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Qing Liu,1,2,* Xiao-Jiao Tang,1,2,* Xin-Ke Chen,1,2 Lin Chen1,2 1Department of Ophthalmology, Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, People’s Republic of China; 2International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lin Chen, Children’s Hospital of Chongqing Medical University, 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, People’s Republic of China, Tel +8618623041022, Fax +86-23-63651759, Email chenlin1220@126.comObjective: To investigate the effectiveness of flipped classrooms (FC) based on outcomes-based education (OBE) on clinical ophthalmology clerkships.Methods: Ninety-nine undergraduates were non-randomly assigned to the FC based on the OBE (FC-OBE) group or traditional lecture (TL) group in the ophthalmology clerkship. Pre- and post-tests were performed to assess student learning outcomes. Anonymous questionnaires were collected to compare students’ attitudes and classroom engagements between the two groups.Results: More participants agreed FC-OBE was helpful in developing teamwork ability and knowing the work standard. Teaching staff in the FC-OBE classroom received higher evaluations. More participants in the FC-OBE group had higher classroom engagement in skills and emotions than in the TL group. The post-class test scores, mainly case analysis scores were higher in the FC-OBE group than in the TL group.Conclusion: FC-OBE classroom improves student engagement and clinical analysis competence in undergraduate ophthalmology clerkship.Keywords: ophthalmology education, OBE, flipped classroom, clinical clerkship, undergraduate

Sha-Sha Tao,1– 3,* Fan Cao,4,* Ruo-Di Zhang,1,2,* Shu-Zhen Xu,1,2 Xiao-Xiao Li,1,2 Jian Tang,1,2 Xiao-Ke Yang,5 Hai-Feng Pan1,2 1Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China; 2Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, People’s Republic of China; 3Experimental Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China; 4Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China; 5Department of Rheumatology and Immunology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hai-Feng Pan, Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China, Email panhaifeng1982@sina.com; panhaifeng@ahmu.edu.cnBackground: Cytokines act a vital role in autoimmune neuroinflammatory diseases (ANDs) with undetermined causal relationships. Mendelian randomization (MR) analysis was performed to estimate the causal effects of circulating levels of cytokines on the risk of ANDs.Methods: The causal relationship between 34 circulating cytokines and 4 kinds of ANDs, including multiple sclerosis (MS), neuromyelitis optica (NOM), chronic inflammatory demyelinating polyneuropathy (CIDP) and myasthenia gravis (MG) were explored using four methods of MR analysis. MR-PRESSO, MR-Egger regression methods and Cochran’s Q statistic were utilized to identify the instrumental variables (IVs) with potential pleiotropy and heterogeneity. The Bonferroni correction was used for multiple group comparisons. P-value less than 3.68E-04 (0.05/ (34*4)) was considered statistically significant.Results: Negative causal effects of circulating levels of interleukin (IL)-8 (OR = 0.648, 95% CI: 0.494-0.851, P = 0.002) on risk of MS, chemokine (C–C Motif) ligand (CCL)-5 (OR = 0.295, 95% CI: 0.103-0.841, P = 0.022) and stem cell growth factor-beta (SCGF-β) (OR = 0.745, 95% CI: 0.565-0.984, P = 0.038) on risk of CIDP, as well as positive causal effects of circulating levels of IL-2 receptor α (IL-2Rα) (OR = 1.216, 95% CI: 1.120-1.320, P = 3.20E-06) and chemokine C-X-C motif ligand (CXCL)-10 (OR = 1.404, 95% CI: 1.094-1.803, P = 0.008) on MS were observed. Nevertheless, only IL-2Rα still had a causal effect on MS after Bonferroni correction.Conclusion: The results identify a genetically predicted causal effect of IL-2Rα, IL-8 and CXCL-10 on MS, CCL-5 and SCGF-β on CIDP.Keywords: cytokines, autoimmune neuroinflammatory diseases, ANDs, causal relationship, Mendelian randomization

Rui-Qi Feng,1 De-Hui Li,2 Xu-Kuo Liu,1 Xiao-Hui Zhao,1 Qian-Er Wen,1 Ying Yang1 1Graduate School of Hebei University of Chinese Medicine, Shijiazhuang, Hebei Province, People’s Republic of China; 2Oncology Department II, the First Affiliated Hospital of Hebei University of Chinese Medicine (Hebei Province Hospital of Chinese Medicine), Shijiazhuang, Hebei Province, People’s Republic of ChinaCorrespondence: De-Hui Li, Email 258289951@qq.comAbstract: A total of 18% of global breast cancer (BC) deaths are attributed to BC in China, making it one of the five most common cancers there. There has been a steady rise in BC morbidity and mortality in women in the last few years and it is now a leading cancer among Chinese women. Conventional treatments for BC are currently effective but have several limitations and disadvantages, and Traditional Chinese medicine (TCM) plays a vital role in the overall process of cancer prevention and therapy. It is known that TCM can treat a variety of conditions at a variety of sites and targets. In recent years, increasingly, research has been conducted on TCM’s ability to treat BC. TCM has shown positive results in the treatment of breast cancer and the adverse effects of radiotherapy and chemotherapy. This review describes the progress of clinical observation and mechanism research of TCM in the treatment of breast cancer in recent years. It provides some ideas and theoretical basis for the treatment of BC with TCM.Keywords: formulas, acupuncture, mechanism of action, therapy

Hai-Tao Zhang,1 Kuo Wang,2 Ze-Shi Li,1 Chuang-Shi Wang,3 Xi-Kun Han,4,5 Wei Chen,6 Fu-Dong Fan,7 Jun Pan,7 Qing Zhou,7 Hai-Long Cao,7 Hao-Dong Pan,8 Xiateke Hafu,9 Chen Li,10 Guo-Liang Fan,10 Tuo Pan,1 Dong-Jin Wang,1,2,6,7 Wei Wang9 1Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Graduate School of Peking Union Medical College, Nanjing, Jiangsu, 210008, People’s Republic of China; 2Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital, the Affiliated Clinical College of Xuzhou Medical University, Nanjing, Jiangsu, 210008, People’s Republic of China; 3Medical Research and Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 102300, People’s Republic of China; 4Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA; 5Program in Genetic Epidemiology and Statistical Genetics, Harvard T. H. Chan School of Public Health, Boston, MA, USA; 6Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210008, People’s Republic of China; 7Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, 210008, People’s Republic of China; 8Department of Clinical Medicine, Norman Bethune Health Science Center of Jilin university, Changchun, Jilin, 130021, People’s Republic of China; 9The Xinhua Hospital of Ili Kazak Autonomous Prefecture, Ili, Xinjiang, People’s Republic of China; 10Department of Cardiac Surgery, Dong Fang Hospital Affiliated to Tongji University, Shanghai, 200120, People’s Republic of ChinaCorrespondence: Dong-Jin Wang, Chief of department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Number 321 Zhongshan Road, Nanjing, Jiangsu, 210008, People’s Republic of China, Email dongjin_wang@126.com Wei Wang, The Xinhua Hospital of Ili Kazak Autonomous Prefecture, Ili, Xinjiang, People’s Republic of China, Email wangwei3342@163.comBackground: Early postoperative bacterial pneumonia and sepsis (ePOPS), which occurs within the first 48 hours after cardiovascular surgery, is a serious life-threatening complication. Diagnosis of ePOPS is extremely challenging, and the existing diagnostic tools are insufficient. The purpose of this study was to construct a novel diagnostic prediction model for ePOPS.Methods: Least Absolute Shrinkage and Selection Operator (LASSO) with logistic regression was used to construct a model to diagnose ePOPS based on patients’ comorbidities, medical history, and laboratory findings. The area under the receiver operating characteristic curve (AUC) was used to evaluate the model discrimination.Results: A total of 1203 patients were recruited and randomly split into a training and validation set in a 7:3 ratio. By early morning on the 3rd postoperative day (POD3), 103 patients had experienced 133 episodes of bacterial pneumonia or sepsis (15 patients had both). LASSO logistic regression model showed that duration of mechanical ventilation (P=0.015), NYHA class ≥ III (P=0.001), diabetes (P< 0.001), exudation on chest radiograph (P=0.011) and IL-6 on POD3 (P< 0.001) were independent risk factors. Based on these factors, we created a nomogram named DICS-I with an AUC of 0.787 in the training set and 0.739 in the validation set.Conclusion: The DICS-I model may be used to predict the risk of ePOPS after cardiovascular surgery, and is also especially suitable for predicting the risk of IRAO. The DICS-I model could help clinicians to adjust antibiotics on the POD3.Keywords: early postoperative pneumonia and sepsis, IL-6, LASSO, nomogram

