Combination of handgrip strength and high-sensitivity modified Glasgow prognostic score predicts survival outcomes in patients with colon cancer.

Objective: Handgrip strength (HGS) and the high-sensitivity modified Glasgow prognostic score (HS-mGPS) are associated with the survival of patients with cancer. However, no studies have investigated the combined effect of HGS and HS-mGPS on the overall survival (OS) of patients with colon cancer. Methods: Prospective follow-up data of colon cancer patients undergoing radical resection from April, 2016 to September, 2019 were retrospectively collected. We combined the HGS and HS-mGPS to create a new composite index, HGS-HS-mGPS. The hazard ratio (HR) and 95% confidence interval (CI) were calculated using Cox regression models to assess the association between variables and OS. Risk factors on OS rates were investigated by Cox analyses and the nomogram was constructed using significant predictors and HGS-HS-mGPS. The predictive performance of the nomogram was evaluated by receiver operating characteristic curve and calibration curve. Results: This study included a total of 811 patients, of which 446 (55.0%) were male. The HGS optimal cut-off values of male and female patients were 28.8 and 19.72 kg, respectively. Multivariate analysis revealed that low HGS and high HS-mGPS were independent risk factors of colon cancer after adjusting confounders (adjusted HR = 3.20; 95% CI: 2.27-4.50; p < 0.001 and adjusted HR = 1.55; 95% CI: 1.12-2.14; p = 0.008 respectively). Patients with low HGS and high HS-mGPS had a 10.76-fold higher mortality risk than those with neither (adjusted HR = 10.76; 95% CI: 5.38-21.54; p < 0.001). A nomogram predicting 1-, 3-, and 5 year OS was constructed based on three clinicopathologic prognostic factors. Importantly, incorporating HGS-HS-mGPS into the nomogram model meaningfully improved the predictive performance. The decision curve analyses demonstrated the application value of the HGS-HS-mGPS nomogram for predicting OS of patients with colon cancer. Conclusion: HGS-HS-mGPS is associated with the survival of patients with colon cancer. These findings indicate the usefulness of HGS and HS-mGPS measurements in clinical practice for improving patient assessment, cancer prognosis, and precise intervention.

Therapeutic effect and mechanisms of traditional Chinese medicine compound (Qilong capsule) in the treatment of ischemic stroke.

