Evaluation of Stripe Rust Resistance and Chip Detection Resistance Genes in 286 Xinjiang Wheat Cultivars and Breeding Lines.

Wheat stripe rust is a destructive disease worldwide, caused by Puccinia striiformis f. sp. tritici (Pst). Resistance breeding is the most effective method of controlling stripe rust. Xinjiang is a relatively independent epidemic region of wheat stripe rust in China. In recent years, wheat stripe rust in this area has shown an upward trend. Therefore, the purpose of this study was to evaluate the resistance level of wheat cultivars (lines) to the prevalent Pst races and determine the genetic background of stripe rust resistance genes in Xinjiang. Six predominant Pst races in China were used to study resistance of 286 wheat cultivars (lines) at both seedling under controlled conditions and adult-plant stages under field conditions. In the seedling tests, 175 (61.19%) entries were resistant to races CYR23, 125 (43.71%) to CYR29, 153 (53.50%) to CYR31, 88 (30.77%) to CYR32, 174 (60.84%) to CYR33, and 98 (34.27%) to CYR34. Among the resistant entries, 23 (8.04%) were resistant to all six races. In the field test, 135 (47.20%) entries were resistant to the tested mixed races. Through comparing the responses in the seedling and adult-plant stages, 109 (38.11%) entries were found to have adult-plant resistance (APR), and 14 (4.90%) entries have all-stage resistance (ASR). The 286 wheat entries were also tested using a wheat breeder chip containing 12 Yr resistance loci. Among these entries, 44 (15.38%) were found to have single gene, 221 (77.27%) have two or more genes, and 21 (7.34%) have none of the 12 genes, including 144 (50.35%) with Yr30 and 5 (1.75%) with YrSP. Entries with two or more genes have stronger resistance to Pst. Overall, the majority of entries have all-stage and/or adult-plant resistance, but their genes for resistance in addition to the 12 tested Yr genes need to be determined. It is also necessary to introduce more effective resistance genes in the breeding programs to improve stripe rust resistance in wheat cultivars in Xinjiang.

Nonfused Ring Electron Acceptors for Ternary Polymer Solar Cells with Low Energy Loss and Efficiency Over 18.

Ternary polymer solar cells(PSCs) have been identified as an effective approach to improving power conversion efficiency (PCE) of binary PSCs. However, most of the third component, especially Y-series non-fullerene acceptors, is a fused ring acceptor which often requires a rather tedious synthesis and the use of hazardous organostannane reagents. In this work, two nonfused ring acceptors IOEH-4F and IOEH-N2F are synthesized by a green synthetic route and incorporated into PM6:Y6 blend. Encouragingly, the IOEH-4F and IOEH-N2F-based ternary PSCs exhibited more efficient charge transfer, exciton separation, and lower energy loss than PM6:Y6-based PSCs. And the IOEH-4F and IOEH-N2F-based ternary PSCs achieved an impressive PCE of 17.80% and 18.13%, respectively, which are higher than that of PM6:Y6 based PSCs (16.18%). Notably, these PCE values are also the highest PCEs for ternary PSCs including non-fused ring acceptors. Importantly, even when the IOEH-N2F:Y6 ratios increased from 0.05:1.2 to 0.50:1.2, the PCE of IOEH-N2F-based ternary PSCs (16.70%) are still higher than that of PM6:Y6 based PSCs, indicating the great potential for cost saving. It is believed that the findings will help the design of better nonfused ring acceptors and the optimization of corresponding ternary PSCs with cost-saving advantage.

Comparative diagnostic performance of contrast-enhanced ultrasound and dynamic contrast-enhanced magnetic resonance imaging for differentiating clear cell and non-clear cell renal cell carcinoma.