Xiao-kun Liu,1,&ast; Dan-ling Huang,1,2,&ast; Li-ping Meng,1 Wei Cheng,1 Yi-yi Li,1 Lu-lu Qin,3 Ao Yang,4 Fan Zeng,5 Qin Zou,1 Qi-fu Li6 1Clinical Psychology Department, The First Affiliated Hospital of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China; 2Neurology Department, Graduate School of Tianjin Medical University, Tianjin City, People’s Republic of China; 3Department of Social Medicine and Health Management, School of Medicine, Hunan Normal University, Changsha City, Hunan Province, People’s Republic of China; 4Health Management Department, School of Management of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China; 5Graduate School of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China; 6Neurology Department, The First Affiliated Hospital of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiao-kun Liu; Qi-fu Li, Email lacyfairy@qq.com; lee-chief@163.comAim: This study was designed to develop an effective measurement tool for occupational stress among medical staff and to identify the underlying risk factors among clinical nurses in China under depression during and after COVID-19.Methods: In the first stage, an occupational stress scale was developed for medical staff based on qualitative and quantitative methods. The dimensions of the scale were based on childhood stress and seven other parameters of working stress. In the second stage, a provincial survey was conducted among clinical nurses in Hainan. The structure of Medical Staff Occupational Stress Scale was tested in secondary and tertiary hospitals. The socio-demographic information, occupational stress (measured using the developed scale), and current depression symptoms (assessed with the nine‐item Patient Health Questionnaire) were evaluated. The risk factors for occupational stress-induced depression were tested using multivariate logistic regression.Results: The Medical Staff Occupational Stress Scale consisted of 42 items under eight dimensions with strong reliability and validity. Almost 80% of the clinical nurses reported obvious symptoms of depression. Based on multivariate logistical regression analysis, the significant risk factors for depression in nurses at secondary hospitals and tertiary hospitals were childhood stress, teaching stress, relationship with patient stress, and administration stress.Conclusion: The Medical Staff Occupational Stress Scale utilized in nursing population is based on strong psychometric features. Childhood stress contributes to occupational stress in nurses. The selection of nurses for clinical work may require evaluation of past history for childhood stress to prevent occupational depression. Teaching stress, relationship with patient stress and administration stress play significant roles in the prevention of depression among clinical nurses.Keywords: occupational stress, depression, teaching stress, relationship with patient stress, nurses

Xing-Kun Zeng,&ast; Shan-Shan Shen,&ast; Hui-Lan Guan, Ling-Yan Chen, Xu-Jiao Chen Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xu-Jiao Chen, Department of Geriatrics, Zhejiang Hospital, Lingyin Road &num;12, Hangzhou, 310013, People’s Republic of China, Tel +86 180 6989 7567, Fax +86 571 8798 5100, Email lily197459@163.comPurpose: This study aimed to investigate the combined effects of frailty and cognitive impairment on adverse outcomes, including new falls and new activities of daily living (ADL) dependency over a 1-year follow-up.Patients and Methods: A total of 311 older hospitalized patients participated in this retrospective observational study and completed a 1-year follow-up. Frailty was assessed by the Clinical Frailty Scale (CFS). Cognitive function was evaluated by the Mini-Mental State Examination (MMSE). All participants were classified into four groups: 1) the healthy group (n=180); 2) the cognitive impairment group only (n=38); 3) the frailty group only (n=44); and 4) coexisting frailty and cognitive impairment group (n=49). The follow-up data of adverse outcomes include the incidences of new falls and new ADL dependence. Binary logistic regression analysis was used to explore the associations of frailty and/or cognitive impairment with adverse outcomes.Results: The prevalence rates of frailty, cognitive impairment, and co-occurring frailty with cognitive impairment were 29.9%, 28%, and 15.8%, respectively. Among these four groups, there was a statistical difference in the incidence of new ADL dependence during the follow-up period (9.5% vs 11.4% vs 35.9% vs 61.9%, P < 0.001). After adjusting the confounding variables, older hospitalized patients with frailty and cognitive impairment had a higher risk of new ADL dependence when compared with the healthy group (OR: 4.786, 95% CI: 1.492– 15.355), but frailty only or cognitive impairment only was not associated with new ADL dependency.Conclusion: Elderly inpatients with comorbid frailty and cognitive impairment on admission were significantly associated with an increased risk of new ADL dependency 1 year after discharge. Therefore, it is necessary for the early identification of frailty and cognitive impairment, and effective interventions should be implemented.Keywords: cognitive impairment, frailty, older adults, ADL dependency, fall

Zuo-Huan Meng,1,* Wen-Yuan Ma,1,* Ying Wang,2 Ya-Rong Li,2 Jing Zhang,3 Yin-Fang Liu,4 Xin-Ke Zhao,5,6 Chun-He Da6 1Institute of Traditional Chinese Medicine, The Third Affiliated Hospital of Gansu University of Chinese Medicine, Baiyin, People’s Republic of China; 2Department of Pharmacy, The Third Affiliated Hospital of Gansu University of Chinese Medicine, Baiyin, People’s Republic of China; 3Nutrition Department, The Third Affiliated Hospital of Gansu University of Chinese Medicine, Baiyin, People’s Republic of China; 4Respiratory Medicine, The Third Affiliated Hospital of Gansu University of Chinese Medicine, Baiyin, People’s Republic of China; 5Gansu University of Chinese Medicine, Lanzhou, People’s Republic of China; 6The Third Affiliated Hospital of Gansu University of Chinese Medicine, Baiyin, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zuo-Huan Meng, Institute of Traditional Chinese Medicine, The Third Affiliated Hospital of Gansu University of Chinese Medicine, Baiyin, 730900, People’s Republic of China, Tel +8609438813373, Email 441390739@qq.com Chun-He Da, The Third Affiliated Hospital of Gansu University of Chinese Medicine, Baiyin, 730900, People’s Republic of China, Tel +8609438810612, Email dachunhedch@outlook.comBackground: “Pneumonia Prevention No.1” belongs to ‘traditional Chinese medicine prescription for prevention of viral pneumonia and influenza’ was urgently formulated by Notice on Printing the Novel Coronavirus Diagnosis and Treatment Scheme for COVID-19 (Trial Version 3) and Traditional Chinese Medicine Prevention and Treatment Scheme for COVID-19 in Hubei Province (Trial). Because the prescription drug has the bidirectional regulation function of human immune function, moderate improvement of immune function can effectively resist virus invasion, while excessive immune function will produce immune overresponse. Excessive immune response will aggravate the condition of patients with COVID-19, resulting in the death of severe patients.Methods: Twenty medical workers aged 20– 60 years old, who had no immune disease, no current disease and healthy physical examination, were selected as participants. The participants took Hubei “Pneumonia Prevention No.1” decoction, one dosage each day, twice a day, for 7 consecutive days. With the before-after control method, blood samples were collected from the median cubital veins before and after medication. Immunoglobulin IgA, IgG and IgM were measured by immunoturbidimetry, and T lymphocyte subsets CD3, CD4, CD8 and CD4/CD8 were measured by flow cytometry. The changes of indexes before and after medication were compared with SPPS 13.0 statistical software. The data were expressed by (mean ± standard deviation). T-test was adopted, and P < 0.05 was considered statistically significant (P < 0.05).Results: The results of this study show that in healthy participants, the immunoglobulin and T lymphocyte subsets did not differ significantly before and after drug administration (P > 0.05).Conclusion: Under normal drug administration circumstances, “Pneumonia Prevention No. 1” had no significant regulating effect on the immune system in a healthy population and did not increase the immune system capacity beyond a reasonable range. It is safe to be used as a prophylactic measure in healthy populations.Keywords: “Pneumonia Prevention No. 1”, healthy population, immunoglobulin, T lymphocyte, safe medication

