In recent years, hybrid brain-computer interfaces (BCIs) have gained significant attention due to their demonstrated advantages in increasing the number of targets and enhancing robustness of the systems. However, Existing studies usually construct BCI systems using intense auditory stimulation and strong central visual stimulation, which lead to poor user experience and indicate a need for improving system comfort. Studies have proved that the use of peripheral visual stimulation and lower intensity of auditory stimulation can effectively boost the user's comfort. Therefore, this study used high-frequency peripheral visual stimulation and 40-dB weak auditory stimulation to elicit steady-state visual evoked potential (SSVEP) and auditory steady-state response (ASSR) signals, building a high-comfort hybrid BCI based on weak audio-visual evoked responses. This system coded 40 targets via 20 high-frequency visual stimulation frequencies and two auditory stimulation frequencies, improving the coding efficiency of BCI systems. Results showed that the hybrid system's averaged classification accuracy was (78.00 ± 12.18) %, and the information transfer rate (ITR) could reached 27.47 bits/min. This study offers new ideas for the design of hybrid BCI paradigm based on imperceptible stimulation.
Brain-Computer Interfaces ; Humans ; Evoked Potentials, Visual/physiology* ; Acoustic Stimulation ; Photic Stimulation ; Electroencephalography ; Evoked Potentials, Auditory/physiology* ; Adult

Gallbladder polypoid lesions (GPLs) refer to any elevated lesion of the mucosal surface of the gallbladder wall, and the prevalence is estimated to be between 0.9% and 12.1%. GPLs include benign polyps and malignant polyps. Benign polyps are further classified as non-neoplastic polyps and neoplastic polyps. Cholesterol polyps are the most common benign polyps and adenocarcinoma is the main type of malignant polyp. Hepatitis B virus infection, liver function abnormalities, dyslipidemia, and obesity are the main risk factors for GPLs. Studies of biological mechanisms have focused on malignant gallbladder polyps, the development of which is regulated by hormone levels in vivo, gut microbiota, inflammation, oxidative stress, Salmonella typhimurium, and related molecules. Diagnostic modalities include chemical examination and imaging examination, with imaging examination currently being the mainstay. Treatment of patients with GPLs is based on the presence or absence of symptoms, age, size of the polyps, tendency of the polyp to increase, and risk factors for symptomatic malignancy to determine whether surgery should be performed.

Objective To evaluate the stability,safety and immune enhancement and anti-tumor effects of Wilms'tumor gene 1(WT1)peptide combined with AddaVaxTM emulsion vaccine for acute myeloid leukemia.Methods The stability of WT1 peptide in the adjuvant vaccine was evaluated using MALDI-TOF-MS time-of-flight mass spectrometry.Female C57BL/6 mice were randomly divided into PBS group,WT1 peptide group,and WT1 peptide+AddaVaxTMemulsion adjuvant vaccine group.The immunization was performed at a dose of 50 μg/mouse for antigen and 50 μg/mouse for adjuvant,with intramuscular injection on days 0,14,and 28.HE staining was used to assess the toxicity of intramuscular vaccination on mouse organ tissues.Cytokine levels were detected by ELISA,and the number of IFN-γ-secreting splenocytes was measured by ELISpot.Flow cytometry was employed to detect the maturation of bone marrow-derived dendritic cells(BMDCs)promoted by the vaccine in vitro and the promotion for lymphocyte activation,and H-2Db WT1 tetramer was utilized to detect the proportion of specific CD8+T cells.After establishing a mouse leukemia tumor model using the C1498-mWT1 stable cell line,the anti-tumor effects of the vaccine for prevention and treatment were evaluated.Results The WT1 peptide stably existed in the vaccine without causing significant organ tissue changes in mice after intramuscular injection.Compared to the mice immunized with WT1 aqueous solution,the mice after intramuscular injection of the WT1 peptide emulsion adjuvant vaccine showed stronger immune responses of Th1 cells,including IFN-γ and TNF-α,as well as Th17 cells of IL-17A(P＜0.05),and the mice had not only promoted number of IFN-γ secreting splenocytes(P＜0.01)but also enhanced maturation of BMDCs,as indicated by an increase in the proportions of CD40+/CD11c+and CD86+CD80+/CD11c+ cells(P＜0.05).Additionally,there were increases in both the proportion of CD4+/CD3+T and CD69+/CD8+T cells(P＜0.05)and the proportion of specific CD8+T cells(P＜0.05).In the anti-tumor effect study using the C1498-mWT1 mouse model,the median survival time of the WT1+AddaVaxTM group was extended by 6 d compared to the WT1 aqueous solution group.At day 50,the survival rate of mice in the WT1+AddaVaxTM group was still 28.5％,while all mice in the other groups had died(P＜0.05).Conclusion The vaccine with the WT1 peptide and AddaVaxTM emulsion adjuvant exhibits good immunological and anti-tumor effects.

