BCL-2 Modulates IRE1α Activation to Attenuate Endoplasmic Reticulum Stress and Pulmonary Fibrosis.

BCL-2 family members are known to be implicated in survival in numerous biological settings. Here, we provide evidence that in injury and repair processes in lungs, BCL-2 mainly acts to attenuate endoplasmic reticulum (ER) stress and limit extracellular matrix accumulation. Days after an intratracheal bleomycin challenge, mice lose a fraction of their alveolar type II epithelium from terminal ER stress driven by activation of the critical ER sensor and stress effector IRE1α. This fraction is dramatically increased by BCL-2 inhibition, because IRE1α activation is dependent on its physical association with the BCL-2-proapoptotic family member BAX, and we found BCL-2 to disrupt this association in vitro. In vivo, navitoclax (a BCL-2/BCL-xL inhibitor) given 15-21 days after bleomycin challenge evoked strong activation of IRE-1α in mesenchymal cells and markers of ER stress, but not apoptosis. Remarkably, after BCL-2 inhibition, bleomycin-exposed mice demonstrated persistent collagen accumulation at Day 42, compared with resolution in controls. Enhanced fibrosis proved to be due to the RNAase activity of IRE1α downregulating MRC2 mRNA and protein, a mediator of collagen turnover. The critical role of MRC2 was confirmed in precision-cut lung slice cultures of Day-42 lungs from bleomycin-exposed wild-type and MRC2 null mice. Soluble and tissue collagen accumulated in precision-cut lung slice cultures from navitoclax-treated, bleomycin-challenged mice compared with controls, in a manner nearly identical to that of challenged but untreated MRC2 null mice. Thus, apart from mitochondrial-based antiapoptosis, BCL-2 functions to attenuate ER stress responses, fostering tissue homeostasis and injury repair.

Mass spectrometry-based metabolic profiling for identification of biomarkers related to footpad dermatitis in ducks.

1. A new assessment method for duck footpad dermatitis (FPD) evaluation was developed, combining visual and histological characters using the images and sections of 400 ducks' feet at 340 d of age. All ducks were graded as G0 (healthy), G1 (mild), G2 (moderate) and G3 (severe) according to the degree of FPD.2. To reveal the potential biomarkers in serum related to duck FPD, non-targeted metabolomics and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were used to explore differential metabolites in each group.3. There were 57, 91 and 210 annotated differential metabolites in groups G1, G2 and G3 compared with G0, which meant that the severity of FPD increased in line with the number of metabolites. Four metabolites, L-phenylalanine, L-arginine, L-leucine and L-lysine, were considered potential biomarkers related to FPD.4. KEGG enrichment analysis showed that the FPD was mainly involved in glycolysis, the tricarboxylic acid (TCA) cycle, the pentose phosphate pathway and amino acid metabolism. These are related to production metabolism and can affect the physiological activities of ducks, which might explain the decrease in production performance.

The safety and efficacy of epidural anaesthesia in acute pancreatitis: a systematic review and meta-analysis.

BACKGROUND: Acute pancreatitis (AP) has variable clinical courses. This systematic review and meta-analysis aimed to determine the safety, efficacy, and impact of epidural anaesthesia (EA) use in AP. METHODS: The PubMed, EMBASE, SCOPUS and Cochrane library databases were systematically searched between 1980 and 2022 using the PRISMA guidelines, to identify observational and comparative studies reporting on EA in AP. The meta-analysis was performed in R Foundation for Statistical Computing using the meta R Package for Meta-Analysis. RESULTS: A total of 9 studies with 2006 patients of which 726 (36%) patients had EA were included. All studies demonstrated high safety and feasibility of EA in AP with no reported major local or neurological complications. One randomised controlled trial demonstrated an improvement in pain severity using a 0-10 visual analogue scale (VAS) at the outset (1.6 in EA vs 3.5 in non-EA, P = 0.02) and on day 10 (0.2 in EA vs 2.33 in non-EA, P = 0.034). There was also improvement in pancreatic perfusion with EA measured with computerised tomography 13 (43%) in EA vs 2 (7%) in non-EA, P = 0.003. The need for ventilatory support and overall mortality was lower in EA patients 40 (19%) vs 285 (24%) P = 0.025 (OR: 0.49, 95% CI: 0.28-0.84) and 16 (7%) vs 214 (20%), P = 0.050 (OR: 0.39, 95% CI: 0.15-1.00), respectively. CONCLUSION: EA is infrequently used for pain management in AP and yet the available evidence suggests that it is safe and effective in reducing pain severity, improving pancreatic perfusion, and decreasing mortality.

