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Guidelines recommend percutaneous nephrolithotomy (PCNL) for larger renal stones, but advances in flexible ureteroscopy (f-URS) with a tip-bendable suction ureteral access sheath (S-UAS) have prompted further investigation. Our multicenter, international, randomized controlled trial is investigating whether f-URS with S-UAS is noninferior to mini-PCNL (mPCNL) for renal stones of 2–3 cm. The primary objective is the immediate stone-free rate (SFR). Secondary outcomes include the 3-mo SFR, complication rates, surgical time, hospital stay, auxiliary procedures, and improvements in quality of life. A total of 720 patients from 12 urological centers will be randomized to either f-URS with S-UAS or PCNL. Statistical analyses will include intention-to-treat and per-protocol approaches, with specific methods for normally and non-normally distributed data. Subgroup analyses will focus on stone location and lithotripter types. The significance threshold will be set at p

Abstract Background Bioterrorism is an important topic in the field of biosecurity. Nurses, the largest group of healthcare workers, play a critical role in addressing the threat of bioterrorism. This study aimed to examine the present level of bioterrorism knowledge, attitudes, and practices among nurses. It also explored the relationships among bioterrorism knowledge, attitudes, and practices, as well as demographic variables that influence the scores of each dimension. Methods A descriptive correlational research design was conducted using a convenience sample of 429 nurses in five tertiary general hospitals in Tianjin. Registered nurses with six months or more of work experience, currently still working in hospitals, and volunteering to participate in the study are included; otherwise, they are excluded. A structured questionnaire with four components was used: sociodemographic characteristics, knowledge of bioterrorism, attitudes toward bioterrorism, and practices related to bioterrorism. The acquired data were analyzed using the Mann‒Whitney test, Kruskal‒Wallis test, Spearman correlation analysis, and multiple linear regression. This study followed the STROBE guidelines. Results The study ultimately included 429 valid surveys. The mean score for bioterrorism knowledge was satisfactory (33.06 ± 4.87), the mean score for bioterrorism attitudes was good (23.83 ± 5.23), and the mean score for bioterrorism practices was poor (10.94 ± 6.51). There was a significant negative correlation between bioterrorism knowledge and attitudes (r=-0.38, p

Abstract Renal cell carcinoma (RCC) is one of the most common tumors that afflicts the urinary system, accounting for 90–95% of kidney cancer cases. Although its incidence has increased over the past decades, its pathogenesis is still unclear. Tumor-associated macrophages (TAMs) are the most prominent immune cells in the tumor microenvironment (TME), comprising more than 50% of the tumor volume. By interacting with cancer cells, TAMs can be polarized into two distinct phenotypes, M1-type and M2-type TAMs. In the TME, M2-type TAMs, which are known to promote tumorigenesis, are more abundant than M1-type TAMs, which are known to suppress tumor growth. This ratio of M1 to M2 TAMs can create an immunosuppressive environment that contributes to tumor cell progression and survival. This review focused on the role of TAMs in RCC, including their polarization, impacts on tumor proliferation, angiogenesis, invasion, migration, drug resistance, and immunosuppression. In addition, we discussed the potential of targeting TAMs for clinical therapy in RCC. A deeper understanding of the molecular biology of TAMs is essential for exploring innovative therapeutic strategies for the treatment of RCC.

