Using three-dimensional model-based tumour volume change to predict the symptom improvement in patients with renal cell cancer.

In our recent study, we explored the efficacy of three-dimensional (3D) measurement of tumor volume in predicting the improvement of quality of life (QoL) in patients suffering from renal cell cancer (RCC), who were treated with axitinib and anti-PD-L1 antibodies. This study encompassed 18 RCC patients, including 10 men and 8 women, with an average age of 56.83 ± 9.94 years. By utilizing 3D Slicer software, we analyzed pre- and post-treatment CT scans to assess changes in tumor volume. Patients' QoL was evaluated through the FKSI-DRS questionnaire. Our findings revealed that 3D models for all patients were successfully created, and there was a moderate agreement between treatment response classifications based on RECIST 1.1 criteria and volumetric analysis (kappa = 0.556, p = 0.001). Notably, nine patients reported a clinically meaningful improvement in QoL following the treatment. Interestingly, the change in tumor volume as indicated by the 3D model showed a higher area under the curve in predicting QoL improvement compared to the change in diameter measured by CT, although this difference was not statistically significant (z = 0.593, p = 0.553). Furthermore, a multivariable analysis identified the change in tumor volume based on the 3D model as an independent predictor of QoL improvement (odds ratio = 1.073, 95% CI 1.002-1.149, p = 0.045).In conclusion, our study suggests that the change in tumor volume measured by a 3D model may be a more effective predictor of symptom improvement in RCC patients than traditional CT-based diameter measurements. This offers a novel approach for assessing treatment response and patient well-being, presenting a significant advancement in the field of RCC treatment.

Surface Finish Analysis of Gradient Voltage Electrochemical Polishing of 316L Stainless Steel Parts Forming by Laser Powder Bed Fusion.

Laser powder bed fusion (LPBF) of complex-structure 316L stainless steel (316L ss) parts has a wide application prospects in aerospace, biomedical, and defense industry fields. However, the surface roughness (Ra) of the LPBF sample is unsatisfactory due to the process characteristics of layer-by-layer selective melting and cumulative forming, which limits its applications in the engineering field. Herein, a gradient voltage electrochemical polishing strategy is proposed based on the characteristics of electrochemical polishing technology, which can polish complex structures. The mechanisms of polishing process parameters and polishing strategy on the surface finish of LPBF parts are investigated. The gradient voltage polishing strategy is extended to complex structures, and the Ra of the inner surfaces of square and round tubes are successfully reduced to about 1 µm. The gradient electrochemical polishing process for surface finish post-treatment of LPBF parts can broaden the engineering applications of complex-structure metal parts.

Scanning Tunneling Spectroscopy Investigation of Au-bis-acetylide Networks on Au(111): The Influence of Metal-Organic Hybridization.

Graphdiyne (GDY) is an appealing two-dimensional carbon material, but the on-surface synthesis of a single layer remains challenging. Demetalation of well-crystalline metal acetylide networks, though in its infancy, provides a new avenue to on-surface synthesized GDY substructures. In spite of the synthetic efforts and theoretical concerns, there are few reports steeped in elaborate characterization of the electronic influence of metalation. In this context, we focused on the surface supported Au-bis-acetylide network, which underwent demetalation after further annealing to form hydrogen-substituted GDY. We made a comprehensive study on the geometric structure and electronic structure and the corresponding demetalized structure on Au(111) through STM, noncontact atomic force microscopy (nc-AFM), scanning tunneling spectroscopy (STS), and density functional theory (DFT) simulations. The bandgap of the Au-bis-acetylide network on Au(111) is measured to be 2.7 eV, while the bandgap of a fully demetalized Au-bis-acetylide network is estimated to be about 4.1 eV. Our findings reveal that the intercalated Au adatoms are positioned closer to the metal surface compared with the organic skeletons, facilitating electronic hybridization between the surface state and unoccupied frontier molecular orbitals of organic components. This leads to an extended conjugation through Au-bis-acetylene bonds, resulting in a reduced bandgap.

Revealing the anti-inflammatory ingredients in wine-processed Radix et Rhizoma Rhei using immobilized cysteinyl leukotriene receptor type 1 as the stationary phase.

