[Comparative study of total knee arthroplasty assisted by robot and remote sensing navigation system].

OBJECTIVE: To compare clinical efficacy of robot-assisted (RA) and remote sensing navigation alignment (RSNA) system-assisted total knee arthroplasty (TKA). METHODS: From March 2023 to June 2023, 60 patients who underwent the first unilateral TKA due to severe knee osteoarthritis (KOA) were admitted and divided into RSNA group and RA group according to different treatment methods, with 30 patients in each group. There were 5 males and 25 females in RSNA group, aged from 56 to 81 years old with an average of(66.33±7.16) years old;body mass index(BMI) ranged from 19.87 to 38.54 kg·m-2 with an average of (28.40±6.18) kg·m-2;the courses of disease ranged from 5 to 36 months with an average of (18.20±8.98) months; RSNA system was used to assist the positioning of osteotomy. There were 7 males and 23 females in RA group, aged from 55 to 82 years old with an average of (67.83±8.61) years old;BMI ranged from 19.67 to 37.25 kg·m-2 with an average of (28.01±4.89) kg·m-2; the courses of disease ranged from 3 to 33 months with an average of (17.93±9.20) months;RA was performed. Operation time, incision length, latent blood loss at 2 weeks after operation and incidence of lower extremity thrombosis were compared between two groups. Hip-knee ankle angle (HKAA), HKAA deviation, lateral distal femoral angle ( LDFA), medial proximal tibial angle (MPTA) and posterior tibial slope (PTS) were compared between two groups;Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and Knee Society score (KSS) were used to evaluate functional recovery before operation, 3 and 6 months after operation. RESULTS: The operation was performed successfully in both groups, and there were no serious complications such as vascular and nerve injury during operation. The wound healed well at stageⅠafter operation, and the follow-up time was 6 months. The operation time, latent blood loss at 2 weeks after operation and incision length in RSNA group were (94.35±5.75) min, (130.54±17.53) ml and (14.73±2.14) cm, respectively;while (102.57±6.88) min, (146.33±19.47) ml and (16.78±2.32) cm in RA group, respectively. RSNA group was better than RA group (P<0.05). No deep vein thrombosis occurred in both groups at 2 weeks after operation, 5 patients occurred intermuscular vein thrombosisin in RSNA group and 8 patients in RA group, the difference was not statistically significant (P>0.05). In RSNA group, HKAA, LDFA and MPTA were (173.00±5.54) °, (86.96±3.45) °, (82.79±3.35) ° before operation, and (178.34±1.85) °, (89.92±0.42) °, (89.84±0.73) ° at 1 week after operation, respectively. In RA group, HKAA, LDFA and MPTA were (173.31±6.48) °, (87.15±3.40) ° and (82.99±3.05) ° before operation, and (178.52±1.79) °, (90.03±0.39) ° and (90.15±0.47) ° at 1 week after operation, respectively. HKAA, LDFA and MPTA were significantly improved in both groups at 1 week after operation (P<0.05). There were no significant difference in HKAA, LDFA, MPTA and PTS between two groups before operation and 1 week after operation (P>0.05). There was no significant difference in deviation distribution of HKAA at 1 week after operation (χ2=2.611, P=0.456). There were no significant difference in WOMAC and KSS between two groups before operation, 3 and 6 months after operation (P>0.05), and postoperative WOMAC and KSS at 3 and 6 months between two groups were improved compared with those before operation (P<0.05). CONCLUSION: Both RA and RSNA system assisted TKA could obtain accurate osteotomy, RA has higher surgical accuracy, RSNA system assisted operation has less trauma, and operation is simpler.

[Application of remote sensing navigation system in total knee arthroplasty].

