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Purpose: The aim of this study was to investigate the prognostic significance of PD-1 inhibitor therapy in nasopharyngeal carcinoma (NPC) and to develop a nomogram to estimate individual risks. Methods: We retrospectively analyzed 162 NPC patients who were administered the PD-1 inhibitor combined with radiotherapy and chemotherapy at the Sun Yat-Sen University Cancer Center. In total, 108 NPC patients were included in the training cohort and 54 NPC patients were included in the validation cohort. Univariate and multivariate Cox survival analyses were performed to determine the prognostic factors for 1-year and 2-year progression-free survival (PFS). In addition, a nomogram model was constructed to predict the survival probability of PFS. A consistency index (C-index), a decision curve, a clinical impact curve, and a standard curve were used to measure predictive accuracy, the clinical net benefit, and the consistency of prognostic factors. Results: Univariate and multivariate analyses indicated that the metastasis stage, the levels of ALT, the AST/ALT ratio, and the LDH were independent risk factors associated with the prognosis of PD-1 inhibitor therapy. A nomogram based on these four indicators was constructed and the Kaplan–Meier survival analysis showed that patients with a higher total score have a shorter PFS. The C-index of this model was 0.732 in the training cohort and 0.847 in the validation cohort, which are higher than those for the TNM stages (training cohort: 0.617; validation cohort: 0.727; p

Purpose This study explores the effects of endometrial thickness (EMT) before embryo transfer on newborn birth weight after in vitro fertilization–frozen embryo transfer (IVF–FET).Methods We collected the medical records related to singleton live births after IVF–FET from June 2015 to February 2019. Pregnant women were aged ≤ 42 years at delivery. Afterward, analyses were performed on outcomes related to newborns (birth weight, gestational age, delivery mode, percentage of newborns with low birth weight, and incidence of macrosomia) and pregnant women (pregnancy-induced hypertension, gestational diabetes mellitus, premature rupture of membranes, and placenta previa).Results The birth weight was higher in singleton newborns delivered by patients with EMT > 12 mm before embryo transfer than those delivered by patients with a thinner endometrium. The mean birth weight was 85.107 g higher in the EMT ≥ 12 mm group and 25.942 g higher in the 8–12 mm EMT group than in the EMT < 8 mm group. Independent predictors of newborn birth weight included pregnancy-induced hypertension, premature rupture of membranes, placenta previa, newborn sex, gestational age, delivery mode, number of implanted embryos, follicle-stimulating hormone levels, estradiol levels, and pre-pregnancy body mass index.Conclusion The weight of newborn singletons is associated with EMT before embryo transfer in patients undergoing the first FET cycle. Specifically, the birth weight is lower for newborns delivered by patients with a thinner endometrium. Accordingly, it is warranted to increase EMT before embryo transfer for improving neonatal outcomes after fertility treatment.

Abstract Background Surgeon and anesthetist share the airway in a simpler way in the resection and reconstruction phase of tracheal surgery in tubeless spontaneous-ventilation video-assisted thoracoscopic surgery (SV-VATS). Tubeless SV-VATS means stable spontaneous ventilation in the resection and reconstruction phase to anesthesiologist, and unobstructed surgical field to surgeon. What’s the ideal airway management strategy during “Visual Field tubeless” SV-VATS for tracheal surgery is still an open question in the field. Methods We retrospectively reviewed 33 patients without sleeve and carina resections during the study period (2018–2020) in our hospital. The initial management strategy for these patients was spontaneous ventilation for intrathoracic tracheal resection and reconstruction. We obtained and reviewed medical records from our institution’s clinical medical records system to evaluate the airway management strategy and device failure rate for tracheal resection in Tubeless SV-VATS. Results Between 2018 and 2020, SV-VATS was first attempted in the 33 patients who had intrathoracic tracheal surgery but without sleeve and carina resections. All patients underwent bronchoscopy (33/33) and 8 patients (8/33) received partial resection before surgery. During the surgery, the airway device comprised either a ProSeal laryngeal mask airway (ProSeal LMA) (n = 27) or single lumen endotracheal tube (n = 6). During the resection and reconstruction phase, Visual Field tubeless SV-VATS failed in 9 patients, and breathing support switched to plan B which is traditional ventilation of a single lumen endotracheal tube for cross field intubation (n = 4) and ProSeal LMA alongside a high-frequency catheter (high-frequency jet ventilation, HFJV) (n = 5) into the distal trachea ventilation. Preoperative respiratory failure or other ventilation-related complications were not observed in this cohort. Conclusion Base on current analysis either ProSeal LMA or endotracheal tube is an effective airway management strategy for tubeless SV-VATS with appropriate patient selection. It also provides breathing support conversion option when there’s inadequate ventilation.