Despite the tremendous progress of wine-processed Radix et Rhizoma Rhei (Jiudahuang, JDH) in removing toxic heat from the blood in the upper portion of the body for hundreds of years, the deep understanding of its functional material basis of the anti-inflammatory ingredients remains unclear due to the lack of high specific and efficient methods. Herein, taking Cysteinyl leukotriene receptor type 1(CysLT1R) as the target protein, we established a chromatographic method based on the immobilized CysLT1R using haloalkane dehalogenases (Halo) at the C-terminus of the receptor in one step. After careful characterization by X-ray photoelectronic spectroscopy, immune-fluorometric analysis, and chromatographic investigations, the immobilized receptor was used to screen the anti-inflammatory ingredients in JDH. Aloe-emodin, rhein, emodin, chrysophanol, and physcion were identified as the main anthraquinone exerting anti-inflammatory effects in the drug. The association constants for the five compounds to bind with the receptor were calculated as (0.30 ± 0.06)× 105, (0.35 ± 0.03)× 105, (0.46 ± 0.05)× 105, (1.05 ± 0.14)× 105, and (1.66 ± 0.17)× 105 M-1 by injection amount-dependent method. Meanwhile, hydrogen bonds were identified as the main driving force for the five compounds to bind with CysLT1R by molecular docking. Based on these results, we believe that the immobilized receptor chromatography preserves historic significance in revealing the functional material basis of the complex matrices.

Copper neurotoxicity: Induction of cognitive dysfunction: A review.

Cognitive dysfunction occurs mainly in certain diseases and in the pathological process of aging. In addition to this, it is also widespread in patients undergoing anesthesia, surgery, and cancer chemotherapy. Neuroinflammation, oxidative stress, mitochondrial dysfunction, impaired synaptic plasticity, and lack of neurotrophic support are involved in copper-induced cognitive dysfunction. In addition, recent studies have found that copper mediates cuproptosis and adversely affects cognitive function. Cuproptosis is a copper-dependent, lipoylated mitochondrial protein-driven, non-apoptotic mode of regulated cell death, which provides us with new avenues for identifying and treating related diseases. However, the exact mechanism by which cuproptosis induces cognitive decline is still unclear, and this has attracted the interest of many researchers. In this paper, we analyzed the pathological mechanisms and therapeutic targets of copper-associated cognitive decline, mainly in the context of neurodegenerative diseases, psychiatric and psychological disorders, and diabetes mellitus.

Comparison of intravenous butorphanol vs. tramadol for post-spinal anesthesia shivering: a meta-analysis and systematic review.

Background: Patients often experience shivering after spinal anesthesia. In recent years, more and more studies have compared the efficacy and side effects of intravenous butorphanol and tramadol in the treatment of shivering after spinal anesthesia. Therefore, we conducted a MATE analysis and systematic review to compare the efficacy and side effects of butorphanol vs. tramadol in the treatment of shivering after spinal anesthesia. Methods: PubMed, Cochrane Library, and Embase databases were searched for randomized controlled trials (RCTs) from inception to 30 December 2022, comparing the effects of butorphanol vs. tramadol for the control of shivering after spinal anesthesia. Data assessment and collection were analyzed using the Review Manager 5.4 software. Results: Five randomized controlled trials involving 302 adult patients were included in this meta-analysis. The results showed that butorphanol has a shorter time to cease shivering (standardized mean difference (SMD) = -0.53; 95% confidence interval (CI) [-0.89, -0.17], P = 0.004, I2 = 0%), a higher rate of cessation of shivering within 1 min after administering the study drugs (relative risk (RR), 1.69; 95% CI [1.15,2.48], P = 0.008, I2 = 0%), and higher incidences of sedation (RR, 2.98; 95% CI [2.11, 4.21], P <0.00001, I2 = 0%), compared with tramadol. Conclusion: In the treatment of shivering after spinal anesthesia, butorphanol has a shorter onset time and a higher rate of cessation of shivering within 1 min after the study drugs were administered than tramadol. Therefore, butorphanol is superior to tramadol in the treatment of shivering after spinal anesthesia.

Genetically predicted plasma levels of amino acids and metabolic dysfunction-associated fatty liver disease risk: a Mendelian randomization study.

