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Abstract Objective The management of length-unstable femoral shaft fractures(LUFSFs) in pediatric patients is still controversial. This study aims to explore the clinical efficacy of ultrasound-guided closed reduction combined with external fixation for treating LUFSFs in children. Methods We conducted a retrospective analysis of clinical data from 19 pediatric patients with LUFSFs who underwent ultrasound-guided closed reduction and external fixation between January 2018 and January 2023. Ultrasound was employed not only to facilitate closed reduction of the fracture but also to guide real-time insertion of Schanz pins and monitor pin length as it traversed the opposite cortex. Surgical time, intraoperative fluoroscopy count, hospital stay length, fracture fixation duration, complication incidence, fracture reduction quality at the final follow-up were recorded. Results The patients’ average age was 7.5 years( range: 5 to 11 years). The mean surgical duration was 70.4 min (range: 48–105 min), and the average intraoperative fluoroscopy count was 6.5 (range: 2–16). Fracture fixation lasted an average of 10.9 weeks (range: 7–20 weeks). All patients were followed up for more than one year. 6 cases of superficial pin tract infection occurred, which resolved with oral antibiotics and enhanced needle tract care. No deep infections were observed. Temporary stiffness of the knee joint was observed in 2 patients. According to Flynn’s efficacy evaluation system, fracture reduction quality at the final follow-up was rated as excellent in 11 cases and satisfactory in 8 cases, yielding a combined success rate of 100% (19/19). Conclusions The technique of ultrasound-guided closed reduction combined with external fixation offers favorable outcomes for children aged 5 to 11 years with LUFSFs, reducing reliance on fluoroscopic guidance.

Abstract The E‐proteinoid 3 receptor (PTGER3), a member of the prostaglandin E2 (PGE2) subtype receptor, belongs to the G‐protein‐coupled superfamily of receptors. Animal studies have demonstrated its involvement in salt sensitivity by regulating sodium reabsorption. This study aimed to investigate the association between genetic variants of PTGER3 and salt sensitivity, longitudinal blood pressure (BP) changes, and the incidence of hypertension in Chinese adults. A chronic salt intake intervention was conducted involving 514 adults from 124 families in the 2004 Baoji Salt‐Sensitivity Study Cohort in northern China. These participants followed a 3‐day regular baseline diet, followed by a 7‐day low‐salt diet (3.0 g/d) and a 7‐day high‐salt diet (18 g/d), and were subsequently followed for 14 years. The findings revealed a significant relationship between the single nucleotide polymorphism (SNP) rs17482751 of PTGER3 and diastolic blood pressure (DBP) response to high salt intervention. Additionally, SNPs rs11209733, rs3765894, and rs2268062 were significantly associated with longitudinal changes in systolic blood pressure (SBP), DBP, and mean arterial pressure (MAP) during the 14‐year follow‐up period. SNP rs6424414 was significantly associated with longitudinal changes in DBP over 14 years. Finally, SNP rs17482751 showed a significant correlation with the incidence of hypertension over 14 years. These results emphasize the significant role of PTGER3 gene polymorphism in salt sensitivity, longitudinal BP changes, and the development of hypertension in the Chinese population.

Abstract When conducting spine-related diagnosis and surgery, the three-dimensional (3D) upright posture of the spine under natural weight bearing is of significant clinical value for physicians to analyze the force on the spine. However, existing medical imaging technologies cannot meet current requirements of medical service. On the one hand, the mainstream 3D volumetric imaging modalities (e.g. CT and MRI) require patients to lie down during the imaging process. On the other hand, the imaging modalities conducted in an upright posture (e.g. radiograph) can only realize 2D projections, which lose the valid information of spinal anatomy and curvature. Developments of deep learning-based 3D reconstruction methods bring potential to overcome the limitations of the existing medical imaging technologies. To deal with the limitations of current medical imaging technologies as is described above, in this paper, we propose a novel deep learning framework, ReVerteR, which can realize automatic 3D Reconstruction of Vertebrae from orthogonal bi-planar Radiographs. With the utilization of self-attention mechanism and specially designed loss function combining Dice, Hausdorff, Focal, and MSE, ReVerteR can alleviate the sample-imbalance problem during the reconstruction process and realize the fusion of the centroid annotation and the focused vertebra. Furthermore, aiming at automatic and customized 3D spinal reconstruction in real-world scenarios, we extend ReVerteR to a clinical deployment-oriented framework, and develop an interactive interface with all functions in the framework integrated so as to enhance human–computer interaction during clinical decision-making. Extensive experiments and visualization conducted on our constructed datasets based on two benchmark datasets of spinal CT, VerSe 2019 and VerSe 2020, demonstrate the effectiveness of our proposed ReVerteR. In this paper, we propose an automatic 3D reconstruction method of vertebrae based on orthogonal bi-planar radiographs. With the 3D upright posture of the spine under natural weight bearing effectively constructed, our proposed method is expected to better support doctors make clinical decision during spine-related diagnosis and surgery.