Background Qilong capsule (QLC) is a well-known traditional Chinese medicine compound extensively used in clinical practice. It has been approved by the China's FDA for the treatment of ischemic stroke (IS). In our clinical trial involving QLC (ClinicalTrials.gov identifier: NCT03174535), we observed the potential of QLC to improve neurological function in IS patients at the 24th week, while ensuring their safety. However, the effectiveness of QLC beyond the initial 12-week period remains uncertain, and the precise mechanisms underlying its action in IS have not been fully elucidated. Purpose In order to further explore the clinical efficacy of QLC in treating IS beyond the initial 12-week period and systematically elucidate its underlying mechanisms. Study Design This study employed an interdisciplinary integration strategy that combines post hoc analysis of clinical trials, transcriptome sequencing, integrated bioinformatics analysis, and animal experiments. Methods In this study, we conducted a post-hoc analysis with 2302 participants to evaluate the effectiveness of QLC at the 12th week. The primary outcome was the proportion of patients achieving functional independence at the 12th week, defined as a score of 0-2 on the modified Rankin Scale (mRS), which ranges from 0 (no symptoms) to 6 (death). Subsequently, we employed RNA sequencing (RNA-Seq) and quantitative reverse transcription polymerase chain reaction (RT-qPCR) techniques in the QLC trial to investigate the potential molecular mechanisms underlying the therapeutic effect of QLC in IS. Simultaneously, we utilized integrated bioinformatics analyses driven by external multi-source data and algorithms to further supplement the exploration and validation of QLC's therapeutic mechanism in treating IS. This encompassed network pharmacology analysis and analyses at the mRNA, cellular, and pathway levels focusing on core targets. Additionally, we developed a disease risk prediction model using machine learning. By identifying differentially expressed core genes (DECGs) between the normal and IS groups, we quantitatively predicted IS occurrence. Furthermore, to assess its protective effects and determine the key regulated pathway, we conducted experiments using a middle cerebral artery occlusion and reperfusion (MACO/R) rat model. Results Our findings demonstrated that the combination of QLC and conventional treatment (CT) significantly improved the proportion of patients achieving functional independence (mRS score 0-2) at the 12th week compared to CT alone (n = 2,302, 88.65 % vs 87.33 %, p = 0.3337; n = 600, 91.33 % vs 84.67 %, p = 0.0165). Transcriptome data revealed that the potential underlying mechanism of QLC for IS is related to the regulation of the NF-κB inflammatory pathway. The RT-qPCR results demonstrated that the regulatory trends of key genes, such as MD-2, were consistent with those observed in the RNA-Seq analysis. Integrated bioinformatics analysis elucidated that QLC regulates the NF-κB signaling pathway by identifying core targets, and machine learning was utilized to forecast the risk of IS onset. The MACO/R rat model experiment confirmed that QLC exerts its anti-CIRI effects by inhibiting the MD-2/TLR-4/NF-κB signaling axis. Conclusion: Our interdisciplinary integration study has demonstrated that the combination of QLC with CT exhibits significant superiority over CT alone in improving functional independence in patients at the 12th week. The potential mechanism underlying QLC's therapeutic effect in IS involves the inhibition of the MD-2/TLR4/NF-κB inflammatory signaling pathway, thereby attenuating cerebral ischemia/reperfusion inflammatory injury and facilitating neurofunctional recovery. The novelty and innovative potential of this study primarily lie in the novel finding that QLC significantly enhances the proportion of patients achieving functional independence (mRS score 0-2) at the 12th week. Furthermore, employing a "multilevel-multimethod" integrated research approach, we elucidated the potential mechanism underlying QLC's therapeutic effect in IS.

Monolithic 24 cm2 flexible triple-junction solar cell encapsulated module based on the ipsilateral electrode welding technology.

The inverted metamorphic multi-junction solar cell is anticipated to be widely applied in stratospheric flight because of its exceptional properties of flexibility and light weight. We propose an ipsilateral welding technology based on Ti/Au electrodes to simplify the fabrication process of GaInP/GaAs/InGaAs solar cells and encapsulate large-sized flexible solar cells. After annealing at 200°C for 2 h, the Ti/Au electrode achieved a low specific contact resistivity of 2.9×10-7 Ω⋅c m 2. The performance of the ohmic contact remains stable after the thermal cycling tests. The Ti/Au electrode can require less heat input for welding to reduce the risk of microcrack formation of the solar cells. By employment of this electrode, a 24c m 2 solar cell achieved a conversion efficiency of 34.74%. A flexible solar cell module with an efficiency of 32.82% under AM 1.5G illumination was obtained by the ipsilateral electrode welding technology.

Monolithic 24 cm2 flexible triple-junction solar cell encapsulated module based on the ipsilateral electrode welding technology: erratum.

This erratum corrects an error in Fig. 1 of the original paper, Appl. Opt.63, 2815 (2024)APOPAI0003-693510.1364/AO.518102.

Photon-enhanced thermionic emission solar cells based on boron-doped graphene/carbon nanosphere composite aerogel photocathode material.

This study employed a two-step hydrothermal reduction process and freeze-drying technique. Initially, carbon nanosphere composite aerogels (CNSs) were synthesized through the hydrothermal reduction of glucose. Subsequently, boron-doped graphene/carbon nanosphere composite aerogel (BGA/CNS) was prepared by utilizing graphene oxide (GO) and boric acid as carbon (C) and boron (B) sources, respectively, in conjunction with CNS. The photo-enhanced thermionic electron emission (PETE) performance of the samples was assessed using a custom-made device. Boron atom doping was found to modulate the bandgap of graphene aerogel and induce P-type semiconductor characteristics, while the addition of CNSs increased its specific surface area, thereby enhancing its photoelectric properties. The results indicated that BGA/CNS-8h exhibited superior PETE effects, with a short-circuit current, open-circuit voltage, and maximum power of 5.81 µA, -2.10V, and-1.57µW.

