Search

Yi Li,1– 3,&ast; Yixuan Lu,1,2,&ast; Youdan Zhao,1 Zhi Lyu1,2 1Department of Senior Cadres Ward, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, People’s Republic of China; 2The School of Clinical Medicine, Fujian Medical University, Fuzhou, People’s Republic of China; 3Department of General Medicine, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhi Lyu, Department of Senior Cadres Ward, Zhongshan Hospital of Xiamen University, No. 201-209 hubin South Road, Siming District, Xiamen, 361000, People’s Republic of China, Tel +86-13779950606, Email lyuzhi@xmu.edu.cnBackground: Central obesity, as measured by examination instruments, has been shown to be associated with both OSA and short sleep duration. However, objective measurement tools like CT, MRI, and DXA are expensive, cause radiation exposure, and have limited availability, especially in resource-limited settings. Thus, this study aimed to demonstrate the relevance of Body Mass Index (BMI) and Waist-to-Height Ratio (WHtR) as surrogate indicators of visceral obesity in the assessment of OSA and short sleep duration. We also intend to evaluate whether WHtR, in combination with BMI, can be a suitable surrogate marker for visceral adiposity.Methods: We recruited 333 adults with complete polysomnographic (PSG) records retrospectively. Logistic regression helped to assess the association of BMI and WHtR as surrogates for central adiposity with OSA and short sleep duration. Moreover, ROC curve analysis was conducted to evaluate the predictive ability of BMI and WHtR.Results: Following the relevant adjustments, logistic regression analysis results showed that the combination of WHtR and BMI acting as central obesity surrogates was significantly associated with OSA and short sleep duration (p< 0.05). According to univariate regression analysis, sleep latency and wake after sleep onset were independent predictors of the risk of central obesity in patients with short sleep duration and OSA. Additionally, ROC curve analysis demonstrated that the combination of BMI and WHtR provided a better assessment of central adiposity in patients with OSA and short sleep duration, compared to each measure alone.Conclusion: BMI and WHtR are significantly associated with OSA and short sleep duration, and might serve as a potential surrogate marker for central obesity. Sleep latency and wake after sleep onset can independently predict the risk of central obesity in patients with short sleep time and OSA. Thus, larger prospective studies are needed to verify our findings.Keywords: body mass index, central obesity, obstructive sleep apnea, short sleep duration, waist-to-height ratio

Zhengyi Lyu,1,&ast; Qiongying Shen,1,&ast; Shuxin Tian,1,&ast; Liyan Gong,2 Haizhou Lou,3 Guanai Bao,2 Zhuoxuan Wu,3 Chao Lu,2 Weiping Zhang,4 Rui Huang,5 Conghua Ji,6 Siyi Zheng,1 Wei Pan,1 Yinyin Ying,4 Jianwei Jin,4 Yi Liang4 1The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China; 2Zhejiang Cancer Hospital, Hangzhou, Zhejiang, People’s Republic of China; 3Department of Medical Oncology, Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, People’s Republic of China; 4Department of Acupuncture, the Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China; 5Department of Acupuncture and Tuina, Wenzhou Central Hospital, Wenzhou, Zhejiang, People’s Republic of China; 6Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yi Liang, Department of Acupuncture, the Third Affiliated Hospital of Zhejiang Chinese Medical University, 219 Moganshan Road, Hangzhou City, Zhejiang Province, 310053, People’s Republic of China, Email liangyiwww@126.comBackground: Transcutaneous Electrical Acupoint Stimulation (TEAS) therapy opens up the possibility for individuals with Cancer-induced bone pain (CIBP) to receive a home-based, patient-controlled approach to pain management. The aim of this study is designed to evaluate the efficacy of patient-controlled TEAS (PC-TEAS) for relieving CIBP in patients with non-small cell lung cancer (NSCLC).Methods/Design: This is a study protocol for a prospective, triple-blind, randomized controlled trial. We anticipate enrolling 188 participants with NSCLC bone metastases who are also using potent opioid analgesics from 4 Chinese medical centers. These participants will be randomly assigned in a 1:1 ratio to either the true PC-TEAS or the sham PC-TEAS group. All participants will receive standard adjuvant oncology therapy. The true group will undergo patient-controlled TEAS intervention as needed, while the sham group will follow the same treatment schedule but with non-conductive gel patches. Each treatment course will span 7 days, with a total of 4 courses administered. There will be 4 assessment time points: baseline, the conclusion of weeks 4, 8, and 12. The primary outcome of this investigation is the response rate of the average pain on the Brief Pain Inventory (BPI) scale at week 4 after treatment. Secondary outcomes include pain related indicators, quality of life scale, mood scales, and routine blood counts on the assessment days. Any adverse events will be promptly addressed and reported if they occur. We will manage trial data using the EDC platform, with a data monitoring committee providing regular quality oversight.Discussion: PC-TEAS interventions offer an attempt to achieve home-based acupuncture treatment and the feasibility of achieving triple blinding in acupuncture research. This study is designed to provide more rigorous trial evidence for the adjuvant treatment of cancer-related pain by acupuncture and to explore a safe and effective integrative medicine scheme for CIBP.Trial Registration: ClinicalTrials.gov NCT05730972, registered February 16, 2023.Keywords: bone cancer pain, TEAS, transcutaneous electrical nerve stimulation, patient-controlled analgesia, integrative medicine, home-based treatment

