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Yawan Jing,1,2 Ruixin Cheng,3 Hao Zeng,1 Qin Huang,1 Dongyu He,1 Jiayi Sun,1 Panwen Tian,1,4 Yalun Li1,4 1Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Institute of Respiratory Health and Multimorbidity, Institute of Respiratory Health, Frontiers Science Center for Disease-Related Molecular Network, Precision Medicine Center/Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Department of Gerontology and Geriatrics, Tibet Autonomous Region People’s Hospital, Lhasa, Tibet Autonomous Region, People’s Republic of China; 3Department of Radiation Oncology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510080, People’s Republic of China; 4Lung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of ChinaCorrespondence: Yalun Li; Panwen Tian, Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, No. 37 GuoXue Alley, Chengdu, Sichuan Province, 610041, People’s Republic of China, Tel/Fax +86 28 85423660, Email lunlunhx@qq.com; mrascend@163.comBackground: KRAS mutation is one of the most common driver oncogenes in non-small cell lung cancer (NSCLC), and the most common mutation subtype is G12C. However, there is still a lack of efficacy and prognosis data related to immunotherapy, which hinders the promotion of new strategies.Methods: Clinical characteristics and treatment outcomes were collected and analyzed for patients with NSCLC harboring KRAS mutations at West China Hospital of Sichuan University from June 2013 to March 2023.Results: Among the 231 patients with KRAS-mutated NSCLC, 29.4% had KRAS G12C mutations. Compared to the KRAS non-G12C NSCLC group, the KRAS G12C NSCLC group had a greater number of pack-years. The programmed death ligand 1 expression and the proportion of patients with a high tumor mutational burden were not significantly different between the two groups. Similar patterns of TP53, STK11, and CDKN2A mutations were observed between KRAS G12C and KRAS non-G12C NSCLC groups. The median progression-free survival (PFS) (8.4 vs 7.0 months, p=0.100) and overall survival (OS) (12.1 vs 18.1 months, p=0.590) were not statistically different between KRAS G12C and KRAS non-G12C. Compared to patients with KRAS G12C NSCLC who did not receive immunotherapy, patients who received immunotherapy had a better objective response rate (46.2% vs 0%, p=0.002), PFS (12.2 vs 7.5 months, p=0.087) and OS (49.9 vs 11.1 months, p=0.12).Conclusion: Patients with KRAS G12C were more likely to be smokers. Advanced KRAS G12C NSCLC patients who received immunotherapy had a better ORR than those who did not, suggesting that patients with G12C mutations are more likely to benefit from immunotherapy.Keywords: non-small cell lung cancer, KRAS G12C mutation, KRAS mutation, immunotherapy, overall survival

Minghui Wang,1,* Zhiwei Lai,1,* Hua Zhang,1,* Weiqi Yang,2 Fengping Zheng,1 Dehua He,2 Xiaofang Liu,2 Rong Zhong,2 Mulan Qahar,1,2 Guang Yang1– 3 1Division of Renal Medicine, Peking University Shenzhen Hospital, Peking University, Shenzhen, 518036, People’s Republic of China; 2Department of Burn and Plastic Surgery, Shenzhen Institute of Translational Medicine, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, People’s Republic of China; 3Department of Life Sciences, Yuncheng University, Yuncheng, 044011, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guang Yang; Mulan Qahar, Email yakoaka@foxmail.com; mulanqahar@126.comBackground: Diabetes mellitus (DM) is known to inhibit skin self-renewal and hair follicle stem cell (HFSC) activation, which may be key in the formation of chronic diabetic wounds. This study aimed to investigate the reasons behind the suppression of HFSC activation in DM mice.Methods: Type 1 DM (T1DM) was induced in 6-week-old mice via streptozotocin, and hair follicle growth was subsequently monitored. RNA sequencing, bioinformatics analyses, qRT‒PCR, immunostaining, and cellular experiments were carried out to investigate the underlying mechanisms involved.Results: T1DM inhibited HFSC activation, which correlated with an increase in caspase-dependent programmed cell death. Additionally, T1DM triggered apoptosis and pyroptosis, predominantly in HFSCs and epidermal regions, with pyroptosis being more pronounced in the inner root sheath of hair follicles. Notably, significant cutaneous immune imbalances were observed, particularly in macrophages. Cellular experiments demonstrated that M1 macrophages inhibited HaCaT cell proliferation and induced cell death, whereas high-glucose environments alone did not have the same effect.Conclusion: T1DM inhibits HFSC activation via macrophage reprogramming-mediated caspase-dependent pyroptosis, and there is a significant regional characterization of cell death. Moreover, T1DM-induced programmed cell death in the skin may be more closely related to immune homeostasis imbalance than to hyperglycemia itself. These findings shed light on the pathogenesis of diabetic ulcers and provide a theoretical basis for the use of hair follicle grafts in wound repair.Keywords: diabetes mellitus, caspases, hair follicle stem cells, chronic wounds, cutaneous immune disorder

Fuyu Zhao,1– 3,* Jianan Zhao,1– 3,* Kai Wei,1– 3 Ping Jiang,1– 3 Yiming Shi,1– 3 Cen Chang,1– 3 Yixin Zheng,1– 3 Yu Shan,1– 3 Yunshen Li,1– 3 Bingheng He,4 Mi Zhou,1,3 Jia Liu,1,3 Li Li,1,3 Shicheng Guo,1 Dongyi He1– 3 1Department of Rheumatology, Shanghai Guanghua Hospital of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 2Guanghua Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 3Institute of Arthritis Research in Integrative Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 4Department of Rehabilitation, Tongren Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Dongyi He, Shanghai Guanghua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China, Email dongyihe@medmail.com.cnAbstract: Psoriasis is a chronic inflammatory skin disease characterized by the excessive proliferation of keratinocytes and heightened immune activation. Targeting pathogenic genes through small interfering RNA (siRNA) therapy represents a promising strategy for the treatment of psoriasis. This mini-review provides a comprehensive summary of siRNA research targeting the pathogenesis of psoriasis, covering aspects such as keratinocyte function, inflammatory cell roles, preclinical animal studies, and siRNA delivery mechanisms. It details recent advancements in RNA interference that modulate key factors including keratinocyte proliferation (Fibroblast Growth Factor Receptor 2, FGFR2), apoptosis (Interferon Alpha Inducible Protein 6, G1P3), differentiation (Grainyhead Like Transcription Factor 2, GRHL2), and angiogenesis (Vascular Endothelial Growth Factor, VEGF); immune cell infiltration and inflammation (Tumor Necrosis Factor-Alpha, TNF-α; Interleukin-17, IL-17); and signaling pathways (JAK-STAT, Nuclear Factor Kappa B, NF-κB) that govern immunopathology. Despite significant advances in siRNA-targeted treatments for psoriasis, several challenges persist. Continued scientific developments promise the creation of more effective and safer siRNA medications, potentially enhancing the quality of life for psoriasis patients and revolutionizing treatments for other diseases. This article focuses on the most recent research advancements in targeting the pathogenesis of psoriasis with siRNA and explores its future therapeutic prospects.Keywords: psoriasis, siRNA, keratinocytes, targeted delivery