Effectiveness and safety of Sanhan Huashi granules versus nirmatrelvir-ritonavir in adult patients with COVID-19: A randomized, open-label, multicenter trial.

Sanhan Huashi granules (SHG) demonstrated therapeutic effects against coronavirus disease 2019 (COVID-19) in observational studies. In order to compare the effectiveness and safety of SHG and nirmatrelvir-ritonavir in treating adults with mild-to-moderate COVID-19, we conducted a randomized, active-controlled, open-label, multi-center trial conducted between February and July in 2023. The patients were randomized in a 1:1 ratio to the SHG group and the nirmatrelvir-ritonavir group. A total of 400 participants were randomized, among which 200 participants ultimately received SHG and 198 received nirmatrelvir-ritonavir. The primary outcome was time to sustained clinical recovery through day 28. SHG significantly shortened the median time to sustained clinical recovery compared to nirmatrelvir-ritonavir (6.0 (95% CI, 5.0 to 6.0) vs. 8.0 (95% CI, 6.0 to 9.0) d; P = 0.001), particularly for individual symptoms including fever, sore throat, cough and fatigue. No participants in either group died and incidence of severe COVID-19 showed no difference between two groups. Participants who received nirmatrelvir-ritonavir demonstrated a higher rate of virus clearance on day 5 compared to those received SHG (46.4% (95% CI, 39.1 to 53.7) vs. 65.6% (95% CI, 58.3 to 72.4); P < 0.001). Most adverse events were mild in both groups. In summary, SHG was superior to nirmatrelvir-ritonavir in shortening the time to sustained clinical recovery in participants with mild-to-moderate COVID-19, despite a lower virus clearance rate observed after 5 d of treatment (Chinese Clinical Trial Registry Identifier: ChiCTR2300067872).

Adherence to the dietary approaches to stop hypertension diet reduces the risk of diabetes mellitus: a systematic review and dose-response meta-analysis.

BACKGROUND: Despite several epidemiological studies reporting a significant association between adherence to the Dietary Approaches to Stop Hypertension (DASH) diet and the risk of diabetes mellitus, the results remain controversial. In this systematic review and meta-analysis, we aimed to summarize the existing evidence from published observational studies and evaluate the dose-response relationship between adherence to the DASH diet and diabetes mellitus risk. METHODS: We performed a systematic search for relevant articles published up to September 2023 using electronic databases of PubMed, Embase, Scopus, and China National Knowledge Infrastructure (CNKI). A random-effects model was applied to calculate the combined relative risks (RR) with 95% confidence intervals (CIs) for the highest compared to the lowest categories of DASH score in relation to diabetes mellitus risk. Heterogeneity among the included studies was assessed using the Cochran's Q test and I-squared (I2) statistic. Literature search, study selection, data extraction, and quality assessment were performed by two independent reviewers. RESULTS: Fifteen studies involving 557,475 participants and 57,064 diabetes mellitus cases were eligible for our analyses. Pooled analyses from included studies showed that high adherence to the DASH diet was significantly associated with a reduced risk of diabetes mellitus (RR: 0.82; 95% CI: 0.76-0.90, P < 0.001). Moreover, the dose-response meta-analysis revealed a linear trend between adherence to the DASH diet and diabetes mellitus (RR:0.99; 95%CI: 0.97-1.02, Pdose-response = 0.546, Pnonlinearity = 0.701). Subgroup analyses further revealed a significant inverse association between adherence to the DASH diet and diabetes mellitus risk in case-control studies (RR: 0.65; 95%CI: 0.29-1.43, P < 0.001), with a marginal inverse association in cohort studies (RR:0.83; 95%CI: 0.76-0.91, P < 0.001). Additionally, we conducted analyses separately by comparison and found a significant inverse association between DASH diet and diabetes mellitus risk in T3 vs T1 comparison studies (RR = 0.74; 95%CI: 0.64-0.86, P = 0.012). CONCLUSION: The findings of this study demonstrate a protective association between adherence to the DASH diet and risk of diabetes mellitus. However, further prospective cohort studies and randomized controlled trials are needed to validate these findings.