Abstract Research into mRNA vaccines is advancing rapidly, with proven efficacy against coronavirus disease 2019 and promising therapeutic potential against a variety of solid tumors. Adjuvants, critical components of mRNA vaccines, significantly enhance vaccine effectiveness and are integral to numerous mRNA vaccine formulations. However, the development and selection of adjuvant platforms are still in their nascent stages, and the mechanisms of many adjuvants remain poorly understood. Additionally, the immunostimulatory capabilities of certain novel drug delivery systems (DDS) challenge the traditional definition of adjuvants, suggesting that a revision of this concept is necessary. This review offers a comprehensive exploration of the mechanisms and applications of adjuvants and self-adjuvant DDS. It thoroughly addresses existing issues mentioned above and details three main challenges of immune-related adverse event, unclear mechanisms, and unsatisfactory outcomes in old age group in the design and practical application of cancer mRNA vaccine adjuvants. Ultimately, this review proposes three optimization strategies which consists of exploring the mechanisms of adjuvant, optimizing DDS, and improving route of administration to improve effectiveness and application of adjuvants and self-adjuvant DDS.

Abstract Recent studies have shifted the spotlight from adult disease to gametogenesis and embryo developmental events, and these are greatly affected by various environmental chemicals, such as drugs, metabolites, pollutants, and others. Growing research has highlighted the critical importance of identifying and understanding the roles of chemicals in reproductive biology. However, the functions and mechanisms of chemicals in reproductive processes remain incomplete. We developed a comprehensive database called the Reproductive Chemical Database (RCDB) ( https://yu.life.sjtu.edu.cn/ChenLab/RCDB ) to facilitate research on chemicals in reproductive biology. This resource is founded on rigorous manual literature extraction and precise protein target prediction methodologies. This database focuses on the delineation of chemicals associated with phenotypes, diseases, or endpoints intricately associated with four important reproductive processes: female and male gamete generation, fertilization, and embryo development in human and mouse. The RCDB encompasses 93 sub-GO processes, and it revealed 1447 intricate chemical–biological process interactions. To date, the RCDB has meticulously cataloged and annotated 830 distinct chemicals, while also predicting 614 target proteins from a selection of 3800 potential candidates. Additionally, the RCDB offers an online predictive tool that empowers researchers to ascertain whether specific chemicals play discernible functional roles in these reproductive processes. The RCDB is an exhaustive, cross-platform, manually curated database, which provides a user-friendly interface to search, browse, and use reproductive processes modulators and their comprehensive related information. The RCDB will help researchers to understand the whole reproductive process and related diseases and it has the potential to promote reproduction research in the pharmacological and pathophysiological areas. Graphical Abstract

Taking advantage of fact that the surface electrons of metallic nanoparticles (NPs) can be effectively released even at a low voltage bias, we demonstrate an improvement in the electrochemical performance of nanosized Prussian Blue (PB)-based secondary batteries through the incorporation of bare Ag or Ni NPs in the vicinity of the working PB NPs. It is found that the capacity for electrochemical energy storage of the 17 nm PB-based battery is significantly higher than the capacity of 10 nm PB-based, 35 nm PB-based or 46 nm PB-based batteries. There is a critical PB size for the highest electrochemical energy storage efficiency. The full specific capacity CF of the 17 nm PB-based battery stabilized to 62 mAh/g after 130 charge–discharge cycles at a working current of IW = 0.03 mA. The addition of 14 mass percent of Ag NPs in the vicinity of the PB NPs gave rise to a 32% increase in the stabilized CF. A 42% increase in the stabilized CF could be obtained with the addition of 14 mass percent of Ag NPs on the working electrode of the 35 nm PB-based battery. An enhancement in CF was also found for electrodes incorporating bare Ni NPs but the effect was smaller.