【Objective】 To investigate the significance of granulocyte macrophage colony-stimulating factor (GM-CSF), nerve growth factor (NGF) and interleukin-17 (IL-17) in the prostate tissue of rats with experimental autoimmune prostatitis(EAP). 【Methods】 EAP rat models were established and divided into control group, EAP group, anti-GM-CSF group (blocking control group) and anti-GM-CSFEAP group (blocking EAP group). Pain behaviors were tested. The pathological changes were observed with HE staining. The mRNA and protein expressions of GM-CSF, NGF and IL-17 were detected with RT-PCR and Western blot. 【Results】 Pain test showed the anti-GM-CSF group had less chronic pelvic pain than the EAP group. HE staining showed the anti-GM-CSF group had less tissue inflammatory response. The EAP inflammation score was higher in the control group than in the anti-GM-CSF group. Immunohistochemistry showed GM-CSF was positive in the EAP group (mainly in the nucleus). RT-PCR and Western blot results showed the mRNA and protein expressions of IL-17 and NGF significantly decreased 50 days after EAP in the anti-GM-CSF group. 【Conclusion】 Increased expressions of GM-CSF, NGF and IL-17 in prostate tissue of EAP rats may be important inflammatory mediators of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS);decreased expressions of NGF and IL-17 after resistance against GM-CSF indicate that GM-CSF may be a potential therapeutic target for CP/CPPS.

Objective:To evaluate the efficacy and safety of peroral endoscopic myotomy (POEM) in achalasia of cardia (AC) patients with the long course.Methods:A total of 159 AC patients who received POEM from January 2015 to March 2022 in the First Affiliated Hospital of Soochow University were divided into the long course group (≥10 years) and the non-long course group (<10 years). The baseline information, POEM procedure and postoperative recurrence were compared and the differences between the recurrent patients and non-recurrent patients in the long course group were explored.Results:The age (57.09±14.30 years VS 42.08±15.68 years, t=5.569, P<0.001), the rate of treatment history [28.9% (13/45) VS 9.6% (11/114), χ2=9.319, P=0.020], the proportion of Henderson grade Ⅲ esophagus [17.8% (8/45) VS 6.1% (7/114), χ2=7.020, P=0.030] in the long course group were significantly higher than those in the non-long course group. The recurrence rate in the long course group was significantly higher than that in the non-long course group [33.3% (15/45) VS 14.9% (17/114), χ2=6.811, P=0.009]. In the long course group, the age (62.50 ± 16.94 years VS 53.77 ± 12.95 years, t=-2.121, P=0.040), and the rate of treatment history [53.3% (8/15) VS 16.7% (5/30), χ2=6.544, P=0.016] in the recurrent patients were higher than those in the non-recurrent patients. Conclusion:POEM is safe and effective for long-course AC patients. In patients with the long course, the aged patients with previous treatment are more likely to relapse.

Severe coronavirus 2019 (COVID-19) infection is associated with myocardial injury and arrhythmia. Bradycardia is a newly recognized consequence of COVID-19. Relative bradycardia and its effects in 4 critically ill patients with COVID-19 was described in this case series. The 4 cases showed the same clinical phenomenon: sinus bradycardia without a compensatory increase in heart rate in response to elevation of body temperature. Typically, heart rate decreases as body temperature rises. The 4 patients were all men with an average age of 67 years. Patient 1 was a 78-year-old man with no major medical history who died from COVID-19 pneumonia. The other 3 patients recovered.

Severe coronavirus 2019 (COVID-19) infection is associated with myocardial injury and arrhythmia. Bradycardia is a newly recognized consequence of COVID-19. Relative bradycardia and its effects in 4 critically ill patients with COVID-19 was described in this case series. The 4 cases showed the same clinical phenomenon: sinus bradycardia without a compensatory increase in heart rate in response to elevation of body temperature. Typically, heart rate decreases as body temperature rises. The 4 patients were all men with an average age of 67 years. Patient 1 was a 78-year-old man with no major medical history who died from COVID-19 pneumonia. The other 3 patients recovered.

