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Lei Gao,1,2,* Yidi Xu,1,2,* Xixue Zhang,1,2 Zhaoshun Jiang,1,2 Jiajun Wu,1,2 Yanjun Dong,1,2 Ming Li,3 Liang Jin,3 Jianjian Qiu,4 Lijue You,5 Chunhui Qin,6 Weidong Gu1,2 1Department of Anaesthesiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China; 2Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China; 3Department of Radiology, Huadong Hospital affiliated to Fudan University, Shanghai, People’s Republic of China; 4Department of Radiation Oncology, Huadong Hospital affiliated to Fudan University, Shanghai, People’s Republic of China; 5Department of Computer Center, Huadong Hospital affiliated to Fudan University, Shanghai, People’s Republic of China; 6Department of Pain Management, Yueyang Integrated Traditional Chinese Medicine and Western Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Weidong Gu, Email hdmz0800@163.comBackground: Performing spinal anaesthesia in elderly patients with ligament calcification or hyperostosis is challenging for novice practitioners. This pilot study aimed to compare the effectiveness of mixed reality-assisted spinal puncture (MRasp) with that of landmark-guided spinal puncture (LGsp) by novice practitioners in elderly patients.Methods: In this pilot study, 36 patients (aged ≥ 65 years) scheduled for elective surgery under spinal anaesthesia by anaesthesiology residents were included. Patients were randomly assigned to the MRasp group (n = 18) or the LGsp group (n = 18). The outcomes included the number of needle insertion attempts, redirection attempts, passes, the rate of successful first-attempt needle insertion, the rate of successful first needle pass, the spinal puncture time, the total procedure time, and the incidence of perioperative complications.Results: The median number of needle insertion attempts was significantly fewer in the MRasp group than in the LGsp group (1.0 vs 2.0, P = 0.023). The proportion of patients with successful first-attempt needle insertion was 72.2% in the MRasp group and 44.4% in the LGsp group (P = 0.176). The incidence of perioperative complications did not significantly differ between the two groups.Conclusion: This pilot study found that novice practitioners made significantly fewer needle insertion attempts in the MRasp group compared to the LGsp group when performing spinal anaesthesia on elderly patients. A future randomized controlled trial (RCT) is warranted to validate its effectiveness.Trial Registration: This trial was registered at https://www.chictr.org.cn/showproj.html?proj=178960 (ChiCTR-IPR-2300068520). Public title: Mixed reality-assisted versus landmark-guided spinal puncture in elderly patients: a randomized controlled pilot study. Principal investigator: Lei Gao. The registration date was February 22, 2023. The date of the first participant enrolment was February 27, 2023.Plain Language Summary: We developed virtual spine-presenting technology and patented optimal trajectory design technology to assist in spinal puncture and reported that the median number of needle insertion attempts was significantly fewer in the mixed reality-assisted spinal puncture group than in the landmark-guided spinal puncture group.Keywords: augmented reality, computer simulation, mixed reality, spinal puncture

Jianchun Xiao,1,&ast; Fangyu Zhao,1,&ast; Wenhao Luo,1,&ast; Gang Yang,1 Yicheng Wang,1 Jiangdong Qiu,1 Yueze Liu,1 Lei You,1 Lianfang Zheng,2 Taiping Zhang1,3 1Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People’s Republic of China; 2Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People’s Republic of China; 3Clinical Immunology Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Taiping Zhang, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People’s Republic of China, Email zhangtaiping@pumch.cnAim: This article aimed to find appropriate pancreatic cancer (PC) patients to treat with Gemcitabine with better survival outcomes by detecting hENT1 levels.Methods: We collected surgical pathological tissues from PC patients who received radical surgery in our hospital from September 2004 to December 2014. A total of 375 PC tissues and paired adjacent nontumor tissues were employed for the construction of 4 tissue microarrays (TMAs). The quality of the 4 TMAs was examined by HE staining. We performed immunohistochemistry analysis to evaluate hENT1 expression in the TMAs. Moreover, we detected hENT1 expression level and proved the role of hENT1 in cell proliferation, drug resistance, migration and invasion in vivo and vitro.Results: The results indicated that low hENT1 expression indicated a significantly poor outcome in PC patients, including shortened DFS (21.6± 2.8 months versus 36.9± 4.0 months, p< 0.001) and OS (33.6± 3.9 versus 39.6± 3.9, p=0.004). Meanwhile, patients in stage I/II of TNM stage had a longer OS (40.2± 3.4 versus 15.4± 1.7, p=0.002) and DFS (31.0± 3.1 versus 12.4± 1.9, p=0.016) than patients in stage III/IV. Patients in M0 stage had a longer OS (39.7± 3.4 versus 16.2± 1.9, p=0.026) and DFS(30.7± 3.0 versus 11.8± 2.2, p=0.031) than patients in M1 stage, and patients with tumors not invading the capsule had a better DFS than those with tumor invasion into the capsule (30.8± 3.0 versus 12.6± 2.3, p=0.053). Patients with preoperative CA19-9 values ≤ 467 U/mL have longer DFS than that of patients who had preoperative CA19-9 values > 467 U/mL (37.9± 4.1 versus 22.9± 4.0, p=0.04). In the subgroup analysis, a high hENT1 expression level was related to a longer OS(39.4± 4.0 versus 31.5± 3.9, p=0.001) and DFS(35.7± 4.0 versus 20.6± 2.7; p< 0.0001) in the Gemcitabine subgroup.Conclusion: PC patients with high hENT1 expression have a better survival outcomes when receiving Gemcitabine. hENT1 expression can be a great prognostic indicator for PC patients to receive Gemcitabine treatment.Keywords: pancreatic cancer, human equilibrative nucleoside transporter 1, hENT1, gemcitabine chemoresistance, prognostic indicator, survival improvement