Dong Huang,1,* Dingxiu He,2,* Linjing Gong,1,* Wei Jiang,2,* Rong Yao,3 Zongan Liang1 1Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Department of Emergency Medicine, The People’s Hospital of Deyang, Deyang, Sichuan, People’s Republic of China; 3Department of Emergency Medicine, Emergency Medical Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zongan Liang, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, People’s Republic of China, Email liangza@scu.edu.cnBackground: There is no predictive tool developed for pneumonia-associated acute respiratory distress syndrome (ARDS) specifically so far, and the clinical risk classification of these patients is not well defined. Our study aims to construct an early prediction model for hospital mortality in patients with pneumonia-associated ARDS.Methods: In this single-center retrospective study, consecutive patients with pneumonia-associated ARDS admitted into intensive care units (ICUs) in West China Hospital of Sichuan University in China between January 2012 and December 2018 were enrolled. The least absolute shrinkage and selection operator (LASSO) regression and then multivariate logistic regression analysis were used to identify independent predictors which were used to develop a nomogram. We evaluated the performance of differentiation, calibration, and clinical utility of the nomogram.Results: The included patients were divided into the training cohort (442 patients) and the testing cohort (190 patients) with comparable baseline characteristics. The independent predictors for hospital mortality included age (OR: 1.04; 95% CI: 1.02, 1.05), chronic cardiovascular diseases (OR: 2.62; 95% CI: 1.54, 4.45), chronic respiratory diseases (OR: 1.87; 95% CI: 1.02, 3.43), lymphocytes (OR: 0.56; 95% CI: 0.39, 0.81), albumin (OR: 0.94; 95% CI: 0.90, 1.00), creatinine (OR: 1.00; 95% CI: 1.00, 1.01), D-dimer (OR: 1.06; 95% CI: 1.03, 1.09) and procalcitonin (OR: 1.14; 95% CI: 1.07, 1.22). A web-based dynamic nomogram (https://h1234.shinyapps.io/dynnomapp/) was constructed based on these factors. The concordance index (C index) of the nomogram was 0.798 (95% CI: 0.756, 0.840) in the training cohort and 0.808 (95% CI: 0.747, 0.870) in testing cohort. The precision–recall (PR) curves, calibration curves, decision curve analyses (DCA) and clinical impact curves showed that the nomogram has good predictive value and clinical utility.Conclusion: We developed and evaluated a convenient nomogram consisting of 8 clinical characteristics for predicting mortality in patients with pneumonia-associated ARDS.Keywords: pneumonia, acute respiratory distress syndrome, mortality, risk factors, nomogram

Yonglin Mu, Dawei He Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of ChinaCorrespondence: Dawei He, Department of Urology, Children’s Hospital of Chongqing Medical University, No. 136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, People’s Republic of China, Tel +86 18680856616, Email hedawei@hospital.cqmu.edu.cnAbstract: ChatGPT, an AI-driven conversational large language model (LLM), has garnered significant scholarly attention since its inception, owing to its manifold applications in the realm of medical science. This study primarily examines the merits, limitations, anticipated developments, and practical applications of ChatGPT in clinical practice, healthcare, medical education, and medical research. It underscores the necessity for further research and development to enhance its performance and deployment. Moreover, future research avenues encompass ongoing enhancements and standardization of ChatGPT, mitigating its limitations, and exploring its integration and applicability in translational and personalized medicine. Reflecting the narrative nature of this review, a focused literature search was performed to identify relevant publications on ChatGPT’s use in medicine. This process was aimed at gathering a broad spectrum of insights to provide a comprehensive overview of the current state and future prospects of ChatGPT in the medical domain. The objective is to aid healthcare professionals in understanding the groundbreaking advancements associated with the latest artificial intelligence tools, while also acknowledging the opportunities and challenges presented by ChatGPT.Keywords: ChatGPT, clinical practice, healthcare, medical education, medical research, challenges

Jie Li,1,* Dejiao He,2,* Yajun Bi,3,* Shengxuan Liu4 1Department of Thyroid and Breast Surgery, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, 518067, People’s Republic of China; 2Department of Nephrology, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China; 3Department of Pediatrics, Dalian Municipal Women and Children’s Medical Center (Group), Dalian Medical University, Dalian, Liaoning Province, 116011, People’s Republic of China; 4Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shengxuan Liu, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, People’s Republic of China, Tel +86 133 8756 1016, Email tongjishengxuanl@163.comAbstract: Breast cancer remains the leading malignancy in terms of morbidity and mortality today. The tumor microenvironment of breast cancer includes multiple cell types, secreted proteins, and signaling components such as exosomes. Among these, exosomes have a lipid bilayer structure. Exosomes can reflect the biological traits of the parent cell and carry a variety of biologically active components, including proteins, lipids, small molecules, and non-coding RNAs, which include miRNA, lncRNA, and circRNA. MiRNAs are a group of non-coding RNAs of approximately 20– 23 nucleotides in length encoded by the genome, triggering silencing and functional repression of target genes. MiRNAs have been shown to play a significant role in the development of cancer owing to their role in the prognosis, pathogenesis, diagnosis, and treatment of cancer. MiRNAs in exosomes can serve as effective mediators of information transfer from parental cells to recipient cells and trigger changes in biological traits such as proliferation, invasion, migration, and drug resistance. These changes can profoundly alter the progression of breast cancer. Therefore, here, we systematically summarize the association of exosomal miRNAs on breast cancer progression, diagnosis, and treatment in the hope of providing novel strategies and directions for subsequent breast cancer treatment.Keywords: breast cancer, tumor microenvironment, exosome, miRNAs, detection, therapy

