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Abstract Aims This article aimed to explore the efficacy of robotic arm-assisted total hip arthroplasty (THA) in improving preoperative planning and intraoperative decision-making. Methods In this single-center, prospective, randomized clinical controlled trial, 60 patients were randomly divided into two groups: conventional THA (cTHA) and robotic arm-assisted THA (rTHA). The rTHA underwent procedures using a robot-assisted surgical system, which generated three-dimensional models to determine the most appropriate prosthesis size and position. The standard process of replacement was executed in cTHA planned preoperatively via X-ray by experienced surgeons. Differences between predicted and actual prosthetic size, prosthetic position, and leg length were evaluated. Results Sixty patients were included in the study, but one patient was not allocated due to anemia. No significant preoperative baseline data difference was found between the two groups. The actual versus predicted implantation size of both groups revealed that 27/30 (90.0%) in the rTHA group and 25/29 (86.2%) in the cTHA group experienced complete coincidence. The coincidence rate for the femoral stem was higher in the rTHA group (83.3%) than that in the cTHA group (62.7%). Between the actual and predicted rTHA, the difference in anteversion/inclination degree (

In order to further explore the added value of corn bran and improve the processing and application of AX, this study used the corn bran as raw material, optimized its extraction process by alkaline preparation, and explored its gel characteristics. AX was extracted from bran, a by-product of deep processing of corn, by using Ba(OH)2. A response surface optimization with three factors and three levels was constructed based on the ratio of material to liquid, extraction temperature and extraction time. The structure of the optimized polysaccharide was characterized by monosaccharide composition, molecular weight and ferulic acid content. On this basis, AX was oxidized and cross-linked by laccase to explore the formation conditions, gel structure and thermal stability of AX gel. The results showed that the optimized extraction conditions of AX were as follows: Solid-liquid ratio 1:44 (g:mL), extraction temperature 69 ℃, extraction time 6.3 h, and the yield of AX was 23.07%±1.15%. The obtained AX was mainly composed of arabinose and xylose. The Ara/Xyl ratio was 2.28±0.11, the weight average molecular weight was 265±6.68 kDa, and the ferulic acid content was 9.6±0.32 mg/100 g. AX could form a stable gel structure under the condition of pH2.0 after laccase oxidation and cross-linking. The microstructure of AX was a dense porous gel structure and had good thermal stability according to scanning electron microscope. Arabinoxylan and its gel prepared in this study had good physical and chemical properties, and had potential application in improving the texture quality of food, embedding and controlled release of functional factors. This paper provides a theoretical basis for the further processing of corn by-products and the application of arabinoxylan in food industry.

Abstract Background Online education has become increasingly popular, but research on the effectiveness of different teaching models in developing cognitive skills is limited. This study investigated the relationship between different teaching models (online and offline) and the development of cognitive skills in clinical medicine students. Methods Survey data were collected from 2018 entry students who participated in online teaching and 2019 entry students in offline teaching at Xiangya School of Medicine, Central South University. National Quality Open Courses (NQROC) were provided to both groups of students. The study examined the total score of physiology final exam, score of each type of question, and NQROC learning engagement in different score segments under the two teaching models. Non-parametric statistical methods were utilized to analyze the total score of physiology final exam, score of each type of question, and the NQROC learning engagement. Spearman’s rank correlation was utilized to analyze the relationship between the score of physiology final exam and the students’ NQROC learning engagement. Results The study found no statistically significant difference in the total score, short-answer questions (SAQs) score, and case study questions (CSQs) score between online and offline teaching models. However, the multiple-choice questions (MCQs) score was higher in the online teaching model (Z=-4.249, P

Among non-destructive testing (NDT) techniques, fast neutron radiography with a higher penetration capability has achieved rapid advancements. However, the application of the radiography detector in many fast neutron imaging systems is limited by unfavorable detection efficiency and imaging spatial resolution. In this paper, a fast neutron radiography detector was designed, which was composed of a pixelated EJ200 scintillator array, a 16 × 16 silicon photomultiplier (SiPM) array, and capacitive multiplexing network readout electronics. The main parameters of the detector were optimized using Monte Carlo simulations. In addition, the prototype of the detector was fabricated and tested under a 14 MeV D-T neutron source. The preliminary test results demonstrated that the spatial resolution of the prototype reached 1.2 mm. Moreover, the conflict between spatial resolution and detection efficiency could be mitigated by using a pixelated scintillator structure. Overall, SiPMs enabled the extensive application of the imaging system because of their excellent photon detection performance, relatively low price, and joint possibility for large areas.

