Reticulocyte hemoglobin content associated with the risk of iron deficiency anemia.

Background/Objective: Reticulocyte hemoglobin content (MCHr) was recognized as a rapid and reliable marker for investigating iron deficiency (ID). We hypothesized that MCHr was associated with the risk of iron deficiency anemia in adults. Methods: This is a dual-center case-control study. A total of 806 patients and healthy individuals were recruited from Ruijin Hospital and Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine between January 2021 and December 2021. The participants were categorized into iron deficiency anemia (IDA) group (n = 302), non-IDA group (n = 366), and healthy control group (n = 138). According to the MCHr level, the participants were divided into two groups, i.e. normal MCHr (≥25 pg) and decreased MCHr (<25 pg) group. Multivariate logistic regression analysis and adjusted subgroup analysis were conducted to estimate the relative risk between MCHr and IDA, with confounding factors including age, sex, hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), Hematocrit (HCT), serum iron (Fe), ferritin (Ferrit), and total iron binding capacity (TIBC). Results: Compared with the non-IDA, the MCHr level with IDA decreased significantly. ROC curve analysis showed that MCHr had the largest area under the AUC curve. After comprehensive adjustment for confounding factors, individuals with normal level of MCHr exhibited a decreased risk of IDA (OR = 0.68 [0.60, 0.77], P < 0.01), while the risk of IDA was up to 5 times higher for those with decreased MCHr. Conclusion: Our findings supported the hypothesis that MCHr was associated with the risk of IDA in adults and could serve as an indicator of IDA severity. MCHr holds clinical value as an auxiliary diagnostic indicator, providing valuable insights into whether invasive examinations are warranted in the assessment of IDA.

A female patient carrying a novel DMD mutation with non-random X-chromosome inactivation from a DMD family.

OBJECTIVE: To analyze the clinical phenotype and genetic characteristics of a female proband carrying a novel mutation in the DMD gene with non-random X-chromosome inactivation in a large pedigree with pseudohypertrophic muscular dystrophy. METHODS: Clinical information of the female proband, her monozygotic twin sister, and other family members were collected. Potential pathogenic variants were detected with Multiplex Ligation-dependent Probe Amplification (MLPA) and whole-exome sequencing (WES). Methylation-sensitive restriction enzyme (HhaI) was employed for X-chromosome inactivation analysis. RESULTS: The proband was a female over 5 years old, displayed clinical manifestations such as elevated creatine kinase (CK) levels and mild calf muscle hypertrophy. Her monozygotic twin sister exhibited normal CK levels and motor ability. Her uncle and cousin had a history of DMD. WES revealed that the proband carried a novel variant in the DMD (OMIM: 300,377) gene: NM_004006.3: c.3051_3053dup; NP_003997.2: p.Tyr1018*. In this pedigree, five out of six female members were carriers of this variant, while the cousin and uncle were hemizygous for this variant. X-chromosome inactivation analysis suggested non-random inactivation in the proband. CONCLUSION: The c.3051_3053dup (p.Tyr1018*) variant in the DMD gene is considered to be the pathogenic variant significantly associated with the clinical phenotype of the proband, her cousin, and her uncle within this family. Integrating genetic testing with clinical phenotype assessment can be a valuable tool for physicians in the diagnosis of progressive muscular dystrophies, such as Becker muscular dystrophy (BMD) and Duchenne muscular dystrophy (DMD).

Whether Detection of Gene Mutations Could Identify Low- or High-Risk Papillary Thyroid Microcarcinoma? Data from 393 Cases Using the Next-Generation Sequencing.

