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Ze-Jiao He,1,2,&ast; Tao Hu,3,&ast; Zi-Shu Zhang,3 Tian-Cheng Wang,3 Wei Huang3 1Guizhou Medical University, Guiyang, Guizhou, People’s Republic of China; 2Department of Radiology, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, People’s Republic of China; 3Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, 410011, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wei Huang, Department of Radiology, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, 410011, People’s Republic of China, Email 2204150303@csu.edu.cnBackground: Bone mineral density (BMD) and monocyte-to-lymphocyte ratio (MLR) were recently identified as novel risk factors for patients with several malignancies. The objective of this study was to validate the role of preoperative BMD/MLR as a potential prognostic biomarker in patients with hepatocellular carcinoma (HCC) undergoing liver resection.Methods: This investigation enrolled 442 adult patients diagnosed with HCC who underwent liver resection. The patients were classified into high- and low-BMD/MLR groups based on the median, and forward stepwise logistic regression was employed to identify independent predictors for early HCC recurrence. To mitigate the impact of confounding factors, a propensity score matching (PSM) analysis was conducted between patients in the high- and low-BMD/MLR groups. The Kaplan-Meier method was employed to assess and compare the disease-free survival (DFS) and overall survival (OS) between the two cohorts.Results: The study categorized patients into high-BMD/MLR and low-BMD/MLR groups. Forward stepwise logistic regression analysis revealed that low BMD/MLR (P < 0.001), tumor size > 50 mm (P < 0.001), and AFP > 200 ug/L (P = 0.001) were significantly associated with the early recurrence of HCC. Moreover, the results suggested that DFS and OS were significantly shorter in the low-BMD/MLR group compared to the high-BMD/MLR group, both before and after PSM (P < 0.05).Conclusion: Preoperative BMD/MLR held promise as a prognostic biomarker for early recurrence and prognosis in patients with HCC who underwent liver resection. Furthermore, the integration of tumor size, AFP level, and BMD/MLR demonstrated a robust predictive capacity for early recurrence within this patient population.Keywords: hepatocellular carcinoma, resection, bone mineral density, recurrence, prognosis

Zi-jun He,1,2,&ast; Jin-tao Wei,1,&ast; Hai-mei Jiang,1 Jin-yong Wang,1 Jiong-yao Lai,1 Shu-qing Li,1 Zhi Chen,1 Qing-lu Luo1– 3 1Department of Rehabilitation Medicine, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital), Dongguan, People’s Republic of China; 2Dongguan Experimental Centre for Sports Rehabilitation Research, Dongguan, People’s Republic of China; 3Dongguan Key Specialty of Traditional Chinese Medicine (Rehabilitation Department), Dongguan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qing-lu Luo; Zhi Chen, Department of Rehabilitation Medicine, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People’s hospital), Wanjiang District, Dongguan, Guangdong, 510280, People’s Republic of China, Email luo_qinglu@126.com; 13686616688@139.comObjective: To identify distinct developmental trajectories of weight-bearing pain (WBP) and non-weight-bearing pain (NWBP) and examine the trajectory predictors in individuals with or at risk of knee osteoarthritis.Methods: We included 971 participants from the Osteoarthritis Initiative whose baseline magnetic resonance imaging data and 9-year follow-up data on pain were available. We applied group-based trajectory modeling to identify WBP and NWBP trajectories over 9 years. Univariate and multivariate multinomial logistic regression analyses were performed to examine the predictors of identified trajectories.Results: Three distinct WBP trajectories were identified: “no pain” (32.4%), “mild pain” (44.6%), and “moderate pain” (23%). Three distinct NWBP trajectories were identified: “no pain” (50.9%), “mild pain” (33.4%), and “moderate pain” (15.7%). In multivariate analyses, high body mass index, depression, multisite pain, radiographic knee OA, and comorbidities were associated with worse development trajectories for WBP and NWBP. Weak quadriceps strength and bone marrow lesion were only associated with worse WBP trajectories, whereas low education level was only associated with worse NWBP trajectories.Conclusion: The developmental course of pain is heterogeneous in WBP or NWBP. Quadriceps strength and bone marrow leisure may be WBP-specific predictors, whereas education level may be a NWBP-specific predictor. The assessment of knee pain should be more accurate, which may help select appropriate therapeutic targets.Keywords: knee osteoarthritis, pain, weight-bearing, trajectories, predictors