Jiong Zhou,&ast; Yang Yang,&ast; Mengjun Xu, Zhongfa Lyu, Xianjie Wu Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xianjie Wu, Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, People’s Republic of China, Email wuxianjie@zju.edu.cnObjective: To evaluate and explore the efficacy, safety, and pharmacoeconomics of three common strategies for pediatric alopecia areata.Methods: Chinese pediatric alopecia areata patients meeting the criteria were included and divided into three groups based on the received treatments. The efficacy, adverse events and pharmacoeconomics of these treatments were retrospectively analyzed.Results: Twenty-four pediatric AA patients were recruited in this study. 100% (12/12) of patients from the traditional group achieved SALT100. In the tofacitinib group, 40.0% (2/5) of patients achieved SALT50. 20.0% (1/5) of patients achieved SALT75 and 40.0% (2/5) of patients achieved SALT100. In the MN group, 42.86% (3/7) of patients were non-responders. 14.28 (1/7) of patients achieved SALT75 and 42.86% (3/7) of patients achieved SALT100. The adverse effects (AEs) were mild in all three groups, and none of the patients discontinued the treatments due to the AEs. Comparing the other two groups, the MN treatment would be more time-intensive and more expensive.Conclusion: For newly diagnosed or naive pediatric patients, the traditional treatment was the first-line approach. For long-duration, severe and refractory patients, tofacitinib and microneedling can be alternative options.Keywords: pediatric, alopecia areata, tofacitinib, microneedling, efficacy

Mingyu Yang,&ast; Meng Li,&ast; Zhuozhen Lyu, Zhen Yang Department of Infectious Diseases, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 25000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhen Yang, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, JingWu Road, Jinan, Shandong, 25000, People’s Republic of China, Tel +86 15168867123, Email yangzhen@sdfmu.edu.cnAbstract: Cholangiocarcinoma (CCA), the second most common liver neoplasm, has a poor overall 5-year survival rate of less than 10%. A deeper understanding of the molecular pathogenesis contributing to CCA progression is essential for developing better therapeutic approaches to manage this disease. Ferroptosis, an oxidative iron-dependent form of regulated cell death, has been reported to be involved in tumorigenesis and progression. In particular, ferroptosis and inflammation, which are common issues in cholangiocarcinogenesis and CCA development, might be in concert with disease progression. Notably, the key feature of cancer cells is “iron addiction”, which is crucial for the high metabolic demand in carcinogenesis and cancer progression. Additionally, iron metabolism is of great importance in ferroptosis. Moreover, that cancer cells are vulnerable to ferroptosis might be a possible mechanism of CCA development. Although the underlying mechanism of how ferroptosis is implicated in CCA development requires further investigation, developing a new strategy combined with a pro-ferroptotic treatment would be an exciting CCA treatment approach in the future.Keywords: cholangiocarcinoma, ferroptosis, inflammation, iron metabolism, treatment target