Objective: The objective of this study is to explore the utilization of next-generation sequencing (NGS) technology in evaluating the likelihood of identifying individuals with papillary thyroid microcarcinoma (PTMC ≤10 mm) who are at high or low risk. Design: NGS was used to analyze 393 formalin-fixed, paraffin-embedded tissues of PTC tumors, all of which were smaller than 15 mm. Results: The study found that bilateralism, multifocality, intrathyroidal spread, and extrathyroidal extension were present in 84 (21.4%), 153 (38.9%), 16 (4.1%), and 54 (13.7%) cases, respectively. Metastasis of cervical lymph nodes was identified in 226 (57.5%) cases and 96 (24.4%) cases with CLNM >5. Out of the total number of cases studied, 8 cases (2.3%) showed signs of tumor recurrence, all of which were localized and regional. Genetic alterations were detected in 342 cases (87.0%), with 336 cases revealing single mutations and 6 cases manifesting compound mutations. 332 cases (84.5%) had BRAFV600E mutation, 2 cases had KRASQ61K mutation, 2 cases had NRASQ61R mutation, 8 cases had RET/PTC1 rearrangement, 3 cases had RET/PTC3 rearrangement, and 1 case had TERT promoter mutation. Additionally, six individuals harbored concurrent mutations in two genes. These mutations were of various types and combinations: BRAFV600E and NRASQ61R (n = 2), BRAFV600E and RET/PTC3 (n = 2), BRAFV600E and RET/PTC1 (n = 1), and BRAFV600E and TERT promoter (n = 1). The subsequent analysis did not uncover a significant distinction in the incidence of gene mutation or fusion between the cN0 and cN1 patient cohorts. The presence of BRAFV600E mutation and CLNM incidence rates were found to be positively correlated with larger tumor size in PTMC. Our data showed that gene mutations did not appear to have much to do with high-risk papillary thyroid microcarcinoma (PTMC). However, when we looked at tumor size, we found that if the tumor was at least 5 millimeters in size, there was a higher chance of it being at high risk for PTM (P < 0.001, odds ratio (OR) = 2.55, 95% confidence interval (CI): 1.57-4.14). Identification of BRAFV600E mutation was not demonstrated to be significantly correlated with advanced clinicopathological characteristics, although it was strongly associated with a bigger tumor diameter (OR = 4.92, 95% CI: 2.40-10.07, P < 0.001). Conclusion: In clinical practice, BRAFV600E mutation does not consistently serve as an effective biomarker to distinguish high-risk PTMC or predict tumor progression. The size of the tumor has a significant correlation with its aggressive characteristics. PTMC with a diameter of ≤5 mm should be distinguished and targeted as a unique subset for specialized treatment.

Performance of the digital cell morphology analyzer MC-100i in a multicenter study in tertiary hospitals in China.

BACKGROUND: This study investigated the performance of the MC-100i, a pre-commercial digital morphology analyzer utilizing a convolutional neural network algorithm, in a multicentric setting involving up to 11 tertiary hospitals in China. METHODS: Blood smears were analyzed by MC-100i, verified by morphologists, and manually differentiated. The classification performance on WBCs and RBCs was evaluated by comparing the classification results using different methods. The PLT and PLT clump counting performance was also assessed. The total assay time including hands-on time was evaluated. RESULTS: The agreements between pre- and post-classification were high for normal WBCs (κ > 0.96) and lower for overall abnormal WBCs (κ = 0.90). The post-classification results correlated well with manual differentials for both normal and abnormal WBCs (r > 0.93), except for basophils (r = 0.8480) and atypical lymphocytes (r = 0.8211). The clinical sensitivity and specificity of each RBC abnormality after verification were above 90 % using microscopy reviews as the reference. The PLTs counted by the MC-100i before and after verification correlated well with those measured by the PLT-O mode (r = 0.98). Moreover, PLT clumps were successfully classified by the analyzer in EDTA-dependent pseudothrombocytopenia blood samples. CONCLUSIONS: The MC-100i is an accurate and reliable digital cell morphology analyzer, offering another intelligent option for hematology laboratories.

An Investigation Into Whether the Facial Nerve and Auditory Nerve can be Protected by Removal of the Posterior Wall of the Internal Auditory Canal Under 30° Neuroendoscopy During Vestibular Schwannoma Surgery.

