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Distal radius fractures (DRFs) are among the most commonly encountered types of fractures in clinical practice. Conventional treatment methods include surgical intervention and traditional small splint fixation following manual reduction based on Traditional Chinese Medicine (TCM). However, these conventional small splints do not adequately meet the current demands for personalized and precision medicine. To address this issue, this study proposes a novel personalized distal radius fixation splint utilizing 3D printing technology. Firstly, a customized splint model that conforms to the patient’s fracture surface is established through three-dimensional scanning of the fracture site. Subsequently, the Tyson polygon structure and Grasshopper software are employed to parameterize the hollowing-out process of the splint, resulting in a personalized splint with a three-dimensional hollow-out structure. During the static analysis of the 3D hollow splint model, forces of 100 N and 150 N were applied. Under a force of 100 N, the maximum deformation of the splint was measured at 0.52 mm with a maximum strain value of 0.02 mm/mm and a maximum equivalent stress level of 19.415 MPa. However, when subjected to a force of 150 N, the maximum deformation increased to 0.78 mm with a corresponding increase in maximum strain value to 0.03 mm/mm and an elevated maximum equivalent stress level measuring 29.122 MPa. Additionally, this study also examined the flexural strength and weight of the 3D-printed splint in comparison to the conventional small splint. The test results demonstrate that, under pressure of 150 N, the radial offset of the 3D printed splint is reduced by 1.7 mm compared to that of the traditional small splint, with a corresponding decrease in stress by 0.01 MPa as well. In terms of weight, a set of 3D printed splints weighs 89 g while a set of conventional splints weighs 102 g, resulting in a significant reduction of 13 g for the 3D printed splints compared to their traditional counterparts. These findings indicate clear advantages associated with utilizing 3D-printed splints in terms of minimizing offset and reducing overall weight.

We aimed to determine disseminated intravascular coagulation (DIC)-associated organ failure and underlying diseases based on data from three ICU wards in tertiary hospitals in China from 2008 to 2016. The diagnosis of DIC was confirmed by an International Society of Thrombosis and Hemostasis score greater than or equal to 5. The maternal outcomes included the changes in organ function 24 h after ICU admission. The durations of hospital stay and ICU stay were recorded as secondary outcomes. Among 297 ICU admissions (median Sequential Organ Failure Assessment score, 4) for obstetric diseases, there were 87 DIC cases, with an estimated DIC incidence of 87 per 87,580 deliveries. Postpartum hemorrhage was the leading disease associated with DIC (71, 81.6%), followed by hypertensive disorders (27, 31.0%), sepsis (15, 17.2%), acute fatty liver of pregnancy (11, 12.6%) and amniotic fluid embolism (10, 11.5%). Compared with patients without DIC, those with DIC had higher rates of multiple organ dysfunction syndrome/death (27.6% vs 4.8%, p = 0.000), organ failure (36.8% vs 24.3%, p = 0.029), among which organ failure included acute renal failure (32.2% vs 10.0%, p = 0.000), respiratory failure (16.1% vs 8.6%, p = 0.057), disturbance of consciousness (12.6% vs 2.4%, p = 0.000) and DIC group also had higher rates of massive transfusion (52.9% vs 21.9%, p = 0.000), hysterectomy (32.2% vs 15.7%, p = 0.001), longer ICU (4 days vs 2 days, p = 0.000) and hospital stays (14 days vs 11 days, p = 0.005). DIC and amniotic fluid embolism were independent risk factors for organ failure in patients admitted to the ICU. Postpartum hemorrhage was the leading cause of DIC associated organ failure in obstetrics admitted to the ICU. The control of obstetric bleeding in a timely manner may improve obstetric prognoses.

At present, there are currently no molecular biomarkers for the early diagnosis of sepsis cardiomyopathy (SCM) in clinical practice. This study focuses on an in-depth examination of the DNA hydroxymethylation profiles within plasma extracellular vesicles and explores potential molecular biomarkers during the process of SCM. The 5hmC-Seal sequencing technology was utilized to examine the hydroxymethylation modifications of extracellular vesicles DNAs in 13 patients with septic cardiomyopathy, 18 patients with sepsis without cardiomyopathy, and 8 patients without sepsis. Additionally, a diagnostic model was constructed using machine learning methods based on the differential hydroxymethylation modifications to screen for candidate biomarkers. The accuracy of the diagnostic model was 0.962, with a sensitivity and specificity of 92.3% and 88.89%, respectively. Furthermore, the diagnostic accuracy was validated using the GEO dataset, with an accuracy rate reaching 1 (GSE79962 and GSE66890), and the differential diagnostic accuracy rates also reached 0.959 and 0.944 (GSE79962). Together, the results suggest that extracellular vesicles DNAs hydroxymethylation markers can be used for diagnosis of septic cardiomyopathy.

