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Failure to obtain timely fire services will lead to thermal runaway phenomenon, which will seriously threaten the lives of people and property safety. In this study, a dynamic method was proposed to estimate fire service accessibility based on real-time traffic. To validate the method, a total of 110,055 POls extracted from online maps and existing 12 fire stations in Yiyang were used as fire service demand points and supply points. Travel times of fire trucks from supply points to demand points were calculated based on real-time traffic, and a total of 550,275 valid samples were obtained. The results showed that the ≥10 min fire service coverage rate in Yiyang is only 71.60 %. Based on the distribution area of demand points ≥10 min, the locations of three optimization solutions of new fire stations are proposed. By calculating the total average time (TAT) of the three optimization solutions of proposed new fire stations, it is concluded that TAT decreases by 743.99 s, 99.72 s, 92.59 s, respectively. From perspectives of safety and economy, the construction of the 10 fire stations of optimized solution I will effectively improve the regional fire service level.

Fire resistance is an important performance for cement-based materials used in constructions and buildings. In this work, the properties of the hardened cement pastes (HCP) and mortars blended with 0–50% fly ash (FA) suffered from high temperatures were investigated, including mass loss, mechanical strength, deformation, and the evolution of mineral phase, micromorphology and pore structure. Results showed that the increase of FA content did not change the mineral phase evolution of HCP during continuous heating. According to the mass loss, crack temperature, and microstructure evolution of HCP suffered from high temperatures, it was concluded that the increase of FA content effectively improved their resistance to high temperatures. However, this positive effect of FA was not reflected in the mortars exposed to high temperatures, as the crystal transformation of quartz played a critical role.

Abstract Sound velocities and densities of Al‐bearing superhydrous phase B (Al‐bearing SuB) were investigated up to 24 GPa and 1300 K by synchrotron X‐rays combined with ultrasonic interferometry techniques in a multi‐anvil apparatus. We found that Al + H incorporation decreases the adiabatic bulk modulus and shear modulus of SuB. Our results however suggest that this effect is less important than that of temperature. The presence of hydrous pyrolite with ∼10 wt.% Al‐bearing SuB in cold subducting slabs could explain up to ∼2% high velocity anomalies at the bottom of the mantle transition zone (500–660 km) while it turns into ∼7.7% low velocity anomalies below 660 km. Al‐bearing SuB is reportedly stable at mantle temperatures, where it could account for ∼12.2% low velocity anomalies beneath subduction zones in the uppermost lower mantle.

BackgroundSensory symptoms linked to tic disorder (TD) are challenging to quantify via self- or parent-reported measures. The current study aimed to develop a novel observer-rated semi-structured interview, namely, the Sensory Phenomenon Assessment Scale (SPAS), to aid clinical evaluation on symptoms of TD among children.MethodsTo test its psychometric properties, tic, premonitory urge (PU), and obsessive–compulsive symptoms (OCS) were also assessed in 223 children via the Yale Global Tic Severity Scale (YGTSS), the Premonitory Urge for Tic Scale (PUTS), and the Children’s Yale–Brown Obsessive–Compulsive Scale (CY-BOCS). Factor analysis and internal consistency test were carried out using data from TD-diagnosed individuals.ResultsGood internal consistency and test–retest reliability were observed. Criterion validity was established by significant correlations between the PUTS, the YGTSS, the CY-BOCS, and scores of the SPAS. Factor analyses supported a single-factor model of the SPAS, in which the five items each showed a factor loading above 0.6.ConclusionThis study demonstrated that the SPAS is reliable and valid and, thus, can serve as a good and concise measure of clinical symptoms among children and adolescents with TD.

PurposeAddressing the challenges of unclear tumor boundaries and the confusion between cysts and tumors in liver tumor segmentation, this study aims to develop an auto-segmentation method utilizing Gaussian filter with the nnUNet architecture to effectively distinguish between tumors and cysts, enhancing the accuracy of liver tumor auto-segmentation.MethodsFirstly, 130 cases of liver tumorsegmentation challenge 2017 (LiTS2017) were used for training and validating nnU-Net-based auto-segmentation model. Then, 14 cases of 3D-IRCADb dataset and 25 liver cancer cases retrospectively collected in our hospital were used for testing. The dice similarity coefficient (DSC) was used to evaluate the accuracy of auto-segmentation model by comparing with manual contours. ResultsThe nnU-Net achieved an average DSC value of 0.86 for validation set (20 LiTS cases) and 0.82 for public testing set (14 3D-IRCADb cases). For clinical testing set, the standalone nnU-Net model achieved an average DSC value of 0.75, which increased to 0.81 after post-processing with the Gaussian filter (P

Abstract Background Secreted Frizzled‐Related Protein 5 (SFRP5) modulates Wnt signalling pathways, affecting diverse biological processes. We assessed the diagnostic and prognostic value of circulating SFRP5 (cSFRP5) in colorectal cancer (CRC) Methods Plasma cSFRP5 concentrations were measured using enzyme‐linked immunosorbent assay (ELISA) in healthy donors (n = 133), individuals diagnosed with CRC (n = 449), colorectal polyps (n = 85), and medical conditions in other organs including cancer, inflammation, and benign states (n = 64). Results Patients with CRC, polyps, and other conditions showed higher cSFRP5 levels than healthy individuals (p