Wen Wu,1,2,&ast; Yu-Pei Zhang,1,2,&ast; Yu-Meng Pan,2 Zhen-Jie He,1,2 Yan-Ping Tan,1 Ding-Deng Wang,1,2 Xing-Guang Qu,1,2 Zhao-Hui Zhang1,2 1Department of Critical Care Medicine, Yichang Central People’s Hospital, Yichang, Hubei, 443003, People’s Republic of China; 2The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, 443003, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhao-Hui Zhang, Department of Critical Care Medicine, Yichang Central People’s Hospital, Yichang, 443003, Hubei, People’s Republic of China, Tel/Fax +86-0717-6481546, Email zhaohuizhang0630@163.comPurpose: This study aims to evaluate the predictive efficacy of the C-reactive protein/albumin ratio (CAR), a cost-effective, easily accessible, and reproducible biomarker obtained from standard blood tests, in forecasting acute kidney injury (AKI) among patients undergoing acute pancreatitis (AP). Considering that changes in the CAR are associated with AKI incidence in AP cases, this work aims to explore whether CAR can be used as the innovative, inflammation-based diagnostic marker for AKI in AP patients.Methods: The current retrospective cohort study consecutively enrolled AP patients admitted to First College of Clinical Medical Science of China Three Gorges University during the period from January 2019 to October 2023. Data were extracted systematically in electronic medical records from these hospitalized individuals, including baseline demographic and clinical characteristics. To ascertain the association of the CAR level with the development of AKI, we carried out multivariate logistic regression, adjusting for potential confounders. These confounders were initially identified through univariate regression. Furthermore, the potential effect modifiers in the relationship between CAR and AKI occurrence were explored by stratified logistic regression.Results: Totally, 1514 AP were recruited, including 257 (16.9%) with AKI. CAR was positively correlated with AKI. When adjusting for potential confounders, the AKI risk in patients in the upper CAR tertile (2.628– 22.994) increased by 83% relative to those in lower tertile (0.05– 0.289) (OR 1.83, 95% CI 1.13– 2.96, P = 0.013). The AKI risk tended to increase according to the increasing CAR tertile (P for trend = 0.013). No significant interactions were observed among subgroups based on age, sex, BMI, admission to ICU, hypertension, DM, chronic obstructive pulmonary disease, severity of AP, etiology of AP, demand for CRRT, mechanical ventilation, and blood transfusion (all P > 0.05).Conclusion: A higher CAR is significantly related to the higher AKI incidence in AP patients in the Chinese population.Keywords: acute pancreatitis, acute kidney injury, CRP/albumin ratio, cohort study

Fei Pei,1,2,* Guan-Rong Zhang,3,* Li-Xin Zhou,4 Ji-Yun Liu,5 Gang Ma,6 Qiu-Ye Kou,7 Zhi-Jie He,8 Min-Ying Chen,1 Yao Nie,1 Jian-Feng Wu,1,2 Xiang-Dong Guan1 On behalf of the China Critical Care Immunotherapy Research Group1Department of Critical Care Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, People’s Republic of China; 2Clinical Trial Unit, The First Affiliated Hospital, Sun Yat-sen University & The University of Birmingham, Guangzhou 510080, People’s Republic of China; 3Information and Statistics Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, People’s Republic of China; 4Department of Critical Care Medicine, Foshan First Municipal People’s Hospital, Foshan 528000, People’s Republic of China; 5Department of Critical Care Medicine, Guangzhou First Municipal People’s Hospital, Guangzhou 510180, People’s Republic of China; 6Department of Critical Care Medicine, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou 510060, People’s Republic of China; 7Department of Critical Care Medicine, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, People’s Republic of China; 8Department of Critical Care Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jian-Feng Wu Email wujianf@mail.sysu.edu.cnXiang-Dong Guan Email guanxiangdong1962@163.comPurpose: Although immune dysfunction has been investigated in adult septic patients, early immune status remains unclear. In this study, our primary aim was to assess early immune status in adult patients with sepsis stratified by age and its relevance to hospital mortality.Patients and Methods: A post hoc analysis of a multicenter, randomized controlled trial was conducted; 273 patients whose immune status was evaluated within 48 hours after onset of sepsis were enrolled. Early immune status was evaluated by the percentage of monocyte human leukocyte antigen-DR (mHLA-DR) in total monocytes within 48 hours after onset of sepsis and it was classified as immunoparalysis (mHLA-DR ≤ 30%) or non-immunoparalysis (> 30%). Three logistic regression models were conducted to explore the associations between early immunoparalysis and hospital mortality. We also developed two sensitivity analyses to find out whether the definition of early immune status (24 hours vs 48 hours after onset of sepsis) and immunotherapy affect the primary outcome.Results: Of the 181 elderly (≥ 60yrs) and 92 non-elderly (< 60yrs) septic patients, 71 (39.2%) and 25 (27.2%) died in hospital, respectively. The percentage of early immunoparalysis in the elderly was twice of that in the non-elderly patients (32% vs 16%, p=0.006). For the elderly, hospital mortality was higher in the immunoparalysis ones than the non-immunoparalysis ones (53.4% vs 32.5%, p=0.009). But there was no significant difference in hospital mortality between immunoparalysis non-elderly patients and non-immunoparalysis non-elderly ones (33.5% vs 26.0%, p=0.541). By means of logistic regression models, we found that early immunoparalysis was independently associated with increased hospital mortality in elderly, but not in non-elderly patients. Sensitivity analysis further confirmed the definition of early immune status and immunotherapy did not affect the outcomes.Conclusion: The elderly were more susceptible to early immunoparalysis after onset of sepsis. Early immunoparalysis was independently associated with poor prognosis in elderly, but not in non-elderly patients.Keywords: early immune status, elderly, mHLA-DR, immunosuppression, immunoparalysis, sepsis