Abstract Background Accurate preoperative identification of ovarian tumour subtypes is imperative for patients as it enables physicians to custom-tailor precise and individualized management strategies. So, we have developed an ultrasound (US)-based multiclass prediction algorithm for differentiating between benign, borderline, and malignant ovarian tumours. Methods We randomised data from 849 patients with ovarian tumours into training and testing sets in a ratio of 8:2. The regions of interest on the US images were segmented and handcrafted radiomics features were extracted and screened. We applied the one-versus-rest method in multiclass classification. We inputted the best features into machine learning (ML) models and constructed a radiomic signature (Rad_Sig). US images of the maximum trimmed ovarian tumour sections were inputted into a pre-trained convolutional neural network (CNN) model. After internal enhancement and complex algorithms, each sample’s predicted probability, known as the deep transfer learning signature (DTL_Sig), was generated. Clinical baseline data were analysed. Statistically significant clinical parameters and US semantic features in the training set were used to construct clinical signatures (Clinic_Sig). The prediction results of Rad_Sig, DTL_Sig, and Clinic_Sig for each sample were fused as new feature sets, to build the combined model, namely, the deep learning radiomic signature (DLR_Sig). We used the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) to estimate the performance of the multiclass classification model. Results The training set included 440 benign, 44 borderline, and 196 malignant ovarian tumours. The testing set included 109 benign, 11 borderline, and 49 malignant ovarian tumours. DLR_Sig three-class prediction model had the best overall and class-specific classification performance, with micro- and macro-average AUC of 0.90 and 0.84, respectively, on the testing set. Categories of identification AUC were 0.84, 0.85, and 0.83 for benign, borderline, and malignant ovarian tumours, respectively. In the confusion matrix, the classifier models of Clinic_Sig and Rad_Sig could not recognise borderline ovarian tumours. However, the proportions of borderline and malignant ovarian tumours identified by DLR_Sig were the highest at 54.55% and 63.27%, respectively. Conclusions The three-class prediction model of US-based DLR_Sig can discriminate between benign, borderline, and malignant ovarian tumours. Therefore, it may guide clinicians in determining the differential management of patients with ovarian tumours.

The automated diagnosis of lumbar spondylolisthesis lacks standardized criteria and the diagnostic of lumbar spondylolisthesis itself inherently relies on the subjective judgment of experts, resulting in a lack of standardized criteria. The objective of this study is to develop a novel, fully automated diagnostic system for lumbar spondylolisthesis. A two-stage system was developed, consisting of a Mask R-CNN with Prime Sample Attention (PISA) for vertebral segmentation in the first stage and a Light Gradient Boosting Machine (LGBM) for spondylolisthesis diagnosis in the second stage. The training data was developed by a total of 936 X-ray images including neutral, extension, and flexion lateral radiographs retrospectively gathered from 312 patients diagnosed with lumbar spondylolisthesis between January 2021 and March 2022. From a model perspective, there were a total of 4680 vertebrae, of which 1056 (22.6 %) were spondylolisthesis and the rest were normal. The Bbox mAP50, Bbox mAP75, Segm mAP50, and Segm mAP75 of Mask R-CNN with PISA were 0.9852, 0.9179, 0.9741, and 0.8957, respectively. The Accuracy, AUC, Recall, Precision, and F1-score of LGBM were 0.9660, 0.9843, 0.9020, 0.9020, and 0.9020, respectively. This study presents a robust system for the diagnosis of lumbar spondylolisthesis, providing accurate detection, classification, and localization of lumbar spondylolisthesis.

Large quantities of waste wood with residual resin adhesives are not recycled efficiently. To address this issue, waste wood with residual resin adhesives was synthesized into carbon dots (CDs) via a facile hydrothermal self-assembly method to enhance the H2 evolution performance of graphite C3N4 (g-C3N4), a metal-free photocatalyst. Among all samples, the most significant enhanced sample was MCN-UF-3.5, which has an H2 evolution of 22.1 mmol·g-1·h-1, which is 3.91 times that of unmodified g-C3N4. The band gap and recombination of photogenerated charges were both improved by the doping of CDs. Meanwhile, the DFT calculation showed that adding CDs, especially with the -NH2 group, can significantly deform the structure and destroy the symmetry. This consequence implies an enhancement in the activity of the hydrogen evolution reaction, confirming the feasibility of the modification.

