[This corrects the article DOI: 10.1016/j.apsb.2022.05.019.].

Objective To explore the association between aspartate aminotransferase(AST)/alanine aminotransferase(ALT)ratio and metabolic syndrome(MS)in elderly hypertensive patients,and to provide reference for early detection and prevention of MS in elderly hypertensive patients.Methods A questionnaire survey and physical examination were conducted among 616 elderly hypertensive patients at community health service centers.Participants were divided into two groups based on MS status:MS group(n=334)and non-MS group(n=282).According to AST/ALT levels,participants were divided into four groups:q1 group(AST/ALT ≤0.88,n=156),q2 group(0.88＜AST/ALT ≤ 1.10,n=155),q3 group(1.10＜AST/ALT ≤ 1.37,n=154),and q4 group(AST/ALT＞1.37,n=151).Blood biochemical parameters including triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),AST,ALT,and blood glucose were measured.The impact of AST/ALT levels on MS was analyzed using a Logistic regression model,while the risk prediction for MS occurrence was evaluated through receiver operating characteristic(ROC)curves.Results MS group showed higher body mass index(BMI),TG,ALT levels,abnormal glucose levels,female proportion,and abdominal obesity rate compared to non-MS group.HDL-C and AST/ALT values of MS group were lower than those in non-MS patients(P＜0.05).Logistic regression analysis revealed that after adjusting for BMI,smoking,alcohol consumption,physical activity,education level,marital status,TG,HDL-C,and glucose levels,both q3 and q4 groups demonstrated reduced MS risk compared to group q1 group(P＜0.05).ROC curve analysis indicated that the area under the curve for AST/ALT in MS was 0.638(P＜0.05).Conclusion The level of AST/ALT was negatively correlated with MS in elderly hypertensive patients,and AST/ALT has certain predictive value for the risk of MS in elderly hypertensive patients.

Objective:To evaluate the safety and efficacy of accelerator-based boron neutron capture therapy (AB-BNCT) in the treatment of recurrent and refractory malignant tumors.Methods:The data of 14 patients admitted to Xiamen Humanity Hospital from September 2022 to April 2023 were prospectively collected, including 7 patients with primary brain malignancies and 7 patients with locally recurrent inoperable head and neck malignancies. All patients received intravenous infusion of boron drug (NBB-001, p-dihydroxyborylphe nylalanine, a patented freeze-dried formulation) at a total nominal dosage of 500 mg/kg (11 patients) or 750 mg/kg (3 patients), and were irradiated with neutrons (operating with NeuPex system). Adverse events after treatment were recorded and assessed. The primary efficacy endpoint was the 90 d objective response rate (ORR), while the secondary endpoints included progression-free survival (PFS) and complete response rate (CRR). Data were compiled and analyzed by SAS 9.4 software. The rate and 95% CI were calculated using Clopper-Pearson method. Results:The median dose delivered to 80% of the target volume (D 80%) was 16.80 GyE (range: 8.93-23.79 GyE). The most common adverse reactions were hyperamylasemia, alopecia, and hyperprolactinemia. Five patients experienced 8 cases of grade 3 or above adverse events, including 1 case of grade 4 acute kidney injury and 7 cases of grade 3 adverse events. All adverse events were recovered after observation or treatment. At 90 d after treatment, the ORR of all patients was 9/14 (64%, 95% CI: 35%-87%), disease control rate (DCR) was 10/14 (71%, 95% CI: 42%-92%), CRR was 2/14 (14%, 95% CI: 2%-42%); and the best overall response during the entire course included an ORR of 10/14 (71% ,95% CI: 42%-92%), DCR of 13/14 (93%, 95% CI: 66%-100%), and CRR of 3/14 (21% ,95% CI: 5%-51%). The 1-year survival rate for head and neck malignancies was 71.4%, and the 2-year survival rate was 42.8%. The 1-year survival rate for recurrent brain malignancies was 42.8%. Conclusion:AB-BNCT demonstrates favorable safety and promising efficacy in treating primary brain malignancies and recurrent/refractory head and neck malignancies, representing a potential therapeutic option.

