Effect of Ultrasound on Thrombus debris during Sonothrombolysis in a Microfluidic device.

Microbubble-mediated sonothrombolysis has been proven to be a non-invasive and efficient method for thrombolysis. Nevertheless, there is a potential risk that the thrombus debris generated during the dissolution of the original thrombus are too large and can lead to hazardous emboli. Using a sonothrombolysis microfluidic platform, we investigated the effects of ultrasound power, thrombolytic agent and microbubble concentration on the size of thrombus debris with the example of microbubble-mediated sonothrombolysis of arterial thrombus. Additionally, we studied the effects of ultrasound power on the size and shape of thrombus debris produced by acute and chronic arterial sonothrombolysis. In acute arterial sonothrombolysis, ultrasound power has significant effect on the size of thrombus debris and steadily increases with the increase of ultrasound power. Conversely, in chronic arterial sonothrombolysis, the size of thrombus debris is minimally affected by ultrasound power. Using the sonothrombolysis microfluidic platform, the relationship between ultrasound power and the safety of sonothrombolysis has been illustrated, and the sonothrombolysis microfluidic platform is demonstrated to be a promising tool for further studies on the process of sonothrombolysis.

Adherence and recommended optimal treatment to Azvudine application for the treatment of outpatient COVID-19 patients: A real-world retrospective study.

Background: Azvudine was approved for the treatment of coronavirus disease 2019 (COVID-19) in China and has been widely used since the outbreak in December 2022. However, real-world research on the adherence of Azvudine is lacking. Additionally, limited research exists on determining the optimal duration for Azvudine treatment. Methods: We studied adult patients with COVID-19 who got Azvudine or supportive treatment at an outpatient department between December 19, 2022 and January 5, 2023. The enrolled patients were divided into two groups: the Azvudine group, which received Azvudine, and the control group, which only received supportive care. We recorded their information and analyzed it using descriptive statistics. The primary outcome of this study was the compliance of outpatients with Azvudine, and the secondary outcome of this study was the optimal duration of Azvudine. Inverse probability weighting (IPW) was used to address the imbalance between groups when comparing the optimal duration of Azvudine, and Cox regression to evaluate the effect of Azvudine on the 28-day disease progression rate. Results: We enrolled a total of 882 patients, of which 382 received Azvudine. Among the patients, 94.0 % (359) had good compliance, and non-compliance was primarily attributed to dosage errors. Azvudine appeared to have a beneficial therapeutic effect when administered for at least 7 days. Conclusions: Outpatients have relatively good compliance with Azvudine, and optimal therapeutic effects were observed with the recommended duration of at least 7 days.

Deciphering Depressor Anguli Oris for Lower Face Rejuvenation: A Prospective Ultrasound-Based Investigation.

BACKGROUND: The depressor anguli oris muscle (DAO) is a pivotal treatment target in creation of harmonic jawline. However, evidence of its live morphology remains scarce. OBJECTIVES: This study aimed to reevaluate DAO by a facile ultrasound analysis and hereby guide safer and more effective botulinum toxin type A (BTX-A) injection. METHODS: A prospective ultrasound assessment was conducted in 41 patients. Morphology of DAO and its relative position with neighboring structures were appraised at the ubiquitous facial landmark, labiomandibular fold (LMF). Three-dimensional images were captured before and after receiving BTX-A injection based on sonographic evidence. RESULTS: The skin-to-muscle depths of DAO on average (measured from the medial to lateral border) were 5.26, 5.61, and 8.42 mm. DAO becomes thinner and wider from zone 1 to 3 (p < 0.001). Overlapping lengths between DAO and DLI increased from zone 1 to 3: 4.74, 9.68, 14.54 mm (p < 0.001). The medial border of DAO was located at 4.33, 6.12, 8.90 mm medial to LMF (zone 1-3), and no muscle fibers of DAO was observed at zone 1 and 2 in near one-third of patients. Mouth corner downturn angle improvement upon receiving BTX-A injection at zone 2 and 3 were 88.3%, 32.3%, and 14.7% for the neutral, maximum smile, and down-pulling mouth corner expressions. CONCLUSIONS: This work established an informative ultrasound portrait of the DAO and structures in the perioral region, which suggests LMF as a convenient landmark to locate DAO. Injections at the middle and lower thirds of LMF at a 4-5 mm depth is recommended.

