Application of postoperative adjuvant radiotherapy in limited-stage small cell lung cancer: A systematic review and meta-analysis.

BACKGROUND AND PURPOSE: One of the most important treatments for small cell lung cancer (SCLC) is radiation therapy. Currently, the criteria for administering postoperative adjuvant radiotherapy (PORT) in SCLC remain uncertain. Therefore, we conducted a meta-analysis to investigate the influence of PORT on the prognosis of limited-stage SCLC (LS-SCLC). METHODS: We conducted a comprehensive search across three databases, PubMed, Embase, and the Cochrane Library. Data analysis involved utilizing both random-effects and fixed-effects models for pooling the results. A comparative analysis was performed to assess the prognostic outcomes of patients with LS-SCLC who did and did not undergo PORT. The primary outcome assessed was overall survival (OS), while the secondary outcome was disease-free survival (DFS). RESULTS: This analysis included 11 retrospective studies comprising 7694 eligible participants. Among the entire population of LS-SCLC patients, the OS was superior in those receiving PORT than in those not receiving it (hazard ratio [HR]: 0.79, 95 % confidence interval [CI]: 0.71-0.87; P < 0.0001). In pN0 stage LS-SCLC patients, PORT was associated with a detrimental effect on OS (HR: 1.22, 95 % CI: 1.04-1.43; P = 0.01). In pN1 stage LS-SCLC patients, additionally administering PORT did not provide a significant OS advantage as compared to not administering it (HR: 0.82, 95 % CI: 0.60-1.12; P = 0.21). In pN2 stage LS-SCLC patients, those receiving PORT demonstrated a significant improvement in OS (HR: 0.59; 95 % CI: 0.50-0.70; P < 0.0001) as compared to those not receiving it. Regarding DFS in LS-SCLC patients, the difference in the protective effect with and without the administration of PORT was less pronounced (HR: 0.76, 95 % CI: 0.58-1.00; P = 0.053). CONCLUSIONS: With respect to OS, PORT is not advisable in patients with pN0 or pN1 stage LS-SCLC but is highly recommended in pN2 stage LS-SCLC. Further research is warranted to confirm these findings.

The application of extracorporeal membrane oxygenation in emergent airway management - a single-center retrospective study.

BACKGROUND: Emergent airway occurrences pose a significant threat to patient life. Extracorporeal membrane oxygenation (ECMO) has been proven to be an effective method for managing emergent airways. METHODS: A retrospective analysis was conducted on all patients receiving ECMO as an adjunct for emergent airway management from January 2018 to December 2022 at the People's Hospital of Zhongshan City. We collected the basic information of the patients, their blood gas data before and after ECMO, the related parameters of ECMO, and the outcome and then analyzed and summarized these data. RESULTS: Six patients, with an average age of 51.0(28-66) years, received veno-venous (VV)- ECMO as an adjunct due to emergent airway issues. The average ECMO support duration was 30.5(11-48) hours. All six patients were successfully weaned off ECMO support, with five (83.3%) being successfully discharged after a hospital stay of 15.5(7-55) days. All six patients underwent VV-ECMO through femoral-internal jugular vein cannulation. Among these, five patients, whose airway obstruction was due to hemorrhage, underwent a non-anticoagulant ECMO strategy with no recorded thrombotic events. CONCLUSIONS: The rapid establishment of ECMO support is aided by the establishment of a standardized ECMO initiation protocol and the formation of a multidisciplinary rapid-response ECMO team, which is particularly crucial for emergent airway management. When airway obstruction results from hemorrhagic factors, the early adoption of a non-anticoagulant ECMO strategy can be considered when implementing VV-ECMO.

Effect of Virtual Reality Upper Limb Rehabilitation Training on Older Adults.

