Screening for early rheumatoid arthritis using high-frequency ultrasound, serum RANKL, and OPG detection.

OBJECTIVE: To conduct a comparative study of high-frequency ultrasound and magnetic resonance imaging (MRI) combined with serum RANKL and OPG detection, and assess the efficacy of high-frequency ultrasound with RANKL and OPG detection in screening early rheumatoid arthritis (RA). METHOD: High-frequency ultrasound and MRI were performed on both carpal joints of 60 patients with early RA, and the frequencies of synovitis, joint effusion, tenosynovitis, and bone erosion detected by high-frequency ultrasound and MRI were observed. The serum levels of receptor activator for nuclear factor-κB ligand (RANKL) and osteoclastogenesis inhibitory factor (OPG) were also detected. The serum levels of RANKL and OPG were also detected in 80 normal healthy examinees. The data were recorded and statistically analyzed. RESULTS: The detection rates of carpal synovitis, joint effusion, tenosynovitis, and bone erosion in RA patients by high-frequency ultrasound were 81.66%, 69.16%, 63.33%, and 1.66%, respectively, while the detection rates by MRI were 80.00%, 71.66%, 65.00%, and 15.00%, respectively. There was no significant difference between high-frequency ultrasound and MRI in the detection rates of carpal synovitis, joint effusion, and tenosynovitis in RA patients (P > 0.05), while the detection rate of bone erosion by high-frequency ultrasound was significantly lower than that by MRI. The serum levels of RANKL and OPG in RA patients were 231.47 and 68.71, respectively, while the serum levels of RANKL and OPG in normal healthy examinees were 123.51 and 385.05, respectively. The serum RANKL levels of RA patients were significantly higher than those of healthy examinees, while the serum OPG levels of RA patients were significantly lower than those of healthy examinees, which were statistically significant (P < 0.01). The AUC values of the ROC curves obtained by high-frequency ultrasound and MRI combined with serum RANKL and OPG detection in Synovitis modeling were 0.955 and 0.954, respectively. The AUC values of the ROC curves obtained from the joint fusion modeling using high-frequency ultrasound and MRI combined with serum RANKL and OPG detection were 0.949 and 0.950, respectively. The AUC values of the ROC curves obtained from modeling Tenosynovitis using high-frequency ultrasound and MRI combined with serum RANKL and OPG detection were 0.941 and 0.949, respectively. The AUC values of ROC curves obtained by combining high-frequency ultrasound and MRI with serum RANKL and OPG detection in Bone erosion modeling were 0.908 and 0.923, respectively. CONCLUSION: High-frequency ultrasound combined with serum RANKL and OPG detection has comparable effects to MRI on screening early RA, providing a safe, simple, and cost-effective screening method for the early detection of RA patients. Key Points • High-frequency ultrasound and MRI can effectively detect early lesions of the wrist joints in RA patients. • Ultrasound diagnosis has the advantages of being quick, inexpensive, and repeatable, making it the preferred choice of imaging examination for RA patients at an early stage.

RARRES2 regulates lipid metabolic reprogramming to mediate the development of brain metastasis in triple negative breast cancer.

BACKGROUND: Triple negative breast cancer (TNBC), the most aggressive subtype of breast cancer, is characterized by a high incidence of brain metastasis (BrM) and a poor prognosis. As the most lethal form of breast cancer, BrM remains a major clinical challenge due to its rising incidence and lack of effective treatment strategies. Recent evidence suggested a potential role of lipid metabolic reprogramming in breast cancer brain metastasis (BCBrM), but the underlying mechanisms are far from being fully elucidated. METHODS: Through analysis of BCBrM transcriptome data from mice and patients, and immunohistochemical validation on patient tissues, we identified and verified the specific down-regulation of retinoic acid receptor responder 2 (RARRES2), a multifunctional adipokine and chemokine, in BrM of TNBC. We investigated the effect of aberrant RARRES2 expression of BrM in both in vitro and in vivo studies. Key signaling pathway components were evaluated using multi-omics approaches. Lipidomics were performed to elucidate the regulation of lipid metabolic reprogramming of RARRES2. RESULTS: We found that down-regulation of RARRES2 is specifically associated with BCBrM, and that RARRES2 deficiency promoted BCBrM through lipid metabolic reprogramming. Mechanistically, reduced expression of RARRES2 in brain metastatic potential TNBC cells resulted in increased levels of glycerophospholipid and decreased levels of triacylglycerols by regulating phosphatase and tensin homologue (PTEN)-mammalian target of rapamycin (mTOR)-sterol regulatory element-binding protein 1 (SREBP1) signaling pathway to facilitate the survival of breast cancer cells in the unique brain microenvironment. CONCLUSIONS: Our work uncovers an essential role of RARRES2 in linking lipid metabolic reprogramming and the development of BrM. RARRES2-dependent metabolic functions may serve as potential biomarkers or therapeutic targets for BCBrM.

