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Background The homeobox (HOX) genes especially for HOXA cluster play crucial roles in leukemogenesis. HOXA overexpression caused by genetic alterations, such as KMT2A rearrangements, NUP98- fusions and FLT3 -ITD mutations, is frequently identified in AML. However, very few studies determined the DNA methylation-mediated epigenetic regulation of the HOXA cluster genes in AML. Methods We systematically first screened the prognostic value of HOXA cluster genes methylation in AML from The Cancer Genome Atlas (TCGA) datasets. Afterwards, the candidate prognosis-related gene HOXA9 were selected for clinical relevance analysis and were further validated in another independent cohort from our research center. Results The methylation of HOXA9 , among HOXA cluster genes, negatively correlated with adverse prognosis and expression were screened and identified in AML among TCGA datasets. Clinically, HOXA9 hypomethylation was positively correlated with specific subtypes of AML, such as French-American-British (FAB)-M5/M7, normal karyotype and FLT3 , NPM1 and DNMT3A mutation, whereas negatively associated with FAB-M3, t(15;17), t(8;21) and t(16;16). Importantly, AML patients with HOXA9 hypomethylation may profit from transplantation, whereas AML patients with HOXA9 hypermethylation could not, suggesting that HOXA9 methylation may be used to guide therapeutic selection between transplantation and chemotherapy. Bioinformatics analysis demonstrated the association of HOXA9 expression with diverse leukemia-related genes ( HOXAs , SOSTDC1 , MEG3 , miR-10a , miR-381 and miR-193b ) and signaling pathways (PI3K-Akt signaling) in AML. Subsequently, we further validate the hypomethylation pattern of HOXA9 in AML patients and the epigenetic regulation of HOXA9 methylation in AML cell-lines. Conclusions HOXA9 methylation linked to HOXA9 expression correlates with diverse genetic abnormalities of AML, such as normal karyotype, t(15;17), t(8;21), t(16;16) and FLT3 , NPM1 and DNMT3A mutations. Moreover, HOXA9 hypomethylation may be associated with adverse prognosis, and may guide treatment choice in AML.

Background CD300s are a group of proteins playing vital roles in immune responses. However, much is yet to be elucidated regarding the expression patterns and clinical significances of CD300s in cancers. Methods In this study, we comprehensively investigated CD300s in a pan‐cancer manner using multi‐omic data from The Cancer Genome Atlas. We also studied the relationship between CD300s and the immune landscape of AML. Results We found that CD300A‐CD300LF were generally overexpressed in tumors (especially AML), whereas CD300LG was more often downregulated. In AML, transactivation of CD300A was not mediated by genetic alterations but by histone modification. Survival analyses revealed that high CD300A‐CD300LF expression predicted poor outcome in AML patients; the prognostic value of CD300A was validated in seven independent datasets and a meta dataset including 1115 AML patients. Furthermore, we demonstrated that CD300A expression could add prognostic value in refining existing risk models in AML. Importantly, CD300A‐CD300LF expression was closely associated with T‐cell dysfunction score and could predict response to AML immunotherapy. Also, CD300A was found to be positively associated with HLA genes and critical immune checkpoints in AML, such as VISTA, CD86, CD200R1, Tim‐3, and the LILRB family genes. Conclusions Our study demonstrated CD300s as potential prognostic biomarker and an ideal immunotherapy target in AML, which warrants future functional and clinical studies. We found that CD300A‐CD300LF were significantly upregulated and high expression of these genes predict worse survival in AML. Specifically, CD300A may aid risk stratification in AML and its expression was likely to be regulated by H3K4me3 histone modification. Importantly, we demonstrated CD300A as an essential co‐inhibitory signal that might cause NK cell exhaustion and promotes immune escape of AML cells.