Dongye He,1,2,* Hailing Sun,1 Mei Zhang,1,3 Yanying Li,1,3 Fupeng Liu,1,2 Yanhong Zhang,1,3 Mingming He,1 Bo Ban1– 3,* 1Department of Endocrinology, Genetics and Metabolism, Affiliated Hospital of Jining Medical University, Jining, 272029, People’s Republic of China; 2Medical Research Center, Affiliated Hospital of Jining Medical University, Jining, 272029, People’s Republic of China; 3Chinese Research Center for Behavior Medicine in Growth and Development, Jining, 272029, People’s Republic of China*These authors contributed equally to this workCorrespondence: Dongye He; Bo Ban, Department of Endocrinology, Genetics and Metabolism, Affiliated Hospital of Jining Medical University, Jining, 272029, People’s Republic of China, Tel/Fax +86 0537 2903579, Email hehe0917@mail.jnmc.edu.cn; banbo2011@163.comPurpose: Genetic factors account for a large proportion of idiopathic hypogonadotropic hypogonadism (IHH) etiologies, although not necessarily a complete genetic basis. This study aimed to characterize the clinical presentations, genetic variants, and therapeutic outcomes of patients with sporadic IHH, which may be helpful for genetic counseling and treatment decisions.Patients and Methods: Eleven Chinese patients with IHH were retrospectively analyzed. Rare genetic variants were evaluated using whole-exome sequencing and bioinformatics analysis and were further classified according to the ACMG-AMP guidelines. The therapeutic responses of patients were further evaluated.Results: Six heterozygous variants of SOX10, WDR11, PROKR2, CHD7 and FGF17 were detected in five Kallmann syndrome (KS) patients, whereas two heterozygous variants of CHD7 and PROKR2 were detected in two normosmic IHH (nIHH) patients. Among these variants, a novel likely pathogenic variant in the SOX10 (c.429– 1G>C) was considered to cause the KS phenotype in patient 02, and two potential variants of uncertain significance (VUS) in CHD7 (c.3344G>A and c.7391A>G) possibly contributed to the KS phenotype in patient 05 and the nIHH phenotype in patient 07, which need to be confirmed by further evidence. Additionally, long-term testosterone or estradiol replacement treatment effectively improved the development of sexual characteristics in patients with IHH.Conclusion: Next-generation sequencing is a powerful tool for identifying the molecular etiology and early diagnosis of IHH. Efficient therapeutic outcomes strongly indicate a need for timely treatment.Keywords: Kallmann syndrome, normosmic idiopathic hypogonadotropic hypogonadism, luteinizing hormone, follicle-stimulating hormone, genetic variant, hormone treatment

Dan He,1,* Qiao Yu,2,* Xiaona Zeng,2,* Jihua Feng,2 Ruiqi Yang,2 Huan Wan,2 Ying Zhong,2 Yanli Yang,2 Ruzhi Zhao,2 Junyu Lu,3,4 Jianfeng Zhang1,2,4 1Department of General Practice, The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530007, People’s Republic of China; 2Department of Emergency Medicine, The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530007, People’s Republic of China; 3Intensive Care Unit, The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530007, People’s Republic of China; 4Guangxi Health Commission Key Laboratory of Emergency and Critical Medicine, Nanning, 530007, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jianfeng Zhang, Junyu Lu, The Second Affiliated Hospital of Guangxi Medical University, No. 166 Daxuedong Road, Nanning, Guangxi, 530007, People’s Republic of China, Tel +86 7713277166, Fax +86 7713277285, Email zhangjianfeng@gxmu.edu.cn; junyulu@gxmu.edu.cnBackground: Acute respiratory distress syndrome (ARDS) is caused by severe pulmonary inflammation and the leading cause of death in the intensive care unit.Methods: We used single-cell RNA sequencing to compare peripheral blood mononuclear cells from sepsis-induced ARDS (SEP-ARDS) and pneumonic ARDS (PNE-ARDS) patient. Then, we used the GSE152978 and GSE152979 datasets to identify molecular dysregulation mechanisms at the transcriptional level in ARDS.Results: Markedly increased CD14 cells were the predominant immune cell type observed in SEP-ARDS and PNE-ARDS patients. Cytotoxic cells and natural killer (NK) T cells were exclusively identified in patients with PNE-ARDS. An enrichment analysis of differentially expressed genes (DEGs) suggested that Th1 cell differentiation and Th2 cell differentiation were enriched in cytotoxic cells, and that the IL-17 signaling pathway, NOD receptor signaling pathway, and complement and coagulation cascades were enriched in CD14 cells. Furthermore, according to GSE152978 and GSE152979, 1939 DEGs were identified in patients with ARDS and controls; they were mainly enriched in the Kyoto Encyclopedia of Genes and Genomes pathways. RBP7 had the highest area under the curve values among the 12 hub genes and was mainly expressed in CD14 cells. Additionally, hub genes were negatively correlated with NK cells and positively correlated with neutrophils, cytotoxic cells, B cells, and macrophages.Conclusion: A severe imbalance in the proportion of immune cells and immune dysfunction were observed in SEP-ARDS and PNE-ARDS patients. RBP7 may be immunologically associated with CD14 cells and serve as a potential marker of ARDS.Keywords: acute respiratory distress syndrome, single-cell RNA sequencing, biomarker, immune disorders, differentially expressed genes

Jinhui Li,1– 3 Dexian He,1– 3 Wei Zhang,1– 3 Ruiwang Huang,1– 3 Xianyou He1– 3 1Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Guangzhou, People’s Republic of China; 2School of Psychology; Center for Studies of Psychological Application, Guangzhou, People’s Republic of China; 3Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People’s Republic of ChinaCorrespondence: Xianyou He, Email xianyouhe@163.comPurpose: Evaluating face attractiveness is a core aspect of face perception, which plays an important role in impression formation. A more reliable source of information in impression formation is moral behavior, which forms the primary basis for the comprehensive evaluation of others. Previous studies have found that one can easily form an association when faces and moral behaviors are presented together, which in turn affects facial attractiveness evaluation. However, little is known of the extent to which these learned associations affect facial attractiveness and whether the influence of moral behavior on facial attractiveness was related to facial appearance.Methods: We used the associative learning paradigm and manipulated face presentation duration (Experiment 1 and Experiment 2) and response deadline (Experiment 2) to investigate these issues. Under these conditions, the association information was difficult to be retrieved. Participants learned associations between faces and scenes of moral behavior, and then evaluated facial attractiveness.Results: We found that both moral behavior and facial appearance influence facial attractiveness under conditions where associated information was difficult to retrieve, and their effects increased with the increase of face presentation time. With increasing response deadlines, the effect of moral behavior on facial attractiveness increased. The influence of moral behavior on facial attractiveness was associated with facial appearance.Conclusion: These results suggest that moral behavior continuously affects facial attractiveness. Our findings expand previous research by showing a robust influence of moral behavior on facial attractiveness evaluation, and highlight the important role of moral character in impression formation.Keywords: facial appearance, moral behavior, learning, facial attractiveness