Effectiveness of inactivated COVID-19 vaccines against SARS-CoV-2 Omicron subvariant BF.7 among outpatients in Beijing, China.

OBJECTIVE: To evaluate the effectiveness of inactivated vaccines against SARS-CoV-2 Omicron subvariant BF.7. METHODS: Information was extracted from outpatients diagnosed with COVID-19 between December 19, 2022 and January 5, 2023 at a single center. Univariate and multivariate logistic regression were performed and three adjusted models were conducted. Vaccine effectiveness (VE) was defined as (1 - OR) × 100 %. RESULTS: Our study comprised a total of 752 outpatients. After adjusting for factors with a P-value < 0.10 in univariable logistic regression, the VE of booster vaccine was 65.4 % (95 % CI6.1-87.3 %, P = 0.037) in comparison with unvaccinated group. Results of the other two adjusted models were similar, which were 66.3 % (95 % CI: 9.0-87.6 %, P = 0.032) and 64.8 % (95 % CI: 3.6-87.1 %, P = 0.042), respectively. Stratified analysis based on underlying diseases indicated that inactivated vaccines did not provide any protection to patients without underlying diseases. In the population with underlying diseases, the VE of booster vaccination was 68.2 % (95 % CI: 8.4-88.9 %, P = 0.034) after adjustment. However, full vaccination did not demonstrate any protection in all models. CONCLUSION: There was an effectiveness of three-dose inactivated vaccines against Omicron subvariant BF.7. Our findings supported the importance of booster vaccination.

Clinical characteristics and factors for serious outcomes among outpatients infected with the Omicron subvariant BF.7.

To evaluate clinical characteristics and identify risk factors associated with severe outcomes in outpatients infected with the Omicron subvariant BF.7, data were collected from outpatients diagnosed with Corona Virus Disease 2019 from December 19, 2022 to January 5, 2023. Clinical characteristics were analyzed using descriptive statistics. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with serious outcomes. Variables with a p < 0.10 in the univariate analysis were included in the multivariate model. Our study analyzed 770 patients, of whom 380 (49.4%) were male, with a median age of 59. The most common symptoms reported were cough (71.2%), fever (64.7%), and sore throat (37.7%). Fever lasted an average of 5.93 ± 3.37 days for the general population and 10.64 ± 7.12 days for impaired-immunity patients. Most cases were mild (68.7%), followed by moderate (27.1%). Severe cases accounted for 2.2%, with 0.5% critically ill. Serious outcomes occurred in 4.2% of cases, with 11 deaths during follow-up. Underlying-diseases patients had a higher rate of serious outcomes. Factors associated with serious outcomes included receiving a three-dose vaccination (odds ratio [OR] = 0.324, 95% confidence interval [CI]: 0.113-0.932, p = 0.037), male gender (OR = 2.890, 95% CI: 1.107-7.548, p = 0.030), age (OR = 1.060, 95% CI: 1.024-1.097, p = 0.001), and chest tightness or dyspnea at the time of visit (OR = 4.861, 95% CI: 2.054-11.507, p < 0.001). Our study found that cough, fever, and sore throat were the most common symptoms reported by patients. Receiving a three-dose vaccination was protective, while male gender, age, and chest tightness or dyspnea were identified as risk factors for serious outcomes.

Oral azvudine for mild-to-moderate COVID-19 in high risk, nonhospitalized adults: Results of a real-world study.

