A multi-channel stimulator with an active electrode array implant for vagal-cardiac neuromodulation studies.

BACKGROUND: Implantable vagus nerve stimulation is a promising approach for restoring autonomic cardiovascular functions after heart transplantation. For successful treatment a system should have multiple electrodes to deliver precise stimulation and complex neuromodulation patterns. METHODS: This paper presents an implantable multi-channel stimulation system for vagal-cardiac neuromodulation studies in swine species. The system comprises an active electrode array implant percutaneously connected to an external wearable controller. The active electrode array implant has an integrated stimulator ASIC mounted on a ceramic substrate connected to an intraneural electrode array via micro-rivet bonding. The implant is silicone encapsulated for biocompatibility and implanted lifetime. The stimulation parameters are remotely transmitted via a Bluetooth telemetry link. RESULTS: The size of the encapsulated active electrode array implant is 8 mm × 10 mm × 3 mm. The stimulator ASIC has 10-bit current amplitude resolution and 16 independent output channels, each capable of delivering up to 550 µA stimulus current and a maximum voltage of 20 V. The active electrode array implant was subjected to in vitro accelerated lifetime testing at 70 °C for 7 days with no degradation in performance. After over 2 h continuous stimulation, the surface temperature change of the implant was less than 0.5 °C. In addition, in vivo testing on the sciatic nerve of a male Göttingen minipig demonstrated that the implant could effectively elicit an EMG response that grew progressively stronger on increasing the amplitude of the stimulation. CONCLUSIONS: The multi-channel stimulator is suitable for long term implantation. It shows potential as a useful tool in vagal-cardiac neuromodulation studies in animal models for restoring autonomic cardiovascular functions after heart transplantation.

Microsatellite instability in mismatch repair proficient colorectal cancer: clinical features and underlying molecular mechanisms.

BACKGROUND: Both defects in mismatch repair (dMMR) and high microsatellite instability (MSI-H) have been recognised as crucial biomarkers that guide treatment strategies and disease management in colorectal cancer (CRC). As MMR and MSI tests are being widely conducted, an increasing number of MSI-H tumours have been identified in CRCs with mismatch repair proficiency (pMMR). The objective of this study was to assess the clinical features of patients with pMMR/MSI-H CRC and elucidate the underlying molecular mechanism in these cases. METHODS: From January 2015 to December 2018, 1684 cases of pMMR and 401 dMMR CRCs were enrolled. Of those patients, 93 pMMR/MSI-H were identified. The clinical phenotypes and prognosis were analysed. Frozen and paraffin-embedded tissue were available in 35 patients with pMMR/MSI-H, for which comprehensive genomic and transcriptomic analyses were performed. FINDINGS: In comparison to pMMR/MSS CRCs, pMMR/MSI-H CRCs exhibited significantly less tumour progression and better long-term prognosis. The pMMR/MSI-H cohorts displayed a higher presence of CD8+ T cells and NK cells when compared to the pMMR/MSS group. Mutational signature analysis revealed that nearly all samples exhibited deficiencies in MMR genes, and we also identified deleterious mutations in MSH3-K383fs. INTERPRETATION: This study revealed pMMR/MSI-H CRC as a distinct subgroup within CRC, which manifests diverse clinicopathological features and long-term prognostic outcomes. Distinct features in the tumour immune-microenvironment were observed in pMMR/MSI-H CRCs. Pathogenic deleterious mutations in MSH3-K383fs were frequently detected, suggesting another potential biomarker for identifying MSI-H. FUNDING: This work was supported by the Science and Technology Commission of Shanghai Municipality (20DZ1100101).

Personalized circulating tumor DNA monitoring improves recurrence surveillance and management after curative resection of colorectal liver metastases: a prospective cohort study.