OBJECTIVE: To explore clinical accuracy of remote sensing navigation alignment (RSNA) system in total knee arthroplasty (TKA) and its influence on postoperative clinical efficacy. METHODS: From May 2021 to May 2022, 60 knee osteoarthritis (KOA) patients with Kellgren-Lawrence (K-L) grade Ⅲ to Ⅳ treated by unilateral primary TKA were selected and divided into RSNA group and traditional operation group according to treatment methods, and 30 patients in each group. There were 6 males and 24 females in RSNA group, aged from 55 to 86 years old with an average of (68.06±8.23) years old;body mass index (BMI) ranged from 22.15 to 34.58 kg·m-2 with an average of (28.20±3.01) kg·m-2;the courses of disease ranged from 2 to 60 months with an average of (18.80±14.80) months;13 patients with grade Ⅲ and 17 patients with grade Ⅳ according to K-L grading. In traditional operation group, there were 8 males and 22 females, aged from 57 to 85 years old with an average of (67.26±6.32) years old;BMI ranged from 23.94 to 34.55 kg·m-2 with an average of (27.49±2.32) kg·m-2;the courses of disease ranged from 3 to 60 months with an average of (21.30±16.44) months;14 patients with grade Ⅲ and 16 patients with grade Ⅳ according to K-L grading. Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and Knee Society score(KSS) were used to evaluate functional recovery of patients. Hip-knee-ankle angle (HKAA), distal femoral valgus angle (FVA) and distal fermoral flexion angle (DFFA) were measured before operation. HKAA and HKAA deviation angle were measured at 1 week after operation, and defective rate of lower limb force line, femur prosthesis valgus angle (FPVA) and femoral prosthesis flexion angle (FPFA), respectively, were calculated. RESULTS: There were no serious complications such as vascular and nerve injury during operation, and wound healed at stage Ⅰ. Both groups were followed up for 6 months. There were no significant difference in WOMAC index, KSS, HKAA, FVA and DFFA between two groups before operation (P>0.05). The force line defect rate, HKAA, HKAA deviation angle, FPVA deviation angle and FPFA of RSNA group were 6.7%, (178.74±1.56) °, (1.25±1.56) °, (1.84±0.16) ° and (4.85±2.46) °, respectively;while in traditional operation group were 20%, (176.73±3.46) °, (3.27±3.46) °, (2.44±0.26) °, (6.60±1.86) °;the difference between two groups were statistically significant (P<0.05). There were no significant difference in WOMAC index and KSS between two groups at 3 and 6 months after operation (P>0.05). CONCLUSION: RSNA system could reduce defective rate of lower limb force line, FPVA deviation angle and FPFA after TKA, which is more accurate and easy to operate than traditional intramedullary localization surgery while ensuring postoperative efficacy.

Prospective Study on the Association Between Blood Heavy Metal Levels and Pulmonary Function in University Students from a Medical College in Shandong Province, China.

Background: This study aimed to examine the blood concentrations of selected heavy metals, their corresponding pulmonary functions, and their interrelationship with university students. Methods: This prospective study, conducted from September 2019 to September 2020, encompassed 593 university students. Participants completed self-administered questionnaires regarding demographic factors and underwent lung function testing and blood mercury analysis at two distinct intervals: an initial assessment and a follow-up examination. Pulmonary function was assessed using Forced Vital Capacity, Forced Expiratory Volume in one second, and Peak Expiratory Flow. The blood concentrations of various heavy metals were determined through inductively coupled plasma mass spectrometry. Results: Notable disparities in pulmonary function emerged among university students when categorized by gender, Body Mass Index, physical activity, and seafood consumption frequency, all showing statistical significance (p<0.05). Blood levels of Pb, Mn, Co, and Ni exhibited diverse patterns and extents of correlation with pulmonary function (p<0.05 in each instance). Specifically, a positive correlation was observed with blood Pb levels, while Mn, Co, and Ni levels were inversely correlated with pulmonary function (p<0.01 for both observations). Conclusion: This study uncovered significant and complex relationships between the blood concentrations of individual heavy metals and pulmonary function in university students. These findings highlight the need for further research to elucidate these associations in greater detail.

Experts consensus on management of tooth luxation and avulsion.