Fetal overgrowth and weight trajectories during infancy and adiposity in early childhood.

BACKGROUND: Large-for-gestational age (LGA), a marker of fetal overgrowth, has been linked to obesity in adulthood. Little is known about how infancy growth trajectories affect adiposity in early childhood in LGA. METHODS: In the Shanghai Birth Cohort, we followed up 259 LGA (birth weight >90th percentile) and 1673 appropriate-for-gestational age (AGA, 10th-90th percentiles) children on body composition (by InBody 770) at age 4 years. Adiposity outcomes include body fat mass (BFM), percent body fat (PBF), body mass index (BMI), overweight/obesity, and high adiposity (PBF >85th percentile). RESULTS: Three weight growth trajectories (low, mid, and high) during infancy (0-2 years) were identified in AGA and LGA subjects separately. BFM, PBF and BMI were progressively higher from low- to mid-to high-growth trajectories in both AGA and LGA children. Compared to the mid-growth trajectory, the high-growth trajectory was associated with greater increases in BFM and the odds of overweight/obesity or high adiposity in LGA than in AGA children (tests for interactions, all P < 0.05). CONCLUSIONS: Weight trajectories during infancy affect adiposity in early childhood regardless of LGA or not. The study is the first to demonstrate that high-growth weight trajectory during infancy has a greater impact on adiposity in early childhood in LGA than in AGA subjects. IMPACT: Large-for-gestational age (LGA), a marker of fetal overgrowth, has been linked to obesity in adulthood, but little is known about how weight trajectories during infancy affect adiposity during early childhood in LGA subjects. The study is the first to demonstrate a greater impact of high-growth weight trajectory during infancy (0-2 years) on adiposity in early childhood (at age 4 years) in subjects with fetal overgrowth (LGA) than in those with normal birth size (appropriate-for-gestational age). Weight trajectory monitoring may be a valuable tool in identifying high-risk LGA children for close follow-ups and interventions to decrease the risk of obesity.

3D nanoprinting for fiber-integrated achromatic diffractive lens.

Achromatic performance is crucial for numerous multi-wavelength optical fiber applications, including endoscopic imaging and fiber sensing. This paper presents the design and nanoprinting of a fiber-integrated achromatic diffractive lens within the visible spectrum (450-650 nm). The 3D nanoprinting is achieved by a high-resolution direct laser writing technology, overcoming limitations in the optical performance caused by the lack of an arbitrary 3D structure writing capability and an insufficient feature resolution in the current manufacturing technology for visible light broadband achromatic diffractive lenses. A three-step optimization algorithm is proposed to effectively balance optical performance with writing difficulty. The characterization results demonstrate excellent achromatic focusing performance, paving the way towards the development of nanoprinted flat optical devices for applications such as optical fiber traps, miniature illumination systems, and integrated photonic chips.

Hybrid SWM-IR narrow bandpass filters with high optical density.

Narrow bandpass filters (NBFs), which are designed to accept a narrow wavelength range and simultaneously reject a much wider range, show great potential in applications such as spectral imaging, lidar detection, fluorescence microscopy, and others. In this paper, we propose and numerically simulate NBF technology for infrared (IR) optical applications. The filter is a combination of plasmonic nanostructures and improved induced transmission layers. The operating wavelength range is from 1360 to 5000 nm [short wave mid-infrared radiation(SWM-IR)], with a FWHM of less than 10 nm and maximum optical density of around 10. Therefore, our SWM-IR hybrid filter can distinguish much smaller differences in terms of spectrum information and reduce the background noise level even if using an optical amplifier.

High-resolution 3D nanoprinting based on two-step absorption via an integrated fiber-coupled laser diode.