[Association of greenness exposure with waist circumference and central obesity in Chinese adults aged 65 years and over].

Objective: To examine the association of greenness exposure with waist circumference (WC) and central obesity in older adults in China. Methods: Based on the cross-sectional data from the Chinese Longitudinal Healthy Longevity Survey in 2017-2018, 14 056 participants aged 65 years and over were included. Demographic characteristics, lifestyle, WC, and other information were collected through a questionnaire and physical examination. Based on the satellite monitoring data of moderate-resolution imaging spectroradiometer (MODIS) provided by NASA, the annual mean of normalized difference vegetation index (NDVI) within a radius of 1 000 meters was obtained as the measurement value of greenness exposure. Multivariate linear regression model, multivariate logistic regression model, and restricted cubic splines (RCS) model were used to analyze the association and dose-response relationship between greenness exposure and WC and central obesity in older adults in China. Results: A total of 14 056 participants were enrolled with a median age of 84.0 years [IQR: 75.0-94.0 years]. About 45.0% (6 330) of them were male and 48.6% (5 853) were illiterate. There were 10 964 (78.0%) participants from rural. The mean of WC was (84.4±10.8) cm. Central obesity accounted for 60.2% (8 465), and the NDVI range was (-0.06, 0.78). After adjusting for confounding factors, the multivariate linear regression model showed that the change value of WC in the urban group [ß (95%CI):-0.49 (-0.93, -0.06)] was smaller than that in the rural [-0.78 (-0.98, -0.58)] for every 0.1 unit increase in NDVI (Pinteraction=0.022). Compared with the Q1 group in NDVI, WC of Q2 and Q3 groups in rural decreased, and the ß (95%CI) values were-1.74 (-2.5, -0.98) and-2.78 (-3.55, -2.00), respectively. The multivariate logistic regression model showed that after adjusting for confounding factors, the risk of central obesity decreased for urban and rural older adults with an increase of 0.1 unit in NDVI, and the OR (95%CI) values were 0.87 (0.80, 0.95) and 0.86 (0.82, 0.89), respectively (Pinteraction=0.284). Compared with the Q1 group in NDVI, the risk of central obesity in the Q2 and Q3 groups in rural was lower, and the OR (95%CI) values were 0.68 (0.58, 0.80) and 0.57 (0.49, 0.68), respectively. The results of the multivariate regression model with RCS showed that there was a non-linear association of NDVI with WC (Pnonlinear=0.006) and central obesity (Pnonlinear=0.025). Conclusion: Greenness exposure is negatively associated with WC and central obesity in older adults in China.

[World Health Organization guidance Ethical and Governance of Artificial Intelligence for health and implications for China].

With the explosive growth of deep learning and big data technology, artificial intelligence has penetrated into various fields of medical and health care, bringing efficient and high-quality health services to patients, but also a series of ethical and social governance issues have emerged. In order to avoid and eliminate the foreseeable ethical risks and governance challenges in the development of medical artificial intelligence, the World Health Organization (WHO) first released the Ethical and Governance of Artificial Intelligence for Health guidance on June 28, 2021, aimed to provide a framework for ethical guidelines on the deployment of artificial intelligence in clinical practice. At present, there are still shortcomings and this paper takes Healthy China 2030 agenda and the WHO guidelines as strategic ideas, and proposes to shape a consensus on the ethics of medical artificial intelligence, establish rules for human subjects and ownership of responsibilities, improve the legal and regulatory system, and determine human decision-making and moral subject status, taking into account the cultivation of interdisciplinary talents' ethical literacy and other Chinese inspirations are expected to promote the development of medical artificial intelligence ethics governance.