The aim of this study was to evaluate the surgical technique of microresection of vestibular schwannoma by removing the posterior wall of the internal auditory canal (IAC) under neuroelectrophysiological monitoring and 30° neuroendoscopy, with respect to the protection of facial and auditory nerve function. Forty-five cases of microscopic resection of auditory neuromas were performed through a posterior approach to the inferior occipital sigmoid sinus using a 30° neuroendoscope to assist in the removal of the posterior wall of the IAC during surgery. Patients underwent cranial enhancement magnetic resonance imaging examination and functional assessment of the facial and auditory nerves before and after surgery, and clinical data were collected for retrospective analysis. All tumors were removed in 41 patients, and most of the tumors were removed in 4 patients. The facial nerve was anatomically preserved in 43 patients (95.6%), and the percentage of facial nerve function preservation (House-Brackmann grade I-II) was 84.4%. Forty patients (88.9%) had anatomical preservation of the auditory nerve, with a 66.7% functional preservation rate. At 3 to 39 months of follow-up, 45 patients were reviewed with 3.0 T-enhanced magnetic resonance imaging, and no tumor recurrence was observed in any of the patients. Microscopic resection of auditory neuroma through the posterior approach of the inferior occipital sigmoid sinus with intraoperative use of 30° neuroendoscopic assistance to abrade the posterior wall of the IAC can eliminate dead space in certain anatomical areas during surgery and minimize surgical damage to the facial and auditory nerves, which is the basis for preservation of facial and auditory nerve function.

The safety and efficacy of delayed surgery by simulating clinical progression of observable papillary thyroid microcarcinoma: a retrospective analysis of 524 patients from a single medical center.

Objective: When active surveillance (AS) is developed in the patients with low-risk papillary thyroid microcarcinoma (PTMC), a medical center needs to ensure the delayed operation that is caused by PTMC clinical progression to have the same prognosis as that of immediate operation. The objective of this study was to investigate the efficacy of delayed surgery by simulating clinical progression (tumor size enlargement and appearance of lymph node metastasis) of PTMCs with AS in a single medical center. Methods: We retrospectively analyzed the response to therapy in 317 papillary thyroid carcinoma patients treated with total thyroidectomy and post-operative radioactive iodine ablation. They were classified into three groups according to tumor size (group A ≤0.5 cm; group B >0.5 cm and ≤1 cm; group C >1 cm and ≤1.5 cm) or two groups according to the presence (cN1) or absence (cN0) of the clinical lymph node (LN) metastasis. Groups C and cN1 were regarded as simulated clinical progression of observational PTMC and the operation for them was assumed to be "delayed surgery". However, Groups A, B and cN0 were regarded as no clinical progression and the operation for them was considered as immediate surgery. Results: There were no significantly differences in excellent response to therapy and recurrence-free survival not only among the group A, B and C, but also between the group cN0 and cN1. In other words, these insignificant differences were found between immediate and simulated "delayed" surgeries. Conclusion: For the PTMC patients suitable for AS, the oncological outcomes were also excellent even if surgery was delayed until after the presence of clinical progression, according to our clinical simulation. Furthermore, we consider that it was feasible for medical centers to assess the ability to implement AS for PTMC patients by retrospectively analyzing their own previous clinical data using the described simulation.

Machine learning-assisted optimization of multi-metal hydroxide electrocatalysts for overall water splitting.

Green hydrogen produced via electrochemical water splitting is a suitable candidate to replace emission-intensive fuels. However, the successful widespread adoption of green hydrogen is contingent on the development of low-cost, earth-abundant catalysts. Herein, machine learning models built on experimental data were used to optimize the precursor ratios of hydroxide-based electrocatalysts, with the objective of improving the product's electrocatalytic performance for overall water splitting. The Neural Network-based models were found to be the most effective in predicting and minimizing the overpotentials of the catalysts, reaching a minimum in two iterations. The relatively mild reaction conditions of the synthesis procedure, coupled with its scalability demonstrated herein, renders the optimized catalyst relevant for industrial implementation in the future. The optimized catalyst, characterized to be a molybdate-intercalated CoFe LDH, demonstrated overpotentials of 266 and 272 mV at 10 mA cm-2 for oxygen and hydrogen evolution reactions respectively in alkaline electrolyte, alongside unwavering stability for overall water splitting over 50 h. Overall, our results reflect the efficacy and advantages of machine learning strategies to alleviate the time and labour-intensive nature of experimental optimizations, which can greatly accelerate electrocatalysts research.

