Integrated neutrophil-to-lymphocyte ratio and handgrip strength better predict survival in patients with cancer cachexia.

OBJECTIVES: Systemic inflammation and skeletal muscle strength play crucial roles in the development and progression of cancer cachexia. In this study we aimed to evaluate the combined prognostic value of neutrophil-to-lymphocyte ratio (NLR) and handgrip strength (HGS) for survival in patients with cancer cachexia. METHODS: This multicenter cohort study involved 1826 patients with cancer cachexia. The NLR-HGS (NH) index was defined as the ratio of neutrophil-to-lymphocyte ratio to handgrip strength. Harrell's C index and receiver operating characteristic (ROC) curve analysis were used to assess the prognosis of NH. Kaplan-Meier analysis and Cox regression models were used to evaluate the association of NH with all-cause mortality. RESULTS: Based on the optimal stratification, 380 women (NH > 0.14) and 249 men (NH > 0.19) were classified as having high NH. NH has shown greater predictive value compared to other indicators in predicting the survival of patients with cancer cachexia according to the 1-, 3-, and 5-y ROC analysis and Harrell's C index calculation. Multivariate survival analysis showed that higher NH was independently associated with an increased risk of death (hazard ratio = 1.654, 95% confidence interval = 1.389-1.969). CONCLUSION: This study demonstrates that the NH index, in combination with NLR and HGS, is an effective predictor of the prognosis of patients with cancer cachexia. It can offer effective prognosis stratification and guidance for their treatment.

Correlating Electrochemical Kinetic Parameters of Single LiNi1/3 Mn1/3 Co1/3 O2 Particles with the Performance of Corresponding Porous Electrodes.

Characterizing microscale single particles directly is requested for dissecting the performance-limiting factors at the electrode scale. In this work, we build a single-particle electrochemical setup and develop a physics-based model for extracting the solid-phase diffusion coefficient (Ds ) and exchange current density (i0 ) from electrochemical impedance measurements. We find that the carbon coating on the LiNi1/3 Mn1/3 Co1/3 O2 surface enhances i0 . In addition, Ds and i0 decay irreversibly by ≈25 % and ≈10 %, respectively, when the cutoff charge voltage increases from 4.3 V to 4.4 V. Moreover, we correlate intrinsic parameters of single particles with the performance of porous electrodes. Porous electrodes assembled with active particles with higher i0 values deliver a greater capacity and faster capacity fade. The methods developed in this combined experimental and theoretical work can be useful in correlating the single-particle scale and porous-electrode scale for other similar systems.

Understanding Enhanced Ionic Conductivity in Composite Solid-State Electrolyte in a Wide Frequency Range of 10-2 -1010 Hz.

The ionic conductivity of composite solid-state electrolytes (SSEs) can be tuned by introducing inorganic fillers, of which the mechanism remains elusive. Herein, ion conductivity of composite SSEs is characterized in an unprecedentedly wide frequency range of 10-2 -1010  Hz by combining chronoamperometry, electrochemical impedance spectrum, and dielectric spectrum. Using this method, it is unraveled that how the volume fraction v and surface fluorine content xF of TiO2 fillers tune the ionic conductivity of composite SSEs. It is identified that activation energy Ea is more important than carrier concentration c in this game. Specifically, c increases with v while Ea has the minimum value at v = 10% and increases at larger v. Moreover, Ea is further correlated with the dielectric constant of the SSE via the Marcus theory. A conductivity of 3.1×10-5 S cm-1 is obtained at 30 °C by tuning v and xF , which is 15 times higher than that of the original SSE. The present method can be used to understand ion conduction in various SSEs for solid-state batteries.

Clinical characteristic and surgical treatment of traumatic lumbar spondylolisthesis: A series of 28 patients.

OBJECTIVE: To explore the clinical characteristics and the short-term efficacy of posterior operation for traumatic lumbar spondylolisthesis. METHODS: All 28 patients (between January 2013 and June 2018) were treated with lumbar pedicle screw fixation combined with posterior intervertebral fusion. The clinical data and imaging materials of these patients were retrospectively analyzed. RESULTS: The mean follow-up period was 24.3 months (12-36 months). The average VAS score and JOA score were significantly improved after surgery, and the difference was statistically significant (P<0.05).The last follow-up X-ray showed that 16 cases were degree 0 and 12 cases were degree I according to Meyerding grading, which were statistically improved compared with preoperative. Postoperative CT indicated lumbar internal fixation well, and the lumbar fusion rate was 100%. The Frankel grading of neurological function was significantly improved compared with preoperative. CONCLUSION: Acute traumatic lumbar spondylolisthesis is caused by severe trauma and mostly occurred at L4/L5 and L5/S1 level. Early posterior reduction, decompression and intervertebral fusion can achieve satisfactory clinical and radiological outcome.

Ionic Conductive Gels for Optically Manipulatable Microwave Stealth Structures.

Smart structures with manipulatable properties are highly demanded in many fields. However, there is a critical challenge in the pursuit of transparent windows that allow optical waves (wavelength of µm-nm) for transmitting while blocking microwave (wavelength of cm) in terms of absorbing electromagnetic energy, specifically for meeting the frequency requirement for the 5th generation (5G) mobile networks. For fundamentally establishing novel manipulatable microwave absorbing structures, here, new polymeric aqueous gels as both optically transparent materials and microwave absorbing materials are demonstrated, in which polar networks play significant roles in attenuating electromagnetic energy. By manipulating the hydrogen bonding networks, the resulting optically transparent solid-state gels are able to offer the capabilities for absorbing microwaves. Interestingly, such gels can be switched into an optically opaque state via converting the amorphous state into a polycrystal state when the temperature is decreased. Such ionic conductive gels can endow the assembled sandwich windows with effective microwave absorbing capability in the range of 15-40 GHz, covering a branch of 5G frequency bands. The results highlight a new strategy for using ionic conductive gels to design and fabricate manipulatable microwave stealth structures for various applications.