BACKGROUND: Approximately 60% of patients with colorectal liver metastases (CRLM) experience relapse within 2 years after radical resection, previous studies have proven that repeat local treatment (LT) could prolong survival, however, it is difficult to seize the window for LT due to the lack of a high-sensitive surveillance method. In this study, the authors aim to examine the value of longitudinal circulating tumor DNA (ctDNA) in guiding adjuvant chemotherapy, optimizing clinical surveillance strategy, and thereby improving CRLM outcomes. MATERIALS AND METHODS: The authors conducted a prospective clinical trial using a personalized, tumor-informed ctDNA assay to monitor 60 CRLM patients undergoing resection with curative intent. Formalin-fixed paraffin-embedded tumor samples were collected after surgery. Blood samples were collected before surgery, 30 days after surgery (post-OP), and every third month until relapse or up to 2 years. RESULTS: A total of 394 plasma samples from 60 eligible patients were analyzed, with a median follow-up time of 31.3 months. Landmark analyses revealed that detectable ctDNA at post-OP (HR, 4.8), postadjuvant chemotherapy (HR, 6.0), and end-of-treatment (HR, 5.6) were associated with higher recurrence risk ( P <0.001). Post-OP ctDNA positivity served as the only independent prognostic marker in the multivariant analysis (HR, 5.1; P <0.001). Longitudinal ctDNA analysis identified relapsed patients at both sensitivity and specificity of 100%. Most (75%) patients were found with radiological relapse within 6 months after the first detectable ctDNA with a median lead time of 3.5 months. In relapsed patients, 73.2% had oligometastatic disease and 61% were liver-restricted, of which 72.0% received repeat LTs, and 60.0% achieved a secondary no evidence of disease status. CONCLUSIONS: Longitudinal ctDNA monitoring assists in early prediction of relapse, and thereby improves survival of CRLM patients by increased secondary resection rate and secondary no evidence of disease rate.

Study protocol of short-course radiotherapy combined with CAPOX and PD-1 inhibitor for locally advanced colon cancer: a randomised, prospective, multicentre, phase II trial (TORCH-C).

INTRODUCTION: The preliminary result of the TORCH trial has shown a promising complete response (CR) for managing locally advanced rectal cancer with neoadjuvant short-course radiotherapy (SCRT) combined with chemotherapy and PD-1 inhibitor. For locally advanced colon cancer (LACC) with bulky nodal disease and/or clinically T4, neoadjuvant chemotherapy followed by colectomy with en bloc removal of regional lymph nodes is the suggested treatment. However, the CR rate is less than 5%. TORCH-C will aim to investigate neoadjuvant SCRT combined with chemotherapy and PD-1 inhibitor in LACC. METHODS AND ANALYSIS: TORCH-C is a randomised, prospective, multicentre, double-arm, open, phase II trial of SCRT combined with chemotherapy and immunotherapy in LACC with microsatellite stable (MSS) patients and cT4 or bulky nodes. Eligible patients will be identified by the multidisciplinary team. 120 patients will be randomised 1:1 to the intervention or control arm. The patients in the control arm will receive four cycles of capecitabine plus oxaliplatin (CAPOX). The patients in the intervention arm will receive SCRT, followed by four cycles of CAPOX and PD-1 inhibitor (serplulimab). Both arms will receive curative surgery, followed by four cycles of CAPOX. The primary endpoint is pathological complete regression.TORCH-C (TORCH-colon) trial aims to investigate whether the combination of immunotherapy and chemoradiotherapy improves the treatment effect in LACC with MSS. TORCH-C will establish the TORCH platform, a key part of our long-term strategy to develop neoadjuvant treatment for colorectal cancer. ETHICS AND DISSEMINATION: This study was approved by the Ethics Committee of Fudan University Shanghai Cancer Center (approval number: 2211265-12). TRIAL REGISTRATION NUMBER: NCT05732493.

Predictors of Perioperative Complications During Leo Baby Stent Treatment for Acutely Ruptured Intracranial Aneurysms: A Retrospective Multicenter Study.

BACKGROUND AND OBJECTIVES: Stent-assisted coiling (SAC) of acutely ruptured aneurysms has been controversial. Moreover, for aneurysms originating from small diameter vessels, the SAC presents more challenges. This study aimed to investigate the predictors of perioperative complications after SAC with Leo baby stent of acutely ruptured aneurysms. METHODS: We performed a retrospective multicenter analysis of 425 patients with acutely ruptured aneurysms treated with Leo baby. We compared clinical characteristics and outcomes among patients with perioperative complications and those without. Subgroup analysis, including thromboembolic and hemorrhagic complications, was also performed. RESULTS: Immediate postoperative angiograms showed Raymond 1 in 357 aneurysms (84.2%), 2 in 53 (12.5%), and 3 in 14 (3.3%). A total of 372 patients (87.5%) were independent (modified Rankin Scale [mRS] score 0-2) at discharge. Perioperative complications occurred in 18 cases (4.2%) harboring 13 cases (3.1%) of thromboembolic complications and 5 cases (1.2%) of hemorrhagic complications. Patients with perioperative complications had a higher rate of unfavorable outcomes at discharge (P = .018), especially with thromboembolic complications (P = .043). Multivariate analysis showed that higher preoperative mRS score (P = .004), irregular shape (P = .017), and larger aneurysms (P = .049) were independent predictors of the overall complications, whereas higher preoperative mRS score (P = .022) was an independent predictor for ischemic complications. The follow-up angiogram was available for 245 patients, and the follow-up angiograms revealed Raymond 1 in 223 aneurysms (91.0%), 2 in 19 (7.8%), and 3 in 3 (1.2%). CONCLUSION: Worse clinical condition, irregular shape, and larger aneurysms were independently associated with overall complications, whereas worse clinical condition was viewed as an independent predictor for thromboembolic complications. Attention to these factors is essential for the safe treatment and prognosis of patients with acutely ruptured aneurysms.