Bei-Xi Bao, Hui Yan, Jia-Guang Tang, Dao-Jing Qiu, Yu-Xuan Wu, Xiao-Kang Cheng Department of Orthopedic Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People’s Republic of ChinaCorrespondence: Jia-Guang Tang, Department of Orthopedic Surgery, Beijing Tongren Hospital, Capital Medical University, No. 1 of Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, People’s Republic of China, Tel/Fax +86 13911003227, Email jgtang123@163.comObjective: To retrospectively analyze the risk factors for adding-on phenomena (AOP) after posterior hemivertebral resection (PHR) and pedicle screw fixation for the treatment of congenital scoliosis (CS) caused by hemivertebral (HV) malformation.Methods: Patients with CS who underwent surgery and were followed up for more than five years were included in this study. The d general data, such as gender, age, HV segment, Risser sign, and triangular cartilage, postoperative complications, and imaging data at different periods, including the standard anteroposterior and lateral x-rays of the total spine were collected.Results: In total, 58 patients were included in this study, of which 10 experienced AOP and 48 did not. The results of the single-factor analysis showed that there were statistically significant differences between the patients with AOP and those without in terms of the HV direction, lowest instrumented vertebra (LIV)–upper instrumented vertebra (UIV) (P < 0.05), and postoperative trunk shift (P < 0.05). The results of the logistic regression analysis showed that the HV direction and the postoperative trunk displacement distance were the main risk factors for postoperative AOP. The area under the receiver operating characteristic curve was 0.842 (P < 0.001). The best cut-off value of the adding-on index as an indicator of the occurrence of AOP after surgery was 0.67. When the adding-on index was > 0.67, the incidence of postoperative AOP was 90.0%, and the non-occurrence rate was 22.9%.Conclusion: PHR and pedicle screw fixation is an effective way to treat HV malformation in CS. The HV direction, LIV–UIV, and postoperative TS are risk factors for AOP in patients with CS treated with PHR and pedicle screw fixation. The adding-on index has a high degree of accuracy for the prediction of the occurrence of AOP after PHR and pedicle screw fixation.Keywords: congenital scoliosis, hemivertebral resection, adding-on phenomena

Di Tang,1,&ast; Duo Zhang,1,&ast; Yu Heng,1 Xiao-Ke Zhu,1 Han-Qing Lin,1 Jian Zhou,1 Lei Tao,1 Li-Ming Lu2 1Department of Otorhinolaryngology and ENT Institute, Eye & ENT Hospital, Fudan University, Shanghai, People’s Republic of China; 2Shanghai Institute of Immunology, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Li-Ming Lu, Shanghai Institute of Immunology, Shanghai Jiaotong University School of Medicine, 280 South Chongqing Road, Shanghai, 200025, People’s Republic of China, Tel +86-13916235624, Fax +86-021-63846383, Email lulunew2003@163.com Lei Tao, ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, People’s Republic of China, Tel +86-13916944810, Email doctortaolei@163.comPurpose: Chronic inflammation contributes to tumor initiation, progression, and immune escape. Neutrophils are the major component of inflammatory response and participate in the tumorigenesis process. However, compared to other immune cells in the tumor microenvironment of laryngeal squamous cell carcinoma (LSCC), neutrophils, especially the tumor-associated neutrophils (TANs), have not yet been comprehensively explored. The mechanism for regulating the crosstalk between TANs and tumor cells still remains unclear.Materials and Methods: The distribution profiles and phenotypic features of neutrophils and other inflammatory immune cell populations from a large LSCC patient cohort were systemically analyzed. Co-culturing of peripheral blood associated neutrophils (PANs) and TANs with PBMCs was performed, and the immunosuppression effect on T-cells was examined.Results: LSCC microenvironment is highly inflammatory with remarkable TANs infiltration, which is often associated with unfavorable prognosis and advanced clinical stage. We find that TANs in LSCC display morphologically immature and lower apoptosis, exhibit distinctively immunosuppressive phenotype of high PD-L1, and suppress CD8+ T lymphocytes proliferation and activation. We subsequently discover that PD-L1+TANs induced by LSCC-derived GM-CSF potently impair CD8+ T-cells proliferation and cytokines production function, which are partially blocked by a PD-L1-neutralizing antibody. Clinical data further support GM-CSF as an unfavorable prognostic biomarker and reveal a potential association with inflammatory immune cell infiltration, in particular neutrophils.Conclusion: Tumor-infiltrating PD-L1+ neutrophils induced by LSCC-derived GM-CSF suppress T cell proliferation and activation in the inflammatory microenvironment of LSCC and predict unfavorable prognosis. These TANs cripple antitumor T cell immunity and promote tumor progression. Our findings provide a basis for targeting PD-L1+TANs or GM-CSF as a new immunotherapeutic strategy for LSCC.Keywords: laryngeal squamous cell carcinoma, LSCC, tumor-associated neutrophils, TANs, PD-L1, inflammatory microenvironment, immune suppression, granulocyte-macrophage colony stimulating factor, GM-CSF

Dan Ren,1 Wen-Ling Wang,2 Gang Wang,2 Wei-Wei Chen,2 Xiao-Kai Li,2 Guo-Dong Li,2 Sai-Xi Bai,2 Hong-Min Dong,2 Wang-Hua Chen2 1Oncology Department, Guizhou Medical University, Guiyang, Guizhou, 550000, People’s Republic of China; 2Department of Abdominal Oncology, Affiliated Hospital of Guizhou Medical University, Affiliated Tumor Hospital of Guizhou Medical University, Guiyang, Guizhou, 550000, People’s Republic of ChinaCorrespondence: Wen-Ling WangDepartment of Abdominal Oncology, Affiliated Hospital of Guizhou Medical University, Affiliated Tumor Hospital of Guizhou Medical University, No. 1 Beijin West Road, Yunyan District, Guiyang, Guizhou, 550000, People’s Republic of ChinaTel +86 138 8507 7539Fax +86 851 86512900Email wangww35@outlook.comObjective: The aim of this study was to develop a nomogram-based model to predict the three-year and five-year overall survival (OS) of patients with stage II/III colon cancer following radical resection.Methods: A total of 1156 patients with stage II/III colon cancer who underwent radical resection at the Affiliated Hospital of Guizhou Medical University between December 2012 and December 2018 were enrolled. Lasso regression was used to screen out 12 variables: age, prealbumin, albumin, degree of differentiation, total tumor-node-metastasis (TNM) stage, T stage, N stage, prognostic nutritional index (PNI), platelet/lymphocyte count, carcinoembryonic antigen, carbohydrate antigen 19-9 (CA19-9), and postoperative adjuvant chemotherapy. The data set was then randomly split into a modeling set and a validation set, and the bootstrap method was used to verify the internal validity of the final model. A nomogram was then used to present the model, and the risk groups were categorized according to the total score in the nomogram.Results: This study established and developed a simple, easy-to-use predictive model that included age, degree of differentiation, N stage, CA19-9, PNI, and postoperative chemotherapy as variables. In the multivariate Cox regression analysis, only postoperative chemotherapy was identified as an independent risk factor for death in patients with colon cancer. The receiver operating characteristic curve showed that the model demonstrated good resolution, with an area under the curve of 0.803. Decision curve analysis indicated that the model had a good positive net gain, and the bootstrap method was used to verify its stability. In the OS rate, the C-index was 0.78. According to the total score of the nomogram, the risk group was layered by drawing the Kaplan–Meier (K–M) curve. In the three-year OS K–M curve, the survival rates of the low-risk group, the medium-risk group, and the high-risk group were 96%, 93%, and 82%, respectively. In the five-year OS K–M curve, the survival rates of the low-risk group, the medium-risk group, and the high-risk group were 94%, 90%, and 73%, respectively.Conclusion: The nomogram-based prediction model developed in this study is stable and has good resolution, reliability, and net gain. It will therefore be useful for clinicians performing risk stratification and postoperative monitoring and in the development of personalized treatment options for patients with stage II/III colon cancer.Keywords: colon cancer, nomogram, overall survival, prognosis

A search for long-lived, massive particles predicted by many theories beyondthe Standard Model is presented. The search targets final states with largemissing transverse momentum and at least one high-mass displaced vertex withfive or more tracks, and uses 32.8 fb$^{-1}$ of $\sqrt{s}$ = 13 TeV $pp$collision data collected by the ATLAS detector at the LHC. The observed yieldis consistent with the expected background. The results are used to extract95\% CL exclusion limits on the production of long-lived gluinos with masses upto 2.37 TeV and lifetimes of $\mathcal{O}(10^{-2})$-$\mathcal{O}(10)$ ns in asimplified model inspired by Split Supersymmetry.

