Controlled ovarian hyperstimulation parameters are not associated with de novo chromosomal abnormality rates and clinical pregnancy outcomes in preimplantation genetic testing

OBJECTIVE

This study aimed to determine whether controlled ovarian hyperstimulation (COH) parameters influence the incidence of de novo chromosomal abnormalities (> 4 Mb) in blastocysts and, thus, clinical pregnancy outcomes in preimplantation genetic testing (PGT).

METHODS

Couples who underwent preimplantation genetic testing for structural chromosome rearrangements (PGT-SR) and monogenic disorders (PGT-M) were included in this study. The relationships of maternal age, paternal age, stimulation protocol, exogenous gonadotropin dosage, duration of stimulation, number of oocytes retrieved and estradiol (E₂) levels on human chorionic gonadotropin (hCG) trigger day with the incidence of de novo chromosomal abnormalities were assessed. Blastocysts were biopsied, and nuclear DNA was sequenced using next-generation sequencing (NGS). Clinical pregnancy outcomes after single euploid blastocyst transfers under different COH parameters were assessed.

RESULTS

A total of 1,710 and 190 blastocysts were biopsied for PGT-SR and PGT-M, respectively. The rate of de novo chromosomal abnormalities was found to increase with maternal age (p< 0.001) and paternal age (p = 0.019) in the PGT-SR group. No significant differences in the incidence of de novo chromosomal abnormalities were seen for different maternal or paternal age groups between the PGT-SR and PGT-M groups (p > 0.05). Stratification analysis by gonadotropin dosage, stimulation protocol, duration of stimulation, number of retrieved oocytes and E₂ levels on hCG trigger day revealed that de novo chromosomal abnormalities and clinical pregnancy outcomes were not correlated with COH parameters after adjusting for various confounding factors.

CONCLUSION

The rate of de novo chromosomal abnormalities was found to increase with maternal or paternal age. COH parameters were found to not influence the incidence of de novo chromosomal abnormalities or clinical pregnancy outcomes.

Competition between Coulomb and van der Waals Interactions in Xe-Cs^{+} Aggregates on Cu(111) Surfaces

Microscopic insight into interactions is a key for understanding the properties of heterogenous interfaces. We analyze local attraction in noncovalently bonded Xe-Cs^{+} aggregates and monolayers on Cu(111) as well as repulsion upon electron transfer. Using two-photon photoemission spectroscopy, scanning tunneling microscopy, and coupled cluster calculations combined with an image-charge model, we explain the intricate impact Xe has on Cs^{+}/Cu(111). We find that attraction between Cs^{+} and Xe counterbalances the screened Coulomb repulsion between Cs^{+} ions on Cu(111). Furthermore, we observe that the Cs 6s electron is repelled from Cu(111) due to xenon's electron density. Together, this yields a dual, i.e., attractive or repulsive, response of Xe depending on the positive or negative charge of the respective counterparticle, which emphasizes the importance of the Coulomb interaction in these systems.

Circular RNA Pvt1 oncogene (CircPVT1) promotes the progression of papillary thyroid carcinoma by activating the Wnt/β-catenin signaling pathway and modulating the ratio of microRNA-195 (miR-195) to vascular endothelial growth factor A (VEGFA) expression

Circular RNAs (circRNAs) have been reported to be involved in the progression of papillary thyroid carcinoma (PTC). However, the role of circular RNA Pvt1 oncogene (circPVT1) in PTC has rarely been reported. In this study, we aimed to investigate the function and mechanism of circPVT1 in PTC. The expression level of circPVT1, miR-195 and VEGFA were determined by reverse transcription‑quantitative PCR (RT‑qPCR). Fisher's exact test was used to analyze the correlation between circPVT1 expression and PTC clinical features. Cell Counting Kit-8 (CCK-8) and 5-Ethynyl-2'-deoxyuridine (EdU) staining assay and transwell assay were conducted to evaluate the cell proliferation, migration and invasion ability. Dual-luciferase reporter and Western blot assay were conducted for evaluating the correlation between miR-195 and circPVT1 or VEGFA. The results of RT-PCR showed that the expression level of circPVT1 was significantly upregulated in PTC tissues and cell lines. After downregulating circPVT1 expression in PTC cells, the abilities of cell proliferation, migration, and invasion were obviously suppressed, and the Wnt/β-catenin signaling pathway was also repressed. Besides, miR-195 could both bind to PVT1 and VEGFA, while PVT1 could promote the expression of VEGFA by binding to miR-195. Downregulation of VEGFA expression in PTC cells revealed weakened cell proliferation, migration, and invasion capacities, and restrained Wnt/β-catenin signaling pathway. Therefore, we demonstrated that circPVT1 could promote VEGFA expression by sponging miR-195. CircPVT1 could serve as a molecule sponge for miR-195 and mediate the ceRNA network to promote the expression of VEGFA, thus contributed to the malignant progression of PTC.