NAD(P)H:quinone Oxidoreductase 1 Is Involved in AZ-1-induced Apoptotic Effects in Nasopharyngeal Carcinoma TW01 Cells.

BACKGROUND/AIM: Current NPC treatment methods have improved the 5-year survival rates of patients; however, some patients do not benefit from the treatments. Therefore, the existing treatment methods or new drugs must be developed to improve the patient's prognosis. NAD (P)H:quinone oxidoreductase 1 (NQO1), an electron reductase highly expressed in various cancers, can convert aziridinyl-substituted quinone-derived compound into an alkylating agent, resulting in cell apoptosis. Therefore, a di-aziridinyl-substituted quinone-derived compound, AZ-1, was designed previously. The present study investigated whether AZ-1 has anticancer activities in NPC cells and explored the underlying mechanism. MATERIALS AND METHODS: NPC-TW01 cells were used in the study, and 3-(4,5-dimethylthiazol- 2-yl)-2,5-diphenyltetrazolium bromide, colony formation, terminal deoxynucleotidyl transferase dUTP nick end labeling, and immunoblotting assays were performed to assess the cell viability, cell survival, DNA fragmentation, and protein expression, respectively. RESULTS: The results show that AZ-1 significantly inhibited the viability and survival of NPC-TW01 cells. AZ-1 also induced the expression of cleaved PARP, cleaved caspase-8, cleaved caspase-9, and cleaved caspase-3, and triggered DNA fragmentation in NPC-TW01 cells. In addition, AZ-1 induced γH2AX expression, a DNA damage marker, in NPC-TW01 cells. Treatment with dicoumarol, an NQO1 activity inhibitor, not only reversed AZ-1-induced cell viability inhibition but also decreased AZ-1-induced expression of γH2AX, cleaved caspase-8, cleaved caspase-9, and cleaved caspase-3. CONCLUSION: NQO1 reverses AZ-1-triggered cell viability inhibition, DNA damage, and apoptosis. The findings of this study may provide a basis for the possible clinical application of AZ-1 in the treatment of NPC to improve the prognosis of patients with NPC.

The Largest Chinese Cohort Study Indicates Homologous Recombination Pathway Gene Mutations as Another Major Genetic Risk Factor for Colorectal Cancer with Heterogeneous Clinical Phenotypes.

While genetic factors were associated with over 30% of colorectal cancer (CRC) patients, mutations in CRC-susceptibility genes were identified in only 5% to 10% of these patients. Besides, previous studies on hereditary CRC were largely designed to analyze germline mutations in patients with single genetic high-risk factor, which limited understanding of the association between genotype and phenotypes. From January 2015 to December 2018, we retrospectively enrolled 2,181 patients from 8,270 consecutive CRC cases, covering 5 categories of genetic high-risk factors. Leukocyte genomic DNA was analyzed for germline mutations in cancer predisposition genes. The germline mutations under each category were detected and analyzed in association with CRC susceptibility, clinical phenotypes, and prognoses. A total of 462 pathogenic variants were detected in 19.3% of enrolled CRC patients. Mismatch repair gene mutation was identified in 9.1% of patients, most prevalent across all high-risk groups. Homologous recombination (HR) gene mutations were detected in 6.5% of cases, penetrated in early-onset and extra-colonic cancer risk groups. Mutations in HR genes, including BARD1, RAD50, and ATM, were found to increase CRC risk with odds ratios of 2.8-, 3.1-, and 3.1-fold, respectively. CRC patients with distinct germline mutations manifested heterogeneous phenotypes in clinicopathology and long-term prognoses. Thus, germline mutation screenings should be performed for CRC patients with any of those genetic risk factors. This study also reveals that HR gene mutations may be another major driver for increased CRC risk.