Xiao-Kun Yu,1 Le Zhang,1 Wen-Jun Ma,2 Wen-Zhong Bi,3 Sheng-Gang Ju4 1Department of Radiology, The Fifth Centre Hospital of Tianjin, Tianjin, 300450, People’s Republic of China; 2Department of Radiology, Huangnan Tibetan Autonomous Prefecture People’s Hospital, Huangnan, Qinghai Province, 811300, People’s Republic of China; 3Department of Radiology, Qinghai Tibetan Hospital, Xining, Qinghai Province, 810000, People’s Republic of China; 4Department of Radiology, Henan Mongol Autonomous County People’s Hospital, Xining, Qinghai Province, 811500, People’s Republic of ChinaCorrespondence: Le ZhangDepartment of Radiology, The Fifth Centre Hospital of Tianjin, No. 41 of Zhejiang Road, Binhai New District, Tianjin, 300450, People’s Republic of ChinaTel +86 10 65665539; +86 13821510635Email zhangle824@outlook.comAbstract: Hepatic echinococcosis is a parasitic, infectious disease with a high incidence in pastoral areas. It is highly infectious with a poor prognosis in some cases, which seriously affects the quality of life for people living in pastoral areas. This study aims to discuss the radiological characteristics, including computed tomography (CT) and magnetic resonance imaging (MRI), of hepatic echinococcosis from its definition, transmission, and pathological physiology. The characteristics of CT and MRI manifestations of cystic echinococcosis and alveolar echinococcosis are summarized in this study. It might help doctors to investigate this disease further and accurately make a diagnosis.Keywords: hepatic echinococcosis, cystic echinococcosis, alveolar echinococcosis, brood capsule, daughter cyst, map sign, peninsula sign

Shu Dan Chen,1 Yun Yu,2 Xing Kai Li,1 Sui Qing Chen,1 Jie Ren1 1School of Education, Guangzhou University, Guangzhou, People’s Republic of China; 2Guangzhou Haizhu Foreign Language School, Guangzhou, People’s Republic of ChinaCorrespondence: Sui Qing Chen; Jie RenSchool of Education, Guangzhou University, No. 230, West Waihuan Road, Higher Education Mega Center, Panyu District, Guangzhou City, Guangdong Province, People’s Republic of ChinaTel +86 135 80313469Fax +86 137 24071821Email chensq@gzhu.edu.cn; renjie@gzhu.edu.cnPurpose: COVID-19 pandemic has been verified as a public health emergency of international concern. During the special period, the health of vulnerable groups, such as children with autism, should be concerned. Some studies have been carried out to investigate the behavioral problems of children with autism during the COVID-19, but underlying mechanisms behind it is not clear. This study examines the role of parenting stress as a mediator in the relationship between parental self-efficacy and behavioral problems in Chinese children as well as the role of perceived social support as a moderator for this mediation effect.Methods: A total of 439 parents of children with autism (mean age=40.17, SD=5.26) were surveyed and completed five questionnaires (Conners Parent Symptom Questionnaire, Parental Self-Efficacy Questionnaire, Parenting Stress Index-Short Form 15, Perceived Social Support Questionnaire, and Neuroticism Extraversion Openness Five Factor Inventory). The statistical analyses were conducted by SPSS 26.0 and SPSS PROCESS macro.Results: Controlling for neuroticism, which is highly associated with psychological changes in parents, the study found that parental self-efficacy was significantly and negatively correlated with behavioral problems in children with autism. In addition, the relationship between parental self-efficacy and behavioral problems was mediated by parenting stress. Furthermore, parenting stress moderated the indirect relationship between parental self-efficacy and behavioral problems via perceived social support.Conclusion: These results provide direct evidences for the inextricable relationship between family, social factors and behavioral problems of children with autism. It suggest that improving perceived social support to enhance parental self-efficacy is critical to buffering against parenting stress and stabilizing children with autism during the COVID-19 pandemic.Keywords: behavioral problems, children with autism, parental self-efficacy, moderated mediation model, COVID-19

Hao Dong,1,* Yan-Qiang Qin,2,* Ying-Chun Sun,2,* Hai-Jiang Yao,2 Xian-Kuan Cheng,2 Yan Yu,1 Shou-Si Lu1 1Beijing Bo’ai Hospital, China Rehabilitation Research Center, China Rehabilitation Science Institute, Beijing, People’s Republic of China; 2Treatment Center of TCM, Beijing Bo’ai Hospital, China Rehabilitation Research Center, China Rehabilitation Science Institute, School of Rehabilitation Medicine, Capital Medical University, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yan-Qiang Qin; Ying-Chun SunTreatment Center of TCM, Beijing Bo’ai Hospital, China Rehabilitation Research Center, China Rehabilitation Science Institute, No. 10 Jiaomen North Road, Beijing, 100068, People’s Republic of ChinaTel +86 18612251241Email yanqiangqin@126.com; syccrrc@sina.comBackground: Electroacupuncture (EA) is a form of physical therapy that has been widely used in clinical practice in China. Post-stroke depression (PSD) is the most common neuropsychiatric complication after stroke. EA has been shown to have beneficial effects on PSD patients. However, the potential mechanism underlying the protective effects of EA on PSD remains unclear. Here, we investigated whether tissue plasminogen activator (tPA)/brain-derived neurotrophic factor (BDNF)/tyrosine kinase receptor B (TrkB) signaling pathway participates in the therapeutic effects of EA in a rat PSD model.Methods: Experimental PSD was induced by combining middle cerebral artery occlusion (MCAO) with chronic unpredictable mild stimulation (CUMS) in adult male rats. Bodyweight gain, neurological score, sucrose preference, and open field test were determined at 0, 7, 14, and 35 days after completing MCAO. The protein expressions of tPA, precursor BDNF (proBDNF), mature BDNF (mBDNF), and TrkB were measured by immunofluorescence and Western blot analysis. The tPA inhibitor plasminogen inhibitor-1 (PAI-1) was used to explore whether tPA plays a crucial role in the protective effects of EA on PSD.Results: Compared with the sham rats, the PSD rats showed decreased bodyweight, deteriorated neurological score, and significant depressive-like behaviors. EA remarkably reversed bodyweight loss, neurological deficit, and depressive-like behaviors in PSD rats. Immunofluorescence staining and Western blot analysis showed that PSD-induced decreased expression of tPA, mBDNF, and TrkB were prevented by EA. Furthermore, we found that the effects of EA against PSD-induced depressive-like behaviors were abolished by PAI-1, the specific inhibitor of tPA.Conclusion: Our results suggest that the improvement in depressive-like behaviors induced by EA is likely achieved via activation of the tPA/BDNF/TrkB pathway.Keywords: electroacupuncture, poststroke depression, depressive-like behaviors, tPA/BDNF/TrkB, chronic unpredictable mild stimulation

Zhong-Wei Luo,1,2 Kun Xia,1,2 Yi-Wei Liu,1,2 Jiang-Hua Liu,1,2 Shan-Shan Rao,2,3 Xiong-Ke Hu,1,2 Chun-Yuan Chen,1,2 Ran Xu,4 Zhen-Xing Wang,1,2 Hui Xie1,2,5– 8 1Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 2Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 3Xiangya Nursing School, Central South University, Changsha, Hunan, People’s Republic of China; 4Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 5Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 6Hunan Key Laboratory of Organ Injury, Aging and Regenerative Medicine, Changsha, Hunan, People’s Republic of China; 7Hunan Key Laboratory of Bone Joint Degeneration and Injury, Changsha, Hunan, People’s Republic of China; 8National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of ChinaCorrespondence: Hui XieDepartment of Orthopedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, 410008, People’s Republic of ChinaEmail huixie@csu.edu.cnRan XuDepartment of Urology, The Second Xiangya Hospital, Central South University, 139 Middle Renmin Road, Changsha, Hunan, 410011, People’s Republic of ChinaEmail xuran@csu.edu.cnPurpose: Prostate cancer (PCa) is one of the most common malignancies in males. Despite the success of immunotherapy in many malignant cancers, strategies are still needed to improve therapeutic efficacy in PCa. This study aimed to investigate the effects of Akkermansia muciniphila-derived extracellular vesicles (Akk-EVs) on PCa and elucidate the underlying immune-related mechanism.Methods: Akk-EVs were isolated by ultracentrifugation and intravenously injected to treat syngeneic PCa-bearing immune-competent mice. Immunophenotypic changes in immune cells, such as cytotoxic T lymphocytes and macrophages, were measured via flow cytometry analysis. Histological examination was used to detect morphological changes in major organs after Akk-EVs treatments. In vitro, flow cytometry was performed to confirm the effects of Akk-EVs on the activation of CD8+ T cells. Quantitative PCR and immunofluorescence staining were carried out to test the impact of Akk-EVs on macrophage polarization. Cell counting kit-8 (CCK-8) analysis, colony formation assays, and scratch wound healing assays were conducted to assess the effects of Akk-EVs-treated macrophages on the proliferation and invasion of PCa cells. CCK-8 assays also confirmed the impact of Akk-EVs on the viability of normal cells.Results: Intravenous injection of Akk-EVs in immune-competent mice reduced the tumor burden of PCa without inducing obvious toxicity in normal tissues. This treatment elevated the proportion of granzyme B-positive (GZMB+) and interferon γ-positive (IFN-γ+) lymphocytes in CD8+ T cells and caused macrophage recruitment, with increased tumor-killing M1 macrophages and decreased immunosuppressive M2 macrophages. In vitro, Akk-EVs increased the number of GZMB+CD8+ and IFN-γ+CD8+ T cells and M1-like macrophages. In addition, conditioned medium from Akk-EVs-treated macrophages suppressed the proliferation and invasion of prostate cells. Furthermore, the effective dose of Akk-EVs was well-tolerated in normal cells.Conclusion: Our study revealed the promising prospects of Akk-EVs as an efficient and biocompatible immunotherapeutic agent for PCa treatment.Keywords: Akkermansia muciniphila, extracellular vesicles, immunotherapy, prostate cancer, cytotoxic T lymphocytes, macrophages