Virtual reality has gained more attention in the physical training field, but few studies focus on the effects of VR on older adults. Based on existing study we suggest that VR-based upper limb training might be more effective for older adults and used functional near inferred spectrum and movement analysis to evaluate the effects of VR-based training on older adults. 20 older and 20 youth adults were recruited to perform VR training by extending their upper limb to reaching the objects, and non-VR training as a contrast. Both age-related and task-related differences were found in cortical activation, showing that the VR training has aroused more cortical activation. The older groups have more intensive movement but perform worse in terms of task completion. Both groups performed better in VR, and the difference in the older group was higher.

Effects of parasternal intercostal block on surgical site wound infection and pain in patients undergoing cardiac surgery: A meta-analysis.

This study aimed to assess the effect of parasternal intercostal block on postoperative wound infection, pain, and length of hospital stay in patients undergoing cardiac surgery. PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP, and Wanfang databases were extensively queried using a computer, and randomised controlled studies (RCTs) from the inception of each database to July 2023 were sought using keywords in English and Chinese language. Literature quality was assessed using Cochrane-recommended tools, and the included data were collated and analysed using Stata 17.0 software for meta-analysis. Ultimately, eight RCTs were included. Meta-analysis revealed that utilising parasternal intercostal block during cardiac surgery significantly reduced postoperative wound pain (standardised mean difference [SMD] = -1.01, 95% confidence intervals [CI]: -1.70 to -0.31, p = 0.005) and significantly shortened hospital stay (SMD = -0.40, 95% CI: -0.77 to -0.04, p = 0.029), though it may increase the risk of wound infection (OR = 5.03, 95% CI:0.58-44.02, p = 0.144); however, the difference was not statistically significant. The application of parasternal intercostal block during cardiac surgery can significantly reduce postoperative pain and shorten hospital stay. This approach is worth considering for clinical implementation. Decisions regarding its adoption should be made in conjunction with the relevant clinical indices and surgeon's experience.

The prognostic value of whole-genome DNA methylation in response to Leflunomide in patients with Rheumatoid Arthritis.

Objective: Although Leflunomide (LEF) is effective in treating rheumatoid arthritis (RA), there are still a considerable number of patients who respond poorly to LEF treatment. Till date, few LEF efficacy-predicting biomarkers have been identified. Herein, we explored and developed a DNA methylation-based predictive model for LEF-treated RA patient prognosis. Methods: Two hundred forty-five RA patients were prospectively enrolled from four participating study centers. A whole-genome DNA methylation profiling was conducted to identify LEF-related response signatures via comparison of 40 samples using Illumina 850k methylation arrays. Furthermore, differentially methylated positions (DMPs) were validated in the 245 RA patients using a targeted bisulfite sequencing assay. Lastly, prognostic models were developed, which included clinical characteristics and DMPs scores, for the prediction of LEF treatment response using machine learning algorithms. Results: We recognized a seven-DMP signature consisting of cg17330251, cg19814518, cg20124410, cg21109666, cg22572476, cg23403192, and cg24432675, which was effective in predicting RA patient's LEF response status. In the five machine learning algorithms, the support vector machine (SVM) algorithm provided the best predictive model, with the largest discriminative ability, accuracy, and stability. Lastly, the AUC of the complex model(the 7-DMP scores with the lymphocyte and the diagnostic age) was higher than the simple model (the seven-DMP signature, AUC:0.74 vs 0.73 in the test set). Conclusion: In conclusion, we constructed a prognostic model integrating a 7-DMP scores with the clinical patient profile to predict responses to LEF treatment. Our model will be able to effectively guide clinicians in determining whether a patient is LEF treatment sensitive or not.

The causal association between peripheral blood eosinophils and nasal polyps: a Mendelian randomization study.