Three-dimensional (3D) laser nanoprinting with high resolution and low cost is highly desirable for fabricating arbitrary 3D structures with fine feature size. In this work, we use a 405-nm integrated fiber-coupled continuous wave (cw) laser diode to establish an easy-to-build 3D nanoprinting system based on two-step absorption. Two-dimensional (2D) gratings with a sub-150-nm period and 3D woodpile nanostructures with a lateral period of 350 nm have been printed at a low speed. At a faster scan velocity of 1000 µm/s, 2D gratings with sub-200-nm resolution and sub-50-nm linewidth can still be fabricated with laser power less than 1 mW. The two-step absorption of the used benzil initiator enables us to use a second cw laser with 532-nm wavelength to enhance the polymerization with sub-100-nm feature size when starting with insufficient 405-nm laser power, which possess the potential to find applications in high-speed high-resolution parallel-writing and in situ manipulation.

High-Precision and Rapid Direct Laser Writing Using a Liquid Two-Photon Polymerization Initiator.

Two-photon polymerization based direct laser writing (DLW) is an emerging micronano 3D fabrication technology wherein two-photon initiators (TPIs) are a key component in photoresists. Upon exposure to a femtosecond laser, TPIs can trigger the polymerization reaction, leading to the solidification of photoresists. In other words, TPIs directly determine the rate of polymerization, physicochemical properties of polymers, and even the photolithography feature size. However, they generally exhibit extremely poor solubility in photoresist systems, severely inhibiting their application in DLW. To break through this bottleneck, we propose a strategy to prepare TPIs as liquids via molecular design. The maximum weight fraction of the as-prepared liquid TPI in photoresist significantly increases to 2.0 wt %, which is several times higher than that of commercial 7-diethylamino-3-thenoylcoumarin (DETC). Meanwhile, this liquid TPI also exhibits an excellent absorption cross section (64 GM), allowing it to absorb femtosecond laser efficiently and generate abundant active species to initiate polymerization. Remarkably, the respective minimum feature sizes of line arrays and suspended lines are 47 and 20 nm, which are comparable to that of the-state-of-the-art electron beam lithography. Besides, the liquid TPI can be utilized to fabricate various high-quality 3D microstructures and manufacture large-area 2D devices at a considerable writing speed (1.045 m s-1). Therefore, the liquid TPI would be one of the promising initiators for micronano fabrication technology and pave the way for future development of DLW.

Annealing temperature effect on the performances of porous ZnO nanosheet-based self-powered UV photodetectors.

Porous ZnO nanosheets (ZnO NSs) may play an important role in self-powered UV photodetectors due to their excellent properties, and their porosity feature affects the photoresponse performance greatly. Porous ZnO NSs were prepared by the hydrothermal method followed with a one-step annealing treatment. The effects of the annealing temperature on the microstructure and photoresponse of porous ZnO NSs and n-ZnO NSs/p-PEDOT:PSS self-powered UV photodetectors were investigated. The results show that the pore density and size of ZnO NSs can be tuned by changing the annealing temperature. At an optimum annealing temperature of 450°C, ZnO NSs exhibit greater absorption capacity for the suitable pore density and size. Meanwhile, more crystal defects due to surface contractile properties increase the number of photogenerated carriers. On this basis, the n-ZnO NSs/p-PEDOT:PSS photodetector presents a larger photocurrent and fast photodetection speed without external bias voltage, indicating the self-powered performance. The higher light absorption and large number of electron-hole pairs resulting from dense pores and surface defects in porous ZnO NSs might account for the enhanced performances.

Efficacy of relative dose intensity of nab-paclitaxel for the short-term outcomes, survival, and quality of life in patients with advanced pancreatic cancer: a retrospective study.