White-light-emitting Ln-hydrogels with multi-stimuli responsiveness and applications in environmental sensing and anti-counterfeiting.

The construction of smart materials, especially white light emitting (WLE) hydrogels with multi-stimuli responsive properties, has received widespread attention from researchers. In this study, a WLE hydrogel was obtained by the in situ doping of Eu3+ and Tb3+ into a blue emission low molecular weight gelator (MPF). Remarkably, the prepared WLE hydrogel possessed excellent stimuli responsiveness to pH, temperature and chemicals, and could be used as a soft thermometer and a selective sensor for Cu2+. The correlated color temperature of the WLE hydrogel was calculated to be 5063 K, suggesting a potential application in cool white light. Moreover, a series of metallohydrogels with different colors were obtained by modulating the ratio of MPF, Eu3+ and Tb3+ or changing the excitation wavelength, which was an excellent candidate to construct soft materials of a full-color system. Additionally, the WLE hydrogel could be used for constructing anti-counterfeiting materials. Therefore, this study provides a new approach for preparing smart WLE hydrogels with multiple functions.

An iron(III) complex-based supramolecular organic framework (SOF) as a theranostic platform via magnetic resonance imaging-guided chemotherapy.

It is crucially important to explore the additional metal-endowed functions of supramolecular organic frameworks (SOFs) for expanding their applications. In this work we have reported the performance of a SOF (designated as Fe(III)-SOF) as a theranostic platform via magnetic resonance imaging (MRI)-guided chemotherapy. The Fe(III)-SOF may be used as an MRI contrast agent for cancer diagnosis because the building unit (iron complex) contains high spin iron(III) ions. Additionally, the Fe(III)-SOF may also be used as a drug carrier because it possesses stable internal voids. We loaded doxorubicin (DOX) into the Fe(III)-SOF to obtain a DOX@Fe(III)-SOF. The Fe(III)-SOF showed good loading content (16.3%) and high loading efficiency (65.2%) for DOX. Additionally, the DOX@Fe(III)-SOF had a relatively modest relaxivity value (r2 = 19.745 mM-1 s-1) and exhibited the strongest negative contrast (darkest) at 12 h of post-injection. Furthermore, the DOX@Fe(III)-SOF effectively inhibited tumor growth and showed high anticancer efficiency. In addition, the Fe(III)-SOF was biocompatible and biosafe. Therefore, the Fe(III)-SOF was an excellent theranostic platform and may have potential applications in tumor diagnosis and treatment in the future. We believe that this work will initiate extensive research endeavors not only on the development of SOFs, but also on the construction of theranostic platforms based on SOFs.

A LaCl3-based lithium superionic conductor compatible with lithium metal.

Inorganic superionic conductors possess high ionic conductivity and excellent thermal stability but their poor interfacial compatibility with lithium metal electrodes precludes application in all-solid-state lithium metal batteries1,2. Here we report a LaCl3-based lithium superionic conductor possessing excellent interfacial compatibility with lithium metal electrodes. In contrast to a Li3MCl6 (M = Y, In, Sc and Ho) electrolyte lattice3-6, the UCl3-type LaCl3 lattice has large, one-dimensional channels for rapid Li+ conduction, interconnected by La vacancies via Ta doping and resulting in a three-dimensional Li+ migration network. The optimized Li0.388Ta0.238La0.475Cl3 electrolyte exhibits Li+ conductivity of 3.02 mS cm-1 at 30 °C and a low activation energy of 0.197 eV. It also generates a gradient interfacial passivation layer to stabilize the Li metal electrode for long-term cycling of a Li-Li symmetric cell (1 mAh cm-2) for more than 5,000 h. When directly coupled with an uncoated LiNi0.5Co0.2Mn0.3O2 cathode and bare Li metal anode, the Li0.388Ta0.238La0.475Cl3 electrolyte enables a solid battery to run for more than 100 cycles with a cutoff voltage of 4.35 V and areal capacity of more than 1 mAh cm-2. We also demonstrate rapid Li+ conduction in lanthanide metal chlorides (LnCl3; Ln = La, Ce, Nd, Sm and Gd), suggesting that the LnCl3 solid electrolyte system could provide further developments in conductivity and utility.

