Added Value of Frequency of Imaging Markers for Prediction of Outcome After Intracerebral Hemorrhage: A Secondary Analysis of Existing Data.

BACKGROUND: Frequency of imaging markers (FIM) has been identified as an independent predictor of hematoma expansion in patients with intracerebral hemorrhage (ICH), but its impact on clinical outcome of ICH is yet to be determined. The aim of the present study was to investigate this association. METHODS: This study was a secondary analysis of our prior research. The data for this study were derived from six retrospective cohorts of ICH from January 2018 to August 2022. All consecutive study participants were examined within 6 h of stroke onset on neuroimaging. FIM was defined as the ratio of the number of imaging markers on noncontrast head tomography (i.e., hypodensities, blend sign, and island sign) to onset-to-neuroimaging time. The primary poor outcome was defined as a modified Rankin Scale score of 3-6 at 3 months. RESULTS: A total of 1253 patients with ICH were included for final analysis. Among those with available follow-up results, 713 (56.90%) exhibited a poor neurologic outcome at 3 months. In a univariate analysis, FIM was associated with poor prognosis (odds ratio 4.36; 95% confidence interval 3.31-5.74; p < 0.001). After adjustment for age, Glasgow Coma Scale score, systolic blood pressure, hematoma volume, and intraventricular hemorrhage, FIM was still an independent predictor of worse prognosis (odds ratio 3.26; 95% confidence interval 2.37-4.48; p < 0.001). Based on receiver operating characteristic curve analysis, a cutoff value of 0.28 for FIM was associated with 0.69 sensitivity, 0.66 specificity, 0.73 positive predictive value, 0.62 negative predictive value, and 0.71 area under the curve for the diagnosis of poor outcome. CONCLUSIONS: The metric of FIM is associated with 3-month poor outcome after ICH. The novel indicator that helps identify patients who are likely within the 6-h time window at risk for worse outcome would be a valuable addition to the clinical management of ICH.

SIMULATED AEROMEDICAL EVACUATION EXACERBATES ACUTE LUNG INJURY VIA HYPOXIA-INDUCIBLE FACTOR 1Α-MEDIATED BNIP3/NIX-DEPENDENT MITOPHAGY.

ABSTRACT: Background: With the advancement of medicine and the development of technology, the limiting factors of aeromedical evacuation are gradually decreasing, and the scope of indications is expanding. However, the hypobaric and hypoxic environments experienced by critically ill patients in flight can cause lung injury, leading to inflammation and hypoxemia, which remains one of the few limiting factors for air medical evacuation. This study aimed to examine the mechanism of secondary lung injury in rat models of acute lung injury that simulate aeromedical evacuation. Methods: An acute lung injury model was induced in SD rats by the administration of lipopolysaccharide (LPS) followed by exposure to a simulated aeromedical evacuation environment (equivalent to 8,000 feet above sea level) or a normobaric normoxic environment for 4 h. The expression of hypoxia-inducible factor 1α (HIF-1α) was stabilized by pretreatment with dimethyloxalylglycine. The reactive oxygen species levels and the protein expression levels of HIF-1α, Bcl-2-interacting protein 3 (BNIP3), and NIX in lung tissue were measured. Results: Simulated aeromedical evacuation exacerbated pathological damage to lung tissue and increased the release of inflammatory cytokines in serum as well as the reactive oxygen species levels and the protein levels of HIF-1α, BNIP3, and NIX in lung tissue. Pretreatment with dimethyloxalylglycine resulted in increases in the protein expression of HIF-1α, BNIP3, and NIX. Conclusion: Simulated aeromedical evacuation leads to secondary lung injury through mitophagy.

Is the frequency of imaging markers still a predictor for revised intracerebral hemorrhage expansion?