Traumatic dental injuries (TDIs) of teeth occur frequently in children and adolescents. TDIs that impact the periodontal tissues and alveolar tissue can be classified into concussion, subluxation, extrusive luxation, intrusive luxation, lateral luxation, and avulsion. In these TDIs, management of injured soft tissue, mainly periodontal ligament, and dental pulp, is crucial in maintaining the function and longevity of the injured teeth. Factors that need to be considered for management in laxation injuries include the maturation stage of the traumatic teeth, mobility, direction of displacement, distance of displacement, and whether there are alveolar fractures. In avulsion, the maturation stage of the permanent tooth, the out-socket time, storage media/condition of the avulsed tooth, and management of the PDL should also be considered. Especially, in this review, we have subdivided the immature tooth into the adolescent tooth (Nolla stage 9) and the very young tooth (Nolla stage 8 and below). This consensus paper aimed to discuss the impacts of those factors on the trauma management and prognosis of TDI to provide a streamlined guide for clinicians from clinical evaluation, diagnostic process, management plan decision, follow-up, and orthodontic treatment for tooth luxation and avulsion injuries.

Portable real-time determination of Escherichia coli O157:H7 and Staphylococcus aureus based on smartphones and hydrogels.

The aptamers functionalized orange-emission carbon dots (OCDs) and green-emission carbon dots (GCDs) had dual-emission peaks with single excitation. Tungsten disulfide nanosheets (WS2 NSs)-triggered fluorescence quenching achieved the ratiometric fluorescence determination of Escherichia coli O157:H7 (E. coli O157:H7) and Staphylococcus aureus (S. aureus) with wide ranges of 18-1.8 × 106 and 37-3.7 × 107 CFU/mL and low detection limits of 8 and 20 CFU/mL, respectively. The results in real sample with recoveries of 90-101 % and RSD < 4.12 % were no significant difference from standard plate counting method. Meanwhile, the dual-color CDs were further adopted in the smartphone-assisted hydrogel platform and achieved speedy, sensitive, portable and real-time determination of E. coli O157:H7 and S. aureus in real samples. This work has not only developed ratiometric fluorescence detection and constructed a portable hydrogel platform, but also provided a unique strategy in developing a time-efficient and easy-to-use portable device in food safety monitoring.

Association of changes in body composition with all-cause mortality in patients undergoing hemodialysis: A prospective cohort study.

OBJECTIVES: This study aimed to explore the effect of longitudinal body composition changes on mortality risk in patients undergoing hemodialysis and identify whether changes in body composition can more accurately predict mortality than baseline status. METHODS: A prospective cohort study was conducted on 340 patients undergoing hemodialysis. Lean mass and body fat were determined using a bioimpedance spectroscopy (BIS) device and expressed as the lean tissue index (LTI) or fat tissue index (FTI), respectively. The patients were subjected to BIS at baseline and after 1 year. The hazard ratio (HR) for death was calculated using Cox regression analysis. RESULTS: Among 340 patients, 289 were tested with a repeat BIS. LTI loss and FTI gain were observed in 51.2% and 47.1% of the patients, respectively. Low baseline LTI was a significant predictor of all-cause mortality after adjusting for demographic and biochemical parameters (HR, 2.41; P = 0.047), but not when comorbidities were included in the multivariate analysis. However, after adjusting for various confounding factors, LTI loss (HR, 3.40; P = 0.039) and FTI gain (HR, 4.06; P = 0.024) were independent risk factors for all-cause mortality, and the adjusted HR for LTI loss and FTI gain vs. no LTI loss and no FTI gain was 5.34 (P = 0.016). CONCLUSIONS: LTI loss and FTI gain, particularly their combination, are important predictors of survival in patients undergoing hemodialysis. Our results emphasize that longitudinal changes in LTI and FTI are more strongly associated with all-cause mortality than single-point values. Therefore, it is important to dynamically assess the muscle and fat tissues and develop potential targeted treatment strategies for this population.

Quantitative CT analysis of idiopathic pulmonary fibrosis and correlation with lung function study.