Gastric Neuroendocrine Tumors According to the 2019World Health Organization Grading System: A Single-Center, Retrospective Study

Background/Aims@#Although gastric neuroendocrine tumors (NETs) are uncommon neoplasms, their prevalence is increasing. The clinical importance of the World Health Organization (WHO) classification of gastric NETs, compared with NETs in other organs, has been underestimated.This study aimed to systematically evaluate the clinical and pathologic characteristics of gastric NETs based on the 2019 WHO classification and to assess the survival outcomes of patients from a single-center with a long-term follow-up. @*Methods@#The medical records of 427 patients with gastric NETs who underwent endoscopic or surgical resection between January 2000 and March 2020 were retrospectively reviewed. All specimens were reclassified according to the 2019 WHO classification. The clinicopathologic characteristics, treatment, and oncologic outcomes of 139 gastric NETs were analyzed. @*Results@#The patients’ median age was 53.0 years (interquartile range [IQR], 46.0 to 63.0 years). The median follow-up period was 36.0 months (IQR, 15.0 to 63.0 months). Of the patients, 92, 44, and 3 had grades 1, 2, and 3 NETs, respectively. The mean tumor size significantly increased as the tumor grade increased (p=0.025). Patients with grades 2 and 3 gastric NETs more frequently had lymphovascular invasion (29.8% vs 10.9%, p=0.005) and deeper tissue invasion (8.5% vs 0%, p=0.012) than those with grade 1 tumors. The overall disease-specific survival rate was 100%. Two patients with grades 2-3 gastric NETs experienced extragastric recurrence. @*Conclusions@#Although gastric NETs have an excellent prognosis, grade 2 or grade 3 gastric NETs are associated with a larger size, deeper invasion, and extragastric recurrence, which require active treatment.

Analysis of Plasma Circulating Tumor DNA in Borderline Resectable Pancreatic Cancer Treated with Neoadjuvant Modified FOLFIRINOX: Clinical Relevance of DNA Damage Repair Gene Alteration Detection / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#There are no reliable biomarkers to guide treatment for patients with borderline resectable pancreatic cancer (BRPC) in the neoadjuvant setting. We used plasma circulating tumor DNA (ctDNA) sequencing to search biomarkers for patients with BRPC receiving neoadjuvant mFOLFIRINOX in our phase 2 clinical trial (NCT02749136). @*Materials and Methods@#Among the 44 patients enrolled in the trial, patients with plasma ctDNA sequencing at baseline or post-operation were included in this analysis. Plasma cell-free DNA isolation and sequencing were performed using the Guardant 360 assay. Detection of genomic alterations, including DNA damage repair (DDR) genes, were examined for correlations with survival. @*Results@#Among the 44 patients, 28 patients had ctDNA sequencing data qualified for the analysis and were included in this study. Among the 25 patients with baseline plasma ctDNA data, 10 patients (40%) had alterations of DDR genes detected at baseline, inclu-ding ATM, BRCA1, BRCA2 and MLH1, and showed significantly better progression-free survival than those without such DDR gene alterations detected (median, 26.6 vs. 13.5 months; log-rank p=0.004). Patients with somatic KRAS mutations detected at baseline (n=6) had significantly worse overall survival (median, 8.5 months vs. not applicable; log-rank p=0.003) than those without. Among 13 patients with post-operative plasma ctDNA data, eight patients (61.5%) had detectable somatic alterations. @*Conclusion@#Detection of DDR gene mutations from plasma ctDNA at baseline was associated with better survival outcomes of pati-ents with borderline resectable pancreatic ductal adenocarcinoma treated with neoadjuvant mFOLFIRINOX and may be a prognostic biomarker.

Attention-Guided Collaborative Counting.