Objective: In this study, we evaluated the effectiveness of health education based on the transtheoretical model in reducing symptoms of kinesiophobia and enhancing rehabilitation outcomes among elderly patients post-total knee arthroplasty. Methods: Elderly patients post-knee replacement surgery were randomly divided into a control group, which received standard health education, and an experimental group, which received transtheoretical model-based health education. The intervention commenced on the day after surgery and continued for a duration of six months. Assessments of kinesiophobia scores, rehabilitation self-efficacy, and knee function were conducted before the intervention, and then at one, three, and six months postoperatively. Results: Between January 2022 and December 2022, 130 elderly patients who met the eligibility criteria were enrolled and subsequently randomly assigned into two groups of equal size. Comparable baseline characteristics were observed between the two groups The experimental group demonstrated lower kinesiophobia scores and higher scores in rehabilitation self-efficacy and knee function at one, three, and six months following surgery, compared to the control group. Conclusion: Health education based on a transtheoretical model reduces the symptoms of kinesiophobia and enhances rehabilitation self-efficacy and knee functions in elderly patients after knee replacement surgery.

Titanium dioxide (TiO2) with advantages including abundance in earth, non-toxicity, high chemical stability, surface hydrophobicity in dark, and extremely high permittivity could be highly promising for advanced electronics. However, the thermal stability and low bandgap (Eg) of TiO2 pose a big challenge for TiO2 to be used as dielectric, which could be resolved by doping with other metal cations. In this work, we studied the impact of gallium incorporation on electrical and material characteristics of TiO2 thin films. These TiO2 and TiXGaO films with thickness of 15 nm were derived by atomic layer deposition (ALD) and then annealed in O2 ambient at 500°C, where the levels of Ga incorporation were tuned by the cycle ratio (X) of TiO2 to that of Ga2O3 during ALD growth. Both thin film transistors (TFTs) using TiXGaO (TiO2) thin films as the channel and metal-oxide semiconductor capacitors (MOSCAPs) using TiXGaO (TiO2) thin films as the dielectric were fabricated to unravel the impact of Ga incorporation on electrical properties of TiO2 thin films. It is found that the Ga incorporation reduces the conductivity of TiO2 thin films significantly. Pure TiO2 thin films could be the ideal channel material for TFTs with excellent switching behaviors whereas Ga-incorporated TiO2 thin films could be the dielectric material for MOSCAPs with good insulating properties. The leakage current and dielectric constant (k) value are also found to be decreased with the increased Ga content in TiXGaO/Si MOSCAPs. Additionally, the density of interface trap (Dit) between TiXGaO and Si were extracted by multi-frequency conductance method, where a “U-shape” trap profile with similar level of Dit values can be observed for TiXGaO MOSCAPs with varying Ga contents. Material characterizations show that the Ga incorporation destabilizes the crystallization and enlarges the bandgap (Eg) of TiO2 while maintaining a smooth surface. Interestingly, Ga incorporation is found to decrease the overall oxygen content and introduce more oxygen-related defects in the film. As a result, the reduction of leakage current upon Ga incorporation in MOSCAPs could be explained by amorphization of the film and enlarged band offset to Si rather than oxygen defect passivation. These Ga-incorporated TiO2 films may found promising usage in future electronic device applications such as trench capacitors in dynamic random-access memory, where the emerging high-k dielectrics with low leakage currents and high thermal stability are demanded.

ObjectiveTo investigate self-stigma’s influence on schizophrenia patients’ quality of life and its mediated impact by various factors.MethodsThis study adopted a cross-sectional design and randomly selected 170 hospitalized patients with schizophrenia for evaluation. The assessment tools included the Positive and Negative Syndrome Scale (PANSS), Internalized Stigma of Mental Illness Scale (ISMI), Schizophrenia Quality of Life Scale (SQLS), and Coping Questionnaire for Schizophrenia Patients (CQSP), among others. Correlation analysis, regression analysis, and mediation analysis were used to test the correlation and mediation effects.ResultsSelf-stigma had a significant impact on quality of life (T = 8.13, p = 0.00). When self-stigma is used as a mediator, the problem-solving factor in coping strategies has an indirect effect on quality of life, which is significant (AB = -0.16, P = 0.02), while the avoidance factor in coping strategies has a direct effect on quality of life, which is significant (C’ = 0.54, p < 0.001), and an indirect effect, which is also significant (AB = 0.25, p < 0.001).ConclusionThe study highlights the significant impact of self-stigma on the quality of life of schizophrenia patients, emphasizing the crucial roles of self-esteem and coping strategies. These findings suggest clinical interventions to improve quality of life should focus on reducing self-stigma, especially enhancing self-esteem and promoting adaptive coping strategies. By addressing these factors, we can better support the mental health and well-being of those with schizophrenia, offering an effective approach to rehabilitation.

