Regulating Catalytic Oxidation Enantiomers Behavior by Imparting Chiral Microenvironment in Zr-Based Metal-Organic Frameworks.

Chiral inversions of enantiomers have significantly different biological activities, so it is important to develop simple and effective methods to efficiently identify optically pure compounds. Inspired by enzyme catalysis, the construction of chiral microenvironments resembling enzyme pockets in the pore space structure of metal-organic frameworks (MOFs) to achieve asymmetric enantioselective recognition and catalysis has become a new research hotspot. Here, a super-stable porphyrin-containing material PCN-224 is constructed by solvothermal method and a chiral microenvironment around the existing catalytic site of the material is created by post-synthesis modifications of the histidine (His) enantiomers. Experimental and theoretical calculations results show that the modulation of chiral ligands around Zr oxide clusters produces different spatial site resistances, which can greatly affect the adsorption and catalytic level of the enantiomeric molecules of tryptophan guests, resulting in a good enantioselective property of the material. It provides new ideas and possibilities for future chiral recognition and asymmetric catalysis.

Single-cell network analysis reveals gene expression programs for Arabidopsis root development and metabolism.

Single-cell RNA-sequencing datasets of Arabidopsis roots have been generated, but related comprehensive gene co-expression network analyses are lacking. We conducted a single-cell gene co-expression network analysis with publicly available scRNA-seq datasets of Arabidopsis roots using a SingleCellGGM algorithm. The analysis identified 149 gene co-expression modules, which we considered to be gene expression programs (GEPs). By examining their spatiotemporal expression, we identified GEPs specifically expressed in major root cell types along their developmental trajectories. These GEPs define gene programs regulating root cell development at different stages and are enriched with relevant developmental regulators. As examples, a GEP specific for the quiescent center (QC) contains 20 genes regulating QC and stem cell niche homeostasis, and four GEPs are expressed in sieve elements (SEs) from early to late developmental stages, with the early-stage GEP containing 17 known SE developmental regulators. We also identified GEPs for metabolic pathways with cell-type-specific expression, suggesting the existence of cell-type-specific metabolism in roots. Using the GEPs, we discovered and verified a columella-specific gene, NRL27, as a regulator of the auxin-related root gravitropism response. Our analysis thus systematically reveals GEPs that regulate Arabidopsis root development and metabolism and provides ample resources for root biology studies.

Supramolecular Anchored Copper Nanoclusters for a Multipath Electrochemiluminescence Probe.

Copper nanoclusters (Cu NCs) are highly promising nanomaterials in the field of electrochemiluminescence (ECL). Nevertheless, their limited stability and efficiency have impeded their practical applications. Here, we introduced a novel supramolecular anchoring strategy resulting in the creation of exceptionally stable Cu NCs (CET-Cu NCs) with remarkable ECL properties. Specifically, CET-Cu NCs exhibited a relative ECL efficiency (ΦECL) of 62% based on the annihilation ECL efficiency of [Ru(bpy)3]2+ (100%), with tripropylamine employed as a coreactant. Moreover, CET-Cu NCs can generate ECL emission through multiple different paths, which enables them to serve as signal probes in a wider range of testing scenarios, thereby enhancing the reliability and robustness of sensing and analytical systems. To demonstrate the practical utility, CET-Cu NCs were selected as an ECL signal probe for a sensing platform that facilitated ultrasensitive detection of progesterone via oriented immobilization technology and antibody/aptamer sandwich assays. This study surmounted the barriers to the practical application of Cu NCs through the implementation of a supramolecular anchoring strategy, thereby providing enhanced utility of Cu NCs in ECL sensing and analysis.

Uptake, accumulation, and degradation of dibutyl phthalate by three wetland plants.

The uptake and degradation mechanisms of dibutyl phthalate (DBP) by three wetland plants, namely Lythrum salicaria, Thalia dealbata, and Canna indica, were studied using hydroponics. The results revealed that exposure to DBP at 0.5 mg/L had no significant effect on the growth of L. salicaria and C. indica but inhibited the growth of T. dealbata. After 28 days, DBP concentrations in the roots of L. salicaria, T. dealbata, and C. indica were 8.74, 5.67, and 5.46 mg/kg, respectively, compared to 2.03-3.95 mg/kg in stems and leaves. Mono-n-butyl phthalate concentrations in L. salicaria tissues were significantly higher than those in the other two plants at 23.1, 15.0, and 13.6 mg/kg in roots, stems, and leaves, respectively. The roots of L. salicaria also had the highest concentration of phthalic acid, reaching 2.45 mg/kg. Carboxylesterase, polyphenol oxidase, and superoxide dismutase may be the primary enzymes involved in DBP degradation in wetland plants. The activities of these three enzymes exhibited significant changes in plant tissues. The findings suggest L. salicaria as a potent plant for phytoremediation and use in constructed wetlands for the treatment of DBP-contaminated wastewater.