Azvudine is recommended by Chinese health authorities for COVID-19 treatment but has not been tested in real-world clinical studies. This study aimed to evaluate the real-world effectiveness of Azvudine among COVID-19 nonhospitalized patients. This was a retrospective cohort study, looking at nonhospitalized patients who tested positive for SARS-CoV-2. Patients admitted between December 19, 2022 and January 5, 2023 were included. Those who received Azvudine treatment were in the Azvudine group, while those who received supportive treatment were the control group. The primary outcome was the disease progression rate by Day 28. Secondary outcomes were individual disease progression outcomes (death or COVID-19-related hospitalization) and duration of fever. The safety outcomes were assessed based on adverse events (AEs) overall, as well as AEs that were considered to be related to the drug. A total of 804 patients with high risk for progression were enrolled in our study. Among them, 317 (39.43%) received treatment with Azvudine. Our study found that Azvudine could reduce the rate of disease progression, as well as rate of COVID-19-related hospitalization in patients comparing the control group. Furthermore, if taken within 3 days of the onset of symptoms, it could also shorten the duration of fever. Despite a higher incidence of drug-related AEs compared to supportive treatment, the majority of these were mild. Azvudine has been found to be effective in reducing the rate of disease progression of COVID-19, albeit with a slight increase in AEs.

Assessment of knowledge, attitude, and practice of sexual health among students in a Chinese medical college: a cross-sectional study.

Background: Sexual health is an essential part of overall well-being, and medical students' sexual education, level of sexual knowledge, and attitudes toward sexual health will affect their sexual behavior. Aim: To explore the correlation among medical decision tendency, sex education level, and sexual health KAP (knowledge, attitudes, and practices). Methods: We conducted a cross-sectional survey in March 2019. Data were collected via online surveys with a self-developed questionnaire covering sexual KAP and sexual education. We used Spearman correlation to assess the effect of sexual education on KAP after scoring the related questions. Outcomes: Outcomes included descriptive analysis and correlation of medical and nursing students' KAP and education regarding sexual health. Results: Medical and nursing students hold a high level of sexual knowledge (74.8%) and a positive attitude toward premarital sex (87.5%) and homosexuality (94.5%). By conducting the correlation analysis, we observed that medical and nursing students' tendency to support friends' homosexuality was positively correlated with the view that medical intervention for transgender or gay/lesbian people is unnecessary (P < .01). A positive correlation was also found between medical and nursing students who want more diverse sexual education and who would tend to provide patients with more humanistic care regarding their sexual needs (P < .01). Clinical Translation: Medical and nursing students who want more diverse sexual education and who had higher scores in the sexual knowledge test tend to provide their patients with more humanistic care regarding sexual needs. Strengths and Limitations: The research shows the current situation of medical and nursing students' sexual education experience and preference and sexual knowledge, attitudes, and behavior. Heat maps were used to more intuitively describe the correlation between medical students' characteristics and their sexual knowledge, attitudes, and behaviors and sex education. The results may not be generalizable across China, as the participants were from 1 medical school. Conclusion: It is essential to provide sexual education for medical and nursing students to ensure a more humanistic approach to patient care regarding sexual needs; therefore, we recommend that medical schools invest in sexual education for medical and nursing students throughout their education.

Flap perfusion assessment with indocyanine green angiography in deep inferior epigastric perforator flap breast reconstruction: A systematic review and meta-analysis.

BACKGROUND: Indocyanine green angiography (ICG-A) has been widely applied for intraoperative flap assessment in DIEP flap breast reconstruction. However, the beneficial effect of ICG-A in DIEP flap breast reconstruction is still uncertain and no standardized protocol is available. This study aims to analyze the clinical outcome and comprehensively review protocols of this field. METHODS: A systematic review was conducted in MEDLINE, EMBASE, and Cochrane CENTRAL databases until September 15, 2022. Studies on the utility of intraoperative ICG-A in DIEP breast reconstruction were included. Data reporting reconstruction outcomes were extracted for pooled analysis. RESULTS: A total of 22 studies were enrolled in the review, among five studies with 1021 patients included in the meta-analysis. The protocols of ICG-A assessment of DIEP flap varied among studies. According to the pooled results, the incidence of postoperative fat necrosis was 10.89% (50 of 459 patients) with ICG-A and 21.53% (121 of 562 patients) with clinical judgment. The risk for postoperative fat necrosis was significantly lower in patients with intraoperative ICG-A than without (RR 0.47 95% CI 0.29-0.78, p = .004, I2 = 51%). Reoperation occurred in 5 of 48 patients (10.42%) in the ICG-A group and in 21 of 64 patients (32.82%) in the control group summarized from reports in two studies. The risk for reoperation was lower in the ICG-A group than in the control group (RR 0.41 95% CI 0.18-0.93, p = .03, I2 = 0%). Other complications, including flap loss, seroma, hematoma, dehiscence, mastectomy skin necrosis, and infection, were comparable between the two groups. Heterogeneities among studies were acceptable. No significant influence of specific studies was identified in sensitivity analysis. CONCLUSIONS: ICG-A is an accurate and reliable way to identify problematic perfusion of DIEP flaps during breast reconstruction. Protocols of ICG-A differed in current studies. Intraoperative ICG-A significantly decreases the rate of fat necrosis and reoperation in patients undergoing DIEP breast reconstruction. The synthesized results should be interpreted sensibly due to the sample size limitation. RCTs on the outcomes and high-quality studies for an optimized ICG-A protocol are still needed in the future.