PurposeTo explore the value of 3D amide proton transfer weighted imaging (APTWI) in the differential diagnosis between benign and malignant bone tumors, and to compare the diagnostic performance of APTWI with traditional diffusion-weighted imaging (DWI).Materials and methodsPatients with bone tumors located in the pelvis or lower limbs confirmed by puncture or surgical pathology were collected from January 2021 to July 2023 in the First Affiliated Hospital of Zhengzhou University. All patients underwent APTWI and DWI examinations. The magnetization transfer ratio with asymmetric analysis at the frequency offset of 3.5 ppm [MTRasym(3.5 ppm)] derived by APTWI and the apparent diffusion coefficient (ADC) derived by DWI for the tumors were measured. The Kolmogorou-Smirnou and Levene normality test was used to confirm the normal distribution of imaging parameters; and the independent sample t test was used to compare the differences in MTRasym(3.5 ppm) and ADC between benign and malignant bone tumors. In addition, the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of different imaging parameters in differentiation between benign and malignant bone tumors. P

Background: The role of cardiopulmonary exercise testing (CPET) parameters in evaluating the functional severity of coronary disease remains unclear. The aim of this study was to quantify the O2-pulse morphology and investigate its relevance in predicting the functional severity of coronary stenosis, using Murray law-based quantitative flow ratio (μQFR) as the reference. Methods: CPET and μQFR were analyzed in 138 patients with stable coronary artery disease (CAD). The O2-pulse morphology was quantified through calculating the O2-pulse slope ratio. The presence of O2-pulse plateau was defined according to the best cutoff value of O2-pulse slope ratio for predicting μQFR ≤ 0.8. Results: The optimal cutoff value of O2-pulse slope ratio for predicting μQFR ≤ 0.8 was 0.4, with area under the curve (AUC) of 0.632 (95 % CI: 0.505–0.759, p = 0.032). The total discordance rate between O2-pulse slope ratio and μQFR was 27.5 %, with 13 patients (9.4 %) being classified as mismatch (O2-pulse slope ratio > 0.4 and μQFR ≤ 0.8) and 25 patients being classified as reverse-mismatch (O2-pulse slope ratio ≤ 0.4 and μQFR > 0.8). Angiography-derived microvascular resistance was independently associated with mismatch (OR 0.07; 95 % CI: 0.01–0.38, p = 0.002) and reverse-mismatch (OR 9.76; 95 % CI: 1.47–64.82, p = 0.018). Conclusion: Our findings demonstrate the potential of the CPET-derived O2-pulse slope ratio for assessing myocardial ischemia in stable CAD patients.

Background: The accurate preoperative localization of pulmonary nodules is essential for a successful video-assisted thoracic surgery (VATS). The aim of this research was to clarify the efficacy and safety of CT-guided localization of pulmonary nodules by mixture of methylene blue and medical adhesive. Methods: Between January 2020 and January 2021, 103 subjects who have received the CT-guidance pulmonary nodules localization operation were included and retrospectively analyzed. The data on efficiency and complications of preoperative localization using medical adhesives mixed with methylene blue mixture were collected and analyzed. Results: 103 patients with 111 localized pulmonary nodules were included, 95 of whom had one nodule and 8 of whom had two nodules. The nodule localization success rate reaches as high as 100 %. The mean diameter of pulmonary nodules was 9.50 ± 3.67 mm. The mean distance of pulmonary nodule and pleural surface was 19.95 ± 14.92 mm. The mean depth of localized adhesive in the lung parenchyma was 18.99 ± 11.62 mm, and the mean time required for localization was 16.98 ± 5.72 min. The average time from the nodule localization to VATS surgery was 16.97 ± 7.34 h. The common complications of localization were minor pulmonary hemorrhage (9.74 %) and mild pneumothorax (15.53 %). Besides, pulmonary hemorrhage was related with depths of medical adhesives and nodules in lung parenchyma (p = 0.018 and 0.002, respectively). Conclusion: Medical adhesive mixed with methylene blue is safe and effective in pulmonary nodules localization for VATS, and surgeons have flexibility in scheduling the procedure.

The carbon storage potential of planted shelterbelts was gradually recognized in recent years, but there was a lack of shelterbelt knowledge for carbon inventory analyses because of their narrow linear feature and extensive distribution. Considering its own characteristics of the shelterbelt, this paper proposed a new remote sensing model for estimating the carbon storage of farmland shelterbelt (CSBelt) based on the single tree carbon storage and tree numbers. In this model, the single tree carbon storage model was established by shelterbelt age, which could be identified from time series images. Tree numbers of each shelterbelt, as another important parameter in the CSBelt model, was detected by numbers of rows, columns, and preservation rate, which were monitored by high resolution remote sensing image and geographic information system method. Finally, overall accuracy (OA), mean absolute error (MAE), and mean error (ME) was used to validate the remotely identified data. The results showed that, the OA of the single tree carbon storage was 80.4% within the error range of 0.05 MgC/tree, the MAE was 0.036 MgC/tree, and ME was 0.020 MgC/tree; the OA of tree numbers was 71.7% within the error range of 100 trees/km, the MAE was 94 trees/km, and ME was 73 trees/km; the OA of shelterbelt carbon storage was 82.6% within the error range of 100 MgC/km, the MAE was 49.63 MgC/km, and ME was 33.78 MgC/km. Compared to other carbon storage models, this model requires fewer parameters and is not restricted by the stand conditions, which has better universality and realizability. This research is helpful for the accurate assessment of shelterbelt ecosystem carbon storage, which is of great significance for predicting climate change and formulating strategies. The results of this research will also provide data support for shelterbelt management on a regional scale.