A one-stop approach to diagnosing hereditary colorectal cancer in the Chinese population.

BACKGROUND AND AIM: The current procedure for identifying hereditary colorectal cancer (HCRC) is time consuming in clinical practice. This study aimed to develop a time-saving approach to diagnosing HCRC. METHODS: A total of 100 suspected HCRC patients were prospectively enrolled (cohort 1) and 116 colorectal cancer patients with DNA mismatch repair-deficient were retrospectively included (cohort 2). Next-generation sequencing (NGS) tests were performed on tumors and matched white blood cells (WBCs) or normal tissues. Using the conventional method upon WBC/normal tissue-based NGS data as a reference, the performance of the ColonCore method using tumor-only-based NGS data in predicting germline variants was explored in cohort 1 and validated in cohort 2. RESULTS: In cohort 1, the ColonCore method diagnosed 17 Lynch syndrome (LS) and 14 familial adenomatous polyposis (FAP); and by the conventional method, the cases were 16 and 10, respectively. The ColonCore method showed sensitivities of 100% in diagnosing LS (positive predictive value [PPV] 94.1%) and FAP (PPV 71.4%). Moreover, two of seven patients with multiple adenomas/polyps who did not meet existing clinical criteria for HCRC were predicted to harbor germline variants in APC and MUTYH. Additionally, the sensitivity of the ColonCore method in identifying LS patients from cohort 2 reached 85.7% with a PPV of 85.7%. CONCLUSION: The ColonCore method might be an acceptable tool for predicting germline variants associated with HCRC. Our work indicates the essentiality of NGS tests in CRC patients for precision diagnosis and treatment.

Interface engineering strategy for multisource spintronic devices via TMPS4 modulation of black-phosphorus.

Interface engineering is an effective strategy for significantly providing performance improvements in logic operations and information storage techniques, given the quantum effects characteristic of pristine two-dimensional ferromagnetic (FM) materials. Furthermore, the van der Waals (vdW) heterostructures enable a more efficient design of logic components. Herein, two novel designs of van der Waals heterostructures are proposed, black-phosphorus (BP)/TMPS4(TM = Cr, Fe-Mn), where the CrPS4 relies on odd and even layers for FM state - antiferromagnetic (AFM) state alternation, which is used to modulate BP with high hole mobility but no magnetism. Based on the first principles, the simulation results show that the two heterojunctions exhibit high stability, carrier mobility, and thermoelectric effects, of which the BP/CrPS4 heterojunction is specifically modulated to a type II electronic bandstructure. These two structures are applied in multi-source logic devices. The device performances show that the devices have spin Sebeck effect (SSE), perfect spin filtering effect (SFE), high extinction ratio (1347), and high thermal magnetoresistivity (1011). The above results suggest BP/TMPS4 bilayers as promising candidates for spin-based vdW devices and facilitate the future development of atomically thin magnetic information storage.

Interfacial "Single-Atom-in-Defects" Catalysts Accelerating Li+ Desolvation Kinetics for Long-Lifespan Lithium-Metal Batteries.

The lithium-metal anode is a promising candidate for realizing high-energy-density batteries owing to its high capacity and low potential. However, several rate-limiting kinetic obstacles, such as the desolvation of Li+ solvation structure to liberate Li+ , Li0 nucleation, and atom diffusion, cause heterogeneous spatial Li-ion distribution and fractal plating morphology with dendrite formation, leading to low Coulombic efficiency and depressive electrochemical stability. Herein, differing from pore sieving effect or electrolyte engineering, atomic iron anchors to cation vacancy-rich Co1- x S embedded in 3D porous carbon (SAFe/CVRCS@3DPC) is proposed and demonstrated as catalytic kinetic promoters. Numerous free Li ions are electrocatalytically dissociated from the Li+ solvation complex structure for uniform lateral diffusion by reducing desolvation and diffusion barriers via SAFe/CVRCS@3DPC, realizing smooth dendrite-free Li morphologies, as comprehensively understood by combined in situ/ex situ characterizations. Encouraged by SAFe/CVRCS@3DPC catalytic promotor, the modified Li-metal anodes achieve smooth plating with a long lifespan (1600 h) and high Coulombic efficiency without any dendrite formation. Paired with the LiFePO4 cathode, the full cell (10.7 mg cm-2 ) stabilizes a capacity retention of 90.3% after 300 cycles at 0.5 C, signifying the feasibility of using interfacial catalysts for modulating Li behaviors toward practical applications.