BACKGROUND: Idiopathic Pulmonary Fibrosis (IPF) is a progressive fibrotic lung disease. However, the field of quantitative CT scan analysis in conjunction with pulmonary function test for IPF patients remains relatively understudied. In this study, we evaluated the diagnostic value of features derived high-resolution computed tomography (HRCT) for patients with IPF and correlated them with pulmonary function tests. METHODS: We retrospectively analyzed the chest HRCT images and pulmonary function test results of 52 patients with IPF during the same period (1 week) and selected 52 healthy individuals, matched for sex, age, and body mass index (BMI) and with normal chest HRCT as controls. HRCT scans were performed using a Philips 256-row Brilliance iCT scanner with standardized parameters. Lung function tests were performed using a Jaeger volumetric tracer for forced vital capacity (FVC), total lung capacity (TLC), forced expiratory volume in first second (FEV1), FEV1/FVC, carbon monoxide diffusing capacity (DLCO), and maximum ventilation volume (MVV) metrics. CT quantitative analysis, including tissue segmentation and threshold-based quantification of lung abnormalities, was performed using 3D-Slicer software to calculate the percentage of normal lung areas (NL%), percentage of ground-glass opacity areas (GGO%), percentage of fibrotic area (F%) and abnormal lesion area percentage (AA%). Semi-quantitative analyses were performed by two experienced radiologists to assess disease progression. The aortic-to-sternal distance (ASD) was measured on axial images as a standardized parameter. Spearman or Pearson correlation analysis and multivariate stepwise linear regression were used to analyze the relationship between the data in each group, and the ROC curve was used to determine the optimal quantitative CT metrics for identifying IPF and controls. RESULTS: ROC curve analysis showed that F% distinguished the IPF patient group from the control group with the largest area under the curve (AUC) of 0.962 (95% confidence interval: 0.85-0.96). Additionally, with F% = 4.05% as the threshold, the Youden's J statistic was 0.827, with a sensitivity of 92.3% and a specificity of 90.4%. The ASD was significantly lower in the late stage of progression than in the early stage (t = 5.691, P < 0.001), with a mean reduction of 2.45% per month. Quantitative CT indices correlated with all pulmonary function parameters except FEV1/FVC, with the highest correlation coefficients observed for F% and TLC%, FEV1%, FVC%, MVV% (r = - 0.571, - 0.520, - 0.521, - 0.555, respectively, all P-values < 0.001), and GGO% was significantly correlated with DLCO% (r = - 0.600, P < 0.001). Multiple stepwise linear regression analysis showed that F% was the best predictor of TLC%, FEV1%, FVC%, and MVV% (R2 = 0.301, 0.301, 0.300, and 0.302, respectively, all P-values < 0.001), and GGO% was the best predictor of DLCO% (R2 = 0.360, P < 0.001). CONCLUSIONS: Quantitative CT analysis can be used to diagnose IPF and assess lung function impairment. A decrease in the ASD may indicate disease progression.

Role of microenvironment characteristics and MRI radiomics in the risk stratification of distant metastases in rectal cancer: A diagnostic study.

OBJECTIVES: To compare the value of tumor stroma ratio (TSR) and radiomic signature from baseline MRI for stratifying the risk of distant metastases (DM) in patients with locally advanced rectal cancer (LARC). MATERIALS AND METHODS: Data from 302 patients with LARC who underwent neoadjuvant chemoradiotherapy and total mesorectal excision in our hospital between 2015 and 2018 were retrospectively reviewed, and the patients were randomly allocated into the training and validation cohorts in a ratio of 7:3. Patients were followed-up for more than 3 years postoperatively with metachronous DM as the endpoint. Independent risk factors for DM-free survival (DMFS) were analyzed using Cox regression. The TSR of endoscopic biopsy specimens was scored automatically. Totally 1229 radiomic features of each tumor were extracted from baseline MRI, and the Radscore was calculated. RESULTS: The median follow-up time was 54.3 (51.6-57.1) months, and the 3-year DMFS was 83.8%. The best cutoff value of the TSR to distinguish patient's DM risk was 0.477 (Sen=70.8%, Sep=78%, P<0.001). Increased TSR (HR=3.072, P=0.006) and Radscore (HR=719.231, P=0.023), advanced MR-evaluated T stage (HR=2.660, P=0.023) and ypN (HR=2.362, P=0.028) stage were independent risk factors for DMFS. The area under the curve of the combined model was significantly higher than that of the radiomic model (P=0.013) but without significant advantage over the TSR model (P=0.086). CONCLUSION: TSR of colonoscopic biopsies can independently stratify DM risk in patients with LARC. The TSR model is the most convenient and efficient method for DM risk stratification in LARC.

A multi-task deep learning approach for real-time view classification and quality assessment of echocardiographic images.