Existing crowd counting designs usually exploit multi-branch structures to address the scale diversity problem. However, branches in these structures work in a competitive rather than collaborative way. In this paper, we focus on promoting collaboration between branches. Specifically, we propose an attention-guided collaborative counting module (AGCCM) comprising an attention-guided module (AGM) and a collaborative counting module (CCM). The CCM promotes collaboration among branches by recombining each branch's output into an independent count and joint counts with other branches. The AGM capturing the global attention map through a transformer structure with a pair of foreground-background related loss functions can distinguish the advantages of different branches. The loss functions do not require additional labels and crowd division. In addition, we design two kinds of bidirectional transformers (Bi-Transformers) to decouple the global attention to row attention and column attention. The proposed Bi-Transformers are able to reduce the computational complexity and handle images in any resolution without cropping the image into small patches. Extensive experiments on several public datasets demonstrate that the proposed algorithm performs favorably against the state-of-the-art crowd counting methods.

Optimally filtering and matching processing for regional upstrokes to improve ultrasound transit time-based local PWV estimation.

BACKGROUND AND OBJECTIVE: Pulse wave velocity (PWV) is an important index for quantifying the elasticity of artery. Local PWV estimates based on ultrasonic transit time (TT) methods, however, are affected by the reflected waves and ultrasonic noise, biasing the spatiotemporal propagation of the time fiduciary point (TFP) positioning in the distension waveforms. In this study, an optimally filtering and matching processing for regional upstrokes is proposed to improve the ultrasound TT-based local PWV estimation. METHOD: (i) Smooth the pulse waves (PWs) using the Savitzky-Golay filter with one set of randomly combined parameters. (ii) An arbitrary region at the first beam upstroke of the smoothed PWs is selected as the curve template, and then matched with the upstrokes of other PWs by calculating the sum of square differences (SSD) between the template and matching regions to find its similar regions. (iii) Update the filter parameters and the template using the moth-flame optimization (MFO) feedback for computing the new SSD value. When the new SSD value is smaller than the historical one, the later will be replaced. (iv) Repeat the above steps until the MFO algorithm converges to the minimum SSD value. (v) Output the optimal filter parameters and the locations of regional curves corresponding to the minimum SSD value. Then the time delay of the PWs propagation can be detected by using the starting points of the regional curves as the TFPs. RESULTS: We conducted performance comparison with the advanced TT method through both simulation and clinical experiments. The results demonstrate that the proposed work observes considerable reductions on both the normalized root mean square error ± the standard deviation (from 6.73 ± 2.27% to 1.57 ± 0.72%) and the coefficient of variation (from 13.39% to 8.87%). CONCLUSIONS: The results of this study support that the proposed method may facilitate the early diagnosis and prevention of local arterial stiffness .

BAHD1 serves as a critical regulator of breast cancer cell proliferation and invasion.

Breast cancer patients with lymphatic metastasis suffer from poor prognoses. There is an urgent need for controlling lymph node metastasis, but it has proven challenging so far. Here, we implemented LASSO analysis of The Cancer Genome Atlas database to identify genes related to lymph node metastasis and prognosis, and 15 genes were selected. We constructed a functional protein association network and univariate Cox regression to identify significant genes. The results showed that BAHD1 could be predictive of lymph node metastasis as well as prognosis. In vitro studies demonstrated that BAHD1 exerted appreciable effects on the proliferation, migration, and invasion capacity of breast cancer cells. Furthermore, downregulation of BAHD1 induced cell cycle arrest in G1 phase. Additionally, the mRNA levels of CCND1, CDK1 and YWHAZ were decreased upon BAHD1 silencing. These findings indicate that the expression of BAHD1 is essential in the progression of breast cancer, which may provide novel therapeutic and diagnostic clues and insights into the prevention of lymph node metastasis in breast cancer.

Decellularized scaffold-based poly(ethylene glycol) biomimetic vascular patches modified with polyelectrolyte multilayer of heparin and chitosan: preparation and vascular tissue engineering applications in a porcine model.

Mechanical property mismatch between vascular patches and native blood vessels can result in post-operation failure; therefore, vascular patches that mimic the biomechanical properties of native blood vessels must be developed. In this study, we constructed a biomimetic vascular patch by coating a poly(ethylene glycol) (PEG) film onto a decellularized scaffold (DCS) and modifying its surface with a heparin-chitosan polyelectrolyte multilayer (PEM). The PEM-modified PEG/DCS vascular patches exhibited comparable mechanical characteristics with native blood vessels. They effectively resisted platelet adhesion, reduced the hemolysis rate, increased the clotting time in vitro, and favoured the adhesion and growth of endothelial progenitor cells. In addition, the modified patches maintained long-term patency (5 months) of the treated arteries in vivo. Because of the synergistic effect of heparin and chitosan in PEM, the vascular patches may be able to manage medical complications. Thus, the PEM-modified PEG/DCS vascular patches may have promising applications in the repair of damaged or diseased blood vessels.