[Epidemiological characteristics of imported COVID-19 cases in Tianjin]

Objective: To understand the epidemiological characteristics of imported COVID-19 cases in Tianjin, and provide references for risk assessment and control of imported COVID-19 cases. Methods: The information of imported COVID-19 cases were obtained from National Notifiable Disease Report System of China CDC. The data of imported COVID-19 cases reported from Tianjin airport and epidemiological surveys by CDCs at all levels from March 15, 2020 to August 31, 2021 were collected and analyzed by using software Excel 2010, SPSS 25.0 and R. Results: From March 15, 2020 to August 31, 2021, a total of 606 imported cases of COVID-19 were reported in Tianjin, in which 552 cases were finally included in the analysis. The male to female ratio of the cases was 1.8∶1, the age of the cases ranged from 3 to 77 years, and the cases were mainly reported in age group 20-39 years (59.8%). The areas where the imported case sojourned within 14 days included Europe (242 cases, 43.8%), Africa (139 cases, 25.2%), Americas (85 cases, 15.4%) and Asia (86 cases, 15.6%). The proportion of confirmed cases in autumn and winter was relatively high. During the study period, the proportion of infected persons found in custom entry quarantine decreased, and the proportion of persons with personal health declaration and under medical isolation observation increased. The interval between entry and diagnosis of infected persons tended to increase. Conclusion: The proportion of imported COVID-19 cases detected on the first day of entry at Tianjin airport decreased, and the interval to detect the infected persons trended to increase, to which close attention must be paid.

[Preliminary application of transoral robotic thyroidectomy: experience from an initial 30 cases]

Objective: To examine the surgical outcome of transoral robotic thyroidectomy. Methods: Clinic data of total 30 cases of transoral robotic thyroidectomy at the Department of Thyroid and Breast Surgery, the 960^th Hospital of People's Liberation Army from May 2020 to December 2020 were analyzed retrospectively. There were 3 males and 27 females, aged (31.5±11.0) years (range: 17 to 55 years), including 6 cases of benign tumor and 24 cases of malignant cancer (all papillary thyroid carcinoma). An inverted U-shaped incision 1.5 cm in length was made over the end of the frenulum of the lower lip. A wide subplatysmal space was created by bluntly passing with a vascular tunneller (8 mm diameter), and a 12 mm trocar was inserted through the lip incision for the camera port. Lateral oral mucosal incisions 8 mm in length were made near both lateral labial commissures, 8 mm robot trocars were inserted through the incisions. An 5 mm trocar was inserted through an incision made along the patient's right axillary fold into the subplatysmal working space and was connected with 5 mm ProGrasp for counter traction during the operation and for later drain insertion. Numerical scoring system (NSS) was used to assess cosmetic effect 1 month post-operation. Results: All the 30 transoral robotic thyroidectomies was successful, no case conversed to open operation. Postoperative hospital stay was (6.3±1.2) days (range: 4 to 10 days). The tumor size of thyroid cancers was (5.3±3.0) mm (range: 2 to 15 mm). Lymph node metastasis was observed in 12 cases. The retrieved central lymph node number was 10.5±4.4 (range: 4 to 20), while the central metastatic lymph node number was 2(2) (range: 1 to 11). Postoperative transient hypoparathyroidism occurred in 2 cases. Permanent hypoparathyroidism and vocal cord palsy didn't occur. Other surgical complications included hematoma, surgical site infection and perforation of chin flap, retrospectively in 1 case. Local regional lymph node recurrence wasn't developed during 1 to 7 months follow-up. All patients were satisfied with the postoperative cosmetic outcomes,NSS was 9.4±0.8 (range: 8.7 to 9.6). Conclusion: Transoral robotic thyroidectomy is safe and effective, suitable for early thyroid cancers without lateral lymph node metastasis, and has superior cosmetic results when the patients are selected carefully.