OBJECTIVE: Observational studies suggested that peripheral blood eosinophils were associated with the risk of nasal polyps. However, these studies did not confirm the causality. This study aims to apply Mendelian randomization (MR) method to comprehensively assess the potential causal association between peripheral blood eosinophils and nasal polyps. METHODS: Genetic instrumental variables were extracted from the largest available genome-wide association study (GWAS) of European participants, which were used to investigate the relationship between peripheral blood eosinophils and nasal polyps. The inverse variance weighted method, the MR Egger method, and the weighted median method were applied for this analysis. MR-Egger intercept tests, leave-one-out analyses, and funnel plots were performed for the sensitivity analysis. RESULTS: With the inverse variance weighted method, the MR analysis suggested that there was a significant difference between peripheral blood eosinophils and the risk of nasal polyps (ukb-a-97, OR 1.004, 95% CI 1.003-1.005, p < 0.001; ukb-a-541, OR 1.005, 95% CI 1.004-1.006, p < 0.001; ukb-b-7211, OR 1.004, 95% CI 1.003-1.005, p < 0.001; ukb-b-8425, OR 1.004, 95% CI 1.003-1.005, p < 0.001; finn-b-J10_NASALPOLYP, OR 3.089, 95% CI 2.537-3.761, p < 0.001). Consistent results were also proved by using the weighted median method and the MR Egger method. CONCLUSIONS: Our findings reveal the causal effect of peripheral blood eosinophils on the increased risk of nasal polyps.

Measurement of pressure discomfort threshold in auricular concha for in-ear wearables design.

In an effort to mitigate the homogenization of in-ear wearables, designers have been focusing on finding new solutions to enhance user comfort. While the concept of pressure discomfort thresholds (PDT) in humans has been applied to product design, research on the auricular concha remains scarce. In this study, we conducted an experiment to measure the PDT at six points in the auricular concha of 80 participants. Our results showed that the tragus was the most sensitive area and that gender, symmetry, and Body Mass Index (BMI)had no significant effect on PDT. Based on these findings, we generated pressure sensitivity maps of the auricular concha to aid in the optimization of in-ear wearable design.

Esterified Soy Proteins with Enhanced Antibacterial Properties for the Stabilization of Nano-Emulsions under Acidic Conditions.

Soy protein isolate (SPI), including ß-conglycinin (7S) and glycinin (11S), generally have low solubility under weakly acidic conditions due to the pH closed to their isoelectric points (pIs), which has limited their application in acidic emulsions. Changing protein pI through modification by esterification could be a feasible way to solve this problem. This study aimed to obtain stable nano-emulsion with antibacterial properties under weakly acidic conditions by changing the pI of soy protein emulsifiers. Herein, the esterified soy protein isolate (MSPI), esterified ß-conglycinin (M7S), and esterified glycinin (M11S) proteins were prepared. Then, pI, turbidimetric titration, Fourier transform infrared (FTIR) spectra, intrinsic fluorescence spectra, and emulsifying capacity of esterified protein were discussed. The droplet size, the ζ-potential, the stability, and the antibacterial properties of the esterified protein nano-emulsion were analyzed. The results revealed that the esterified proteins MSPI, M7S, and M11S had pIs, which were measured by ζ-potentials, as pH 10.4, 10.3, and 9.0, respectively, as compared to native proteins. All esterified-protein nano-emulsion samples showed a small mean particle size and good stability under weakly acidic conditions (pH 5.0), which was near the original pI of the soy protein. Moreover, the antibacterial experiments showed that the esterified protein-based nano-emulsion had an inhibitory effect on bacteria at pH 5.0.

The influence of target layout and target graphic type on searching performance based on eye-tracking technology.

With the development of various intelligent technologies, the application of interactive interfaces is becoming more and more widespread, and the related researches conducted for interactive interfaces are also increasing. The purpose of this study was to explore the influence of icon layout location, icon graphic type, and icon layout method on users' searching performance in interactive interfaces through eye-tracking technology. Participants were asked to perform search tasks for the search target (facet icon or linear icon) on each image. Thus, each trial consisted of a search task on a given image. In total, each participant had 36 trials to complete. Searching time, fixation duration, and fixation count were collected to evaluate the searching performance of participants. Results showed that when faced with familiar icons, whether the graphic type of icons was facet or linear did not affect the user's experience, but when other factors of the interaction interface changed, facet icons provided a more stable experience for users. And compared to the rectangular layout, the circular layout method provided a more stable experience for users when the location of icons in the interactive interface changed, but icons located in the top half of the interactive interface were easier to find than those located in the bottom half, regardless of whether the layout was circular or rectangular. These results could be used in the layout and icon design of the interactive interfaces to facilitate their optimization.