Previous studies have suggested an association between Proton Pump Inhibitors (PPIs) and the progression of chronic kidney disease (CKD). This study aims to assess the association between PPI use and CKD progression by analysing estimated glomerular filtration rate (eGFR) trajectories using a process mining approach. We conducted a retrospective cohort study from 1 January 2006 to 31 December 2011, utilising data from the Stockholm Creatinine Measurements (SCREAM). New users of PPIs and H2 blockers (H2Bs) with CKD (eGFR < 60) were identified using a new-user and active-comparator design. Process mining discovery is a technique that discovers patterns and sequences in events over time, making it suitable for studying longitudinal eGFR trajectories. We used this technique to construct eGFR trajectory models for both PPI and H2B users. Our analysis indicated that PPI users exhibited more complex and rapidly declining eGFR trajectories compared to H2B users, with a 75% increased risk (adjusted hazard ratio [HR] 1.75, 95% confidence interval [CI] 1.49 to 2.06) of transitioning from moderate eGFR stage (G3) to more severe stages (G4 or G5). These findings suggest that PPI use is associated with an increased risk of CKD progression, demonstrating the utility of process mining for longitudinal analysis in epidemiology, leading to an improved understanding of disease progression.

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BackgroundGaussian shaping is commonly used to filter and extract the amplitude of nuclear pulse signals owing to its high signal-to-noise ratio, resistance to ballistic loss, and ease of amplitude extraction. However, the problems of asymmetry and downwash exist in Gaussian-like signals generated by Sallen-Key and CR-(RC)m filters.PurposeThis study aims to address the problems of asymmetry and downwash in Gaussian-like signals generated by Sallen-Key and CR-(RC)m filters, this paper presents a trigonometric function-based Gaussian-like pulse shaping algorithm for dual-exponential signals.MethodsFirst, the impact of shaping parameters on the shaping pulse and filtering performance of the algorithm was examined by applying Gaussian-like pulse shaping to simulated nuclear pulse signals. Then, the filtering performances of Gaussian-like and sin pulse shaping algorithms were compared and analyzed using the same shaping width. Finally, the characteristic X-ray signals of manganese (FAST-SDD detector) were collected using a self-made digital nuclear signal acquisition board under various tube flows. The energy resolution and count rate characteristics of the energy spectra obtained from Gaussian-like, sin, and trapezoidal shaping algorithms were comparatively analyzed for different tube flows and shaping times.ResultsComparison results show that Gaussian pulse shaping exhibits superior denoising performance to sin pulse shaping, with an 8.95% improvement in the SNR for the same peak arrival time. Additionally, the energy resolution of the spectrum obtained using Gaussian pulse shaping exceeds that of sin pulse shaping, and its stacking pulse separation ability outperforms that of trapezoidal pulse shaping, making it highly applicable.ConclusionsGaussian-like pulse shaping presented in this study demonstrats better stacking pulse separation capability than trapezoidal pulse shaping, indicating promising application prospects.

In deep underground engineering, the deformation, failure characteristics, and mechanism of surrounding rock under the influence of grain sizes and mineral compositions are not clear. Based on CJPL-II variously colored marbles, the differences in grain size and mineral composition of the marble were analyzed by thin-section analysis and XRD tests, and the effect of intermediate principal stress on the mechanical properties of marble was investigated. Both SEM and microfracture analysis were coupled to reveal the failure mechanisms. The results highlight that the crack initiation strength, damage strength, peak strength, and elasticity modulus of Jinping marble exhibit an increasing trend with an increase in intermediate principal stress, while the peak strain initially increases and subsequently decreases. Moreover, this study established negative correlations between marble strength, brittleness characteristics, and fracture angle with grain size, whereas positive correlations were identified with the content of quartz, sodium feldspar, and the magnitude of the intermediate principal stress. The microcrack density in marble was found to increase with larger grain sizes and decrease with elevated quartz and sodium feldspar content, as well as with increasing intermediate principal stress. Notably, as the intermediate principal stress intensifies and grain size diminishes, the transgranular tensile failure of marble becomes more conspicuous. These research findings contribute to the effective implementation of disaster prevention and control strategies.

