The H/F substitution strategy can achieve large spontaneous polarization in 1D hybrid perovskite ferroelectrics.

Hybrid organic-inorganic perovskite (HOIP) ferroelectrics exhibit polarization reversibility and have a wide range of applications in the fields of smart switches, memorizers, sensors, etc. However, the inherent limitations of small spontaneous polarization (P s) and large coercive field (E c) in ferroelectrics have impeded their broader utilization in electronics and data storage. Molecular ferroelectrics, as a powerful supplement to inorganic ferroelectrics, have shown great potential in the new generation of flexible wearable electronic devices. The important research responsibility is to greatly improve progressiveness and overcome the above limitations. Here, a novel one-dimensional (1D) HOIP ferroelectric, (3-F-BTAB)PbBr3 (3-F-BTAB = 3-fluorobenzyltrimethylammonium), was successfully synthesized by employing the H/F substitution strategy to modify parent compound (BTAB)PbBr3 (BTAB = benzyltrimethylammonium), which undergoes a ferroelectric phase transition with Aizu notation 2/mF2 at 420 K. Notably, (3-F-BTAB)PbBr3 demonstrates exceptional ferroelectric properties with a large P s of 7.18 µC cm-2 and a low E c of 1.78 kV cm-1. As far as we know, (3-F-BTAB)PbBr3 features the largest P s among those reported for 1D lead-based HOIP ferroelectrics. This work enriches the 1D lead-based ferroelectric family and provides guidance for applying ferroelectrics in low-voltage polar memories.

Effectiveness of propofol in anesthetic management and cognitive function in schizophrenic patients undergoing convulsion-free modified electroconvulsive therapy.

OBJECTIVE: To investigate the effects of propofol on anesthetic effectiveness and cognitive functioning in schizophrenic patients undergoing convulsion-free modified electroconvulsive therapy (MECT). METHODS: A retrospective analysis was conducted on the clinical data of 80 schizophrenia patients treated with MECT at the Affiliated Brain Hospital of Guangzhou Medical University from January 2021 to December 2023. Patients were divided into a control group (39 patients) receiving etomidate and an observation group (41 patients) receiving a combination of etomidate and propofol for general anesthesia induction. Parameters compared between the groups included systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), arterial oxygen saturation (SaO2), time to spontaneous respiration recovery, wakefulness time, cognitive function (assessed by the Wechsler Adult Intelligence Scale-Revised in China, WAIS-RC), symptom severity (measured by the Positive and Negative Syndrome Scale, PANSS), and adverse reactions. RESULTS: No significant differences were observed in SBP, DBP, HR, and SaO2 between the groups over time, nor was there any interaction between group and time on these parameters (all P>0.05). However, the observation group showed significantly shorter times to spontaneous respiration recovery and wakefulness (both P<0.05). Post-treatment, the observation group also had higher WAIS-RC scores and lower PANSS scores, along with a reduced total incidence of adverse reactions (all P<0.05). CONCLUSION: Propofol for the induction of general anesthesia in MECT, enhances clinical anesthetic outcomes, diminishes the impact on cognitive functions, and reduces the incidence of adverse reactions, thereby suggesting its high safety and efficacy.

Association Between Sarcopenia, Clinical Outcomes, and Survival in Patients with Extensive-Stage Small Cell Lung Cancer Treated with First-Line Immunochemotherapy: A Prospective Cohort Study.