OBJECTIVE: To compare the diagnostic efficiency of contrast-enhanced ultrasound (CEUS) with that of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for the differential diagnosis of clear and non-clear cell renal cell carcinoma, as confirmed by subsequent pathology. METHODS: A total of 181 patients with 184 renal lesions diagnosed by both CEUS and DCE-MRI were enrolled in the study, including 136 clear cell renal cell carcinoma (ccRCC) and 48 non-clear cell renal cell carcinoma (non-ccRCC) tumors. All lesions were confirmed by histopathologic diagnosis after surgical resection. Interobserver agreement was estimated using a weighted kappa statistic. Diagnostic efficiency in evaluating ccRCC and non-ccRCC was compared between CEUS and DCE-MRI. RESULTS: The weighted kappa value for interobserver agreement was 0.746 to 0.884 for CEUS diagnosis and 0.764 to 0.895 for DCE-MRI diagnosis. Good diagnostic performance in differential diagnosis of ccRCC and non-ccRCC was displayed by both CEUS and DCE-MRI: sensitivity was 89.7% and 91.9%, respectively; specificity was 77.1% and 68.8%, respectively; and area under the receiver operating curve was 0.834 and 0.803, respectively. No statistically significant differences were present between the two methods (p = 0.54). CONCLUSIONS: Both CEUS and DCE-MRI imaging are effective for the differential diagnosis of ccRCC and non-ccRCC. Thus, CEUS could be an alternative to DCE-MRI as a first test for patients at risk of renal cancer, particularly where DCE-MRI cannot be carried out. KEY POINTS: • CEUS and DCE-MRI features can help differentiate ccRCC and non-ccRCC. • The differential diagnosis of ccRCC and non-ccRCC by CEUS is comparable to that of DCE-MRI. • Interobserver agreement is generally high using CEUS and DCE-MRI.

Psychometric Properties of the Chinese Warwick-Edinburgh Mental Well-being Scale in Medical Staff: Cross-sectional Study.

BACKGROUND: Worldwide, mental well-being is a critical issue for public health, especially among medical staff; it affects professionalism, efficiency, quality of care delivery, and overall quality of life. Nevertheless, assessing mental well-being is a complex problem. OBJECTIVE: This study aimed to evaluate the psychometric properties of the Chinese-language version of the 14-item Warwick-Edinburgh Mental Well-being Scale (WEMWBS) in medical staff recruited mainly from 6 hospitals in China and provide a reliable measurement of positive mental well-being. METHODS: A cross-sectional online survey was conducted of medical staff from 15 provinces in China from May 15 to July 15, 2020. Confirmatory factor analysis (CFA) was conducted to test the structure of the Chinese WEMWBS. The Spearman correlations of the Chinese WEMWBS with the 5-item World Health Organization Well-Being Index (WHO-5) were used to evaluate convergent validity. The Cronbach α and split-half reliability (λ) represented internal consistency. A graded response model was adopted for an item response theory (IRT) analysis. We report discrimination, difficulty, item characteristic curves (ICCs), and item information curves (IICs). ICCs and IICs were used to estimate reliability and validity based on the IRT analysis. RESULTS: A total of 572 participants from 15 provinces in China finished the Chinese WEMWBS. The CFA showed that the 1D model was satisfactory and internal consistency reliability was excellent, with α=.965 and λ=0.947, while the item-scale correlation coefficients ranged from r=0.727 to r=0.900. The correlation coefficient between the Chinese WEMWBS and the WHO-5 was significant, at r=0.746. The average variance extraction value was 0.656, and the composite reliability value was 0.964, with good aggregation validity. The discrimination of the Chinese WEMWBS items ranged from 2.026 to 5.098. The ICCs illustrated that the orders of the category thresholds for the 14 items were satisfactory. CONCLUSIONS: The Chinese WEMWBS showed good psychometric properties and can measure well-being in medical staff.

Analysis of Adhesion at the Interface of Steamed Bread and Eggshell.