Zhuo Li,1– 3,* La-Xiu Li,3,4,* Yan-Jun Diao,3 Juan Wang,3 Yun Ye,1,3 Xiao-Ke Hao2,3,5 1Department of Laboratory Medicine, The First Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi 710077, People’s Republic of China; 2The National Engineering Research Center for Miniaturized Detection Systems, College of Life Science, Northwest University, Xi’an, Shaanxi 710069, People’s Republic of China; 3Department of Laboratory Medicine, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi 710032, People’s Republic of China; 4Department of Laboratory Medicine, Xi’an Fourth Hospital, Xi’an, Shaanxi 710004, People’s Republic of China; 5School of Medicine, Northwest University, Xi’an, Shaanxi 710069, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiao-Ke HaoSchool of Medicine, Northwest University, Xi’an, Shaanxi 710069, People’s Republic of ChinaEmail haoxkg@126.comBackground: Novel and non-invasive biomarkers with higher sensitivity and specificity for the diagnosis of prostate cancer (PCa) is urgently needed. In this study, we used next-generation sequencing (NGS) to characterize the genome-wide exosomal miRNA expression profiling in urine specimens and explored the diagnostic potential of urinary exosomal miRNAs for PCa.Methods: Urinary exosomal microRNA expression profiling was performed by next-generation sequencing (NGS) and then validated by quantitative real-time PCR.Results: Significant downregulation of urinary exosomal miR-375 was observed in PCa patients compared with healthy controls, while the expression levels of urinary exosomal miR-451a, miR-486-3p and miR-486-5p were found to be significantly up-regulated in the PCa patients. Furthermore, the expression level of urinary exosomal miR-375 showed a significant correlation with the clinical T-stage and bone metastasis of patients with PCa (P< 0.05). Receiver operator characteristic curve demonstrated that the urinary exosomal miR-375, miR-451a, miR-486-3p and miR-486-5p levels can be used to differentiate PCa patients from healthy controls, with area under the curves (AUCs) of 0.788, 0.757, 0.704 and 0.796, respectively. The urinary exosomal miR-375 was found to be superior in discriminating between localized and metastatic PCa with an AUC of 0.806. Moreover, PCa patients can be distinguished from patients with benign prostatic hyperplasia by using a panel combining urinary exosomal miR-375 and miR-451a with an AUC of 0.726.Conclusion: These findings demonstrate that the urinary exosomal miRNAs can serve as novel and non-invasive biomarkers for diagnosing and predicting the progression of PCa.Keywords: prostate cancer, next-generation sequencing, urinary, exosomal miRNAs

Abstract Background Abundant clinical evidences indicate that the increased risk of cerebral palsy (CP) may be associated with the intrauterine exposure to maternal infection. Cytomegalovirus (CMV) is a common cause of CP. However, little is known about the relationship between the intrauterine exposure of the fetus to CMV infection and CP. This study aims to explore the relationships between intrauterine CMV infection and clinical symptoms, classification, intelligence development and brain neuroimaging findings in children with CP. Methods In this study, 147 children with CP in recent 6 years were retrospectively analyzed (average age: 14.76 ± 3.07months; sex (M/F): 103/44). 148 children had CMV IgG and IgM positive sera identified by TORCH examination were selected as the control group (average age: 15.10 ± 3.21months; sex (M/F): 102/46), which also undergo the examination of CMV-DNA in urine. The age and sex of children in the control group were matched with those in the CP group. CMV-DNA in urine was detected by CMV fluorescence quantitative PCR, and t-test was performed to analyze the number of copies. For the CP group, standardized rehabilitation treatment was performed and the function of gross motor was evaluated by GMFM scale before and after treatment. The Gesell developmental scale (GDS) was used to assess the level of intellectual development. The classification of CP was conducted and the results of magnetic resonance imaging were analyzed. Finally, the correlations between the copy number of CMV-DNA and the clinical characteristics of children with CP were evaluated by the method of Pearson and Spearman correlation analysis. Results The level of CMV infection was negatively correlated with the developmental quotient (DQ) of children with CP. Negative association was found between the level of CMV infection and the level of the gross motor development. The level of CMV infection was positively related with the occurrence probability of spastic quadriplegia. However, no associations were found between the abnormalities of brain tissue and the number of CMV copies. Moreover, CMV infection might add the difficulty of the rehabilitation treatment. Conclusions CMV infection is a risk factor for the occurrence of CP in children. Pregnancy examination should be strengthened. Early detection and control of CMV infection may contribute to the rehabilitation of children with CP and reduce the disability and social burden.

By analyzing 2.93 fb$^{-1}$ data collected at the center-of-mass energy$\sqrt s=3.773$ GeV with the BESIII detector, we measure the absolute branchingfraction of the semileptonic decay $D^+\rightarrow\bar K^0 e^{+}\nu_{e}$ to be${\mathcal B}(D^{+}\rightarrow\bar K^0 e^{+}\nu_{e})=(8.59 \pm 0.14 \pm0.21)\%$ using $\bar K^0\to K^0_S\to \pi^0\pi^0$, where the first uncertaintyis statistical and the second systematic. Our result is consistent withprevious measurements within uncertainties.

By analyzing 2.93 fb$^{-1}$ data collected at the center-of-mass energy$\sqrt s=3.773$ GeV with the BESIII detector, we measure the absolute branchingfraction of the semileptonic decay $D^+\rightarrow\bar K^0 e^{+}\nu_{e}$ to be${\mathcal B}(D^{+}\rightarrow\bar K^0 e^{+}\nu_{e})=(8.59 \pm 0.14 \pm0.21)\%$ using $\bar K^0\to K^0_S\to \pi^0\pi^0$, where the first uncertaintyis statistical and the second systematic. Our result is consistent withprevious measurements within uncertainties.

Results of a search for new phenomena in final states with an energetic jet and large missing transverse momentum are reported. The search uses proton-proton collision data corresponding to an integrated luminosity of 3.2 fb-1 at s=13 TeV collected in 2015 with the ATLAS detector at the Large Hadron Collider. Events are required to have at least one jet with a transverse momentum above 250 GeV and no leptons. Several signal regions are considered with increasing missing-transverse-momentum requirements between ETmiss>250 GeV and ETmiss>700 GeV. Good agreement is observed between the number of events in data and Standard Model predictions. The results are translated into exclusion limits in models with large extra spatial dimensions, pair production of weakly interacting dark-matter candidates, and the production of supersymmetric particles in several compressed scenarios.

The differential cross-section for pair production of top quarks with high transverse momentum is measured in 20.3 fb-1 of proton-proton collisions at a center-of-mass energy of 8 TeV. The measurement is performed for tt¯ events in the lepton+jets channel. The cross-section is reported as a function of the hadronically decaying top quark transverse momentum for values above 300 GeV. The hadronically decaying top quark is reconstructed as an anti-kt jet with radius parameter R=1.0 and identified with jet substructure techniques. The observed yield is corrected for detector effects to obtain a cross-section at particle level in a fiducial region close to the event selection. A parton-level cross-section extrapolated to the full phase space is also reported for top quarks with transverse momentum above 300 GeV. The predictions of a majority of next-to-leading-order and leading-order matrix-element Monte Carlo generators are found to agree with the measured cross-sections.

A search for radiative decays of the P-wave spin singlet charmonium resonance h_{c} is performed based on 4.48×10^{8} ψ^{'} events collected with the BESIII detector operating at the BEPCII storage ring. Events of the reaction channels h_{c}→γη^{'} and γη are observed with a statistical significance of 8.4σ and 4.0σ, respectively, for the first time. The branching fractions of h_{c}→γη^{'} and h_{c}→γη are measured to be B(h_{c}→γη^{'})=(1.52±0.27±0.29)×10^{-3} and B(h_{c}→γη)=(4.7±1.5±1.4)×10^{-4}, respectively, where the first errors are statistical and the second are systematic uncertainties.

From 2011 to 2014, the BESIII experiment collected about 5 fb-1 data at center-of-mass energies around 4 GeV for the studies of the charmonium-like and higher excited charmonium states. By analyzing the di-muon process e+e- → γISR/FSRμ+μ-, the center-of-mass energies of the data samples are measured with a precision of 0.8 MeV. The center-of-mass energy is found to be stable for most of the time during data taking.