ICP-MS based metallomics and GC-MS based metabolomics reveals the physiological and metabolic responses of Dendrobium huoshanense plants exposed to Fe3O4 nanoparticles.

It is found that the growth of Dendrobium huoshanense was dependent on Fe3O4, while the bioavailability of plants to ordinary Fe3O4 was low on the earth. In order to improve the growth, quality and yield of D. huoshanense, we used Fe3O4 NPs (100 or 200 mg/L) that was easily absorbed by plants as nano-fertilizer to hydroponically treat seedlings of D. huoshanense for 3 weeks. Fe3O4 NPs induced not only earlier flowering and increased sugar content and photosynthesis, but also stressed to plants, increased MDA content and related antioxidant enzymes activities. Inductively Coupled Plasma Mass Spectrometry (ICP-MS) revealed that Fe3O4 NPs caused a significant accumulation of Fe and some other nutrient elements (Mn, Co, B, Mo) in stems of D. huoshanense. Metabolomics revealed that the metabolites were reprogrammed in D. huoshanense when under Fe3O4 NPs exposure. Fe3O4 NPs inhibited antioxidant defense-related pathways, demonstrating that Fe3O4 NPs have antioxidant capacity to protect D. huoshanense from damage. As the first study associating Fe3O4 NPs with the quality of D. huoshanense, it provided vital insights into the molecular mechanisms of how D. huoshanense responds to Fe3O4 NPs, ensuring the reasonable use of Fe3O4 NPs as nano-fertilizer.

Genome-wide identification of R2R3-MYB family genes and gene response to stress in ginger.

Ginger (Zingiber officinale Roscoe) is an important plant used worldwide for medicine and food. The R2R3-MYB transcription factor (TF) family has essential roles in plant growth, development, and stresses resistance, and the number of genes in the family varies greatly among different types of plants. However, genome-wide discovery of ZoMYBs and gene responses to stresses have not been reported in ginger. Therefore, genome-wide analysis of R2R3-MYB genes in ginger was conducted in this study. Protein phylogenetic relations and conserved motifs and chromosome localization and duplication, structure, and cis-regulatory elements were analyzed. In addition, the expression patterns of selected genes were analyzed under two different stresses. A total of 299 candidate ZoMYB genes were discovered in ginger. Based on groupings of R2R3-MYB genes in the model plant Arabidopsis thaliana (L.) Heynh., ZoMYBs were divided into eight groups. Genes were distributed across 22 chromosomes at uneven densities. In gene duplication analysis, 120 segmental duplications were identified in the ginger genome. Gene expression patterns of 10 ZoMYBs in leaves of ginger under abscisic acid (ABA) and low-temperature stress treatments were different. The results will help to determine the exact roles of ZoMYBs in anti-stress responses in ginger.

Optimal timing of postmastectomy radiotherapy in two-stage prosthetic breast reconstruction: An updated meta-analysis.