PurposeQuantitative computed tomography (CT) analysis is an important method for diagnosis and severity evaluation of lung diseases. However, the association between CT-derived biomarkers and chronic obstructive pulmonary disease (COPD) exacerbations remains unclear. We aimed to investigate its potential in predicting COPD exacerbations.MethodsPatients with COPD were consecutively enrolled, and their data were analyzed in this retrospective study. Body composition and thoracic abnormalities were analyzed from chest CT scans. Logistic regression analysis was performed to identify independent risk factors of exacerbation. Based on 2-year follow-up data, the deep learning system (DLS) was developed to predict future exacerbations. Receiver operating characteristic (ROC) curve analysis was conducted to assess the diagnostic performance. Finally, the survival analysis was performed to further evaluate the potential of the DLS in risk stratification.ResultsA total of 1,150 eligible patients were included and followed up for 2 years. Multivariate analysis revealed that CT-derived high affected lung volume/total lung capacity (ALV/TLC) ratio, high visceral adipose tissue area (VAT), and low pectoralis muscle cross-sectional area (CSA) were independent risk factors causing COPD exacerbations. The DLS outperformed exacerbation history and the BMI, airflow obstruction, dyspnea, and exercise capacity (BODE) index, with an area under the ROC (AUC) value of 0.88 (95%CI, 0.82–0.92) in the internal cohort and 0.86 (95%CI, 0.81–0.89) in the external cohort. The DeLong test revealed significance between this system and conventional scores in the test cohorts (p

In environmental psychology literature, an individual's perception of the surroundings leads to subsequent behaviors. In this regard, small-scale sport events (SSE) have been used as a marketing tool for tourism development. However, how SSEs are leveraged to improve destination image (DI) for tourists has not been fully understood. Building on Mehrabian-Russell's environmental psychology model, this study examined the relationship between the SSE environmental stimuli and revisit intentions through the sequential mediation of cognitive and affective DI. Data from the 423 respondents were collected from 2023 Wuxi Marathon held in Wuxi, China. Structural equation modeling was employed to analyze the hypothesized framework. The results indicated that the SSE environmental stimuli were positively associated with both cognitive and affective DI, which were positively correlated with revisit intentions. The applicability of the serial mediation of cognitive and affective DI within the relationship was confirmed. This study contributes to the sport and tourism literature by extending the applicability of Mehrabian and Russell's model to SSE settings and identifying the serial mediating effects of cognitive and affective DI.

The sand fixing shelter forests in the Horqin Sandy Land are a key area in the “3-North” Shelter Forest Program in China, which has a history of over 50 years of artificial afforestation. Populus simonii Carr is one of the most dominant silvicultural species in the region. The aim of this study is to understand the soil characteristics and soil fertility of Populus simonii shelter forests at different growth stages and to establish a scientific basis for soil nutrient regulation and sustainable management of Populus simonii shelter forests at the southern edge of the Horqin Sandy Land. Sample plots were selected for young (≤15 a), middle-aged (16–25 a), near-mature (26–30 a), mature (31–40 a), and over-mature (≥41 a) forests. Each forest studied was in a state of natural restoration with uniform stand conditions and no artificial fertilizer was applied. These sites were selected to study changes in the soil characteristics in soil depths of 0–20, 20–40, and 40–60 cm. In order to avoid the problem of multicollinearity between soil variables and to reduce redundancy, principal component analysis (PCA), Pearson’s correlation analysis, and Norm value calculation were used to select the least correlated indicators with the highest factor loadings. This was used to establish the minimum data set. The soil fertility quality of these shelterbelts in different forest ages was quantified using the soil quality index (SQI). In the growth stage from young to nearly mature forests, the soil bulk weight and pH decreased with increasing forest age. Soil capillary porosity, noncapillary porosity, total porosity, water content, field water holding capacity, and organic carbon content increased with increasing forest age and soil nutrient content gradually improved. At the stage of near-mature to over-mature forests, the effect of forest age on soil bulk density was not significant and all other soil characteristics decreased to varying degrees as the forest age increased. The soil also developed from alkaline to neutral. The SQI of the total data set and the SQI of the minimum data set consistently showed that near-mature forests (NMF) > middle-aged forests (MAF) > mature forests (MF) > over-mature forests (OMF) > young forests (YF). The results of the two evaluation systems showed a significant positive correlation (P < 0.05, R 2 = 0.8263) indicating that it is feasible to use the minimum data set to evaluate the soil fertility of shelter forests of different forest ages. The age of the forest has an obvious effect on the soil characteristics and overall soil fertility of shelter forests. The Populus simonii shelter forests on the southern edge of the Horqin Sandy Land have great soil development at the early stage of afforestation and the soil nutrient content gradually increases. The soil fertility reaches a peak when the forest is nearly mature and the soil fertility declines after the age of the forest reaches 30 years.