In recent years, colon cancer has become one of the most common malignant tumors worldwide, posing a great threat to human health. Studies have shown that natural polysaccharides have rich biological activities and medicinal value, such as anti-inflammatory, anti-cancer, anti-oxidation, and immune-enhancing effects, especially with potential anti-colon cancer mechanisms. Natural polysaccharides can not only protect and enhance the homeostasis of the intestinal environment but also exert a direct inhibition effect on cancer cells, making it a promising strategy for treating colon cancer. Preliminary clinical experiments have demonstrated that oral administration of low and high doses of citrus pectin polysaccharides can reduce tumor volume in mice by 38% (p

This study is aimed at assessing the impact of soluble dietary fiber inulin on the treatment of diabetes-related chronic inflammation and kidney injury in mice with type 2 diabetes (T2DM). The T2DM model was created by feeding the Institute of Cancer Research (ICR) mice a high-fat diet and intraperitoneally injecting them with streptozotocin (50 mg/kg for 5 consecutive days). The thirty-six ICR mice were divided into three dietary groups: the normal control (NC) group, the T2DM (DM) group, and the DM + inulin diet (INU) group. The INU group mice were given inulin at the dose of 500 mg/kg gavage daily until the end of the 12th week. After 12 weeks, the administration of inulin resulted in decreased serum levels of fasting blood glucose (FBG), low-density lipoprotein cholesterol (LDL-C), blood urea nitrogen (BUN), and creatinine (CRE). The administration of inulin not only ameliorated renal injury but also resulted in a reduction in the mRNA expressions of inflammatory factors in the spleen and serum oxidative stress levels, when compared to the DM group. Additionally, inulin treatment in mice with a T2DM model led to a significant increase in the concentrations of three primary short-chain fatty acids (SCFAs) (acetic acid, propionic acid, and butyric acid), while the concentration of advanced glycation end products (AGEs), a prominent inflammatory factor in diabetes, exhibited a significant decrease. The results of untargeted metabolomics indicate that inulin has the potential to alleviate inflammatory response and kidney damage in diabetic mice. This beneficial effect is attributed to its impact on various metabolic pathways, including glycerophospholipid metabolism, taurine and hypotaurine metabolism, arginine biosynthesis, and tryptophan metabolism. Consequently, oral inulin emerges as a promising treatment option for diabetes and kidney injury.

With the increasing demand for electric vehicles, further development of Li+ batteries require more comprehensive studies and advanced techniques to analyze various battery material and mechanisms. Determining the concentration of Li+ and electric potential inside batteries can effectively reveal and predict the electrochemical performance, understanding the charge/discharge processes and failure mechanisms. Recently, in situ observation of Li+ movement have been reported by utilizing optical microscopy, neutron imaging (NI), neutron depth profiling (NDP), and transmission electron microscopy (TEM)-based electron energy-loss spectroscopy (EELS). These extensive works suggest their broad potential applications, including revealing the spatial distribution of Li+, mapping electrode elements, and indicating degradation mechanisms. Moreover, direct visualization of potential changes through TEM-based electron holography (EH) and Kelvin probe force microscopy (KPFM) can discover and validate more valuable information. This perspective paper summarizes the current development of advanced in situ techniques for observing Li+ and potential distribution inside batteries for the first time. Additionally, we address the key challenges faced by these techniques along with their possible solutions. The aim of this paper is to provide a comprehensive discussion of in situ methods for analyzing reaction mechanisms, optimizing electrochemical performance, and potentially supporting the further development of battery simulation.