Natural products as potential lead compounds to develop new antiviral drugs over the past decade.

Virus infection has been one of the main causes of human death since the ancient times. Even though more and more antiviral drugs have been approved in clinic, long-term use can easily lead to the emergence of drug resistance and side effects. Fortunately, there are many kinds of metabolites which were produced by plants, marine organisms and microorganisms in nature with rich structural skeletons, and they are natural treasure house for people to find antiviral active substances. Aiming at many types of viruses that had caused serious harm to human health in recent years, this review summarizes the natural products with antiviral activity that had been reported for the first time in the past ten years, we also sort out the source, chemical structure and safety indicators in order to provide potential lead compounds for the research and development of new antiviral drugs.

Targeting lactate metabolism and immune interaction in breast tumor via protease-triggered delivery.

Lactate is abundant in cancer tissues due to active glycolysis (aka Warburg effect) and mediates crosstalk between tumor cells and the immune microenvironment (TIME) to promote the progression of breast cancer. Quercetin (QU) is a potent monocarboxylate transporters (MCT) inhibitor, which can reduce lactate production and secretion of tumor cells. Doxorubicin (DOX) can induce immunogenic cell death (ICD), which promotes tumor-specific immune activation. Thus, we propose a combination therapy of QU&DOX to inhibit lactate metabolism and stimulate anti-tumor immunity. To enhance tumor-targeting efficiency, we developed a legumain-activatable liposome system (KC26-Lipo) with modification of KC26 peptide for co-delivery of QU&DOX for modulation of tumor metabolism and TIME in breast cancer. The KC26 peptide is a legumain-responsive, hairpin-structured cell-penetrating peptide (polyarginine) derivative. Legumain is a protease overexpressed in breast tumors, allowing selective activation of the KC26-Lipo to subsequently facilitate intra-tumoral and intracellular penetration. The KC26-Lipo effectively inhibited 4T1 breast cancer tumor growth through chemotherapy and anti-tumor immunity. Besides, inhibition of lactate metabolism suppressed the HIF-1α/VEGF pathway and angiogenesis and repolarized the tumor-associated macrophages (TAM). This work provides a promising breast cancer therapy strategy by regulating lactate metabolism and TIME.

Living Cells and Cell-Derived Vesicles: A Trojan Horse Technique for Brain Delivery.

Brain diseases remain a significant global healthcare burden. Conventional pharmacological therapy for brain diseases encounters huge challenges because of the blood-brain barrier (BBB) limiting the delivery of therapeutics into the brain parenchyma. To address this issue, researchers have explored various types of drug delivery systems. Cells and cell derivatives have attracted increasing interest as "Trojan horse" delivery systems for brain diseases, owing to their superior biocompatibility, low immunogenicity, and BBB penetration properties. This review provided an overview of recent advancements in cell- and cell-derivative-based delivery systems for the diagnosis and treatment of brain diseases. Additionally, it discussed the challenges and potential solutions for clinical translation.

Cyber-physical oil spill monitoring and detection for offshore petroleum risk management service.

Petroleum industry has started to embrace the advanced petroleum cyber-physical system (CPS) technologies. Offshore petroleum CPS is particularly hard to build, mainly due to the difficulty in detecting and preventing offshore oil leaking. During the oil exploration and transportation process, the remote multi-sensing technology is typically employed for emerging service. It can be utilized for leak detection by enabling the underwater modeling of an offshore petroleum CPS. However, such a technology suffers from insufficient remote sensing resources and expensive computational overhead. In this work, a cross-entropy based leak detection technique is proposed to detect the oil leak, which facilitates the understanding of the oil leak induced marine pollution. Furthermore, a hierarchical parallel approach is proposed on the super computer Tianhe-2 to improve the efficiency of the proposed leak detection technique. Experimental results on Penglai oil spill events demonstrate that the proposed method can effectively identify the sources of oil spilling with accuracy up to [Formula: see text].

Antecedents of Rural Tourism Experience Memory: Tourists' Perceptions of Tourism Supply and Positive Emotions.