Abstract Three‐dimensional (3D) echocardiography is an emerging technique for assessing right ventricular (RV) volume and function, but 3D‐RV normal values from a large Chinese population are still lacking. The aim of the present study was to establish normal values of 3D‐RV volume and function in healthy Chinese volunteers. A total of 1117 Han Chinese volunteers from 28 laboratories in 20 provinces of China were enrolled, and 3D‐RV images of 747 volunteers with optimal image quality were ultimately analyzed by a core laboratory. Both vendor‐dependent and vendor‐independent software platforms were used to analyze the 3D‐RV images. We found that men had larger RV volumes than women did in the whole population, even after indexing to body surface area, and older individuals had smaller RV volumes. The normal RV volume was significantly smaller than that recommended by the American Society of Echocardiography/European Association of Cardiovascular Imaging guidelines in both sexes. There were significant differences in 3D‐RV measurements between the two vendor ultrasound systems and the different software platforms. The echocardiographic measurements in normal Chinese adults II study revealed normal 3D‐RV volume and function in a large Chinese population, and there were significant differences between the sexes, ages, races, and vendor groups. Thus, normal 3D‐RV values should be stratified by sex, age, race, and vendor.

Background: Trigeminal neuralgia (TN) secondary to a dural arteriovenous fistula (DAVF) is quite rare, and the goal of treatment is to resolve both the fistula and the pain. Case presentation: We herein report a case of TN secondary to a DAVF in a 64-year-old woman with a 1-year history of right-sided TN. Brain magnetic resonance imaging and digital subtraction angiography showed a right tentorial DAVF. Interventional embolization was performed, but the pain was not relieved after the operation. Six months later, we performed microvascular decompression of the trigeminal nerve. During the operation, we electrocoagulated the tortuous and dilated malformed vein, which was compressing the trigeminal nerve, to reduce its diameter and mitigate the compression on the cisternal segment of the trigeminal nerve. That patient's pain was relieved postoperatively. In addition, we reviewed the literature of TN caused by DAVF and found a total of 30 cases, 22 of which were treated by interventional embolization. Of these 22 cases, the interventional embolization healed the fistula with pain relief in 14 cases and healed the fistula without pain relief in 8 cases. We found that the venous drainage methods of the 8 cases were all classified into the posterior mesencephalic group. Conclusions: We believe that this drainage pattern contributes to the more common occurrence of unrelieved pain. For such patients, microvascular decompression can be performed with intraoperative coagulation to narrow the dilated veins until the cisternal segment of the trigeminal nerve is no longer compressed. Satisfactory curative effects can be obtained using this technique.

Abstract Pulmonary thromboembolism caused by thrombi blocking major pulmonary artery and its branches, is a frequently encountered phenomenon and an important cause of high morbidity and mortality in lung diseases and may develop into persistent pulmonary hypertension (PH). Nuclear factor‐κB (NF‐κB) signaling pathway had been reported participated in the formation and development of PH by promoting inflammatory response. The aim of this study was to investigate the effects of NF‐κB activation on the serum levels of tumor necrosis factor α (TNF‐α) and interleukin‐1β (IL‐1β) in acute pulmonary microthromboembolism (APMTE) rats. Rats were randomized into five groups. APMTE group received jugular vein injection of autologous thrombus, while control group rats received normal saline injection. Pulmonary hemodynamic parameters were measured through ECHO‐guided transthoracic puncture. Pulmonary vascular morphological changes were analyzed by HE. The expression changes of NF‐κB and serum TNF‐α、IL‐1β levels were detected by enzyme‐linked immunosorbent assay. Protein expression of the MAPK/NF‐κB signaling pathway including p‐IκBα, p‐p38 MAPK, p‐NF‐κB p65, IκBα, p38 MAPK, and NF‐κB p65 was determined using western blot analysis. Compared with control group, the expression of NF‐κB in lung tissue and the levels of serum TNF‐α and IL‐1β rats were higher, a significant reduction in IκBα and elevation in the phosphorylation of IκBα, p38 MAPK, and NF‐κB p65 were found in APMTE group rats. And UK administration reversed the APMTE‐induced increase in TNF‐α, IL‐1β, p‐IκBα, p‐MAPK, and p‐NF‐κB protein. Furthermore, the levels of NF‐κB, TNF‐α, and IL‐1β were positively correlated with mean pulmonary artery. And the levels of TNF‐α and IL‐1β were positively correlated with NF‐κB. These findings suggest that the activation of MAPK/NF‐κB pathway as a critical driver of increasing TNF‐α and IL‐1β level in APMTE rats and UK exerted protective effects against APMTE‐induced PH may be related to the downregulation of the MAPK/NF‐κB signaling pathway.