INTRODUCTION: Frequency of imaging markers (FIM) has been described as a novel predictor for hematoma expansion after intracerebral hemorrhage (ICH). A revised definition of hematoma expansion that incorporates intraventricular hemorrhage (IVH) growth, that is, revised hematoma expansion (RHE), has also been proposed. Nevertheless, the associations between FIM and IVH growth or RHE remains unexplored. The objective of this study was to assess the influence and performance of the FIM on two types. MATERIALS AND METHODS: Patient selection and variables were based on our published protocol. FIM was defined as the ratio of the number of imaging markers to the onset-to-neuroimaging time. The association between FIM and two definitions was tested by multivariate analysis. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the FIM on two definitions were also evaluated. RESULTS: There were 303 (20.36%) and 583 (39.18%) subjects in the IVH growth and RHE, respectively. Multivariate analysis demonstrated that FIM was associated with both IVH growth and RHE (odds ratio [OR] = 1.96, 95% confidence interval [CI] = 1.60-2.39; OR = 15.01, 95% CI = 10.51-21.43, respectively). The optimal cutoff points for FIM to predict IVH growth and RHE were 0.63 and 0.62, with AUC, sensitivity, specificity, PPV, and NPV of 0.66, 0.50, 0.78, 0.36, and 0.86 versus 0.80, 0.60, 0.93, 0.84, and 0.78, respectively. DISCUSSION AND CONCLUSION: FIM was not only a predictor of IVH growth, but also of RHE. These findings may have important clinical implications for decision-making based on risk stratification of patients with ICH.

Combining Non-Contrast CT Signs With Onset-to-Imaging Time to Predict the Evolution of Intracerebral Hemorrhage.

OBJECTIVE: This study aimed to determine the predictive performance of non-contrast CT (NCCT) signs for hemorrhagic growth after intracerebral hemorrhage (ICH) when stratified by onset-to-imaging time (OIT). MATERIALS AND METHODS: 1488 supratentorial ICH within 6 h of onset were consecutively recruited from six centers between January 2018 and August 2022. NCCT signs were classified according to density (hypodensities, swirl sign, black hole sign, blend sign, fluid level, and heterogeneous density) and shape (island sign, satellite sign, and irregular shape) features. Multivariable logistic regression was used to evaluate the association between NCCT signs and three types of hemorrhagic growth: hematoma expansion (HE), intraventricular hemorrhage growth (IVHG), and revised HE (RHE). The performance of the NCCT signs was evaluated using the positive predictive value (PPV) stratified by OIT. RESULTS: Multivariable analysis showed that hypodensities were an independent predictor of HE (adjusted odds ratio [95% confidence interval] of 7.99 [4.87-13.40]), IVHG (3.64 [2.15-6.24]), and RHE (7.90 [4.93-12.90]). Similarly, OIT (for a 1-h increase) was an independent inverse predictor of HE (0.59 [0.52-0.66]), IVHG (0.72 [0.64-0.81]), and RHE (0.61 [0.54-0.67]). Blend and island signs were independently associated with HE and RHE (10.60 [7.36-15.30] and 10.10 [7.10-14.60], respectively, for the blend sign and 2.75 [1.64-4.67] and 2.62 [1.60-4.30], respectively, for the island sign). Hypodensities demonstrated low PPVs of 0.41 (110/269) or lower for IVHG when stratified by OIT. When OIT was ≤ 2 h, the PPVs of hypodensities, blend sign, and island sign for RHE were 0.80 (215/269), 0.90 (142/157), and 0.83 (103/124), respectively. CONCLUSION: Hypodensities, blend sign, and island sign were the best NCCT predictors of RHE when OIT was ≤ 2 h. NCCT signs may assist in earlier recognition of the risk of hemorrhagic growth and guide early intervention to prevent neurological deterioration resulting from hemorrhagic growth.

The frequency of imaging markers adjusted for time since symptom onset in intracerebral hemorrhage: A novel predictor for hematoma expansion.

BACKGROUND: Hematoma expansion (HE) is common in patients with intracerebral hemorrhage (ICH) and associated with a worse outcome. Imaging makers and shorter time from symptom onset are both associated with HE, but prognostic scores based on these parameters individually have not been satisfactory. We hypothesized that a score including both imaging markers of expansion, and time of onset, would improve prediction. METHODS: Patients with supratentorial ICH within 6 h after onset were consecutively recruited from six centers between January 2018 and August 2022. Three markers were used: hypodensities, the blend sign, and the island sign. We first defined frequency of imaging markers (FIM) as the relationship between the number of imaging markers and onset-to-CT time (OCT). The time-adjusted FIM was defined as the ratio of the number of imaging markers to the onset-to-initial imaging time. Multivariate analysis was performed to determine the relationship between FIM and HE. Receiver operating curve analysis was used to identify potential threshold values of FIM that optimally predict HE. In addition, the sensitivity, specificity, positive and negative predictive values (PPVs and NPVs), and the area under the curve (AUC) of the optimal cut-off in predicting HE were calculated. RESULTS: In total, 1488 patients were eligible for inclusion, of whom 418 had incident HE. Multivariate analysis showed that age, male sex, baseline Glasgow Coma Scale score, presence of intraventricular hemorrhage, and FIM were independent predictors of HE (odds ratio (OR) = 0.98, 95% confidence interval (CI) = 0.97-0.99; OR = 1.73, 95% CI = 1.28-2.35; OR = 0.87, 95% CI = 0.83-0.92; OR = 0.42, 95% CI = 0.28-0.62; OR = 7.82, 95% CI = 5.86-10.42, respectively). The optimal cut-off point for FIM in predicting HE was 0.63, with sensitivity, specificity, PPV, NPV, and AUC values of 0.69, 0.89, 0.71, 0.88, and 0.83, respectively. CONCLUSION: The FIM adjusted for time since symptom onset is a significant predictor of HE. Its use may allow improved prediction of those patients with ICH who develop HE, and the score may be clinically applicable in the management of patients with ICH.

