (DCE) sequences. A new multiscale attention (MA) model is designed to embed into the neural network (CNN) end to further extract rich features from T2WI and DCE. Finally, a self-attention feature fusion strategy (SAFF) was used to effectively capture and fuse the common and complementary features of patients' MP-MRIs. Results: In a clinically collected sample of 138 BCa patients, the SMMF network demonstrated superior performance compared to the existing deep learning-based bladder cancer grading model, with accuracy, F1 value, and AUC values of 0.9488, 0.9426, and 0.9459, respectively. Conclusion: Our proposed SMMF framework combined with MP-MRI information can accurately predict the pathological grading of BCa and can better assist physicians in diagnosing BCa.

Blood Urea Nitrogen to Serum Albumin Ratio as A New Prognostic Indicator in Critically Ill Patients with Diabetic Ketoacidosis: A Retrospective Cohort Study.

OBJECTIVE: To investigate the predictive value of the blood urea nitrogen to serum albumin ratio for in-hospital and out-of-hospital mortality in critically ill patients with diabetic ketoacidosis. METHODS: Data were obtained from the Medical Information Mart for Intensive Care III (MIMIC III) database, and all eligible participants were categorized into two groups based on the BAR cutoff value. Multiple logistic regression analysis was conducted to determine the association between BAR and in-hospital mortality. The Kaplan-Meier (K-M) analysis was performed to evaluate the predictive performance of BAR. Propensity score matching (PSM) was applied to control confounding factors between the low and high BAR groups. RESULTS: A total of 589 critically ill patients with diabetic ketoacidosis were enrolled. Patients with diabetic ketoacidosis with a higher BAR level were associated with higher in- and out-hospital mortality (all p<0.001). A significant 4-year survival difference was observed between the low and high BAR groups (p<0.0001). After PSM analysis, two PSM groups (202 pairs, n=404) were generated, and similar results were observed in the K-M curve (p<0.0001). DISCUSSION: Elevated BAR levels were associated with an increased risk of in-hospital mortality in critically ill patients with diabetic ketoacidosis, and BAR could serve as an independent prognostic factor in in-hospital and out-of-hospital mortality for patients diagnosed with diabetic ketoacidosis.

Clinical characteristics and prognostic analysis of postoperative recurrence or metastasis of low-risk gastrointestinal stromal tumors.

BACKGROUND: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive tract. This study aimed to investigate the clinical characteristics and prognosis of postoperative recurrence or metastasis in patients with low-risk stromal tumors, in order to take individualized postoperative management and treatment for patients with low-risk GISTs with relatively high recurrence. METHODS: We retrospectively analyzed the clinicopathological and follow-up data of patients with GISTs who underwent surgical resection in Nanjing Drum Tower Hospital from March 2010 to December 2021. A total of 282 patients with low-risk GISTs were included, none of whom were treated with imatinib. Univariate and multivariate Cox analysis and survival curves were used to explore the relationship between clinical features and recurrence or metastasis in patients with low-risk GISTs. RESULTS: Of the 282 patients with low-risk GISTs who met inclusion criteria, 14 (4.96%) had recurrence or metastasis. There was a correlation between tumor size, primary site, resection type, Ki67 index, neutrophil lymphocyte ratio (NLR) and CD34 expression and postoperative recurrence or metastasis of GISTs (P < 0.05). Subsequently, multifactorial analysis showed that tumor primary site, tumor size, and Ki67 index were independent risk factors affecting postoperative recurrent or metastasis in patients with low-risk GISTs (P < 0.05). Ultimately, According to Kaplan-Meier analysis, non-gastric primary tumors, larger tumors, and high Ki67 index were significantly associated with poor progression-free survival ( PFS ). CONCLUSIONS: Tumor location, tumor size and Ki-67 were independent risk factors for postoperative recurrence and metastasis in patients with low-risk GISTs. Based on the 2008 modified NIH recurrence risk grading system, combined with the above three factors, it can be used to evaluate the prognosis of patients with low-risk GISTs and provide personalized postoperative review and follow-up management recommendations.