Abstract Introduction Approximately 50% of cases with recurrent spontaneous abortion (RSA) have unexplained etiology. Aberrant expression of transmembrane and ubiquitin‐like domain containing 1 (TMUB1) is closely related to a series of diseases, including RSA. However, the function and underlying mechanism of TMUB1 in the occurrence of RSA has not been described. Methods TMUB1 expression was detected in the placental villous tissues of 30 women with normal miscarriages and 12 women with RSA. The pregnant mice were injected intraperitoneally with lipopolysaccharide (LPS) to induce abortion. Human chorionic trophoblast cells were treated with LPS. Pathological analysis of placental tissues was performed by hematoxylin and eosin staining. Results TMUB1 was highly expressed in the placental villous tissues of RSA patients compared to the patients who underwent induced abortions. After LPS administration, the mice exhibited high embryo absorption and pathological alterations, as well as presented an increase in inflammation and apoptosis (the etiology of RSA induction) in placental tissues. Moreover, the upregulated expression of TMUB1 was also found in placental tissues of LPS‐induced mice, and further investigation showed that TMUB1 deficiency blocked embryo loss as well as inhibited apoptotic rate and inflammation after LPS activation. Furthermore, we found that the loss of TMUB1 suppressed the phosphorylation of IkappaB kinase (IKK) α/β and attenuated cytoplasmic‐nuclear translocation of nuclear factor‐κB (NF‐κB) p65 in LPS‐induced cells. Conclusion Our results indicate that TMUB1 may involve in the modulation of apoptosis and NF‐κB pathway‐mediated inflammation in RSA. Therefore, TMUB1 may develop as a potential biomarker for RSA treatment.

The Kuqa Depression in Tarim Basin develops fan deltaic, braided river deltaic, and lacustrine sedimentation, especially extensive braided river deltaic sedimentation, in the Cretaceous-Paleogene Systems. However, fine sedimentary pattern of the Kuqa Depression and North Tarim Uplift belt since the Middle Cenozoic still needs to be studied. As a combination zone of the Kuqa Depression and North Tarim Uplift, the sedimentary characteristics of the DB area in the southern margin of the east of the Kuqa depression have been paid more attention. To better understand the sedimentary framework in the Kuqa Depression and North Tarim Uplift in the Mesozoic and Cenozoic, through joint geologic-geophysical study, sedimentation of sandstone at the bottom of the Paleogene Suweiyi Formation in the DB area and its peripheral area is investigated. Sedimentary facies and sandstone distribution in the area are identified through core observation, component analysis, logging interpretation and seismic inversion. Based on seismic facies analysis, sedimentary facies distribution in the area is delineated. Results show that sandstone at the bottom of the Paleogene Suweiyi Formation in the DB area and its peripheral area is developed in shore-shallow lacustrine beach-bar facies. The beach-bar arenaceous sediments are mainly distributed in the southern DB area and the shallow lacustrine mudstone is developed in northern DB area, showing obvious north-south differentiation characteristics.

This paper evaluated the oil and gas potential of the Cretaceous Yageliemu clastic reservoir within the Yakela condensed gas field lying in the Kuqa Depression, Tarim Basin, China. The petrophysical properties of the interest zones in the Kuqa area were characterized using geophysical logs from five wells. The results reveal that the gas-bearing zones are characterized by high resistivity, good permeability (K) and effective porosity (Φeff), low water saturation (Sw), and low shale concentration (Vsh), reflecting clean sand. The shale distribution model showed that these shales have no major influence on porosity and fluid saturation. The average shale volume, average effective porosity, and hydrocarbon saturation indicate that the Cretaceous Yageliemu Formation in the studied area contains prospective reservoir properties. The spatial distribution of petrophysical parameters, reservoir rock typing (RRT), and lithofacies were analyzed using the cross plots of litho saturation (volumetric analysis), iso-parametric representations of the petrophysical characteristics, cluster analysis, and self-organizing feature maps, respectively. The southeastern and northeastern regions of the research area should be ignored because of their high water and shale concentrations. The sediments in the southwest and northwest include the most potential reservoir intervals that should be considered for the future exploration and development of oil and gas fields in the study area.