The pH dependence of emulsifying properties for glutathione disulfide at oil-water interfaces.

Although peptides were widely used in many fields, their interface behaviors as surfactants have not been explored. The results of the surface tension experiments by an automatic surface tension meter indicate that the stability and emulsifying ability of glutathione disulfide (GSSG) under alkaline conditions were stronger than those under acidic conditions. With encoding the different oxygen and nitrogen atoms in GSSG, as well as the different hydrogen atoms bonded with oxygen and nitrogen atoms. The pH Dependence of the number of hydrogen bonds, affected by the protonation and deprotonation of the functional groups in GSSG, is calculated by LAMMPS software. The results demonstrate that GSSG forms twice as many hydrogen bonds under alkaline conditions as under acidic conditions, resulting in a better surface-interface activity in alkaline conditions. The interface properties of the GSSG surfactant can be regulated by pH. Therefore, GSSG is a potential pH-responsive surfactant.

Real-World Efficacy Data and Predictive Clinical Parameters for Treatment Outcomes in Advanced Esophageal Squamous Cell Carcinoma Treated with Immune Checkpoint Inhibitors / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#This study aimed to evaluate the real-world efficacy of immune checkpoint inhibitors (ICIs), and to identify clinicolaboratory factors to predict treatment outcomes in patients with advanced esophageal squamous cell carcinoma (ESCC) receiving ICIs. @*Materials and Methods@#Sixty patients with metastatic or unresectable ESCC treated with nivolumab (n=48) or pembrolizumab (n=12) as ≥ second-line treatment between 2016 and 2019 at Asan Medical Center were included. @*Results@#The median age of the patients was 68 years (range, 52 to 76 years), and 93.3% were male. Most patients had metastatic disease (81.7%) and had been previously treated with fluoropyrimidines, platinum, and taxane. In 53 patients with measurable disease, the overall response rate and disease control rate were 15.1% and 35.8%, respectively. With a median follow-up duration of 16.0 months, the median progression-free survival (PFS) and overall survival (OS) were 1.9 months (95% confidence interval [CI], 1.54 to 2.19) and 6.4 months (95% CI, 4.77 to 8.11), respectively. After multivariate analysis, recent use of antibiotics, low prognostic nutrition index (< 35.93), high Glasgow Prognosis Score (≥ 1) at baseline, and ≥ 1.4-fold increase in neutrophil-to-lymphocyte ratio after one cycle from baseline were significantly unfavorable factors for both PFS and OS. Younger age (< 65 years) was a significant factor for unfavorable PFS and hyponatremia (< 135 mmol/L) for unfavorable OS. @*Conclusion@#The use of ICIs after the failure of chemotherapy showed comparable efficacy in patients with advanced ESCC in real practice; this may be associated with host immune-nutritional status, which could be predicted by clinical and routine laboratory factors.

Diagnostic and prognostic impact of fluorodeoxyglucosepositron emission tomography in diagnosing intraductal papillary neoplasms of the bile duct of the liver