Pan Lei,1,2 Wanying Shen,2 Huijuan Tang,2 Li You,2 Guoyi Chen,2 Yijun Tang,1 Wei Lu3 1Hubei Key Laboratory of Embryonic Stem Cell Research, Taihe Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China; 2Hubei Hongshan Laboratory, College of Biomedicine and Health, College of Life Science and Technology, Huazhong Agricultural University, Wuhan, People’s Republic of China; 3Department of Pharmacy, Taihe Hospital, Hubei University of Medicine, Shiyan, People’s Republic of ChinaCorrespondence: Yijun Tang, Hubei Key Laboratory of Embryonic Stem Cell Research, Taihe Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China, Email tyj_799@taihehospital.com Wei Lu, Department of Pharmacy, Taihe Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China, Email luwei0903@taihehospital.comPurpose: Adagrasib is a selective and reversible inhibitor of KRAS G12C, which significantly delays the progression of solid tumors. However, the absorption, distribution, metabolism, and excretion of adagrasib in vivo are unclear. This study explores the absorption and distribution of adagrasib in vivo.Methods: An ultra-high performance liquid chromatography-tandem quadrupole mass spectrometry (UPLC-MS/MS) method was established for the determination of adagrasib in the rat plasma and tissue. Sprague-Dawley rats were intravenous administrated (5 mg/kg) and oral administrated (30 mg/kg) with adagrasib, and the plasma concentration of adagrasib was determined. After single oral administration of adagrasib (30 mg/kg), the heart, liver, spleen, lung, kidney, intestine, and pancreas were excised. The organs were homogenized with saline solution, and the concentration of adagrasib in tissues was determined.Results: The intra- and inter-day accuracy were from 84.90% to 113.47%, and the precision was within ± 15%. The matrix effect and recovery were within ± 15%. The maximum plasma concentration (Cmax) of adagrasib was 677.45 ± 58.72 ng/mL. The elimination half-life time (t1/2) was 3.50 ± 0.21 h after oral administration and 2.08 ± 0.54 h after intravenous administration. The oral bioavailability was 50.72%. The highest concentrations of adagrasib in liver was 5047.80 ± 676.48 ng/g at 2 h after administration, and it was still detectable at 24 hours after administration.Conclusion: Adagrasib was slowly absorbed and cleared rapidly, and it was also widely distributed in vivo. This study provides a potential reference for adagrasib in clinical studies.Keywords: adagrasib, UPLC-MS/MS, pharmacokinetics, tissue distribution