Clinical characteristics and prognosis of patient with leptospirosis: A multicenter retrospective analysis in south of China.

Purpose: Leptospirosis is a zoonotic disease caused by pathogenic spirochetes of the genus Leptospira. However, there is currently no consensual definition or diagnostic criteria for severe and different forms of leptospirosis. Therefore, more insight on clinical manifestations, risk factors, and outcomes of leptospirosis is warranted. The identification of leptospirosis with distinct clinical manifestations and prognosis in our population. Methods: Multiple correspondence analysis and hierarchical classification on principal components were presented to identify different clinical types of leptospirosis. The outcomes were clinical phenotypes, laboratory and imaging findings, and prognosis. Results: The 95 enrolled patients had median values of 54.0 years (39.0-65.0) for age, 9.0 (7.0-14.0) for total hospital stay lengths, of whom 86.3% was male and 40.0% was transferred to ICU. Three clinical types were distinguished: mild leptospirosis (n=43, 45.3%) with less organ dysfunction and shorter hospital stays; respiratory leptospirosis (n=28, 29.5%) with hemoptysis, and respiratory and circulatory failure; and hepato-renal leptospirosis (n=24, 25.3%) with worst liver and kidney dysfunction. Total hospital mortality was 15.8% and was associated with dyspnea and high levels of neutrophil counts. Conclusions: The identification of leptospirosis with distinct clinical manifestations and prognosis in our population may assist clinicians to distinguish leptospirosis-like disease. Moreover, dyspnea and neutrophil count were found to be independent risk factors for severe leptospirosis progression.

Physicochemical Antioxidative and Emulsifying Properties of Soybean Protein Hydrolysates Obtained with Dissimilar Hybrid Nanoflowers.

This study investigated the changes in the structure and properties of soybean protein after hydrolysis using two types of hybrid nanoflowers (alcalase@Cu3(PO4)2•3H2O (ACHNs) and dispase@Cu3(PO4)2•3H2O (DCHNs)) and examined the basic properties and oxidative stability of hydrolyzed soybean protein emulsions. The formations of the two hybrid nanoflowers were first determined using a scanning electron microscope, transmission electron microscope, and Fourier infrared spectroscopy. The structure and functional properties of soybean protein treated with hybrid nanoflowers were then characterized. The results indicated that the degree of hydrolysis (DH) of the ACHNs hydrolysates was higher than that of the DCHNs for an identical reaction time. Soybean protein hydrolysates treated with two hybrid nanoflowers showed different fluorescence and circular dichroism spectra. The solubility of the hydrolysates was significantly higher (p < 0.05) than that of the soybean protein (SPI) at all pH values tested (2.0−10.0)*: at the same pH value, the maximum solubility of ACHNs hydrolysates and DCHNs hydrolysates was increased by 46.2% and 42.2%, respectively. In addition, the ACHNs hydrolysates showed the highest antioxidant activity (DPPH IC50 = 0.553 ± 0.009 mg/mL, ABTS IC50 = 0.219 ± 0.019 mg/mL, and Fe2+ chelating activity IC50 = 40.947 ± 3.685 µg/mL). The emulsifying activity index of ACHNs and DCHNs hydrolysates reached its maximum after hydrolysis for 120 min at 61.38 ± 0.025 m2/g and 54.73 ± 0.75 m2/g, respectively. It was concluded that the two hydrolysates have better solubility and antioxidant properties, which provides a theoretical basis for SPI product development. More importantly, the basic properties and oxidative stability of the soybean-protein-hydrolysates oil-in-water emulsions were improved. These results show the importance of proteins hydrolyzed by hybrid nanoflowers as emulsifiers and antioxidants in the food and pharmaceutical industry.