High-quality standard views in two-dimensional echocardiography are essential for accurate cardiovascular disease diagnosis and treatment decisions. However, the quality of echocardiographic images is highly dependent on the practitioner's experience. Ensuring timely quality control of echocardiographic images in the clinical setting remains a significant challenge. In this study, we aimed to propose new quality assessment criteria and develop a multi-task deep learning model for real-time multi-view classification and image quality assessment (six standard views and "others"). A total of 170,311 echocardiographic images collected between 2015 and 2022 were utilized to develop and evaluate the model. On the test set, the model achieved an overall classification accuracy of 97.8% (95%CI 97.7-98.0) and a mean absolute error of 6.54 (95%CI 6.43-6.66). A single-frame inference time of 2.8 ms was achieved, meeting real-time requirements. We also analyzed pre-stored images from three distinct groups of echocardiographers (junior, senior, and expert) to evaluate the clinical feasibility of the model. Our multi-task model can provide objective, reproducible, and clinically significant view quality assessment results for echocardiographic images, potentially optimizing the clinical image acquisition process and improving AI-assisted diagnosis accuracy.

Development and validation of the job stressor scale for specialty nurses.

Objectives: Specialty nurses play a crucial role in specialized nursing practice, teaching, management, and research. These nurses often face significant work pressure; therefore, scientifically and effectively assessing their job stress and its sources is vital for enhancing the quality of their work. However, there is currently a dearth of verified assessment tools for measuring job stressors among specialty nurses. Therefore, this study aimed to develop and test an instrument to assess the job stressors applicable to specialty nurses. Methods: We conducted a multiphase mixed-methods study. The initial scale items were developed from a literature review and structured interviews. The scale was then refined through two rounds of expert consultation (N = 14) and a primary test (N = 20). A main survey (N = 552) was then conducted to evaluate the scale's construct validity and reliability using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). Results: The final scale comprises four dimensions with 27 items. The factors included "specialized nursing and work," "workload and time allocation," "patient care," and "work resources and environment." The EFA explained 69.10% of the variance, while the CFA confirmed a good model fit. The content validity index was 0.980 at the scale level and 0.790-1.000 at the item level. The scale's reliability was supported by its high Cronbach's α (0.958), test-retest reliability (0.946), and split-half reliability (0.868). Conclusion: Our findings indicate that the job stressor scale developed in this study is valid and reliable, and is recommended for use among specialty nurses to assess their stressors.

Suggested guidelines in reporting results from mediation analysis, standardized or unstandardized?

Mediation analysis is commonly implemented in psychological, epidemiological, and social behavior studies to identify potential factors that mediate associations between exposures and physical or psychological outcomes. Various analytical tools are available to perform mediation analyses, among which Mplus is widely used due to its user-friendly interface. In practice, sumptuous results provided by Mplus, such as the estimated standardized and unstandardized effect sizes, can be difficult for researchers to choose to match their studies. Through a comprehensive review and utilizing findings from a proven study, we proposed guidelines and recommendations to help users select between standardized or unstandardized results based on data attributes and users' hypotheses. We also provided guidelines to choose from several types of standardized values based on the types of variables, including exposures, mediators, and outcomes.

Survey of role stress among specialty nurses working in tertiary general hospitals across China: a cross-sectional descriptive study.

BACKGROUND: Occupational stress can affect specialty nurses' quality of work, especially for those working in care units. This study, therefore, investigated role stress and its related factors among specialty nurses working in tertiary general hospitals. METHODS: This cross-sectional descriptive study used convenience sampling to recruit 795 Chinese specialty nurses in 11 tertiary general hospitals (from February to March 2023). A questionnaire survey was conducted using the Basic Information Questionnaire and the Role Stress Scale. Multiple linear regression analyses were performed on the survey data to explore the factors affecting role stress. RESULTS: The total role stress score of specialty nurses in tertiary general hospitals was 52.05 ± 19.98. The highest mean item score was quantitative overload, followed by qualitative overload, role conflict, and role ambiguity, which had the lowest score. Multiple linear regression analysis revealed that gender (ß = -0.085, p < 0.05), educational background (ß = 0.077, p < 0.05), and work experience (ß = -0.104, p < 0.05) were the main factors influencing role stress among specialty nurses. CONCLUSIONS: Specialty nurses in tertiary general hospitals had higher levels of role stress than general nurses. Their role stress was primarily reflected in role overload, followed by role conflict and ambiguity. The factors affecting specialty nurses' role stress included gender, work experience, and educational background. Nursing managers should monitor the role stress experienced by specialty nurses in tertiary general hospitals. Providing psychological support for male specialty nurses, performance rewards and learning opportunities for highly educated specialty nurses, and continuous training for inexperienced specialty nurses are essential measures to relieve role stress.