Background: To optimize treatment, choosing the appropriate relative dose intensity (RDI) of nab-paclitaxel is an important way to improve patient tolerance, therapeutic efficacy, and survival. However, few studies have focused on the efficacy of the RDI of nab-paclitaxel in patients with advanced pancreatic cancer, and whether the RDI of nab-paclitaxel could be employed as an index for treatment remains unknown. To explore the relationship between RDI of nab-paclitaxel and chemotherapy efficacy, survival, quality of life (QoL), and adverse effects in patients with advanced pancreatic cancer. Methods: In this retrospective study, a total of 32 patients with advanced pancreatic cancer, ECOG score of 0 to 2 were included from January 2017 to March 2020. The patients were treated with nab-paclitaxel combined with gemcitabine as a first-line treatment and divided into high and low RDI groups. Chemotherapy efficacy, survival, QoL, and adverse effects between two groups were compared. Results: The disease control rate (DCR) was 20.0% in the low RDI group, compared with 81.8% in the high RDI group (P=0.002). A good correlation between nab-paclitaxel RDI and short-term efficacy was observed in all 32 patients (r=0.728, P<0.01). Furthermore, the high RDI group had significantly better median overall survival (mOS: 12 vs. 8 months, P=0.034) and median progression-free survival (mPFS: 5.5 vs. 3 months, P=0.052) compared to that of low RDI patients. Univariate regression analysis showed that longer overall survival was associated with lower ECOG score [hazard ratio (HR): 10.88; 95% confidence interval (CI): 2.54-46.5, P=0.001], tumors located in the body or tail of pancreases (HR: 3.82; 95% CI: 1.4-10.3, P=0.0081), and higher RDI (HR: 0.21; 95% CI: 0.071-0.6, P=0.004). The high RDI group had a significantly better physical function and emotional function improvement compared to the low RDI group (P<0.05). Moreover, high RDI did not increasing the severity and frequency of the adverse events. Conclusions: It is recommended to maintain a sufficient RDI of nab-paclitaxel to ensure that the balance between lerability, therapeutic efficacy, and survival benefits is satisfied in patients with advanced pancreatic cancer.

Dip-In Photoresist for Photoinhibited Two-Photon Lithography to Realize High-Precision Direct Laser Writing on Wafer.

For decades, photoinhibited two-photon lithography (PI-TPL) has been continually developed and applied into versatile nanofabrication. However, ultrahigh precision fabrication on wafer by PI-TPL remains challenging, due to the lack of a refractive index (n) matched photoresist (Rim-P) with effective photoinhibition capacity for dip-in mode. In this paper, various Rim-P are developed and then screened for their applications in PI-TPL. In addition, different lithography methods (in terms of oil-mode and dip-in mode) are analyzed by use of optical simulations combined with experiments. Remarkably, one type of Rim-P (n = 1.518) shows effective photoinhibition capacity, which represents an outstanding breakthrough in the field of PI-TPL. In contrast to photoresist with an unsuitable refractive index, optical aberrations are almost completely eliminated in the dip-in mode by using the Rim-P. Consequently, features with a minimum critical dimension as small as 39 nm are successfully achieved on wafer by dip-in PI-TPL, which paves the way for subdiffraction silicon-based chip manufacturing by PI-TPL. Moreover, through a combination of the Rim-P and dip-in mode, the ability to achieve tall and high-precision three-dimensional nanostructures is no longer problematic.

Clinical effectiveness of Qilong capsule in patients with ischemic stroke: A prospective, multicenter, non-randomized controlled trial.