Dental pulp stem cell-derived exosomes revitalize salivary gland epithelial cell function in NOD mice via the GPER-mediated cAMP/PKA/CREB signaling pathway.

BACKGROUND: Restoration of salivary gland function in Sjogren's syndrome (SS) is still a challenge. Dental pulp stem cells (DPSCs) derived exosomes had shown anti-inflammatory, anti-oxidative, immunomodulatory, and tissue function restorative abilities. However, the salivary gland function restoration potential of DPSCs-derived exosomes (DPSC-Exos) during SS has not been investigated yet. METHODS: DPSC-Exos was isolated by ultracentrifugation methods and characterized. Salivary gland epithelial cells (SGEC) were treated with interferon-gamma (IFN-γ) to mimic SS in vitro and cultured with or without DPSC-Exos. SGEC survival and aquaporin 5 (AQP5) expression were analyzed. mRNA sequencing and bioinformatics analysis were performed in IFN-γ vs. DPSC-Exos+ IFN-γ treated SGEC. Non-obese diabetic (NOD)/ltj female mice (SS model), were intravenously administered with DPSC-Exos, and salivary gland functions and SS pathogenicity were analyzed. Furthermore, the mRNA sequencing and bioinformatics predicted mechanism of the therapeutic effect of DPSC-Exos was further investigated both in vitro and in vivo using RT-qPCR, Western blot, immunohistochemistry, immunofluorescence, flowcytometry analysis. RESULTS: DPSC-Exos partially rescued IFN-γ triggered SGEC death. IFN-γ inhibited AQP5 expression in SGEC and DPSC-Exos reversed this effect. Transcriptome analysis showed GPER was the upregulated DEG in DPSC-Exos-treated SGEC with a positive correlation with salivary secretion-related DEGs. Pathway enrichment analysis revealed that DEGs were mainly attributed to estrogen 16 alpha-hydroxylase activity, extracellular exosome function, cAMP signaling, salivary secretion, and estrogen signaling. Intravenous injection of DPSC-Exos in NOD/ltj mice alleviated the SS syndrome as indicated by the increased salivary flow rate, attenuated glandular inflammation, and increased AQP5 expression. GPER was also upregulated in the salivary gland of DPSC-Exos-treated NOD/ltj mice compared with the PBS-treated NOD/ltj mice. IFN-γ+DPSC-Exos-treated SGEC showed higher expression of AQP5, p-PKA, cAMP, and intracellular Ca2+ levels compared with IFN-γ-treated SGEC. These effects were reversed by the inhibition of GPER. CONCLUSIONS: Our results showed that DPSC-Exos revitalize salivary gland epithelial cell function during SS via the GPER-mediated cAMP/PKA/CREB pathway suggesting the possible therapeutic potential of DPSC-Exos in SS-treatment.

Spin-gapless van der Waals heterostructure for spin gating through magnetic injection devices.

Spin-gapless semiconductors (SGSs) are new magnetic zero-bandgap materials whose band structure is extremely sensitive to external influences (pressure or magnetic fields) and have great potential for high-speed and low-energy spintronics applications. The first-principles method was used to systematically study the heterostructures constructed of an asymmetric surface-functionalized Janus MXene material, Cr2NOF, and a two-dimensional hexagonal lattice (2DH) semiconductor material and to study the effects of the electronic structure, Curie temperature, magnetism, and the design of unusual band structures and magnetic injection in the bilayer to obtain an SGS structure. Through the design and construction of Cr2NOF/2DH van der Waals heterojunction spintronic devices, the spin-filtering effect of the devices can reach 100%, especially, realizing spin gating through magnetic injection. We report the transport mechanism of the heterojunction spintronic devices to achieve the goal of a controllable optimization of the device functions, which provides a theoretical basis for the design of MXene van der Waals heterojunctions for high-efficiency and low-power-consumption spintronic devices.

Quasi-2D Mn3Si2Te6 Nanosheet for Ultrafast Photonics.