Zhiyong Lyu,1 Jing Li,2 Jinghui Zhen,1 Wei Shi,3 Qingying Meng,1 Wei Zhou,1 Jingyun An,1 Kaihu Yao,3,&ast; Fang Dong1,&ast; 1Department of Clinical Laboratory Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China; 2Department of Clinical Laboratory, Capital Institute of Pediatrics, Beijing, People’s Republic of China; 3Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Fang Dong; Kaihu Yao, Department of Clinical Laboratory Center, Beijing Children’s Hospital Affiliated to Capital Medical University, No. 56 Nan Lishi Road, Beijing, 100045, People’s Republic of China, Email fangd32@163.com; yaokaihu@bch.com.cnIntroduction: Streptococcus pneumoniae (S. pneumoniae) is a major pathogen causing death in children. Few studies have evaluated the importance of S. pneumoniae in the identified bacteria in clinical work. This retrospective study aimed to reveal the rank of S. pneumoniae in determined bacteria isolated from children in Beijing, China, as well as the antimicrobial resistance of this pathogen.Methods: The number of specimen for bacterial culture and of bacterial species were cumulated and ranked based on the data of the two largest children’s hospitals in Beijing from 2015 to 2021. The temporal change of S. pneumoniae culture, as well as the clinical data of S. pneumoniae isolates were collected and analyzed. The minimum inhibitory concentrations of antimicrobial agents were determined by BD Phoenix 100 automated system or Vitek 2 automated system for antimicrobial susceptibility testing. The breakpoints recommended by CLSI were adopted.Results: During the 7-year study period, a total of 45,631 bacterial isolates were cultured from 462,144 submitted specimens, in which S. pneumoniae was the third frequent agent following S. aureus and H. influenza, and accounting for 8.79% of the isolates (4011/45,631). In the 4011 S. pneumoniae isolates, 2239 and 997 ones were, respectively, isolated from sputum and bronchial lavage fluid. Most of S. pneumoniae strains were identified in winter (34.7%) and spring (26.1%), and were mainly isolated from patients under 5 years old (77.1%). Low susceptible rate (27.6%) of CSF isolates was determined to penicillin according to the parenteral meningitis breakpoints, while high susceptible rate (56.9%) of non-CSF isolates was obtained according to the parenteral non-meningitis breakpoints. The isolates showed low sensitivity to erythromycin and tetracycline (< 5%). All isolates were susceptible to vancomycin and linezolid.Conclusion: The present results demonstrated that S. pneumoniae was one of the most commonly detected bacteria in current pediatric clinical tests, especially in young children under 5 years old, which emphasized the importance of prevention. Penicillin could still be the first empiric choice to treat non-meningitis pneumococcal infections, while erythromycin should not be involved in the treatment.Keywords: Streptococcus pneumoniae, antimicrobial resistance, children, China