Epigenomic imbalance drives abnormal transcriptional processes, promoting the onset and progression of cancer. Although defective gene regulation generally affects carcinogenesis and tumor suppression networks, tumor immunogenicity and immune cells involved in antitumor responses may also be affected by epigenomic changes, which may have significant implications for the development and application of epigenetic therapy, cancer immunotherapy, and their combinations. Herein, we focus on the impact of epigenetic regulation on tumor immune cell function and the role of key abnormal epigenetic processes, DNA methylation, histone post-translational modification, and chromatin structure in tumor immunogenicity, and introduce these epigenetic research methods. We emphasize the value of small-molecule inhibitors of epigenetic modulators in enhancing antitumor immune responses and discuss the challenges of developing treatment plans that combine epigenetic therapy and immunotherapy through the complex interaction between cancer epigenetics and cancer immunology.

The parameters identification of the diode model under reference condition are crucial and have significant impact on output characteristics estimation of photovoltaic (PV) module under varying operating conditions. The traditional methods of extracting model parameters have always focused on solving the parameter optimization problem only under some certain condition, which neglects their effect of performance estimation under other operating condition. In this paper, a novel method is proposed to identify the reference physical parameters and enhance the accuracy of electrical property estimation for PV modules under varying operating conditions. New objective function with penalty function is constructed by considering the estimated performance not only under reference condition but also under multiple real operating conditions. The maximum permissible error (MPE) is proposed to constrain the accuracy for key electrical output indicators and added in penalty function to ensure the accuracy under reference condition. Taking into account the inequality constraints, the guaranteed convergence particle swarm optimization with penalty function (P-GCPSO) is introduced for parameter identification. A set of comparisons between the measured and calculated results of PV modules indicate that the proposed method substantially more accurate than other documented methods for both single and double diode model. For the six different materials tested, the root mean square error (RMSE) was compared. The RMSE of the single-diode model is reduced by at least 57.98% compared to the compared method, with a maximum reduction of 86.57%. Similarly, the RMSE of the double -diode model was reduced by at least 47.24% with a maximum reduction of 88.71% compared to the compared methods. Additionally, the tests with six different types of PV modules at varying environmental conditions for over one year prove that the proposed method is reliable and practical for real-world applications. The relative error of power generation reached a minimum of 2.20%. This proves the reliability and practicability of the proposed method in practical applications. The proposed method is envisaged to be valuable for both offline analysis and online monitoring applications where an accurate, fast and consistent performance estimation tool is required.

Abstract Background Macrophages and neutrophils are rapidly recruited around Schistosome eggs to form granulomas. Extracellular traps (ETs) of macrophages and neutrophils are part of the pathogen clearance armamentarium of leukocytes. Schistosome eggs possess the ability to resist attack by the host’s immune cells and survive by employing various immune evasion mechanisms, including the release of extracellular vesicles (EVs). However, the specific mechanisms by which Schistosome egg-derived EVs (E-EVs) evade the immune response and resist attack from macrophage and neutrophil ETs remain poorly understood. In this study, we aimed to investigate the association between E-EVs and macrophage/neutrophil ETs. Methods EVs were isolated from the culture supernatant of S. japonicum eggs and treated macrophages and neutrophils with E-EVs and Sja-miR-71a. The formation of ETs was then observed. Additionally, we infected mice with S. japonicum, administered HBAAV2/9-Sja-miR-71a, and the formation of macrophage ETs (METs) and neutrophil ETs (NETs) in the livers was measured. Sema4D-knockout mice, RNA sequencing, and trans-well assay were used to clarify Sja-miR-71a in E-EVs inhibits METs and NETs formation via the Sema4D/ PPAR-γ/ IL-10 axis. Results Our findings revealed that E-EVs were internalized by macrophages and neutrophils, leading to the inhibition of METs and NETs formation. The highly expressed Sja-miR-71a in E-EVs targeted Sema4D, resulting in the up-regulation of IL-10 and subsequent inhibition of METs and NETs formation. Sema4D knockout up-regulated IL-10 expression and inhibited the formation of METs and NETs. Furthermore, we further demonstrated that Sja-miR-71a inhibits METs and NETs formation via the Sema4D/ PPAR-γ/ IL-10 axis. Conclusions In summary, our findings provide new insights into the immune evasion abilities of Schistosome eggs by demonstrating their ability to inhibit the formation of METs and NETs through the secretion of EVs. This study enhances our understanding of the host-pathogen interaction and may have implications for the development of novel therapeutic approaches. Video Abstract