New treatment methods for myocardial infarction.

For a long time, cardiovascular clinicians have focused their research on coronary atherosclerotic cardiovascular disease and acute myocardial infarction due to their high morbidity, high mortality, high disability rate, and limited treatment options. Despite the continuous optimization of the therapeutic methods and pharmacological therapies for myocardial ischemia-reperfusion, the incidence rate of heart failure continues to increase year by year. This situation is speculated to be caused by the current therapies, such as reperfusion therapy after ischemic injury, drugs, rehabilitation, and other traditional treatments, that do not directly target the infarcted myocardium. Consequently, these therapies cannot fundamentally solve the problems of myocardial pathological remodeling and the reduction of cardiac function after myocardial infarction, allowing for the progression of heart failure after myocardial infarction. Coupled with the decline in mortality caused by acute myocardial infarction in recent years, this combination leads to an increase in the incidence of heart failure. As a new promising therapy rising at the beginning of the twenty-first century, cardiac regenerative medicine provides a new choice and hope for the recovery of cardiac function and the prevention and treatment of heart failure after myocardial infarction. In the past two decades, regeneration engineering researchers have explored and summarized the elements, such as cells, scaffolds, and cytokines, required for myocardial regeneration from all aspects and various levels day and night, paving the way for our later scholars to carry out relevant research and also putting forward the current problems and directions for us. Here, we describe the advantages and challenges of cardiac tissue engineering, a contemporary innovative therapy after myocardial infarction, to provide a reference for clinical treatment.

Optimal cut-off values of haematoma volume for predicting haematoma expansion at different intracerebral haemorrhage locations.

BACKGROUND: Haematoma expansion (HE) is a frequent manifestation of acute intracerebral haemorrhage (ICH) and is associated with early disease progression and poor functional status. Approximately 30 % of patients with ICH experience substantial HE within the first few hours of onset. OBJECTIVES: This study aimed to investigate the relationship between HE and initial volume at different locations in patients with ICH. METHODS: We investigated consecutive patients with ICH admitted to the emergency room at Xiangyang No. 1 People's Hospital between January 2018 and June 2022. Haematoma volume was calculated using a three-dimensional slicer platform. Prediction models were assessed using a logistic regression model. The Youden index was used to assess the haematoma volume cut-off values for predicting HE. RESULTS: This study included 306 patients: 161 had basal ganglia ICH, 41 lobar ICH, and 104 thalamic ICH. The area under the ROC curve (AUC) for the thalamic ICH score in predicting intraventricular haemorrhage (IVH) expansion ≥ 1 mL or delayed IVH expansion was 0.786, and the best cut-off value was 7.05 mL (specificity, 85.3 %; sensitivity, 62.8 %; and accuracy, 76.0 %). The AUC for the thalamic ICH and lobar ICH scores in predicting haematoma or IVH expansion were 0.756 and 0.653, respectively; the best cut-offs were 7.05 mL for the thalamus (specificity, 84.8 %; sensitivity, 60.0 %; and accuracy, 74.0 %) and 31.89 mL in the lobar area (specificity, 81.8 %; sensitivity, 52.3 %; and accuracy, 68.3 %). CONCLUSIONS: Initial ICH volume predicted haematoma or IVH expansion at different locations. Moreover, it can assist clinicians in determining whether patients are suitable for future surgical interventions or other procedures.