Association between papillary thyroid carcinoma and lymphocytic thyroiditis: A retrospective study.

The aim of the present study was to evaluate the association between coexisting lymphocytic thyroiditis (LT) and the clinicopathological features of papillary thyroid carcinoma (PTC). The records of 458 patients with PTC who underwent a total thyroidectomy and lymph node dissection in Sir Run Run Shaw Hospital (Hangzhou, China) were analyzed. In accordance with the histopathology of thyroid parenchyma, the cases were divided into three groups, including Hashimoto's thyroiditis (HT), non-Hashimoto's type LT (NHLT) and no LT. Based on the histopathology, data on age, sex, maximum diameter of tumor, multifocality, extrathyroidal extension, metastatic lymph node size, extranodal extension and tumor grades in the different groups were analyzed and compared. The prevalence of coexisting LT was 29.0% (133/458), of which 7.6% (35/458) was HT and 21.4% (98/458) was NHLT. PTC concomitant with LT was significantly associated with female patients (95.5 vs. 70.2%; P<0.001), a lower rate of extrathyroidal extension and/or capsular invasion (25.6 vs. 39.7%; P=0.004), central lymph node metastasis (CLNM) ratio (10.71 vs. 17.37; P=0.014), higher number of dissected central lymph nodes (16.83 vs. 11.7; P<0.001), larger metastatic lymph nodes (0.66 vs. 0.46 cm; P<0.001), higher occurrence of multifocality (61.7 vs. 50.5%; P=0.029) and earlier pT stage (57.9 vs. 38.8%; P<0.001), regardless of the combined or separate consideration of HT and NHLT. Besides, LT was associated with multifocality [odds ratio (OR), 1.578; 95% confidence interval (CI), 1.046-2.382; P=0.030]. Furthermore, in patients with PTC, CLNM had a significant association with the male sex (OR, 2.000; 95% CI, 1.216-3.288; P=0.006), an age of <45 years (OR, 0.592; 95% CI, 0.398-0.879; P=0.009) and a tumor size of >1 cm (OR, 3.913; 95% CI, 2.431-5.734; P<0.001). In conclusion, patients with PTC and LT showed a greater female preponderance, multifocality, a lower extrathyroidal extension and a lower CLNM ratio. LT was associated with an increased risk of multifocality in PTC.

High-Performance NiS2 Hollow Nanosphere Cathodes in Magnesium-Ion Batteries Enabled by Tunable Redox Chemistry.

Two-dimensional metal dichalcogenides have demonstrated outstanding potential as cathodes for magnesium-ion batteries. However, the limited capacity, poor cycling stability, and severe electrode pulverization, resulting from lack of void space for expansion, impede their further development. In this work, we report for the first time, nickel sulfide (NiS2) hollow nanospheres assembled with nanoparticles for use as cathode materials in magnesium-ion batteries. Notably, the nanospheres were prepared by a one-step solvothermal process in the absence of an additive. The results show that regulating the synergistic effect between the rich anions and hollow structure positively affects its electrochemical performance. Crystallographic and microstructural characterizations reveal the reversible anionic redox of S2-/(S2)2-, consistent with density functional theory results. Consequently, the optimized cathode (8-NiS2 hollow nanospheres) could deliver a large capacity of 301 mA h g-1 after 100 cycles at 50 mA g-1, supporting the promising practical application of NiS2 hollow nanospheres in magnesium-ion batteries.