Teng Leng Ooi, 1 Zijiang J He 2 1College of Optometry, The Ohio State University, Columbus, OH, USA; 2Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USACorrespondence: Teng Leng OoiCollege of Optometry, The Ohio State University, 338 West 10th Ave, Columbus, OH 43210, USATel +1 614 292 1384Fax +1 614 292 7493Email ooi.22@osu.eduAbstract: Eye dominance refers to the preference to use one eye more than the fellow eye to accomplish a task. However, the dominant eye revealed can be task dependent especially when the tasks are as diverse as instructing the observer to sight a target through a ring, or to report which half-image is perceived more of during binocular rivalry stimulation. Conventionally, the former task is said to reveal motor eye dominance while the latter task reveals sensory eye dominance. While the consensus is that the motor and sensory-dominant eye could be different in some observers, the reason for it is still unclear and has not been much researched. This review mainly focuses on advances made in recent studies of sensory eye dominance. It reviews studies conducted to quantify and relate sensory eye dominance to other visual functions, in particular to stereopsis, as well as studies conducted to explore its plasticity. It is recognized that sensory eye dominance in observers with clinically normal vision shares some similarity with amblyopia at least at the behavioral level, in that both exhibit an imbalance of interocular inhibition. Furthermore, sensory eye dominance is probably manifested at multiple sites along the visual pathway, perhaps including the level of ocular dominance columns. But future studies with high-resolution brain imaging approaches are required to confirm this speculation in the human visual system.Keywords: amblyopia, binocular combination, binocular rivalry, excitatory-inhibitory balance, plasticity, stereopsis

Xiao-Ai Chen1,5*, Li-Jun Zhang2*, Zhi-Jie He3, Wei-Wei Wang4, Bo Xu1, Qian Zhong1, Xin-Tao Shuai4, Li-Qun Yang4, Yu-Bin Deng11Department of Pathophysiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China; 2Futian Affiliated Hospital, Guangdong Medical College, Shenzhen, China; 3Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; 4Institute of Polymer Science, School of Chemistry and Chemical Engineering, BME Center, State Key Laboratory of Optoelectronic Materials and Technologies, Sun Yat-sen University, Guangzhou, China; 5Yunnan Cancer Hospital, The Third Affiliated Hospital, Kunming Medical College, Kunming, China*Both authors contributed equally to this workBackground: Mesenchymal stem cell transplantation is a promising method in regenerative medicine. Gene-modified mesenchymal stem cells possess superior characteristics of specific tissue differentiation, resistance to apoptosis, and directional migration. Viral vectors have the disadvantages of potential immunogenicity, carcinogenicity, and complicated synthetic procedures. Polyethylene glycol-grafted polyethylenimine (PEG-PEI) holds promise in gene delivery because of easy preparation and potentially targeting modification.Methods: A PEG8k-PEI25k graft copolymer was synthesized. Agarose gel retardation assay and dynamic light scattering were used to determine the properties of the nanoparticles. MTT reduction, wound and healing, and differentiation assays were used to test the cytobiological characteristics of rat mesenchymal stem cells, fluorescence microscopy and flow cytometry were used to determine transfection efficiency, and atomic force microscopy was used to evaluate the interaction between PEG-PEI/plasmid nanoparticles and mesenchymal stem cells.Results: After incubation with the copolymer, the bionomics of mesenchymal stem cells showed no significant change. The mesenchymal stem cells still maintained high viability, resettled the wound area, and differentiated into adipocytes and osteoblasts. The PEG-PEI completely packed plasmid and condensed plasmid into stable nanoparticles of 100–150 nm diameter. After optimizing the N/P ratio, the PEG-PEI/plasmid microcapsules delivered plasmid into mesenchymal stem cells and obtained an optimum transfection efficiency of 15%–21%, which was higher than for cationic liposomes.Conclusion: These data indicate that PEG-PEI is a valid gene delivery agent and has better transfection efficiency than cationic liposomes in mesenchymal stem cells.Keywords: stem cells, gene delivery, nanoparticles, atomic force microscopy