Crosslinking of a polycaprolactone/tourmaline scaffold by sodium stearate with improved mechanical strength and bioactivity.

Although polycaprolactone (PCL) matrix composites have been extensively studied, the weak interface with nanofillers limits their further applications in bone tissue engineering. Herein, this study has designed a porous bone scaffold model using the triply periodic minimal surfaces (TPMS), and the optimal porosity was determined by comparing the mechanical properties. A sodium stearate-modified PCL/tourmaline (PCL/TM) composite scaffold with a strong interfacial effect was prepared by selective laser sintering technology. Wherein, sodium stearate acts as a bridge to improve the interaction between TM and PCL interface, while promoting its uniform dispersion. The results showed that the PCL/3% modified TM specimens exhibit the optimum mechanical properties, and their ultimate tensile and compressive strength increases by 21.8% and 32.1%, respectively, compared with pure PCL. The factors of mechanical enhancement of composite scaffolds can be elaborated from the construction of interface bridges. On the one hand, the carboxyl group at one end of sodium stearate will interact with the hydroxyl group on the surface of TM to enhance interfacial adsorption by forming ionic bonds and hydrogen bonds. On the other hand, the hydrophobic long chain at the other end of sodium stearate is universally compatible with hydrophobic PCL, thereby improving the dispersion of TM. These characteristics make the PCL/TM composite scaffold a valuable reference for its application in bone tissue engineering.

3D-Printed lattice-inspired composites for bone reconstruction.

Mechanical performance is crucial for biomedical applications of scaffolds. In this study, the stress distribution of six lattice-inspired structures was investigated using finite element simulations, and scaffolds with pre-designed structures were prepared using selective laser sintering (SLS) technology. The results showed that scaffolds with face-centered cubic (FCC) structures exhibited the highest compressive strength. Moreover, scaffolds composed of polylactic acid/anhydrous calcium hydrogen phosphate (PLA/DCPA) showed good mechanical properties and bioactivity. An in vitro study showed that these scaffolds promoted cell proliferation significantly and showed excellent osteogenic performance. Composite scaffolds with FCC structures are promising for bone tissue engineering.

Clinical Effect of Modified Ultrasound-Guided Subclavian Vein Puncture.

Objective: This study compared the effect of ultrasound-guided subclavian vein puncture with traditional blind puncture and the double-screen control method by evaluating the one-time puncture success and total success rates, the completion time for puncture and catheterization, and short-term complications. Methods: From January 2020 to January 2021, 72 patients with right subclavian venipuncture catheterization were collected, 12 of whom were excluded (including 3 cases of pneumothorax, 2 cases of hemothorax, 1 case of difficult positioning of thoracic deformity, 1 case of severe drug eruption, 3 cases of clavicle fracture, and 1 case of severe coagulation dysfunction). The remaining 60 cases were randomly divided into the traditional group (n = 30) and the improved group (n = 30). We record two sets of ultrasound localization time, puncture time, one-time puncture power, total puncture success rate, and short-term (24-hour) complications. Results: Compared with the traditional group, the ultrasound positioning time and puncture time in the improved group were significantly reduced and the puncture success rate was higher. There were no complications, such as incorrect arterial puncture and the occurrence of pneumothorax, in either group. Conclusion: The improved ultrasound-guided subclavian vein catheterization technique can greatly reduce the catheterization time and improve the success rate of puncture and catheterization. It can also reduce the occurrence of complications and damage to adjacent tissues. The operation is simple, fast, and easy to master, and it has a high popularization clinical value.

The role of cytoreductive radical prostatectomy and lymph node dissection in bone-metastatic prostate cancer: A population-based study.

BACKGROUNDS: The role of cytoreductive radical prostatectomy (cRP) for bone-metastatic prostate cancer (bmPCa) remains controversial. We aimed to figure out whether cRP and lymph node dissection (LND) can benefit bmPCa. METHODS: 11,271 PCa patients with bone metastatic burden from 2010 to 2019 were identified using SEER-Medicare. Overall survival (OS) and cancer-specific survival (CSS) rates were visualized using Kaplan-Meier plots. Multivariable Cox regression analyses were constructed to examine the effects of cRP and LND on survival, after stratifying to age, prostate specific antigen (PSA), clinical stages, Gleason score, metastatic burden, radiotherapy, and chemotherapy status. RESULTS: 317 PCa patients underwent cRP and cRP was increasingly performed for bmPCa from 2010 (2.2%) to 2019 (3.0%) (p < 0.05). In multi analyses, cRP was predisposed to a better OS or CSS in patients with age < 75, PSA < 98 ng/mL, bone-only metastatic sites or patients not receiving chemotherapy (all p < 0.05). For the patients undergoing cRP, LND especially extended LND was associated with a better OS or CSS (all p < 0.05). CONCLUSIONS: cRP might benefit OS or CSS in young patients with low PSA and bone-only metastatic sites not receiving chemotherapy. And a clear OS or CSS benefit of LND especially extended LND was observed in patients undergoing cRP.