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) represent a significant global burden of morbidity and mortality, with lung injury being the primary cause of death in affected patients. The pathogenesis of lung injury, however, remains a complex issue. In recent years, the role of the immune system in lung injury has attracted extensive attention worldwide. Despite advancements in our understanding of various lung injury subtypes, significant limitations persist in both prevention and treatment. This review investigates the immunopathogenesis of ALI/ARDS, aiming to elucidate the pathological processes of lung injury mediated by dendritic cells (DCs), natural killer (NK) cells, phagocytes, and neutrophils. Furthermore, the article expounds on the critical contributions of gut microbiota, inflammatory pathways, and cytokine storms in the development of ALI/ARDS.

The interaction between microplastics (MPs) and cadmium (Cd) poses a threat to agricultural soil environments, and their effects on plant growth and rhizosphere microbial community functions are not yet clear. In this study, energy sorghum was used as a test plant to investigate the effects of two types of MPs, polystyrene (PS) and polyethylene (PE), at different particle sizes (13 μm, 550 μm) and concentrations (0.1%, 1% w/w), and Cd, as well as their interactions, on the growth of sorghum in a soil-cultivation pot experiment. The results showed that the combined effects of MP and Cd pollution on the dry weight and Cd accumulation rate in sorghum varied depending on the type, concentration, and particle size of the MPs, with an overall trend of increasing stress from combined pollution with increasing Cd content and accumulation. High-throughput sequencing analysis revealed that combined MP and Cd pollution increased bacterial diversity, and the most significant increase was observed in the abundance-based coverage estimator (ACE), Shannon, and Sobs indices in the 13 μm 1% PS+Cd treatment group. Metagenomic analysis based on the Kyoto Encyclopedia of Genes and Genomes (KEGG) metabolic pathways revealed that 19 groups of metabolic pathways, including microbial metabolism and methane metabolism, differed significantly under combined MP and Cd pollution. Hierarchical clustering results indicated that Cd treatment and combined MP and Cd treatment affected the abundances of sorghum rhizosphere soil nitrogen (N) and phosphorus (P) cycling genes and that the type of MP present was an important factor affecting N and P cycling genes. The results of this study provide a basis for exploring the toxic effects of combined MP and Cd pollution and for conducting soil environmental risk assessments.

Ferroptosis is a nonapoptotic form of regulated cell death that has been reported to play a central role in cardiac ischemia‒reperfusion (I/R) injury. N-acetyltransferase 10 (NAT10) contributes to cardiomyocyte apoptosis by functioning as an RNA ac4c acetyltransferase, but its role in cardiomyocyte ferroptosis during I/R injury has not been determined. This study aimed to elucidate the role of NAT10 in cardiac ferroptosis as well as the underlying mechanism. The mRNA and protein levels of NAT10 were increased in mouse hearts after I/R and in cardiomyocytes that were exposed to hypoxia/reoxygenation. P53 acted as an endogenous activator of NAT10 during I/R in a transcription-dependent manner. Cardiac overexpression of NAT10 caused cardiomyocyte ferroptosis to exacerbate I/R injury, while cardiomyocyte-specific knockout of NAT10 or pharmacological inhibition of NAT10 with Remodelin had the opposite effects. The inhibition of cardiomyocyte ferroptosis by Fer-1 exerted superior cardioprotective effects against the NAT10-induced exacerbation of post-I/R cardiac damage than the inhibition of apoptosis by emricasan. Mechanistically, NAT10 induced the ac4C modification of Mybbp1a, increasing its stability, which in turn activated p53 and subsequently repressed the transcription of the anti-ferroptotic gene SLC7A11. Moreover, knockdown of Mybbp1a partially abolished the detrimental effects of NAT10 overexpression on cardiomyocyte ferroptosis and cardiac I/R injury. Collectively, our study revealed that p53 and NAT10 interdependently cooperate to form a positive feedback loop that promotes cardiomyocyte ferroptosis to exacerbate cardiac I/R injury, suggesting that targeting the NAT10/Mybbp1a/p53 axis may be a novel approach for treating cardiac I/R.

In order to reveal the spatial and temporal distribution of COVID-19's economic impact on the Beijing-Tianjin-Hebei region, this study uses the NPP/VIIRS night light remote sensing data from January to September in 2020 to compare the development trend of COVID-19 and analyze its economic impact on the Beijing-Tianjin-Hebei region. At the same time, the regional economic resilience measurement algorithm is introduced by coupling the regional night light greyscale value to obtain the economic resilience data of various cities during the epidemic. The findings show that: 1. there are structural differences in the spatial distribution of COVID-19 outbreaks in the Beijing-Tianjin-Hebei region. Beijing-Tianjin-Hebei region present a ''core-adjacent-external'' structure and the spatial distribution pattern of Tianjin-Beijing-Shijiazhuang prominent in the inverted ''L'' shape. 2. There are differences in the economic resilience of the Beijing-Tianjin-Hebei region in the face of the epidemic, with high economic resilience in the core urban areas close to Beijing and Tianjin. Therefore, strengthening regional cooperation and establishing relatively stable economic ties with surrounding areas are the key to improving the overall economic resilience of Beijing-Tianjin-Hebei region.