BACKGROUND: There is no consensus on the timing of postmastectomy radiotherapy (PMRT) in relation to the exchange procedure in breast cancer patients undergoing the immediate two-stage prosthetic breast reconstruction. This meta-analysis investigated the reconstruction failure, complications, and cosmesis between PMRT to the tissue expander (TE) and PMRT to the permanent implant (PI). METHODS: A literature search was conducted in PubMed and Embase databases until February 2022. Studies presenting at least one aspect relating to reconstruction failure, complications, and cosmesis between two cohorts were included. Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias in included studies. RESULTS: Eleven studies presenting 1447 patients were enrolled. Three studies were prospective controlled research. The risk for implant loss was higher in PMRT to TE cohort (RR 1.75; 95% CI, 1.03 to 2.98; p = 0.04); meanwhile, the PMRT to TE cohort had a significantly lower risk of capsular contracture (RR 0.47; 95% CI, 0.29 to 0.78; p = 0.003). However, the synthesized result should be interpreted sensibly due to heterogeneity in statistical methods and definitions. CONCLUSION: Delivering PMRT to PI may reduce the risk of implant loss, while delivering PMRT to TE can reduce the risk of severe capsular contracture. More high-quality studies are warranted for the refinement of clinical practice.

Enhanced thrombolysis by endovascular low-frequency ultrasound with bifunctional microbubbles in venous thrombosis: in vitro and in vivo study.

There is a need to improve the efficacy and safety of endovascular techniques in venous thrombotic diseases, and microbubble enhanced sonothrombolysis is a promising approach. However, whether endovascular low-frequency ultrasound (LFUS) can be utilized in microbubble enhanced sonothrombolysis is unclear. Here, we present a catheter-based thrombolytic system that combines unfocused low-frequency low-intensity ultrasound with novel fibrin-targeted drug-loaded bifunctional microbubbles. We develop an in vitro flow model and an in vivo rabbit inferior vena cava (IVC) thrombosis model to evaluate the safety and efficacy of the thrombolytic system. The results indicate that microbubble enhanced sonothrombolysis with endovascular LFUS treatment for 30 min is equally effective compared to pure pharmacologic treatment. Furthermore, the thrombolytic efficacy of this system is safely and substantially improved by the introduction of a fibrin-targeted drug-loaded bifunctional microbubble with a reduction of the fibrinolytic agent dosage by 60%. The microbubble enhanced endovascular LFUS sonothrombolysis system with excellent thrombolytic efficacy may serve as a new therapeutic approach for venous thrombotic diseases.

Comparative Proteome and Phosphoproteome Analyses Reveal Different Molecular Mechanism Between Stone Planting Under the Forest and Greenhouse Planting of Dendrobium huoshanense.

The highly esteemed Chinese herb, Dendrobium huoshanense, whose major metabolites are polysaccharides and alkaloids, is on the verge of extinction. The stone planting under the forest (SPUF) and greenhouse planting (GP) of D. huoshanense are two different cultivation methods of pharmaceutical Dendrobium with significantly differences in morphology, metabolites content and composition, and medication efficacy. Here, we conducted proteomics and phosphoproteomics analyses to reveal differences in molecular mechanisms between SPUF and GP. We identified 237 differentially expressed proteins (DEPs) between the two proteomes, and 291 modification sites belonging to 215 phosphoproteins with a phosphorylation level significantly changed (PLSC) were observed. GO, KEGG pathway, protein domain, and cluster analyses revealed that these DEPs were mainly localized in the chloroplast; involved in processes such as posttranslational modification, carbohydrate transport and metabolism, and secondary metabolite biosynthesis; and enriched in pathways mainly including linoleic acid metabolism, plant-pathogen interactions, and phenylpropanoid, cutin, suberin, and wax biosynthesis. PLSC phosphoproteins were mainly located in the chloroplast, and highly enriched in responses to different stresses and signal transduction mechanisms through protein kinase and phosphotransferase activities. Significant differences between SPUF and GP were observed by mapping the DEPs and phosphorylated proteins to photosynthesis and polysaccharide and alkaloid biosynthesis pathways. Phosphorylation characteristics and kinase categories in D. huoshanense were also clarified in this study. We analyzed different molecular mechanisms between SPUF and GP at proteomic and phosphoproteomic levels, providing valuable information for the development and utilization of D. huoshanense.

Molecular Cloning and Functional Characterization of a ß-Glucosidase Gene to Produce Platycodin D in Platycodon grandiflorus.