BACKGROUND: Emerging metabolomics-based studies suggested links between amino acid metabolism and metabolic dysfunction-associated fatty liver disease (MAFLD) risk; however, whether there exists an aetiological role of amino acid metabolism in MAFLD development remains unknown. The aim of the present study was to assess the causal relationship between circulating levels of amino acids and MAFLD risk. METHODS: We conducted a two-sample Mendelian randomization (MR) analysis using summary-level data from genome-wide association studies (GWAS) to evaluate the causal relationship between genetically predicted circulating levels of amino acids and the risk of MAFLD. In the discovery MR analysis, we used data from the largest MAFLD GWAS (8434 cases and 770,180 controls), while in the replication MR analysis, we used data from a GWAS on MAFLD (1483 cases and 17,781 controls) where MAFLD cases were diagnosed using liver biopsy. We used Wald ratios or inverse variance-weighted (IVW) methods in the MR main analysis and weighted median and MR-Egger regression analyses in sensitivity analyses. Furthermore, we performed a conservative MR analysis by restricting genetic instruments to those directly involved in amino acid metabolism pathways. RESULTS: We found that genetically predicted higher alanine (OR = 1.43, 95% CI 1.13-1.81) and lower glutamine (OR = 0.83, 95% CI 0.73-0.96) levels were associated with a higher risk of developing MAFLD based on the results from the MR main and conservative analysis. The results from MR sensitivity analyses and complementary analysis using liver proton density fat fraction as a continuous outcome proxying for MAFLD supported the main findings. CONCLUSIONS: Novel causal metabolites related to MAFLD development were uncovered through MR analysis, suggesting future potential for evaluating these metabolites as targets for MAFLD prevention or treatment.

Effects of extracorporeal circulation with different time on platelet count after cardiac surgery: a retrospective study based on medical records.

Our objective was to observe the effects of extracorporeal circulation (ECC) with different time on platelet count in patients undergoing cardiac surgery. A total of 427 patients who underwent elective cardiac surgery under ECC in affiliated hospital of north Sichuan medical college from January 1, 2018 to July 31, 2021 were divided into three groups according to ECC time. We concluded that thrombocytopenia was common after ECC, maximum drop of the platelet counts after ECC was usually seen on the second day after ECC, and platelet counts started to recover on the fifth day after ECC. With the extension of ECC time, the drop in platelet counts is more pronounced, the volume of perioperative blood loss and blood products transfusion are more, and the recovery level and speed of platelet counts is lower.

The role of anesthetic drug and technique in endothelial glycocalyx: A narrative review.

The level of endothelial glycocalyx (EG) shedding is associated with morbidity and mortality, and vascular endothelial barrier dysfunction is one of the pivotal clinical problems faced by critically ill patients, so research on the protective effects of EG is of great clinical significance for the treatment of critically ill diseases. Studies have illustrated that clinical anesthesia has different degrees of effects on vascular EG. Therefore, we reviewed the effects of distinct anesthesia methods and diverse anesthetic drugs on EG, aiming to provide a brief summary of what we know now, and to discuss possible future directions for investigations in this area. So as to provide a theoretical basis for future research on potential EG-positive drugs and targets, to minimize perioperative complications and improve the prognosis of surgical patients.

Significantly anisotropic Raman response of the (110) surface in quasi-one-dimensional system (TaSe4)2I by polarized Raman spectroscopy.

Quasi-one-dimensional materials are usually characterized by optical response spectroscopy methods, which show significant polarization dependence. Herein, we report a systematical investigation of polarized Raman scattering on the (110) crystal surface of the layered (TaSe4)2I compound. Taking into account group theory analysis of the crystal structure and the Raman tensor transformation technique, the vibrational mode of the Raman peaks can be differentiated by the angular dependence of the Raman peak intensity in parallel and vertical polarization Raman scattering tests. Moreover, density functional perturbation theory (DFPT) calculation confirmed the form of the Raman tensor of the (110) crystal surface, which was consistent with the result of the Raman tensor transformation technique, and the Raman spectrum and phonon dispersion curve calculations were also performed based on the Vienna ab initio simulation package (VASP). This new method provides useful insight for accurately identifying the lattice vibration behavior in new 2D layered structures.