Purpose@#Malignant intraductal papillary neoplasm of the bile duct of the liver (IPNB-L) cannot readily be diagnosed through preoperative CT or MRI, but fluorodeoxyglucose (FDG)-PET is a viable alternative. This study evaluated the diagnostic and prognostic impacts of FDG-PET in patients with IPNB-L. @*Methods@#This was a retrospective single-center study of 101 IPNB-L patients who underwent hepatectomy between 2010 and 2019. @*Results@#Mean age was 64.4 ± 8.3 years and 76 (75.2%) were male. Anatomical hepatic resection was performed in 99 (98.0%). Concurrent bile duct resection and pancreaticoduodenectomy were performed in 41 (40.6%) and 1 (1.0%), respectively. R0 and R1 resections were performed in 88 (87.1%) and 13 (12.9%), respectively. Low-grade intraepithelial neoplasia and high-grade neoplasia/invasive carcinoma were diagnosed in 19 (18.8%) and 82 (81.2%), respectively. Median FDG-PET maximal standardized uptake values (SUVmax) in low-grade neoplasia and high-grade neoplasia/carcinoma were 3.6 (range, 1.7–7.6) and 5.2 (range, 1.5–18.7) (P = 0.019), respectively. Receiver operating characteristic curve analysis of SUVmax showed area under the curve of 0.674, with sensitivity of 84.2% and specificity of 47.4% at SUVmax cutoff of 3.0. This cutoff had no significant influence on tumor recurrence (P = 0.832) or patient survival (P = 0.996) in patients with IPNB-L of high-grade neoplasia or invasive carcinoma. @*Conclusion@#IPNB-L is a rare type of biliary neoplasm and encompasses a histological spectrum ranging from benign disease to invasive carcinoma. An FDG-PET SUVmax cutoff of 3.0 appears to effectively discern high-grade neoplasia/ carcinoma from low-grade neoplasia, which will assist with the surgical strategy for these cases.

Source Symbol Purging-Based Distributed Conditional Arithmetic Coding.

A distributed arithmetic coding algorithm based on source symbol purging and using the context model is proposed to solve the asymmetric Slepian-Wolf problem. The proposed scheme is to make better use of both the correlation between adjacent symbols in the source sequence and the correlation between the corresponding symbols of the source and the side information sequences to improve the coding performance of the source. Since the encoder purges a part of symbols from the source sequence, a shorter codeword length can be obtained. Those purged symbols are still used as the context of the subsequent symbols to be encoded. An improved calculation method for the posterior probability is also proposed based on the purging feature, such that the decoder can utilize the correlation within the source sequence to improve the decoding performance. In addition, this scheme achieves better error performance at the decoder by adding a forbidden symbol in the encoding process. The simulation results show that the encoding complexity and the minimum code rate required for lossless decoding are lower than that of the traditional distributed arithmetic coding. When the internal correlation strength of the source is strong, compared with other DSC schemes, the proposed scheme exhibits a better decoding performance under the same code rate.

Effects of Dexmedetomidine on Patients Undergoing Laparoscopic Surgery for Colorectal Cancer.

BACKGROUND: Pneumoperitoneum during laparoscopic surgery has a systemic impact on the renal system and might contribute to acute kidney injury or postoperative renal dysfunction. However, effective preventive strategies are still lacking. We aimed to explore the effects of dexmedetomidine (DEX) on kidney and other organ function in patients undergoing elective laparoscopic surgery for colorectal cancer. MATERIALS AND METHODS: Fifty-six patients were randomly enrolled into the Control or DEX group. The DEX group received 1 µg kg-1 DEX intravenously within 10 min followed by a maintenance dose of 0.5 µg kg-1 h-1 infused until 30 min before closing the peritoneum. In the Control group, 0.9% sodium chloride was administered as a placebo. The primary outcome was serum neutrophil gelatinase-associated lipocalin (NGAL) levels reflecting kidney injury. Secondary outcomes included variables reflecting the kidney, intestinal injury and systemic inflammatory response. RESULTS: NGAL levels were significantly lower in the DEX group than in the Control group at 1 d and 5 d postoperatively (107.5 ± 55.6 ng mL-1versus 179.5 ± 78.2 ng mL-1; 70.3 ± 45.8 ng mL-1versus 135.2 ± 59.6 ng mL-1, P < 0.001), while the BUN and Cr levels showed no differences between the groups. Serum DAO activity was significantly lower in the DEX group patients 24 h after surgery. Moreover, I-FABP levels were markedly lower at 2 h and 24 h postoperatively in the DEX group than in the Control group (P < 0.001). CONCLUSIONS: Perioperative DEX administration may potentially confer kidney and intestinal protection during laparoscopic surgery for colorectal cancer patients.

MXene (Ti3C2) Based Pesticide Delivery System for Sustained Release and Enhanced Pest Control.