Photocatalytic conversion of carbon dioxide to value-added chemicals, particularly multi-carbon products, offers a promising route toward carbon-neutral cycles. However, achieving high activity and selectivity remains extremely challenging due to the instability of key reaction intermediates and limited C–C coupling efficiency. Herein, we report a low-coordination manganese single-atom catalyst embedded in zinc sulfide (Mn 1 –ZnS v ) that enables efficient and selective CO 2 -to-C 2+ conversion. In-situ spectroscopic analyses and density functional theory calculations reveal that sulfur vacancies are created at the Mn single-atom coordination sites and induce the formation of coordination-unsaturated Mn-S 2 configuration. The asymmetric coordination environment of Mn modulates local charge distribution, strengthens *CO adsorption, and promotes *CO and *CHO coupling to form the *COCHO intermediate for efficient C–C coupling. As a result, the Mn 1 –ZnS v catalyst achieved 99.1% selectivity for ethylene with a formation rate of 76.6 μmol g -1 h -1 . This study highlights the critical role of atomic-level coordination engineering in advancing photocatalytic CO 2 -to-C 2+ conversion. This work develops an atomic-level coordination engineering strategy that strengthens key intermediate adsorption to promote C–C coupling, enabling highly selective photocatalytic CO 2 conversion to ethylene.

Clinical trials have confirmed that chimeric antigen receptor (CAR) T cell therapies are revolutionizing approaches for treating several relapsed or refractory hematological tumors. Cytokine release syndrome (CRS) is an adverse event with high incidence during CAR-T treatment. A further understanding of the characteristics and related risk factors of CRS is important for effective management. A total of 142 patients with relapsed or refractory acute lymphocyte leukemia (ALL), lymphoma, or multiple myeloma (MM) received lymphodepletion chemotherapy followed by infusion of CAR-T cells. The characteristics of CRS at different time points after treatment were monitored and risk factors were analyzed. The incidence of CRS for ALL, lymphoma, and multiple myeloma were 82%, 90%, and 90% respectively. Fever was observed on a median of day 3 for ALL, day 1 for lymphoma, and day 8.5 for MM after CAR-T cell infusion, and the duration was different between grade 1–2 CRS and grade 3–5 CRS. Disease types, peak concentration of IL-6, and CRP were associated with CRS. For patients with ALL, numbers of lymphoblast in bone marrow before lymphodepletion, peak concentration of IL-6, and CRP were independent risk factors of CRS. Clinical stage of lymphoma patients and high tumor burden in marrow of MM patients were independent risk factors of CRS. In conclusion, the characteristics and risk factors of CRS in different B-cell hematological tumors are different and should be managed individually during CAR-T cell therapy.

Background Metastatic non-clear cell renal cell carcinoma (mnccRCC) are several rare subtypes of renal cell carcinoma, with standard treatment under investigation. This study retrospectively analyzes the largest Chinese cohort to assess the efficacy and safety of PD-1 blockades combined with tyrosine kinase inhibitors (TKIs) in mnccRCC. Patients and methods A retrospective review was conducted on treatment-naive patients with mnccRCC who received first-line PD-1 blockades combined with TKIs or TKIs monotherapy. The baseline characteristics of the patients and adverse events (AEs) were collected. Efficacy measures included objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS). Results The study enrolled 183 patients (99 TKI monotherapy, 84 combination therapy), with a median follow-up time of 20.0 (IQR, 11.1–32.4) months. ORR (32.1% vs. 20.2%) and DCR (82.1% vs. 55.6%) were improved in combination group compared with TKI group. Patients receiving combination therapy had a longer PFS and OS compared with those receiving TKI monotherapy [median PFS (95% CI): 19.1 (11.1–27.5) vs 8.1 (6.2–10.2)m, P  < 0.001; median OS: not reached vs 44.1 (95% CI 27.4–70.0)m P  = 0.017]. Subgroup analyses identified good performance status, non-chromophobe/Mit family translocation histologies and intermediate/poor IMDC classification derived pronounced survival advantages. The incidence of treatment-related AEs of grade three or higher was similar between the two groups (35.7% vs. 27.3%). Conclusions PD-1 blockades combined with TKIs appeared an effective and safe choice in first-line treatment of mnccRCC, especially in individuals with good performance status, non-chromophobe/Mit family translocation histologies, and intermediate/poor IMDC classification.