OBJECTIVE: To investigate the association between sarcopenia, short-term efficacy, and long-term survival in patients with extensive small-cell lung cancer (SCLC) treated with standard first-line immunochemotherapy. METHODS: A total of 63 patients initially diagnosed with extensive-stage small cell lung cancer were enrolled in the prospective study from December 1, 2020 to December 31, 2022. The clinical characteristics, body composition, blood test results, and image data were obtained before treatment. Patients were divided into sarcopenia and non-sarcopenia groups according to the diagnostic criteria of the Asian Sarcopenia Working Group 2019. The primary outcome was overall survival (OS) and comprehensive survival analyses were performed. Secondary outcomes included short-term efficacy and adverse events associated with first-line immunochemotherapy. RESULTS: The median age of the 63 patients enrolled in our study was 63.0 years (40-80 years). The incidence of sarcopenia was 19.0% (12/63) in patients with extensive SCLC. Compared with non-sarcopenia patients, extensive-stage SCLC patients with sarcopenia were significantly older (69.0 vs. 62.0, P = 0.017), and had lower body mass index (BMI) (20.29 vs. 24.27, P < 0.001), hand grip strength (HGS) (20.42 vs. 30.75, P < 0.001), and albumin (35.9 vs. 41.40, P < 0.001). The objective response rate after two cycles of standard first-line immunochemotherapy in the sarcopenia group was lower than in the non-sarcopenia group (30.0 vs. 78.9%, P = 0.012). There was no significant difference in chemotherapy-related hematological toxicity between the two groups. During a median follow-up of 15 months (3-33 months), patients with extensive SCLC had a median OS of 24 months, with 1-year survival of 75% and 2-year survival of 52%, respectively. Compared to non-sarcopenia patients, the median OS in the sarcopenia group was significantly shorter (9 vs. 24 months, P = 0.0014). Multivariate Cox analysis showed that sarcopenia was an independent risk factor for OS in patients with extensive SCLC (HR = 4.993, 95%CI = 1.106-22.538, P = 0.037). CONCLUSIONS: Patients with Extensive SCLC and sarcopenia had worse clinical outcomes and shorter OS. Sarcopenia is a prognostic factor affecting first-line treatment efficacy and long-term survival of patients with SCLC in the era of immunotherapy.

Targeted regulation and optimization of multifunctional phase transition materials by novel void occupancy engineering.

As an innovative form of stimulus-response materials, organic-inorganic hybrid phase transition materials have become a wonderful contender in the field of functional electronic equipment due to their versatile structure, intensive functions and straightforward preparation. However, the targeted regulation and optimization of the electrical/optical response, along with the establishment of regular structure-performance relationships, pose significant challenges in meeting the diverse demands of practical applications over an extended period. Herein, we conducted a systematic investigation into the role of lattice void occupancy in regulating phase transition temperature (Tp) and related optical/electrical bistability. By taking hybrid material [TMEA][Cd(SCN)3] featuring a flexible ammonium cation [TMEA]+ (TMEA = ethyltrimethylammonium) as the prototype, we successfully synthesized three phase transition materials, namely [DEDMA][Cd(SCN)3], [TEMA][Cd(SCN)3] and [TEA][Cd(SCN)3] (DEDMA = diethyldimethylammonium, TEMA = triethylmethylammonium, and TEA = tetraethylammonium), and the excellent regulation of the physical properties of these compounds was achieved through subtle engineering of void occupancy. More strikingly, [TEA][Cd(SCN)3] exhibits remarkable bistable properties in terms of dielectric and nonlinear optical responses (with second-harmonic generation intensity reaching 2.5 times that of KDP). This work provides a feasible avenue to reasonably customise organic-inorganic hybrid phase transition materials and finely adjust their intriguing functionalities.

Fascia- vs vessel-oriented lateral lymph node dissection for rectal cancer: Short-term outcomes and prognosis in a single-center experience.