The adhesion phenomenon of polymers occurs in nature and in human activity. In the present paper, an adhesion system of steamed bread and eggshell was observed in formation when steamed bread and eggshells were placed in close contact and cooled slightly in the ambient air. The adhesion phenomena and mechanism of the adhesion interface between the steamed bread and eggshell were investigated and systematically discussed. Strong-bond interfaces were observed by scanning electron microscope (SEM). The formation process and mechanism of the strong-bond adhesion were also analyzed molecular dynamics simulation technology, and the results are discussed. The simulation analyses showed that the starch molecules at the calcite (104) crystal face were diffused in a water vapor environment, and the formation and solidification of multiple hydrogen bonds in the starch chain and oxygen atoms in the calcium carbonate were observed in detail during cooling. The diffusion rate of hydrogen atoms in hydroxyl groups on the calcite surface decreased gradually with the decrease of the cooling temperature of the steamed bread's upper surface. The strong adhesion of the steamed bread and eggshell is attributed to the synthetic effect of the absorption, diffusion, surface chemistry, and the formation of multiple hydrogen bonds between the starch from the steamed bread and the calcium carbonate crystals in eggshell. The interesting findings are helpful for the design of strong bonds, and provide an idea for new environmentally friendly adhesive materials.

[Value of Trans-lymphatic Contrast-enhanced Ultrasound in the Diagnosis of Cervical Lymph Node Metastasis of Thyroid Cancer].

Objective To explore the value of trans-lymphatic contrast-enhanced ultrasound(CEUS)in the diagnosis of cervical lymph node metastasis of thyroid cancer. Methods The patients with suspected thyroid cancer underwent conventional ultrasound and trans-lymphatic CEUS examinations before the biopsy.The differences in ultrasound and CEUS characteristics of cervical lymph nodes between the metastatic group and the non-metastatic group were compared,and pathological results were regarded as the golden standard. Results Twenty patients had thyroid cancer,including 12 cases with lymph node metastasis and 8 cases without metastasis.The diagnostic sensitivity(91.7% vs. 75.0%)and accuracy(90.0% vs.80.0%)of trans-lymphatic CEUS were higher than those of conventional ultrasound.The normal lymph nodes presented homogeneous enhancement,while the metastatic lymph nodes showed heterogeneous or non-enhancement during the trans-lymphatic CEUS examination.Conclusion As a new modality of ultrasound,trans-lymphatic CEUS contributes to the diagnosis of cervical lymph node metastasis of thyroid cancer and supplements the deficiencies of conventional ultrasound.

Contrast-enhanced ultrasound for the characterization of portal vein thrombosis vs tumor-in-vein in HCC patients: a systematic review and meta-analysis.

OBJECTIVES: Portal vein thrombosis (PVT) is a common complication of liver cirrhosis. However, differentiation of thrombosis and tumor-in-vein (TIV) may be challenging. Contrast-enhanced ultrasound (CEUS) is an excellent method for detection of vascularization and could help in the distinction. We performed a systematic review and meta-analysis for evaluating the diagnostic value of CEUS in differentiating between PVT and TIV in hepatocellular carcinoma (HCC) patients. METHODS: PubMed, Embase, Cochrane Library, and Web of Science were searched up to the 5th of May 2019. The study quality was assessed by QUADAS-2 tool. Pooled sensitivity and specificity were calculated by the bivariate random effect model and hierarchical summary receiver-operating characteristic (SROC) curve was plotted. RESULTS: Seven studies including 425 participants were analyzed after screening 986 articles searched from databases. The pooled sensitivity and specificity of CEUS in diagnosing TIV were 0.94 (95%CI, 0.89-0.97) and 0.99 (95%CI, 0.80-1.00), respectively. The area under the curve (AUC) of SROC curve was 0.97 (95%CI, 0.95-0.98). The pooled sensitivity and AUC were consistent across all the subgroups of different subject numbers, country, study design, CEUS contrast agents, and diagnostic criteria. CONCLUSIONS: CEUS is highly efficient in differentiating TIV from PVT and is an alternative or a substitute for CT and/or MRI. TRIAL REGISTRATION: PROSPERO registration number: CRD42019138847 KEY POINTS: • Characterization of portal vein thrombosis (PVT) vs tumor-in-vein (TIV) is critical for HCC staging. • CEUS has an excellent safety profile, provides a real-time analysis without any loss in accuracy compared with CT and MRI. • This meta-analysis demonstrates that contrast-enhanced ultrasound (CEUS) is a suitable method for the detection of PVT and distinction with TIV.