Tourism experiences bring about physical or psychological feelings in tourists, which can not only leave tourists with deep memories, but also affect their behavioral intentions. Tourism experiences are meaningful only if they can be remembered and influence word of mouth and decision making. A better understanding of what influences tourism experience memory will help optimize the supply and further development of tourism destinations. This study explores the antecedents of rural tourism experience memory from the tourism supply perspective, revealing the mechanism of effect of these antecedents on tourists' tourism experience memory formation through a questionnaire-based survey of 556 participants in Xidi Village, China, and correlation and multiple regression analyses. The results show that perceptions about the supply of rural tourism destinations trigger positive emotions that, in turn, affect the formation of rural tourism experience memory. Through the mediating role of positive emotions, there is a significant correlation between perception of rural tourism destination supply and the formation of rural tourism experience memories.

The spatial pattern and influencing factors of tourism eco-efficiency in Inner Mongolia, China.

Background: Tourism eco-efficiency is a performance basis for evaluating green total factor productivity and sustainable development. Objective: The objective of this study was to measure tourism eco-efficiency in Inner Mongolia and explore its influencing factors. The aim was to provide an accurate reference for improving the quality and efficiency of tourism in Inner Mongolia and promoting the sustainable development of the regional economy and society. Methods: Tourism eco-efficiency in Inner Mongolia from 2009 to 2019 was calculated using a super-slacks-based measure (SBM) model with an undesirable output. The spatial variation function was used to explore the spatial evolution pattern of tourism eco-efficiency in Inner Mongolia, and the influencing factors of the spatial evolution were analyzed by geographically weighted regression. Results: Tourism eco-efficiency in Inner Mongolia is relatively low. Eco-efficiency values among cities in Inner Mongolia vary, and their distribution is not balanced. The structural eco-efficiency of tourism in Inner Mongolia has been consistent from 2009 to 2019. The degree of homogenization in the overall direction is relatively good. Furthermore, its spatial distribution form and internal structure evolution show a certain regularity and continuity. The pattern evolution of tourism eco-efficiency in Inner Mongolia is jointly driven by the economic level, environmental regulation, industrial structure, traffic conditions, resource endowment, and tourism reception facilities. These influencing factors show obvious spatial heterogeneity. Conclusion: From the perspective of Inner Mongolia, the difference in the tourism eco-efficiency value from 2009 to 2019 was relatively large, but the number of effective areas in the efficiency frontier generally showed a fluctuating growth trend. The range parameters of tourism eco-efficiency showed a decreasing trend, and the spatial correlation effect of tourism eco-efficiency in Inner Mongolia showed a decreasing trend under the influence of structural and spatial differentiation.

The Effect of Preoperative Health Education, Delivered as Animation Videos, on Postoperative Anxiety and Pain in Femoral Fractures.

Objective: This article explores the effect of preoperative health education, in the form of animation videos, on postoperative self-reported pain levels and anxiety in femoral fractures. Methods: Ninety cases of femoral fracture were divided at random into the oral instruction group, the recorded video group, and the animation video group, with 30 cases in each group. Sociodemographic data were collected the day before surgery. Health education was then offered in one of three ways: orally, using a recorded video, or using an animation video. On days 2, 4, and 7 after surgery, the state-trait anxiety inventory (STAI) and the visual analog scale (VAS) were used to assess postoperative anxiety and pain levels, respectively, in the participants. Results: At different time points during the evaluation, total anxiety scores in the animation and recorded video groups were significantly lower than in the oral instruction group (P < 0.01), and the pairwise comparisons indicated statistically significant differences (F = 11.04, 10.06, 10.37, P < 0.01). However, the levels of postoperative pain in the animation and recorded video groups were not significantly different (P > 0.05). STAI scores in the three groups were found to have significant interactions with the measurement time (F = 6.74, P < 0.01). However, there were no apparent interactions between the VAS score and the measurement time (F = 1.31, P > 0.05) in the three groups. Conclusion: Preoperative health education with the aid of multimedia is more effective than oral instruction in lowering patients' postoperative anxiety and pain levels. In addition, animation videos are superior to recorded videos in mitigating postoperative anxiety. Whether the two approaches differ in reducing postoperative pain in bone fractures remains to be further tested.

Thoracic Endovascular Aortic Repair of Highly Tapered Type B Aortic Dissection with Proximal Tapered Stent Grafts and Distal Restrictive Stent Grafts.