Hui Wu, Tao Li, Jian Cao, Dingwen He, Tianlong Wu, Jiahao Liu, Jinghong Yuan, Xigao Cheng Department of Orthopaedic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of ChinaCorrespondence: Xigao Cheng, Department of Orthopaedics Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China, 330006, Email xigaocheng@hotmail.comObjective: This study aims to compare the efficacy of percutaneous endoscopic lumbar discectomy (PELD) in treating adolescent posterior ring apophysis fracture (APRAF) accompanied by lumbar disc herniation (LDH) and lumbar disc herniation alone.Methods: Herein we present a case series of adolescent patients who underwent PELD surgery from June 2017 to September 2021. All patients were divided into two distinct groups (ie Group A and B), based on their preoperative Computed tomography (CT) scans. Group A included patients with PRAF (type III) accompanied by LDH. Group B patients had LDH alone. The general clinical characteristics, clinical outcomes, and complications in patients from the two groups were assessed and compared.Results: Compared to before surgery, the back and leg visual analog scores (VAS) and Oswestry Disability Index (ODI) were markedly improved in both groups’ patients at all follow-ups. Notably, no significant differences were observed in the back and leg VAS scores, and ODI values between the two groups at different time points after surgery. The mean intraoperative blood loss was significantly lower in Group B, relative to Group A. The mean operation time was significantly shorter in Group B, compared to Group A. There was no statistically significant difference in complication and recurrence rates between the two groups.Conclusion: APRAF (type III) accompanied by LDH and LDH alone can obtain roughly equal surgical effects through PELD surgery and turns out to be a safe and effective surgical approach.Keywords: adolescent, posterior ring apophysis fracture, percutaneous endoscopic lumbar discectomy, lumbar disc herniation

In this study, aluminum matrix composites reinforced with micro-TiN were fabricated using selective laser melting (SLM) technique. The study investigates the effects of TiN content on densification, microstructure evolution, crystal textures, and mechanical properties. The results show that the relative density of composite samples containing 0–3 wt. % TiN exceeds 98%. However, further increase in TiN content leads to a decrease in relative density. The TiN particles are uniformly distributed and wetted by the AlSi10Mg matrix, forming a graded interfacial layer. The TiN particles refine the matrix grains and significantly reduce the prevalence (001) texture by promoting a heterogeneous nucleation process. In comparison to the AlSi10Mg alloy, the TiN/AlSi10Mg composite exhibits improved microhardness, tensile strength, and wear resistance. The exceptional mechanical properties of the Al matrix composites are attributed to the dispersion strengthening of the TiN particles and the fine-grain strengthening of the matrix. The optimal TiN content is found to be 3 wt. %, resulting in excellent mechanical performance of the fabricated samples (132.4±4.1 HV for hardness and 379.7±4.6 MPa for tensile strength) with a low friction coefficient of 0.49.

Jun Li,1,* Di He,1,* Jiazhou Yu,2,* Shuohua Chen,3 Qiong Wu,1 Zongxue Cheng,1 Qiaohui Wei,1 Yuying Xu,1 Yimin Zhu,1,4 Shouling Wu3 1Department of Epidemiology & Biostatistics and Department of Respiratory Diseases of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 2Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China; 3Department of Cardiology, Kailuan General Hospital, Tangshan, People’s Republic of China; 4Cancer Center, Zhejiang University, Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shouling Wu, Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Road, Tangshan, People’s Republic of China, Email drwusl@163.com Yimin Zhu, Department of Respiratory Diseases, Sir Run Run Shaw Hospital Affiliated to School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310020, People’s Republic of China, Email zhuym@zju.edu.cnBackground: Two novel systemic inflammation indices, SII and SIRI, are associated with increased risk of cardiovascular diseases (CVD). However, SII and SIRI are prone to change over time and the association between changeable status and long-term outcome risk remains to be uncovered. This study aims to examine the association between the dynamic status of SII and SIRI and risk of CVD.Methods: This prospective study included a total of 45,809 subjects without MI, stroke and cancer prior to or in 2010 (baseline of this study). The dynamic status of SII and SIRI during 2006, 2008, and 2010 was assessed by dynamic trajectories (primary exposure), annual increase, and average value. The outcome was CVD incidence during 8.6 years’ follow-up. Multiple Cox regression models were used to calculate the adjusted hazard ratios (HRs) and confidence intervals (95% CIs).Results: Four dynamic trajectories of SII and SIRI were identified as follows: low stable pattern, moderate stable pattern, increase pattern, and decrease pattern. For SII, compared with “low stable pattern”, after controlling confounders and level of SII in 2006, adjusted HRs were 1.24 (95% CI = 1.02– 1.51) for “increase pattern” and 1.11 (95% CI = 1.00– 1.23) for “moderate-stable pattern” while the association was not significant for “decrease pattern”. Additionally, the highest group of annual SII increase and average SII had respective HR of 1.20 (95% CI = 1.05– 1.37) and 1.32 (95% CI = 1.13– 1.55). The results were consistent for SIRI. “Increase pattern” and “moderate stable pattern” increased the risk of CVD by 38% (HR = 1.38, 95% CI = 1.17– 1.63) and 12% (HR = 1.12, 95% CI = 1.01– 1.25), while no significant association was found for “decrease pattern”. The highest group of annual SIRI increase and average SIRI had respective HR of 1.25 (95% CI = 1.09– 1.44) and 1.39 (95% CI = 1.19– 1.63).Conclusion: Dynamic status of SII and SIRI was significantly associated with risk of CVD, which highlighted that we should focus on the dynamic change of SII and SIRI.Keywords: systemic inflammation, dynamic status, prospective study, cardiovascular diseases