Overexpression of RACGAP1 by E2F1 Promotes Neuroendocrine Differentiation of Prostate Cancer by Stabilizing EZH2 Expression.

Neuroendocrine prostate cancer (NEPC) is a lethal subtype of prostate cancer. It is characterized by the loss of androgen receptor (AR) signaling in neuroendocrine transdifferentiation, and finally, resistance to AR-targeted therapy. With the application of a new generation of potent AR inhibitors, the incidence of NEPC is gradually increasing. The molecular mechanism of neuroendocrine differentiation (NED) after androgen deprivation therapy (ADT) remains largely unclear. In this study, using NEPC-related genome sequencing database analyses, we screened RACGAP1, a common differentially expressed gene. We investigated RACGAP1 expression in clinical prostate cancer specimens by IHC. Regulated pathways were examined by Western blotting, qRT-PCR, luciferase reporter, chromatin immunoprecipitation, and immunoprecipitation assays. The corresponding function of RACGAP1 in prostate cancer was analyzed by CCK-8 and Transwell assays. The changes of neuroendocrine markers and AR expression in C4-2-R and C4-2B-R cells were detected in vitro. We confirmed that RACGAP1 contributed to NE transdifferentiation of prostate cancer. Patients with high tumor RACGAP1 expression had shorter relapse-free survival time. The expression of RACGAP1 was induced by E2F1. RACGAP1 promoted neuroendocrine transdifferentiation of prostate cancer by stabilizing EZH2 expression in the ubiquitin-proteasome pathway. Moreover, overexpression of RACGAP1 promoted enzalutamide resistance of castration-resistant prostate cancer (CRPC) cells. Our results showed that the upregulation of RACGAP1 by E2F1 increased EZH2 expression, which drove NEPC progression. This study explored the molecular mechanism of NED and may provide novel methods and ideas for targeted therapy of NEPC.

Pyridinic Nitrogen Modification for Selective Acetylenic Homocoupling on Au(111).

On-surface acetylenic homocoupling has been proposed to construct carbon nanostructures featuring sp hybridization. However, the efficiency of linear acetylenic coupling is far from satisfactory, often resulting in undesired enyne products or cyclotrimerization products due to the lack of strategies to enhance chemical selectivity. Herein, we inspect the acetylenic homocoupling reaction of polarized terminal alkynes (TAs) on Au(111) with bond-resolved scanning probe microscopy. The replacement of benzene with pyridine moieties significantly prohibits the cyclotrimerization pathway and facilitates the linear coupling to produce well-aligned N-doped graphdiyne nanowires. Combined with density functional theory calculations, we reveal that the pyridinic nitrogen modification substantially differentiates the coupling motifs at the initial C-C coupling stage (head-to-head vs head-to-tail), which is decisive for the preference of linear coupling over cyclotrimerization.

Highly Selective On-Surface [2 + 2] Cycloaddition Induced by Hierarchical Metal-Organic Hybrids.

On-surface synthesis of phenylenes is a promising strategy to form extended π-conjugated frameworks but normally lacks selectivity in achieving uniform products. Herein we demonstrate that the debromination reaction of 2,3-dibromophenazine (DBPZ) on Au(111) and Ag(111) surfaces can vary significantly considering the involvement of metal-organic hybrids (MOHs). On Au(111), [2 + 2] and [2 + 2 + 2] cycloadditions facilitate instantaneously upon the debromination occurring, while on Ag(111), several MOHs have been observed under sequential thermal annealing, leading to finally the uniform [2 + 2] cycloaddition product exclusively. By means of scanning tunneling microscopy (STM) and bond-resolved atomic force microscopy (BR-AFM), we have unambiguously depicted the chemical structure of related reaction intermediates and unraveled the undocumented role of hierarchical evolution of MOHs in steering the chemical selectivity.

Metallic 4D Printing of Laser Stimulation.