We study the decays of the charmonium resonances J/ψ and ψ(3686) to the final states Ξ-Ξ+, Σ(1385) Σ(1385)± based on a single baryon tag method using data samples of (223.7±1.4)×106 J/ψ and (106.4±0.9)×106 ψ(3686) events collected with the BESIII detector at the BEPCII collider. The decay ψ(3686)→Σ(1385) Σ(1385)± is observed for the first time, and the measurements of the other processes, including the branching fractions and angular distributions, are in good agreement with, and much more precise than, the previously published results. Additionally, the ratios B(ψ(3686)→Ξ-Ξ+)B(J/ψ→Ξ-Ξ+), B(ψ(3686)→Σ(1385)-Σ(1385)+)B(J/ψ→Σ(1385)-Σ(1385)+) and B(ψ(3686)→Σ(1385)+Σ(1385)-)B(J/ψ→Σ(1385)+Σ(1385)-) are determined.

We present the first search for the rare decay of η′ into K±π in J/ψ→φη′, using a sample of 1.3×109 J/ψ events collected with the BESIII detector. No significant signal is observed, and the upper limit at the 90% confidence level for the ratio B(η′→K±π)B(η′→γπ+π-) is determined to be 1.3×10-4. In addition, we report the measurement of the branching fraction of J/ψ→φη′ to be [5.10±0.03(stat)±0.32(syst)]×10-4, which agrees with previous results from BESII.

Using a data sample of 1.31×109 J/ψ events accumulated with the BESIII detector, the decay J/ψ→ppφ is studied via two decay modes, φ→KS0KL0 and φ→K+K-. The branching fraction of J/ψ→pp φ is measured to be B(J/ψ→pp φ)=[5.23±0.06(stat)±0.33(syst)]×10-5, which agrees well with a previously published measurement, but with a significantly improved precision. No evident enhancement near the pp-mass threshold, denoted as X(pp ), is observed, and the upper limit on the branching fraction of J/ψ→X(pp )φ→pp φ is determined to be B(J/ψ→X(pp )φ→pp φ)

Based on 2.93  fb^{-1} e^{+}e^{-} collision data taken at center-of-mass energy of 3.773 GeV by the BESIII detector, we report searches for the singly Cabibbo-suppressed decays D^{+}→ωπ^{+} and D^{0}→ωπ^{0}. A double tag technique is used to measure the absolute branching fractions B(D^{+}→ωπ^{+})=(2.79±0.57±0.16)×10^{-4} and B(D^{0}→ωπ^{0})=(1.17±0.34±0.07)×10^{-4}, with statistical significances of 5.5σ and 4.1σ, where the first and second uncertainties are statistical and systematic, respectively.

By analyzing a data set of 2.92 fb$^{-1}$ of $e^+e^-$ collision data taken at$\sqrt s= 3.773~\rm GeV$ and 106.41$\times 10^{6}$ $\psi(3686)$ decays taken at$\sqrt s= 3.686~\rm GeV$ with the BESIII detector at the BEPCII collider, wemeasure the branching fraction and the partial decay width for$\psi(3770)\to\gamma\chi_{c0}$ to be ${\mathcalB}(\psi(3770)\to\gamma\chi_{c0})=(6.88\pm0.28\pm0.67)\times 10^{-3}$ and$\Gamma[\psi(3770)\to\gamma\chi_{c0}]=(187\pm8\pm19)~\rm keV$, respectively.These are the most precise measurements to date.

We report the first measurement of absolute hadronic branching fractions of Λ_{c}^{+} baryon at the Λ_{c}^{+}Λ[over ¯]_{c}^{-} production threshold, in the 30 years since the Λ_{c}^{+} discovery. In total, 12 Cabibbo-favored Λ_{c}^{+} hadronic decay modes are analyzed with a double-tag technique, based on a sample of 567  pb^{-1} of e^{+}e^{-} collisions at sqrt[s]=4.599  GeV recorded with the BESIII detector. A global least-squares fitter is utilized to improve the measured precision. Among the measurements for twelve Λ_{c}^{+} decay modes, the branching fraction for Λ_{c}^{+}→pK^{-}π^{+} is determined to be (5.84±0.27±0.23)%, where the first uncertainty is statistical and the second is systematic. In addition, the measurements of the branching fractions of the other 11 Cabibbo-favored hadronic decay modes are significantly improved.

We extract the e+e-→π+π- cross section in the energy range between 600 and 900 MeV, exploiting the method of initial state radiation. A data set with an integrated luminosity of 2.93 fb-1 taken at a center-of-mass energy of 3.773 GeV with the BESIII detector at the BEPCII collider is used. The cross section is measured with a systematic uncertainty of 0.9%. We extract the pion form factor |Fπ|2 as well as the contribution of the measured cross section to the leading-order hadronic vacuum polarization contribution to (g-2)μ. We find this value to be aμππ,LO(600-900MeV)=(368.2±2.5stat±3.3sys)10-10, which is between the corresponding values using the BaBar or KLOE data.

By analyzing a data set of 2.92 fb$^{-1}$ of $e^+e^-$ collision data taken at$\sqrt s= 3.773~\rm GeV$ and 106.41$\times 10^{6}$ $\psi(3686)$ decays taken at$\sqrt s= 3.686~\rm GeV$ with the BESIII detector at the BEPCII collider, wemeasure the branching fraction and the partial decay width for$\psi(3770)\to\gamma\chi_{c0}$ to be ${\mathcalB}(\psi(3770)\to\gamma\chi_{c0})=(6.88\pm0.28\pm0.67)\times 10^{-3}$ and$\Gamma[\psi(3770)\to\gamma\chi_{c0}]=(187\pm8\pm19)~\rm keV$, respectively.These are the most precise measurements to date.

We present a measurement of the azimuthal asymmetries of two charged pions in the inclusive process e^{+}e^{-}→ππX, based on a data set of 62  pb^{-1} at the center-of-mass energy of 3.65 GeV collected with the BESIII detector. These asymmetries can be attributed to the Collins fragmentation function. We observe a nonzero asymmetry, which increases with increasing pion momentum. As our energy scale is close to that of the existing semi-inclusive deep inelastic scattering experimental data, the measured asymmetries are important inputs for the global analysis of extracting the quark transversity distribution inside the nucleon and are valuable to explore the energy evolution of the spin-dependent fragmentation function.

Based on data samples collected with the BESIII detector operating at the BEPCII storage ring at center-of-mass energies s>4.4 GeV, the processes e+e-→ωχc1,2 are observed for the first time. With an integrated luminosity of 1074 pb-1 near s=4.42 GeV, a significant ωχc2 signal is found, and the cross section is measured to be (20.9±3.2±2.5) pb. With 567 pb-1 near s=4.6 GeV, a clear ωχc1 signal is seen, and the cross section is measured to be (9.5±2.1±1.3) pb, while evidence is found for an ωχc2 signal. The first errors are statistical, and the second are systematic. Due to low luminosity or low cross section at other energies, no significant signals are observed. In the ωχc2 cross section, an enhancement is seen around s=4.42 GeV. Fitting the cross section with a coherent sum of the ψ(4415) Breit-Wigner function and a phase-space term, the branching fraction B(ψ(4415)→ωχc2) is obtained to be of the order of 10-3.

Using 2.92 fb-1 of electron-positron annihilation data collected at s=3.773 GeV with the BESIII detector, we obtain the first measurements of the absolute branching fraction B(D+→KL0e+νe)=(4.481±0.027(stat)±0.103(sys))% and the CP asymmetry ACPD+→KL0e+νe=(-0.59±0.60(stat)±1.48(sys))%. From the D+→KL0e+νe differential decay rate distribution, the product of the hadronic form factor and the magnitude of the Cabibbo-Kobayashi-Maskawa matrix element, f+K(0)|Vcs|, is determined to be 0.728±0.006(stat)±0.011(sys). Using |Vcs| from the SM constrained fit with the measured f+K(0)|Vcs|, f+K(0)=0.748±0.007(stat)±0.012(sys) is obtained, and utilizing the unquenched Lattice QCD (LQCD) calculation for f+K(0), |Vcs|=0.975±0.008(stat)±0.015(sys)±0.025(LQCD).