Uric acid fluctuation had no effect on renal function among gout patients.

BACKGROUND AND AIMS: To investigate the effects of serum uric acid (SUA) level and its fluctuation on renal dysfunction in gout patients. METHODS AND RESULTS: Data on gout patients was collected from Huzhou city electronic medical record system data sharing platform, and information about relevant diagnoses, prescriptions, biochemical indexes and imaging characteristics was extracted. The gout patients with baseline normal renal function were enrolled in this analysis, and the estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 was defined as renal dysfunction. The generalized estimating equation and Cox regression analysis were used. A total of 1009 patients with gout were enrolled. Compared with the reference group (normal baseline SUA with endpoint SUA to be < 6 mg/dL), endpoint SUA ≥ 10 mg/dL was associated with an increased risk of renal dysfunction (baseline normal SUA group: HR [95% CI] = 3.28 [1.21, 8.91]; baseline high SUA group: HR [95% CI] = 3.01 [1.43, 6.35]). Subgroup analysis of 771 SUA stable gout patients demonstrated that SUA levels at 8-10 (excluding 10), and ≥10 mg/dL were significantly associated with an increased risk for renal dysfunction, with HR [95%CI] to be 1.99 [1.05, 3.77], and 2.98 [1.38, 6.43], respectively. CONCLUSION: Regardless of the baseline SUA level, SUA >10 mg/dL was a significant risk factor for renal dysfunction. SUA between 6 and 10 mg/dL was a potential risk factor for renal dysfunction. No significant correlation of SUA fluctuation and renal function was found.

Meta-analysis: compared with anti-CCP and rheumatoid factor, could anti-MCV be the next biomarker in the rheumatoid arthritis classification criteria?

Background Previous reviews of the diagnosis for rheumatoid arthritis (RA) have not compared anti-mutated citrullinated vimentin (MCV) with anti-cyclic citrullinated peptide (CCP) and rheumatoid factor (RF) in respect of sensitivity, specificity and the area under the curve (AUC) against disease controls for differential diagnosis. This meta-analysis aims to evaluate the value of anti-MCV in the diagnosis for RA, the combined sensitivity of anti-MCV and anti-CCP, and certain clinical characteristics related to the performance of anti-MCV. Methods Medline, Embase, Cochrane Library and Web of Science were searched for articles published up to 25 August 2018. A total of 33 studies including 6044 RA patients and 5094 healthy or disease controls achieved inclusive criteria. QUADAS-2 was applied to evaluate the quality of the included studies. The bivariate random effects model was employed in primary data synthesis to evaluate the diagnostic performance. Results The sensitivity of anti-MCV, anti-CCP and RF in RA diagnosis against a disease control group was 0.71, 0.71, 0.77, with the specificity of 0.89, 0.95, 0.73, and the AUC of the SROC of 0.89, 0.95, 0.82, respectively. The predesign of the primary study and diagnostic criteria were statistically significant as sources of heterogeneity. Anti-MCV and anti-CCP tests demonstrated a sensitivity of 0.77 when performed in parallel, with a sensitivity of 0.60 when performed in series; whereas, the combination of anti-MCV and RF presented a sensitivity of 0.64 when used in series. Conclusions Anti-MCV demonstrates comparable diagnostic value to anti-CCP and RF, thus it can be an effective diagnostic marker for RA and may be written into the next authoritative criteria.

Financial toxicity, family resilience and negative emotions among young and middle-aged breast cancer patients: A multicentre cross-sectional study.