Individualized prognosis stratification in muscle invasive bladder cancer: A pairwise TP53-derived transcriptome signature.

TP53 is the most frequently mutated gene in muscle invasive bladder cancer (MIBC) and there are two gene signatures regarding TP53 developed for MIBC prognosis. However, they are limited to immune genes only and unable to be used individually across platforms due to their quantitative manners. We used 827 gene expression profiles from seven MIBC cohorts with varied platforms to build a pairwise TP53-derived transcriptome signature, 13 gene pairs (13-GPs). Since the 13-GPs model is a single sample prognostic predictor, it can be applied individually in practice and is applicable to any gene-expression platforms without specific normalization requirements. Survival difference between high-risk and low-risk patients stratified by the 13-GPs test was statistically significant (HR range: 2.26-2.76, all P < .0001). Discovery and validation sets showed that the 13-GPs was an independent prognostic factor after adjusting other clinical features (HR range: 2.21-2.82, all P < .05). Moreover, it was a potential supplement to the consensus molecular classification of MIBC to further stratify the LumP subtype (patients with better prognoses). High- and low-risk patients by the 13-GPs model presented distinct immune microenvironment and DDR mutation rates, suggesting that it might have the potential for immunotherapy. Being a general approach to other cancer types, this study demonstrated how we integrated gene variants with pairwise gene panels to build a single sample prognostic test in translational oncology.

Using starch graft copolymer gel to assist the CO2 huff-n-puff process for enhanced oil recovery in a water channeling reservoir.

The CO2 huff-n-puff process is an effective method to enhance oil recovery (EOR) and reduce CO2 emissions. However, its utilization is limited in a channeling reservoir due to early water and gas breakthrough. A novel starch graft copolymer (SGC) gel is proposed for treating the channels and assisting with the CO2 huff-n-puff process. Firstly, the bulk and dynamic performances of the SGC gel including rheology, injectivity and plugging ability are compared with the polymer gel in the laboratory. Then, 3D physical models with water channels are established to reveal the EOR mechanisms of gel assisted CO2 huff-n-puff. Several pilot tests of gel assisted CO2 huff-n-puff are also discussed in this paper. The bulk and dynamic experimental results show that although these two gelants have similar viscosities, the SGC gelant has a better injectivity compared with the polymer gelant. The SGC gel is predominantly a viscous solution, which make it easier to flow through the pore throats. The RF of the SGC gelant is only 0.58 times that of the polymer gelant. After the gelation, a 3D network-like gel with a viscosity of 174 267 mPa s can be formed using the SGC gelant. The RRF of the SGC gel is about three times that of the polymer gel, which shows that the SGC gel has a stronger plugging ability within the porous media. The 3D experimental results show that four cycles of gel assisted CO2 huff-n-puff can achieve an EOR of 11.36%, which is 2.56 times that of the pure CO2 huff-n-puff. After the channels are plugged by the SGC gel, the remaining oil of the near-wellbore area can be first extracted by CO2, and the oil of the deep formation can then be effectively displaced by the edge water. Pilot tests on five wells were conducted in the Jidong Oilfield, China, and a total oil production of 3790.86 m3 was obtained between 2016 and 2021. The proposed novel SGC gel is suitable for assisting with the CO2 huff-n-puff process, which is a beneficial method for further EOR in a water channeling reservoir.

In Situ Grown Nanohydroxyapatite Hybridized Graphene Oxide: Enhancing the Strength and Bioactivity of Polymer Scaffolds.

