Deep Learning Combined with Radiologist's Intervention Achieves Accurate Segmentation of Hepatocellular Carcinoma in Dual-Phase Magnetic Resonance Images.

Purpose: Segmentation of hepatocellular carcinoma (HCC) is crucial; however, manual segmentation is subjective and time-consuming. Accurate and automatic lesion contouring for HCC is desirable in clinical practice. In response to this need, our study introduced a segmentation approach for HCC combining deep convolutional neural networks (DCNNs) and radiologist intervention in magnetic resonance imaging (MRI). We sought to design a segmentation method with a deep learning method that automatically segments using manual location information for moderately experienced radiologists. In addition, we verified the viability of this method to assist radiologists in accurate and fast lesion segmentation. Method: In our study, we developed a semiautomatic approach for segmenting HCC using DCNN in conjunction with radiologist intervention in dual-phase gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid- (Gd-EOB-DTPA-) enhanced MRI. We developed a DCNN and deep fusion network (DFN) trained on full-size images, namely, DCNN-F and DFN-F. Furthermore, DFN was applied to the image blocks containing tumor lesions that were roughly contoured by a radiologist with 10 years of experience in abdominal MRI, and this method was named DFN-R. Another radiologist with five years of experience (moderate experience) performed tumor lesion contouring for comparison with our proposed methods. The ground truth image was contoured by an experienced radiologist and reviewed by an independent experienced radiologist. Results: The mean DSC of DCNN-F, DFN-F, and DFN-R was 0.69 ± 0.20 (median, 0.72), 0.74 ± 0.21 (median, 0.77), and 0.83 ± 0.13 (median, 0.88), respectively. The mean DSC of the segmentation by the radiologist with moderate experience was 0.79 ± 0.11 (median, 0.83), which was lower than the performance of DFN-R. Conclusions: Deep learning using dual-phase MRI shows great potential for HCC lesion segmentation. The radiologist-aided semiautomated method (DFN-R) achieved improved performance compared to manual contouring by the radiologist with moderate experience, although the difference was not statistically significant.

Urban vs. rural: colorectal cancer survival and prognostic disparities from 2000 to 2019.

This study aimed to analyze the differences in colorectal cancer (CRC) survival between urban and rural areas over the past 20 years, as well as investigate potential prognostic factors for CRC survival in both populations. Using registry data from Surveillance, Epidemiology, and End Results (SEER) from 2000 to 2019, 463,827 CRC cases were identified, with 85.8% in urban and 14.2% in rural areas. The mortality of CRC surpassed its survival rate by the sixth year after diagnosis in urban areas and the fifth year in rural areas. Furthermore, the 5-year overall survival (OS) of CRC increased by 2.9-4.3 percentage points in urban and 0.6-1.5 percentage points in rural areas over the past two decades. Multivariable Cox regression models identified independent prognostic factors for OS and disease-specific survival (DSS) of CRC in urban and rural areas, including age over 40, Black ethnicity, and tumor size greater than 5 cm. In addition, household income below $75,000 was found to be an independent prognostic factor for OS and DSS of CRC in urban areas, while income below $55,000 was a significant factor for rural areas. In conclusion, this study found a notable difference in CRC survival between rural and urban areas. Independent prognostic factors shared among both rural and urban areas include age, tumor size, and race, while household income seem to be area-specific predictive variables. Collaboration between healthcare providers, patients, and communities to improve awareness and early detection of CRC may help to further advance survival rates.

Combination of Ethacrynic Acid and ATRA Triggers Differentiation and/or Apoptosis of Acute Myeloid Leukemia Cells through ROS.