In Situ Formed Magnesiophilic Sites Guiding Uniform Deposition for Stable Magnesium Metal Anodes.

Owing to its high volumetric capacity and natural abundance, magnesium (Mg) metal has attracted tremendous attention as an ideal anode material for rechargeable Mg batteries. Despite Mg deposition playing an integral role in determining the cycling lifespan, its exact behavior is not clearly understood yet. Herein, for the first time, we introduce a facile approach to build magnesiophilic In/MgIn sites in situ on a Mg metal surface using InCl3 electrolyte additive for rechargeable Mg batteries. These magnesiophilic sites can regulate Mg deposition behaviors by homogenizing the distributions of Mg-ion flux and electric field at the electrode-electrolyte interphase, allowing flat and compact Mg deposition to inhibit short-circuiting. The as-designed Mg metal batteries achieve a stable cycling lifespan of 340 h at 1.0 mA cm-2 and 1.0 mAh cm-2 using Celgard separators, while the full cell coupled with Mo6S8 cathode maintains a high capacity retention of 95.5% over 800 cycles at 1 C.

Fine-Needle Pricking Test of the Parathyroid Gland during Thyroid Surgery in Predicting Parathyroid Function.

Background: Permanent hypoparathyroidism is a serious complication following total thyroidectomy plus central neck dissection (CND). How to evaluate the vascularization of the parathyroid gland in real time is a major concern of thyroid surgeons. This study aimed to evaluate the fine-needle pricking (FNP) test in predicting parathyroid gland function. Methods: The FNP test was performed in patients undergoing total thyroidectomy plus CND between January 1, 2014, and December 31, 2019, to visualize the vascularization of the parathyroid glands. Patients were classified according to the number of parathyroid glands preserved in situ with excellent vascularity (PGPIEV) demonstrated by FNP: group 0 (without PGPIEV), group 1 (with one PGPIEV), group 2 (with two PGPIEV), group 3 (with three PGPIEV), and group 4 (with four PGPIEV). Results: A total of 608 patients with four parathyroid glands underwent FNP testing during thyroidectomy. At least one PGPIEV was demonstrated by FNP testing in 581 patients who had intact parathyroid hormone (iPTH) levels in the normal range after the operation. The prevalence of hypocalcemia decreased from 77.8% in group 0 to 9.8% in group 4 (P < 0.001), and the incidence of hypoparathyroidism decreased from 44.4% in group 0 to 0% in groups 1-4 (P < 0.001). iPTH concentrations on postoperative day 1 were positively correlated with PGPIEV groups (increased from 14.58 ng/l in group 0 to 45.22 ng/l in group 4, P < 0.001). Conclusions: The FNP test is a safe and reliable method to predict parathyroid function. One PGPIEV demonstrated by the FNP test rules out the possibility of patients developing hypoparathyroidism.

Gut Microbiome Composition Abnormalities Determined Using High-Throughput Sequencing in Children With Tic Disorder.

Object: To investigate the distribution characteristics of gut microbiota in children with tic disorder (TD) and the possible role of these characteristics in the pathogenesis of TD. Methods: The medical records of 28 children with TD treated at Wuxi Children's Hospital from January 1 to October 31, 2020, and 21 age-matched healthy children (controls) were included. The relative quantification of bacterial taxa was performed using 16S ribosomal RNA gene amplicon sequencing. Results: There was no significant difference in the alpha diversity of gut microbiota between the TD and control groups. Analyses of beta diversity were able to differentiate the TD patients from the healthy controls based on their gut microbiota. At the phylum level, the two groups were mainly composed of four phyla, Firmicutes, Actinobacteria, Bacteroidetes, and Proteobacteria. There were significant differences in Firmicutes and Actinobacteria between the two groups (P <0.05). At the level of genera, the abundance of Bifidobacterium and Collinsella reduced while that of Ruminococcaceae unclassified, Prevotella, Faecalibacterium, Coprobacillus, and Odoribacter increased in the TD group compared to that in the control group. The intergroup differences were significant (P < 0.05). Conclusion: The abnormal composition of gut microbiota in children with TD suggests that the change in gut microbiota may play an important role in TD development.