Emotion recognition utilizing EEG signals has emerged as a pivotal component of human–computer interaction. In recent years, with the relentless advancement of deep learning techniques, using deep learning for analyzing EEG signals has assumed a prominent role in emotion recognition. Applying deep learning in the context of EEG-based emotion recognition carries profound practical implications. Although many model approaches and some review articles have scrutinized this domain, they have yet to undergo a comprehensive and precise classification and summarization process. The existing classifications are somewhat coarse, with insufficient attention given to the potential applications within this domain. Therefore, this article systematically classifies recent developments in EEG-based emotion recognition, providing researchers with a lucid understanding of this field’s various trajectories and methodologies. Additionally, it elucidates why distinct directions necessitate distinct modeling approaches. In conclusion, this article synthesizes and dissects the practical significance of EEG signals in emotion recognition, emphasizing its promising avenues for future application.

Background and aimsSeveral pharmacological interventions, such as nicotine replacement therapy (NRT), varenicline, and bupropion, have been approved for clinical use of smoking cessation. E-cigarettes (EC) are increasingly explored by many RCTs for their potentiality in smoking cessation. In addition, some RCTs are attempting to explore new drugs for smoking cessation, such as cytisine. This network meta-analysis (NMA) aims to investigate how these drugs and e-cigarettes compare regarding their efficacy and acceptability.Materials and methodsThis systematic review and NMA searched all clinical studies on smoking cessation using pharmacological monotherapies or e-cigarettes published from January 2011 to May 2022 using MEDLINE, COCHRANE Library, and PsychINFO databases. NRTs were divided into transdermal (TDN) and oronasal nicotine (ONN) by administrative routes, thus 7 network nodes were set up for direct and indirect comparison. Two different indicators measured the efficacy: prevalent and continuous smoking abstinence. The drop-out rates measured the acceptability.ResultsThe final 40 clinical studies included in this study comprised 77 study cohorts and 25,889 participants. Varenicline is more effective intervention to assist in smoking cessation during 16–32 weeks follow-up, and is very likely to prompt dropout. Cytisine shows more effectiveness in continuous smoking cessation but may also lead to dropout. E-cigarettes and oronasal nicotine are more effective than no treatment in encouraging prevalent abstinence, but least likely to prompt dropout. Finally, transdermal nicotine delivery is more effective than no treatment in continuous abstinence, with neither significant effect on prevalent abstinence nor dropout rate.ConclusionThis review suggested and agreed that Varenicline, Cytisine and transdermal nicotine delivery, as smoking cessation intervention, have advantages and disadvantages. However, we had to have reservations about e-cigarettes as a way to quit smoking in adolescents.

With the deep application of automation and digitalization technologies, the global automobile value chains are undergoing a new round of large-scale restructuring, and the traditional supply chain structure taken vehicle manufacturers as the core has been broken. The dual-credit policy (DCP), taking over the subsidies for new energy vehicles (NEVs), plays a vital role in reconstructing, transforming, and upgrading the automobile industry. The target group of DCP is passenger vehicle manufacturers, but it is unclear how its implementation will affect the NEV industry chain. To address this issue, this study examined the impact of the DCP on the innovation performance of automobile manufacturing enterprises using a DID (difference-in-difference) model based on the data of 693 listed advanced manufacturing enterprises in China A-shares from 2014 to 2021. The empirical results show that the DCP has significantly promoted the innovation performance of automobile manufacturing enterprises. In terms of supply chain role heterogeneity, the impact of the DCP on the innovation performance of parts manufacturers is more significant. Regarding enterprise ownership heterogeneity, the DCP has a greater impact on the innovation performance of SOEs(state-owned enterprises). In addition, regarding regional heterogeneity, enterprises in eastern and middle regions are significantly affected by the DCP to improve innovation performance.

ObjectiveTo analyze the CT and MR features of Primary hepatic neuroendocrine neoplasms (PHNENs) in order to enhance the diagnostic accuracy of this disease.MethodsA retrospective analysis was conducted on patients diagnosed with hepatic neuroendocrine neoplasms, excluding other sites of origin through general examination and postoperative follow-up. The CT and MR signs were analyzed according to the 2018 version of Liver Imaging Reporting and Data System (LI-RADS), along with causes of misdiagnosis.ResultsTwelve patients, including 6 males and 6 females, were enrolled in this study. There was no significant increase in liver tumor markers among all cases. Most masses were multiple (9/12), exhibiting low attenuation on pre-contrast CT scans, T1-hypointense signal, T2-hyperintense signal, and restricted diffusion. The majority of these masses (7/10) demonstrated similar rim arterial phase hyper-enhancement as well as peripheral “washout” during venous portal phase and delayed phase imaging. Three cases had incomplete capsules while one case had a complete capsule. Cyst/necrosis was observed in 7 out of all cases following administration of contrast agent, with 5 mainly distributed in the periphery. All masses lacked fat, calcification, vascular or bile duct tumor thrombus formation.ConclusionThe imaging findings associated with PHNENs possess certain specificity, often presenting as multiple masses within the liver accompanied by peripheral cyst/necrosis, similar rim arterial phase hyper-enhancement during venous portal phase and delayed phase imaging.