PURPOSE: To determine financial toxicity in young and middle-aged women with breast cancer and examine the associations between family resilience and negative emotions. METHODS: A multicentre cross-sectional study was conducted, 538 women with breast cancer were recruited from four hospitals. FT, family resilience, and negative emotions were collected using the Comprehensive Score for FT, the Chinese version of the Family Resilience Assessment in Breast Cancer Patients, Patient Health Questionnaire-9 item, and Generalized Anxiety Disorder-7. This study adhered to the STROBE guidelines. RESULTS: The valid response rate was 96.8 % (N = 521). Overall, the score for FT was 19.63 ± 10.13. FT was significantly correlated with family resilience (r = 0.30, p < 0.010) and depression (r = -0.11, p < 0.050). The hierarchical multiple linear regression analysis showed that career status, monthly income, religion, and family resilience were the main factors influencing FT in patients with breast cancer (R2 = 0.37; F = 6.83; p < 0.001). CONCLUSIONS: FT was more prevalent among women from low-income career. Women with poor family resilience, no religious also suffer greater financial toxicity. It is necessary to pay more attention of the financial toxicity of female' low-income career, no religious belief and poor family resilience. Developing effective interventions based on family resilience might be helpful in promoting their well-being.

Overexpression of cat2 restores antioxidant properties and production traits in degenerated strains of Volvariella volvacea.

Strain degeneration is an important factor hindering the development of the edible fungus industry. Strain degeneration is associated with the excessive accumulation of reactive oxygen species (ROS) in vivo. Catalase (CAT), an important antioxidant enzyme, can promote the clearance of ROS. In this study, the cat2 gene of Volvariella volvacea was first cloned into an overexpression plasmid via homologous recombination. Finally, through Agrobacterium-mediated transformation, this plasmid was inserted into degenerated strains of V. volvacea T19. The physiological properties, antioxidant properties, ROS content, matrix degradation activity, and cultivation properties of the transformants were tested. The results showed that the cloned cat2 gene was 99.94% similar to the reference sequence. Screening revealed that six positive transformants were successfully obtained. After the overexpression of cat2, the growth rate and biomass of the mycelium increased significantly in the transformant strains (versus the V. volvacea T19 degenerated strains). Moreover, the accumulation of superoxide radical (O2•-) and hydrogen peroxide (H2O2) was significantly reduced, and the activity of the enzymes CAT, superoxide dismutase (SOD), glutathione reductase (GR), and glutathione peroxidase (GPX) was significantly increased. Meanwhile, the expression of cat2, Mnsod1, Mnsod2, gpx, and gr was significantly upregulated, and the activity of eight matrix degradation-related enzymes was increased to varying degrees. More importantly, the overexpression of the cat2 gene promoted the regrowth of fruiting bodies in degenerated strains of V. volvacea T19. This study provides a new biotechnological strategy to control the degeneration of V. volvacea and other edible fungi.

Involvement of RNA methylation modification patterns mediated by m7G, m6A, m5C and m1A regulators in immune microenvironment regulation of Sjögren's syndrome.

Keratoconjunctivitis is the most common complication of Sjögren's syndrome (SS). It has always been a hot research topic due to its complex pathogenesis. A further understanding of keratoconjunctiva xerosis can be obtained by studying the primary diseases. 7-Methylguanine (m7G), N6-methyladenosine (m6A), 5-methylcytosine (m5C), and N1-methyladenosine (m1A) are newly discovered epigenetic mechanisms involved in the development of SS. This study aimed to investigate the effects of m7G, m6A, m5C, and m1A modifications on the immune microenvironment of SS. Three microarray datasets were downloaded from the Gene Omnibus Expression (GEO) database, including 56 SS samples and 35 normal samples. Then, genes with m7G, m6A, m5C, and m1A methylation were explored, and the RNA modification patterns mediated by 59 m7G, m6A, m5C, and m1A regulators were summarized. The effects of m7G, m6A, m5C, and m1A modifications on immune infiltrating cells were discussed. Eukaryotic translation initiation factor 3 subunit D(EIF3D) was closely related to monocytes, and the expression of EIF3D was higher in SS with less monocytes. Two distinct patterns of RNA modification mediated by the 59 m7G, m6A, m5C, and m1A regulators were also identified, which infiltrated immune cells differently. Moreover, the two distinct RNA patterns were enriched in different signaling pathways, and their biological functions were explored. The findings revealed that m7G, m6A, m5C, and m1A modifications played vital roles in the diversity and complexity of the immune microenvironment in SS.

microRNA-141-3p mediates epithelial cell proliferation, apoptosis, and epithelial-mesenchymal transition and alleviates pulmonary fibrosis in mice via Spred2.