BACKGROUND: For the management of lateral lymph node (LLN) metastasis in patients with rectal cancer, selective LLN dissection (LLND) is gradually being accepted by Chinese scholars. Theoretically, fascia-oriented LLND allows radical tumor resection and protects of organ function. However, there is a lack of studies comparing the efficacy of fascia-oriented and traditional vessel-oriented LLND. Through a preliminary study with a small sample size, we found that fascia-oriented LLND was associated with a lower incidence of postoperative urinary and male sexual dysfunction and a higher number of examined LLNs. In this study, we increased the sample size and refined the postoperative functional outcomes. AIM: To compare the effects of fascia- and vessel-oriented LLND regarding short-term outcomes and prognosis. METHODS: We conducted a retrospective cohort study on data from 196 patients with rectal cancer who underwent total mesorectal excision and LLND from July 2014 to August 2021. The short-term outcomes included perioperative outcomes and postoperative functional outcomes. The prognosis was measured based on overall survival (OS) and progression-free survival (PFS). RESULTS: A total of 105 patients were included in the final analysis and were divided into fascia- and vessel-oriented groups that included 41 and 64 patients, respectively. Regarding the short-term outcomes, the median number of examined LLNs was significantly higher in the fascia-oriented group than in the vessel-oriented group. There were no significant differences in the other short-term outcomes. The incidence of postoperative urinary and male sexual dysfunction was significantly lower in the fascia-oriented group than in the vessel-oriented group. In addition, there was no significant difference in the incidence of postoperative lower limb dysfunction between the two groups. In terms of prognosis, there was no significant difference in PFS or OS between the two groups. CONCLUSION: It is safe and feasible to perform fascia-oriented LLND. Compared with vessel-oriented LLND, fascia-oriented LLND allows the examination of more LLNs and may better protect postoperative urinary function and male sexual function.

Influence of PD-L1 expression on the efficacy of EGFR-TKIs in EGFR-mutant non-small cell lung cancer.

BACKGROUND: Evidence on the influence of programmed death-ligand 1 (PD-L1) expression on the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in EGFR-mutant non-small cell lung cancer (NSCLC) patients is at variance. METHODS: A single-center retrospective study was conducted to evaluate the influence of PD-L1 expression on the efficacy of EGFR-TKIs for NSCLC patients with EGFR mutation. Clinical information was retrieved from electronic medical records. The patients were divided into three subgroups according to PD-L1 expression level: PD-L1 < 1% (negative), PD-L1 1%-49% and PD-L1 ≥ 50%. The clinicopathological features, overall response rate (ORR), progression-free survival (PFS) and comutation information were collected and compared between the three subgroups. RESULTS: A total of 117 patients were included. For PD-L1 < 1%, PD-L1 1%-49% and PD-L1 ≥ 50% group, there were 39 (33.3%), 51 (43.5%) and 27 (23.0%) patients respectively, and the ORR was 43.2%, 64.0%, and 51.9%, respectively (p = 0.162), and the median progression-free survival (mPFS) was 22.0 months (95% CI: 14.0-29.9 months), 15.4 months (95% CI: 8.9-21.8 months) and 13.0 months (95% CI: 10.6-15.3 months), respectively (log-rank, p = 0.01). The mPFS was negatively correlated with PD-L1 expression level (r = -0.264, p = 0.041) and PD-L1 expression was an independent risk factor for worse PFS of EGFR-TKIs in multivariate Cox regression. Patients with concurrent TP53 mutation had shorter PFS (p = 0.039) and the patients harboring both mutant TP53 and positive PD-L1 had the shortest PFS (p = 0.006). CONCLUSIONS: The efficacy of EGFR-TKIs was influenced by the baseline PD-L1 expression. Higher PD-L1 expression was associated with shorter PFS. The combined indicators of TP53 and PD-L1 identified subgroups showing divergent benefits from EGFR-TKIs.

New 5-methyl-4-hydroxycoumarin polyketide derivatives from Gerbera delavayi with anti-inflammatory activity.

Five new 5-methyl-4-hydroxycoumarin polyketide derivatives (MPDs), delavayicoumarins A-E (1-5), were isolated from the whole plants of Gerbera delavayi. Among them, compounds 1-3 are the common monoterpene polyketide coumarins (MPCs), while 4 is a modified MPC with both the lactone ring contracted to a five-membered furan ring and a carboxyl at C-3, and 5 is a pair of unusual phenylpropanoid polyketide coumarin enantiomers (5a and 5b), featuring a phenylpropanoid unit at C-3. The planar structures were elucidated by spectroscopic methods and biosynthetic arguments, and the absolute configurations of 1-3, 5a and 5b were confirmed by calculated electronic circular dichroism (ECD) experiment. Furthermore, compounds 1-3, (+)-5 and (-)-5 were tested for the nitric oxide (NO) inhibitory activity by using lipopolysaccharide (LPS)-induced RAW 264.7 cells in vitro. The results showed that compounds 1-3, (+)-5 and (-)-5 remarkably inhibited NO production at the concentration of 10.0 µM, exhibiting that they have significant anti-inflammatory activity.