A functional near-infrared spectroscopy study of the effects of video game-based bilateral upper limb training on brain cortical activation and functional connectivity.

Video game-based therapies are widely used in rehabilitation. Compared with conventional bilateral upper limb training (CBULT), the effects of video game-based bilateral upper limb training (VGBULT) on brain cortical activation and functional connectivity, still not fully clear. We have developed a VGBULT system, and measured the brain activity of 20 elderly subjects (10 male, mean age = 62.4 ± 5.8) while performing CBULT and VGBULT tasks by using functional near infrared spectroscopy (fNIRS). The results showed that the cerebral cortex of the two groups both showed significant activation (p < 0.05), compared with the baseline; In the VGBLUT group, the activation of motor cortex (MC) and prefrontal cortex (PFC) was stronger, and the functional connectivity between PFC and MC was also enhanced. This study showed that VGBULT is potentially more beneficial for the elderly neural activities and cognitive control, and provides a theoretical basis for future research and development of such rehabilitation products. Moreover, fNIRS is a reliable tool for tracking brain activation in the evaluation of retraining regimens.

Gel Property of Soy Protein Emulsion Gel: Impact of Combined Microwave Pretreatment and Covalent Binding of Polyphenols by Alkaline Method.

This study investigated the effects of microwave modification, alkali polyphenol (ferulic acid) covalently combined modification, and microwave-alkali polyphenol covalently combined modification on the gel properties of soy protein emulsions. The results showed that the properties of soy protein emulsions were improved significantly by the three modification methods. After three kinds of modification, the viscoelasticity of soy protein emulsion gel increased, and a gel system with stronger elasticity was formed. The texture, water-holding, and hydration properties of the emulsion gel increased significantly. The SEM and ClSM results showed that the modified soy protein emulsion gel had a more compact and uniform porous structure, and the oil droplets could be better embedded in the network structure of the gel. Among the three modification methods, the microwave-alkali method polyphenol covalently combining the compound modification effect was best, and the microwave modification effect was least effective compared to the other two methods. Our obtained results suggested that for gel property modification of soy protein emulsion gels, microwave pretreatment combined with the covalent binding of polyphenols by an alkaline method is an effective method.

Effects of ultrasonic pretreatment of soybean protein isolate on the binding efficiency, structural changes, and bioavailability of a protein-luteolin nanodelivery system.

The combination of protein and flavonoids can ameliorate the problems of poor solubility and stability of flavonoids in utilization. In this study, soybean protein isolate pretreated by ultrasonication was selected as the embedding wall material, which was combined with luteolin to form a soybean protein isolate-luteolin nanodelivery system. The complexation effect and structural changes of soybean protein isolate (SPI) and ultrasonic pretreatment (100 W, 200 W, 300 W, 400 W and 500 W) of soybean protein isolate with luteolin (LUT) were compared, as well as the changes in digestion characteristics and antioxidant activity in vitro. The results showed that proper ultrasonic pretreatment increased the encapsulation efficacy, loading amount and solubility to 89.72%, 2.51 µg/mg and 90.56%. Appropriate ultrasonic pretreatment could make the particle size and the absolute value of ζ-potential of SPI-LUT nanodelivery system decrease and increase respectively. The FTIR and fluorescence results show that appropriate ultrasonic pretreatment could reduce α-helix, ß-sheet and random coil, increase ß-turn, and enhance fluorescence quenching. The thermodynamic evaluation results indicate that the ΔG < 0, ΔH > 0 and ΔS > 0, so the interaction of LUT with the protein was spontaneous and mostly governed by hydrophobic interactions. The XRD results show that the LUT was amorphous and completely wrapped by SPI. The DSC results showed that ultrasonic pretreatment could improve the thermal stability of SPI-LUT nanodelivery system to 112.66 ± 1.69 °C. Digestion and antioxidant analysis showed that appropriate ultrasonic pretreatment increased the LUT release rate and DPPH clearance rate of SPI-LUT nanodelivery system to 89.40 % and 55.63 % respectively. This study is a preliminary source for the construction of an SPI nanodelivery system with ultrasound pretreatment and the deep processing and utilization of fat-soluble active substances.