OBJECTIVE: This study probed the mechanism of microRNA (miR)-141-3p in the progression of pulmonary fibrosis (PF). METHODS: Mice were intratracheally administered with bleomycin (BLM) to establish a PF mouse model. To investigate the effects of miR-141-3p/Spred2 on PF in mice, PF mice received tail vein injections with agomir-141-3p and/or adenovirus vectors overexpressing Spred2 one week after BLM treatment. Then, the pathological changes of lung tissues were analyzed with H&E and Masson's trichrome staining and hydroxyproline contents in lung tissues were measured. For cell experiments, after loss- and gain-of-function assays, the role of miR-141-3p/Spred2 in the apoptosis and viability of TGF-ß1-stimulated MLE-12 cells was examined by flow cytometry and CCK-8 assay. miR-141-3p, Spred2, COl 1, and α-SMA expression was determined in cells and mice. Then, the binding of miR-141-3p to Spred2 was tested with a dual-luciferase reporter assay. RESULTS: There were abnormally upregulated Spred2 and downregulated miR-141-3p in lung tissues of PF mice. TGF-ß1 decelerated viability and augmented apoptosis and COl 1 and α-SMA expression in MLE-12 cells. Spred2 knockdown diminished apoptosis and α-SMA and COl 1 expression while enhancing proliferation in TGF-ß1-treated MLE-12 cells. Mechanistically, Spred2 was a target gene of miR-141-3p. miR-141-3p upregulation accelerated proliferation and repressed apoptosis and α-SMA and COl 1 expression in TGF-ß1-treated MLE-12 cells, which was nullified by further overexpressing Spred2. miR-141-3p alleviated PF in mice by targeting Spred2. CONCLUSION: miR-141-3p negatively modulates Spred2 to promote proliferation and repress epithelial-mesenchymal transition and apoptosis of epithelial cells, as well as ameliorating PF in mice.

Correlation between ultrasonographic scores and American college of rheumatology recommended rheumatoid arthritis disease activity measures: a systematic review and network meta-analysis.

BACKGROUND: To validate and facilitate ultrasound examinations on rheumatoid arthritis (RA) disease activity measurements in routine clinical practice. METHODS: A systematic review and network meta-analysis (NMA) of ultrasound examinations on joints and its correlation with clinical RA disease activity was performed. PubMed, Embase and Cochrane library were searched for literatures published up to May 01st 2021. Bayesian random-effect NMA was conducted to pool the correlations of ultrasonographic assessment scores with composite RA disease activity measurements. RESULTS: Fifteen studies evaluating twelve different existing ultrasonographic measurements on joints evaluation for RA disease activity scoring were included in this NMA. For comparisons with clinical disease activity index and simplified disease activity index, synovitis gray scale ultrasound 7 joints (GSUS7) demonstrated modest correlation of 0.30[- 0.74, 1.23] and 0.46[- 0.45, 1.15] respectively, followed by synovitis power Doppler ultrasound 7 joints (PDUS7) (0.25[- 0.57, 1.14], 0.31[- 0.46, 1.24]) and power Doppler ultrasound 12 joints (PDUS12) (0.23[- 1.36, 0.83], 0.25[- 1.18, 0.88]). As for disease activity score using 28 joint counts, PDUS12 showed the biggest correlation of 0.53[- 0.09, 1.11], followed by ultrasound 7 joints (US7) (0.50[0.06, 0.93]), PDUS7 (0.49[- 0.24, 1.12]), power Doppler ultrasound 6 joints (PDUS6) (0.42[- 0.29, 1.21]), synovitis PDUS7 (0.47[- 0.09, 1.27]) and synovitis GSUS7 (0.40[0.01, 0.86]). CONCLUSION: Comparative validity was observed on fewer joints ultrasonic evaluation for RA disease activity measurements, such as synovitis GSUS7 and synovitis PDUS7. Ultrasonographic measurements can be complementary for clinical RA disease activity measures with clinical efficiency, and technical guidelines were in need for clinical routine practice.