Ningcen Li,1,2,&ast; Yi Guo,1,3,4,&ast; Yinan Gong,1– 3 Yue Zhang,1,2 Wen Fan,5 Kaifang Yao,1,2 Zhihan Chen,1,2 Baomin Dou,1,2 Xiaowei Lin,1,3,4 Bo Chen,1– 3 Zelin Chen,1– 3 Zhifang Xu,1– 3 Zhongxi Lyu1– 3 1Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin City, People’s Republic of China; 2School of Acupuncture & Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin City, People’s Republic of China; 3National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin City, People’s Republic of China; 4School of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin City, People’s Republic of China; 5Suzuka University of Medical Science, Suzuka City, Japan&ast;These authors contributed equally to this workCorrespondence: Zhifang Xu; Zhongxi LyuSchool of Acupuncture & Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, No. 10 Poyang Lake Road, Tuanbo New Town, Jinghai District, Tianjin, 301617, People’s Republic of ChinaTel/Fax +86 22-5959-6290Email xuzhifangmsn@hotmail.com; 1025117807@qq.comAbstract: Inflammation plays a significant role in the occurrence and development of multiple diseases. This study comprehensively reviews and presents literature from the last five years, showing that acupuncture indeed exerts strong anti-inflammatory effects in multiple biological systems, namely, the immune, digestive, respiratory, nervous, locomotory, circulatory, endocrine, and genitourinary systems. It is well known that localized acupuncture-mediated anti-inflammatory effects involve the regulation of multiple populations and functions of immune cells, including macrophages, granulocytes, mast cells, and T cells. In acupuncture stimulation, macrophages transform from the M1 to the M2 phenotype and the negative TLR4 regulator PPARγ is activated to inhibit the intracellular TLR/MyD88 and NOD signaling pathways. The downstream IκBα/NF-κB and P38 MAPK pathways are subsequently inhibited by acupuncture, followed by suppressed production of inflammasome and proinflammatory mediators. Acupuncture also modulates the balance of helper T cell populations. Furthermore, it inhibits oxidative stress by enhancing SOD activity via the Nrf2/HO-1 pathway and eliminates the generation of oxygen free radicals, thereby preventing inflammatory cell infiltration. The anti-inflammatory effects of acupuncture on different biological systems are also specific to individual organ microenvironments. As part of its anti-inflammatory action, acupuncture deforms connective tissue and upregulates the secretion of various molecules in acupoints, further activating the NF-κB, MAPK, and ERK pathways in mast cells, fibroblasts, keratinocytes, and monocytes/macrophages. The somatic afferents present in acupuncture-activated acupoints also convey sensory signals to the spinal cord, brainstem, and hypothalamic neurons. Upon information integration in the brain, acupuncture further stimulates multiple neuro-immune pathways, including the cholinergic anti-inflammatory, vagus-adrenal medulla-dopamine, and sympathetic pathways, as well as the hypothalamus-pituitary-adrenal axis, ultimately acting immune cells via the release of crucial neurotransmitters and hormones. This review provides a scientific and reliable basis and viewpoints for the clinical application of acupuncture in various inflammatory conditions.Keywords: inflammation, acupuncture, immune, vagus, sympathetic nerve

Xiang Li,1 Jinzhu Bai,2 Yi Hong,2 Junwei Zhang,2 Hehu Tang,2 Zhen Lyu,2 Shujia Liu,2 Shizheng Chen,2 Jiesheng Liu2 1Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China; 2Department of Spine and Spinal Cord Surgery, Beijing Bo’ai Hospital, China Rehabilitation Research Center; School of Rehabilitation, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Jinzhu BaiDepartment of Spine and Spinal Cord Surgery, Beijing Bo’ai Hospital, China Rehabilitation Research Center; School of Rehabilitation, Capital Medical University, No. 10 North Jiaomen Road, Fengtai District, Beijing, 100068, People’s Republic of ChinaEmail baijinzhu@126.comPurpose: To investigate the long-term (> 7 years) clinical outcomes of percutaneous endoscopic lumbar discectomy for lumbar degenerative disease to address postoperative problems including postoperative dysesthesia (POD), residual back pain and segmental instability.Methods: Inclusion and exclusion criteria were established. All patients who met the above criteria were treated by PELD using the transforaminal approach. Limited discectomy was performed to preserve the disc material in the intervertebral space as much as possible. The Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) score for back pain (VAS-B) and leg pain (VAS-L) and Modified MacNab’s criterion were used for clinical evaluation. Radiographic parameters including height of intervertebral disc and segmental instability were also evaluated.Results: Forty-two patients (24 men and 18 women) who met our inclusion and exclusion criteria were included in our study. The average follow-up period was 95.71± 5.63 months (ranging from 87 to 105 months). There were no neurological complications associated with the operation. POD was found in 14.29% of patients, while only 2 patients (4.76%) complained of mild dysesthesia at final follow-up. Two patients (4.76%) required revision surgery during the follow-up period. The final follow-up ODI, JOA score, VAS-B and VAS-L were significantly better than preoperative values. The average disc-height ratio was 84.52± 5.66% of the preoperative disc height. No instability at the operation level was noted at final follow-up.Conclusion: Our study showed that PELD using the transforaminal approach can provide favorable results after a long-term follow-up period. POD is a common complication at initial prognosis. Limited discectomy can preserve the disc height well and minimize the risk of residual back pain.Keywords: percutaneous endoscopic lumbar discectomy, transforaminal approach, long-term follow-up, back pain