BACKGROUND: This study evaluated aortic remodeling in highly tapered type B aortic dissection (TBAD) patients who underwent thoracic endovascular aortic repair (TEVAR) with a proximal tapered stent graft plus a distal restrictive stent graft to maximize thoracic coverage while avoiding distal excessive oversizing. METHODS: Thirty-four patients presenting with highly tapered TABD were randomized to restricted TEVAR (r-TEVAR) and standard TEVAR groups. Highly tapered TBAD was defined as the maximal diameter of the true lumen at proximal and distal thoracic aorta landing zone tapers greater than 8 mm or taper ratio greater than 20%. Patients in the r-TEVAR group underwent proximal tapered stent grafts plus distal restrictive stent grafts, to match the taper ratio of the descending thoracic aorta (DTA) and extend the length of stent coverage. Patients in the standard TEVAR group underwent proximal tapered stent grafts implantation without distal restrictive stent grafts. Aortic remodeling was estimated by computed tomography angiography (CTA) during the follow-up. RESULTS: In total, 16 patients underwent r-TEVAR, and 18 patients underwent standard TEVAR. The taper ratio of the stent graft matched the DTA in the r-TEVAR group (24.7 ± 3.4% vs. 27.3 ± 4.2%, P = 0.068), but did not match that in the standard TEVAR group (13.5 ± 3.3% vs. 30.5 ± 9.6%, P < 0.001). The length of stent graft coverage in the r-TEVAR group was longer than that in the standard TEVAR group (220.4 ± 21.1 mm vs. 175.3 ± 17.8 mm, P < 0.001). Compared with the standard TEVAR group, the r-TEVAR group had better complete remodeling of the DTA at 6 months (40% vs. 5.6%, P = 0.03), 12 months (60% vs. 16.7%, P = 0.027), and 24 months (78.6% vs. 41.2%, P = 0.036) after the operation. There was no difference in the cumulative survival rate between the r-TEVAR and standard TEVAR groups (P = 0.166). CONCLUSIONS: The r-TEVAR with overlapping proximal tapered stent grafts and distal restrictive stent grafts can match the taper of highly tapered TABD, extend the length of stent graft coverage, and lead to better remodeling of the DTA than standard TEVAR.

Colorizing Grayscale CT images of human lungs using deep learning methods.

Image colorization refers to computer-aided rendering technology which transfers colors from a reference color image to grayscale images or video frames. Deep learning elevated notably in the field of image colorization in the past years. In this paper, we formulate image colorization methods relying on exemplar colorization and automatic colorization, respectively. For hybrid colorization, we select appropriate reference images to colorize the grayscale CT images. The colours of meat resemble those of human lungs, so the images of fresh pork, lamb, beef, and even rotten meat are collected as our dataset for model training. Three sets of training data consisting of meat images are analysed to extract the pixelar features for colorizing lung CT images by using an automatic approach. Pertaining to the results, we consider numerous methods (i.e., loss functions, visual analysis, PSNR, and SSIM) to evaluate the proposed deep learning models. Moreover, compared with other methods of colorizing lung CT images, the results of rendering the images by using deep learning methods are significantly genuine and promising. The metrics for measuring image similarity such as SSIM and PSNR have satisfactory performance, up to 0.55 and 28.0, respectively. Additionally, the methods may provide novel ideas for rendering grayscale X-ray images in airports, ferries, and railway stations.

Profiling of the full-length transcriptome in abdominal aortic aneurysm using nanopore-based direct RNA sequencing.

Abdominal aortic aneurysm (AAA) is a common and serious disease with a high mortality rate, but its genetic determinants have not been fully identified. In this feasibility study, we aimed to elucidate the transcriptome profile of AAA and further reveal its molecular mechanisms through the Oxford Nanopore Technologies (ONT) MinION platform. Overall, 9574 novel transcripts and 781 genes were identified by comparing and analysing the redundant-removed transcripts of all samples with known reference genome annotations. We characterized the alternative splicing, alternative polyadenylation events and simple sequence repeat (SSR) loci information based on full-length transcriptome data, which would help us further understand the genome annotation and gene structure of AAA. Moreover, we proved that ONT methods were suitable for the identification of lncRNAs via identifying the comprehensive expression profile of lncRNAs in AAA. The results of differentially expressed transcript (DET) analysis showed that a total of 7044 transcripts were differentially expressed, of which 4278 were upregulated and 2766 were downregulated among two groups. In the KEGG analysis, 4071 annotated DETs were involved in human diseases, organismal systems and environmental information processing. These pilot findings might provide novel insights into the pathogenesis of AAA and provide new ideas for the optimization of personalized treatment of AAA, which is worthy of further study in subsequent studies.