Health-related quality of life in Chinese medical staff: a latent profile analysis.

Objective: To investigate subgroups of health-related quality of life (HRQoL) in the Chinese medical staff and identify the demographic factors associated with these profiles. Methods: 574 Chinese medical staff were surveyed online. HRQoL was measured by using the 36-Item Short Form Health Survey, Version 2. Latent profile analysis (LPA) was used to identify the profiles of HRQoL. The associations between HRQoL profiles and covariates were assessed using multinomial logistic regression. Results: Three HRQoL profiles were developed: low HRQoL at 15.6%, moderate HRQoL at 46.9%, and high HRQoL at 37.6%. Multinomial logistic regression showed night shift times, aerobic exercise conditioning, and personality type significantly predicted the profile membership. Conclusion: Our findings develop earlier approaches that only used total scores to evaluate this group's HRQoL and help them with tailored interventions to promote better HRQoL.

Contrast-enhanced ultrasound (CEUS) of benign and malignant renal tumors: Distinguishing CEUS features differ with tumor size.

BACKGROUND: Contrast-enhanced ultrasound (CEUS) is now a guideline-recommended strategy for diagnosing renal lesions. Tumor size is related to the risk of the treatment and prognosis in renal tumors. Thus, we aim to analyze the CEUS features of solid renal tumors in relation to tumor size. METHODS: The CEUS appearance of 156 pathologically diagnosed solid renal tumors were retrospectively analyzed. Three groups were stratified according to the tumor size (≤2 cm [group I], 2.1-4 cm [group II] and 4.1-7 cm [group III]). For each group, the features of wash-in type, enhancement degree, enhancement homogeneity, and the presence of a pseudocapsule sign were compared between benign and malignant tumors. RESULTS: All 156 included lesions were detected by CEUS. The proportion of benign tumors in three size groups was 37.1%, 19.4%, and 20.4%, respectively. The proportion of malignant tumors was highest (80.6%) in group II, followed by group III (79.6%) and group I (62.9%). In group I, malignant and benign tumors differed significantly in the presence of a pseudocapsule sign (p = 0.015) and homogeneity (p = 0.007). In group II, the degree of enhancement differed (p = 0.02) between tumor types. In group III, the two tumor types differed in both the wash-in pattern (p = 0.015) and enhancement degree (p = 0.024). The weighted and Cohen's kappa values for the concordance between inter-observer agreement ranged from 0.31 (95% CI: 0.36-0.57) to 0.90 (95% CI: 0.77-1.00). CONCLUSIONS: CEUS features of malignant and benign renal tumors change along with the tumor size. The use of CEUS features in the diagnosis of benign and malignant tumors requires consideration of tumor size.

The impact of local government competition and green technology innovation on economic low-carbon transition: new insights from China.