The influence of ultrasonic treatment (UT) on the microstructure morphology and hardness of Al–Cu–Mg–Ag alloy is systematically investigated by a combination of electron backscatter diffraction (EBSD), x-ray diffraction (XRD), scanning electron microscope (SEM) and transmission electron microscope (TEM) analysis. Our results show that the hardness of as-cast and T6-tempered alloys becomes higher by UT. TEM analysis indicates that UT greatly accelerates the precipitation of θ precipitates and prohibits its rapid coarsening during exposing at 225 °C. This positive effect is ascribed to the combined results of the increasing Cu content in matrix, reduced dendritic segregation and more uniform distribution of Cu solutes by UT. Besides, UT is found to affect the precipitation kinetics of Ω phase because the higher number density of Ω plates is detected in UT alloys. This feature ensures a greater precipitation strengthening contribution to hardening in T6-termperd alloy with UT. Although the grain sizes of as-cast and T6-tempered alloys are reduced by UT, the grain boundary strengthening effect is very limited in UT alloys. This work also reveals that the solute content within the matrix increases by UT and therefore favors a stronger solid solution strengthening effect, leading to the higher hardness of as-cast UT alloys. After exposing at 225 °C for 100 h, all the T6-tempered alloys with and without UT exhibit a similar hardness despite the exposed microstructures exhibit clear differences. The absence of the enhanced hardening by UT in exposed alloys is arising from the fact that Ω and θ precipitates significantly coarsen during exposing.

Abstract Purpose Breast density has consistently been shown to be an independent risk factor for breast cancer in Western populations; however, few studies have evaluated this topic in Chinese women and there is not yet a unified view. This study investigated the association between mammographic density (MD) and breast cancer risk in Chinese women. Methods The PubMed, Cochrane Library, Embase, and Wanfang databases were systematically searched in June 2023 to include all studies on the association between MD and breast cancer risk in Chinese women. A total of 13,977 breast cancer cases from 14 studies were chosen, including 10 case-control/cross-sectional studies, and 4 case-only studies. For case-control/cross-sectional studies, the odds ratios (ORs) of MD were combined using random effects models, and for case-only studies, relative odds ratios (RORs) were combinations of premenopausal versus postmenopausal breast cancer cases. Results Women with BI-RADS density category II-IV in case-control/cross-sectional studies had a 0.93-fold (95% confidence interval [CI] 0.55, 1.57), 1.08-fold (95% CI 0.40, 2.94), and 1.24-fold (95% CI 0.42, 3.69) higher risk compared to women with the lowest density category. Combined RORs for premenopausal versus postmenopausal women in case-only studies were 3.84 (95% CI 2.92, 5.05), 22.65 (95% CI 7.21, 71.13), and 42.06 (95% CI 4.22, 419.52), respectively, for BI-RADS density category II-IV versus I. Conclusions For Chinese women, breast cancer risk is weakly associated with MD; however, breast cancer risk is more strongly correlated with mammographic density in premenopausal women than postmenopausal women. Further research on the factors influencing MD in premenopausal women may provide meaningful insights into breast cancer prevention in China.

To improve the accuracy and efficiency of the aging life prediction and assessment of transformer oil-paper insulation, and to make up for the deficiencies of traditional characterizers, such as 2-furfural, carbon monoxide, and carbon dioxide, a method for the simultaneous determination of methanol, ethanol, $n-\mathbf{propanol}$, and $n$-butanol in oil with a single injection is established by headspace-gas chromatography-mass spectrometry. The measured results show that the determination limits of the four alcohol characterizers can be controlled to $\mathbf{10}\ \mu \mathbf{g}/\mathbf{kg}$ level. Based on this method, the change patterns of the above four alcohols with thermal aging time and degree of polymerization are obtained through thermal aging experimental research. Ethanol, $n$-propanol, and $n$-butanol in oil indicate nearly linear correlations with thermal aging time and degree of polymerization, similar to that of methanol. By analyzing 52 sets of measured data of 500 kV EHV transformers in operation, $n$-butanol is found to have excellent performance, and a new method to evaluate the aging state of oil-paper insulation employing $n$-butanol and methanol is proposed along with the aging attention value model. The measured data of 500 kV EHV transformers in operation indicate that the combination of $n$-butanol and methanol as the preferred characterizers can effectively compensate for the shortcoming of traditional characterizers in the early stages of aging, and the feasibility of the method is verified. Two possible pathways for the generation of $n$-butanol by cellulose cleavage during the aging of oil-paper are proposed from the chemical structure of cellulose.