Objective: The aim of this study was to analyze the ultrasound and MRI features of eight patients with cervical large-cell neuroendocrine carcinoma to improve awareness of this disease among sonographers, radiologists, and clinicians. Methods: Clinical data for eight patients with cervical large-cell neuroendocrine carcinoma confirmed by pathology at Sun Yat-sen Memorial Hospital of Sun Yat-sen University between February 2018 and April 2021 were retrospectively analyzed according to clinical, conventional ultrasound, contrast-enhanced ultrasound, and MRI characteristics. Results: Conventional ultrasound examination of the cervical large-cell neuroendocrine carcinoma lesions in the eight patients revealed two features: (1) irregular hypoechoic areas in the muscular layer, with slightly hyperechoic inlay streaks, and poorly delineated lesions, and (2) slightly abundant blood flow distribution in the lesions. The contrast-enhanced ultrasound showed a “fast-in and fast-out” mode; after subsidence, a “fence-like” change was observed, and the enhancement range was significantly greater than the range of two-dimensional ultrasound. In MRI, T1WI showed a low signal or isosignal; T2WI showed a high signal; DWI showed a high signal and low ADC value; and most of the enhanced MRI showed inhomogeneous hyperenhancement. Conclusion: Conventional ultrasound, contrast-enhanced ultrasound and MRI are complementary methods that provide additional imaging information for the diagnosis of cervical large-cell neuroendocrine carcinoma.

A circular non-touch mode capacitive pressure sensor can operate in both transverse and normal uniform loading modes, but the elastic behavior of its movable electrode plate is different under the two different loading modes, making its input–output analytical relationships between pressure and capacitance different. This suggests that when such a sensor operates, respectively, in transverse and normal uniform loading modes, the theory of its numerical design and calibration is different, in other words, the theory for the transverse uniform loading mode (available in the literature) cannot be used as the theory for the normal uniform loading mode (not yet available in the literature). In this paper, a circular non-touch mode capacitive pressure sensor operating in normal uniform loading mode is considered. The elastic behavior of the movable electrode plate of the sensor under normal uniform loading is analytically solved with the improved governing equations, and the improved analytical solution obtained can be used to mathematically describe the movable electrode plate with larger elastic deflections, in comparison with the existing two analytical solutions in the literature. This provides a larger technical space for developing the circular non-touch mode capacitive pressure sensors used for measuring the static gas pressure (belonging to normal uniform loading).

BackgroundAtrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with a high risk of stroke. This study was designed to investigate the relationship between hemodynamic parameters and left atrial thrombus/spontaneous echo contrast (LAT/SEC) in non-valvular atrial fibrillation (NVAF) patients and establish a predictive nomogram that integrates hemodynamic parameters with clinical predictors to predict the risk of LAT/SEC.MethodsFrom January 2019 to September 2022, a total of 354 consecutive patients with NVAF were enrolled in this cross-sectional study at the First Affiliated Hospital of Guangxi Medical University. To identify the optimal predictive features, we employed least absolute shrinkage and selection operator (LASSO) regression. A multivariate logistic regression model was subsequently constructed, and the results were visualized with a nomogram. We evaluated the model's performance using discrimination, calibration, and the concordance index (C-index).ResultsWe observed a 38.7% incidence of SEC/TH in NVAF patients. Independent influencing factors of LAT/SEC were identified through LASSO and multivariate logistic regression. Finally, four indicators were included, namely, previous stroke/transient ischaemic attack (OR = 4.25, 95% CI = 1.57–12.23, P = 0.006), left atrial volume index (LAVI) (OR = 1.04, 95% CI = 1.01–1.06, P = 0.001), S/D ratio (OR = 0.27, 95% CI = 0.11–0.59, P = 0.002), and left atrial acceleration factor (OR = 4.95, 95% CI = 2.05–12.79, P = 0.001). The nomogram, which incorporated these four influencing factors, demonstrated excellent predictive ability. The training set had a C-index of 0.878, while the validation set had a C-index of 0.872. Additionally, the calibration curve demonstrated great consistency between the predicted probabilities and the observed outcomes, and the decision curve analysis confirmed the important clinical advantage of the model for patients with NVAF.ConclusionOur findings indicate that an enlarged left atrium and abnormal hemodynamic parameters in the left atrial and pulmonary veins are linked to a greater risk of LAT/SEC. Previous stroke/transient ischaemic attack, LAVI, the S/D ratio, and left atrial acceleration factor were independently associated with LAT/SEC in NVAF patients. With the incorporation of these four variables, the developed nomogram effectively predicts the risk of LAT/SEC and outperforms the CHA2DS2-VASc score.