The Clinical Significance of Detecting Blood Supply to the Inferior Parathyroid Gland Based on the "Layer of Thymus-Blood Vessel-Inferior Parathyroid Gland" Concept.

Objective: How to preserve the inferior parathyroid gland (IPTG) in situ during central neck dissection (CND) is the major concern of thyroid surgeons. The "layer of thymus-blood vessel-IPTG" (TBP layer) concept showed to be effective in preserving IPTG. The objective of this study was to identify the origin and course of blood supply to IPTG (IPBS) within the TBP layer and to take key points of operation during CND. Design: This is a retrospective control study. Participants. Patients who underwent thyroidectomy plus CND using the TBP layer concept and conventional technique between 2017 and 2019 were enrolled. Measurements. The origin and course of IPBS in relation to recurrent laryngeal nerve (RLN) and thymus and prevalence of hypoparathyroidism were detected. Results: A total of 71.3% of IPTGs (251 of 352) were supplied by ITA branches, defined as type A. Type A was further divided into Types A1 (branches of ITA, coursing laterally to the RLN (53.1%, 187 of 352)) and A2 (branches of ITA, traversing medially to the RLN (18.2%, 64 of 352)). Type A2 was more common on the right side than on the left side (P < 0.001). Fifty-five (15.6%) IPTG feeding vessels originated from the thymus or mediastinum. Nineteen (5.4%) IPTGs were supplied by branches of the superior thyroid artery. The incidence of transient hypoparathyroidism decreased from 45.7% to 3.6% (P < 0.001), in the TBP layer group compared with the conventional technique group. Conclusion: The origin and course of IPBS follow a definite pattern. This mapping and precautions help surgeons optimize intraoperative manipulations for better preservation of IPBS during CND.

Resection of Tumors Located in the Anterior Skull Base and Sellar Region Through the Supraorbital Keyhole Approach via a Forehead Wrinkle Incision: Modifications and Deficiencies.

OBJECTIVE: To investigate the clinical effect of the supraorbital keyhole approach (SKA) via a forehead wrinkle incision in the resection of tumors in the anterior skull base and sellar region. METHODS: Sixty patients with tumors located in the anterior skull base and sellar region treated through the SKA in our hospital from 2017 to 2020. The skin incision and bone flap position were designed individually according to the size and growth of the tumor. The clinical data of the patients were retrospectively analyzed. RESULTS: Based on the feasibility of this surgical approach, personalized skin incisions and bone flaps were designed for different lesions. Among the 60 patients, gross total resection was achieved in 53 cases (88.3%), for meningiomas 97.8% (46/47) and near-total resection in 7 cases (11.7%). In the survey of the patients' scale scores toward skin incision after operation, the "no pain" level was 90.0% (54/60) and 91.7% (55/60) for the level of "very satisfactory" of the aesthetic of the skin incision (as shown in Supplementary Digital Content, Table 2, http://links.lww.com/ SCS/D742). Three patients whose satisfaction with the aesthetic of the incision excelled scale 3, suggesting that they were not completely satisfied with the wound healing. No permanent skin incision discomfort was noted during follow-up. There were no surgical deaths. CONCLUSIONS: The SKA via forehead wrinkle incision is a flexible and feasible method for tumors near the midline of the anterior skull base and sellar region. However, this approach requires strict preoperative planning, which includes choosing appropriate tumors and applicable forehead wrinkles.

Performance evaluation of the new platelet measurement channel on the BC-6800 Plus automated hematology analyzer.