Xue Huang,1,* Yukun Zhang,1,* Du He,1 Lin Lai,1 Jun Chen,1 Tao Zhang,2 Huilin Mao2 1Department of Medical Oncology, Enshi Tujia and Miao Autonomous Prefecture Central Hospital, Enshi, 445000, People’s Republic of China; 2Department of Pediatric Surgery, Enshi Tujia and Miao Autonomous Prefecture Central Hospital, Enshi, 445000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Tao Zhang, Department of Pediatric Surgery, Enshi Tujia and Miao Autonomous Prefecture Central Hospital, No. 158 Wuyang Avenue, Enshi, People’s Republic of China, Email taozhang870214@163.com Huilin Mao, Enshi Tujia, and Miao Autonomous Prefecture, Enshi, Hubei Province, 445000, People’s Republic of China, Email maohuilin2022@163.comPurpose: Although many factors determine the prognosis of papillary thyroid carcinoma (PTC), cervical lymph node metastasis (CLNM) is one of the most terrible factors. In view of this, this study aimed to build a CLNM prediction model for papillary thyroid microcarcinoma (PTMC) with the help of machine learning algorithm.Methods: We retrospectively analyzed 387 PTMC patients hospitalized in the Department of Medical Oncology, Enshi Tujia and Miao Autonomous Prefecture Central Hospital from January 1, 2015, to January 31, 2022. Based on supervised learning algorithms, namely random forest classifier (RFC), artificial neural network(ANN), support vector machine(SVM), decision tree(DT), and extreme gradient boosting gradient(XGboost) algorithm, the LNM prediction model was constructed, and the prediction efficiency of ML-based model was evaluated via receiver operating characteristic curve(ROC) and decision curve analysis(DCA).Results: Finally, a total of 24 baseline variables were included in the supervised learning algorithm. According to the iterative analysis results, the pulsatility index(PI), resistance index(RI), peak systolic blood flow velocity(PSBV), systolic acceleration time(SAT), and shear wave elastography elastic index(SWEEI), such as average value(Emean), maximum value(Emax), and minimum value(Emix) were candidate predictors. Among the five supervised learning models, RFC had the strongest prediction efficiency with area under curve(AUC) of 0.889 (95% CI: 0.838– 0.940) and 0.878 (95% CI: 0.821– 0.935) in the training set and testing set, respectively. While ANN, DT, SVM and XGboost had prediction efficiency between 0.767 (95% CI: 0.716– 0.818) and 0.854 (95% CI: 0.803– 0.905) in the training set, and ranged from 0.762 (95% CI: 0.705– 0.819) to 0.861 (95% CI: 0.804– 0.918) in the testing set.Conclusion: We have successfully constructed an ML-based prediction model, which can accurately classify the LNM risk of patients with PTMC. In particular, the RFC model can help tailor clinical decisions of treatment and surveillance.Keywords: papillary thyroid microcarcinoma, cervical lymph node metastasis, shear wave elastography elastic index, machine learning algorithm, prediction model

Hui Wu, Shen Hu, Jiahao Liu, Dingwen He, Qi Chen, Xigao Cheng Department of Orthopaedics, the Second Affiliated Hospital of Nanchang University, Nanchang city, Jiangxi Province, 330006, People’s Republic of ChinaCorrespondence: Xigao Cheng, Department of Orthopaedics, the Second Affiliated Hospital of Nanchang University, Nanchang city, Jiangxi Province, 330006, People’s Republic of China, Email xigaocheng@hotmail.comObjective: To investigate the risk factors involved in the early and medium-term poor outcomes of percutaneous endoscopic transforaminal discectomy (PETD) treatment of lumbar disc herniation (LDH) at the L4-5 level.Methods: Between January 2015 and May 2020, we recruited 148 LDH patients at the L4-5 level who underwent PETD surgery. The patients were divided into Groups A and B, according to the surgical outcomes. Good and excellent outcomes were categorized into Group A, and generally good and poor outcomes were categorized into Group B. Clinical parameters (age, gender, symptom duration, hospital stay, operation time, blood loss, straight-leg raising (SLR), visual analog scale (VAS), Oswestry Disability Index (ODI) score and modified MacNab criteria) and radiologic parameters (foraminal height (FH), intervertebral height index (IHI), intervertebral angle (IVA), sagittal range of motion (sROM), and lumbar lordosis (LL)) were collected and analyzed using univariate and multiple logistic regression analyses.Results: At the 6-month follow-up post operation, univariate analysis revealed that the symptom duration, SLR, IHI, and sROM were strongly associated with poor outcomes. However, multiple logistic regression analysis demonstrated that prolonged symptom duration, large SLR angel, and large sROM were independent risk factors for poor outcomes. At the 2-year follow-up post operation, univariate analysis suggested that advanced age, prolonged symptom duration, large preoperative VAS score, small FH, small IHI, and large sROM were potential risk factors for poor outcomes. However, multiple logistic regression analysis demonstrated that prolonged symptom duration, small IHI, and large sROM were independent risk factors for poor outcomes.Conclusion: Our study demonstrated that prolonged symptom duration, large SLR angel, and large sROM were independent risk factors for poor outcomes immediately following PETD at the L4-5 level. However, prolonged symptom duration, small IHI, and large sROM were independent risk factors for poor outcomes at medium-term post PETD at the L4-5 level.Keywords: percutaneous endoscopic transforaminal discectomy, risk factors, lumbar disc herniation, early and medium-term, surgical outcomes

There has been increasing attention to virtual real- ity applications in recent years, especially to immersive or 360-degree videos that typically consume much more bandwidth than traditional ones. Though all produced data is transferred, only a small part (denoted as Field of View or viewport) is watched by users due to the nature of immersive videos. Obviously, this causes a large waste of network resources. Hence, it is important to define a viewport-dependent streaming transmission strategy by detecting where the user is gazing and the movement of the user’s head. Unfortunately, there are few datasets providing this information. In this paper, we propose a tile-based simulation approach to generate the distribution of the user’s behavior and to provide information that can be used to optimize future view-dependent streaming protocols. We first characterize the users’ viewport pattern from datasets gathered from real users by decomposing the 360-degree stream into tiles and analyzing the frequency and time-interval distribution for each tile. Then, we devise a hierarchical Markov model that incorporates the beta distribution of each tile time interval to predict tile transition. The results show that the simulation tool characterizes the tile sequences of users accurately, performing close to the empirical results.