[The clinical value of multi-target stool fecal immunochemical test-DNA in early screening and diagnosis for colorectal cancer].

Objective: To investigate the clinical diagnostic value of multi-target stool fecal immunochemical test-DNA (FIT-DNA) test in colorectal cancer (CRC) and advanced adenoma (AA). Methods: A total of 235 patients who were undergoing colonoscopy or colorectal cancer surgery in the Cancer Hospital, Chinese Academy of Medical Sciences from April 2021 to January 2022 were prospectively enrolled. There were 141 males and 94 females, with an average age of (55±13) years (22-86). The patients were divided into two groups, including 215 patients who were first diagnosed but not treated (86 cases of CRC, 12 cases of AA, 25 cases of non-advanced adenoma, 8 cases of hyperplastic or other polyps and 84 apparently healthy cases) and 20 patients in the intervention group (2 cases with a history of CRC surgery, 6 cases with a history of endoscopic surgery, 4 non-CRC patients with special diseases and 8 cases with a history of neoadjuvant chemoradiotherapy). Fresh stool samples were collected before intestinal preparation or surgery for FIT-DNA test using the matching kit for sample processing and nucleic acid purification. KRAS mutation and methylation of BMP3 and NDRG4 genes were detected by fluorescence probe method, and FIT method was employed to detect fecal occult blood. Colonoscopy or pathological biopsy results were used as the gold standard. And the screening and diagnostic efficacy of FIT-DNA test for colorectal cancer and advanced adenoma were evaluated by receiver operating curve (ROC). Results: The sensitivity of FIT-DNA test for early colorectal cancer and advanced adenoma was 7/7 and 8/12, respectively. And the negative predictive value was 98.1% (104/106) and 93.7% (104/111), respectively. The overall screening sensitivity for both early colorectal cancer and advanced adenoma was 15/19, and the negative predictive value was 96.3% (104/108). Besides, the area under the curves (AUCs) were 0.982 (95%CI: 0.960-1.000, P<0.05), 0.758 (95%CI: 0.592-0.924, P<0.05) and 0.841 (95%CI: 0.724-0.957, P<0.05), respectively. Moreover, the diagnostic sensitivity of FIT-DNA test was 98.8% (85/86) for colorectal cancer, 8/12 for advanced adenoma, and 94.9% (93/98) for both colorectal cancer and advanced adenoma, with a specificity of 88.9% (104/117). The AUCs were 0.968 (95%CI: 0.937-0.997, P<0.05), 0.758 (95%CI: 0.592-0.924, P<0.05) and 0.942 (95%CI: 0.905-0.979, P<0.05), respectively. After the inclusion of intervention group, the overall diagnostic sensitivity and specificity of FIT-DNA test was 91.6% (98/107) and 89.1% (114/128), respectively. Conclusion: FIT-DNA test has a high early screening and diagnostic efficacy for colorectal cancer.

A selective anticoagulation policy for splanchnic vein thrombosis in acute pancreatitis is associated with favourable outcomes: experience from a UK tertiary referral centre.

INTRODUCTION: There is a paucity of data on the incidence, risk factors, and treatment of splanchnic vein thrombosis (SVT) in acute pancreatitis (AP). METHODS: All AP admissions between 2018 and 2021 across North East of England were included. Anticoagulation was considered in the presence of superior mesenteric vein/portal vein (SMV/PV) thrombus or progressive splenic vein thrombus (SpVT). The impact of such a selective anticoagulation policy, on vein recanalisation rates and bleeding complications were explored. RESULTS: 401 patients (median age 58) were admitted with AP. 109 patients (27.2%) developed SVT. The splenic vein in isolation was the most common site (n = 46) followed by SMV/PV (n = 36) and combined SMV/PV and SpVT (n = 27). On multivariate logistic regression alcohol aetiology (OR 2.64, 95% CI [1.43-5.01]) and >50% necrosis of the pancreas (OR 14.6, 95% CI [1.43-383.9]) increased the risk of developing SVT. The rate of recanalization with anticoagulation was higher for PVT (66.7%; 42/63) than in SpVT (2/11; p = 0.003). 5/74 of anticoagulated patients developed bleeding complications while 0/35 patients not anticoagulated had bleeding complications (p = 0.4). CONCLUSION: The risk of SVT increases with AP severity and with extent of pancreatic necrosis. A selective anticoagulation policy for PVT and progressive SpVT in AP is associated with favourable outcomes with no increased risk of bleeding complications.