BackgroundAlpha-fetoprotein-producing gastric cancer (AFPGC) represents a particularly aggressive subtype of gastric carcinoma characterized by elevated rates of vascular invasion, lymphatic dissemination, hepatic metastasis, and an unfavorable clinical outcome. Treatment strategies for AFPGC have historically lacked specificity. Herein, a case is presented involving AFPGC in which the patient exhibited a notable response to combined anti-PD-1 antibody immunotherapy and SOX chemotherapy, potentially achieving a cure. This report marks the first application of this regimen in neoadjuvant therapy for AFP gastric cancer, followed by radical resection and postoperative adjuvant therapy.Case summaryA 62-year-old male patient presented with persistent upper abdominal distension and discomfort lasting over 2 months. Initial investigations revealed markedly elevated serum alpha-fetoprotein (AFP) levels, and subsequent pathological examination confirmed the diagnosis of AFPGC via gastroscopy. Due to the patient’s condition, surgical resection was initially deemed unfeasible. Therefore, a chemo-immunotherapy regimen consisting of SOX chemotherapy and the PD-1 inhibitor tislelizumab was administered for 3 cycles. Following this, successful laparoscopic radical gastrectomy was performed. The treatment protocol was continued with an additional 3 cycles postoperatively. At the time of this case report, the patient maintained a good quality of life with no evidence of disease recurrence or adverse events.ConclusionThe present report highlights a case of AFPGC where significant therapeutic success was achieved through a combined regimen of chemotherapy and immunotherapy, both before and after surgery. The use of anti-PD-1 antibody (tislelizumab) in combination with SOX regimen (S-1 and oxaliplatin) demonstrated effective treatment of AFPGC, potentially offering a curative approach. This approach represents a promising targeted therapy option for patients with AFPGC.

BackgroundPrevention and intervention of procrastination in college students are of great practical significance， and studies have illustrated a pairwise correlation among mindfulness， self-control， insecure attachment and procrastination， whereas the mechanism by which insecure attachment leads to procrastination remains unclear， and the related mediation path is quite understudied.ObjectiveTo investigate the effect of insecure attachment on procrastination among college students and the pathway of mindfulness and self-control， so as to inform the design of interventions for procrastination among college students.MethodsRandom and cluster sampling method were utilized to enroll 514 college students from 4 colleges in Guangdong Province From February to April 2023. Subjects were assessed using Irrational Procrastination Scale （IPS）， Adult Attachment Scale （AAS）， Mindful Attention Awareness Scale （MAAS） and Brief Self-Control Scale （BSCS）. Pearson correlation analysis were adopted to identify the correlation among above scales， and the mediation effect was examined via Bootstrap procedure.ResultsAAS score was positively correlated with IPS score （r=0.382， P