Li Qin,1 Lin Lai,2 Hongli Wang,3 Yukun Zhang,2 Xiaoyuan Qian4 *, Du He2 &#x002A1Department of Obstetrics and Gynecology, the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, 445000, People’s Republic of China; 2Department of Oncology, the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, 445000, People’s Republic of China; 3Department of Pathology, the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, 445000, People’s Republic of China; 4Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430079, People’s Republic of China*These authors contributed equally to this workCorrespondence: Du He, Department of Oncology, the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, 445000, People’s Republic of China, Email hdu1234@163.comPurpose: Deep myometrial invasion (DMI) is an independent high-risk factor for lymph node metastasis and a prognostic risk factor in early-stage endometrial cancer (EC-I) patients. Thus, we developed a machine learning (ML) assistant model, which can accurately help define the surgical area.Methods: 348 consecutive EC-I patients with the pathological diagnosis were recruited in the tertiary medical centre between January 1, 2012, and October 31, 2021. Five ML-assisted models were developed using two-step estimation methods from the candidate gray level co-occurrence matrix (GLCM). Receiver operating characteristic curve (ROC), decision curve analysis (DCA), and clinical impact curve (CIC) were prepared to evaluate the robustness and clinical practicality of each model.Results: Our analysis identified several significant differences between the stage IA and IB groups. The top seven-candidate factors included correlation all direction offset1, correlation angle0 offset1, correlation angle45 offset1, correlation angle90 offset1, ID moment all direction offset1, ID moment angle0 offset1, and ID moment angle45 offset1. The areas under the ROC curve (AUCs) of the random forest classifier (RFC) model, support vector machine (SVM), eXtreme gradient boosting (XGBoost), artificial neural network (ANN), and decision tree (DT) ranged from 0.765 to 0.877 in the training set and from 0.716 to 0.862 in the testing set, respectively. Among the five machine algorithms, RFC obtained the optimal prediction efficiency using correlation angle0 offset1, correlation angle45 offset1, correlation angle90 offset1, correlation all direction offset1, ID moment angle0 offset1, and ID moment angle45 offset1, and ID moment angle90 offset1, respectively.Conclusion: Our ML-based prediction model combined with GLCM parameters assessed the risk of DMI in EC-I patients, especially RFC, which helped distinguish stage IA and IB EC patients. This new predictive model based on supervised learning can be used to establish personalized treatment strategies.Keywords: endometrial cancer, myometrial invasion, gray level co-occurrence matrix, machine learning, prediction

Dan He,1 Wan Dan,1 Qing Du,1 Bing-Bing Shen,1 Lin Chen,1 Liang-zi Fang,1 Jian-Jun Kuang,1 Chun-yu Tang,2 Ping Cai,1 Rong Yu,1,3 Shui-han Zhang,1 Jian-hua Huang1,3 1Hunan Academy of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, 410013, People’s Republic of China; 2Hunan Times Sunshine Pharmaceutical Co., Ltd., Changsha, Hunan, 425007, People’s Republic of China; 3Hunan Key Laboratory of TCM Prescription and Syndromes Translational Medicine Hunan, Changsha, Hunan, 410208, People’s Republic of ChinaCorrespondence: Shui-han Zhang; Jian-hua Huang, Hunan Academy of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, 410013, People’s Republic of China, Tel +86 13637400650 ; +86 18692265317, Email zhangshuihan0220@126.com; huangjianhua1985@163.comPurpose: This study aimed to reveal the multicomponent synergy mechanisms of SWP based on network pharmacology and metabolomics for exploring the relationships of active ingredients, biological targets, and crucial metabolic pathways.Materials: Network pharmacology, including TRRUST, GO, and KEGG, enrichment was used to discover the active ingredients and potential regulation mechanisms of SWP. LC-MS and multivariate data analysis method were further applied to analyze serum metabolomics profiling for discovering the potential metabolic mechanisms of SWP on AA induced by Cyclophosphamide (CTX) and 1-Acetyl-2-phenylhydrazine (APH).Results: A total of 27 important bioactive ingredients meeting the ADME (absorption, distribution, metabolism, and excretion) screening criteria from SWP were selected. Interaction networks were constructed and validated based on the 10 associated ingredients with the relevant targets. A total of 125 biomarkers were found by Metabolomics approach, which associated with the development of AA, mainly involved in amino acid metabolism and lipid metabolism. While SWP can reverse the above 12 metabolites changed by AA. Network analysis revealed the synergistic effects of SWP through the 43 crucial pathways, including Sphingolipid signaling pathway, Sphingolipid metabolism, Arginine and proline metabolism, VEGF signaling pathway, Estrogen signaling pathway.Conclusion: The study suggested that SWP is a useful alternative for the treatment of AA induced by CTX + APH. Its potential mechanisms are to improve hematopoietic microenvironment and promote bone marrow hematopoiesis therapies.Keywords: aplastic anemia, Siwu Paste, network pharmacology, metabolomics, integration analysis

The negative impact of excessive fertilization on the sustainable development of agriculture has become the focus of universal attention. Thus, the aim is to maximize the yield of rice without imposing too much damage on the environment. This paper uses data regression analysis based on the statistical data (from 1990 to 2020) of a certain region to explore the impact of fertilizer application on rice yield, and adopts the sensitivity analysis to study the sensitivity of rice yield to the applied amount of chemical fertilizer. The results show that the average rice yield increased with increasing Nitrogen (N) and potassium (K) fertilizers application within the statistical data range; while the average rice yield decreased as Phosphorus (P) fertilizer application increased. Simultaneously, increasing the application of N and K fertilizers improved the average rice yield. Reducing the amount of P fertilizer and increasing the proportion of K fertilizer positively affected the average rice yield. The sensitivity analysis indicated that the average rice yield was most sensitive to K application amount. The sensitivity value maximized at a small amount of N fertilizer (11.25 kg hm-2) and a large amount of P fertilizer (6 kg hm-2). The findings reveal the interactive effect of multiple fertilizer application rates on grain yield and address the unclear mechanism of single fertilizer application on grain yield in the existing research. This paper provides a theoretical basis for scientific fertilizer use, agricultural quality, efficiency improvement, and sustainable development of agriculture. [ABSTRACT FROM AUTHOR]