BACKGROUND AND OBJECTIVE: All-trans retinoic acid (ATRA), an effective differentiation inducer, has been applied clinically to treat acute promyelocytic leukemia (APL). Unfortunately, it is not as potent in other kinds of acute myeloid leukemia (AML). Ethacrynic acid (EA), a classical powerful diuretic, can increase reactive oxygen species (ROS) contents, which can assist ATRA in inducing differentiation in AML cells. Here, we investigated the effect of EA combined with ATRA (EA+RA) on some AML cells except APL. METHODS: Apoptosis and differentiation were determined by morphology, cell viability, Annexin-V assay and CD11c expression. Western blot analysis and the detection of ROS and mitochondrial transmembrane potentials (MMP) were used to investigate the mechanisms. RESULTS: AML cells exhibited differentiation and/or apoptosis after EA+RA treatment. EA+RA increased the intracellular ROS contents. EA+RA-induced apoptosis was accompanied by MMP attenuation and caspase-3/7 activation. EA+RA-induced differentiation was along with MEK/ERK and Akt activation and increased expression of PU.1, CCAAT/enhancer-binding protein ß (C/EBPß) and C/EBPε. N-acetyl-L-cysteine (NAC), an antioxidant, thoroughly reduced EA+RA-increased ROS, and also inhibited MMP attenuation, the activation of caspase- 3/7, MEK/ERK and Akt pathways, the elevation of PU.1 and C/EBPs, and apoptosis and differentiation. However, MEK or PI3K specific inhibitors only suppressed EA+RA-triggered differentiation and the elevation of PU.1 and C/EBPs, but not ROS levels. CONCLUSION: EA+ATRA induced cell apoptosis through ROS dependent MMP attenuation and caspase 3/7 activation while inducing differentiation by ROS-MEK/ERK-PU.1/C/EBPs and ROS-Akt-PU.1/C/EBPs pathways. In summary, it may provide innovative ATRA-based combination therapy strategies for AML patients via ROS.

Assessing the option water-saving willingness of irrigation areas considering farmers' risk tolerance.

Water option trading could facilitate water conservation in irrigation areas to achieve optimal allocation of agricultural water resources. However, the risk associated with water-saving decisions increases due to the uncertainties of tradeable water and water-saving benefits, which makes farmers in the irrigation area with heterogeneous risk tolerances exhibit varied option water-saving willingness (OWSW) in response to the water option contract. Thus, this article provides a novel framework for prior assessing the OWSW in the irrigated area that considers farmers' heterogeneous risk tolerance and proposes the optimal contractual water demand to stimulate the OWSW. First, a multiobjective optimal allocation model for cropping water is constructed to predict tradeable water, and then risk trust, risk-return perception and reference are integrated into water-saving return analysis for proposing a willingness calculation model involving forecast information. Finally, the influence of heterogeneous risk tolerance on farmers' water-saving path choices and the irrigation area's OWSW is analyzed with three sets of comparative data from 2014 to 2021. Results indicate that the intensity and stability of OWSW in water-scarce irrigation areas increase as farmers' risk tolerance rises, but the enhancement utility exhibits a diminishing marginal trend. When both prediction accuracy and farmers' risk tolerance are low, contracts with relatively adventurous and differentiated water demands are more likely to stimulate OWSW. This study provides insights into activating water options trading and stimulating water conservation in agriculture from a risk management perspective.

Posttraumatic arteriovenous fistula of the lower extremity and the pathological characteristic-case series and literature review.

The clinical presentation, treatment history, and outcomes of two patients with posttraumatic arteriovenous fistula (PTAVF) were analyzed and compared with the pathological tissues of patients with hemodialysis arteriovenous fistula (HAVF). A search of the biomedical literature database (PubMed), using the keywords " lower extremity" and "PTAVF," was conducted to obtain results and review the data. Postoperative histological analysis of patients with PTAVF showed differences from that of HAVF. The literature screening and analysis revealed that PTAVF is a chronic progressive process, with 70% of patients diagnosed after 3 months. The choice of treatment revealed that 20% of patients had severe complications and all were treated endovascularly. Due to the abnormal fistula of PTAVF and its specific histopathological features, the disease is not self-limiting. It is unwise to wait for PTAVF to cause "failure." We recommend early and timely cure of this disease by surgery to avoid serious complications.

Bioinformatics Integrative Analysis of Circadian Rhythms Effects on Atopic Dermatitis and Dendritic Cells.