Nowadays, lead poisoning in children commonly occurs, but lead poisoning caused by the administration of Tibetan medicine is rarely reported. This report describes the diagnosis and management of lead poisoning in a 16-year-old girl presented with abdominal pain, vomiting, and anemia with limb numbness, who had a childhood history of epilepsy and took Tibetan medicine intermittently to control the symptoms. After admission into hospital, Computed tomography showed high-density shadows in the gastrointestinal tract. Video-Electroencephalography showed no signs of seizure. Reflux esophagitis was observed in gastroscopy. And no obvious abnormalities in the colonic mucosa through colonoscopy. Bone marrow smear test showed basophilic stippling in the erythrocytes. The blood and urine lead levels of 626 and 75.9 μg/L, respectively. We therefore considered lead poisoning, and the patient improved after chelation therapy. Due to its atypical clinical manifestations, lead poisoning is easily misdiagnosed. Thus, clinicians should pay more attention to this disease. When abdominal pain, anemia, and neurological symptoms are present, the possibility of lead poisoning should be considered.

Breast cancer is the most common cause of female morbidity and death worldwide. Compared with other cancers, early detection of breast cancer is more helpful to improve the prognosis of patients. In order to achieve early diagnosis and treatment, clinical treatment requires rapid and accurate diagnosis. Therefore, the development of an automatic detection system for breast cancer suitable for patient imaging is of great significance for assisting clinical treatment. Accurate classification of pathological images plays a key role in computer-aided medical diagnosis and prognosis. However, in the automatic recognition and classification methods of breast cancer pathological images, the scale information, the loss of image information caused by insufficient feature fusion, and the enormous structure of the model may lead to inaccurate or inefficient classification. To minimize the impact, we proposed a lightweight PCSAM-ResCBAM model based on two-stage convolutional neural network. The model included a Parallel Convolution Scale Attention Module network (PCSAM-Net) and a Residual Convolutional Block Attention Module network (ResCBAM-Net). The first-level convolutional network was built through a 4-layer PCSAM module to achieve prediction and classification of patches extracted from images. To optimize the network's ability to represent global features of images, we proposed a tiled feature fusion method to fuse patch features from the same image, and proposed a residual convolutional attention module. Based on the above, the second-level convolutional network was constructed to achieve predictive classification of images. We evaluated the performance of our proposed model on the ICIAR2018 dataset and the BreakHis dataset, respectively. Furthermore, through model ablation studies, we found that scale attention and dilated convolution play an important role in improving model performance. Our proposed model outperforms the existing state-of-the-art models on 200 × and 400 × magnification datasets with a maximum accuracy of 98.74 %.

BackgroundPrevious studies have revealed the sex-specific features of pituitary–thyroid hormone (TH) actions and the prevalence of thyroid nodules (TNs) in children and adolescents. However, it was unclear in adults. We aimed to investigate the features of pituitary–TH actions in women and men at different ages, and the associations of thyrotropin (TSH), THs, and central sensitivity to THs indices including the thyroid feedback quantile-based index by FT4 (TFQIFT4) and the thyroid feedback quantile-based index by FT3(TFQIFT3) with of TNs in Chinese euthyroid adults.Methods8771 euthyroid adults from the communities in China were involved. Demographic, behavioral, and anthropometric data were gathered through the questionnaires. Ultrasound was performed to evaluate the TNs. TSH and THs levels were measured. The multivariable logistic regression and multivariable ordinal logistic regression were conducted.ResultsTFQIFT3 among both genders, except women aged 43 to 59 years, where it increased slightly. Additionally, there was an age-related decline in TFQIFT4 levels in both women and men at ages < 50 and < 53, respectively, but a marked increase after that. Lower TSH levels were significantly associated with a higher prevalence and lower odds of having fewer TNs using multiple nodules as the base category in both men and women (both P for trend < 0.05). Additionally, lower TFQIFT3 and TFQIFT4 levels were significantly associated with a higher prevalence of TNs in women (both P for trend < 0.05), and lower TFQIFT3 levels were significantly associated with a higher prevalence of TNs in men. Both higher TFQIFT3 and TFQIFT4 levels were significantly associated with higher odds of having fewer TNs using multiple nodules as the base category in women. However, the relationships between TFQIFT4 and the prevalence or number of TNs in men were not found.ConclusionsThe trends of THs, TSH, TFQIFT4, and TFQIFT3 at different ages were sex-dependent. Both TFQIFT4 and TFQIFT3 levels were negatively associated with the prevalence and number of TNs in women. The present results may lead to a better understanding of the sex-specific relationships between the development of the pituitary-TH axis and the formation of TNs.