Age-related changes in brain functional networks under multisensory-guided hand movements assessed by the functional near - Infrared spectroscopy.

OBJECTIVES: This study aims to explore the age-related effects of hand rehabilitation training under multisensory stimulation interaction on brain functional networks. METHODS: A multisensory stimulation training glove (MSTG) was designed to realize 3 sensory guidance modes, namely audio-visual guidance (AVG), visual guidance (VG) and no guidance (NG). This study recruited 20 older subjects as the experimental group and 22 young people as the control group. Functional near-infrared spectroscopy (fNIRS) was used to monitor haemoglobin concentration in the motor cortex (MC), prefrontal cortex (PFC), temporary lo be (TL) and occipital lobe (OL) under three different guidance stages, and further analysed the cortical activation and functional connectivity (FC). RESULTS: Multisensory guidance stage showed more activation and higher FC in all subjects. The activated brain regions of the older subjects showed bilateral activation, which is consistent with the Hemispheric Asymmetry Reduction in Older Adults (HAROLD) model. In terms of brain region coordination, older people have a more balanced and denser functional network in the left and right hemispheres compared to younger people. Meanwhile, multisensory stimulation produced a positive training effect on the number of training and reaction time. CONCLUSION: Audio-visual combined stimulation had a significant gain effect on hand training at different ages. However, older adults induce a wider range of cortical activations. At the same time, young and older people have different intercortical coordination networks. All these results provide theoretically and applied references for multisensory stimulation in the prevention and rehabilitation of ageing and brain neurological disorders.

Bisphenol A drives di(2-ethylhexyl) phthalate promoting thyroid tumorigenesis via regulating HDAC6/PTEN and c-MYC signaling.

Bisphenol A (BPA) and di-(2-ethylhcxyl) phthalate (DEHP) are exist widespread in the environment and produce adverse effect to human as environmental disruptors (EDCs). Epidemiological studies have found that the exposure of DEHP and BPA could increase the susceptibility to thyroid diseases including thyroid cancer and benign thyroid nodules. Due to the existence of multiple pollutants in our daily life, the mixed toxic effects of exposure and their interrelationships may distinguish from the exposure to a single chemical, so it is of great significance to explore the mixed toxic effect of DEHP and BPA co-exposure. Thyroid, as one of the target organs of EDCs, is prone to tumor occurrence, however, whether the mixture of BPA and DEHP will affect the occurrence of thyroid cancer is still obscure. We aim to investigate the effect of single or combined exposure to BPA and DEHP on the occurrence of thyroid cancer. An animal model of exposure to BPA and DEHP was firstly established to evaluate their effect on DMD-induced thyroid cancer. Additionally, human thyroid cancer cells BCPAP and thyroid cells Nthy-ori3-1 were used to further clarify some possible mechanisms of BPA and MEHP, the main metabolite of DEHP. Consequently, we found that BPA alone could increase the incidence of thyroid tumors in female rats compared with DEHP, and DEHP enhanced the effect of BPA on cancer promotion. BPA alone and in combination with DEHP mainly induced the expression of HDAC6, inhibited tumor suppressor gene PTEN upregulated the expression of oncogene c-MYC, and eventually elevate the susceptibility to thyroid tumors. Mechanistically, BPA alone and in combination with MEHP could significantly induce the proliferation of BCPAP cells depending on HDAC6, which could modulate H3K9ac to inhibit PTEN, activate AKT signaling pathway, and simultaneously upregulate the expression of c-MYC. Interestingly, we found that BPA alone and in combination with MEHP could significantly induce the proliferation of Nthy-ori3-1 cells independent on HDAC6 via activating ERK signaling pathway. Taken together, these findings not only provide new evidence of the promoting effect of BPA and DEHP on thyroid cancer but also discusses some possible mechanisms underlying these effects.