Cadmium is a severe environmental pollutant that mainly targets kidney and causes kidney disease in the end. However, the mechanism of cadmium-induced kidney disease is still unclear. In this study, we treated SD rats, kidney epithelial or fibroblast cells with cadmium, and examined the renal fibrosis process and underlying cellular and molecular mechanism. Rats received daily (Monday-Friday) subcutaneous injections of CdCl2, 0.6 mg/kg, for 6 weeks or 12 weeks, and NRK-52E cells were treated with CdCl2 of 8 μM for 24 h. Sirius red staining and immunohistochemistry assay showed that sub-chronic exposure to cadmium caused interstitial fibrosis in rat kidneys. Cell experiments showed that cadmium treatment in NRK-52E cells only changed levels of α-SMA, vimentin and E-cadherin, but not collagen1, indicating that cells other than EMT cells might be responsible for the extracellular matrix production. By contrast, co-culture of NRK-49F cells with cadmium-treated NRK-52E cells produced collagen1. Assays of supernatant of NRK-52E cell culture showed that the secreted Wnt1, Wnt4 were increased, while miR-503-5p was decreased by cadmium treatment. RT-QPCR assay found that miR-503-5p was downregulated in both kidney of rats and NRK-52E cells exposed to cadmium. miR-503-5p was further shown to be competent in hindering epithelial-mesenchymal transition and fibroblast activation. Given the well established involvement of Wnt/β-catenin pathway in fibrosis, this study suggested that dysregulations of Wnts and miR-503-5p coordinate in mediating cadmium-induced kidney fibrosis. Our findings might provide new insight in the cellular and molecular mechanisms of kidney interstitial fibrosis and novel therapeutic targets for cadmium-induced kidney disease.

OBJECTIVE To explore the application of blocking the unilateral main pulmonary artery (MPA) in pulmonary lobectomy (PL) for patients with stage II and III lung cancer, and to retrospectively analyze the methods of surgery for blocking the unilateral main pulmonary artery, perioperative indications, intraoperative concerns and postoperative cardio-pulmonary complications. METHODS During a period from January 2006 to January 2008, intra-pericardial, or extra-pericardial separation and blockade of the le t or right MPA followed by completion of various PLs were conducted for 30 lung cancer patients in stage-II to III with ill-defi ned anatomic structure of the pulmonary hilum and difficult pulmonary angiodiastasis. RESULTS In the 30 patients, 5 were diagnosed as stage-IIb, 11 stage-IIIa, and 14 stage-IIIb. During the surgery, giant tumors at the superior pulmonary lobe, with a diameter of over 10 cm, were seen in 13 cases, in which tumor invasion in the extra pericardiac pulmonary artery was found in 5 cases. Hilar lymphadenectasis with severe tumor adhesion to pulmonary blood vessel could be seen in 20 cases and partial tumorous invasion in the pericardium in 7. In most of the cases, adhesions existed around the tumor, aorta, superior vena, and azygous vein. Invasion of the laryngeal and vagus nerves on the left side was found in 3 cases. Of the 30 patients, simple PL was conducted in 12, and sleeve lobectomy combined with a pulmonary arterioplasty in 18 cases. With a blockade of unilateral MPA, no intraoperative hemorrhea of pulmonary blood vessels occurred during surgery, when there was a clear surgical field of vision. Both PL and lymphadenectomy were smoothly completed in the 30 patients. The healthy pulmonary lobes with normal function were kept and total pneumonectomy was avoided. The time of blocking the pulmonary artery ranged from 10 to 30 min, and intraoperative blood loss was from 200 to 300 ml. Postoperative complicated acute pulmonary edema occurred in 5 patients and tachycardia in 7 cases. Nevertheless, all patients recovered and let the hospital after treatment. No severe cardiopulmonary complications were found in all patients of the group. CONCLUSION Blocking the unilateral MPA is effective to decrease the risk of intraoperative hemorrhea in the PL. It can shorten the time of surgery, improve the excision rate of lung cancer, and cut down on the rate of total pneumonectomy.