[Abnormal expression of CD44 aggravates liver disease progression in patients with non-alcoholic fatty liver disease accompanied with hepatitis B virus replication]

Objective: To analyze the expression of CD44 in non-alcoholic fatty liver disease (NAFLD) accompanied with hepatitis B virus (HBV) infection and its clinical significance. Methods: Blood sample of hospitalized patients with NAFLD, chronic hepatitis B, cirrhosis, and healthy population (control) was collected. The study was approved by the hospital ethics committee. Serum CD44 level and clinopathological characteristics were analyzed quantitatively by enzyme-linked immunosorbent-assay. Flow cytometry was used to analyze the proportion of CD44(+)T lymphocytes in patients with NAFLD and chronic hepatitis B. NAFLD model was prepared with high-fat diet to verify the abnormal expression of CD44. Results: Compared with the healthy control group, the expression of serum CD44 in the cirrhosis group, chronic hepatitis B group and NAFLD group was increased, and the difference between the groups were statistically significant (P < 0.01). NAFLD patients graded as mild or severe group were equally accompanied by hepatocyte injury, abnormal blood glucose, lipid or CD44. In NAFLD patients accompanied with HBV infection, serum CD44 concentrations were significantly higher in HBsAg, HBeAg and HBV DNA positive group than HBsAg, HBeAg and HBV DNA negative group (P < 0.01). The proportion of CD44(+)T lymphocytes in peripheral blood of NAFLD and chronic hepatitis B group were 78.2% ± 16.3% and 68.5% ± 20.9%, respectively, and both groups (NAFLD and chronic hepatitis B) were significantly higher than the healthy control group (46.5% ± 20.5%) (P < 0.05). The high-fat diet model confirmed that in rat liver tissues the CD44 was overexpressed with fat deposition accompanied with liver cell damage, especially remarkable in liver tissues containing carcinogens. Conclusion: The abnormal expression of CD44 in patients with NAFLD may be related to the malignant transformation of HBV-related liver disease.

Leaching and In Vivo Bioavailability of Antimony in PET Bottled Beverages

Antimony (Sb) may leach from polyethylene terephthalate (PET) materials into bottled water under improper storage conditions, particularly at high temperatures, leading to potential Sb chronic exposure and adverse health effects. However, Sb leaching may be promoted by various beverage constituents, which has received limited attention to date. In addition, few studies have considered Sb bioavailability in beverages and the influence of the beverage matrix on Sb bioavailability. In this study, PET-bottled beverages (n = 50) covering six categories (namely, carbonated, fruit juices, tea, sports, protein, and coffee beverages) were explored. Antimony leaching was assessed following the incubation of beverages at 60 °C for 7 days, which resulted in Sb concentrations 1.10-10.9 times greater than concentrations observed pre-incubation. Although regulatory standards vary internationally, a total of 21 beverages exceeded the Japanese Sb drinking water standard of 2 μg/L (up to 4.08 ± 0.11 μg/L) following incubation at 60 °C. pH significantly influenced Sb leaching (r = -0.38, p = 0.007) with beverages displaying lower pH (e.g., carbonated drinks) exhibiting higher Sb concentrations. An in vivo mouse model, using the liver as the biological endpoint, was adopted to assess Sb relative bioavailability (RBA) in bottled beverages. Sb RBA ranged from 1.97-58.7% with coffee beverages exhibiting the lowest Sb RBA (1.97-13.7%) and protein drinks the highest (41.1-58.7%). Linear regression revealed that Sb RBA in beverages was negatively influenced by Fe (r = -0.69, p = 0.02) and P (r = -0.73, p = 0.01) concentrations but positively correlated with tartaric acid (r = 0.59, p = 0.02). When an exposure assessment was undertaken using data generated in this study, carbonated and protein-rich beverages exhibited a higher exposure risk due to elevated Sb leaching and high Sb RBA compared to other beverage categories.