ObjectiveIn recent years, there has been a significant increase in the severity of leaf diseases in maize, with a noticeable trend of mixed occurrence. This poses a serious threat to the yield and quality of maize. However, there is a lack of studies that combine the identification of different types of leaf diseases and their severity classification, which cannot meet the needs of disease prevention and control under the mixed occurrence of different diseases and different severities in actual maize fields.MethodsA method was proposed for identifying the types of typical leaf diseases in maize and classifying their severity using hyperspectral technology. Hyperspectral data of three leaf diseases of maize: northern corn leaf blight (NCLB), southern corn leaf blight (SCLB) and southern corn rust (SCR), were obtained through greenhouse pathogen inoculation and natural inoculation. The spectral data were preprocessed by spectral standardization, SG filtering, sensitive band extraction and vegetation index calculation, to explore the spectral characteristics of the three leaf diseases of maize. Then, the inverse frequency weighting method was utilized to balance the number of samples to reduce the overfitting phenomenon caused by sample imbalance. Relief-F and variable selection using random forests (VSURF) method were employed to optimize the sensitive spectral features, including band features and vegetation index features, to construct models for disease type identification based on the full stages of disease development (including all disease severities) and for individual disease severities using several representative machine learning approaches, demonstrating the effectiveness of the research method. Furthermore, the study individual occurrence severity classification models were also constructed for each single maize leaf disease, including the NCLB, SCLB and SCR severity classification models, respectively, aiming to achieve full-process recognition and disease severity classification for different leaf diseases. Overall accuracy (OA) and Macro F1 were used to evaluate the model accuracy in this study.Results and DiscussionThe research results showed significant spectrum changes of three kinds of maize leaf diseases primarily focusing on the visible (550-680 nm), red edge (740-760 nm), near-infrared (760-1 000 nm) and shortwave infrared (1 300-1 800 nm) bands. Disease-specific spectral features, optimized based on disease spectral response rules, effectively identified disease species and classify their severity. Moreover, vegetation index features were more effective in identifying disease-specific information than sensitive band features. This was primarily due to the noise and information redundancy present in the selected hyperspectral sensitive bands, whereas vegetation index could reduce the influence of background and atmospheric noise to a certain extent by integrating relevant spectral signals through band calculation, so as to achieve higher precision in the model. Among several machine learning algorithms, the support vector machine (SVM) method exhibited better robustness than random forest (RF) and decision tree (DT). In the full stage of disease development, the optimal overall accuracy (OA) of the disease classification model constructed by SVM based on vegetation index reached 77.51%, with a Macro F1 of 0.77, representing a 28.75% increase in OA and 0.30 higher of Macro F1 compared to the model based on sensitive bands. Additionally, the accuracy of the disease classification model with a single severity of the disease increased with the severity of the disease. The accuracy of disease classification during the early stage of disease development (OA=70.31%) closely approached that of the full disease development stage (OA=77.51%). Subsequently, in the moderate disease severity stage, the optimal accuracy of disease classification (OA=80.00%) surpassed the optimal accuracy of disease classification in the full disease development stage. Furthermore, the optimal accuracy of disease classification under severe severity reached 95.06%, with a Macro F1 of 0.94. This heightened accuracy during the severity stage can be attributed to significant changes in pigment content, water content and cell structure of the diseased leaves, intensifying the spectral response of each disease and enhancing the differentiation between different diseases. In disease severity classification model, the optimal accuracy of the three models for maize leaf disease severity all exceeded 70%. Among the three kinds of disease severity classification results, the NCLB severity classification model exhibited the best performance. The NCLB severity classification model, utilizing SVM based on the optimal vegetation index features, achieved an OA of 86.25%, with a Macro F1 of 0.85. In comparison, the accuracy of the SCLB severity classification model (OA=70.35%, Macro F1=0.70) and SCR severity classification model (OA=71.39%, Macro F1=0.69) were lower than that of NCLB.ConclusionsThe aforementioned results demonstrate the potential to effectively identify and classify the types and severity of common leaf diseases in maize using hyperspectral data. This lays the groundwork for research and provides a theoretical basis for large-scale crop disease monitoring, contributing to precision prevention and control as well as promoting green agriculture.