Xinyi Guo, Lin You Center for Collaborative Innovation of Civilization Practice in New Era, Jiangxi Normal University, Nanchang, Jiangxi, People’s Republic of ChinaCorrespondence: Lin You, Center for Collaborative innovation of Civilization Practice in New Era, Jiangxi Normal University, Nanchang, Jiangxi, 330022, People’s Republic of China, Tel +86 791-88122985, Email 18137809001@163.comPurpose: The current study examined the effect of group identity on social mindfulness, how awe mediates this effect, and lastly how empathy may moderate the various indirect pathway.Methods: A total of 2041 Chinese college students were recruited from different universities or colleges to complete the questionnaire including group identity scale, awe scale, empathy scale and social mindfulness scale. This study was conducted using random and convenient sampling, as well as SPSS and its plugin PROCESS as a statistical tool.Results: The present study showed that group identity was positively associated with awe and social mindfulness. Awe was positively associated with social mindfulness. Empathy further moderated the relationship between group identity and awe, awe and social mindfulness, as well as group identity and social mindfulness.Conclusion: The findings of this study shed light on a correlation between group identity and social mindfulness. Furthermore, this study emphasizes the practical importance of intervening in the empathy level of students who have poor empathy in order to increase their social mindfulness.Keywords: group identity, social mindfulness, empathy, awe

Beibei Feng,1– 4,&ast; Chen Gong,1,3,4,&ast; Longfei You,1,3,4,&ast; Yangyang Lin,1,3,4 Yafei Wang,1,3,4 Wing Yuk Ip,2 Yuling Wang1,3,4 1Department of Rehabilitation Medicine, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China; 2Department of Orthopaedics & Traumatology, the University of Hong Kong, Hong Kong, Special Administrative Regions, People’s Republic of China; 3Guangdong Provincial Clinical Research Center for Rehabilitation Medicine, Guangzhou, People’s Republic of China; 4Biomedical Innovation Center, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yuling Wang, Department of Rehabilitation Medicine, the Sixth Affiliated Hospital, Sun Yat-sen University, No. 26, Yuancun 2nd Cross Road, Guangzhou, 510655, People’s Republic of China, Tel + 86-20-38476737, Fax +86-20-38254221, Email wangyul@mail.sysu.edu.cn Wing Yuk Ip, Department of Orthopaedics & Traumatology, the University of Hong Kong, Hong Kong, Special Administrative Regions, People’s Republic of China, Tel +852-22554581, Fax +852-28174392, Email wyip@hku.hkPurpose: Central sensitization (CS) is commonly seen in chronic pain disorders, including neuropathic pain. However, there exist inconsistencies concerning the presence of CS in chronic pain secondary to carpal tunnel syndrome (CTS). CS and neuropathic pain manifestations in CTS remain not well established. Therefore, this study aims to investigate the CS and pain profiles in patients with CTS and to explore the potential determinants associated with CS.Patients and Methods: Patients with suspected CTS symptoms lasting 3 months or above and healthy controls were enrolled. History, physical examinations, and nerve conduction studies were employed to confirm the diagnosis and severity of median nerve dysfunction. The central sensitization inventory (CSI) was used to screen CS. Other outcomes included neuropathic pain, CTS-specific symptom severity and functions, emotion, and health-related quality of life. Between-group comparisons were conducted in terms of the CS presence. Logistic regression analysis was performed to identify determinants associated with CS.Results: Over 60% of participants with CTS were found with clinical CS, significantly higher than that in the control group. More than 70% of the CTS participants were identified to have possible or very likely neuropathic pain components. In addition, one-fourth of CTS cases had depression or anxiety. Anxiety was associated with an increased risk of developing CS in CTS (adjusted OR=1.31, 95% CI 1.08– 1.59), whereas higher self-perceived general health rating was negatively associated with the presence of CS (adjusted OR=0.92, 95% CI 0.88– 0.97) in the multivariate adjusted regression model.Conclusion: CS is prevalent in patients with CTS. Predominant neuropathic pain characteristics were uncovered in CTS patients as well as comorbid psychological distress. Significant association was found between anxiety and CS presence. Self-perceived general health was inversely related to CS. Further research is warranted to explore the mechanisms of anxiety and central pain processing in painful entrapment neuropathy.Keywords: central sensitization, chronic pain, carpal tunnel syndrome, determinants