A social network analysis of tourism cooperation in the Yangtze River Delta: A supply and demand perspective.

This study explores the spatial structure of regional tourism cooperation networks among 27 cities in the Yangtze River Delta from the perspective of supply and demand. Data from the supply network were collected from official news released by the Chinese government and quotations for tour routes published by travel agencies. Travel notes published on tourists' blog community platforms about their travel experiences were used as source data for the demand network. The degree of cooperation between the cities was analyzed based on the frequency of occurrence and co-occurrence of information on tourist attractions or cities in the Yangtze River Delta region in tourist notes, tourist route quotes, and official news. This study divides 27 cities in the Yangtze River Delta region into three categories: those where supply matches demand (e.g., Shanghai and Nanjing), nine cities where there is a demand lag (e.g., Zhenjiang), and 16 cities where there is a supply lag (e.g., Wuxi). Investigating the differences between the supply and demand networks is helpful to understand the effectiveness of regional tourism cooperation mechanisms and government policies, which is crucial for the sustainability and good governance of regional tourism.

Using Cryo-ET to distinguish platelets during pre-acute myeloid leukemia from steady state hematopoiesis.

Early diagnosis of acute myeloid leukemia (AML) in the pre-leukemic stage remains a clinical challenge, as pre-leukemic patients show no symptoms, lacking any known morphological or numerical abnormalities in blood cells. Here, we demonstrate that platelets with structurally abnormal mitochondria emerge at the pre-leukemic phase of AML, preceding detectable changes in blood cell counts or detection of leukemic blasts in blood. We visualized frozen-hydrated platelets from mice at different time points during AML development in situ using electron cryo-tomography (cryo-ET) and identified intracellular organelles through an unbiased semi-automatic process followed by quantitative measurement. A large proportion of platelets exhibited changes in the overall shape and depletion of organelles in AML. Notably, 23% of platelets in pre-leukemic cells exhibit abnormal, round mitochondria with unfolded cristae, accompanied by a significant drop in ATP levels and altered expression of metabolism-related gene signatures. Our study demonstrates that detectable structural changes in pre-leukemic platelets may serve as a biomarker for the early diagnosis of AML.

Combined Detection of Plasma Tumor Necrosis Factor-α Converting Enzyme and Notch1 is Valuable in Screening Endoleak After Endovascular Abdominal Aortic Aneurysms Repair.

OBJECTIVES: Endoleaks may be present in up to 25% of patients after endovascular abdominal aortic aneurysm repair (EVAR) and there is no clear consensus on valuable biomarkers to determine endoleak presence. The aim of this study was to examine the potential value of plasma tumor necrosis factor-α converting enzyme (TACE) and Notch1 concentrations in determining endoleak presence after EVAR. METHODS: A total of 110 patients with abdominal aortic aneurysm who underwent EVAR were enrolled in our study, and plasma TACE and Notch1 concentrations were measured prior to and 6 months after EVAR. Logistic regression was performed to assess the association of postoperative plasma TACE and Notch1 concentrations with endoleak after adjusting for potential confounders. The ability of plasma TACE and Notch1 concentrations to determine endoleak presence was assessed using receiver operating characteristic curves and area under the curve (AUC). RESULTS: Twenty-four patients developed endoleaks 6 months after EVAR. Both postoperative plasma TACE and Notch1 concentrations were higher in patients with endoleak than in those without endoleak (2376.4 ± 28.1 pg/ml vs. 2094.1 ± 27.3 pg/ml, P < 0.01; 218.6 ± 1.9 pg/ml vs. 195.0 ± 2.1 pg/ml, P < 0.01, respectively). The AUCs from receiver operating characteristic curve analysis of plasma TACE and Notch1 concentrations in determining endoleak presence were 0.844 (95% CI 0.771 to 0.918, P < 0.01) and 0.860 (95% CI 0.791 to 0.930, P < 0.01), respectively. Combining the detection of plasma Notch1 and TACE concentrations could improve the accuracy in determining endoleak presence (AUC 0.930, 95% CI 0.883 to 0.978, P < 0.01). The predicted probability cutoff of 0.22 yielded a sensitivity of 95.8% and a specificity of 82.6% for endoleak presence. CONCLUSIONS: Plasma TACE and Notch1 levels can discriminate patients with and without endoleak 6 months after EVAR, and have a potential role in screening patients requiring computed tomography angiography.