Background: Atopic dermatitis (AD) is an allergic inflammatory skin disease caused by aberrant and over-reactive immune response. Although circadian rhythm disruption is implicated in multiple immunoinflammatory conditions, including AD, the mechanisms at the molecular level underlying AD and circadian rhythms remain elusive. Methods: Bulk and single-cell RNA-sequencing data of AD patients were acquired from the Gene Expression Omnibus, including GSE121212, GSE120721, and GSE153760 datasets. A single-sample gene set enrichment analysis was performed to estimate circadian rhythm gene expression levels. A differential expression analysis was utilized to identify the key candidate genes in AD. CIBERSORT was used to quantify the proportions of immune cells, and the R package "Seurat" was utilized to investigate single-cell RNA-sequencing data. Results: Circadian rhythm gene expression levels were lower in AD skin samples than in normal skin samples. Dendritic cells were significantly upregulated and negatively correlated with circadian rhythm gene expression levels in AD patients. Compared with circadian rhythm-related genes in the control samples, ARNTL2, NOCT, and RORC were differentially expressed in AD; ARNTL2 and NOCT were significantly upregulated, whereas RORC was significantly downregulated in AD. ARNTL2, NOCT, and RORC also showed robust abilities to diagnose AD. We validated that the abundance of the dendritic cell was positively correlated with the ARNTL2 and NOCT expression levels using bulk RNA-sequencing data of the GSE121212 and single-cell RNA-sequencing data of the GSE153760. Moreover, the functional enrichment analysis showed that the IL-17 and NF-κB signaling pathways, Th1 and Th2 cell differentiations, and primary immunodeficiency, were enriched in AD patients. Conclusion: The findings of this study suggested that the circadian rhythm is involved in the progression of AD, and RNTL2, NOCT, and RORC as well as dendritic cells are differentially expressed in AD. These findings could be used to introduce diagnostic and chronotherapeutic modalities for AD.

Nursing model based on Snyder's hope theory in emergency care of patients with acute myocardial infarction.

OBJECTIVE: To investigate the effect of Snyder's hope theory in emergency care for patients with acute myocardial infarction (AMI). METHODS: This retrospective study included 200 AMI patients admitted to Rugao People's Hospital from January 2019 to December 2021. The patients were divided into a conventional group (routine care, n=100) and an intervention group (care based on Snyder's Hope theory, n=100) according to differences in nursing approach. Baseline data of the two groups were collected. The psychological state was evaluated using the self-rating anxiety scale (SAS) and self-rating depression scale (SDS). Self-care ability was assessed using the exercise of self-care agency (ESCA) scale. The myocardial enzyme indexes including cardiac troponin T (cTnT) and myocardial creatine kinase isoenzyme (CK-MB), as well as electrocardiogram index (Tp-Te/QT) were compared between the two groups. Complications of the two groups were recorded, and the risk factors for complications in the intervention group were examined. RESULTS: After nursing, the SAS and SDS scores in the intervention group were lower than those in the conventional group (P < 0.05). The ESCA scores in all dimensions were higher in the intervention group than those of the conventional group (P < 0.05). The cTnT and CK-MB decreased in both groups, but the decreases in the intervention group were greater than those of the conventional group (P < 0.05). The Tp-Te/QT in the intervention group (0.25±0.04) was lower than that in the conventional group (0.32±0.06, P < 0.05). The incidence of complications in the intervention group was 9.00%, lower than 21.00% in the conventional group (P < 0.05). Multivariate logistic regression analysis showed that cTnT, CK-MB, and Tp-Te/QT were influencing factors for complications in the intervention group (P < 0.05). CONCLUSION: The effect of nursing based on Snyder's hope theory in emergency care fof AMI patients is promising because it can improve the psychological state of patients and reduce the incidence of complications.

Phase separation is required for PML nuclear body biogenesis and function.