Application of Integrated Medical Care "Cloud-Based Virtual Ward" Management Model on Postoperative Analgesia: Based on Zigbee Technology.

PURPOSE: This study aimed to compare acute care postoperative patients monitored by standard care to those monitored through virtual ward technology by pain team to evaluate status in real-time. DESIGN: Retrospective cohort study. METHODS: We included 72,240 and 68,424 postoperative patients who underwent the acute pain service model between January 2021 and April 2022 and the "cloud-based virtual ward" management model between May 2022 and September 2023, respectively. Patients were administered patient-controlled intravenous analgesia after surgery, and we collected perioperative data regarding the general condition, operation type, postoperative moderate-to-severe pain, nausea and vomiting, dizziness, hoarseness, and drowsiness of the patients. RESULTS: The incidences of moderate-to-severe postoperative pain, postoperative nausea and vomiting, dizziness, drowsiness, hoarseness, resting pain, and activity pain were significantly reduced in the "cloud-based virtual ward" management model when compared with the acute pain service model. CONCLUSIONS: Compared to the acute pain service model, the "cloud-based virtual ward" management model can enhance pain management satisfaction and lower the frequency of moderate-to-severe postoperative pain and adverse effects. CLINICAL IMPLICATIONS: The "cloud-based virtual ward" management model proposed in this study may improve the care of patients with acute postoperative pain. By reviewing the two pain management models for postoperative patients, we were able to compare the incidence of postoperative adverse reactions and use the standard process of the integrated medical care "cloud-based virtual ward" management model to optimize the management of postoperative patients and promote their health outcomes.

Linkage between role stress and work engagement among specialty nurses: a cross-sectional study of China.

OBJECTIVES: Specialty nurses play a significant role in improving patient care; however, little is known about the factors affecting their work engagement. This study aimed to explore the relationship between role stress and work engagement among specialty nurses in China. DESIGN: A descriptive, cross-sectional study was applied in this study. SETTING: The study was conducted in the Henan Provincial People's Hospital in China. PARTICIPANTS: From March to April 2023, we conducted a cross-sectional descriptive study, using convenience sampling to recruit 972 specialty nurses from 42 specialised fields in China. METHODS: An online questionnaire survey was conducted using the Basic Information Questionnaire, Role Stress Scale and Specialty Nurse Work Engagement Scale. The collected data were analysed by using SPSS 21.0 software. The differences in total work engagement scores between subgroups were investigated using a single-factor analysis of variance. A Spearman's rank correlation and a Pearson's correlation were used to determine the relationship between general information, role stress and work engagement. A ridge regression analysis explored the impact of role stress on work engagement. RESULTS: The total score of role stress was (52.44±19.92) and the total score of work engagement was (140.27±17.76). Among the scores of various dimensions of specialty nurses' work engagement, the standardised score for work attitude was the highest (4.54±0.56), followed by work values (4.46±0.64); the standardised score of work enthusiasm and focus was the lowest (4.22±0.64). Additionally, role ambiguity (r=-0.352, p<0.001), role conflict (r=-0.367, p<0.001), role overload (r=-0.313, p<0.001) and role stress (r=-0.380, p<0.001) were negatively correlated with work engagement. The total score of role stress was negatively correlated with the total score of work engagement; the results of ridge regression analysis showed that age, professional title and role stress explain 14.6% of the variance in work engagement. CONCLUSION: Our study found that specialty nurses' work engagement was mid-level or above. Role stress was significantly and negatively correlated with specialty nurses' work engagement, which was an important predictor of their work engagement. Nursing managers should instate effective measures to reduce role stress, thereby increasing work engagement.