Effects of the low-speed continuous infusion catheter technique on double-lumen central venous catheters: A randomized controlled trial.

BACKGROUND: Central venous catheters are widely used in clinical practice, and the incidence of central venous catheter occlusion is between 25 % and 38 %. The turbulence caused by the pulsatile flushing technique is harmful to the vascular endothelium and may lead to phlebitis. The low-speed continuous infusion catheter technique is a new type of continuous infusion that ensures that the catheter is always in a keep-vein-open state by continuous low-speed flushing; hence, avoiding the problem of catheter occlusion. OBJECTIVE: To investigate the effectiveness of the low-speed continuous infusion catheter technique and the routine care of double-lumen central venous catheters. DESIGN: This was a prospective, randomized, controlled, open-label trial. SETTING: Patients were recruited from 14 medical institutions in China between February and June 2023. PARTICIPANTS: In total, 251 patients were recruited, with 125 in the intervention group and 126 in the control group. METHODS: Patients who used double-lumen central venous catheters for infusion treatment were selected, and those who met the sampling criteria were randomly divided into intervention and control groups using the random envelope method. The intervention group used the low-speed continuous infusion catheter technique to maintain catheter patency, whereas the control group used routine care with a trial period of 7 days. The primary outcome was the occlusion rate. The secondary outcomes included nursing satisfaction and complication rates of the two groups. RESULTS: After 7 days, the rate of catheter occlusion was 28.0 % (35/125, 95 % confidence interval (CI):0.203, 0.367) in the intervention group and 53.97 % (68/126, 95 % CI: 0.449-0.629) in the control group, with a statistically significant difference (χ2 = 17.488, p < 0.001); at 3 days of intervention, the rate of catheter blockage was 8.0 % (10/125, 95 % CI: 0.039-0.142) in the intervention group and 23.8 % (30/126, 0.167-0.322) in the control group, with a statistically significant difference (χ2 = 11.707, p < 0.001). Nurse satisfaction was significantly higher in the intervention group (115/125, 92.0 %, 95 % CI: 0.858-0.961) than in the control group (104/126, 82.54 %, 95 % CI: 0.748-0.887) (χ2 = 5.049, p = 0.025). There were no statistically significant complication rates in either group (p = 0.622). CONCLUSION: The low-speed continuous infusion catheter technique helps maintain catheter patency, improves nurse satisfaction, and provides a high level of safety. REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2200064007, www.chictr.org.cn). The first recruitment was conducted in February. https://www.chictr.org.cn/showproj.html?proj=177311.

Identification of concurrent STAT3::RARA and RARA::STAT5b fusions in a variant APL case.

Acute promyelocytic leukemia (APL) with typically PML::RARA fusion gene caused by t (15;17) (q22; q12) was distinguished from other types of acute myeloid leukemia. In a subset of patients with APL, t (15;17) (q22;q21) and PML::RARA fusion cannot be detected. In this report, we identified the coexistence of STAT3::RARA and RARA::STAT5b fusions for the first time in a variant APL patient lacking t (15;17)(q22;q21)/PML::RARA fusion. Then, this patient was resistant to all-trans retinoic acid combined arsenic trioxide chemotherapy. Accurate detection of RARA gene partners is crucial for variant APL, and effective therapeutic regime is urgently needed.

GSTM2 alleviates heart failure by inhibiting DNA damage in cardiomyocytes.