Weather-Manipulated Smart Broadband Electromagnetic Metamaterials.

Smart materials and structures with tunable electromagnetic (EM) properties are highly demanded for active environmental sensitive systems. As polar molecules in the environment, in this work, water and ice are utilized as wetting and freezing conditions to manipulate the electromagnetic response behaviors in a graphene-based composite material, aiming to achieve a smart weather-manipulated EM metamaterial. Owing to the introduced polar water and ice phase in the self-assembled porous electromagnetic attenuating networks, energy consumption of EM waves is significantly altered via multiple scattering of polar induced interfaces. In frozen conditions, a wide absorption band (2-18 GHz) with efficient absorption (reflection loss < -10 dB) has been obtained. Additionally, the mechanical feature of the as-assembled metamaterials could also be manipulated via altering the weather conditions in terms of changing the phase of the introduced water. Interestingly, the mechanical properties could be massively changed while the broadband absorption capability has rarely been impacted. Implication of the results highlights an efficient method for fabricating smart EM metamaterials that are capable of being manipulated by the environment.

Right Anterolateral Minithoracotomy versus Median Sternotomy Approach for Resection of Left Atrial Myxoma.

BACKGROUND: Minimally invasive surgery has become the standard approach for several cardiac diseases. In this retrospective study, we compared right anterolateral minithoracotomy (RALT) with standard median sternotomy (SMS) for resection of left atrial myxoma (LAM). MATERIALS AND METHODS: From January 2009 to June 2015, the clinical data of patients who underwent RALT (n = 30) and SMS (n = 36) for resection of LAM in our hospital were collected. The preoperative clinical data and operative results were compared between the two groups. RESULTS: There were no significant differences in aortic cross-clamp and cardiopulmonary bypass time between the two groups. The total incision length was significantly shorter in RALT group compared with SMS group (p < 0.001). For RALT and SMS groups, respectively, the intensive care unit length of stay was 29.2 ± 6.5 versus 43.5 ± 6.9 hours (p < 0.001), and the postoperative hospital length of stay was 5 days (interquartile range [IQR]: 4-6) versus 8 days (IQR: 7-10) (p < 0.001). The total cost in RALT group was 27,000 RMB (IQR: 25,000-29,000) versus 33,000 RMB (IQR: 31,000-35,000) in SMS group (p < 0.001). There were no significant differences in mortality and postoperative complications between the two groups. CONCLUSION: RALT approach for LAM resection can be performed safely with favorable cosmetic outcome, accepted clinical results, and lower cost. It should be considered as a promising alternative to SMS and merit additional study.

Clinical experience in the use of marginal donor hearts.

BACKGROUND: Although heart transplantation has become a standard therapy for end-stage heart disease, there are few published studies regarding the use of transplant organs from marginal donors. Here we describe the clinical outcome we have obtained using marginal donor hearts. METHODS: We analyzed 21 cases of orthotopic heart transplantation for end-stage heart disease performed in our department between September 2008 and July 2010. Of these patients, six received hearts from marginal donors and the remainder received standard-donor hearts. The two groups were compared in terms of both mortality and the incidence of perioperative complications such as infection, acute rejection, and right heart insufficiency. RESULTS: The 1-year survival rate of both groups was 100%. Only one death was recorded in standard-donor group during follow-up. Patients who received marginal donor hearts (83%) experienced more early complications than did the standard-donor-heart group (13%), but the mortality of the two groups was the same. The duration of post-ICU stay was greater in the marginal donor group than in the standard-donor group, (35.5 ± 17.4) days and (21.7 ± 2.6) days, respectively (P < 0.05). CONCLUSIONS: The use of marginal donor hearts increases the number of patients who can receive and benefit from transplants. However, it may introduce an increased risk of early complications, thus care should be taken both in the choice of patients who will receive marginal donor hearts and in the perioperative treatment of those for whom the procedure is performed.

The vascular endothelial growth factor expression and vascular regeneration in infarcted myocardium by skeletal muscle satellite cells.

BACKGROUND: Myocardial infarction results in tissue necrosis, leading to cell loss and ultimately to cardiac failure. Implantation of skeletal muscle satellite cells into the scar area may compensate for the cell loss and provides a new strategy for infarct therapy. Vascular endothelial growth factor (VEGF) is a promising reagent for inducing myocardial angiogenesis. Skeletal myoblast transplantation has been shown to improve cardiac function in chronic heart failure models by regenerating muscle. We hypothesized that VEGF expression and vascular regeneration increased in infarcted myocardium by skeletal muscle satellite cells, which can promote vascular producing and improve survival environment in infarcted myocardium. METHODS: The skeletal muscle satellite cells were implanted into the infarcted myocardium in a model through ligated left anterior artery in Louis Inbrad Strain rat. Specimens were got for identifying the expression of VEGF and the density of vascular by immunochemical method at two weeks after implantation. RESULTS: The proliferation and differentiation of the skeletal muscle satellite cell was very well. The expression of VEGF was higher in the implanted group (146.83 +/- 2.49) than that in the control group (134.26 +/- 6.84) (P < 0.05). The vascular density in the implanted group (13.00 +/- 1.51) was also higher than that in the control (10.68 +/- 1.79) (P < 0.05). CONCLUSION: The implanted satellite cell could excrete growth factor that would induce angiogenesis and improve cell survival environment in infarcted myocardium.