Platycodin D (PD) is a deglycosylated triterpene saponin with much higher pharmacological activity than glycosylated platycoside E (PE). Extensive studies in vitro showed that the transformation of platycoside E to platycodin D can be achieved using ß-glucosidase extracted from several bacteria. However, whether similar enzymes in Platycodon grandiflorus could convert platycoside E to platycodin D, as well as the molecular mechanism underlying the deglycosylation process of platycodon E, remain unclear. Here, we identified a ß-glucosidase in P. grandiflorus from our previous RNA-seq analysis, with a full-length cDNA of 1,488 bp encoding 495 amino acids. Bioinformatics and phylogenetic analyses showed that ß-glucosidases in P. grandiflorus have high homology with other plant ß-glucosidases. Subcellular localization showed that there is no subcellular preference for its encoding gene. ß-glucosidase was successfully expressed as 6 × His-tagged fusion protein in Escherichia coli BL21 (DE3). Western blot analysis yielded a recombinant protein of approximately 68 kDa. In vitro enzymatic reactions determined that ß-glucosidase was functional and could convert PE to PD. RT-qPCR analysis showed that the expression level of ß-glucosidase was higher at night than during the day, with the highest expression level between 9:00 and 12:00 at night. Analysis of the promoter sequence showed many light-responsive cis-acting elements, suggesting that the light might regulate the gene. The results will contribute to the further study of the biosynthesis and metabolism regulation of triterpenoid saponins in P. grandiflorus.

Qualitative Proteome-Wide Analysis Reveals the Diverse Functions of Lysine Crotonylation in Dendrobium huoshanense.

The lysine crotonylation of histone proteins is a newly identified posttranslational modification with diversified cellular functions. However, there are few reports on lysine crotonylation of non-histone proteins in medicinal plant cells. By using high-resolution liquid chromatography-mass spectrometry (LC-MS) coupled with highly sensitive-specific immune-affinity antibody analysis, a whole crotonylation proteome analysis of Dendrobium huoshanense was performed. In total, 1,591 proteins with 4,726 lysine crotonylation sites were identified; among them, 11 conserved motifs were identified. Bioinformatic analyses linked crotonylated proteins to the drought stress response and multiple metabolic pathways, including secondary metabolite biosynthesis, transport and catabolism, energy production and conversion, carbohydrate transport and metabolism, translation, and ribosomal structure and biogenesis. This study contributes toward understanding the regulatory mechanism of polysaccharide biosynthesis at the crotonylation level even under abiotic stress.

External validation of five predictive models for postoperative cardiopulmonary morbidity in a Chinese population receiving lung resection.

BACKGROUND: No postoperative cardiopulmonary morbidity models have been developed or validated in Chinese patients with lung resection. This study aims to externally validate five predictive models, including Eurolung models, the Brunelli model and the Age-adjusted Charlson Comorbidity Index, in a Chinese population. METHODS: Patients with lung cancer who underwent anatomic lung resection between 2018/09/01 and 2019/08/31 in our center were involved. Model discrimination was assessed by the area under the receiver operating characteristic curve. Model calibration was evaluated by the Hosmer-Lemeshow test. Calibration curves were plotted. Specificity, sensitivity, negative predictive value, positive predictive value and accuracy were calculated. Model updating was achieved by re-estimating the intercept and/or the slope of the linear predictor and re-estimating all coefficients. RESULTS: Among 1085 patients, 91 patients had postoperative cardiopulmonary complications defined by the European Society of Thoracic Surgeons. For original models, only parsimonious Eurolung1 had acceptable discrimination (area under the receiver operating characteristic curve = 0.688, 95% confidence interval 0.630-0.745) and calibration (p = 0.23 > 0.05) abilities simultaneously. Its sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 0.700, 0.649, 0.153, 0.960 and 0.653, respectively. In the secondary analysis, increased pleural effusion (n = 94), which was nonchylous and nonpurulent, was labeled as a kind of postoperative complication. The area under the receiver operating characteristic curve of the models increased slightly, but all models were miscalibrated. The original Eurolung1 model had the highest discrimination ability but poor calibration, and thus it was updated by three methods. After model updating, new models showed good calibration and small improvements in discrimination. The discrimination ability was still merely acceptable. CONCLUSIONS: Overall, none of the models performed well on postoperative cardiopulmonary morbidity prediction in this Chinese population. The original parsimonious Eurolung1 and the updated Eurolung1 were the best-performing models on morbidity prediction, but their discrimination ability only achieved an acceptable level. A multicenter study with more relevant variables and sophisticated statistical methods is warranted to develop new models among Chinese patients in the future.