OBJECTIVE: To evaluate the performance of new optical platelet measurement channel on the BC-6800 Plus automated blood cell analyzer. METHODS: The basic PLT count performance of the BC-6800 Plus was evaluated according to the requirements of the Clinical Laboratory and Standards Institute (CLSI) Document H26-A2. In addition, low-PLT-value specimens, red blood cell debris specimens, small red blood cell specimens, and giant PLT specimens were detected with the blood cell analyzer and a flow cytometer. Whole-blood specimens in ethylenediaminetetraacetic acid (EDTA) or sodium citrate anticoagulant tubes from 20 patients with EDTA-dependent PLT aggregation were determined in CDR mode of the analyzer. RESULTS: Blank counting and the carryover contamination rate of PLTs using the BC-6800 Plus both met the technical requirements. For abnormal PLT specimens, PLT-O 8× and PLT-I both exhibited high comparability with flow cytometry. The comparability of PLT-O 8× with flow cytometry was better than that of PLT-I. In EDTA-anticoagulated blood specimens from 20 patients with EDTA-dependent PLT aggregation, the results of PLT-O were significantly higher than those for PLT-I using samples from the same tubes (P < .001). However, the PLT counts were similar between these two methods for sodium citrate-anticoagulated blood specimens (P = .263). CONCLUSION: The performance of PLT-O 8× in the BC-6800 Plus met the technical requirements. PLT-O 8× exhibited better reproducibility than did PLT-I for low-PLT-value samples. Reexamination of abnormal PLT specimens using PLT-O 8× yielded more accurate results. PLT-O performed significantly better than PLT-I in the detection of EDTA-dependent PLT-aggregation specimens.

Low crystalline 1T-MoS2@S-doped carbon hollow spheres as an anode material for Lithium-ion battery.

A low crystalline 1T-MoS2@S-doped carbon (MoS2@SC) composite was successfully synthesized via a facile hydrothermal process. The composite is comprised by few-layer 1T-MoS2 nanosheets covered by an amorphous carbon layer with an expanded interlayer d-spacing of 1.01 nm. This structure is conducive to the fast transport of lithium-ions and volume accommodation during the charge-discharge process when the composite is applied as an anode material for LIBs. Additionally, the high conductivity and layered structure of 1T-MoS2 also facilitate fast of ion/electron transport, contributing to the improvement of the electrochemical properties. Therefore, this material demonstrated a high rate performance and excellent cycling stability, with the capacities of 847 and 622 mA h g-1 achieved at the current densities of 0.2 A g-1 and 2 A g-1, respectively. Even at a larger current density of 2 A g-1, MoS2@SC delivered a high reversible capacity of 659 mA h g-1 with an average capacity loss of 0.006% per cycle after 500 cycles.

The effect of the area proportion of the metastatic lesion within the central metastatic lymph node on response to therapy in papillary thyroid carcinoma.

Lymph node (LN) metastasis has been strongly associated with locoregional recurrence and decreased survival time of patients with papillary thyroid carcinoma (PTC). Although the characteristics of the metastatic LNs (mLN) have been determined, including size, number, micro-metastasis and extra-nodal extension (ENE), further analysis is warranted. The present study introduced a new parameter known as the area proportion of the metastatic lesion within the central mLNs (APmCLN). The objective was to evaluate the impact of the APmCLN on response to therapy in patients with PTC. In total, 355 patients with PTC treated with total thyroidectomy and neck dissection, post-operative radioactive iodine and thyroid-stimulating hormone suppression were retrospectively studied. The patients were classified into two groups: Group A (APmCLN ≤75%) and group B (APmCLN >75%). The association of various clinicopathological characteristics between these two groups was investigated. Univariate and multivariate analyses were used to evaluate risk factors associated with a non-Excellent response to therapy and recurrence-free survival (RFS). The analysis showed that APmCLN >75% was significantly associated with extra-thyroidal extension, clinically apparent nodes (cN1), pathological N1b (pN1b), ENE, greater number and larger size of central mLN and larger size of the central LN metastatic lesion. Furthermore, it was reported that chronic lymphocytic thyroiditis, larger central mLN size and APmCLN >75% were independent risk factors for a non-excellent response to therapy. Finally, it was determined that the rate of excellent response to therapy was significantly higher in pathological N1 (pN1) patients with APmCLN ≤75% (108/144, 75.0%) compared with patients with APmCLN >75% (27/47, 57.4%) (P=0.022). However, there was no significant difference (P=0.247) between patients with APmCLN ≤75% and pN0 (132/164, 80.5%). RFS was 89.4% in patients with pN1-APmCLN >75%, whereas those with pN1-APmCLN ≤75% and pN0 did not experience a relapse. Patients with PTC with APmCLN >75% should be regarded as high-risk and may require more aggressive treatment and careful follow-up.