Background The transversus abdominis plane (TAP) block in conjunction with intrathecal morphine has been demonstrated to provide more superior postcesarean analgesia to intrathecal morphine alone. However, the analgesia efficacy of their conjunction has not been demonstrated in patients with severe pre-eclampsia. The study aimed to compare the postcesarean analgesia of TAP block in conjunction with intrathecal morphine versus intrathecal morphine alone in women with severe pre-eclampsia. Methods Pregnant women with severe pre-eclampsia undergoing planned cesarean section were randomly allocated into 2 groups to receive TAP block with 20 ml of 0.35% Ropivacaine (TAP group) or with the same volume of 0.9% saline (Sham group) after undergoing elective cesarean section under spinal anaesthesia with 15 mg of 0.5% Ropivacaine plus 0.1 mg of morphine. The outcomes for this analysis include the visual analog scale (VAS) pain score at rest and with movement at 4,8,12,24 h after TAP block was performed, times of use of intravenous patient-controlled analgesia (PCA) within 12 h after anesthesia, the occurrence of maternal side effects, maternal satisfaction, and Apgar score at 1 and 5 min of newborns. Results 119 subjects receive TAP block with 0.35% Ropivacaine (n = 59)or 0.9% saline (n = 60). At 4,8, 12 h after TAP block, the TAP group reported lower VAS score at rest [at 4 h: 1(0,1) vs. 1(1,2), P < 0.001 ; at 8 h:1(1,1) vs. 1(1.5,2), P < 0.001 ; at 12 h:1(1,2) vs. 2(1,2), P = 0.001 ] and higher satisfaction [53(89.9%) vs.45(75.0%), P < 0.05 ]. There were no differences between groups in VAS score at 24 h at rest and at all time points above with movement, times of use of PCA within 12 h after anesthesia, maternal side-effect, and Apgar score at 1 and 5 min of newborns. Conclusions In conclusion, The TAP block performed in conjunction with intrathecal morphine may not reduce opioid consumption, but it could reduce VAS scores at rest in the first 12 h after cesarean section in women with severe pre-eclampsia, and improve maternal satisfaction, which is worthy of clinical promotion. Trial registration Registered at Chinese Clinical Trial Registry( http://www.chictr.org.cn ) on 13/12/2021: ChiCTR2100054293.

Background Reintubation is a severe complication during foreign body (FB) removal that uses flexible bronchoscopy. Objective To investigate the incidence and risk factors for reintubations in children undergoing FB extraction by flexible bronchoscopy in a single center. Design A retrospective cross-sectional study. Setting All children with foreign body aspiration at Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University from January 2015 to December 2020. Patients Children with FB removal using a flexible bronchoscopy were enrolled in the trial according to the inclusion criteria. Measurements Both multivariable and logistic regression analyses were used to analyze the association between characteristic data and reintubations. The results were presented as odds ratios (ORs) with 95% confidence intervals (CIs). Results In total, 244 patients met with the inclusion criteria and were included in the analysis. Among those participants, 28 children (11.5%) underwent reintubations after FB removal by flexible bronchoscopy. Independent factors associated with reintubations were identified as operative time ≥ 60 min [OR: 3.68, 95% CI (1.64–8.82)] and ASA ≥ III [OR: 5.7, 95% CI (1.23–26.4)]. Conclusions Children undergoing FB removal by a flexible bronchoscopy may encounter with a high incidence of postoperative reintubations. Both long operative duration and a severe physical status cause a growing risk of reintubations.

Reliable analysis of the flooding process and motion responses onboard a damaged ship is extremely significant for assessing the remaining survivability and improving the damage stability. This study implemented the Unsteady Reynold-Average Navier–Stokes (URANS) solver to monitor the three degrees of freedom (DOF) motion, investigating the effect of symmetric and asymmetric flooding on the damage stability. The Volume of Fluid (VOF) method was applied to visualize the flooding process and capture the complex hydrodynamics behavior. Additionally, basic governing equations of fluid flow and free motion are detailed. The simulation results show that in the same damage condition, the transverse asymmetric flooding results in a larger heel angle. However, for the pitch and heave motion, there are small differences between the symmetric flooding and asymmetric flooding. Therefore, if the damaged ship is predicted to keep afloat, the transverse symmetric flooding should be guaranteed as much possible. In this case, the flooding water can flow from the damaged side to the intact side. Consequently, the damaged ship can maintain a relatively stable floating state, decreasing the risk of capsizing due to the excessive heel angle. Finally, all the numerical simulation cases are performed on the commercial software CD Adapco STAR-CCM+.

