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Background The features and survival of stage IV breast cancer patients with different metastatic sites are poorly understood. This study aims to examine the clinicopathological features and survival of stage IV breast cancer patients according to different metastatic sites. Methods Using the Surveillance, Epidemiology, and End Results database, we restricted our study population to stage IV breast cancer patients diagnosed between 2010 to 2015. The clinicopathological features were examined by chi-square tests. Breast cancer-specific survival (BCSS) and overall survival (OS) were compared among patients with different metastatic sites by the Kaplan-Meier method with log-rank test. Univariable and multivariable analyses were also performed using the Cox proportional hazard model to identify statistically significant prognostic factors. Results A total of 18,322 patients were identified for survival analysis. Bone-only metastasis accounted for 39.80% of patients, followed by multiple metastasis (33.07%), lung metastasis (10.94%), liver metastasis (7.34%), other metastasis (7.34%), and brain metastasis (1.51%). The Kaplan-Meier plots showed that patients with bone metastasis had the best survival, while patients with brain metastasis had the worst survival in both BCSS and OS ( p  < 0.001, for both). Multivariable analyses showed that age, race, marital status, grade, tumor subtype, tumor size, surgery of primary cancer, and a history of radiotherapy or chemotherapy were independent prognostic factors. Conclusion Stage IV breast cancer patients have different clinicopathological characteristics and survival outcomes according to different metastatic sites. Patients with bone metastasis have the best prognosis, and brain metastasis is the most aggressive subgroup.

Increasing evidences indicate that systemic inflammation plays a significant role of adverse prognosis in patients with coronary heart disease (CHD). The inflammatory burden index (IBI) is a novel biomarker that reflects systemic inflammation. The aim of this study was to investigate the association between IBI and prognosis of CHD patients. In this retrospective analysis, data from 2453 CHD patients enrolled from December 2017 to December 2022.IBI was defined as neutrophil/lymphocyte*C-reactive protein, with patients categorized into four groups based on quartiles of baseline IBI levels. The primary outcome was adverse cardiovascular and cerebrovascular events (MACCEs) occurring during hospitalization, which included repeat revascularization, new-onset atrial fibrillation (NOAF), stroke, and all-cause in-hospital mortality. Multivariate logistic regression models and restricted cubic spline (RCS) analysis were used to investigate the association between IBI and prognosis of CHD patients. High levels of IBI were associated with higher risk of MACCEs, especially when IBI ≥ 45.68, patients exhibited a higher risk of MACCEs (P < 0.05). After adjusting for baseline confounders, multivariate logistic regression analysis demonstrated that baseline IBI was an independent predictor for NOAF (Odds Ratio (OR): 2.05; 95% confidence interval (CI): 1.30-3.24; P = 0.002) and contrast-induced nephropathy (CIN) (OR: 1.95; 95%CI: 1.16-3.28; P = 0.012) in CHD patients, mainly driven by the highest quartile. In addition, RCS confirmed a linear relationship between IBI and NOAF (P for non-linear = 0.425) and a nonlinear relationship with CIN (P for non-linear = 0.032). IBI is a promising biomarker of systemic inflammation in CHD patients, where higher IBI levels are associated with adverse prognosis. These findings may aid clinicians in precise decision-making to improve outcomes in patients with CHD.