Influence of school mental health education combined with family intervention on the mental health of middle school students / 中国学校卫生

Objective@#To explore the influence of school mental health education combined with family intervention on the mental and physical health of middle school students.@*Methods@#A total of 280 students in six classes of the experimental middle school attached to Hebei Normal University were convenient selected as participants, and two classes in each grade were included in the experimental group and the control group. The experimental group received school mental health education and family intervention, while the control group only received school mental health education. The changes in GHQ, SCL-90 and common mental health problems were compared before and after intervention.@*Results@#The total score of GHQ-12 was (5.06±1.33) in the experimental group after intervention and (15.62±3.84) before intervention. The total score of GHQ-12 in the experimental group after intervention was significantly lower than that before intervention, and significantly lower than that in the control group(t=13.65, 8.39, P<0.05). The scores for somatization, anxiety, depression, paranoia, interpersonal sensitivity, obsessive-compulsive symptoms, hostility, paranoia and psychosis in the experimental group were significantly lower than those in the control group(t=-13.21--6.71, P<0.05). After the intervention, the proportions of good interpersonal relationships, good parent-child relationships and after-school hobbies in the experimental group were 68.28%, 66.21% and 84.14%, respectively, which were significantly higher than those in the control group(35.56%, 40.74% and 51.85%, respectively), the proportions of people without intimate friends, early love and love after school were 9.66%, 9.66% and 4.14%, respectively, which were significantly lower than those in the control group(20.74%, 24.44%, 21.48%)(P<0.05).@*Conclusion@#School mental health education and family intervention can effectively improve the mental health of middle school students, improve their interpersonal relationships and promote their mental and physical health.

Predicting non-small-volume central lymph node metastases (>5 or ≥2 mm) preoperatively in cN0 papillary thyroid microcarcinoma without extrathyroidal extension.

The ability to identify patients with aggressive papillary thyroid microcarcinoma (PTMC) from the low-risk patients is critical to planning proper management of PTMC. Lymph node metastases showed association with recurrence and low survival rate, especially in patients with >5 or ≥2 mm metastatic lymph nodes. Therefore, this study aimed to investigate the preoperatively predictive factors of non-small-volume (metastatic lymph nodes >5 or ≥2 mm in size) central lymph node metastases (NSVCLNM) in PTMC patients. A total of 420 patients with clinically node-negative (cN0) PTMC without extrathyroidal extension underwent thyroidectomy plus central neck dissection (CND) between January 2013 and December 2015, were retrospectively analyzed. Of the 420 patients, 33 (7.9%) had NSVCLNM. The 5-year recurrence-free survival was significantly less in cN0 PTMC patients with NSVCLNM, when compared with patients without NSVCLNM (80.8% vs 100%, P < .001). Multivariate logistic regression revealed age ≤36 years (P < .001), male sex (P = .002), ultrasonic tumor sizes of >0.65 cm (P < .001), and ultrasonic multifocality (P = .039) were independent predictive factors of NSVCLNM. A prediction equation (Y = 1.714 × age + 1.361 × sex + 1.639 × tumor size + 0.842 × multifocality -5.196) was developed, with a sensitivity (69.7%) and a specificity (84.0%), respectively, at an optimal cutoff point of -2.418. In conclusion, if the predictive value was >-2.418 according to the equation, immediate surgery including CND rather than active surveillance might be considered for cN0 PTMC patients.