Lu Lu Bai,1,2,* Jin Peng Du,1 Xu Kai Xue,1,* Ding Jun Hao,1 Wen Tao Wang1 1Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi 710054, People’s Republic of China; 2Graduate School, Xi’an Medical University, Xi’an, Shaanxi, 710021, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wen Tao WangDepartment of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Youyidong Road, Xi’an, Shaanxi 710054, People’s Republic of ChinaTel/Fax +86-29-87800002Email w15686024394@163.comBackground: Ankylosing spondylitis with Andersson lesions is not rare, but its potential pathogenesis and natural course remain unclear.Case Description: We describe a case of CT image changes in ankylosing spondylitis from fracture to Andersson lesions. A 40-year-old man with a 23-year history of ankylosing spondylitis presented with acute back pain after a slight fall, and the CT showed a T12 fracture; the patient refused surgery for 12 months. The process from fracture to Andersson lesions was characterized by CT, including the subsequent interbody bone graft with internal fixation and successful bone fusion at the last follow-up. Histopathologic analysis showed degenerative fibrocartilage tissue calcification, necrotic intervertebral disc tissue, fibrovascular hyperplasia, and focal accumulation of inflammatory cells.Conclusion: Aseptic inflammation and persistent instability caused by a fracture contributed in the course from fracture to Andersson lesions in ankylosing spondylitis. CT can accurately track the pathological process, and interbody fusion via the posterior pedicle lateral approach can achieve satisfactory effectiveness, good fusion and kyphosis correction.Keywords: ankylosing spondylitis, Andersson lesions, CT

Xiao-Kang Cheng, Bin Chen Orthopaedic Department, Chengde Medical University Affiliated Hospital, Chengde 067000, Hebei, People’s Republic of ChinaCorrespondence: Bin ChenOrthopaedic Department, Chengde Medical University Affiliated Hospital, Chengde 067000, Hebei, People’s Republic of ChinaTel +86 15633142760Email drchenbin@vip.sina.comPurpose: Percutaneous transforaminal endoscopic decompression (PTED) is an ultra-minimally invasive surgical option for patients that does not involve the same amount of destabilizing facet joint removal as a traditional laminectomy. The objective of this study was to describe the procedure of PTED under local anesthesia for geriatric patients with central spinal stenosis and degenerative lumbar spondylolisthesis (CSS-DLS).Materials and Methods: From January 2016 to December 2018, 30 consecutive geriatric patients who underwent surgery for single-level CSS-DLS were retrospectively reviewed. All patients were followed for at least 12 months (12– 24 months). The visual analog scale (VAS) scores, Oswestry disability index (ODI) scores and modified MacNab criteria were used to evaluate the clinical results.Results: The mean age was 73.1± 6.0 years. Follow-up ranged from 12 to 36 months. The mean±SD values of the preoperative VAS for leg pain and ODI were 7.4± 1.0 and 67.2± 8.4, respectively. The values improved to 2.2± 1.1 and 19.9± 8.1 at 12 months postoperatively. The outcomes of the modified MacNab criteria showed that 93.3% of patients obtained a good-to-excellent rate. The percent slippage of spondylolisthesis before surgery (13.8± 2.5%) and at the end of follow-up (14.0± 2.5%) was not significantly different.Conclusion: PTED under local anesthesia could be a useful supplement to traditional decompression in geriatric patients with CSS-DLS.Keywords: percutaneous transforaminal endoscopic decompression, degenerative lumbar spondylolisthesis, central spinal stenosis, geriatric patients

Phuc Duc Dang,1,2 Minh Hien Nguyen,1,2 Xuan Khan Mai,3,4 Dinh Dai Pham,1,2 Minh Duc Dang,1 Dang Hai Nguyen,1 Van Nam Bui,1 Duy Ton Mai,5 Nhu Binh Do,6,7 Duc Thuan Do1,2 1Department of Stroke, Military Hospital 103, Hanoi, Vietnam; 2Department of Neurology, Vietnam Military Medical University, Hanoi, Vietnam; 3Respiratory Center, Military Hospital 103, Hanoi, Vietnam; 4Department of Tuberculosis and Lung Disease, Vietnam Military Medical University, Hanoi, Vietnam; 5Emergency Department, Bach Mai Hospital, Hanoi, Vietnam; 6Division of Military Science, Military Hospital 103, Hanoi, Vietnam; 7Department of Infectious Disease, Vietnam Military Medical University, Hanoi, VietnamCorrespondence: Duc Thuan Do Tel +84 982275220Email thuandd@vmmu.edu.vnBackground: There have been many scales to predict pneumonia in stroke patients, but they are so complex, making it difficult to apply in practice. Therefore, we conducted this study to assess the role of the National Institutes of Health Stroke Scale (NIHSS) and the Gugging Swallowing Screen (GUSS) in predicting stroke-associated pneumonia (SAP). These scales are routinely used in stroke patients. Therefore, their application in predicting SAP risk will be of high value in clinical practice. There has been no previous study evaluating the effectiveness of SAP risk prediction for each of these scales.Aim: This study aimed to compare the value of NIHSS and GUSS in SAP prediction and their convenience in clinical practice.Methods: It was a cohort study. The receiver operating characteristics (ROC) curves were constructed to assess the sensitivity (Se) and specificity (Sp) of the scales. Area under the curves (AUC) were calculated, and we compared them.Results: NIHSS had a medium value of predictor of SAP with AUC 0.764 (95% CI 0.735– 0.792), 65.4% Se, 76.5% Sp. GUSS had good value in predicting SAP with AUC 0.858 (95% CI 0.833– 0.880), 80.5% Se, 80.1% Sp. Pairwise comparison of ROCs curves demonstrated that the difference between two AUCs was significant (p < 0.01). Performing GUSS required 24.5 ± 6.7 minutes, 2.5 times longer than NIHSS (9.9 ± 2.0 minutes).Conclusion: GUSS had a better predictive value of SAP than NIHSS. But NIHSS was more convenient in clinical practice because of its simple instrument and quick performance.Keywords: stroke-related pneumonia, post-stroke pneumonia, pneumonia after stroke, pneumonia prediction

Yong Wang, Xiao-Ke Wang, Pei-Pei Wu, Yi Wang, Liang-Yu Ren, Ai-Hui Xu Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Anhui Medical University, Hefei 230022, People’s Republic of ChinaCorrespondence: Ai-Hui XuDepartment of Respiratory and Critical Care Medicine, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei 230022, People’s Republic of ChinaEmail xuaihui0909@163.comIntroduction: Cigarette smoke (CS)-induced inflammation in macrophages is involved in the pathological process of chronic obstructive pulmonary disease (COPD). Necroptosis, which is a form of programmed necrosis, has a close relationship with robust inflammation, while its roles in COPD are unclear.Materials and Methods: Necroptosis markers were measured in mouse alveolar macrophages and cultured bone marrow-derived macrophages (BMDMs). Necroptosis inhibitors were used to block necroptosis in BMDMs, and inflammatory cytokines were detected. We further explored the related signaling pathways.Results: In this study, we demonstrated the way in which necroptosis, in addition to its upstream and downstream signals, regulates CS-induced inflammatory responses in macrophages. We observed that CS exposure caused a significant increase in the levels of necroptosis markers (receptor interacting kinases [RIPK] 1 and 3) in mouse alveolar macrophages and BMDMs. Pharmacological inhibition of RIPK1 or 3 caused a significant suppression in CS extract (CSE)-induced inflammatory cytokines, chemokine ligands (CXCL) 1 and 2, and interleukin (IL)-6 in BMDMs. CSE-induced necroptosis was regulated by mitochondrial reactive oxygen species (mitoROS), which also promoted inflammation in BMDMs. Furthermore, necroptosis regulated CSE-induced inflammatory responses in BMDMs, most likely through activation of the nuclear factor-κB pathway.Conclusion: Taken together, our results demonstrate that mitoROS-dependent necroptosis is essential for CS-induced inflammation in BMDMs and suggest that inhibition of necroptosis in macrophages may represent effective therapeutic approaches for COPD patients.Keywords: cigarette smoke, macrophage, necroptosis, inflammatory response, NF-κB pathway

A neutral structure in the DD[over ¯]^{*} system around the DD[over ¯]^{*} mass threshold is observed with a statistical significance greater than 10σ in the processes e^{+}e^{-}→D^{+}D^{*-}π^{0}+c.c. and e^{+}e^{-}→D^{0}D[over ¯]^{*0}π^{0}+c.c. at sqrt[s]=4.226 and 4.257 GeV in the BESIII experiment. The structure is denoted as Z_{c}(3885)^{0}. Assuming the presence of a resonance, its pole mass and width are determined to be [3885.7_{-5.7}^{+4.3}(stat)±8.4(syst)]  MeV/c^{2} and [35_{-12}^{+11}(stat)±15(syst)]  MeV, respectively. The Born cross sections are measured to be σ[e^{+}e^{-}→Z_{c}(3885)^{0}π^{0},Z_{c}(3885)^{0}→DD[over ¯]^{*}]=[77±13(stat)±17(syst)]  pb at 4.226 GeV and [47±9(stat)±10(syst)]  pb at 4.257 GeV. The ratio of decay rates B[Z_{c}(3885)^{0}→D^{+}D^{*-}+c.c.]/B[Z_{c}(3885)^{0}→D^{0}D[over ¯]^{*0}+c.c.] is determined to be 0.96±0.18(stat)±0.12(syst), consistent with no isospin violation in the process, Z_{c}(3885)^{0}→DD[over ¯]^{*}.