Fate and biodegradation characteristics of triclocarban in wastewater treatment plants and sewage sludge composting processes and risk assessment after entering the ecological environment.

Triclocarban (TCC) has a high detection frequency in soil, rivers, sediments, and organisms, and its ecological risks have attracted substantial attention. In this study, we analyzed the fate of TCC in four wastewater treatment plants (WWTPs) in Zhengzhou, China, the biodegradation characteristics during the composting process, and the ecological risks of TCC when entering different environmental compartments. The concentration of TCC in the influent was 731.1-812.4 ng/L. More than 53.4% of TCC was biodegraded during the wastewater treatment process, and less than 2.5% was retained in the effluent. TCC was effectively removed through microbial degradation and sewage sludge absorption, and there were only minor differences in the different wastewater treatment processes. It is worth noting that more than 38% of TCC was enriched in sewage sludge (1430.1-1663.8 ng/g). The corresponding biodegradation rates of TCC were 65.7% and 82.8% in sewage sludge after 17 days of composting treatment with sawdust and straw as bulking agents, respectively. The estimated results showed that effluent discharge into the city rivers was safe. Composting could effectively degrade TCC and decrease the ecological risk of TCC when applied to sewage sludge.

Impact of prior endovascular interventions on outcomes of lower limb bypass surgery: A systematic review and meta-analysis.

The aim of this meta-analysis was to evaluate the mortality, amputation and complication rates in patients with peripheral lower limb arterial disease undergoing bypass surgery with or without a prior history of endovascular operation. A systematic literature screen was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines on four academic databases, Medline, Scopus, Embase and Cochrane Central Register of Controlled Trials. Out of 1,072 records, six articles involving 11,420 patients (mean age, 68.1±2.0 years) met the inclusion criteria. The findings presented a 2b level of evidence (i.e. overall evidence represents data from individual cohort study or low quality randomized controlled trials) and suggested lower mortality, amputation and complication rates for patients undergoing bypass surgery without any history of endovascular operation, compared with those with a history of prior endovascular operation. Moreover, a random-effect meta-analysis suggested a small, positive reduction in mortality (Hedge's g=0.08), amputation (Hedge's g=0.18) and complication rates (Hedge's g=0.05) for patients undergoing bypass surgery without any history of endovascular operation. Nevertheless, owing to the scarcity of high-quality data, further studies and randomized clinical trials are needed to confirm these effects.

A novel highly frequent single­nucleotide polymorphism site of cadherin 23 in clear cell renal cell carcinoma with sarcomatoid differentiation based on whole exome sequencing.

Clear cell renal cell carcinoma (CCRCC) with sarcomatoid differentiation (CCRCCS) displays invasive behavior, poor prognosis, and poor therapeutic response. The present study was aimed to gain new insights into the molecular mechanisms of sarcomatoid transformation, and identify new prognostic and therapeutic targets for CCRCCS. Whole exome sequencing was performed on matched carcinomatous and sarcomatoid elements from five specimens with CCRCCS. A non­synonymous single­nucleotide polymorphism (SNP) of cadherin 23 (CDH23) was further studied through Sanger sequencing in expanded 40 specimens with CCRCCS and 50 specimens with CCRCC. Carcinomatous and sarcomatoid elements shared most somatic single­nucleotide variants (SSNVs) as revealed through whole exome sequencing. Sarcomatoid element had higher overall SSNVs than carcinomatous element. A highly frequent mutation of CDH23 (rs3802711) was observed in CCRCCS that resulted in an alteration in the highly conserved calcium­binding site in the three­dimensional (3D) structure mediating the functions of cadherins. In the expanded 90 specimens, CDH23 SNP (rs3802711) was a highly frequent mutation in CCRCCS than that in all CCRCC samples and even high grade CCRCC. Cox multivariate analysis indicated that CDH23 (rs3802711) genotype was an independent prognostic factor affecting the overall survival of the cohort. CDH23 gene and protein were negatively or weakly expressed in most CCRCCS specimens with CDH23 mutation. The present study revealed, for the first time, that the CDH23 (rs3802711) was a highly genetic risk factor for CCRCCS. It was associated with the decreased expression of CDH23 protein, resulting in the absence of cadherin function of CDH23, indicating that the CDH23 mutation may be involved in the sarcomatoid transformation in CCRCCS. Collectively, a novel and specific SNP of CDH23 was identified in CCRCCS and a new candidate cadherin involved in EMT was revealed. Furthermore, a new prognostic evaluation factor and potential therapeutic target for CCRCCS was identified.