BackgroundDesmoid tumor (DT) is a rare locally aggressive but non-metastatic mesenchymal soft tissue neoplasm that predominantly occurs in the abdominal wall, abdominal cavity, and extremities. Its occurrence in the mesentery is relatively uncommon.Case reportsThis article reports two cases of desmoid tumor treated at the Department of Gastrointestinal Surgery, Weifang People’s Hospital. The first case was a 59-year-old male patient who had previously undergone surgery for esophagogastric junction cancer. Postoperatively, he developed an intra-abdominal mass that rapidly increased in size within three months. The second case was a 60-year-old male patient who incidentally discovered a mass in the left lower abdomen. Both patients underwent surgical treatment, and the postoperative pathological diagnosis was mesenteric desmoid tumor.ConclusionThe treatment of desmoid tumor remains challenging. Simple surgical resection often yields unsatisfactory outcomes, and the efficacy of adjuvant radiotherapy and chemotherapy is also limited. Further research and clinical practice are necessary to improve diagnostic and therapeutic strategies, aiming to enhance patient survival and quality of life.

Gynostemma pentaphyllum (Thunb.) Makino is an important producer of dammarene-type triterpenoid saponins. These saponins (gypenosides) exhibit diverse pharmacological benefits such as anticancer, antidiabetic, and immunomodulatory effects, and have major potential in the pharmaceutical and health care industries. Here, we employed single-cell RNA sequencing (scRNA-seq) to profile the transcriptomes of more than 50,000 cells derived from G. pentaphyllum shoot apexes and leaves. Following cell clustering and annotation, we identified five major cell types in shoot apexes and four in leaves. Each cell type displayed substantial transcriptomic heterogeneity both within and between tissues. Examining gene expression patterns across various cell types revealed that gypenoside biosynthesis predominantly occurred in mesophyll cells, with heightened activity observed in shoot apexes compared to leaves. Furthermore, we explored the impact of transposable elements (TEs) on G. pentaphyllum transcriptomic landscapes. Our findings the highlighted the unbalanced expression of certain TE families across different cell types in shoot apexes and leaves, marking the first investigation of TE expression at the single-cell level in plants. Additionally, we observed dynamic expression of genes involved in gypenoside biosynthesis and specific TE families during epidermal and vascular cell development. The involvement of TE expression in regulating cell differentiation and gypenoside biosynthesis warrant further exploration. Overall, this study not only provides new insights into the spatiotemporal organization of gypenoside biosynthesis and TE activity in G. pentaphyllum shoot apexes and leaves but also offers valuable cellular and genetic resources for a deeper understanding of developmental and physiological processes at single-cell resolution in this species.

Chimeric antigen receptor-T (CAR-T) cell therapy has made remarkable strides in treating hematological malignancies. However, the widespread adoption of CAR-T cell therapy is hindered by several challenges. These include concerns about the long-term and complex manufacturing process, as well as efficacy factors such as tumor antigen escape, CAR-T cell exhaustion, and the immunosuppressive tumor microenvironment. Additionally, safety issues like the risk of secondary cancers post-treatment, on-target off-tumor toxicity, and immune effector responses triggered by CAR-T cells are significant considerations. To address these obstacles, researchers have explored various strategies, including allogeneic universal CAR-T cell development, infusion of non-activated quiescent T cells within a 24-hour period, and in vivo induction of CAR-T cells. This review comprehensively examines the clinical challenges of CAR-T cell therapy and outlines strategies to overcome them, aiming to chart pathways beyond its current Achilles heels.

Introduction: Non-steroid anti-inflammatory drugs (NSAIDs) are a class of prescription drugs with antipyretic, analgesic, anti-inflammatory, and antiplatelet effects. However, long-term use of NSAIDs will disrupt the intestinal mucosal barrier, causing erosion, ulcers, bleeding, and even perforation. Pure total flavonoids from Citrus (PTFC) is extracted from the dried peel of Citrus, showing a protective effect on intestinal mucosal barrier with unclear mechanisms. Methods: In the present study, we used diclofenac (7.5 mg kg−1, i.g.) to induce a rat model of NSAIDs-related intestinal lesions. PTFC (50, 75, 100 mg·kg−1 d−1, i.g.) was administered 9 days before the initial diclofenac administration, followed by co-administration on the last 5 days. Exosomes were identified by western blotting and transmission electron microscopy (TEM), and then co-cultured with IEC-6 cells. The expression of long non-coding RNA (lncRNA) H19, autophagy-related 5 (Atg5), ZO-1, Occludin, and Claudin-1 were detected by quantitative real-time PCR (qRT-PCR). The expression of light chain 3 (LC3)-I, LC3-II, ZO-1, Occludin and Claudin-1 proteins was tested by western blotting. The localization of both exosomes and autophagosomes was examined by immunofluorescent technique. Results: The treatment of PTFC attenuated intestinal mucosal mechanical barrier function disturbance in diclofenac-induced NSAIDs rats. IEC-6 cells co-cultured with NSAIDs rats-derived exosomes possessed the lowest levels of protective autophagy, and severe intestinal barrier injuries. Cells co-cultured with the exosomes extracted from rats administrated PTFC exhibited an improvement of autophagy and intestinal mucosal mechanical barrier function. The prevention effect was proportional to the concentration of PTFC administered. Conclusion: PTFC ameliorated NSAIDs-induced intestinal mucosal injury by down-regulating exosomal lncRNA H19 and promoting autophagy.