A smartphone-assisted portable dual-mode immunoassay of gentamicin based on curcumin nanoparticles and carbon dots.

A smartphone-assisted portable dual-mode immunoassay was constructed based on curcumin nanoparticles (CNPs) and carbon dots (CDs) for gentamicin (GEN) detection. CNPs were labeled with goat anti-mouse IgG (Ab2) to create a conjugation that coupled dual signals to concentrations of GEN antigens. CNPs were introduced to pH 7.4 water and showed insignificant color and optical responses. When exposed to the high pH environment, the structure of CNPs changed and color and optical properties were restored. Because of the inner filter effect (IFE) between CNPs and CDs, the fluorescence of CNPs at 550 nm quenched the fluorescence of CDs at 450 nm. Colorimetry and ratiometric fluorescence (F550 nm/F450 nm) dual-mode immunoassay linearly correlated with GEN ranged from 10-4 to 100 µg/mL with a detection limit (LOD) of 8.98 × 10-5 µg/mL and 4.66 × 10-5 µg/mL, respectively. This work supplied a portable, sensitive, and specific platform to detect GEN.

Synthesis, Modulation, and Application of Two-Dimensional TMD Heterostructures.

Two-dimensional (2D) transition metal dichalcogenide (TMD) heterostructures have attracted a lot of attention due to their rich material diversity and stack geometry, precise controllability of structure and properties, and potential practical applications. These heterostructures not only overcome the inherent limitations of individual materials but also enable the realization of new properties through appropriate combinations, establishing a platform to explore new physical and chemical properties at micro-nano-pico scales. In this review, we systematically summarize the latest research progress in the synthesis, modulation, and application of 2D TMD heterostructures. We first introduce the latest techniques for fabricating 2D TMD heterostructures, examining the rationale, mechanisms, advantages, and disadvantages of each strategy. Furthermore, we emphasize the importance of characteristic modulation in 2D TMD heterostructures and discuss some approaches to achieve novel functionalities. Then, we summarize the representative applications of 2D TMD heterostructures. Finally, we highlight the challenges and future perspectives in the synthesis and device fabrication of 2D TMD heterostructures and provide some feasible solutions.

The Clinicopathological Characteristics and Prognosis of 55 Patients With TFE3-Rearranged Renal Cell Carcinomas.

OBJECTIVE: To explore the clinicopathological features and prognosis of TFE3-rearranged renal cell carcinomas (TFE3-rRCC). METHODS: In this retrospective observational study, the data of patients with TFE3-rRCC admitted to Xijing Hospital from January 2010 to October 2023 were collected, encompassing the general information, pathological diagnosis, immunohistochemistry, and the results of FISH detection. The treatment information and survival data of the patients were recorded during the follow-up. RESULTS: A total of 55 patients with TFE3-rRCC were enrolled, among whom 25 were males and 30 were females. TFE3 FISH assay suggested the disruption of the TFE3 gene. Fifty-four patients underwent surgical resection of kidney lesions, while 1 patient did not. By the end of follow-up in December 2023, 3 patients were lost to follow-up, 28 patients remained alive, and 24 patients had died. Among the 52 patients followed up, 31 developed metastases, involving lymph nodes, liver, bone, lung, peritoneum, pleura, adrenal gland, and brain. The 1-year and 5-year survival rates of the patients were 84.6% and 50.6%, respectively. In this study, there were 31 patients with TFE3-rRCC recurrence or metastasis. Median PFS was 7 and 13 months in the VEGFR-TKI and VEGFR-TKI+ ICI groups, respectively. The median OS was 12 months in the VEGFR-TKI treatment group. The median OS data of VEGFR-TKI+ ICI group has not been reached. The ORR and DCR was 25%, 66.7% in the VEGFR-TKI group. The ORR and DCR was 33.3%, 77.8% in the VEGFR-TKI+ ICI group. CONCLUSION: TFE3-rRCC is a rare subtype of malignant renal tumor. The diagnosis mainly relies on pathological morphology, immunohistochemistry, and the detection of TFE3 gene disruption by FISH. In terms of treatment, surgery is the primary approach, and lymph nodes, liver, and bone are the main metastatic sites. VEGFR-TKI+ICI treatment might be an option of recurrent or metastatic TFE3-rRCC.