Haochen Jiang,1,2,&ast; Zhi Shang,2,&ast; Liping You,1,2,&ast; Jinghao Zhang,1 Junzhe Jiao,2 Yihan Qian,2 Jiacheng Lin,2 Fang Wang,2 Yueqiu Gao,1 Xiaoni Kong,2 Xuehua Sun1 1Department of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 2Central Laboratory, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xuehua Sun, Department of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China, Email susan_sxh@shutcm.edu.cn Xiaoni Kong, Central Laboratory, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China, Email xiaonikong@shutcm.edu.cnBackground and Purpose: Current pharmacological approaches to prevent hepatic ischemia/reperfusion injury (IRI) are limited. To mitigate hepatic injury, more research is needed to improve the understanding of hepatic IRI. Depending on traditional Chinese medicine (TCM) theory, acupuncture therapy has been used for the treatment of ischemic diseases with good efficacy. However, the efficacy and mechanism of acupuncture for hepatic IRI are still unclear.Methods: Blood provided to the left and middle lobe of mice livers was blocked with a non-invasive clamp and then the clamps were removed for reperfusion to establish a liver IRI model. Quantitative proteomics approach was used to evaluate the impact of EA pretreatment on liver tissue proteome in the IRI group. Serum biochemistry was used to detect liver injury, inflammation, and oxidative stress levels. H&E staining and TUNEL staining were used to detect hepatocyte injury and apoptosis. Immunohistochemistry and ELISA were used to detect the degree of inflammatory cell infiltration and the level of inflammation. The anti-inflammatory and antioxidant capacities were detected by Quantitative RT-PCR and Western blotting.Results: We found that EA at Zusanli (ST36) has a protective effect on hepatic IRI in mice by alleviating oxidative stress, hepatocyte death, and inflammation response. Nuclear factor E2-related factor 2 (Nrf2) as a crucial target was regulated by EA and was then successfully validated. The Nrf2 inhibitor ML385 and cervical vagotomy eliminated the protective effect in the EA treatment group.Conclusion: This study firstly demonstrated that EA pretreatment at ST36 significantly ameliorates hepatic IRI in mice by inhibiting oxidative stress via activating the Nrf2 signal pathway, which was vagus nerve-dependent.Keywords: inflammation, liver, proteomics

New types of functional material structures will emerge if the shape and properties are controlled in three-dimensional nanodevices. Possible applications of these would be nanoelectronics and medical systems. Magnetic nanoparticles (MNPs) are especially important in electronics such as magnetic storage, sensors, and spintronics. Also, in those that are used as magnetic resonance imaging contrasts, and tissue specific therapeutic agents, as well as in the labeling and sorting of cells, drug delivery, separation of biochemical products, and in other medical applications. Most of these applications require MNPs to be chemically stable, uniform in size, and controllable in terms of their magnetic properties and shape. In this paper three new functions of iron (Fe)-based nanoparticles are reported: shape transformation, oxidation prevention, and self-alignment. The shape of the Fe nanoparticles could be controlled by changing their oxidation states and properties by using a nanocarbon coating. Full field X-ray microscopy using synchrotron radiation revealed controllable magnetic properties of MNPs at the L3 edge which depended on the oxidation states. Then, inkjet printing was successfully performed to deposit a uniform layer of MNPs by the size.

Suzhen Chen,1,2 Zhi Xu,1,2 Yinghui Li,1,2 Tianyu Wang,1,2 Yingying Yue,1,2 Zhenghua Hou,1,2 Linlin You,1,2 Na Lu,1,2 Yingying Yin,1,2 Xiaoyun Liu,1,2 Liangliang Tan,1,2 Houcheng Ji,3 Yaoran Shi,1,2 Xiaoyun Xin,1,2 Wenhao Jiang,1,2 Yonggui Yuan1,2 1Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, People’s Republic of China; 2Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, People’s Republic of China; 3Department of Psychiatry, The Second People’s Hospital of Jiangning District, Nanjing, People’s Republic of ChinaCorrespondence: Yonggui Yuan, Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009, People’s Republic of China, Tel +86-25-83285124, Email yygylh2000@sina.comPurpose: Shumian capsule (SMC) is a patent Chinese herbal medicine that can soothe the liver and relieves depression, quiet the spirit. Here, we aimed to investigate the efficacy of SMC for treating insomnia using both scales and polysomnography (PSG).Patients and Methods: A randomized, double-blind, placebo-controlled trial was performed. Twenty-six insomnia patients randomly received SMC (n = 11) or placebo (n = 15) for four weeks. Pittsburgh Sleep Quality Inventory (PSQI), Insomnia Severity Index (ISI), 9-items Patient Health Questionnaire (PHQ-9), 7-items Generalized Anxiety Disorder (GAD-7), 17-item Hamilton Depression Rating Scale (HAMD-17), and Hamilton Anxiety Rating Scale (HAMA) were applied at the baseline and the 2nd, 4th week after treatment. Treatment Emergent Symptom Scale was used to assess adverse reactions. We used PSG to record and analyze sleep features at baseline and after four weeks.Results: PSQI, ISI, PHQ-9, HAMD-17, and HAMA scores decreased significantly after SMC treatment. Also, the total sleep time, rapid-eye-movement (REM) sleep latency, stage 2 sleep, deep sleep, REM sleep, and sleep efficiency improved significantly after SMC treatment. In the placebo group, the only significant change was the decrease of PHQ-9 at week-2. Furthermore, both SMC and placebo reported no adverse events.Conclusion: SMC could safely improve sleep quality with depression and anxiety remission in insomnia patients.Keywords: Chinese herbal medicine, shumian capsule, insomnia, polysomnography, clinical trial, randomized and double-blind method