[Analysis of influence factors for short-term recurrence of retroperitoneal liposarcoma after complete resection].

Objective: To examine the influence factors of short-term recurrence after complete surgical resection of retroperitoneal liposarcoma. Methods: The clinicopathological data of retroperitoneal liposarcoma at Department of General Surgery, the First Medical Center, People's Liberation Army General Hospital from January 2000 to January 2020 were retrospectively analyzed. There were 60 males and 31 females, aged (52.1±9.9) years (range: 30 to 84 years). Tumor recurrence within 12 months after complete resection was defined as short-term recurrence, and tumor recurrence more than 12 months was defined as non-short-term recurrence. The t test, rank-sum test, χ2 test and Fisher exact test were conducted for inter-group comparison. Logistic regression analysis was used to analyze the independent influence factors for the short-term recurrence of retroperitoneal liposarcoma after complete resection. The Kaplan-Meier curve was used to calculate the recurrence-free survival, and the Log-rank test was adopted for the comparison between the groups. Results: The univariate analysis results showed that irregular tumor morphology, multiple pathological subtypes, pathological scores>3, and multiple primary tumors are influence factors for short-term recurrence after complete resection of retroperitoneal liposarcoma (χ2: 4.422 to 7.773, all P<0.05). Regression analysis of the above risk factors showed that multiple primary tumors was the independent risk factor (OR=2.918, 95%CI: 1.127 to 7.556, P=0.027). In the short-term recurrence group, Kaplan-Meier curve analysis showed that patients with multiple primary tumors had a shorter median recurrence time than patients with unifocal tumor (6 months vs. 9 months, P=0.028). Conclusions: Multiple primary tumor is an independent risk factor for short-term recurrence after complete resection of retroperitoneal liposarcoma. It suggests that the frequency of follow-up after surgery should be increased for such patients.

Caspofungin combined with TMP/SMZ as a first-line therapy for moderate-to-severe PCP in patients with human immunodeficiency virus infection.

OBJECTIVES: The effectiveness of trimethoprim/sulfamethoxazole (TMP/SMZ) for pneumocystis pneumonia (PCP) is limited with adverse events. Caspofungin, by inhibiting the cyst form of Pneumocystis jirovecii, may be an alternative therapy for PCP. However, the availability of clinical data about caspofungin combined with TMP/SMZ in the treatment of PCP in HIV-infected patients is limited. Thus, we aimed to examine the clinical effectiveness and safety of caspofungin combined with TMP/SMZ as a first-line therapy for moderate-to-severe PCP in HIV-infected patients. METHODS: From January 2017 to December 2019, data of HIV-infected patients with moderate-to-severe PCP who received either TMP/SMZ alone or caspofungin combined with TMP/SMZ as first-line therapy were retrospectively reviewed to assess the effectiveness and safety of each regimen. The Kaplan-Meier curve and log-rank test were used for survival analysis. RESULTS: A total of 278 patients met the criteria. The overall positive response rate of PCP treatment was 48.92%, and the overall all-cause in-hospital mortality rate was 33.09%. Patients who received combination therapy consisting of caspofungin and TMP/SMZ had a better positive response rate (59.44% vs. 37.78%, P < 0.001) and lower all-cause in-hospital mortality rate (24.48% vs. 42.22%, P = 0.003). Also, patients who received combination therapy had higher survival rate during a hospital stay (75.52% vs. 57.78%, P = 0.004), and those who received longer combination therapy were more likely to have higher survival rate (P = 0.042). We found that age (P = 0.019), CD4 cell count (P = 0.001) and therapeutic regimen (P = 0.002) were significant risk factors for all-cause in-hospital mortality rate in univariate analysis. In multivariate analysis, only CD4 cell count and therapeutic regimen were statistically significant factors associated with all-cause in-hospital mortality rate. Patients with a CD4 count of > 30 cells/µL and patients who received combination therapy consisting of caspofungin and TMP/SMZ were more likely to survive from PCP (P = 0.011 and P = 0.002, respectively). There were no additional severe adverse events caused by adding caspofungin. CONCLUSIONS: For HIV-infected patients with moderate-to-severe PCP, combination therapy with caspofungin and TMP/SMZ is an effective and promising first-line therapy with no greater number of adverse events compared with TMP/SMZ monotherapy. Patients who received caspofungin had better positive response rates and lower all-cause in-hospital mortality rates. Also, we recommend early initiation of caspofungin.