1. Melanin distribution typically exhibits a gradient dilution along the dorsal-ventral axis of the body, including in domestic geese. However, the specific genes and molecular mechanisms responsible for this melanin distribution pattern remain incompletely understood. 2. The transcriptomic comparisons were conducted at three embryonic stages, specifically on embryonic d 15 (E15), 22 (E22), and 29 (E29), between the pigmented dorsal skin and the depigmented distal foot. 3. Differentially expressed genes (DEGs) associated with melanin synthesis were identified, particularly TYR, TYRP1, and EDNRB2, which exhibited significantly higher expression levels in the dorsal skin at E15 and E22. However, expression levels significantly decreased in later stages (E29). 4. The ASIP gene showed remarkably high-expression levels in the distal feet compared to the dorsal skin post-E22 stage (log2FC: 5.31/6.88 at E22/E29). Gene Ontology (GO) enrichment analysis detected eight terms associated with melanin synthesis and melanosome formation (p < 0.05), including melanosome membrane (GO: 0033162) and melanin biosynthetic process (GO: 0042438). Additionally, KEGG pathway analysis showed significant enrichment of the melanogenesis pathway (hsa004916) at d 22 (E22). [ABSTRACT FROM AUTHOR]

In this research, the characteristics of nickel-titanium (NiTi) powders produced by electrode induction melting inert gas atomization (EIGA) technique for additive manufacturing (AM) technology are investigated using various powder characterization technologies. The results show that the particle size distribution (PSD) of pre-alloyed NiTi powders prepared by EIGA has the range of 10 μm to 180 μm. The mean particle size distribution (D50) of the powder is 75 μm. The oxygen increase of the powder is only 0.005% compared to the raw rod. According to the requirements of the characteristics of the metal powder material used for AM, the powders are sieved into three categories, P1 (15-63 μm), P2 (63-150 μm), and P3 (>150 μm), respectively. The flow rates of P1 and P2 are 19.3 and 17.5 s·(50 g)-1, respectively. The surface, crosssectional microstructure, phase structure, and martensitic transformation temperature of the pre-alloyed NiTi powders with different particle sizes are investigated. The results show that powders of different particle sizes are primarily spherical or nearly spherical. The grain size of powders reduces with the decreasing of particle size. Both the bar stock and the powders of P1, P2, and P3 mainly exhibit the B2 phase. Comparing the powders P1, P2, and P3, the transformation temperature reduces with the decrease of particle size. A high density (99.55%) pre-alloyed NiTi specimen is successfully produced by selective laser melting (SLM) technology using P1 powders. The results indicate that the pre-alloyed NiTi alloy powder is appropriate for AM, which also has a good reference value for researchers producing AM powders.

Lei Yang,1,&ast; Dingxiu He,2,&ast; Dong Huang,1,&ast; Zhongwei Zhang,3 Zongan Liang1 1Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Department of Emergency Medicine, The People’s Hospital of Deyang, Deyang, Sichuan, People’s Republic of China; 3Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zongan Liang Tel +8618980601259Email liangza@scu.edu.cnPurpose: Risk factors and prognostic model of fatal outcomes need to be investigated for the increasing number of immunocompromised hosts (ICHs) who are hospitalized for severe pneumonia with high hospital mortality.Patients and Methods: In this single-center, retrospective study, we recruited 1,933 ICHs with severe pneumonia who were admitted to the intensive care unit (ICU) in West China hospital, Sichuan university, China between January, 2012 and December, 2018. Clinical features, laboratory findings, and fatal outcomes were collected from electronic medical records. Patients were randomly separated into a 70% training set (n=1,353) and a 30% testing set (n=580) for the development and validation of a prediction model. All data within 24 hours of ICU admission were compared between survivors and non-survivors. The risk factors were identified through LASSO and multivariate logistic regression analysis, and then used to develop a predicting nomogram. The nomogram for predicting hospital mortality of ICHs with severe pneumonia in the ICU was validated by C-index, AUC (area under the curve), calibration curve, and Decision Curve Analysis (DCA).Results: Eight risk factors, including age, fever, dyspnea, chronic renal disease, platelet counts, neutrophil counts, PaO2/FiO2 ratio, and the requirement for vasopressors, were adopted in a nomogram for predicting hospital mortality. The nomogram had great predicting accuracy with a C-index of 0.819 (95% CI=0.795– 0.842) in the training set, and a C-index of 0.819 (95% CI=0.783– 0.855) in the testing set for hospital mortality. Additionally, the nomogram had well-fitted calibration curves. DCA demonstrated that the nomogram was clinically beneficial.Conclusion: This study developed a novel nomogram for predicting hospital mortality of ICHs with severe pneumonia in the ICU. Validation showed good discriminatory ability and calibration, indicating that the nomogram was expected to be a superior predictive tool for doctors to identify risk factors and predict mortality, and might be generally applied in clinical practice after more external validations.Keywords: immunocompromised, severe pneumonia, ICU, risk factors, nomogram

Augmented Reality and Virtual Reality are rapidly gaining attention and are increasingly being deployed over the network. These technologies have large industrial potential to become next big platform with a wide range of applications. This experience will only be satisfying when the network infrastructure is able to support these applications. Current networks however, are still having a hard time streaming high quality videos. The advent of 5G Networks will improve the network performance, but it is unclear it will be sufficient to provide new applications delivering augmented reality and virtual reality services. There are few surveys on the topic of augmented reality systems, and their focus mostly stays on the actual displays and potential applications. We survey the literature on AR/VR networking, and we focus here on the potential underlying network issues.