Spin-transfer torque magnetic tunneling junction devices capable of a multilevel three-dimensional (3D) information processing are studied in the sub-20-nm size range. The devices are built using He+ and Ne+ focused ion beam etching. It has been demonstrated that due to their extreme scalability and energy efficiency, these devices can significantly reduce the device footprint compared to the modern CMOS approaches and add advanced features in a 3D stack with a sub-20-nm size using a spin polarized current.

Cracks in solid-state materials are typically irreversible. Here we report electrically reversible opening and closing of nanoscale cracks in an intermetallic thin film grown on a ferroelectric substrate driven by a small electric field (~0.83 kV/cm). Accordingly, a nonvolatile colossal electroresistance on-off ratio of more than 108 is measured across the cracks in the intermetallic film at room temperature. Cracks are easily formed with low-frequency voltage cycling and remain stable when the device is operated at high frequency, which offers intriguing potential for next-generation high-frequency memory applications. Moreover, endurance testing demonstrates that the opening and closing of such cracks can reach over 107 cycles under 10-μs pulses, without catastrophic failure of the film.

Underground goaf in metallurgical mining area leads to surface subsidence and has destructive effect on blast furnace. This paper studies the influence of underground goaf on blast furnace.The overlying strata and surface subsidence due to the formed gob area after the underground mining led to a different degree of destruction to blast furnace. Hence, blast furnace was modeled to theoretically analyze the additional stress applied to blast furnace body and foundation when withstanding the surface deformation. On this basis, the anti-deformation structure was designed to analyze the influences of Class I - IN surface deformation on the setting of Blast furnace body unit [ABSTRACT FROM AUTHOR]

Magnetoelectric coupling in ferromagnetic/multiferroic systems is often manifested in the exchange bias effect, which may have combined contributions from multiple sources, such as domain walls, chemical defects, or strain. In this study we magnetically "fingerprint" the coupling behavior of CoFe grown on epitaxial BiFeO3 (BFO) thin films by magnetometry and the first-order-reversal-curves (FORC). The contribution to exchange bias from 71°, 109° and charged ferroelectric domain walls (DWs) was elucidated by the FORC distribution. CoFe samples grown on BFO with 71° DWs only exhibit an enhancement of the coercivity, but little exchange bias. Samples grown on BFO with 109° DWs and mosaic DWs exhibit a much larger exchange bias, with the main enhancement attributed to 109° and charged DWs. Based on the Malozemoff random field model, a varying-anisotropy model is proposed to account for the exchange bias enhancement. This work sheds light on the relationship between the exchange bias effect of the CoFe/BFO heterointerface and the ferroelectric DWs, and provides a path for multiferroic device analysis and design.

We propose adjustable phase shift pilots (APSPs) for channel acquisition in wideband massive multiple-input multiple-output (MIMO) systems employing orthogonal frequency division multiplexing (OFDM) to reduce the pilot overhead. Based on a physically motivated channel model, we first establish a relationship between channel space-frequency correlations and the channel power angle-delay spectrum in the massive antenna array regime, which reveals the channel sparsity in massive MIMO-OFDM. With this channel model, we then investigate channel acquisition, including channel estimation and channel prediction, for massive MIMO-OFDM with APSPs. We show that channel acquisition performance in terms of sum mean square error can be minimized if the user terminals' channel power distributions in the angle-delay domain can be made nonoverlapping with proper pilot phase shift scheduling. A simplified pilot phase shift scheduling algorithm is developed based on this optimal channel acquisition condition. The performance of APSPs is investigated for both one symbol and multiple symbol data models. Simulations demonstrate that the proposed APSP approach can provide substantial performance gains in terms of achievable spectral efficiency over the conventional phase shift orthogonal pilot approach in typical mobility scenarios.