The Kuqa Depression is an important oil-gasbearing area in the Tarim Basin. The gas-producing layers are mainly the Cretaceous and Lower Tertiary of the Mesozoic and Cenozoic. It is a typical highquality sandstone reservoir with the characteristics of excellent reservoir and large resource. This paper takes the newly explored Qiaogu area in the Kuqa structural belt as the research object. Using experimental methods such as core analysis, scanning electron microscopy, casting thin sections, and mercury intrusion testing, combined with the relevant theories of sedimentology and petrology, the sandstone reservoirs of the Cretaceous Bashkirqike Formation are analyzed and studied. The research shows that the porosity of sandstone reservoir cores in the Bashkirqike Formation is distributed between 18 and 24%, with an average value of 20.29%. The permeability distribution is between 100 and 1000%0-3pm2. with an average value of 273.05%0-3pm2. The core pore type is simple, and the pore connectivity is good. The Cretaceous Bashkirqike Formation is a braided river delta facies sedimentary system. The Cretaceous sediments are mainly transported by the gradient suspension of the traction current. The sedimentary microfacies can be divided into underwater distributary channel, mouth bar and underwater distributary bay, and front edge sheet sand. The main diagenesis of the Cretaceous includes compaction, cementation, and dissolution. The differences in reservoir properties are jointly controlled by sedimentary microfacies and lithology, tectonic compression, dissolution, and burial, and are mainly controlled by dissolution and burial vertically. [ABSTRACT FROM AUTHOR]

OBJECTIVES: At present, few data exist regarding the comparisons of perioperative outcomes and recurrence of spontaneous ventilation (SV) video-assisted thoracic surgery (VATS) bullectomy using total intravenous anaesthesia (TIVA) with local anaesthesia (LA) or thoracic epidural anaesthesia (TEA).We evaluated the feasibility and safety of TIVA with LA in the management of primary spontaneous pneumothorax (PSP). METHODS: We conducted a single-institution retrospective analysis of patients undergoing VATS bullectomy between July 2011 and May 2015; 240 patients were included for analysis. Preoperative, intraoperative and postoperative variables of patients undergoing VATS bullectomy using TIVA-TEA (n = 140) were compared with those using TIVA-LA (n = 100). RESULTS: Baseline demographics were similar between groups. No patients in either group required conversion to thoracotomy. Three patients (TIVA-TEA: 2; TIVA-LA: 1) required conversion to intubated general anaesthesia. Both groups had comparable surgical duration, estimated blood loss, peak EtCO2 and lowest intraoperative SpO2 level. Postoperatively, thoracic drainage volume, duration of chest tube drainage and hospitalization cost did not differ between groups. The incidence of postoperative complications between groups was not significant (2% for TIVA-TEA vs 2% for TIVA-LA, P = 1.00). Pneumothorax recurrence rate was 3% in TIVA-TEA cases (n = 4) and 2% in TIVA-LA cases (n = 2). CONCLUSIONS: SV-VATS bullectomy using TIVA with LA or TEA is technically feasible and safe. Both groups have comparable short-term outcomes and recurrence rates; TIVA-LA seems a valid alternative to TIVA-TEA for the surgical management of PSP under SV. [ABSTRACT FROM AUTHOR]

Abstract: In this paper we represent the performance of an ejector used in the CO2 heat pump water heater system by means of experimental and theoretical studies. This work accounts for the effects of primary flow pressure, entrained flow pressure and back pressure on the entrainment ratio in off-design conditions. The performance of the ejector is experimentally investigated in a CO2-ejector test rig. Using ejector characteristic-curve equations, we provide predictions in good agreement with the experimental data. Furthermore, the model predictions will be utilized as a design tool for optimizing the performance of next generation ejector. [Copyright &y& Elsevier]