The magnetic nanomaterial Mn3Si2Te6 is a promising option for spin-dependent electronic and magneto-optoelectronic devices. However, its application in nonlinear optics remains fanciful. Here, we demonstrate a pulsed Er-doped fiber laser (EDFL) based on a novel quasi-2D Mn3Si2Te6 saturable absorber (SA) with low pump power at 1.5 µm. The high-quality Mn3Si2Te6 crystals were synthesized by the self-flux method, and the ultrathin Mn3Si2Te6 nanoflakes were prepared by a simple mechanical exfoliation procedure. To the best of our knowledge, this is the first time laser pulses have been generated using quasi-2D Mn3Si2Te6. A stable pulsed laser at 1562 nm with a low threshold pump power of 60 mW was produced by integrating the Mn3Si2Te6 SA into an EDFL cavity. The maximum power of the output pulse is 783 µW. The repetition rate can vary from 24.16 to 44.44 kHz, with corresponding pulse durations of 5.64 to 3.41 µs. Our results indicate that the quasi-2D Mn3Si2Te6 is a promising material for application in ultrafast photonics.

Multiconfiguration b-AsP-based doping systems with enriched elements (C and O): novel materials for spintronic devices.

Black arsenical phosphorus (b-AsP), a derivative of black phosphorus, is a bimetallic alloy compound with the advantage of high carrier mobility, high stability, and tailorable configuration. However, lack of an effective tool to facilitate the application of AsP as a magnetic device. Herein, band gap modulation and the introduction of magnetism can be achieved by doping non-metallic atoms in three different AsP configurations. And the doping of the same atom will cause variation in the electronic structure depending on the configuration. Surprisingly, doping with both enriched elements C and O transforms AsP into a magnetic material. Furthermore, the source of the magnetic moment is explained by solving the wave function of the doped AsP, which is caused by the orbital coupling of the C and O atoms to AsP. To excavate the potentials of this magnetic AsP system for magnetic devices, field-effect transistors based on two doped armchair AsP3 nanoribbons are simulated. The devices show considerable negative differential conductivity effect and good spin filtering efficiency. These findings suggest that AsP doping with enriched elements C and O could be an excellent candidate for future spintronics applications.

Bimetallic Alloys b-AsxP1-x at High Concentration Differences: Ideal for Photonic Devices.

Black arsenic phosphorus (b-AsxP1-x) is expected to be one of the primary materials for future photonic devices. However, the x-factor is randomly estimated and applied in photonic devices in current studies, rather than systematically analyzing it for a comprehensive understanding. Herein, AsxP1-x switches from a direct band gap semiconductor to an indirect band gap one at x = 0.75. AsxP1-x at x ≤ 0.25 is capable of broadband absorption, while b-AsxP1-x at x ≥ 0.75 can only absorb at specific wavelengths in the perspective of the electron energy transition. Additionally, the optoelectronic response of the integral field-effect transistor configurations constructed with b-AsxP1-x is investigated systematically as a photodetector device. The photonic response characteristics show high polarization sensitivity at x ≥ 0.75, but a typical circuit system signal at x ≤ 0.25. These results suggest that b-AsxP1-x with high concentration differences is a perfect candidate for photonic material.

The pattern and treatment outcomes for rectal cancer with concurrent locoregional recurrence and distant metastases after total mesorectal excision.

BACKGROUND: To study the pattern and treatment outcome of rectal cancer (RC) with concurrent locoregional recurrence (LR) and distant metastasis (DM) after total mesorectal excision (TME) and to identify patient-, disease-, and treatment-related factors associated with differences in prognosis after concurrent LR and DM. METHODS: RC patients who were diagnosed with concurrent LR and DM after TME from May 2015 to June 2019 were included in our study. All patients received single or multiple treatment modalities under the guidance of multidisciplinary team (MDT) of colorectal cancer in Fudan University Shanghai Cancer Center. The prognostic value of various clinicopathological factors for survival were calculated by Kaplan-Meier curves and Cox regression analyses. RESULTS: A total of 74 RC patients with concurrent LR and DM who had undergone TME with a median follow-up of 27 months were eligible for analysis. The median survival of the included patients was 34 months, and 30 patients (41%) died. Fifty-nine patients (80%) underwent comprehensive treatments. Patients with oligometastatic disease (OMD) achieved no evidence of disease (NED) status more frequently than those with multiple metastases (P = 0.003). In the univariate analysis, patients achieving NED, diagnosed with OMD and five or less peritoneal metastases tended to have longer survival after LR and DM diagnosis (P < 0.05). In the multivariate analysis, attaining NED status was the only independent factor for survival (hazard ratio (HR), 2.419; P = 0.032). Survival after concurrent LR and DM in the non-NED group was significantly shorter than that in the NED group (median survival, 32 vs. 46 months; HR, 2.7; P = 0.014). CONCLUSIONS: The pattern and treatment outcome of RC with concurrent LR and DM after TME has changed with the development of multiple treatment modalities. Although the prognosis remains poor, pursuing NED status through comprehensive treatments may improve the survival of RC patients with concurrent LR and DM after TME.