Immune checkpoint inhibitors (ICIs) have been approved for the treatment of urothelial carcinoma(UC). However, the use of antibiotics, proton pump inhibitors, corticosteroids, beta-blockers, metformin, and statin concomitant medications in some patients due to complications during the treatment process may affect the clinical efficacy of ICIs through different pathway, making it difficult for patients to derive clinical benefit or making it more likely to develop drug resistance. In this paper, we present a review of the effects of the above concomitant drugs on ICIs in the treatment of patients with advanced UC, with a view to provide reference for the application of individualized treatment strategies of ICIs in patients with advanced UC.

Hydrogen energy storage has many characteristics such as large energy storage capacity, long storage time, clean and pollution-free, and it realizes the interconnection and complementation of multiple energy networks and collaborative optimization. It is expected to become an important supporting technology to promote the development of distributed energy and improve the efficiency of terminal energy utilization. In order to improve the reliability and renewable energy utilization rate of islanded microgrid, the operation characteristics of typical electric, hydrogen and thermal devices are analyzed, and a multi-objective optimization configuration model of the islanded microgrid is proposed. Then, the target problem is solved based on simulated annealing particle swarm optimization (SAPSO) algorithm to obtain technical and economic indicators under different configuration schemes. Finally, based on the annual natural resource and electric heating load characteristic curve of a certain place in the north, the model built on MATLAB can effectively promote that the load loss rate of the proposed multi-energy complementary configuration scheme decreases by 3.18%, and the utilization rate of renewable energy increases by 8.37% compared with the traditional electric energy storage configuration scheme. Thus, the proposed configuration scheme can effectively promote the consumption of renewable energy and ensure the economy and power supply reliability of the independent micro-grid.

Duchenne and Becker muscular dystrophies are caused by pathogenic variants in the dystrophin (DMD) gene. The variants cause the absence or severe reduction of the dystrophin protein in the muscle cells and myocardium. In affected males, the pathogenic variants cause progressive muscular weakness, dilated cardiomyopathy, arrhythmias, and congestive heart failure. We investigated the cardiac affection of 53 DMD gene carriers six years ago and found over 2/3 of the females had cardiac involvement, affecting either the cardiac structure, function, or both. However, the cardiac progression rate is still unknown. Thus, we do not know if the findings are stable or if they can progress fast. It is essential to understand the cardiac progression rate in counseling patients and planning the frequency of clinical visits. This study describes the change over a 6-year follow-up period in the structure and function of the heart of carriers of pathogenic DMD gene variants. We invite the 53 female carriers of DMD gene variants we investigated six years ago to participate again in the same investigations. We use cardiac MRI with late gadolinium enhancement, 24-hour Holter monitoring, ECG, and blood samples analyzed for cardiac biomarkers to assess the progression of cardiac symptoms. The study is still ongoing. Preliminary results from the study will be presented at the conference. [ABSTRACT FROM AUTHOR]

Duchenne and Becker muscular dystrophies are caused by pathogenic variants in the dystrophin (DMD) gene. The absence or severe reduction of the cytoskeletal protein dystrophin leads to cell necrosis and replacement by fat and connective tissue, resulting in progressive muscle degeneration. Males are primarily affected because of the X-linked inheritance, but women can also be affected despite their carrier status. We investigated 53 DMD gene carriers six years ago, and found that almost all of them had muscular involvement, such as reduced muscle strength, higher fat fraction, and symptoms as myalgia, cramps, or fatigue. However, we do not know the progression rate of female carriers. This study investigated the same 53 DMD gene carriers with the same measurements as 6 years ago to describe the progression of symptoms. We use Dixon MRI, stationary dynamometry of lower extremities, a 6-minute walk test and blood muscle biomarkers to assess the progression of muscular symptoms. Results will be presented at the conference. [ABSTRACT FROM AUTHOR]