Macrophage-derived exosomes promote intestinal mucosal barrier dysfunction in inflammatory bowel disease by regulating TMIGD1 via mircroRNA-223.

BACKGROUND & AIM: Exosomes are effective mediators of cell-to-cell interactions and transport several regulatory molecules, including microRNAs (miRNAs), involved in diverse fundamental biological processes. The role of macrophage-derived exosomes in the development of inflammatory bowel disease (IBD) has not been previously reported. This study investigated specific miRNAs in macrophage-derived exosomes in IBD and their molecular mechanism. METHODS: A dextran sulfate sodium (DSS)-induced IBD mouse model was established. The culture supernatant of murine bone marrow-derived macrophages (BMDMs) cultured with or without lipopolysaccharide (LPS) was used for isolating exosomes, which were subjected to miRNA sequencing. Lentiviruses were used to alter miRNA expression and investigate the role of macrophage-derived exosomal miRNAs. Both mouse and human organoids were co-cultured with macrophages in a Transwell system to model cellular IBD in vitro. RESULTS: LPS-induced macrophages released exosomes containing various miRNAs and exacerbated IBD. Based on miRNA sequencing of macrophage-derived exosomes, miR-223 was selected for further analysis. Exosomes with upregulated miR-223 expression contributed to the exacerbation of intestinal barrier dysfunction in vivo, which was further verified using both mouse and human colon organoids. Furthermore, time-dependent analysis of the mRNAs in DSS-induced colitis mouse tissue and miR-223 target gene prediction were performed to select the candidate gene, resulting in the identification of the barrier-related factor Tmigd1. CONCLUSION: Macrophage-derived exosomal miR-223 has a novel role in the progression of DSS-induced colitis by inducing intestinal barrier dysfunction through the inhibition of TMIGD1.

Endoscopic management of pancreatic fluid collections with disconnected pancreatic duct syndrome.

Disconnected pancreatic duct syndrome (DPDS) is an important and common complication of acute necrotizing pancreatitis. Endoscopic approach has been established as the first-line treatment for pancreatic fluid collections (PFCs) with less invasion and satisfactory outcome. However, the presence of DPDS significantly complicates the management of PFC; besides, there is no standardized treatment for DPDS. The diagnosis of DPDS presents the first step of management, which can be preliminarily established by imaging methods including contrast-enhanced computed tomography, ERCP, magnetic resonance cholangiopancreatography (MRCP), and EUS. Historically, ERCP is considered as the gold standard for the diagnosis of DPDS, and secretin-enhanced MRCP is recommended as an appropriate diagnostic method in existing guidelines. With the development of endoscopic techniques and accessories, the endoscopic approach, mainly including transpapillary and transmural drainage, has been developed as the preferred treatment over percutaneous drainage and surgery for the management of PFC with DPDS. Many studies concerning various endoscopic treatment strategies have been published, especially in the recent 5 years. Nonetheless, existing current literature has reported inconsistent and confusing results. In this article, the latest evidence is summarized to explore the optimal endoscopic management of PFC with DPDS.

[Responses of blood parameters and hemoglobin subtypes in plateau zokors and plateau pikas to different altitude habitats].