PML nuclear body (NB) malfunction often leads to acute leukemia outbreaks and other severe diseases. PML NB rescue is the molecular basis of arsenic success in acute promyelocytic leukemia (APL) treatment. However, it is unclear how PML NBs are assembled. Here, we observed the presence of liquid-liquid phase separation (LLPS) in NB formation by fluorescence recovery after photobleaching (FRAP) experiment. Compared with the wild-type (WT) NBs, PML A216V derived from arsenic-resistant leukemia patients markedly crippled LLPS, but not altered the overall structure and PML RBCC oligomerization. In parallel, we also reported several Leu to Pro mutations that were critical to PML coiled-coil domain. FRAP characterization and comparison between L268P and A216V revealed markedly different LLPS activities in these mutant NBs. Transmission electron microscopy (TEM) inspections of LLPS-crippled and uncrippled NBs showed aggregation- and ring-like PML packing in A216V and WT/L268P NBs, respectively. More importantly, the correct LLPS-driven NB formation was the prerequisite for partner recruitment, post-translational modifications (PTMs), and PML-driven cellular regulations, such as ROS stress control, mitochondria production, and PML-p53-mediated senescence and apoptosis. Altogether, our results helped to define a critical LLPS step in PML NB biogenesis.

The gut microbial metabolite trimethylamine N-oxide and cardiovascular diseases.

Morbidity and mortality of cardiovascular diseases (CVDs) are exceedingly high worldwide. Researchers have found that the occurrence and development of CVDs are closely related to intestinal microecology. Imbalances in intestinal microecology caused by changes in the composition of the intestinal microbiota will eventually alter intestinal metabolites, thus transforming the host physiological state from healthy mode to pathological mode. Trimethylamine N-oxide (TMAO) is produced from the metabolism of dietary choline and L-carnitine by intestinal microbiota, and many studies have shown that this important product inhibits cholesterol metabolism, induces platelet aggregation and thrombosis, and promotes atherosclerosis. TMAO is directly or indirectly involved in the pathogenesis of CVDs and is an important risk factor affecting the occurrence and even prognosis of CVDs. This review presents the biological and chemical characteristics of TMAO, and the process of TMAO produced by gut microbiota. In particular, the review focuses on summarizing how the increase of gut microbial metabolite TMAO affects CVDs including atherosclerosis, heart failure, hypertension, arrhythmia, coronary artery disease, and other CVD-related diseases. Understanding the mechanism of how increases in TMAO promotes CVDs will potentially facilitate the identification and development of targeted therapy for CVDs.

Combined Application of Salinomycin and ATRA Induces Apoptosis and Differentiation of Acute Myeloid Leukemia Cells by Inhibiting WNT/ß-Catenin Pathway.

BACKGROUND AND OBJECTIVE: All-trans retinoic acid (ATRA) is only effective in acute promyelocytic leukemia (APL), but not in other subtype of acute myeloid leukemia (AML). Salinomycin targets tumor cells rather than non-tumorigenic cells, and WNT/ß-catenin pathway inhibition is one of the mechanisms of its anti-tumor activity. There is a crosstalk between RA and WNT/ß-catenin pathway. Here, we investigate the effect of the combination of salinomycin and ATRA (S+RA) in non-APL AML cells. METHODS: Apoptosis was evaluated by cell viability and Annexin-V assay. Cell differentiation was analyzed by CD11c expression and morphology. To explore the underlying mechanisms, Western blot analysis and mitochondrial transmembrane potentials (ΔΨm) were used. RESULTS & DISCUSSION: S+RA induced differentiation and apoptosis in AML cell lines and AML primary cells. S+RA inhibited the ß-catenin signal pathway as determined by the decreased protein levels of ß-catenin, the low-density lipoprotein receptor-related proteins 6 (LRP6), and its downstream proteins such as survivin, c-Myc, caspase-3/7, cdc25A and cyclinD1 and reduced phosphorylation level of GSK3ß S9. S+RA also increased the protein levels of CCAAT/enhancer-binding proteins (C/EBPs) and PU.1 and collapsed Δψm. The above molecular and cellular changes induced by S+RA were inhibited by ß-catenin specific activator and promoted by ß-catenin specific inhibitor. CONCLUSION: S+RA induced differentiation by ß-catenin-inhibition-mediated up-regulation of C/EBPs and PU.1 and suppression of c-Myc. S+RA triggered apoptosis through ß-catenin-inhibition-regulated ΔΨm collapse and caspase-3/7 activation. Taken together, our findings may provide novel therapeutic strategies for AML patients by targeting the WNT/ß-catenin pathway.

Clinicopathological features, prognostic significance, and associated tumor cell functions of family with sequence similarity 111 member B in pancreatic adenocarcinoma.