Objective: To analyze the causes and correlative factors of high perioperative blood transfusion demand in patients with lung tumor, and to discuss the influence of high blood transfusion demand on patients’ postoperative recovery and its predictive factors. Methods: From November 2007 to October 2017, clinical data of patients who had underwent surgery for lung tumors in the Department of Thoracic Surgery, Cancer Hospital, Chinese Academy of Medical Sciences were collected. A total of 83 cases with perioperative transfusion of red blood cells ≥5U were classified as high transfusion demand group. Another 83 cases were selected from the rest of the patients with transfusion of red blood cells <5U as normal transfusion demand group. Related clinical and transfusion data were summarized to analyze the causes of high blood transfusion demand and its effect on postoperative recovery, univariate and multivariate logistic regressions were used to analyse correlative factors. Results: From November 2007 to October 2017, 23 898 patients with lung tumor underwent surgery in our department and the high blood transfusion demand rate was 0.35%. In the last 10 years, the ratio of high transfusion demand was 0.61%(46/7 503) in the first 5 years versus 0.23%(37/16 395) in the later 5 years(P<0.01). By contrasting high transfusion demand group and normal transfusion demand group, the ratio of thoracoscopic surgery was 42.17%(35/83) vs. 26.51%(22/83)(P<0.05), the ratio of postoperative blood transfusion was 39.76%(33/83) vs. 22.90%(19/83)(P<0.05) and the ratio of left upper lung surgery was 24.10%(20/83) vs. 12.05%(10/83)(P<0.05). The ratio of patients with preoperative comorbidities was 21.69%(18/83) in the high transfusion demand group versus 8.43%(7/83) in the normal transfusion demand group(P<0.05), and the ratio of patients with anemia was 57.83%(48/83) vs. 52.63%(30/83)(P<0.05). The incidence of complications was 39.76%(33/83) in the high transfusion demand group versus 18.07%(15/83) in the normal transfusion demand group(P<0.01), and the incidence of Infection-related complication were 25.30%(21/83) vs. 8.43%(7/83)(P<0.01). Conclusion For perioperative high blood transfusion demand in lung tumors, there were significant differences between different operation approaches, site of operation and phase of blood transfusion. The perioperative high blood transfusion demand may also increase the risk of postoperative complications, comorbidities or anemia were its predictive factors.

Objective To determine the risk factors associated with early allograft dysfunction (EAD) after liver transplantation. Methods We retrospectively analyzed the records of 138 patients who underwent liver transplantation from January 2006 to October 2016 in our department. Transplant recipients were divided into two groups:those who met the diagnostic criteria of EAD (EAD group) and those who did not (non-EAD group). We compared blood flow into the transplanted livers and other clinical features between the two groups using univariate and multivariate analysis. Results Intraoperative portal vein flow (PVF) maximum was significantly different between the two groups. Multivariate analysis revealed that intraoperative PVF maximum ＜1 600 mL/min was the only independent risk factor for the occurrence of EAD after liver transplantation in this cohort. Conclusion Intraoperative PVF maximum ＜1 600 mL/min is an independent risk factor for the occurrence of EAD after liver transplantation. Measuring intraoperative blood flow into the transplanted liver in liver transplant recipients may help identify patients at risk for developing EAD.

Objective To evaluate the long-term efficacy of cervical artificial disc replacement for patients with degenerative cervical canal stenosis.Methods All of 43 patienta underwent single level Bryan cervical artificial disc replacement for degenerative cervical canal stenosis were retrospectively analyzed with a minimum 10 years follow-up in our hospital between December 2003 and December 2007.There were 28 males and 15 females with an average age of 56.7 ± 8.0 years which ranged from 37 to 76 including 1 case of C3.4 level,11 xases of ~ level,26 cases of C~ level and 5 cases of C6,7 level.According to the symptoms and location of compression on radiograph,the patients were divided into 3 groups:15 patients in radiculopathy group,10 patients in myelopathy group and 18 patients in myeloradiculo p~hy group.Radidogical evaluation indexes include global range of motion (ROM),segmental ROM,segmental Cobb angle.Clinical evaluation indexes including Japanese Orthopaedic Association (JOA) score,neck disability index (NDI) and Odom's criteria.The variable data were analyzed by one-way ANOVA,the grading data were analyzed by Kruskal-Wallis H test.The preoperative and postoperative data were analyzed by paired t test.Results At the last follow-up,the Cobb angle of the operative segment was 1.29°±1.34°in myelopathy group(t=4.606,P=0.001),0.71°±2.20°in radiculopathy group (t=2.355,P=0.034),and 0.69°±2.12° in myeloradiculopathy group (t=3.312,P=0.004),which was significantly lower than that before operation.At the last follow-up,ROM of the operative segment in myelopathy group was 6.41 o ±4.87°,which was significantly lower than that before operation (11.46° ±5.19°,t=3.589,P＜ 0.05),and there was no significant difference in the other two groups.There was no significant difference in other imaging parameters among the three groups.JOA scores at the last follow-up were 16.33±0.75 in radiculopathy group (t=5.857,P＜ 0.001),16.00±1.05 in myelopathy group(t=8.337,P＜ 0.001) and 14.78±1.69 in radiculopathy group (t=4.045,P＜ 0.001);NDI were 13.07％±5.90％ in radiculopathy group (t=7.097,P＜ 0.001),12.60％±4.22％ in myelopathy group (t=7.319,P＜ 0.001) and 23.11％±14.18％ in radiculopathy group (t=4.229,P＜ 0.001),which were all significantly improved than those before operation.The excellent and good rate of Odom's criteria (H=2.719,2.411,P＜ 0.05),JOA (LAD-t=3.770,4.080,P＜0,05) and NDI(LAD-t=2.850,2.643,P＜ 0.05) at the last follow-up of the patients in radiculopathy group and myelopathy group were better than those of patients in myeloradiculopathy group (P＜ 0.05).Conclusion Cervical artificial disc replacement has a satisfied long-term clinical efficacy with degenerative cervical canal stenosis.The efficacy of myelopathy and radiculopathy were better than myeloradiculopathy.