Pulmonary hypertension (PH) is a progressive and complex pulmonary vascular disease with poor prognosis. The aim of this study was to provide a new understanding of the lung pathology of disease and a noninvasive method in monitoring the establishment of animal models for basic and clinical studies of PH, indeed to explore clinical application value of lung ultrasound for patients with PH. Totally 32 male SD rats were randomly divided into control group, MCT (monocrotaline) group, PDTC (pyrrolidine dithiocarbamate) group, and NS (normal saline) group. Rats in the MCT group, PDTC group, and NS group received single intraperitoneal injection of MCT, while the control group received the same dose of NS. Then, PDTC group and NS group received PDTC and NS daily for treatment at the end of the model. Each group received lung ultrasound examination and measurement of pulmonary arterial pressure (PAP). Then, the rats were sacrificed to take the lung specimens to being observed. The ultrasound and pathological results were analyzed with a semiquantitative score. With the pulmonary artery pressure increases, the MCT group had a higher pulmonary ultrasound score and pathological score compared with the control group (p 0.8, p 0.8, p

BackgroundThe linkage between psoriasis and hypertension has been established through observational studies. Despite this, a comprehensive assessment of the combined effects of psoriasis and hypertension on all-cause mortality is lacking. The principal aim of the present study is to elucidate the synergistic impact of psoriasis and hypertension on mortality within a representative cohort of adults residing in the United States.MethodsThe analysis was conducted on comprehensive datasets derived from the National Health and Nutrition Examination Study spanning two distinct periods: 2003-2006 and 2009-2014. The determination of psoriasis status relied on self-reported questionnaire data, whereas hypertension was characterized by parameters including systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, self-reported physician diagnosis, or the use of antihypertensive medication. The assessment of the interplay between psoriasis and hypertension employed multivariable logistic regression analyses. Continuous monitoring of participants' vital status was conducted until December 31, 2019. A four-level variable amalgamating information on psoriasis and hypertension was established, and the evaluation of survival probability utilized the Kaplan-Meier curve alongside Cox regression analysis. Hazard ratios (HRs) and their associated 95% confidence intervals (CIs) were computed to scrutinize the correlation between psoriasis/hypertension and all-cause mortality.ResultsIn total, this study included 19,799 participants, among whom 554 had psoriasis and 7,692 had hypertension. The findings from the logistic regression analyses indicated a heightened risk of hypertension among individuals with psoriasis in comparison to those devoid of psoriasis. Throughout a median follow-up spanning 105 months, 1,845 participants experienced all-cause death. In comparison to individuals devoid of both hypertension and psoriasis, those with psoriasis alone exhibited an all-cause mortality HR of 0.73 (95% CI: 0.35-1.53), individuals with hypertension alone showed an HR of 1.78 (95% CI: 1.55-2.04), and those with both psoriasis and hypertension had an HR of 2.33 (95% CI: 1.60-3.40). In the course of a stratified analysis differentiating between the presence and absence of psoriasis, it was noted that hypertension correlated with an elevated risk of all-cause mortality in individuals lacking psoriasis (HR 1.77, 95% CI: 1.54-2.04). Notably, this association was further accentuated among individuals with psoriasis, revealing an increased HR of 3.23 (95% CI: 1.47-7.13).ConclusionsThe outcomes of our investigation demonstrated a noteworthy and positive association between psoriasis, hypertension, and all-cause mortality. These findings indicate that individuals who have both psoriasis and hypertension face an increased likelihood of mortality.