BACKGROUND: The Qilong capsule (QLC) is a Chinese patented medicine characterized by an equal emphasis on replenishing Qi and activating blood circulation. In 2000, China's FDA approved the use of QLC for ischemic stroke (IS). However, there is not yet much high-quality evidence of the clinical effectiveness of QLC combined with conventional treatment (CT) for IS with Qi deficiency and blood stasis syndrome. PURPOSE: In this study, we conducted a prospective, multicenter, non-randomized controlled trial at 7 hospitals in China to investigate the clinical effectiveness of QLC combined with CT for IS with Qi deficiency and blood stasis syndrome. METHODS: Participants aged 35 to 80 years old diagnosed as IS with Qi deficiency and blood stasis syndrome in TCM were recruited. Participants were treated with QLC (intervention group) or non-QLC (control group). The intervention course of QLC was 12 weeks. All participants in two groups received standard treatment. All participants returned for in-person follow-up visits at the 12th week and 24th week. Primary outcome measures included a modified Rankin Scale (mRS), the National Institute of Health Stroke Scale (NIHSS), and the Barthel Index (BI). Secondary outcome measures included TCM syndromes (Qi deficiency syndrome score, blood stasis syndrome score), psychological index (self-rating depression scale, SDS; self-rating anxiety scale, SAS), blood lipid index, blood coagulation index, homocysteine, and favorable functional outcome (mRS 0 - 3). Multiple imputations were used for any missing data. Propensity score matching (PSM) was used to deal with any confounding factors (age, gender, scale score, etc.). Rank alignment transformation variance analysis (ART ANOVA) and generalized linear mixed model (GLMM) were introduced to improve the scientific and accuracy of repeated measurement data. All statistical calculations were carried out with R 3.6.1 statistical analysis software. RESULTS: A total of 2468 participants were screened from November 2016 to January 2019. Finally, 2302 eligible participants were included in the analysis. There were 1260 participants in the intervention group (QLC group) and 1042 participants in the control group (non-QLC group). After PSM matching, sub-samples of 300 participants in the QLC group and 300 participants in the non-QLC group were finally formed. The final results of clinical effectiveness are the same results shared by the total samples and sub-samples after PSM. In the 24th week after treatment, QLC combined with CT proved to be significantly better than CT alone in reducing the scores of mRS (p < 0.05), NIHSS (p < 0.001), Qi deficiency syndrome (p < 0.01), and blood stasis syndrome (p < 0.001), SAS (p < 0.05), as well as in improving BI score (p < 0.05). The favourable functional outcome (mRS score of 0 to 3 at week 12) was statistically different between QLC and non-QLC group in the sub-samples (p < 0.01, 97% vs 91.7%). The results of the ART ANOVA showed that the improvement of mRS (p < 0.01), BI (p < 0.05) and NIHSS (p < 0.001) in QLC group was better than non-QLC group when the interaction effect was considered. The results of GLMM showed that the reduction of mRS and NIHSS scores of patients in the QLC group were better than those of the non-QLC group (p < 0.001). The BI score of the QLC group in the sub-samples after PSM increased more than the non-QLC group (p < 0.001). There was no evidence showing that QLC can cause serious adverse reactions (ADRs) in treating patients with IS. CONCLUSION: QLC combined with CT was better than CT alone in reducing mRS score, NIHSS score, Qi deficiency syndrome score, blood stasis syndrome score, and SAS score, as well as improving BI score after treatment. Further high-quality RCTs are needed to confirm the positive results. The study protocol was embedded in a registry study that registered in the Clinical Trials USA Registry (registration No. NCT03174535).

Development and verification of a hypoxia- and immune-associated prognosis signature for esophageal squamous cell carcinoma.

Background: Esophageal cancer is one of the most common gastrointestinal malignancies worldwide, with high morbidity and mortality in China. The clinical importance of the interaction between hypoxia and immune status in the tumor microenvironment has been established in esophageal squamous cell carcinoma (ESCC). This study aims to develop a new hypoxia- and immune-based gene signature to predict the survival of ESCC patients. Methods: The RNA-sequencing and clinical data of 173 cases of ESCC and 271 normal tissues were obtained from The Cancer Genome Atlas (TCGA) data portal and the Genotype-Tissue Expression (GTEx) database. Hypoxia-related genes (HRGs) and immune-related genes (IRGs) were retrieved from publicly shared data. Differentially expressed gene (DEG) analyses were carried out by the DESeq2 method using the edgeR package in R. Based on the intersection of the DEGs and HRGs/IRGs, differentially expressed HRGs (DEHRGs) and differentially expressed IRGs (DEIRGs) were obtained. DEHRGs and DEIRGs associated with prognosis were evaluated using univariate Cox proportional hazards analysis. A prognostic risk score model was constructed according to the genes acquired through Cox regression. Univariate analysis and Cox proportional hazards analysis were used to determine the independent prognostic factors related to prognosis. A nomogram was developed to predict the 1-, 2-, and 3-year overall survival (OS) probability. Results: A total of 73 intersecting genes were obtained as DEHRGs and a total of 548 intersecting genes were obtained as DEIRGs. The risk score was established using 8 genes (FABP7, TLR1, SYTL1, APLN, OSM, EGFR, IL17RD, MYH9) acquired from univariate Cox analysis. Based on this 8-gene-based risk score, a risk prognosis classifier was constructed to classify the samples into high- and low-risk groups according to the median risk score. The nomogram model was constructed to predict the OS of ESCC patients. Conclusions: The hypoxia- and immune-based gene signature might serve as a prognostic classifier for clinical decision-making regarding individualized management, follow-up plans, and treatment strategies for ESCC patients.