Graphene oxide (GO) and nanohydroxyapatite (nHA) are usually used for improving the strength and bioactivity of polymer scaffolds. However, due to the nano-aggregation effect, these applications often face the problems of uneven dispersion and poor interface bonding. In this work, their hybrids (GO@nHA) were constructed by combining chemical modification and in situ growth methods, realizing the perfect combination of nHA and GO. First, the functionalization of GO was realized through oxidative self-polymerization of dopamine (DA), and the product was denoted GO@DA. Furthermore, the in situ growth of nHA on GO@DA was induced by hydrothermal reactions to prepare GO@nHA hybrids. Then, the obtained hybrid was added to the polymer matrix, and a composite scaffold was prepared through a selective laser sintering process. The results demonstrated that with the addition of GO@DA and GO@nHA, the ultimate strength was increased to 16.8 and 18.6 MPa, respectively, which is 66 and 84% higher than the 10.1 MPa of the polylactic acid (PLA) scaffold. In addition, composite scaffolds exhibited good biomineralization ability in vitro and also promoted the adhesion and proliferation of MG63 cells.

Influence of Mo on the Microstructure and Corrosion Behavior of Laser Cladding FeCoCrNi High-Entropy Alloy Coatings.

FeCoCrNi and FeCoNiCrMo0.2 high-entropy alloy powders were prepared by gas atomization. Two kinds of coatings were prepared on the surface of 304 stainless steel by laser cladding technology. The effect of Mo element on the microstructure of laser cladding FeCoCrNi coating and its corrosion behavior in 3.5 wt.% NaCl solution was investigated. Both FeCoCrNi and FeCoCrNiMo0.2 powders exhibit a single-phase FCC structure. Due to the remelting and multiple heat treatments during the preparation of the laser cladding coating, a small amount of σ and µ phases appeared in the FeCoCrNiMo0.2 coating. The microstructures of the two coatings from the bonding area to the top layer are planar, columnar and equiaxed grains, respectively. The addition of the Mo element causes the dendrite size in the middle region of the FeCoCrNiMo0.2 coating increases significantly and exhibits obvious orientation characteristics. FeCoCrNiMo0.2 coating has high corrosion potential (-0.01 VSHE) and low current density (0.94 × 10-7 A/cm2) in 3.5 wt.% NaCl solution, showing excellent corrosion resistance. The passivation film formed on corroded the FeCoCrNiMo0.2 coating contains high content of oxides of Cr and Mo. The addition of the Mo element enhances the compactness and pitting resistance of the passivation film.

MUC20 as a novel prognostic biomarker in ccRCC correlating with tumor immune microenvironment modulation.

Tumor microenvironment (TME) broadly participates in genesis development of clear cell renal cell carcinoma (ccRCC). To recognize the immune and stromal modulation in TME, we screened the differentially expressed TME-related genes generated by the ESTIMATE algorithm in ccRCC specimens. Following the construction of protein-protein interaction (PPI) network and univariate COX regression, mucin 20 (MUC20) was judged to be a predictive factor. Further analysis, including immunohistochemistry (IHC) showed that MUC20 was positively correlated with survival and negatively correlated with the clinicopathologic characteristics (grade, clinical and TNM stages) in ccRCC patients. Gene Set Enrichment Analysis suggested that the low-expression MUC20 group was primarily enriched in immune-related activities, inflammation and epithelial-mesenchymal transition. Based on the CIBERSORT analysis for tumor-infiltrating immune cells (TICs), MUC20 was positively correlated with CD8+ T cells and resting mast cells and negatively correlated with activated CD4+ memory T cells, Treg cells, and plasma cells, implying that MUC20 may contribute to immune component in TME. Additionally, the patients with low MUC20 expression had better response to immune checkpoint blockades (ICBs) and 17 potential anticancer drugs were screened regarding calculating IC50 value. Thus, MUC20 may contain a value of prognosis assessment for ccRCC patients and indicate the immune modulation status of TME, which provided a novel insight for comprehensive immunotherapy.

Clinical characteristics and survival analysis of patients with hepatocellular carcinoma after hepatitis B virus turning negative.