The plateau zokor (Myospalax baileyi) and plateau pika (Ochotona curzoniae) are native species unique to the Qinghai-Tibetan Plateau with successful adaptation to the hypoxic environment. In this study, the number of red blood cells, hemoglobin concentration, mean hematocrit and mean volume of red blood cells were measured in plateau zokors and plateau pikas at different altitudes. Hemoglobin subtypes of two plateau animals were identified by mass spectrometry sequencing. The forward selection sites in two animals' hemoglobin subunits were analyzed by PAML4.8 program. Homologous modeling was used to analyze the effect of forward selection sites on the affinity of hemoglobin to oxygen. The adapting strategies of plateau zokors and plateau pikas to hypoxia at different altitudes were analyzed through comparing blood parameters between the two species. The results indicated that, with increasing altitudes, plateau zokors responded to hypoxia by increasing red blood cell count and decreasing red blood cell volume, while plateau pikas took the opposite strategies to plateau zokors. In erythrocytes of plateau pikas, both adult α2ß2 and fetal α2ε2 hemoglobins were identified, while erythrocytes of plateau zokors only had adult α2ß2 hemoglobin, however the affinities and the allosteric effects of the hemoglobin of plateau zokors were significantly higher than those of plateau pikas. Mechanistically, in the α and ß subunits of hemoglobin of plateau zokors and pikas, the numbers and the sites of the positively selected amino acids as well as the side chain groups polarities and orientations of the amino acids differed significantly, which may result in the difference of the affinities to oxygen of hemoglobin between plateau zokors and pikas. In conclusion, the adaptive mechanisms to respond to hypoxia in blood properties of plateau zokors and plateau pikas are species-specific.

PADs and NETs in digestive system: From physiology to pathology.

Peptidylarginine deiminases (PADs) are the only enzyme class known to deiminate arginine residues into citrulline in proteins, a process known as citrullination. This is an important post-translational modification that functions in several physiological and pathological processes. Neutrophil extracellular traps (NETs) are generated by NETosis, a novel cell death in neutrophils and a double-edged sword in inflammation. Excessive activation of PADs and NETs is critically implicated in their transformation from a physiological to a pathological state. Herein, we review the physiological and pathological functions of PADs and NETs, in particular, the involvement of PAD2 and PAD4 in the digestive system, from inflammatory to oncological diseases, along with related therapeutic prospects.

Semantic-Aware Dehazing Network With Adaptive Feature Fusion.

Despite that convolutional neural networks (CNNs) have shown high-quality reconstruction for single image dehazing, recovering natural and realistic dehazed results remains a challenging problem due to semantic confusion in the hazy scene. In this article, we show that it is possible to recover textures faithfully by incorporating semantic prior into dehazing network since objects in haze-free images tend to show certain shapes, textures, and colors. We propose a semantic-aware dehazing network (SDNet) in which the semantic prior is taken as a color constraint for dehazing, benefiting the acquisition of a reasonable scene configuration. In addition, we design a densely connected block to capture global and local information for dehazing and semantic prior estimation. To eliminate the unnatural appearance of some objects, we propose to fuse the features from shallow and deep layers adaptively. Experimental results demonstrate that our proposed model performs favorably against the state-of-the-art single image dehazing approaches.

Effectiveness and Safety of Chinese Medicine at Shenque (CV 8) for Primary Dysmenorrhea: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Primary dysmenorrhea (PD) is the most common complaint associated with menstruation and affects up to three-quarters of women at some stage of their reproductive life. In Chinese medicine, navel therapy, treatment provided at Shenque (CV 8), is used as a treatment option for PD. OBJECTIVE: To evaluate the effect of navel therapy on pain relief and quality of life in women with PD, compared with Western medicine (WM). METHODS: China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), SinoMed and Wanfang Database, MEDLINE, the Cochrane Library, Embase, Web of Science, and the International Clinical Trial Registry of the U.S. National Institutes of Health were searched from their inceptions to April 1, 2021. Randomized controlled trials (RCTs) assessing therapeutic effects of navel therapy on PD were eligible for inclusion. RevMan 5.4 software was used for data analyses. The certainty of the evidence was assessed using the online GRADEpro tool. RESULTS: Totally 24 RCTs involving 2,614 participants were identified. Interventions applied to acupuncture point CV 8 included: herbal patching, moxibustion or combined navel therapy (using at least 2 types of stimulation). Compared to placebo, there was a significant effect in favor of navel therapy on reducing overall menstrual symptom scores at the end of treatment [mean difference: -0.82, 95% confidence interval (CI): -1.00 to -0.64, n=90; 1 RCT]. As compared with Western medicine, navel therapy had a superior effect on pain intensity as assessed by Visual Analogue Scale at the end of treatment [standardized mean difference (SMD): -0.64, 95% CI: -1.22 to -0.06, I2=80%, n=262; 3 RCTs]; on symptom resolution rate at 3-month follow-up (risk ratio: 1.94, 95% CI: 1.47 to 2.56, n=1527, I2=38%; 13 RCTs); and on global menstrual symptoms score at the end of treatment (SMD: -0.67, 95% CI: -0.90 to -0.45, I2=63%, n=990; 12 RCTs). Subgroup analyses showed either a better or an equivalent effect comparing navel therapy with Western medicine. No major adverse events were reported. The methodological quality of included trials was poor overall. CONCLUSIONS: Navel therapy appears to be more effective than Western medicine in decreasing menstrual pain and improving overall symptoms of PD. However, these findings need to be confirmed by well-designed clinical trials with adequate sample size (Systematic review registration at PROSPERO, No. CRD42021240350).