Objective To explore the association between aspartate aminotransferase(AST)/alanine aminotransferase(ALT)ratio and metabolic syndrome(MS)in elderly hypertensive patients,and to provide reference for early detection and prevention of MS in elderly hypertensive patients.Methods A questionnaire survey and physical examination were conducted among 616 elderly hypertensive patients at community health service centers.Participants were divided into two groups based on MS status:MS group(n=334)and non-MS group(n=282).According to AST/ALT levels,participants were divided into four groups:q1 group(AST/ALT ≤0.88,n=156),q2 group(0.88＜AST/ALT ≤ 1.10,n=155),q3 group(1.10＜AST/ALT ≤ 1.37,n=154),and q4 group(AST/ALT＞1.37,n=151).Blood biochemical parameters including triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),AST,ALT,and blood glucose were measured.The impact of AST/ALT levels on MS was analyzed using a Logistic regression model,while the risk prediction for MS occurrence was evaluated through receiver operating characteristic(ROC)curves.Results MS group showed higher body mass index(BMI),TG,ALT levels,abnormal glucose levels,female proportion,and abdominal obesity rate compared to non-MS group.HDL-C and AST/ALT values of MS group were lower than those in non-MS patients(P＜0.05).Logistic regression analysis revealed that after adjusting for BMI,smoking,alcohol consumption,physical activity,education level,marital status,TG,HDL-C,and glucose levels,both q3 and q4 groups demonstrated reduced MS risk compared to group q1 group(P＜0.05).ROC curve analysis indicated that the area under the curve for AST/ALT in MS was 0.638(P＜0.05).Conclusion The level of AST/ALT was negatively correlated with MS in elderly hypertensive patients,and AST/ALT has certain predictive value for the risk of MS in elderly hypertensive patients.

Objective:To evaluate the safety and efficacy of accelerator-based boron neutron capture therapy (AB-BNCT) in the treatment of recurrent and refractory malignant tumors.Methods:The data of 14 patients admitted to Xiamen Humanity Hospital from September 2022 to April 2023 were prospectively collected, including 7 patients with primary brain malignancies and 7 patients with locally recurrent inoperable head and neck malignancies. All patients received intravenous infusion of boron drug (NBB-001, p-dihydroxyborylphe nylalanine, a patented freeze-dried formulation) at a total nominal dosage of 500 mg/kg (11 patients) or 750 mg/kg (3 patients), and were irradiated with neutrons (operating with NeuPex system). Adverse events after treatment were recorded and assessed. The primary efficacy endpoint was the 90 d objective response rate (ORR), while the secondary endpoints included progression-free survival (PFS) and complete response rate (CRR). Data were compiled and analyzed by SAS 9.4 software. The rate and 95% CI were calculated using Clopper-Pearson method. Results:The median dose delivered to 80% of the target volume (D 80%) was 16.80 GyE (range: 8.93-23.79 GyE). The most common adverse reactions were hyperamylasemia, alopecia, and hyperprolactinemia. Five patients experienced 8 cases of grade 3 or above adverse events, including 1 case of grade 4 acute kidney injury and 7 cases of grade 3 adverse events. All adverse events were recovered after observation or treatment. At 90 d after treatment, the ORR of all patients was 9/14 (64%, 95% CI: 35%-87%), disease control rate (DCR) was 10/14 (71%, 95% CI: 42%-92%), CRR was 2/14 (14%, 95% CI: 2%-42%); and the best overall response during the entire course included an ORR of 10/14 (71% ,95% CI: 42%-92%), DCR of 13/14 (93%, 95% CI: 66%-100%), and CRR of 3/14 (21% ,95% CI: 5%-51%). The 1-year survival rate for head and neck malignancies was 71.4%, and the 2-year survival rate was 42.8%. The 1-year survival rate for recurrent brain malignancies was 42.8%. Conclusion:AB-BNCT demonstrates favorable safety and promising efficacy in treating primary brain malignancies and recurrent/refractory head and neck malignancies, representing a potential therapeutic option.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Background: Intrahepatic cholangiocarcinoma (ICC) is a highly desmoplastic tumor with poor prognosis even after curative resection. We investigated the associations between the composition of the ICC stroma and immune cell infiltration and aimed to develop a stromal-immune signature to predict prognosis in surgically treated ICC. Patients and methods: We recruited 359 ICC patients and performed immunohistochemistry to detect α-smooth muscle actin (α-SMA), CD3, CD4, CD8, Foxp3, CD68, and CD66b. Aniline was used to stain collagen deposition. Survival analyses were performed to detect prognostic values of these markers. Recursive partitioning for a discrete-time survival tree was applied to define a stromal-immune signature with distinct prognostic value. We delineated an integrated stromal-immune signature based on immune cell subpopulations and stromal composition to distinguish subgroups with different recurrence-free survival (RFS) and overall survival (OS) time. Results: We defined four major patterns of ICC stroma composition according to the distributions of α-SMA and collagen: dormant (α-SMAlow/collagenhigh), fibrogenic (α-SMAhigh/collagenhigh), inert (α-SMAlow/collagenlow), and fibrolytic (α-SMAhigh/collagenlow). The stroma types were characterized by distinct patterns of infiltration by immune cells. We divided patients into six classes. Class I, characterized by high CD8 expression and dormant stroma, displayed the longest RFS and OS, whereas Class VI, characterized by low CD8 expression and high CD66b expression, displayed the shortest RFS and OS. The integrated stromal-immune signature was consolidated in a validation cohort. Conclusion We developed and validated a stromal-immune signature to predict prognosis in surgically treated ICC. These findings provide new insights into the stromal-immune response to ICC.