BACKGROUND: Heart failure (HF) seriously threatens human health worldwide. However, the pathological mechanisms underlying HF are still not fully clear. RESULTS: In this study, we performed proteomics and transcriptomics analyses on samples from human HF patients and healthy donors to obtain an overview of the detailed changes in protein and mRNA expression that occur during HF. We found substantial differences in protein expression changes between the atria and ventricles of myocardial tissues from patients with HF. Interestingly, the metabolic state of ventricular tissues was altered in HF samples, and inflammatory pathways were activated in atrial tissues. Through analysis of differentially expressed genes in HF samples, we found that several glutathione S-transferase (GST) family members, especially glutathione S-transferase M2-2 (GSTM2), were decreased in all the ventricular samples. Furthermore, GSTM2 overexpression effectively relieved the progression of cardiac hypertrophy in a transverse aortic constriction (TAC) surgery-induced HF mouse model. Moreover, we found that GSTM2 attenuated DNA damage and extrachromosomal circular DNA (eccDNA) production in cardiomyocytes, thereby ameliorating interferon-I-stimulated macrophage inflammation in heart tissues. CONCLUSIONS: Our study establishes a proteomic and transcriptomic map of human HF tissues, highlights the functional importance of GSTM2 in HF progression, and provides a novel therapeutic target for HF.

Stem cell antigen-1+cell-derived fibroblasts are crucial for cardiac fibrosis during heart failure.

AIMS: Mesenchymal stem cells (MSCs) present in the heart cannot differentiate into cardiomyocytes, but may play a role in pathological conditions. Therefore, the aim of this study was to scrutinise the role and mechanism of MSC differentiation in vivo during heart failure. METHODS AND RESULTS: We performed single-cell RNA sequencing of total non-cardiomyocytes from murine and adult human hearts. By analysing the transcriptomes of single cells, we illustrated the dynamics of the cell landscape during the progression of heart hypertrophy, including those of stem cell antigen-1 (Sca1)+ stem/progenitor cells and fibroblasts. By combining genetic lineage tracing and bone marrow transplantation models, we demonstrated that non-bone marrow-derived Sca1+ cells give rise to fibroblasts. Interestingly, partial depletion of Sca1+ cells alleviated the severity of myocardial fibrosis and led to a significant improvement in cardiac function in Sca1-CreERT2;Rosa26-eGFP-DTA mice. Similar non-cardiomyocyte cell composition and heterogeneity were observed in human patients with heart failure. Mechanistically, our study revealed that Sca1+ cells can transform into fibroblasts and affect the severity of fibrosis through the Wnt4-Pdgfra pathway. CONCLUSIONS: Our study describes the cellular landscape of hypertrophic hearts and reveals that fibroblasts derived from Sca1+ cells with a non-bone marrow source largely account for cardiac fibrosis. These findings provide novel insights into the pathogenesis of cardiac fibrosis and have potential therapeutic implications for heart failure. Non-bone marrow-derived Sca1+ cells differentiate into fibroblasts involved in cardiac fibrosis via Wnt4-PDGFRα pathway.

Novel mesothelin-targeted chimeric antigen receptor-modified UNKT cells are highly effective in inhibiting tumor progression.

The design of chimeric antigen receptors (CAR) significantly enhances the antitumor efficacy of T cells. Although some CAR-T products have been approved by FDA in treating hematological tumors, adoptive immune therapy still faces many difficulties and challenges in the treatment of solid tumors. In this study, we reported a new strategy to treat solid tumors using a natural killer-like T (NKT) cell line which showed strong cytotoxicity to lyse 15 cancer cell lines, safe to normal cells and had low or no Graft-versus-host activity. We thus named it as universal NKT (UNKT). In both direct and indirect 3D tumor-like organ model, UNKT showed efficient tumor-killing properties, indicating that it could penetrate the microenvironment of solid tumors. In mesothelin (MSLN)-positive tumor cells (SKOV-3 and MCF-7), MSLN targeting CAR modified-UNKT cells had enhanced killing potential against MSLN positive ovarian cancer compared with the wild type UNKT, as well as MSLN-CAR-T cells. Compared with CAR-T, Single-cell microarray 32-plex proteomics revealed CAR-UNKT cells express more effector cytokines, such as perforin and granzyme B, and less interleukin-6 after activation. Moreover, our CAR-UNKT cells featured in more multifunctionality than CAR-T cells. CAR-UNKT cells also demonstrated strong antitumor activity in mouse models of ovarian cancer, with the ability to migrate and infiltrate the tumor without inducing immune memory. The fast-in and -out, enhanced and prolonged tumor killing properties of CAR-UNKT suggested a novel cure option of cellular immunotherapy in the treatment of MSLN-positive solid tumors.