Clinicopathological Features of Sessile Serrated Polyps in China: A Retrospective Study of a Tertiary Hospital.

BACKGROUND: Serrated polyps have been recognized as the important premalignant lesions. In this study, we aimed to analyze the clinicopathological features of sessile serrated polyps and determine the association between sessile serrated polyps and synchronous advanced adenomas. METHODS: Consecutive patients undergoing diagnostic or therapeutic colonoscopies (including 156 681 diagnostic colonoscopies) from 2011 to 2019 were included. RESULTS: A total of 958 patients, including 699 (73%) males, were detected with at least 1 sessile serrated polyp, and 65.9% (n = 658) of sessile serrated polyps were located in the distal colon. Advanced serrated lesions accounted for 9.1% (n = 91) of all the sessile serrated polyp (n = 999). The types of SSP included flat type (953/999, 95.4%) and sub-pedunculated or pedunculated type (46/999, 4.6%). Meanwhile, there was no obvious evidence supporting the association between advanced adenomas and characteristics of advanced serrated lesions or sessile serrated polyps. CONCLUSION: Sessile serrated polyps seem to be more frequently seen in the distal colon of men in this study. However, more evidence is required to confirm the actual distribution of sessile serrated polyp in colon among Chinese people. There is still much room for improvement of sessile serrated polyp detection rate, and more importance should be attached to sessile serrated polyp both for pathologists and endoscopists.

Comparative Performance of Endoscopic Ultrasound-Based Techniques in Patients With Pancreatic Cystic Lesions: A Network Meta-Analysis.

INTRODUCTION: Evidence on the comparative diagnostic performance of endoscopic ultrasound (EUS)-based techniques for pancreatic cystic lesions (PCLs) is limited. This network meta-analysis comprehensively compared EUS-based techniques for PCL diagnosis. METHODS: A comprehensive literature search was performed for all comparative studies assessing the accuracy of 2 or more modalities for PCL diagnosis. The primary outcome was the diagnostic efficacy for mucinous PCLs. Secondary outcomes were the diagnostic efficacy for malignant PCLs, diagnostic success rate, and adverse event rate. A network meta-analysis was conducted using the ANOVA model to assess the diagnostic accuracy of each index. RESULTS: Forty studies comprising 3,641 patients were identified. The network ranking of the superiority index for EUS-guided needle-based confocal laser endomicroscopy (EUS-nCLE) and EUS-guided through-the-needle biopsy (EUS-TTNB) were significantly higher than other techniques for differentiating mucinous PCLs; besides, EUS-TTNB was also the optimal technique in identifying malignant PCLs. The evidence was inadequate for EUS-nCLE diagnosing malignant PCLs and contrast-enhanced harmonic EUS diagnosing both mucinous and malignant PCLs. Glucose showed a high sensitivity but low specificity, and molecular analysis (KRAS, GNAS, and KRAS + GNAS mutations) showed a high specificity but low sensitivity for diagnosing mucinous PCLs. Satisfactory results were not obtained during the evaluation of the efficiency of pancreatic cyst fluid (PCF) biomarkers in detecting malignant PCLs. DISCUSSION: For centers with relevant expertise and facilities, EUS-TTNB and EUS-nCLE were better choices for the diagnosis of PCLs. Further studies are urgently required for further improving PCF biomarkers and validating the diagnostic performance of the index techniques.