4D printing of metallic shape-morphing systems can be applied in many fields, including aerospace, smart manufacturing, naval equipment, and biomedical engineering. The existing forming materials for metallic 4D printing are still very limited except shape memory alloys. Herein, a 4D printing method to endow non-shape-memory metallic materials with active properties is presented, which could overcome the shape-forming limitation of traditional material processing technologies. The thermal stress spatial control of 316L stainless steel forming parts is achieved by programming the processing parameters during a laser powder bed fusion (LPBF) process. The printed parts can realize the shape changing of selected areas during or after forming process owing to stress release generated. It is demonstrated that complex metallic shape-morphing structures can be manufactured by this method. The principles of printing parameters programmed and thermal stress pre-set are also applicable to other thermoforming materials and additive manufacturing processes, which can expand not only the materials used for 4D printing but also the applications of 4D printing technologies.

Analysis of the efficacy and risk factors of surgical treatment of recurrent UPJO in adults.

BACKGROUND: To compare the efficacy of secondary pyeloplasty and balloon dilation and to analyze the risk factors for secondary surgical failure in patients with recurrent uretero-pelvic junction obstruction (UPJO). METHODS: We retrospectively analyzed 65 patients with recurrent UPJO who underwent secondary surgery between September 2011 and March 2019, of whom 33 had complete baseline data and follow-up data. General clinical information, perioperative data, and follow-up results were collected from patients. Risk factors for surgical failure in patients with recurrent UPJO were analyzed using logistic regression. RESULTS: The failure rates of secondary pyeloplasty and balloon dilation in secondary surgery were 16.7% and 33.3%, respectively. Univariate analysis showed that ureteral stenosis length and operative time were associated with secondary pyeloplasty and balloon dilatation failure (p < 0.05), and ureteral stenosis length was an independent risk factor for secondary pyeloplasty failure (OR = 0.074, 95% CI: 0.006-0.864, p = 0.038). In the balloon dilation group, treatment failure rates were significantly lower in patients with stenotic segment lengths less than 1 ± 0.32 cm than in patients with stenotic segment lengths greater than 1 ± 0.32 cm (p = 0.019). CONCLUSIONS: The secondary pyeloplasty may provide better benefit. Ureteral stricture length is an independent risk factor for failure of secondary pyeloplasty and a potential risk factor for balloon dilatation. Operation time is a potential risk factor for pyeloplasty and balloon dilatation.

Development and validation of a 3D-convolutional neural network model based on chest CT for differentiating active pulmonary tuberculosis from community-acquired pneumonia.

PURPOSE: To develop and validate a 3D-convolutional neural network (3D-CNN) model based on chest CT for differentiating active pulmonary tuberculosis (APTB) from community-acquired pneumonia (CAP). MATERIALS AND METHODS: Chest CT images of APTB and CAP patients diagnosed in two imaging centers (n = 432 in center A and n = 61 in center B) were collected retrospectively. The data in center A were divided into training, validation and internal test sets, and the data in center B were used as an external test set. A 3D-CNN was built using Keras deep learning framework. After the training, the 3D-CNN selected the model with the highest accuracy in the validation set as the optimal model, which was applied to the two test sets in centers A and B. In addition, the two test sets were independently diagnosed by two radiologists. The 3D-CNN optimal model was compared with the discrimination, calibration and net benefit of the two radiologists in differentiating APTB from CAP using chest CT images. RESULTS: The accuracy of the 3D-CNN optimal model was 0.989 and 0.934 with the internal and external test set, respectively. The area-under-the-curve values with the 3D-CNN model in the two test sets were statistically higher than that of the two radiologists (all P < 0.05), and there was a high calibration degree. The decision curve analysis showed that the 3D-CNN optimal model had significantly higher net benefit for patients than the two radiologists. CONCLUSIONS: 3D-CNN has high classification performance in differentiating APTB from CAP using chest CT images. The application of 3D-CNN provides a new automatic and rapid diagnosis method for identifying patients with APTB from CAP using chest CT images.

Mapping of Global Research on Electronic Cigarettes: A Bibliometric Analysis.