BACKGROUD: Among digestive tract tumors, pancreatic adenocarcinoma (PAAD) has a high degree of malignancy. Therefore, it is important to search for pancreatic adenocarcinoma-related differential genes and new oncogene therapeutic targets for early diagnosis, treatment, and prognosis of pancreatic adenocarcinoma. AIMS: This study aims to investigate the expression and clinical significance of Family with sequence similarity 111 member B (FAM111B) in PAAD. MATERIALS & METHODS: Bioinformatics was used to analyze the relationship between FAM111B expression and pancreatic adenocarcinoma and to predict its role in related pathways. Tissue microarrays were used to assess the levels of FAM111B in pancreatic cancer tissues by immunohistochemical staining, and the effects of FAM111B expression levels on apoptosis, proliferation, invasion and migration of tumor cells were observed and verified by in vitro cellular assays. RESULTS: FAM111B expression was higher in PAAD tissue than in matched normal tissues (p < 0.05). The expression level of FAM111B, the metastatic status of lymph nodes was an independent prognostic factor for PAAD survival (p < 0.05). Meanwhile, overexpression of FAM111B promoted PAAD cell proliferation, migration, invasion and inhibited PAAD cell apoptosis (p < 0.05). In contrast, knockdown of FAM111B triggered the opposite result (p < 0.05). In the results of GSEA, it was shown that FAM111B may be involved in PAAD progression through p53 signaling pathway, cell cycle, and other signaling pathways (p < 0.05 and FDR q-val <0.25). FAM111B is highly expressed in PAAD tissues and is closely associated with poor prognosis of PAAD. CONCLUSION: FAM111B significantly promotes the proliferation, invasion, and migration of pancreatic adenocarcinoma cells while it inhibits their apoptosis. FAM111B may be a new biomarker for PAAD. It may provide a new direction for the treatment and diagnosis of PAAD.

Analysis of ARHGAP4 Expression With Colorectal Cancer Clinical Characteristics and Prognosis.

Background: This study aims to analyze the correlation between ARHGAP4 in the expression and clinical characteristics of colorectal cancer (CRC), and the influence of ARHGAP4 expression on the prognosis of CRC, and to evaluate whether ARHGAP4 is a potential prognostic oncotarget for CRC. Methods: ARHGAP4 was identified using the Gene Expression Omnibus database through weighted gene coexpression network analysis. Using the Gene Expression Profiling Interactive Analysis to perform and analyze the expression and prognosis of ARHGAP4 in CRC. The expression of AGRGAP4 and immune cells was analyzed by the Tumor IMmune Estimation Resource online database. Finally, immunohistochemistry was used to analyze the expression difference and prognosis of ARHGAP4 in CRC and adjacent normal tissues, as well as the relationship between AGRGAP4 expression and clinical features of CRC. Results: We identified ARHGAP4 that is related to the recurrence of CRC from GSE97781 data. ARHGAP4 has not been reported in CRC. The high expression of ARHGAP4 in select colon adenocarcinoma indicates a poor prognosis by database analysis. In our clinical data results, ARHGAP4 is highly expressed in CRC and lowly expressed in normal tissues adjacent to cancer. Compared with the low-expression group, the high-expression group has a significantly poorer prognosis. In colon cancer, the B-cell, macrophage, neutrophil, and dendritic-cell levels are downregulated after ARHGAP4 gene knockout; the levels of CD8+ and CD4+ T cells, neutrophils, and dendritic cells are upregulated after the amplification of the ARHGAP4 gene. In addition, ARHGAP4 expression is related to N,M staging and clinical staging. Conclusion: ARHGAP4 is highly expressed in CRC, and the high expression of ARHGAP4 has a poor prognosis. The expression of ARHGAP4 in CRC is related to the immune cells such as B cells, CD8+ and CD4+ T cells, macrophages, neutrophils, and dendritic cells. ARHGAP4 is correlated with N,M staging and clinical staging in CRC. ARHGAP4 may be a potential biomarker for the prognosis of CRC.

Combination of midostaurin and ATRA exerts dose-dependent dual effects on acute myeloid leukemia cells with wild type FLT3.