Objective. Large-scale studies on the characteristics and management of abdominal trauma in megacities in China are lacking. The aim of this study was to analyze and present the clinical patterns and treatment status of abdominal trauma in regional medical centers. Methods. Cases of abdominal trauma treated at seven medical centers in Beijing from 2010 to 2021 were collected. Clinical information about age, sex, injury cause, geographic distribution, abbreviated injury scale/injury severity score (AIS/ISS) value, injury-hospital time, preoperative time, surgically identified organ injuries, type of surgery, causes of reoperation and 90-day mortality was included in this study. Clinical characteristics, treatment methods, and short-term prognoses (90-days survival) were compared between blunt abdominal trauma (BAT) and penetrating abdominal trauma (PAT) cases. Non-normally distributed data are described as medians (IQR), and the Mann‒Whitney U test was performed; qualitative data were analyzed using the X2 test. Univariate and multivariate survival analyses were performed by the Cox proportional hazards model. Results. A total of 553 patients (86.98% male) with a median age of 36.50 (27.00–48.00) years were included. The BAT group had a significantly higher proportion of serious injury (P=0.001), lower initial hemoglobin level (P=0.001), and a lower laparoscopy surgery rate (P=0.044) compared to the PAT group. Additionally, more BAT cases were from the area around Beijing (P=0.008) and a longer injury-regional hospital time (10.47 (5.18–22.51) hours vs. 7.00 (3.80–15.38) hours, P=0.001). In the hollow viscus injury subgroup, the BAT group had a significantly longer injury-regional hospital time and preoperative time compared to the PAT group (injury-regional hospital time: 10.23 (6.00–21.59) hours vs. 7.07 (3.99–13.85) hours, P=0.002; preoperative time: 3.02 (2.01–5.58) hours vs. 2.81 (1.85–3.63) hours, P=0.047). The overall 90-day mortality was 11.9%, and longer injury-regional hospital time (HR: 1.01, 95% CI: 1.00–1.02, P=0.008), receipt of ICU treatment (HR: 4.69, 95% CI: 2.54–8.65, P=0.001), and severe ISSs (ISS > 25 vs. ISS

Mixed flow pump has received widespread applications in various perspectives, therefore, enhancing the operational stability is crucial to pump design and applications. To address this phenomenon, the present work explores the efficacy of fluid–structure coupling approach to analyze the vibration characteristics and fluid-excited dynamic properties of mixed flow pump. In this study, ANSYS Workbench is employed for static and modal analysis of the pump, while dynamic analysis is performed based on the outcomes of unsteady fluid analysis. The findings, however, revealed that the guide vane region registered the largest stress and most violent deformation in the entire pump. Compared with other parts of the pump body, the thickness of the guide vane is relatively small, and at the same time, considering the influence of periodic changes in the pressure in the flow channel, its strength should be considered in the design while preventing fatigue damage, and the material and processing method should be selected to meet the requirements. Meanwhile, at the entrance of the guide vane, the impeller rotation attained supremacy in the fluid pressure pulsation, and at the same time, a low-frequency pulsation caused by the vortex structure in the guide vane emanate in the channel. It is worth noticing that both blade deformation and equivalent stress depicted periodic variations. Interestingly, the blades recorded the modest values for both maximum average equivalent stress and maximum average total deformation at the design operating points. However, at over-load operating points, the blades registered their maximum values. The conclusions of this study could lay a foundation for conducting stability analysis on mixed-flow pumps and optimizing the design of the guide vane.

Cellobiose, a β-1,4-linked glucose dimer, is a major cellodextrin resulting from the enzymatic hydrolysis of cellulose. It is a major source of carbon for soil bacteria. In bacteria, the phosphoenolpyruvate (PEP): carbohydrate phosphotransferase system (PTS), encoded by the cel operon, is responsible for the transport and utilization of cellobiose. In this study, we analyzed the transcription and regulation of the cel operon in Bacillus thuringiensis (Bt). The cel operon is composed of five genes forming one transcription unit. β-Galactosidase assays revealed that cel operon transcription is induced by cellobiose, controlled by Sigma54, and positively regulated by CelR. The HTH-AAA+ domain of CelR recognized and specifically bound to three possible binding sites in the celA promoter region. CelR contains two PTS regulation domains (PRD1 and PRD2), which are separated by two PTS-like domains-the mannose transporter enzyme IIA component domain (EIIAMan) and the galactitol transporter enzyme IIB component domain (EIIBGat). Mutations of His-546 on the EIIAMan domain and Cys-682 on the EIIBGat domain resulted in decreased transcription of the cel operon, and mutations of His-839 on PRD2 increased transcription of the cel operon. Glucose repressed the transcription of the cel operon and catabolite control protein A (CcpA) positively regulated this process by binding the cel promoter. In the celABCDE and celR mutants, PTS activities were decreased, and cellobiose utilization was abolished, suggesting that the cel operon is essential for cellobiose utilization. Bt has been widely used as a biological pesticide. The metabolic properties of Bt are critical for fermentation. Nutrient utilization is also essential for the environmental adaptation of Bt. Glucose is the preferred energy source for many bacteria, and the presence of the phosphotransferase system allows bacteria to utilize other sugars in addition to glucose. Cellobiose utilization pathways have been of particular interest owing to their potential for developing alternative energy sources for bacteria. The data presented in this study improve our understanding of the transcription patterns of cel gene clusters. This will further help us to better understand how cellobiose is utilized for bacterial growth.