Electronic cigarettes (E-cigarettes) use has increased rapidly in the past decades and has been widely studied by scholars worldwide, whereas the research topics and development trends in this field are still unclear. This study aimed to explore the landscape of research relating to e-cigarettes. The data outputted from the Web of Science Core Collection database was used for bibliometric analysis. Frequencies and percentages were used to describe the publications' characteristics. Visualizing maps were designed using VOSviewer 1.6.9 and CiteSpace 5.8 R2. Overall, a total of 7,979 records were identified in the database and the number of researches increased rapidly since 2010. All publications involved 19837 authors, with the top ten authors contributing to 8.71% (695) of all documents. The most productive country and institution were the United States of America and the University of California San Francisco, respectively. Nicotine & Tobacco Research was not only the journal with the most published papers but also the most co-cited journal. The main research domains in this field were the prevalence, awareness, reasons for using e-cigarettes; e-cigarettes use for tobacco harm reduction; exposure in the population; and the relationship between e-cigarettes and tobacco and nicotine. E-cigarettes researches have become a popular field for scholars. The hot topics on e-cigarette research were extensive and changed over the past decade.

Converting n-Alkanol to Conjugated Polyenal on Cu(110) Surface at Mild Temperature.

Achieving C(sp3)-H activation at a mild temperature is of great importance from both scientific and technologic points of view. Herein, on the basis of the on-surface synthesis strategy, we report the significant reduction of the C(sp3)-H activation barrier, which results in the full C(sp3)-H to C(sp2)-H transformation of n-alkanol (octacosan-1-ol) at a mild temperature as low as 350 K on the Cu(110) surface, yielding the conjugated polyenal (octacosa-tridecaenal) as the final product. The reaction mechanism is revealed by the combined scanning tunneling microscope, density functional theory, and synchrotron radiation photoemission spectroscopy.

On-Surface Debromination of 2,3-Bis(dibromomethyl)- and 2,3-Bis(bromomethyl)naphthalene: Dimerization or Polymerization?

We describe the on-surface dehalogenative homocoupling of benzylic bromides, namely bis-bromomethyl- and bis-gem-(dibromomethyl) naphthalene as a potential route to either hydrocarbon dimers or conjugated polymers on Au(111). While bis-gem-(dibromomethyl) naphthalene affords different dimers with naphthocyclobutadiene as the key intermediate, bis-bromomethyl naphthalene furnishes a poly(o-naphthylene vinylidene) as a non-conjugated polymer which undergoes dehydrogenation toward its conjugated derivative poly(o-naphthylene vinylene) upon mild annealing. A combination of scanning tunneling microscopy, non-contact atomic force microscopy and density functional theory calculations provides deep insights into the prevailing mechanisms.

Development of a Core Outcome Set in the Clinical Trials of Traditional Chinese Medicine for Stroke: A Study Protocol.

Introduction: Stroke, an acute cerebrovascular disease, is mainly caused by the sudden rupture or occlusion of blood vessels, and is subdivided into ischemic stroke and hemorrhagic stroke. It has become the second leading cause of death worldwide. In Chinese clinical practice, traditional Chinese medicine (TCM)/Integrative Medicine has been widely used for the treatment of stroke. Numerous randomized controlled trials (RCTs) of TCM/Integrative Medicine for stroke have been conducted to improve the efficacy and safety outcomes. However, their conclusions should be treated with caution because of the methodological quality defects in the clinical research. Pervasive inconsistencies are present in the outcomes collected and reported across these studies, which may lead to the pooling of discrepant data and preclude meta-analysis. The issue could be addressed by developing a core outcome set (COS). Aim: The aim of this study is to develop a COS in the clinical trials of TCM/Integrative Medicine in the treatment of stroke. Method and Analysis: A steering group will be set up to organize and guide the development of the COS. The study contains three phases: (I) development of an initial outcome list covering all relevant outcomes, via two steps: (i) systematic reviews of outcomes for clinical trials of TCM/ Integrative Medicine for stroke; (ii) semi-structured interviews with patients suffering from stroke; (II) conduction of three round of Delphi surveys with different stakeholder groups to prioritize important outcomes; (III) integration of outcomes into a core outcome set by a consensus meeting. Ethics and Dissemination: This study has been granted by the Ethics Committee of Tianjin University of Traditional Chinese Medicine (TJUTCM-EC20210003). When the COS is completed, we will publish it in an appropriate journal to promote further widespread use. Registration: This study has been registered at the Core Outcome Measures in Effectiveness Trials initiative, COMET database (Registration #1678).