Frontier and Hot Topics of Pulsed Fiber Lasers via CiteSpace Scientometric Analysis: Passively Mode-Locked Fiber Lasers with Real Saturable Absorbers Based on Two-Dimensional Materials.

Pulsed fiber lasers, with high peak power and narrow pulse widths, have been proven to be an important tool for a variety of fields of application. In this work, frontier and hot topics in pulsed fiber lasers were analyzed with 11,064 articles. Benefitting from the scientometric analysis capabilities of CiteSpace, the analysis found that passively mode-locked fiber lasers with saturable absorbers (SAs) based on two-dimensional (2D) materials have become a hot research topic in the field of pulsed fiber lasers due to the advantages of self-starting operation, high stability, and good compatibility. The excellent nonlinear optical properties exhibited by 2D materials at nanometer-scale thicknesses have become a particularly popular research topic; the research has paved the way for exploring its wider applications. We summarize the performance of several typical 2D materials in ultrafast fiber lasers, such as graphene, topological insulators (TIs), transition metal dichalcogenides (TMDs), and black phosphorus (BP). Meanwhile, we review and analyze the direction of the development of 2D SAs for ultrafast fiber lasers.

A first-principles study of the ultra-high spin rectification effect based on nitride MXenes (Sc2NO2, Ti2NO2).

Nitride MXenes exhibit inherent strong chemical stability and ferromagnetic properties, which are significant for their application in nanoscale spintronic devices. To demonstrate the potential of nitride MXenes in spintronics, we have designed a Sc2NO2/Ti2NO2 heterojunction and investigated its spin transport properties using first principles calculations combined with the non-equilibrium Green's function. The results show that the Sc2NO2/Ti2NO2 heterojunction has a stable negative differential resistance effect and a great spin rectification effect with a rectification ratio of 1.73 × 1011. The corresponding energy band structures and the transport behavior establish the mechanism for such properties. In addition, the perfect two-dimensional morphology provides a suitable nanostructured material for developing spintronic devices.

Patient-Derived Organoids from Colorectal Cancer with Paired Liver Metastasis Reveal Tumor Heterogeneity and Predict Response to Chemotherapy.

There is no effective method to predict chemotherapy response and postoperative prognosis of colorectal cancer liver metastasis (CRLM) patients. Patient-derived organoid (PDO) has become an important preclinical model. Herein, a living biobank with 50 CRLM organoids derived from primary tumors and paired liver metastatic lesions is successfully constructed. CRLM PDOs from the multiomics levels (histopathology, genome, transcriptome and single-cell sequencing) are comprehensively analyzed and confirmed that this organoid platform for CRLM could capture intra- and interpatient heterogeneity. The chemosensitivity data in vitro reveal the potential value of clinical application for PDOs to predict chemotherapy response (FOLFOX or FOLFIRI) and clinical prognosis of CRLM patients. Taken together, CRLM PDOs can be utilized to deliver a potential application for personalized medicine.

A Fully Implantable Opto-Electro Closed-Loop Neural Interface for Motor Neuron Disease Studies.

This paper presents a fully implantable closed-loop device for use in freely moving rodents to investigate new treatments for motor neuron disease. The 0.18 µm CMOS integrated circuit comprises 4 stimulators, each featuring 16 channels for optical and electrical stimulation using arbitrary current waveforms at frequencies from 1.5 Hz to 50 kHz, and a bandwidth programmable front-end for neural recording. The implant uses a Qi wireless inductive link which can deliver >100 mW power at a maximum distance of 2 cm for a freely moving rodent. A backup rechargeable battery can support 10 mA continuous stimulation currents for 2.5 hours in the absence of an inductive power link. The implant is controlled by a graphic user interface with broad programmable parameters via a Bluetooth low energy bidirectional data telemetry link. The encapsulated implant is 40 mm × 20 mm × 10 mm. Measured results are presented showing the electrical performance of the electronics and the packaging method.