Aims: The purpose of this study was to explore the impacts of salidroside on vascular regeneration, vascular structural changes and long-term neurological recuperation following cerebral ischemia and its possible mechanism. Main methods: From Day 1 to Day 28, young male mice with middle cerebral artery blockage received daily doses of salidroside and measured neurological deficits. On the 7th day after stroke, the volume of cerebral infarction was determined using TTC and HE staining. Microvascular density, astrocyte coverage, angiogenesis and the expression of the Shh signaling pathway were detected by IF, qRTPCR and WB at 7, 14 and 28 days after stroke. Changes in blood flow, blood vessel density and diameter from stroke to 28 days were measured by the LSCI and TPMI. Key findings: Compared with the dMACO group, the salidroside treatment group significantly promoted the recovery of neurological function. Salidroside was found to enhance cerebral blood flow perfusion and reduce the infarct on the 7th day after stroke. From the 7th to the 28th day after stroke, salidroside treatment boosted the expression of CD31, CD31+/BrdU+, and GFAP in the cortex around the infarction site. On the 14th day after stroke, salidroside significantly enhanced the width and density of blood vessels. Salidroside increased the expression of histones and genes in the Shh signaling pathway during treatment, and this effect was weakened by the Shh inhibitor Cyclopamine. Significance: Salidroside can restore nerve function, improve cerebral blood flow, reduce cerebral infarction volume, increase microvessel density and promote angiogenesis via the Shh signaling pathway.

Fluorosis due to high fluoride levels in drinking water profoundly affects the development of human skeletal and dental structures. Sodium butyrate (NaB) has been found to regulate overall bone mass and prevent pathological bone loss. However, the mechanism of NaB action on fluorosis remains unclear. In this study, a rat model of fluorosis induced by 100 mg/L sodium fluoride was used to investigate the impact of NaB on bone homeostasis and serum metabolomics. It was found that NaB significantly reduced the levels of bone resorption markers CTX-Ⅰ and TRACP-5B in fluorosis rats. Moreover, NaB increased calcium and magnesium levels in bone, while decreasing phosphorus levels. In addition, NaB improved various bone microstructure parameters, including bone mineral density (BMD), trabecular thickness (Tb. Th), trabecular bone separation (Tb. SP), and structural model index (SMI) in the femur. Notably, NaB intervention also enhanced the antioxidant capacity of plasma in fluorosis rats. Furthermore, a comprehensive analysis of serum metabolomics by LC-MS revealed a significant reversal trend of seven biomarkers after the intervention of NaB. Finally, pathway enrichment analysis based on differential metabolites indicated that NaB exerted protective effects on fluorosis by modulating arginine and proline metabolic pathways. These findings suggest that NaB has a beneficial effect on fluorosis and can regulate bone homeostasis by ameliorating metabolic disorders.

The recent remarkable success of mesoporous silica nanoparticle (MSN) technology has stimulated intensive efforts to expand nanoparticle strategies to treat various diseases. However, as an anti-tumor drug delivery system, traditional MSN is prone to clearance by the host immune system, resulting in suboptimal pharmacokinetics and inadequate drug concentrations in tumors. The emergence of biomimetic drug delivery systems has effectively addressed these challenges. In this study, we aimed to develop a biomimetic drug delivery system based on MSN to achieve both immune evasion and tumor targeting. To this end, we coated folic acid-modified mesoporous silica (FMSN) cores with lipid-hybridized macrophage membranes (HEs) through co-extrusion, yielding FMSN@HEs. Initially, we demonstrated effective retention of key proteins Integrin α4 and Integrin β1 in the HEs, leading to significantly reduced clearance of FMSN@HEs by phagocytes in vitro. CCK-8 experiments validated the ability of CUR-FMSN@HEs to effectively inhibit the proliferation of tumor cells. In tumor-bearing mice, FMSN@HEs exhibited stronger tumor targeting and penetration abilities compared to MSN without HEs. The immune escape and tumor-targeting properties of the FMSN@HEs suggest that they could be used as novel bionic drug carriers, potentially providing more options for antitumor therapy.

Background The reported prevalence rate of anxiety disorder in the paediatric population varies widely between different counties. Currently, there is no national epidemiological survey of childhood anxiety disorder in China. This study aims to investigate the national prevalence of anxiety disorder, the distribution profiles of different subtypes and its comorbidity rates among school students.Methods A nationwide epidemiological survey of mental disorders in school students aged 6–16 years was conducted. Participants were randomly recruited from five provinces in China. The Child Behavior Checklist was used to screen students at high risk for mental disorders. The final diagnosis was made based on the Diagnostic and Statistical Manual-IV. The point prevalence and comorbidity rate of anxiety disorder were calculated, and the difference between age, sex and socioeconomic status groups was also compared.Results Generalised anxiety disorder (GAD) was the most common anxiety disorder in school-attending children and adolescents, with a prevalence rate of 1.3% (95% CI: 1.2 to 1.3). Separation anxiety and specific phobia were more common in children than in adolescents. Girls had a higher prevalence of panic disorder (0.3% vs 0.2%, χ2=14.6, p