The government-led Chinese economic development system determines that local government competition is a significant factor affecting the economic low-carbon transition. Driving an economic development mode with green technology innovation as the core is the critical path to realizing an economic low-carbon transition. Consequently, it is of significant practical relevance to investigate the impact of local government competition and green technology innovation on the economic low-carbon transition under the government-led Chinese economic development system. This paper systematically explores the nexus between green technology innovation and economic low-carbon transition in terms of local government competition perspective using the system generalized method of moments, panel threshold model, and geographically weighted regression on the basis of a dataset of 30 provincial administrative areas in China from a period of 2006-2019. The results indicate that green technology innovation significantly promotes the economic low-carbon transition. Local government competition not only significantly dampens the economic low-carbon transition but also considerably inhibits the positive effect of green technology innovation on the economic low-carbon transition. A significant N-shaped association is evident between green technology innovation and the economic low-carbon transition when green technology innovation is applied as a threshold, while such association is insignificant when local government competition is used as a threshold. Compared with high-competition intensity areas, green technology innovation promotes economic low-carbon transition weaker in low- competition intensity areas, while local government competition inhibits economic low-carbon transition stronger. However, local government competition significantly inhibits the positive effect of green technology innovation on the economic low-carbon transition in low-competition intensity areas, while insignificant in high-competition intensity areas. The geographically weighted regression technique as a whole also verified the above results. Therefore, policymakers should not only increase research and development investment in green technologies, but also develop a regionally linked low-carbon emission reduction system to avoid ineffective competition among governments to facilitate the earlier fulfillment of the "dual carbon" goal.

Important parameters should be paid attention in PTMC radiofrequency ablation.

In order to provide clinical references for the RFA procedure and to study the pivotal factors affecting the recovery time of radiofrequency ablation (RFA) in patients with papillary thyroid microcarcinoma (PTMC), 176 patients with low-risk intrathyroidal PTMC were included in this research. We randomly divided the whole cohort into training and test groups at a ratio of 7:3. The two-sample t-test was used to detect differences between the two groups. Least absolute shrinkage and selection operator (LASSO) regression was used to select the best predictor variables for predicting the status of RFA zone. Multiple test methods were used to ensure the scientific nature and accuracy of the Cox proportional hazards model. We tested the performance for the parameters and revealed the best cut-off value of each variable by the ROC curve and log-rank tests. The results showed patients aged above 49 years old, with RFA energy above 2800 J, the average diameter of the original tumour above 0.6 cm, or the average diameter of ablation zone at 1 month after RFA above 1.1 cm are risk factors for RFA zone delayed healing.

Cardiopulmonary Rehabilitation in Elderly Patients with Heart Failure: A Prospective Cohort Study.

Objective: To determine the impact of cardiopulmonary rehabilitation administered through WeChat on exercising resilience and life quality in aged people with heart failure (HF). Methods: We conducted prospective cohort study that included 80 heart failure patients who were admitted to the Second Affiliated Hospital of Wenzhou Medical University from June 2018 to September 2020, 80 patients with heart failure. Patients were grouped according to their use of WeChat for rehabilitation. WeChat cohort provides remote supervision of rehabilitation and nursing guidance through WeChat. Specifically, the findings below were predetermined and compared across treatment groups utilizing analysis of variance corrected for baseline levels of the end measure and location: changes in the length of cardiopulmonary exercise tests, peak VO2, the proportion of predicted maximum VO2, and variation in the distance covered during the 6-minute walk distance (6MWD) assessment. Comparison of negative emotions between two groups, a Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS), and Survey Short Form-36 (SF36) at baseline and at month 2. Results: In contrast with the control cohort, the WeChat cohort did not show any significant differences in general data (P > 0.05). After the rehabilitation, the WeChat group has a notably higher level in 6MWD than in the control group. Prior to the rehabilitation, there were no statistical gaps between the two cohorts in terms of SAS and SDS scores (P > 0.05). Even though the two cohorts saw a decline in SAS and SDS scores following nursing, the observation cohort indicated a much relatively low level in contrast with the control cohort (P < 0.05). The comparison of the SF-36 scores between the two cohorts revealed no significant differences (P > 0.05). Following nursing, the scores of the two cohorts declined significantly, with the control cohort scoring far lower than the other (P < 0.05). Conclusions: In summary, cardiopulmonary rehabilitation via WeChat is very beneficial for HF patients who are at a stable phase of the disease. It may substantially improve patients' exercise stamina, reduce adverse emotions, boost patients' quality of life, and have significant clinical relevance.