BACKGROUND: Midostaurin combined with chemotherapy is currently used to treat newly diagnosed acute myeloid leukemia (AML) patients with FMS-like tyrosine kinase 3 (FLT3)-mutations. However, midostaurin acts as an antagonist to some chemotherapeutic agents in leukemia cell lines without FLT3 mutations. All-trans retinoic acid (ATRA) induces apoptosis when used in combination with midostaurin in FLT3-mutated AML cells. This combination has been shown to be safe in AML patients. However, the effect of this combination has not been investigated in AML without FLT3 mutations. METHODS: Cell proliferation was assessed by a cell counting assay. Cell death was evaluated by cell viability and Annexin-V assays. Cell differentiation was assessed by CD11b expression profiling and morphological analysis. To explore the underlying mechanisms, we studied the role of caspase3/7, Lyn, Fgr, Hck, RAF, MEK, ERK, AKT, PU.1, CCAAT/enhancer binding protein ß (C/EBPß) and C/EBPε by Western blot analysis and immunoprecipitation assays. Antitumor activity was also confirmed in mouse xenograft models established with AML cells. RESULTS: In this study, 0.1 - 0.25 µM midostaurin (mido(L)) combined with ATRA induced differentiation while 0.25 - 0.5 µM midostaurin (mido(H)) combined with ATRA triggered apoptosis in some AML cell lines without FLT3-mutations. Midostaurin combined with ATRA (mido-ATRA) also exhibited antitumor activity in mouse xenograft models established with AML cells. Mechanistically, mido(H)-ATRA-induced apoptosis was dependent on caspase-3/7. Mido(L)-ATRA inhibited Akt activation which was associated with decreased activity of Lyn/Fgr/Hck, resulted in dephosphorylation of RAF S259, activated RAF/MEK/ERK, along with upregulating the protein levels of C/EBPß, C/EBPε and PU.1. A MEK specific inhibitor was observed to suppress mido(L)-ATRA-induced increases in the protein levels of C/EBPs and PU.1 and mido(L)-ATRA-induced differentiation. Furthermore, inhibition of Akt activity promoted mido(L)-ATRA-induced downregulation of RAF S259 phosphorylation and mido(L)-ATRA-induced differentiation. Therefore, Lyn/Fgr/Hck-associated Akt inhibition activated RAF/MEK/ERK and controlled mido(L)-ATRA-induced differentiation by upregulation of C/EBPs and PU.1. Mido(L)-ATRA also promoted assembly of the signalosome, which may facilitate RAF activation. CONCLUSIONS: Midostaurin combined with ATRA exerts antitumor activity against AML with wild-type FLT3 mutations in vitro and in vivo. These findings may provide novel therapeutic strategies for some AML patients without FLT3 mutations and imply a new target of midostaurin.

MAKO robotic assisted total hip replacement (THR) for patients with fused hips.

BACKGROUND: Previous articles about MAKO robotic-assisted total hip replacement (THR) were mainly in patients with comparatively normal anatomy. METHODS: From July 2020 to June 2021, we performed MAKO robotic-assisted THR in three hip-fused patients. We assessed the accuracy of prostheses implantation, collected clinical data, and discussed the value of this technique in this kind of patients. RESULT: All three patients achieved good leg length and prostheses position. A patient got femoral artery injury during the surgery. Moreover, she developed a thrombus. All three patients got acceptable Visual Analogue Scale scores and function recovery 6 months later. CONCLUSION: MAKO robotic-assisted THR achieved excellent prosthesis position in hip fused patients. More cases are needed to confirm this advantage. The function recovery was acceptable. Caution should be paid to protect the surrounding abnormal arteries, especially in a limited surgical field.

Clinical significance of circulating tumour cells and tumour marker detection in the chemotherapeutic evaluation of advanced colorectal cancer.