Acute type A aortic dissection (ATAAD) is a serious cardiovascular emergency with high risk and mortality after surgery. Recent studies have shown that serum glucose-potassium ratio (GPR) is associated with the prognosis of cerebrovascular diseases. The purpose of this study was to investigate the relationship between GPR and in-hospital mortality in patients with ATAAD. From June 2019 to August 2021, we retrospectively analyzed the clinical data of 272 patients who underwent ATAAD surgery. According to the median value of GPR (1.74), the patients were divided into two groups. Univariate and multivariate logistic regression analysis were used to determine the risk factors of in-hospital mortality after ATAAD. In-hospital death was significantly more common in the high GPR group (> 1.74) (24.4% vs 13.9%; P  = 0.027). The incidence of renal dysfunction in the low GPR group was significantly higher than that in the high GPR group (26.3% vs 14.8%: P  = 0.019). After controlling for potential confounding variables and adjusting for multivariate logistic regression analysis, the results showed a high GPR (> 1.74) (AOR 4.70, 95% confidence interval (CI) 2.13–10.40; P  =  < 0.001), lactic acid (AOR 1.14, 95% CI 1.03–1.26; P  = 0.009), smokers (AOR 2.45, 95% CI 1.18–15.07; P  = 0.039), mechanical ventilation (AOR 9.47, 95% CI 4.00–22.38; P  =  < 0.001) was independent risk factor for in-hospital mortality in ATAAD patients, albumin (AOR 0.90, 95% CI 0.83–0.98; P  = 0.014) was a protective factor for in-hospital prognosis. High GPR is a good predictor of in-hospital mortality after ATAAD surgery.

Background Previous research results on the predictive factors of neoadjuvant chemotherapy (NCT) efficacy in breast cancer are inconsistent, suggesting that the ability of a single factor to predict efficacy is insufficient. Combining multiple potential efficacy-related factors to build a model may improve the accuracy of prediction. This study intends to explore the clinical and biological factors in breast cancer patients receiving NCT and to establish a nomogram that can predict the pathologic complete response (pCR) rate of NCT. Methods We selected 165 breast cancer patients receiving NCT from July 2017 to May 2019. Using pretreatment biopsy materials, immunohistochemical studies to assess estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), and Ki-67 expression. The correlation between biological markers and pCR was analyzed. These predictors were used to develop a binary logistic regression model with cross-validation and to show the established predictive model with a nomogram. Results The nomogram for pCR based on lymphovascular invasion, anemia (hemoglobin≤120 g/L), ER, Ki67 expression levels and NCT regimen had good discrimination performance (area under the curve [AUC], 0.758; 95% confidence interval [CI], 0.675–0.841) and calibration coordination. According to the Hosmer-Lemeshow test, the calibration chart showed satisfactory agreement between the predicted and observed probabilities. The final prediction accuracy of cross-validation was 76%. Conclusions We developed a nomogram based on multiple clinical and biological covariations that can provide an early prediction of NCT response and can help to quickly assess the individual benefits of NCT.

Malnutrition is linked to adverse outcomes in post-cardiac surgery patients. This study investigates the correlation between the Geriatric Nutritional Risk Index (GNRI) and adverse hospital outcomes in patients following cardiac surgery. This retrospective study included elderly patients with heart disease who were admitted to the Department of Cardiology, Fujian Medical University Union Hospital from January 2020 to December 2022. Patients were divided into two groups based on the cut-off value (98 g/dL). Data from 407 patients were assessed, with 278 (68.3%) classified as having nutritional risk and 129 (31.7%) as having no nutritional risk. Notable distinctions were observed in body weight, BMI, and left ventricular ejection fraction ( P  < 0.05). Laboratory indicators indicated lower levels of serum albumin, lymphocytes, red blood cells, hemoglobin, admission blood glucose, and admission triglyceride in the nutritional risk group ( P  < 0.05). Neutrophils and serum creatinine were higher in the nutritional risk group ( P  < 0.05). Poor prognosis was prevalent in the nutrition risk group (64.7%), with higher incidences of adverse outcomes ( P  < 0.05). Univariate and multivariate studies showed that GNRI < 98 g/dL was an independent predictor of postoperative cardiac surgery. Nutritional risk was an important predictor of adverse hospital outcomes after the surgery.