Objectives: Rituximab is frequently used off-label for the treatment of frequent-relapsing/steroid-dependent nephrotic syndrome (FRNS/SDNS). However, the optimal dosing schedules remain undetermined. The objective of this study was to establish a population pharmacokinetic-pharmacodynamic (PK-PD) model in pediatric patients with FRNS/SDNS, and to investigate dosing regimens that provide adequate suppression of B lymphocytes.Methods: A prospective, open-label, single-center study was conducted in Nephrology Department at Children’s Hospital of Fudan University, and a two-compartment PK model of rituximab in pediatric FRNS/SDNS has been developed previously by our group. CD19+ lymphocyte count profiles were obtained from these patients. The presence of anti-rituximab antibodies was assessed prior to medication in children who had previously received rituximab or during follow-up at the last sampling point for PK analysis. PK-PD analyses were performed to describe the changes of CD19+ lymphocytes, with rituximab assumed to increase their death rate. Monte Carlo simulation was conducted to evaluate different dosing regimens.Results: In total, 102 measurements of CD19+ lymphocyte counts were available for PK-PD analysis. No detectable levels of anti-rituximab antibodies were observed during the PK follow-up period. A turnover model with saturable stimulatory action of rituximab on the removal of lymphocytes best characterized the relationship between rituximab concentration and CD19+ lymphocyte counts, where the Emax and EC50 were estimated to be 99.6*106/L and 5.87 μg/mL, respectively. Simulations indicated that a single infusion of 750 mg/m2 and 2 infusions of 375 mg/m2 both yielded a 10-week suppression of CD19+ lymphocytes.Conclusion: This study represents a first attempt to quantitatively describe the PK-PD relationship of rituximab in pediatric patients with FRNS/SDNS, and provide a potential pathway for future precision dosing strategy for rituximab therapy. Further clinical studies are warranted to evaluate the efficacy and safety of different dosing schemes.

The seriousness of the greenhouse effect has forced more and more national and international institutions to actively develop carbon dioxide separation technologies, capture and storage technologies to control CO2 emissions. Among the many CO2 separation technologies, adsorption separation is a common method used in mixed gas separation technology at present. Pressure swing adsorption (PSA) has less regeneration time and less energy consumption, so is used more widely than temperature swing adsorption (TSA) and vacuum swing adsorption (VSA), which are the other two types of adsorption separation technologies. However, the adsorption capacity and adsorption selectivity of the existing adsorbents are poor, resulting in high energy consumption. This study is based on the results of industrial process simulation of flue gas from power plants [Sai et al. 2022], when the economic benefits of CO2 / N2 mixed gas PSA separation process are optimal, the adsorption capacity of MOF material is within a certain range. More than 4000 computation-ready, experimental metal-organic frameworks (CoRE MOFs) were calculated using Grand Canonical Monte Carlo (GCMC) high-throughput simulation, the PSA process of 1bar and a temperature of 298K, obtained 142 MOFs with potential performance.

Objectives Implementing ethics is crucial to prevent harm and promote widespread benefits in social experiments based on medical artificial intelligence (MAI). However, insufficient information is available concerning this within the paediatric healthcare sector. We aimed to conduct a comparative survey among paediatricians, nurses and health information technicians regarding ethics implementation knowledge of and attitude towards MAI social experiments at children’s hospitals in Shanghai.Design and setting A cross-sectional electronic questionnaire was administered from 1 July 2022 to 31 July 2022, at tertiary children’s hospitals in Shanghai.Participants All the eligible individuals were recruited. The inclusion criteria were as follows: (1) should be a paediatrician, nurse and health information technician, (2) should have been engaged in or currently participating in social experiments based on MAI, and (3) voluntary participation in the survey.Primary outcome Ethics implementation knowledge of and attitude to MAI social experiments among paediatricians, nurses and health information technicians.Results There were 137 paediatricians, 135 nurses and 60 health information technicians who responded to the questionnaire at tertiary children’s hospitals. 2.4–9.6% of participants were familiar with ethics implementation knowledge of MAI social experiments. 31.9–86.1% of participants held an ‘agree’ ethics implementation attitude. Health information technicians accounted for the highest proportion of the participants who were familiar with the knowledge of implementing ethics, and paediatricians or nurses accounted for the highest proportion among those who held ‘agree’ attitudes.Conclusions There is a significant knowledge gap and variations in attitudes among paediatricians, nurses and health information technicians, which underscore the urgent need for individualised education and training programmes to enhance MAI ethics implementation in paediatric healthcare.