Chimeric antigen receptor (CAR)-T-cell is a safe and effective therapy of B-cell cancers but it is unknown if this is so in persons with prior hepatitis B virus (HBV) infection. We studied 70 subjects with advanced B-cell cancers receiving CAR-T-cell therapy, 12 of whom had chronic HBV-infection (HBsAg positive) and 29 with resolved HBV-infection (HBsAg negative and anti-HBc positive). Safety and efficacy were compared with 29 subjects without HBV-infection. HBV was reactivated in 2 subjects with chronic HBV-infection and 1 with resolved HBV-infection. There was no HBV-related hepatitis flare. Responses to CAR-T-cell therapy in the three cohorts were not significantly different. There was no significant difference in the incidence or severity of cytokine release syndrome (CRS) and neurologic toxicity between the cohorts. Our data suggest that chronic and resolved HBV-infection do not affect the safety and efficacy of CAR-T-cell therapy.

This study explored the relationship between the concentrations of homoarginine and arginine and between homoarginine concentration and laboratory parameters in coronavirus disease 2019 (COVID-19) patients with different severity to demonstrate the role of homoarginine in the progress of COVID-19. The laboratory-confirmed COVID-19 patients were included from Peking University Third Hospital during December 2022 to January 2023. Serum, urine, and stool samples were collected from the patients and detected by liquid chromatography-mass spectrometry. Totally 46 patients were recruited, including 18 in the mild group, 19 in the severe group, and 9 fatal. The concentration of homoarginine was positively correlated with the concentration of arginine in serum ( r  = 0.50), urine ( r  = 0.55), and stool samples ( r  = 0.39), respectively (all P < 0.001). The serum concentration and urine concentration of homoarginine were lower in severe patients than in mild patients (both P < 0.05). 13 indicators reflecting immunity and coagulation, including but not limited to T cell, white blood cell, natural killer cell, interleukin 6 (IL-6), and IL-8, had statistically significant correlations with both disease severity and the homoarginine concentration. Patients with hypertension were significantly associated with the decreased serum homoarginine (odds ratio 10.905, 95% confidence interval 1.454 − 137.144). Our results suggest that the homoarginine plays a role in the progress of COVID-19, which may be achieved by influencing arginine metabolism.

Objective This study aimed to comprehensively analyze the detection capacity of non-invasive prenatal testing (NIPT) for chromosomal abnormalities of all 24 chromosomes, as well as high-risk indications for pregnancy and the fetal fraction, in a large cohort. Methods We retrospectively enrolled 118,969 pregnant women who underwent NIPT at Sichuan Provincial Maternity and Child Health Care Hospital from March 2019 to June 2022. The sensitivity, specificity, positive predictive value, negative predictive value, and positive chromosomal abnormality rate were calculated. The fetal fraction based on gestational age, maternal body mass index, and number was examined. Results NIPT demonstrated > 99% sensitivity and specificity for almost all of the common trisomies (T21, T18, and T13), sex chromosomal aneuploidies, rare autosomal trisomies, and microdeletion/microduplication syndromes. Positive predictive values varied from 12.0% to 89.6%. Advanced maternal age was associated with an increased risk of three major aneuploidies. The fetal fraction was positively correlated with gestational age and negatively correlated with the maternal body mass index. Conclusions NIPT can be used to effectively screen for chromosomal abnormalities across all 24 chromosomes. Advanced maternal age is a risk factor for high-risk pregnancy, and careful consideration of the fetal fraction is essential during NIPT.

Purpose The therapeutic efficacy of metastatic renal cell carcinoma (mRCC) has been significantly enhanced with the advent of immune checkpoint inhibitors (ICIs). However, there are limited data on the efficacy of Tislelizumab in patients with mRCC. This study aimed to assess the effectiveness and safety of Tislelizumab plus tyrosine kinase inhibitor (TKI) for patients with mRCC. Methods Demographic and clinicopathological data of mRCC patients treated with first-line TKI monotherapy or Tislelizumab plus TKI therapy between March 2019 to February 2023 were collected. Outcome measures included the objective response rate (ORR), median progression-free survival (mPFS). Patient baseline characteristics and adverse events (AEs) were documented. Results Totally 136 patients were included in the analysis, with a median age of 57 years. Of the patients, 72.1% were male, 78.8% with intermediate/poor-risk disease. For the overall population, the combination group ( n  = 61) exhibited a longer PFS compared to the TKI monotherapy group ( n  = 75) (mPFS (95% CI): 15.9 (10.9–20.9) vs. 6.2 (5.4–6.9) months, P  < 0.001) and improved ORR (44.3% vs. 18.7%, P  = 0.001). In the non-clear cell RCC (nccRCC) subgroup ( n  = 39), the combination group ( n  = 20) showed improved PFS (mPFS (95% CI): 11.9 (0.6–23.3) vs. 4.6 (3.4–5.9) months, P  < 0.001) and ORR (40.0% vs. 10.5%, P  = 0.006) compared to the TKI monotherapy group ( n  = 19). The incidence of grade three or higher treatment-related AEs are comparable between the groups (47.54% vs. 40.00%). Conclusion Our data demonstrated the promising efficacy and safety profile of Tislelizumab plus TKI as first-line treatment for both ccRCC and nccRCC.