Owing to high pixel density and brightness, gallium nitride (GaN) based micro-light-emitting diodes (Micro-LEDs) are considered revolutionary display technology and have important application prospects in the fields of micro-display and virtual display. However, Micro-LEDs with pixel sizes smaller than 10 μm still encounter technical challenges such as sidewall damage and limited light extraction efficiency, resulting in reduced luminous efficiency and severe brightness non-uniformity. Here, we reported high-brightness green Micro-displays with a 5 μm pixel utilizing high-quality GaN-on-Si epilayers. Four-inch wafer-scale uniform green GaN epilayer is first grown on silicon substrate, which possesses a low dislocation density of 5.25 × 108 cm−2, small wafer bowing of 16.7 μm, and high wavelength uniformity (standard deviation STDEV < 1 nm), scalable to 6-inch sizes. Based on the high-quality GaN epilayers, green Micro-LEDs with 5 μm pixel sizes are designed with vertical non-alignment bonding technology. An atomic sidewall passivation method combined with wet treatment successfully addressed the Micro-LED sidewall damages and steadily produced nano-scale surface textures on the pixel top, which unlocked the internal quantum efficiency of the high-quality green GaN-on-Si epi-wafer. Ultra-high brightness exceeding 107 cd/m2 (nits) is thus achieved in the green Micro-LEDs, marking the highest reported results. Furthermore, integration of Micro-LEDs with Si-based CMOS circuits enables the realization of green Micro-LED displays with resolution up to 1080 × 780, realizing high-definition playback of movies and images. This work lays the foundation for the mass production of high-brightness Micro-LED displays on large-size GaN-on-Si epi-wafers.Ultra-high brightness green Micro-LEDs with 5 μm pixels were achieved using uniform GaN-on-Si epilayers, exceeding 107 cd/m2 brightness and enabling high-resolution Micro-LED displays with CMOS circuit integration.

Objective Cancer antigen-125 (CA-125), a tumor marker, has received increasing attention in recent years for its role in the cardiovascular field. However, no study has reported the association of CA-125 with early postoperative atrial fibrillation (POAF) after heart valve surgery. Therefore, the aim of this study was to assess whether there is a correlation between CA-125 and early postoperative POAF after heart valve surgery. Methods Patients who underwent valve surgery at Fujian Heart Medical Center from January 2020 to August 2022 were retrospectively analyzed and divided into postoperative atrial fibrillation group (POAF group) and postoperative non-atrial fibrillation group (NO-POAF), and the differences in clinical data between the two groups were compared, and the variables with statistical significance in the univariate analysis were included in the COX regression analysis, and finally the receivers’ operating characteristics (ROC) curves were drawn. Results From January 2020 to August 2022, a total of 1653 patients underwent valve surgery. A total of 344 patients were finally included, including 52 patients (15.1%) in the POAF group and 292 patients (84.9%) in the NO-POAF group. Univariate analysis showed higher CA-125 levels in patients in the POAF group than in those in the NO-POAF group [27.89 (13.64, 61.54), 14.48 (9.87, 24.08), P = 0.000]. Analysis of the incidence of POAF based on CA-125 quartiles showed an incidence of up to 29.2% in the highest quartile (> 27.88). Multivariate COX regression analysis showed that CA-125 [OR = 1.006, 95% CI (1.002, 1.010), P = 0.001] was an independent predictor of POAF. The final ROC curve plot showed that the area under the curve for CA-125 was 0.669, with an optimal cut-off value of 27.08 U/ml, and the difference in the area under the curve between the two groups was statistically significant (P = 0.000). Conclusion Elevated preoperative CA-125 levels can affect the incidence of POAF and have a predictive value for the occurrence of POAF in the early stage after valve surgery. However, due to the small sample size and single-center retrospective study, further validation of this result is needed.

Patients with advanced breast cancer (BC) showed a higher incidence of regional and distant metastases. Sine oculis homeobox homolog 1 (SIX‐1) has been confirmed to be a key tumorigenic and metastatic regulator in BC progression. Yet, molecular mechanisms behind SIX‐1‐induced BC metastases remain largely unknown. Here we found that SIX‐1 was frequently up‐regulated in BC and correlated with poor outcomes when tested in human BC tissue microarray. Then, we manipulated the expression of SIX‐1 by via shRNA‐mediated knockdown and lentivirus‐mediated overexpression. Transwell assay in vitro and lung metastases model of nude mice in vivo showed that SIX‐1 promoted BC cell invasion and migration in vitro, and facilitated metastases in vivo. Mechanistically, SIX‐1 could promote the transcription of lncATB, which exerts critical pro‐metastatic role in BC by directly binding to the miR‐200 family, especially for miR‐200c, to induce EMT and promote metastases. In conclusion, SIX‐1 exerts its pro‐metastatic role in BC through lncATB/miR‐200s axis of EMT signalling pathway and could act as an important diagnostic marker as well as a significant therapeutic target for clinically advanced BC.