AIM: Systemic chemotherapy combining biological targeted therapies is the standard therapy for patients with metastatic colorectal cancer (mCRC), but effective markers are needed to identify clinical responders. Circulating tumour cells (CTCs) have been associated with prognosis in patients with mCRC. This study aimed to explore the relationship between CTC number and the clinical response of patients with advanced CRC. METHOD: Epithelial cell adhesion molecule-independent enrichment and CD45- fluorescence in situ hybridization immunofluorescence were used to detect peripheral blood CTCs in 79 patients with advanced CRC. Fisher's exact test and Spearman's rank correlation coefficient were used to analyse the correlation between CTC number and efficacy of chemotherapy. Kaplan-Meier and Cox regression analyses were used to evaluate progression-free survival (PFS). RESULTS: Among the evaluable patients, CTCs were significantly correlated with clinical response (r =4.891, p = 0.031). High CTC numbers were associated with a poor treatment response (r = -0.250, p = 0.027). Dynamic decrease in CTC number was associated with clinical response (p = 0.046). High baseline CTC number and carcinoembryonic antigen levels were prognostic factors for unfavourable PFS in multivariable analysis [hazard ratio (HR) = 3.30, p = 0.011 and HR = 2.04, p = 0.044, respectively]. Compared with the CTC-positive group, the CTC-negative group showed superior PFS (median PFS 15.53 vs. 9.43 months, p = 0.041) among CRC patients receiving first-line treatment. CONCLUSION: CTC number is a feasible biomarker for predicting outcomes in mCRC patients receiving systemic chemotherapy.

Antiferromagnetism Induced by Bond Su-Schrieffer-Heeger Electron-Phonon Coupling: A Quantum Monte Carlo Study.

Antiferromagnetism (AFM) such as Néel ordering is often closely related to Coulomb interactions such as Hubbard repulsion in two-dimensional (2D) systems. Whether Néel AFM ordering in two dimensions can be dominantly induced by electron-phonon couplings (EPC) has not been completely understood. Here, by employing numerically exact sign-problem-free quantum Monte Carlo (QMC) simulations, we show that bond Su-Schrieffer-Heeger (SSH) phonons with frequency ω and EPC constant λ can induce AFM ordering for a wide range of phonon frequency ω>ω_{c}. For ω<ω_{c}, a valence-bond-solid (VBS) order appears and there is a direct quantum phase transition between VBS and AFM phases at ω_{c}. The phonon mechanism of the AFM ordering is related to the fact that SSH phonons directly couple to electron hopping whose second-order process can induce an effective AFM spin exchange. Our results shall shed new light on understanding AFM ordering in correlated quantum materials.

Multiplexed sensing interrogation technique based on a flexibly switchable multi-passband RF filter by using a Solc-Sagnac loop.

In this paper, we have proposed and experimentally demonstrated a multiplexed sensing interrogation technique based on a flexibly switchable multi-passband RF filter with a polarization maintaining fiber (PMF) Solc-Sagnac loop. A high-order Solc-Sagnac loop can be used as a spectrum slicer as well as sensing heads, and a multi-passband microwave photonic filter (MPF) can be achieved together with a dispersive medium. Environmental parameter variations will cause a frequency shift of the corresponding passband of the MPF, so by employing only one Sagnac loop, it is possible to monitor several environmental parameters simultaneously. In this article, we have demonstrated and analyzed the performance of the flexibly switchable multi-passband MPF by using a second-order Solc-Sagnac loop. To demonstrate the temperature sensing capabilities of our interrogation system, we have applied temperature changes individually to Sensor Head 1 (L P M F 1 ≈0.97m) only, Sensor Head 2 (L P M F 2 ≈2.97m) only, and both Sensor Head 1 and 2 in the experiment. By monitoring frequency shift of the MPF's passbands, the sensitivities for Sensor Head 1 and Sensor Head 2 have been estimated to be -0.275 ± 0.011 MHz/℃ and -0.811 ± 0.013 MHz/℃ respectively, which show a good sensing linearity and stability. By utilizing the longer length of the sensing PMF, higher sensitivity can be achieved. By using Solc-Sagnac loop with higher order, more sensors can be multiplexed.

Feasible Catalytic-Insoluble Strategy Enabled by Sulfurized Polyacrylonitrile with In Situ Built Electrocatalysts for Ultrastable Lithium-Sulfur Batteries.