Danhua Guo,1 Deqin He,1 Qingmei Shen,1 Na Lin,1 Shuqiong He,1 Yifang Dai,1 Ying Li,1 Liangpu Xu,1 Xiaoqing Wu1,2 1Medical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Hospital, Affiliated Hospital of Fujian Medical University, Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, People’s Republic of China; 2Department of Laboratory Medicine, Fujian Medical University, Fuzhou, 350002, Fujian, People’s Republic of ChinaCorrespondence: Liangpu Xu; Xiaoqing WuMedical Genetic Diagnosis and Therapy Center of Fujian Provincial Maternity and Child Hospital, Affiliated Hospital of Fujian Medical University, Fujian Provincial Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou City, Fujian Province, 350001, People’s Republic of ChinaEmail xiliangpu@fjmu.edu.cn; wuxiaoqing013@126.comObjective: This retrospective study aimed to systematically evaluate the genetic disorders, cytomegalovirus (CMV) infection, extra ultrasound findings and outcomes of fetuses with bilateral ventriculomegaly (BVM).Methods: Data from pregnancies with fetal BVM were obtained between 2014 and 2020. The cases were divided into groups of isolated bilateral ventriculomegaly (IBVM) and non-isolated bilateral ventriculomegaly (NIBVM) according to the presence of extra prenatal imaging. Subgroups of mild, moderate, and severe were determined according to lateral ventricle widths. The NIBVM group was further classified into pregnancies with soft markers, non-structural abnormalities, and structural abnormalities.Results: A total of 353 pregnancies were enrolled, including 153 cases of IBVM and 200 cases of NIBVM. Conventional karyotyping was performed on 192 samples, and 15 cases of numerical abnormalities and 3 cases of unbalanced structural abnormalities were identified. Chromosomal microarray analysis (CMA) was concurrently performed on 108 of them and revealed additional 5 cases (4.7%) of copy number variants with clinical significance. CMV DNA testing was performed on 154 of the 192 cases that underwent invasive prenatal diagnosis, and a positive result was found in 2 (1.3%) cases. In the IBVM group, the percentage of favorable prognosis in the mild, moderate and severe pregnancies were 94.4%, 79.2%, and 4.8%, respectively, and the termination of pregnancy (TOP) rates were 4.6%, 20.8%, and 85.7%, respectively. In both the mild and moderate NIBVM, the TOP rates progressively increased and the favorable prognosis survival rates progressively decreased relative to the soft markers, non-structural abnormalities, and structural abnormalities, respectively. Approximately 94.1% of severe NIBVM ended in termination.Conclusion: Genetic disorders and fetal infection are important etiology of BVM. CMA is highly recommended for genetic disorders’ evaluation. Pregnancies with severe BVM always ended in TOP, while in mild-to-moderate NIBVM, prenatal imaging by ultrasound and/or MRI plays important roles in the pregnancy outcomes.Keywords: bilateral ventriculomegaly, genetic disorders, cytomegalovirus infection, prenatal imaging

Menglin Zhu,1,&ast; Bo Wang,2,&ast; Tiejun Wang,3 Yilin Chen,1,4 Du He1,5 1Department of Anesthesiology, Hubei Minzu University Affiliated Enshi Clinical Medical School, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, 445000, People’s Republic of China; 2National Clinical Research Center for Obstetrical and Gynecological Diseases; Key Laboratory of Cancer Invasion and Metastasis, Ministry of Education; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China; 3Department of Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 4Department of Pulmonary and Critical Care Medicine, Hubei Minzu University Affiliated Enshi Clinical Medical School, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, 445000, People’s Republic of China; 5Department of Oncology, Hubei Minzu University Affiliated Enshi Clinical Medical School, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, 445000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Du He; Yilin Chen Email hdu1234@163.com; chenyl891128@163.comObjective: Pulmonary metastasis (PM) is an independent risk factor affecting the prognosis of cervical patients, but it still lacks a prediction. This study aimed to develop machine learning-based predictive models for PM.Methods: A total of 22,766 patients diagnosed with or without PM from the Surveillance, Epidemiology, and End Results (SEER) database were enrolled in this study. The cohort was randomly split into a train set (70%) and a validation set (30%). In addition, 884 Chinese patients from two tertiary medical centers were included as an external validation set. Duplicated and useless candidate variables were excluded, and sixteen variables were included for the machine learning algorithm. We developed five predictive models, including the generalized linear model (GLM), random forest model (RFM), naive Bayesian model (NBM), artificial neural networks model (ANNM), and decision tree model (DTM). The predictive performance of these models was evaluated by the receiver operating characteristic (ROC) curve and calibration curve. The Cox proportional hazard model (CPHM) and competing risk model (CRM) were also included for survival outcome prediction.Results: Of the patients included in the analysis, 2456 (4.38%) patients were diagnosed with PM. Age, organ-site metastasis (liver, bone, brain), distant lymph metastasis, tumor size, and pathology were the important predictors of PM. The RFM with 9 variables introduced was identified as the best predictive model for PM (AUC = 0.972, 95% CI: 0.958– 0.986). The C-index for the CPHM and CRM was 0.626 (95% CI: 0.604– 0.648) and 0.611 (95% CI: 0.586– 0.636), respectively.Conclusion: The prediction algorithm derived by machine-learning-based methods shows a robust ability to predict PM. This result suggests that machine learning techniques have the potential to improve the development and validation of predictive modeling in cervical patients with PM.Keywords: cervical cancer, pulmonary metastasis, machine learning, predictive model, prognosis, SEER database

Di He,1,2,&ast; Yuanyi Qian,1,2,&ast; Limei Zhou,3 Haozhao Qi,1,2 Yanming Liu1,2 1Department of Oral and Maxillofacial Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, People’s Republic of China; 2Clinical Research Center for Oral Diseases of Zhejiang Province, Hangzhou, 310020, People’s Republic of China; 3Hangzhou Dental Hospital, Hangzhou, 310002, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yanming LiuDepartment of Oral and Maxillofacial Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Shangcheng District, Hangzhou, Zhejiang, People’s Republic of ChinaTel/Fax +86571-87783741Email liuyanming@zju.edu.cnPurpose: Odontogenic deep fascial space infection in the head and neck is a common potentially fatal clinical problem. Traditional drainage method is considered laborious and gravity-dependent. In this study, we aimed to evaluate the clinical effect of a modified multifunctional irrigation-assisted vacuum drainage (MIVD) by comparing it with the traditional drainage method in the treatment of odontogenic deep fascial infection.Patients and Methods: Patients diagnosed with odontogenic deep fascial space infection in the Second Affiliated Hospital, Zhejiang University School of Medicine, China between March 2018 and March 2021 were studied. We divided the patients into two groups based on the drainage method they received: patients with the MIVD device were included in the MIVD group, patients with traditional drainage were included in the traditional group. Data were collected retrospectively including baseline characteristics and treatment outcome variables.Results: A total of 65 patients were included. All the patients were eventually cured. There were no significant differences in age, gender, diabetes, end stage renal disease, autoimmune diseases, other systemic diseases, tobacco use, number of the infected spaces, preoperative white blood cell count and C-reactive protein between the two groups. The number and frequency of manual irrigation by clinicians (MIC), time required for white blood cell count to return to normal levels (TWBC), time required for C-reactive protein to return to normal levels (TCRP), the length of hospitalization and the length and total cost of antibiotics use were significantly less in the MIVD group. There was no significant difference in the cost of hospitalization between the 2 groups.Conclusion: The MIVD device significantly reduced the number and frequency of MIC, TWBC, TCRP, the length of hospitalization and the length and total cost of antibiotics use in comparison with the traditional drainage method. It provided a favorable treatment method for patients with odontogenic deep fascial space infection in the head and neck.Keywords: deep fascial space infection, odontogenic infection, irrigation, vacuum drainage, head and neck