Aim The aim of the study was to explore the mediating effect of resilience between learning engagement and professional identity of nursing interns. Design A descriptive, cross‐sectional study design. Methods An online questionnaire survey was conducted among nursing interns in Fujian Medical University from February 2022 to April 2022 by convenience sampling. The scores of learning engagement, resilience and professional identity were evaluated. The PROCESS Marco in SPSS was used to analyse the mediating effect. Results A total of 222 senior nursing students participated in the questionnaire survey. Both learning engagement (r = 0.491, p < 0.01) and resilience (r = 0.537, p < 0.01) correlated positively with PI. Resilience is also positively related to PI (r = 0.693, p < 0.01). Also resilience played a partial mediating role in the relationship between learning engagement and professional identity (a*b = b = 0.2451, 95% CI: 0.1543, 0.3581), and its effect accounted for 53.3%.

Background The prevalence of type 2 diabetes mellitus (T2DM) is increasing each year and has become one of the most prominent health concerns worldwide. Patients with T2DM are prone to infectious diseases, and urinary tract infections are also widespread. Despite a comprehensive understanding of urinary tract infection (UTI), there is a lack of research regarding primary prevention strategies for asymptomatic bacteriuria (ASB). Objective To clarify the incidence and risk factors of asymptomatic urinary tract infection in patients with T2DM by meta-analysis to provide evidence for preventing UTI. Help patients, their families, and caregivers to identify the risk factors of patients in time and intervene to reduce the incidence of ASB in patients with T2DM. Fill in the gaps in existing research. Study design Meta-analyses were conducted in line with PRISMA guidelines. Methods Eleven databases were systematically searched for articles about ASB in T2DM, and the retrieval time was selected from the establishment of the database to February 5, 2023. Literature screening, quality evaluation, and meta-analysis were independently performed by two researchers according to the inclusion and exclusion criteria, and a meta-analysis was performed using Stata 17.0. Results Fourteen articles were included, including cohort and case–control studies. A meta-analysis of 4044 patients with T2DM was included. The incidence of ASB in patients with T2DM was 23.7%(95% CI (0.183, 0.291); P  < 0.001). After controlling for confounding variables, the following risk factors were associated with ASB in patients with T2DM: age (WMD = 3.18, 95% CI (1.91, 4.45), I 2  = 75.5%, P < 0.001), female sex (OR = 1.07, 95% CI(1.02, 1.12), I 2  = 79.3%, P  = 0.002), duration of type 2 diabetes (WMD = 2.54, 95% CI (1.53, 5.43), I 2  = 80.7%, P  < 0.001), HbA1c (WMD = 0.63, 95% CI (0.43, 0.84), I 2  = 62.6,%. P  < 0.001), hypertension (OR = 1.59, 95% CI (1.24, 2.04), I 2  = 0%, <0.001), hyperlipidemia (OR = 1.66, 95% CI (1.27, 2.18), I 2  = 0%, P  < 0.001), Neuropathy (OR = 1.81, 95% CI (1.38, 2.37), I 2  = 0%, P  < 0.001), proteinuria (OR = 3.00, 95% CI (1.82, 4.95), I 2  = 62.7%, P  < 0.001). Conclusion The overall prevalence of ASB in T2DM is 23.7%. Age, female sex, course of T2DM, HbA1C, hypertension, hyperlipidemia, neuropathy, and proteinuria were identified as related risk factors for ASB in T2DM. These findings can provide a robust theoretical basis for preventing and managing ASB in T2DM.