Molecular characteristics in Chinese with chronic lymphocytic leukemia by next-generation sequencing: A single-center retrospective analysis.

INTRODUCTION: Although the prevalence of Asian chronic lymphocytic leukemia (CLL) patients is not as high as that of Caucasians, there are more atypical CLLs in Asia whose genetic characteristics and their clinical significance are distinct and remain unclear. METHODS: A retrospective analysis of 85 CLL samples in our center was conducted from 2019 to 2022. We used next-generation sequencing with a 172 gene panel to explore the multi-gene mutational data and the mutational status of immunoglobulin heavy variable (IGHV) gene. RESULTS: MYD88 (20.0%) was the most frequently mutated gene, much higher than in Europe, followed in order by TP53 (18.8%), NOTCH1 (14.1%), IGLL5 (11.8%), and DNMT3A (8.2%). In addition, the incidence of ATM and SF3B1 mutations was relatively lower in our centre compared to Europe. Mutated (M)-IGHV patients were more likely to have a cooccurrence of MYD88 mutation, while complex karyotype and DNMT3A mutation were more common in the unmutated (U)-IGHV group. MYD88 mutated CLL was characterized by prevalence in young males in high-risk staging, with isolated 13q deletion and concomitant mutation of IGLL5. CLL patients with MYD88 and TP53 mutation showed an unfavorable prognosis. CONCLUSION: These results would be valuable in helping to understand the characteristics and significance of cytogenetic genetics in Chinese patients with CLL.

Controlling Nutritional Status (CONUT) score as a prognostic marker for gastrointestinal stromal tumours.

BACKGROUND: The Controlling Nutritional Status (CONUT) score, regarded as the effective indicator of patient nutrition, has been demonstrated to be related to prognosis of numerous tumours. Nevertheless, the significance of CONUT for gastrointestinal stromal tumour (GIST) remains unclear. This study intended to clarify the association between CONUT and the prognosis of GISTs. METHODS: Three hundred and fifty-five patients with GISTs undergoing surgical resection at our center were retrospectively assessed. Receiver operating characteristic curve analysis was used to help determine the cut-off value of CONUT score. Relapse-free survival (RFS) and overall survival (OS) were assessed by Kaplan-Meier curve analysis. Prognostic factors for RFS and OS were examined by Cox proportional hazards models. RESULTS: A total of 355 patients were enrolled in this study. Areas under the curve (AUC) were 0.638 for CONUT score, and the cut-off value of CONUT was shown to be three. Kaplan-Meier curve analysis showed that high CONUT score was linked to poorer RFS and OS. Univariate and multivariate analyses ultimately revealed that CONUT was a risk factor for RFS and OS, independent of demographics and clinicopathological tumour characteristics. CONCLUSIONS: CONUT score was an effective and novel predictor for prognosis of GIST patients treated with surgery, indicating its potential as a prognostic marker in the overall management.

Forms of nitrogen inputs regulate the intensity of soil acidification.