Effectively Identifying Compound-Protein Interaction Using Graph Neural Representation.

Effectively identifying compound-protein interactions (CPIs) is crucial for new drug design, which is an important step in silico drug discovery. Current machine learning methods for CPI prediction mainly use one-demensional (1D) compound/protein strings and/or the specific descriptors. However, they often ignore the fact that molecules are essentially modeled by the molecular graph. We observe that in real-world scenarios, the topological structure information of the molecular graph usually provides an overview of how the atoms are connected, and the local chemical context reveals the functionality of the protein sequence in CPI. These two types of information are complementary to each other and they are both significant for modeling compound-protein pairs. Motivated by this, we propose an end-to-end deep learning framework named GraphCPI, which captures the structural information of compounds and leverages the chemical context of protein sequences for solving the CPI prediction task. Our framework can integrate any popular graph neural networks for learning compounds, and it combines with a convolutional neural network for embedding sequences. To compare our method with classic and state-of-the-art deep learning methods, we conduct extensive experiments based on several widely-used CPI datasets. The experimental results show the feasibility and competitiveness of our proposed method.

Three new species of Illiesonemoura Baumann, 1975 (Plecoptera, Nemouridae) from China.

Background: The genus Illiesonemoura Baumann, 1975 (Plecoptera, Nemouridae) is a small-sized stonefly with slender and curved embranous cerci. Currently, 18 species of the genus are known worldwide, mainly distributed in the Palaearctic and Oriental Regions, with a total of two species known to China. New information: Three new species of Illiesonemoura Baumann, 1975, I.bituberculata Wang & Du, sp. nov., I.motuoensis Du & Ji, sp. nov. and I.weii Du & Ji, sp. nov. are described and illustrated, based on male adults from China. Illiesonemourabituberculata is characterised by two pairs of tubercles arising posteromedially from tergum 10 and by two rows of spinules outlining the lateral edge of the ventral sclerite of the epiproct. Illiesonemouramotuoensis is characterised by the heart-shaped epiproct with a thin and slightly sclerotised protrusion between the sclerotised bands. Illiesonemouraweii is characterised by a pair of small knobs on tergum 10, outer lobes of paraprocts basally broad, then slender towards apices with a pointed tip and the epiproct with lateral spinules.

Optimal sampling technique for EUS-guided fine-needle biopsy of solid pancreatic lesions using a 25-gauge ProCore needle: A multicenter randomized crossover superiority study.

Background and Objectives: It remains unclear whether the use of the stylet slow-pull (SP) and wet suction (WS) can improve the yield of endoscopic ultrasound-guided fine-needle biopsy compared to standard suction (SS). The aim of this study was to compare the diagnostic efficacy of the three sampling techniques when using 25G ProCore needles for solid pancreatic lesions. Materials and Methods: This multicenter single-blind randomized crossover superiority trial enrolled patients with solid pancreatic lesions (n = 300) from four digestive endoscopic centers in China. All three sampling techniques were performed on each patient using a 25G ProCore needle in a randomized sequence. The diagnostic efficacy, the specimen yield, and quality of each technique, the overall technical success rate and diagnostic yield of the 25G ProCore needle, and rate of adverse events were evaluated. Results: A total of 291 patients were analyzed. No significant difference was found in diagnostic efficiency among the three techniques (sensitivity, 82.14% vs. 75.00% vs. 77.86, P = 0.1186; accuracy, 82.82% vs. 75.95% vs. 78.69%, P = 0.1212). The SP had an inferior tissue integrity compared to the SS and WS techniques (71.82% vs. 62.55% vs. 69.76%, P = 0.0096). There was no significant difference in the degree of blood contamination among the three groups (P = 0.2079). After three passes, the overall sensitivity was 93.93%, and the accuracy was 94.16%. Conclusions: SS and WS techniques are better choices than SP technique for 25G ProCore needle, for they could provide higher specimen adequacy without increasing the amount of blood contamination. The 25G ProCore needle can provide a satisfactory diagnostic yield for solid pancreatic lesions.