BACKGROUND: Hepatitis B virus (HBV) infection is one of the most common infections, affecting 248 million people worldwide. Hepatitis B virus can progress to cirrhosis, liver failure and hepatocellular carcinoma (HCC). OBJECTIVES: To analyze the clinical characteristics and survival time of HCC occurrence in patients with HBV infection after virus turning negative. MATERIAL AND METHODS: The Kaplan-Meier and log rank survival analysis were performed to compare the overall survival (OS) of the patients with HCC in different groups. RESULTS: The 1-, 3- and 5-year OS rates of the 104 investigated patients were 76.4%, 54.4% and 20.5%, respectively. The median survival time was 37 months. The median survival time of HBV-DNA-negative group was longer than that of the HBV-DNA-positive group (negative compared to positive: 42 compared to 36, p = 0.003). The 5-year OS rate of patients receiving antiviral therapy before HCC diagnosis in the HBV-DNA-negative group was higher than that in the HBV-DNA-positive group (negative compared to positive: 53.0% compared to 0%, p = 0.022). There was no significant difference in the 5-year OS rate in patients who did not receive antiviral therapy before HCC diagnosis between HBV-DNA-negative and HBV-DNA-positive groups (p = 0.195). CONCLUSIONS: Among HBV-infected patients, a significant proportion of virus-negative patients develop liver cancer and require long-term continuous monitoring. A long-term effective antiviral therapy can improve the survival rate of patients with liver cancer. This study revealed important clinical characteristics of HCC patients and provided useful information for their clinical management and monitoring.

Application of the ultrasound-guided double-screen contrast method in the standardized teaching and training of resident doctors in femoral vein puncture.

Objective: The aim of this study was to investigate the advantages of the double-screen contrast method compared with the short-axis ultrasound display method for teaching ultrasound-guided femoral vein puncture during the standardized training of resident doctors. Methods: Sixty resident doctors undergoing standardized training were randomly divided into a test group (short-long axis switching double-screen contrast, n = 30) and a control group (n = 30). These two groups of physicians underwent teaching and training of ultrasound-guided femoral vein puncture, and the success rate of the first puncture attempt, the total catheterization time, and any accidental femoral artery punctures were recorded and compared between the two groups. Results: The success rate of the first puncture attempt in the test group was significantly higher than that in the control group (P < 0.05). In the control group, two doctors accidentally punctured the artery, while in the test group, no arterial punctures occurred. The puncture time for the test group was longer than for the control group (P < 0.05). Conclusion: In the standardized training of ultrasound-guided femoral vein puncture for resident doctors, the double-screen contrast method has significant advantages. It enables resident doctors to quickly understand and apply the technique, so it is worth making this the method of choice.

Corrosion Behavior of the CoNiCrAlY-Al2O3 Composite Coating Based on Core-Shell Structured Powder Design.

The oxidation of the metal powder during the thermal spraying process usually leads to significant deterioration of the microstructure and performance of the coating. In order to isolate the metal powder from oxygen during the spraying process, the CoNiCrAlY-Al2O3 core-shell structured powder with Al2O3 as the shell was designed in this study. The influence of the core-shell structured powder on the microstructure and corrosion resistance of the HVOF coating has been studied in detail. The results show that the temperature field of the molten CoNiCrAlY powder during the spraying process is significantly changed by the Al2O3 shell. The poor deformability of the CoNiCrAlY-Al2O3 droplets leads to an increase in the porosity and unmelted particles of the coating. In addition, the significant difference is that the coating also maintains a high content of ß-NiAl phase. The lower oxide content in the CoNiCrAlY-Al2O3 coating indicates that the core-shell structured powder significantly inhibits the oxidation of the CoNiCrAlY core powder during the spraying process. The CoNiCrAlY-Al2O3 coating exhibits high corrosion potential, passive film resistance, charge transfer resistance, and low corrosion current density in 3.5 wt.% NaCl solution, indicating that the coating has excellent corrosion resistance.

Modulating OFC Activity With tDCS Alters Regret About Human Decision-Making.

Regret is a common emotion in daily life. Humans always regret their decision-making choices if the chosen outcome is bad. Neuroscientific studies suggest that the orbitofrontal cortex (OFC) influences feelings of regret. We used a transcranial direct current stimulation (tDCS) device to study the role of regret in participants' decision-making by modulating the activity of the OFC. The two-wheel-of-fortune gamble task was used in our experimental design, and we asked the participants to rate their feelings of regret after the computer presented the obtained and unobtained outcomes. The experimental results revealed that the effect of stimulation type was significant, which indicated that the influence of the OFC in regret was modulated by tDCS. Furthermore, based on post hoc analyses (Bonferroni), regret was lower in those who received left anodal/right cathodal stimulation than in those who received sham stimulation, which revealed that modulating the activity of the OFC reduced the emotional intensity of regret. In addition, an inverted U-shaped curve characterized the mean ratings of regret over time.