A rapid rise in the popularity of e-scooters has brought forth an increasing number of e-scooter-related conflicts, crashes, and injuries to pedestrians in many cities. There is a pressing need to understand the factors influencing the severity of injury to pedestrians involved in e-scooter collisions. This paper investigates the dynamics of e-scooter-pedestrian collisions and presents a new method for relating the probability of severe head injury to collision speed in e-scooter-pedestrian collisions. A total of 160 computer simulations representing different collision scenarios have been analyzed. Our results have shown that e-scooter speed is the main determinant of the severity of pedestrian head injury. E-scooter speed ranging from 10 to 15 km/h is found to be critical for pedestrian safety as the probability of severe head injury rises rapidly within this speed range. Moreover, an e-scooter-pedestrian collision is more likely to cause severe head injury to the pedestrian than a bicycle-pedestrian collision within the same speed range. It has also been found that the weight of the e-scooter and the direction of impact do not have a strong influence on the collision metrics, especially on the probability of severe head injury. The study has also investigated the post-collision fall mechanism for different pedestrian profiles and the influence of different impact angles. Finally, some recommendations have been proposed, including a speed limit of not more than 11 km/h for e-scooterist on shared paths where the likelihood of pedestrian and e-scooter conflicts is higher. The recommendations could help authorities develop legislation for safe micro-mobility.

Abstract Background RNA methylation modifications, such as N1-methyladenosine/N6-methyladenosine /N5-methylcytosine (m1A/m6A/m5C), are the most common RNA modifications and are crucial for a number of biological processes. Nonetheless, the role of RNA methylation modifications of m1A/m6A/m5C in the pathogenesis of renal interstitial fibrosis (RIF) remains incompletely understood. Methods Firstly, we downloaded 2 expression datasets from the GEO database, namely GSE22459 and GSE76882. In a differential analysis of these datasets between patients with and without RIF, we selected 33 methylation-related genes (MRGs). We then applied a PPI network, LASSO analysis, SVM-RFE algorithm, and RF algorithm to identify key MRGs. Results We eventually obtained five candidate MRGs (WTAP, ALKBH5, YTHDF2, RBMX, and ELAVL1) to forecast the risk of RIF. We created a nomogram model derived from five key MRGs, which revealed that the nomogram model may be advantageous to patients. Based on the selected five significant MRGs, patients with RIF were classified into two MRG patterns using consensus clustering, and the correlation between the five MRGs, the two MRG patterns, and the genetic pattern with immune cell infiltration was shown. Moreover, we conducted GO and KEGG analyses on 768 DEGs between MRG clusters A and B to look into their different involvement in RIF. To measure the MRG patterns, a PCA algorithm was developed to determine MRG scores for each sample. The MRG scores of the patients in cluster B were higher than those in cluster A. Conclusions Ultimately, we concluded that cluster A in the two MRG patterns identified on these five key m1A/m6A/m5C regulators may be associated with RIF.

Abstract Multiple primary lung cancers (MPLCs) pose diagnostic and therapeutic challenges in clinic. Here, we orchestrated the cellular and spatial architecture of MPLCs by combining single-cell RNA-sequencing and spatial transcriptomics. Notably, we identified a previously undescribed sub-population of epithelial cells termed as CLDN2 + alveolar type II (AT2) which was specifically enriched in MPLCs. This subtype was observed to possess a relatively stationary state, play a critical role in cellular communication, aggregate spatially in tumor tissues, and dominate the malignant histopathological patterns. The CLDN2 protein expression can help distinguish MPLCs from intrapulmonary metastasis and solitary lung cancer. Moreover, a cell surface receptor−TNFRSF18/GITR was highly expressed in T cells of MPLCs, suggesting TNFRSF18 as one potential immunotherapeutic target in MPLCs. Meanwhile, high inter-lesion heterogeneity was observed in MPLCs. These findings will provide insights into diagnostic biomarkers and therapeutic targets and advance our understanding of the cellular and spatial architecture of MPLCs.