We study $D_{s}^{+}$ decays to final states involving the $\eta'$ with a482$\,$pb$^{-1}$ data sample collected at $\sqrt{s}$ = 4.009$\,$GeV with the\mbox{BESIII} detector at the BEPCII collider. We measure the branchingfractions $\mathcal{B}(D^+_{s}\rightarrow \eta'X)$ = (8.8$\pm$1.8$\pm$0.5)$\%$and $\mathcal{B}(D_{s}^{+}\rightarrow \eta'\rho^{+})$ = ($5.8\pm1.4\pm0.4$)$\%$where the first uncertainty is statistical and the second is systematic. Inaddition, we estimate an upper limit on the non-resonant branching ratio$\mathcal{B}(D_{s}^{+}\rightarrow \eta'\pi^+\pi^0)

We present a study of the process e+e-→π±(DD¯∗)∓ using data samples of 1092 pb-1 at s=4.23 GeV and 826 pb-1 at s=4.26 GeV collected with the BESIII detector at the BEPCII storage ring. With full reconstruction of the D meson pair and the bachelor π± in the final state, we confirm the existence of the charged structure Zc(3885)∓ in the (DD¯∗)∓ system in the two isospin processes e+e-→π+D0D∗- and e+e-→π+D-D∗0. By performing a simultaneous fit, the statistical significance of Zc(3885)∓ signal is determined to be greater than 10σ, and its pole mass and width are measured to be Mpole=(3881.7±1.6(stat)±1.6(syst)) MeV/c2 and Γpole=(26.6±2.0(stat)±2.1(syst)) MeV, respectively. The Born cross section times the (DD¯∗)∓ branching fraction (σ(e+e-→π±Zc(3885)∓)×Br(Zc(3885)∓→(DD¯∗)∓)) is measured to be (141.6±7.9(stat)±12.3(syst)) pb at s=4.23 GeV and (108.4±6.9(stat)±8.8(syst)) pb at s=4.26 GeV. The polar angular distribution of the π±-Zc(3885)∓ system is consistent with the expectation of a quantum number assignment of JP=1+ for Zc(3885)∓.

We study $D_{s}^{+}$ decays to final states involving the $\eta'$ with a482$\,$pb$^{-1}$ data sample collected at $\sqrt{s}$ = 4.009$\,$GeV with the\mbox{BESIII} detector at the BEPCII collider. We measure the branchingfractions $\mathcal{B}(D^+_{s}\rightarrow \eta'X)$ = (8.8$\pm$1.8$\pm$0.5)$\%$and $\mathcal{B}(D_{s}^{+}\rightarrow \eta'\rho^{+})$ = ($5.8\pm1.4\pm0.4$)$\%$where the first uncertainty is statistical and the second is systematic. Inaddition, we estimate an upper limit on the non-resonant branching ratio$\mathcal{B}(D_{s}^{+}\rightarrow \eta'\pi^+\pi^0)

We report a study of the process e^{+}e^{-}→(D^{*}D[over ¯]^{*})^{0}π^{0} using e^{+}e^{-} collision data samples with integrated luminosities of 1092 pb^{-1} at sqrt[s]=4.23 GeV and 826 pb^{-1} at sqrt[s]=4.26 GeV collected with the BESIII detector at the BEPCII storage ring. We observe a new neutral structure near the (D^{*}D[over ¯]^{*})^{0} mass threshold in the π^{0} recoil mass spectrum, which we denote as Z_{c}(4025)^{0}. Assuming a Breit-Wigner line shape, its pole mass and pole width are determined to be (4025.5_{-4.7}^{+2.0}±3.1) MeV/c^{2} and (23.0±6.0±1.0) MeV, respectively. The Born cross sections of e^{+}e^{-}→Z_{c}(4025)^{0}π^{0}→(D^{*}D[over ¯]^{*})^{0}π^{0} are measured to be (61.6±8.2±9.0) pb at sqrt[s]=4.23 GeV and (43.4±8.0±5.4) pb at sqrt[s]=4.26 GeV. The first uncertainties are statistical and the second are systematic.

Using the data sets taken at center-of-mass energies above 4 GeV by the BESIII detector at the BEPCII storage ring, we search for the reaction e+e-→γISRX(3872)→γISRπ+π-J/ψ via the Initial State Radiation technique. The production of a resonance with quantum numbers JPC=1++ such as the X(3872) via single photon e+e- annihilation is forbidden, but is allowed by a next-to-leading order box diagram. We do not observe a significant signal of X(3872), and therefore give an upper limit for the electronic width times the branching fraction ΓeeX(3872)B(X(3872)→π+π-J/ψ)

In an analysis of a 2.92 fb-1 data sample taken at 3.773 GeV with the BESIII detector operated at the BEPCII collider, we measure the absolute decay branching fractions B(D0→K-e+νe)=(3.505±0.014±0.033)% and B(D0→π-e+νe)=(0.295±0.004±0.003)%. From a study of the differential decay rates we obtain the products of hadronic form factor and the magnitude of the Cabibbo-Kobayashi- Maskawa (CKM) matrix element f+K(0)|Vcs|=0.7172±0.0025±0.0035 and f+π(0)|Vcd|=0.1435±0.0018±0.0009. Combining these products with the values of |Vcs(d)| from the SM constraint fit, we extract the hadronic form factors f+K(0)=0.7368±0.0026±0.0036 and f+π(0)=0.6372±0.0080±0.0044, and their ratio f+π(0)/f+K(0)=0.8649±0.0112±0.0073. These form factors and their ratio are used to test unquenched lattice QCD calculations of the form factors and a light cone sum rule (LCSR) calculation of their ratio. The measured value of f+K(π)(0)|Vcs(d)| and the lattice QCD value for f+K(π)(0) are used to extract values of the CKM matrix elements of |Vcs|=0.9601±0.0033±0.0047±0.0239 and |Vcd|=0.2155±0.0027±0.0014±0.0094, where the third errors are due to the uncertainties in lattice QCD calculations of the form factors. Using the LCSR value for f+π(0)/f+K(0), we determine the ratio |Vcd|/|Vcs|=0.238±0.004±0.002±0.011, where the third error is from the uncertainty in the LCSR normalization. In addition, we measure form factor parameters for three different theoretical models that describe the weak hadronic charged currents for these two semileptonic decays. All of these measurements are the most precise to date.

From December 2011 to May 2014, about 5 fb-1 of data were taken with the BESIII detector at center-of-mass energies between 3.810 GeV and 4.600 GeV to study the charmonium-like states and higher excited charmonium states. The time-integrated luminosity of the collected data sample is measured to a precision of 1% by analyzing events produced by the large-angle Bhabha scattering process.

© 2015 American Physical Society. Based on a sample of η′ mesons produced in the radiative decay J/ψ→γη′ in 1.31×109J/ψ events collected with the BESIII detector, the decay η′→ωe+e- is observed for the first time, with a statistical significance of 8σ. The branching fraction is measured to be B(η′→ωe+e-)=(1.97±0.34(stat)±0.17(syst))×10-4, which is in agreement with theoretical predictions. The branching fraction of η′→ωγ is also measured to be (2.55±0.03(stat)±0.16(syst))×10-2, which is the most precise measurement to date, and the relative branching fraction B(η′→ωe+e-)B(η′→ωγ) is determined to be (7.71±1.34(stat)±0.54(syst))×10-3.

We report an observation of the process J/ψ→γX(1835)→γK_{S}^{0}K_{S}^{0}η at low K_{S}^{0}K_{S}^{0} mass with a statistical significance larger than 12.9σ using a data sample of 1.31×10^{9} J/ψ events collected with the BESIII detector. In this region of phase space the K_{S}^{0}K_{S}^{0} system is dominantly produced through the f_{0}(980). By performing a partial wave analysis, we determine the spin parity of the X(1835) to be J^{PC}=0^{-+}. The mass and width of the observed X(1835) are 1844±9(stat)_{-25}^{+16}(syst)  MeV/c^{2} and 192_{-17}^{+20}(stat)_{-43}^{+62}(syst)  MeV, respectively, which are consistent with the results obtained by BESIII in the channel J/ψ→γπ^{+}π^{-}η^{'}.