A multifunctional nanomaterials based pesticide delivery system provides a powerful strategy for the efficient utilization of pesticides. We present here the application of a 2D MXene (Ti3C2) nanomaterial for pesticide delivery and plant protection. Avermectin (AV), a hydrophobic and unstable insecticide, was chosen as the model pesticide. In our study, AV@Ti3C2 was formed by fast adsorption of AV on Ti3C2, with a maximum loading capacity of 81.44%. Compared with hydrophobic AV, AV@Ti3C2 exhibited significantly improved water solubility, which is beneficial for ensuring the bioactivity of pesticide. The AV@Ti3C2 nanoformulation showed pH responsive slow-release behavior, overcoming the burst-release of conventional AV formulations. Besides, AV@Ti3C2 possessed excellent photostability under UV irradiation, which prolonged the persistent period of AV. Therefore, AV@Ti3C2 performed sustaining and enhanced antipest activity, according to the bioactivity assay. Furthermore, AV@Ti3C2 showed satisfactory biosafety, with no negative effect to the germination and growth of maize. Our current research provides a potential candidate, AV@Ti3C2, for pest control, and also broadens the application of 2D MXene materials in plant protection and sustainable agriculture.

Postresection prognosis of combined hepatocellular carcinoma-cholangiocarcinoma according to the 2010World Health Organization classification: single-center experience of 168 patients

Purpose@#Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) has wide histologic diversity. This study investigated the effects of cHCC-CC histology, according to the 2010 World Health Organization (WHO) classification, on patient prognosis. @*Methods@#The medical records of patients who underwent surgical resection for cHCC-CC at our institution between July 2012 and June 2019 were retrospectively evaluated. @*Results@#During the study period, 168 patients, 122 males (72.6%) and 46 females (27.4%), underwent surgical resection for cHCC-CC, including 159 patients (94.6%) who underwent R0 resection. Mean tumor diameter was 4.4 ± 2.8 cm, and 161 patients (95.8%) had solitary tumors. Histologically, 86 patients (51.2%) had classical type, and 82 (48.8%) had tumors with stem cell (SC) features, including 33 (19.6%) with intermediate-cell and 23 (13.7%) each with typical SC and cholangiolocellular features; 3 tumors (1.8%) were unclassifiable. At 1, 3, and 5 years, tumor recurrence rates were 31.9%, 49.6%, and 58.1%, respectively, and patient survival rates were 91.0%, 70.2%, and 60.3%, respectively. Univariate analysis showed that tumor size of >5 cm, microscopic and macroscopic vascular invasion, lymph node metastasis, 8th edition of the American Joint Committee on Cancer (AJCC) tumor stage, and 2010 WHO classification were significantly prognostic. Multivariate analysis showed that the 8th AJCC tumor stage and 2010 WHO histologic classification were independently prognostic for tumor recurrence and patient survival. There were no significant prognostic differences among the 3 SC subtypes. @*Conclusion@#Postresection outcomes are better in patients with SC-type than with classical-type cHCC-CC.

Postresection prognosis of combined hepatocellular carcinoma-cholangiocarcinoma according to the 2010World Health Organization classification: single-center experience of 168 patients

Purpose@#Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) has wide histologic diversity. This study investigated the effects of cHCC-CC histology, according to the 2010 World Health Organization (WHO) classification, on patient prognosis. @*Methods@#The medical records of patients who underwent surgical resection for cHCC-CC at our institution between July 2012 and June 2019 were retrospectively evaluated. @*Results@#During the study period, 168 patients, 122 males (72.6%) and 46 females (27.4%), underwent surgical resection for cHCC-CC, including 159 patients (94.6%) who underwent R0 resection. Mean tumor diameter was 4.4 ± 2.8 cm, and 161 patients (95.8%) had solitary tumors. Histologically, 86 patients (51.2%) had classical type, and 82 (48.8%) had tumors with stem cell (SC) features, including 33 (19.6%) with intermediate-cell and 23 (13.7%) each with typical SC and cholangiolocellular features; 3 tumors (1.8%) were unclassifiable. At 1, 3, and 5 years, tumor recurrence rates were 31.9%, 49.6%, and 58.1%, respectively, and patient survival rates were 91.0%, 70.2%, and 60.3%, respectively. Univariate analysis showed that tumor size of >5 cm, microscopic and macroscopic vascular invasion, lymph node metastasis, 8th edition of the American Joint Committee on Cancer (AJCC) tumor stage, and 2010 WHO classification were significantly prognostic. Multivariate analysis showed that the 8th AJCC tumor stage and 2010 WHO histologic classification were independently prognostic for tumor recurrence and patient survival. There were no significant prognostic differences among the 3 SC subtypes. @*Conclusion@#Postresection outcomes are better in patients with SC-type than with classical-type cHCC-CC.