Soil acidification induced by reactive nitrogen (N) inputs can alter the structure and function of terrestrial ecosystems. Because different N-transformation processes contribute to the production and consumption of H+ , the magnitude of acidification likely depends on the relative amounts of organic N (ON) and inorganic N (IN) inputs. However, few studies have explicitly measured the effects of N composition on soil acidification. In this study, we first conducted a meta-analysis to test the effects of ON or IN inputs on soil acidification across 53 studies in grasslands. We then compared soil acidification across five different ON:IN ratios and two input rates based on long-term field N addition experiments. The meta-analysis showed that ON had weaker effects on soil acidification than IN when the N addition rate was above 20 g N m-2 year-1 . The field experiment confirmed the findings from meta-analysis: N addition with proportions of ON ≥ 20% caused less soil acidification, especially at a high input rate (30 g N m-2 year-1 ). Structural equation model analysis showed that this result was largely due to a relatively low rate of H+ production from ON as NH3 volatilization and uptake of ON and NH4 + by the dominant grass species Leymus chinensis (which are both lower net contributors to H+ production) result in less NH4 + available for nitrification (which is a higher net contributor to H+ production). These results indicate that the evaluation of soil acidification induced by N inputs should consider N forms and manipulations of relative composition of N inputs may provide an effective approach to alleviate the N-induced soil acidification.

Prognostic analysis of 2-5 cm diameter gastric stromal tumors with exogenous or endogenous growth.

BACKGROUND: There has been limited research on the prognosis differences in patients with gastric stromal tumor invasion of the plasma membrane surface. This study intended to investigate whether there is a difference in prognosis in patients with endogenous or exogenous 2-5 cm diameter GISTs. METHODS: We retrospectively analyzed the clinicopathological and follow-up data of gastric stromal tumor patients, all of whom underwent surgical resection for primary GIST at Nanjing Drum Tower Hospital from December 2010 to February 2022. We classified patients based on tumor growth patterns and then investigated the association between tumor growth patterns and clinical outcomes. Progression-free survival (PFS) and overall survival (OS) were calculated by the Kaplan‒Meier method. RESULTS: A total of 496 gastric stromal tumor patients were enrolled in this study, among which 276 patients had tumors of 2-5 cm in diameter. Of these 276 patients, 193 had exogenous tumors, and 83 had endogenous tumors. Tumor growth patterns were significantly related to age, rupture status, resection style, tumor site, tumor size, and intraoperative bleeding. According to Kaplan‒Meier curve analysis, the tumor growth pattern among patients with 2-5 cm diameter tumors was significantly correlated with worse progression-free survival (PFS). Ultimately, multivariate analyses identified the Ki-67 index (P = 0.008), surgical history (P = 0.031), and resection style (P = 0.045) as independent prognostic markers for PFS. CONCLUSIONS: Although gastric stromal tumors with a diameter of 2-5 cm are classified as low risk, the prognosis is lower for exogenous tumors than for endogenous tumors, and exogenous gastric stromal tumors have a risk of recurrence. Consequently, clinicians should be vigilant regarding the prognosis of patients with this type of tumor.

Charge Carrier Recombination Dynamics in MAPb(BrxCl1-x)3 Single Crystals.

Understanding carrier recombination processes in MAPb(BrxCl1-x)3 crystals is essential for their photoelectrical applications. In this work, carrier recombination dynamics in MAPb(BrxCl1-x)3 single crystals were studied by steady-state photoluminescence (PL), time-resolved photoluminescence (TRPL), and time-resolved microwave photoconductivity (TRMC). By comparing TRPL and TRMC, we find TRPL of MAPb(BrxCl1-x)3 (x < 0.98) single crystals is dominated by a hole trapping process while the long-lived component of TRMC is dominated by an electron trapping process. We also find both electron and hole trapping rates of MAPb(BrxCl1-x)3 (x < 0.98) crystals decrease with an increase in Br content. A temperature-dependent PL study shows there are shallow trap states besides the deep level trap states in the MAPb(Br0.82Cl0.18)3 crystal. The activation energy for holes in shallow trap states detrapped into the valence band is ∼0.1 eV, while the activation energy for free holes to be trapped into deep trap states is ∼0.4 eV. This work provides insight into carrier recombination processes in MAPb(BrxCl1-x)3 single crystals.