Effects of lobectomy in stage II/IIIA second primary lung cancer patients with prior non-small cell lung cancer: a SEER-based study.

OBJECTIVE: Our study aimed to reveal the prognostic factors of second primary lung cancer and explore the optimal surgical procedure for Stage II/IIIA second primary lung cancer patients with prior non-small cell lung cancer. METHODS: Patients with Stage II/IIIA second primary lung cancer were collected from the Surveillance, Epidemiology and End Results database from 2004 to 2016. Lasso regression, along with univariate and multivariate Cox regression, was used to screen prognostic factors. The propensity score matching was used to minimize baseline differences, and restricted mean survival time was used to compare overall survival and cancer-specific survival of different groups. RESULTS: A total of 579 patients were enrolled in the study. After data was screened by lasso regression and univariate Cox regression, multivariate Cox regression revealed that age, sex, race, tumor size of initial primary lung cancer, tumor size, histological grade, T stage, N stage and surgical procedure of second primary lung cancer were independent prognostic factors. Further analysis showed that surgery, especially lobectomy, provided better survival in Stage II/IIIA second primary lung cancer. CONCLUSIONS: Our study identified nine independent prognostic factors of Stage II/IIIA second primary lung cancer. Surgery can provide a better prognosis, and lobectomy might be the optimal surgical procedure for these patients.

Correlation of clinical manifestations and condylar morphology of patients with temporomandibular degenerative joint diseases.

OBJECTIVE: To study the correlation between condylar morphology and clinical manifestations in patients with degenerative joint disease (DJD) of the temporomandibular joint (TMJ). METHODS: A total of 175 joints of 131 patients with DJD were included. Data on patients' basic information and symptoms were collected and analyzed. Condylar morphology was evaluated using cone beam computed tomography (CBCT). The correlation between the condylar morphology and clinical manifestations was analyzed. RESULTS: The prevalence of joint noises, clicks, and crepitus was 93/175 (53%), 73/175 (42%), and 20/175 (11%), respectively. Condylar anteroposterior diameter and condylar height were correlated with pain. There was a correlation between the shape of the condyle in the sagittal plane and joint noise. CONCLUSION: Condylar morphology and clinical features of DJD were correlated to some extent.

Suprasellar Mature Cystic Teratoma Mimicking Rathke's Cleft Cyst: A Case Report and Systematic Review of the Literature.

In this article, we present a 31-year-old female who presented with intermittent headache and oligomenorrhea of over 10 years' duration. Imaging revealed a large suprasellar mass with sellar extension. The patient underwent an endoscopic endonasal trans-sphenoidal surgery to resection of the mass. Clinical, radiological, and operative findings from this patient were initially considered to be Rathke's cleft cyst (RCC). However, postoperative histological examinations revealed a mature cystic teratoma. No radiotherapy was performed after surgery. At the most recent follow-up, approximately 1 year later, the patient is doing well with no headache and no recurrence of the teratoma.

Current Strategies for Microbubble-Based Thrombus Targeting: Activation-Specific Epitopes and Small Molecular Ligands.

Microbubbles with enhanced ultrasound represent a potentially potent evolution to the administration of a free drug in the treatment of thrombotic diseases. Conformational and expressional changes of several thrombotic biological components during active coagulation provide epitopes that allow site-specific delivery of microbubble-based agents to the thrombus for theranostic purpose. Through the interaction with these epitopes, emerging high-affinity small molecular ligands are able to selectively target the thrombi with tremendous advantages over traditional antibody-based strategy. In this mini-review, we summarize recent novel strategies for microbubble-based targeting of thrombus through epitopes located at activated platelets and fibrin. We also discuss the challenges of current targeting modalities and supramolecular carrier systems for their translational use in thrombotic pathologies.