To discover the deformation behavior and corresponding mechanism of the typical material under fluid pressure, we proposed a test method for the uniaxial tensile deformation performance of the sheet under fluid pressure and developed a testing device as well as a special fixture. The aluminum and aluminum alloy were tested based on this method, respectively. The results indicate that under the uniaxial tension, the plastic zone expands significantly and the uniform elongation decreases gradually with the increase of fluid pressure. The uniaxial tensile deformation performances of the sheets are improved differently corresponding to the various fluid pressures, and the increment of the elongation after fracture is higher for aluminum than aluminum alloy. The dimples on the fracture surface of the aluminum and aluminum alloy sheets are directionally distributed under fluid pressure. Aluminum sheets have no significant shear lip and the dimples become relatively evenly rounded. It is shown from our experiment that the deformation performance of the sheet can be significantly improved by applying fluid pressure, which provides a new way to improve the deformation ability of the sheets with low plasticity and expand their applications.

Psoriasis is an inflammatory skin disease that relapses frequently. Keratinocyte apoptosis dysregulation plays a crucial role in the pathological mechanisms of psoriasis. PANoptosis is a process with intermolecular interaction among pyroptosis, apoptosis, and necroptosis. The mechanism of PANoptosis in the occurrence and development of psoriasis is still unclear. Here we present a novel approach by identifying PANoptosis-related signatures (PANoptosis-sig) from skin tissue of psoriasis patients and healthy controls on transcriptional and protein levels. Five PANoptosis-sig (TYMP, S100A8, S100A9, NAMPT, LCN2) were identified. Enrichment analysis showed they were mainly enriched in response to leukocyte aggregation, leukocyte migration, chronic inflammatory response and IL−17 signaling pathway. Single cell transcriptome analysis showed TYMP and NAMPT were expressed in almost all cell populations, while LCN2, S100A8 and S100A9 were significantly highly expressed in keratinocyte. We then constructed predictive and diagnostic models with the PANoptosis-sig and evaluated their performance. Finally, unsupervised consensus clustering analysis was conducted to ascertain psoriasis molecular subtypes by the PANoptosis-sig. The psoriasis cohort was divided into two distinct subtypes. Immune landscape showed that the stromal score of cluster 1 was significantly higher than cluster 2, while the immune and estimate scores of cluster 2 were expressively higher than cluster 1. Cluster 1 exhibited high expression of Plasma cells, Tregs and Mast cells resting, while cluster 2 showed high expression of T cells, Macrophages M1, Dendritic cells activated, and Neutrophils in immune infiltration analysis. And cluster 2 was more sensitive to immune checkpoints. In conclusion, our findings revealed potential biomarkers and therapeutic targets for the prevention, diagnosis, and treatment of psoriasis, enhancing our understanding of the molecular mechanisms underlying PANoptosis.

An accurate analysis of the entire flooding process is critical to assess the damaged stability when a ship encounters distressed accidents such as collision, stranding, or grounding. Among many factors affecting the flooding process and damaged stability, the complex effect of air compression is significant and worthy of further research. In this paper, through establishing scenarios of the damage flooding for a cruise ship, the commercial software CD Adapco STARCCM+ is applied to perform time domain simulation of flooding processes under different ventilation levels. The basic mathematical models about air compression and specific simulation settings of computational fluid dynamics (CFD) are presented in detail. The simulation results show that water ingression results in an increase of air pressure and density inside the flooded compartment. The corresponding air compression can significantly delay the flooding process if the ventilation level is limited to a certain ratio. Finally, the stability of the damaged ship is affected.

Lightweight forming was one of the main ways to achieve energy conservation and emission reduction in advanced manufacturing. However, the cold-pressing process was easier to realize dissimilar sheets joining and could reduce the weight of both the material and the structure; therefore, this process was widely used. Taking aluminum and stainless sheets joining as an example, this study designed three kinds of joining schemes based on the theory of materials mechanics. It was concluded that the increase of the load pressure made the joining parts of the two sheets fitted quickly, but it decreased the joining thickness through the research of different joining project results. In the joining process, defects such as overlap, warping, protrusions, pitting, and partial cracking led to decreasing surface quality and reliability of the joining part. It was demonstrated by the sheet specimen unidirectional tensile test that the “embedding” and the “interlocking” were the main mechanisms of cold-pressing joining.

Point-of-care transthoracic echocardiography （TTE） is an evolving field in anesthesia field and verified to have the potential to provide rapid diagnostic information during the hemodynamic collapse in operating room.[1] In this retrospective observatory study, we retrieved all the data of 1-year consecutive use of intraoperative echocardiography in patients with circulatory collapse or undergoing selective high-risk noncardiac surgery.