Variation in plant functional traits explains the substitution distribution and allocation strategy of Stipa species across natural grasslands of Ningxia, Northern China.

Functional traits reflect plants' adaptability to their environment, and environmental gradients influence their distribution. But few studies have investigated the link between these traits and species substitution patterns or the relevant ecological factors. We measured the aboveground (leaf) and belowground (root) functional traits of Stipa species in 17 plots across natural grasslands in Ningxia in Northern China. Redundancy analysis was used to explore the relationships between Stipa's functional traits and its species substitution distribution. Then, on the species substitution gradient, principal component analysis (PCA) was used to verify and quantify the leaf economic spectrum (LES), root economic spectrum (RES), and whole-plant economic spectrum (WPES), with the relation between these spectra investigated by fitting standardized major axis regressions. The effects of aboveground, belowground, and whole-plant ecological factors were quantified and ranked by variance decomposition and hierarchical partitioning. Our results showed that functional traits drive the substitution distribution of Stipa species, in being variously coupled with its desert, typical, and meadow steppe habitat types. The leaf, root, and whole-plant economic spectra of Stipa species in desert steppe exhibit a "quick investment-acquisition" strategy. In typical steppe, the leaf and whole-plant economic spectra of Stipa species correspond to a "fast investment-acquisition" strategy, whereas the root economic spectrum adopts a "slow investment-acquisition" strategy. On meadow steppe, the leaf, root, and whole-plant economic spectra of Stipa species similarly adopt a "slow investment-acquisition" strategy. Finally, when considering the environmental factors involved, we find that the substitution distribution of Stipa spp. is chiefly a response to shifting soil patterns, these mainly driven by soil total nitrogen and nitrogen/phosphorus ratio. Collectively, these findings provide an important reference for the ecological restoration and reconstruction of grassland ecosystems, to better understand the relationship between plant functional traits and ecological niche attributes, and thus guide the reasonable restoration of grassland vegetation.

Ginsenoside Re inhibits non-small cell lung cancer progression by suppressing macrophage M2 polarization induced by AMPKα1/STING positive feedback loop.

Tumor-associated macrophages (TAMs) in non-small cell lung cancer (NSCLC) promote tumor cell metastasis by interacting with cancer cells. Ginsenoside Re is capable of modulating the host immune system and exerts anticancer effects through multiple pathways. Both AMPK and STING are involved in the regulation of MΦ polarization, thereby affecting tumor progression. However, whether there is a regulatory relationship between them and its effect on MΦ polarization and tumor progression is unclear. The aim of this study was to provide mechanistic evidence that ginsenoside Re modulates MΦ phenotype through inhibition of the AMPKα1/STING positive feedback loop and thus exerts an antimetastatic effect in NSCLC immunotherapy. Cell culture models and conditioned media (CM) systems were constructed, and the treated MΦ were analyzed by database analysis, RT-PCR, Western blotting, flow cytometry, and immunofluorescence to determine the regulatory relationship between AMPK and STING and the effects of ginsenoside Re on MΦ polarization and tumor cells migration. The effects of ginsenoside Re (10, 20 mg/kg/day) on TAMs phenotype as well as tumor progression in mice were assessed by HE staining, immunohistochemical staining, and Western blotting. In this study, AMPKα1/STING positive feedback loop in NSCLC TAMs induced M2 type polarization, which in turn promoted NSCLC cell migration. In addition, ginsenoside Re was discovered to inhibit M2-like MΦ polarization, thereby inhibiting NSCLC cell migration. Mechanistically, Re was able to inhibit the formation of the AMPKα1/STING positive feedback loop, thereby inhibiting its induction of M2-like MΦ and consequently inhibiting the epithelial-mesenchymal transition (EMT) process of NSCLC cells. Furthermore, in mouse models, Re was found to suppress LLC tumor growth and colonization by inhibiting M2-type polarization of TAMs. Our finding indicates that ginsenoside Re can effectively modulate MΦ polarization and thus play an important role in antimetastatic immunotherapy of NSCLC.