[Analysis of seven cases of multiple myeloma with initial manifestation of bleeding].

A retrospective analysis of 7 patients of multiple myeloma (MM) with initial manifestation of bleeding and coagulation abnormalities were performed. Clinical manifestations, laboratory and imaging examinations were collected. The activity of coagulation factors was measured before the treatment. Single factor X deficiency was seen in one patient. Two cases had factor Ⅶ deficiency, while four other patients had multiple factor deficiency. The time from onset of symptoms to diagnosis ranged from 2 to 10 months. After anti-MM treatment started and plasma or coagulation factors were transfused, the prolonged coagulation time returned to normal from 28-84 days. Most of these patients presented large, deep and multiple sites of hematoma, which caused concerns of bone marrow puncture and may direct to other differential diagnoses. This is helpful to improve physicians' understanding of the special clinical characteristics in MM patients.

[Efficacy and safety of Kangbingdu granules in the treatment of influenza: a randomized, double-blind, double-dummy, positive-drug parallel control multicenter clinical trial].

Objective: To observe the efficacy and safety of Kangbingdu granules (KBD) in the treatment of influenza. Methods: A multicenter, randomized, double-blind, double-dummy, and positive-drug parallel control trial was conducted in 27 Grade ⅢA hospitals in China and the subjects were randomly assigned to the KBD test group or the oseltamivir phosphate capsule control group at a ratio of 1∶1. 200 subjects were planned to be enrolled in each group. The experimental group was given KBD (18g each time, 3 times a day) and oseltamivir phosphate simulator orally, while the control group was given oseltamivir phosphate capsule (75 mg each time, twice a day) and KBD simulator orally for 5 days. The primary efficacy indicators included the remission time of major clinical symptoms and the time of complete defervescence. The secondary efficacy indicators included dosage of acetaminophen, the change of traditional Chinese medicine (TCM) syndrome score and the remission time of other important clinical symptoms. The efficacy of KBD in the test group and Oseltamivir phosphate control group were compared. Adverse events or adverse reactions were observed at the same time to evaluate the safety of KBD Granules. Results: A total of 393 subjects from 27 Grade ⅢA hospitals in China were enrolled. The experimental group included 195 subjects and 191 subjects (97.95%) completed the trial, While the control group included 198 subjects and 195 subjects (98.48%) completed the trial. There was no significant difference in the shedding rate and rejection rate between the two groups (P>0.05). In the Full Analysis Set (FAS), the mean age of the experimental group was (34.9±14.4) years old, with 83 males (42.78%). The mean age of the control group was (33.3±13.5) years old, with 78 males (39.59%). There were no statistically significant differences between the two groups in demographic data, physical examination, viral pathogen detection, total score of TCM syndromes and scores of each symptom at baseline (P>0.05). In the FAS, the remission time M (Q1, Q3) of major clinical symptoms was 3.0 (3.0, 4.0) days in the experimental group and 3.0 (3.0, 4.0) days in the control group, and the difference was not statistically significant (P>0.05). The time M (Q1, Q3) of complete defervescence was 34.0 (20.3, 49.0) hours in the experimental group and 36.5 (19.6, 48.8) hours in the control group, and the difference was not statistically significant (P>0.05). KBD granules had the same effect as Oseltamivir phosphate capsule (P>0.05) in terms of acetaminophen dosage, TCM syndrome effect and disappearance rate of most important clinical symptoms. Meanwhile, the disappearance rate of dizziness and chest distress on day 3 in the KBD granules group was better than that of oseltamivir phosphate capsule (P<0.05). Conclusion: KBD granules have the same efficacy as Oseltamivir Phosphate capsule in the treatment of influenza and the drug safety is good.