Objective The aim of this study was to investigate the potential impact of facial heated steam treatment on the Demodex mite detection rate.Methods Overall,215 patients to suspected demodicidosis who visited the dermatology outpatient department of a tertiary hospital in Lanzhou between May and July 2023 were selected as study subjects.The facial skin scraping method was employed following no pretreatment or heated steam treatment for 10 min to detect facial Demodex.Results The Demodex mite detection rate was significantly(χ2=54.07,P=0.00)higher with heated steam facial treatment(63.7%,137/215)compared to no pretreatment(28.4%,61/215).Conclusions The results indicate a statistically significant difference in the detection rate of human Demodex mites between patients who received facial heated steam treatment and those who did not.These findings provide a novel reference for experimental diagnostic methods of demodicosis.

Metabolic reprogramming is a hallmark of cancer, including lung cancer. However, the exact underlying mechanism and therapeutic potential are largely unknown. Here we report that protein arginine methyltransferase 6 (PRMT6) is highly expressed in lung cancer and is required for cell metabolism, tumorigenicity, and cisplatin response of lung cancer. PRMT6 regulated the oxidative pentose phosphate pathway (PPP) flux and glycolysis pathway in human lung cancer by increasing the activity of 6-phospho-gluconate dehydrogenase (6PGD) and α-enolase (ENO1). Furthermore, PRMT6 methylated R324 of 6PGD to enhancing its activity; while methylation at R9 and R372 of ENO1 promotes formation of active ENO1 dimers and 2-phosphoglycerate (2-PG) binding to ENO1, respectively. Lastly, targeting PRMT6 blocked the oxidative PPP flux, glycolysis pathway, and tumor growth, as well as enhanced the anti-tumor effects of cisplatin in lung cancer. Together, this study demonstrates that PRMT6 acts as a post-translational modification (PTM) regulator of glucose metabolism, which leads to the pathogenesis of lung cancer. It was proven that the PRMT6-6PGD/ENO1 regulatory axis is an important determinant of carcinogenesis and may become a promising cancer therapeutic strategy.

Background/Aims: The accuracy of endosonographers in diagnosing gastric subepithelial lesions (SELs) using endoscopic ultrasonography (EUS) is influenced by experience and subjectivity. Artificial intelligence (AI) has achieved remarkable development in this field. This study aimed to develop an AI-based EUS diagnostic model for the diagnosis of SELs, and evaluated its efficacy with external validation. Methods: We developed the EUS-AI model with ResNeSt50 using EUS images from two hospitals to predict the histopathology of the gastric SELs originating from muscularis propria. The diagnostic performance of the model was also validated using EUS images obtained from four other hospitals. Results: A total of 2,057 images from 367 patients (375 SELs) were chosen to build the models, and 914 images from 106 patients (108 SELs) were chosen for external validation. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the model for differentiating gastrointestinal stromal tumors (GISTs) and non-GISTs in the external validation sets by images were 82.01%, 68.22%, 86.77%, 59.86%, and 78.12%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in the external validation set by tumors were 83.75%, 71.43%, 89.33%, 60.61%, and 80.56%, respectively. The EUS-AI model showed better performance (especially specificity) than some endosonographers.The model helped improve the sensitivity, specificity, and accuracy of certain endosonographers. Conclusions We developed an EUS-AI model to classify gastric SELs originating from muscularis propria into GISTs and non-GISTs with good accuracy. The model may help improve the diagnostic performance of endosonographers. Further work is required to develop a multi-modal EUS-AI system.