To date, elemental sulfur has been considered as a prospective cathode material for exploring high-energy power systems with low cost and sustainability. However, its practical commercialization has been impeded by inherent drawbacks of notorious capacity decay, unsatisfied insulating nature, and sluggish conversion chemistry. To address these issues, for the first time, freestanding nanofibrous networks with hierarchical nanostructures are facilely constructed by inlaying electrocatalytic bimetallic chalcogenides (FexMn1-xS nanoparticles) into conductive graphene nanosheet (GN)-doped sulfurized polyacrylonitrile (SPAN) fiber matrices. Covalent-bonded SPAN featuring an insoluble mechanism serves as a reliable cathode substrate with enhanced electrostability and high sulfur utilization, while high-surface-area GN dopants promote conductivity improvement and rapid electron transfer. Meanwhile, the results prove that sulfiphilic FexMn1-xS nanoparticles with abundant electrochemically active sites facilitate construction of uniform deposition interfaces and efficient electrocatalysis conversion toward lithium polysufides. This feasible catalytic-insoluble cathode strategy drives the Li-S battery, which exhibits excellent electrochemical performances with a remarkable reversible discharge capacity of 967 mA h g-1 and a capacity retention of 623 mA h g-1 after 500 cycles. Moreover, the corresponding lithiation/delithiation mechanisms are systematically investigated through complementary morphological and spectral analyses, providing valuable insights into advanced metal-sulfur batteries.

Trametinib enhances ATRA-induced differentiation in AML cells.

All-trans retinoic acid (ATRA) is only clinically useful in acute promyelocytic leukemia (APL), but not other subtypes of acute myeloid leukemia (AML). In the present study, a clinically achievable concentration of trametinib, a highly selective inhibitor of MEK, enhanced ATRA-induced differentiation in AML cell lines, HL-60 and U937 as well as AML primary cells. Moreover, trametinib-ATRA (tra-ATRA) co-treatment restored ATRA sensitivity in ATRA-resistant AML cell line, HL-60Res. The protein level of STAT3 and the phosphorylation of Akt or JNK were enhanced with tra-ATRA treatment in HL-60, U937, and HL-60Res cells, respectively. Furthermore, tra-ATRA-induced differentiation in HL-60, U937, and HL-60Res cells was inhibited by STAT3, PI3K, and JNK inhibitors, respectively. Therefore, STAT3, Akt, and JNK signaling pathways were involved in tra-ATRA-induced differentiation in HL-60, U937, and HL-60Res cells, respectively. Taken together, our findings may provide novel therapeutic strategies for AML patients.

Atrial Arrhythmias in Patients with Severe COVID-19.

The number of confirmed COVID-19 cases has increased drastically; however, information regarding the impact of this disease on the occurrence of arrhythmias is scarce. The aim of this study was to determine the impact of COVID-19 on arrhythmia occurrence. This prospective study included patients with COVID-19 treated at the Leishenshan Temporary Hospital of Wuhan City, China, from February 24 to April 5, 2020. Demographic, comorbidity, and arrhythmias data were collected from patients with COVID-19 (n = 84) and compared with control data from patients with bacterial pneumonia (n = 84) infection. Furthermore, comparisons were made between patients with severe and nonsevere COVID-19 and between older and younger patients. Compared with patients with bacterial pneumonia, those with COVID-19 had higher total, mean, and minimum heart rates (all P < 0.01). Patients with severe COVID-19 (severe and critical type diseases) developed more atrial arrhythmias compared with those with nonsevere symptoms. Plasma creatine kinase isoenzyme (CKMB) levels (P=0.01) were higher in the severe group than in the nonsevere group, and there were more deaths in the severe group than in the nonsevere group (6 (15%) vs. 3 (2.30%); P=0.05). Premature atrial contractions (PAC) and nonsustained atrial tachycardia (NSAT) were significantly positively correlated with plasma CKMB levels but not with high-sensitive cardiac troponin I or myoglobin levels. Our data demonstrate that COVID-19 patients have higher total, mean, and minimum heart rates compared with those with bacterial pneumonia. Patients with severe or critical disease had more frequent atrial arrhythmias (including PAC and AF) and higher CKMB levels and mortality than those with nonsevere symptoms.