[Investigation of noise annoyance among the exposed anesthesiologists in a hospital].

Objective: To investigation noise annoyance among the exposed anesthesiologists, and to analyze the influencing factors of noise annoyance. Methods: From January to May 2017, cluster sampling was used to select 62 anesthesiologists from Peking University Third Hospital as the survey subjects. The Likert Scale (five-level) and the Visual Analog Scale (0-10 points) were used to conduct noise annoyance and noise sensitivity survey. Linear regression was used for multi-factor analysis to explore the influencing factors of noise annoyance. Results: The age of the research subjects was (32.3±6.1) years old, the working experience was 4.9 (2.0, 8.9) years, and the daily working hours were (9.8±2.8) h. The noise level in the operating room on the measurement day was (64.4±1.7) dB (A) . In the Likert Scale and the Visual Analog Scale, 88.7% (55/62) and 95.2% (59/62) anesthesiologists believed that operating room noise had adverse reactions, 6.5% (4/62) and 14.5% (9/62) anesthesiologists measured a high degree of annoyance. The results of linear regression analysis showed that noise sensitivity was an independent factor influencing the anesthesiologists' noise annoyance in the Likert Scale and the Visual Analog Scale (r=0.524, 0.700, P<0.05) . Conclusion: Noise in the operating room can cause anesthesiologists to feel annoyed and is a hidden danger to the quality of medical services, which should be paid attention to by the academic and management departments.

Amount of Eurotium sp. in Chinese Liupao tea and its relationship with tea quality.

OBJECTIVE: Eurotium sp. are the sexual states of the genus Aspergillus, and their ascospore is a spherical closed capsule with a golden colour. The growth of Eurotium sp. during tea production is a key step in achieving the unique quality of dark tea. This study aimed to evaluate the relationship between Eurotium sp. amount and Liupao tea quality. METHODS AND RESULTS: The amounts of Eurotium sp. in 26 differently aged Liupao tea samples from several factories were studied. Indicators related to the quality of Liupao tea were investigated. The amounts of Eurotium sp. were divided into 0, 105 and 106 levels, and quantitative real-time polymerase chain reaction (qPCR) was performed. Using ultrahigh-performance liquid chromatography and high-performance liquid chromatography, the amounts of emodin and physcion were determined to be closely related to the amount of Eurotium sp. Emodin was not found or occurred in minimal amounts in all raw Liupao tea samples. By contrast, physcion was found in Liupao tea at the 106 level of Eurotium sp. Liupao tea samples with varying levels of Eurotium sp. also exhibited evident differences in aroma and chromaticity. Result of the Pearson correlation test showed that the amount of Eurotium sp. plays a key role in creating the unique quality of Liupao tea. CONCLUSION: The amount of Eurotium sp. in dark tea detected via qPCR can be used as a quantitative quality indicator for evaluating dark tea. SIGNIFICANCE AND IMPACT OF THE STUDY: The present study provides an efficient method for identifying the different qualities of dark tea and addressing quality control issues in fermenting dark tea.

Genome-wide analysis of differentially expressed lncRNA in sporadic parathyroid tumors.