A series of β-carboline derivatives containing nitrogen heterocycles were designed and synthesized. All compounds were screened for their antitumor activity against four human tumor cell lines (A549, K562, PC-3, T47D). Notably, compound N-(4-(morpholinomethyl)phenyl)-2-((5-(1-(3,4,5-trimethoxyphenyl)-9H-pyrido[3,4-b]indol-3-yl)-1,3,4-oxadiazol-2-yl)thio)acetamide (8q) exhibited significant inhibitory activity against PC-3 cells with an IC50 value of 9.86 µM. Importantly, compound 8q effectively suppressed both the proliferation and migration of PC-3 cells. Mechanistic studies revealed that compound 8q induced cell apoptosis and caused the accumulation of reactive oxygen species (ROS), leading to cell cycle arrest in the G0/G1 phase in PC-3 cells.

Background: The thyroid gland exhibits a subtle interconnection with the lungs. We further investigated the correlation between thyroid hormone sensitivity and lung function in euthyroid individuals. Methods: Data on spirometry and mortality for participants aged 19–79 years were extracted from the NHANES database. Obstructive lung function was defined as a forced expiratory volume in 1 s to forced vital capacity ratio (FEV1/FVC)

Background. Cellular senescence is thought to play a significant role in the onset and development of diabetic nephropathy. The goal of this study was to explore potential biomarkers associated with diabetic glomerulopathy from the perspective of senescence. Methods. Datasets about human glomerular biopsy samples related to diabetic nephropathy were systematically obtained from the Gene Expression Omnibus database. Hub senescence-associated genes were investigated by differential gene analysis and Least Absolute Shrinkage and Selection Operator analysis. Cluster analysis was employed to identify senescence molecular subtypes. A single-cell dataset was used to validate the above findings and further evaluate the senescence environment. The relationship between these genes and the glomerular filtration rate was explored based on the Nephroseq database. These gene expressions have also been explored in various kidney diseases. Results. Twelve representative senescence-associated genes (VEGFA, IQGAP2, JUN, PLAT, ETS2, ANG, MMP14, VEGFC, SERPINE2, CXCR2, PTGES, and EGF) were finally identified. Biological changes in immune inflammatory response, cell cycle regulation, metabolic regulation, and immune microenvironment have been observed across different molecular subtypes. The above results were also validated based on single-cell analysis. Additionally, we also identified several significantly altered cell communication pathways, including COLLAGEN, PTN, LAMININ, SPP1, and VEGF. Finally, almost all these genes could well predict the occurrence of diabetic glomerulopathy based on receiver operating characteristic analysis and are associated with the glomerular filtration rate. These genes are differently expressed in various kidney diseases. Conclusion. The present study identified potential senescence-associated biomarkers and further explored the heterogeneity of diabetic glomerulopathy that might provide new insights into the diagnosis, assessment, management, and personalized treatment of DN.

Benzimidazole fungicides are a class of highly effective, low-toxicity, systemic broad-spectrum fungicides developed in the 1960s and 1970s, based on the fungicidal activity of the benzimidazole ring structure. They exhibit biological activities including anticancer, antibacterial, and antiparasitic effects. Due to their particularly outstanding antibacterial properties, they are widely used in agriculture to prevent and control various plant diseases caused by fungi. The main products of benzimidazole fungicides include benomyl, carbendazim, thiabendazole, albendazole, thiophanate, thiophanate-methyl, fuberidazole, methyl (1-{[(5-cyanopentyl)amino]carbonyl}-1H-benzimidazol-2-yl) carbamate, and carbendazim salicylate. This article mainly reviews the physicochemical properties, toxicological properties, disease control efficacy, and pesticide residue and detection technologies of the aforementioned nine benzimidazole fungicides and their main metabolite (2-aminobenzimidazole). On this basis, a brief outlook on the future research directions of benzimidazole fungicides is presented.