Preparation of graphene aerogel and application in photon-enhanced thermionic emission.

Photon-enhanced thermionic emission (PETE) is a novel concept of solar energy conversion in recent years. Porous 3D graphene aerogels (GA) were prepared by hydrothermal reduction of graphene oxide (GO). The morphology of GO and GA was characterized by scanning electron microscopy and transmission electron microscopy respectively. The functional groups of GO and GA were characterized by Electron Microscopy and Fourier Transform infrared spectroscopy. The PETE properties of the samples were tested by a self-made device. Thermoelectron emission can be detected when the energy density of the excitation laser was higher than 35 W. The efficiency of the device was between 8.14 × 10-6% and 1.89 × 10-5%, and the output voltage was about 1 V. Compared with 3D graphene powder and 2D graphene in the control group, GA has more significant and stable thermionic emission properties. GA is a promising cathode material for a PETE solar energy converter, and the conductivity of GA should be further optimized.

Onset and Recurrence Characteristics of Chinese Patients with Noncardiogenic Ischemic Stroke in Chinese Medicine Hospital.

OBJECTIVE: To delineate the onset and recurrence characteristics of noncardiogenic ischemic stroke patients in China. METHODS: A prospective, multicenter and registry study was carried out in 2,558 patients at 7 representative clinical sub-centers during November 3, 2016 to February 17, 2019. A questionnaire was used to collect information of patients regarding CM syndromes and constitutions and associated risk factors. Additionally, stroke recurrence was defined as a primary outcome indicator. RESULTS: A total of 327 (12.78 %) patients endured recurrence events, 1,681 (65.72%) were men, and the average age was 63.33 ± 9.45 years. Totally 1,741 (68.06%) patients suffered first-ever ischemic stroke, 1,772 (69.27%) patients reported to have hypertension, and 1,640 (64.11%) of them reported dyslipidemia, 1,595 (62.35%) patients exhibited small-artery occlusion by The Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. Specifically, 1,271 (49.69%) patients were considered as qi-deficient constitution, and 1,227 (47.97%) patients were determined as stagnant blood constitution. There were 1,303 (50.94%) patients diagnosed as blood stasis syndrome, 1,280 (50.04%) patients exhibited phlegm and dampness syndrome and 1,012 (39.56%) patients demonstrated qi deficiency syndrome. And 1,033 (40.38%) patients declared intracranial artery stenosis, and 478 (18.69%) patients reported carotid artery stenosis. The plaque in 1,508 (41.36%) patients were of mixed. Particularly, 41.09% of them demonstrated abnormal levels of glycated hemoglobin levels. CONCLUSIONS: Recurrence in minor and small-artery stroke cannot be ignored. Hypertension, dyslipidemia, abnormal HbA1c, intracranial artery stenosis and carotid plaque were more common in stroke patients. Particularly, phlegm-dampness and blood stasis syndromes, as well as qi deficiency and blood stasis constitutions, were still the main manifestations of stroke. (Trial registration at ClinicalTrials.gov No. NCT03174535).

Interventional treatment of traumatic carotid-cavernous fistula: A case report.

RATIONALE: Patients with traumatic carotid-cavernous fistula (TCCF) usually go to the ophthalmology department first because of the symptoms such as protrusion of eyes, edema and congestion of combined membrane, vision loss and so on. It is easy to be misdiagnosed and missed. PATIENT CONCERNS: We report a case of left eye swelling and vision loss caused by TCCF after head injury due to traffic accident, which failed to respond to ophthalmic treatment for many times. The similar situation is very likely to cause panic among patients. DIAGNOSIS: Cerebral angiography revealed left internal carotid-cavernous fistula (high flow type). INTERVENTIONS: Left internal carotid artery covered stent implantation was performed. OUTCOMES: The fistulas and the original venous mass were completely covered by the covered stent, and the development of the vascular mass disappeared. The patient's eye symptoms basically disappeared 14 days after the operation. LESSONS: Interventional treatment of TCCF is effective.