Diagnosis of parathyroid carcinoma on histological examination is challenging. Thousands of differentially expressed lncRNAs were identified on the microarray data between parathyroid cancer and adenoma samples. Four lncRNAs were significantly dysregulated in further validation. The "lncRNA score" calculated from these lncRNAs differentiated parathyroid carcinomas from adenomas. LncRNAs serve as biomarkers for parathyroid cancer diagnosis. INTRODUCTION: Diagnosis of parathyroid carcinoma (PC) on histological examination is challenging. LncRNA profile study was conducted to find diagnostic biomarkers for PC. METHODS: LncRNA arrays containing 91,007 lncRNAs as well as 29,857 mRNAs were used to assess parathyroid specimen (5 carcinomas and 6 adenomas). Bioinformatics analyses were also conducted to compare the microarray results between parathyroid carcinomas and adenomas (PAs). Differentially expressed lncRNAs of 11 PCs and 31 PAs were validated by real-time quantitative PCR. RESULTS: On the microarray data between PC and PA samples (fold change ≥ 2, P < 0.05), 1809 differentially expressed lncRNAs and 1349 mRNAs also were identified. All carcinomas were clustered in the same group by clustering analysis using dysregulated lncRNAs or mRNAs. Four lncRNAs (LINC00959, lnc-FLT3-2:2, lnc-FEZF2-9:2, and lnc-RP11-1035H13.3.1-2:1) identified were significantly dysregulated in further RT-PCR validation. The global "lncRNA score" calculated from the lncRNAs above also differentiated parathyroid carcinomas from adenomas. CONCLUSIONS: LncRNA profiling shows distinct differentially expressed lncRNAs in parathyroid neoplasm. They may play a key role in parathyroid cancer and serve as potential biomarkers to distinguish parathyroid cancers from parathyroid adenomas.

A theoretical study of Ar8+-acetylene collisions at 1.2 MeV: Ionization and dissociation dynamics.

We theoretically study Ar8+-induced dissociation of C2H2 molecule at 1.2 MeV using the time-dependent density-functional theory non-adiabatically coupled to nuclear dynamics. We find that molecular dissociation depends strongly on the ionization at the initial stage and the collision configuration. A detailed analysis shows a correspondence between the charge state of [C2H2]q+ and the final fragments. A remarkable impact parameter effect provides deep insights of bond breakup and electronic transport. We analyze two typical sequential dissociation channels reported in experiments by tracking structural and electronic dynamics in real time. Our results provide better understanding of experiments. Moreover, the comparison between various exchange-correlation functionals reveals that electrons' correlation and self-interaction do not significantly impact the initial ionization and fragment distribution in the present study.

Proton migration in hydrocarbons induced by slow highly charged ion impact.

Different from most of the previous studies using light or photons, we use highly charged ions as projectiles to activate proton migration in the smallest saturated and unsaturated hydrocarbon molecules, i.e., CH4 and C2H2. The H3 + formation channel (H3 + + CH+) and isomerization channel (C+ + CH2 +), serving as indicators of proton migration, are observed in the fragmentation of CH4 and C2H2 dications. Corresponding kinematical information, i.e., kinetic energy release, is for the first time obtained in the collisions with highly charged ions. In particular, for the C+ + CH2 + channel, a new pathway is identified, which is tentatively attributed to the isomerization on high-lying states of acetylene dication. The kinetic energy release spectra for other two-body breakup channels are also determined and precursor dication states could thus be identified.

Local Schottky contacts of embedded Ag nanoparticles in Al2O3/SiN x :H stacks on Si: a design to enhance field effect passivation of Si junctions.

This paper describes an original design leading to the field effect passivation of Si n+-p junctions. Ordered Ag nanoparticle (Ag-NP) arrays with optimal size and coverage fabricated by means of nanosphere lithography and thermal evaporation, were embedded in ultrathin-Al2O3/SiN x :H stacks on the top of implanted Si n+-p junctions, to achieve effective surface passivation. One way to characterize surface passivation is to use photocurrent, sensitive to recombination centers. We evidenced an improvement of photocurrent by a factor of 5 with the presence of Ag NPs. Finite-difference time-domain (FDTD) simulations combining with semi-quantitative calculations demonstrated that such gain was mainly due to the enhanced field effect passivation through the depleted region associated with the Ag-NPs/Si Schottky contacts.

Multivariate analysis of inflammatory endotypes in recurrent nasal polyposis in a Chinese population.

BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) remains a challenging clinical problem due to its propensity for recurrence. However, data on the frequency of CRSwNP recurrence after surgery in China are rare. METHODS: 78 CRSwNP patients undergoing functional endoscopic sinus surgery were followed-up for 8 years and classified into recurrent and non-recurrent groups. A cluster analysis of the CRSwNP based on inflammatory endotypes was performed, and the endotypes were secondarily matched with clinical phenotypes. RESULTS: The recurrence rate of CRSwNP in Southwest China was 21.8% over 8 years post-surgery. The CRSwNP was classified into 4 clusters: cluster 1 (higher expression of IL-5, IgE, and ECP and high positivity rate for SE-IgE); cluster 2 (higher concentrations of IL-6, IL-8 and MPO); cluster 3 (higher concentrations of TNF-alpha; and IFN-gamma); and cluster 4 (higher expression of IL-17). Cluster 1 (type-2 inflammation) exhibited the highest recurrence rate, co-morbid asthma and atopy. Notably, the ECP/MPO ratio increased significantly in patients with non-type-2 recurrent CRSwNP 8 years after the first surgery. CONCLUSION: Different inflammatory endotypes of CRSwNP exhibited clearly different prognoses. The type-2 subgroup had high recurrence and co-morbid asthma rates comparable to the rates reported in Western countries.

[Analysis of preoperative predictive factors and clinical characteristics in patients with parathyroid carcinoma].

Objective: To evaluate the clinical characteristics and preoperative predictive factors in patients with parathyroid carcinoma. Methods: From January 2010 to December 2016, 150 patients with pathologically and biochemically confirmed primary hyperparathyroidism were enrolled in this study. The clinical data were reviewed to define 28 cases of parathyroid hyperplasia, 14 cases of parathyroid carcinoma (PC), and 108 cases of parathyroid adenoma (PA). The clinical characteristics between PC and PA group were compared and analyzed to explore predictive factors for PC. Results: Patients in PC group were significantly younger than those in PA group (47.9±13.9 vs 57.2±14.6 years, P=0.026). The diameter of tumor in PC group was larger than that in PA group (3.6±1.8 vs 2.2±1.4 cm, P=0.005). The levels of albumin-corrected serum calcium, parathyroid hormone (PTH), and alkaline phosphatase (AKP) were all higher in PC group than those in PA group (3.4±0.6 vs 2.9±0.3 mmol/l; 1 157.1 vs 201.6 pg/ml; 168 vs 97 IU/L; all P<0.05). PC correlated with age(r=-0.241, P=0.007), albumin-corrected serum calcium (r=0.324, P<0.001), PTH levels (r=0.301, P=0.001), serum AKP (r=0.217, P=0.019) and tumor size(r=0.238, P=0.011). Receiver operator characteristic curve analysis showed that the optimum cut-off values as follows: albumin-corrected serum calcium 3.15 mmol/L, serum PTH concentration 1 011 pg/ml and tumor diameter 3.35 cm. These indicators can be helpful in the preoperative diagnosis of PC. Conclusions: Patients with PC were younger than the patients with PA. Albumin-corrected serum calcium, serum PTH concentration, and tumor diameter can be helpful in preoperative diagnosis of PC.

[The influence of gender on clinical manifestations of primary hyperparathyroidism].

To explore the impact of gender on presentation of primary hyperparathyroidism (PHPT), clinical data of 150 histopathologically proven PHPT patients were collected and retrospectively analyzed. Most of the patients (72.0%) were parathyroid adenoma (PA), and 9.3% of them were parathyroid carcinoma (PC). In PA patients, albumin-corrected serum calcium levels (TASC) were lower in women than in men [ (2.84±0.28) mmol/L vs. (3.03±0.34) mmol/L, P=0.006]. In all PHPT subjects, serum urea nitrogen, creatinine, uric acid levels were lower in women than in men. Bone pain was more frequent in women over 50 years old than in men (52.33% vs.29.17%, P=0.045). The incidence of PC was higher in men than in women (20.59% vs. 6.03%, P=0.010). In conclusion, there are gender differences in the clinical presentation of PHPT. TASC was high in men with PA compared to women with PA. Bone pain was more common in the woman patients over 50 years old, and PC was more common in men.