[Outcomes of 1 000 cases of robotic thyroidectomy by bilateral axillo-breast approach: a retrospective study in a single center]

Objective: To examine the surgical outcome, completeness and safety of robotic thyroidectomy by bilateral axillo-breast approach (BABA). Methods: From February 2014 to May 2019, 1 000 cases of robotic thyroidectomy via BABA at the Department of Thyroid and Breast Surgery, the 960^th Hospital of People's Liberation Army were performed. The clinicopathologic characteristics, operation times, perioperative complications, and oncologic outcomes of patients underwent robotic thyroidectomy were collected and reviewed retrospectively. There were 216 males and 784 females, aging (42.3±11.5) years (range: 7 to 75 years). There were 270 cases with benign tumors, and 730 cases with malignant cancers (the tumor diameter was (7.9±6.7) mm (range: 0.1 to 60.0 mm)). Results: There were 999 patients received robotic thyroidectomy using BABA approach successfully, while only 1 case conversed to open operation. The postoperative hospital stay was (7.5±2.5) days (range: 2 to 30 days). Among the 730 patients with thyroid cancers, 725 cases (99.3%) were papillary thyroid carcinoma, 579(79.3%) cases were with papillary thyroid microcarcinoma. Lymph node metastasis was observed in 371(50.8%) cases. The retrieved central lymph node number was 11.2±6.1 (range: 1 to 44),and the retrieved lateral lymph node number was 14.0±8.8 (range: 1 to 52). Postoperative transient hypoparathyroidism and vocal cord palsy occurred in 247(24.70%) and 56(5.60%) cases. Both of permanent hypoparathyroidism and vocal cord palsy occurred in 2 (0.20%) cases. Other surgical complications included chyle leakage (6.1%, 28/460), trachea injury (0.40%, 4/1 000), carotid artery injury (0.10%, 1/1 000). Local regional lymph node recurrence was developed in 4 patients. All patients were satisfied with the postoperative cosmetic outcomes. Conclusions: Robotic thyroidectomy by BABA is safe and effective, suitable for large benign tumors and early thyroid cancers with central or lateral lymph node metastasis. It could obtain superior cosmetic results.

Enhanced Energy Density for P-Doped Hierarchically Porous Carbon-Based Symmetric Supercapacitor with High Operation Potential in Aqueous H2SO4 Electrolyte

Phosphorus-doped hierarchically porous carbon (HPC) is prepared with the assistance of freeze-drying using colloid silica and phytic acid dipotassium salt as a hard template and phosphorus source, respectively. Intensive material characterizations show that the freeze-drying process can effectively promote the porosity of HPC. The specific surface area and P content for HPC can reach up to 892 m² g^-1 and 2.78 at%, respectively. Electrochemical measurements in aqueous KOH and H₂SO₄ electrolytes reveal that K⁺ of a smaller size can more easily penetrate the inner pores compared with SO₄^2-, while the developed microporosity in HPC is conducive to the penetration of SO₄^2-. Moreover, P-doping leads to a high operation potential of 1.5 V for an HPC-based symmetric supercapacitor, resulting in an enhanced energy density of 16.4 Wh kg^-1. Our work provides a feasible strategy to prepare P-doped HPC with a low dosage of phosphorus source and a guide to construct a pore structure suitable for aqueous H₂SO₄ electrolyte.

Three-dimensional thiophene-diketopyrrolopyrrole-based molecules/graphene aerogel as high-performance anode material for lithium-ion batteries

Herein, 3,6-di(thiophen-2-yl)-2,5-dihydropyrrolo[3,4-c]pyrrole-1,4-dione (TDPP) and di-tert-butyl 2,2'-(1,4-dioxo-3,6-di(thiophen-2-yl)pyrrolo[3,4-c]pyrrole-2,5(1H,4H)-diyl)diacetate (TDPPA) were synthesized, which were then loaded in graphene aerogels. The as-prepared thiophene-diketopyrrolopyrrole-based molecules/reduced graphene oxide composites for lithium-ion battery (LIB) anode composites consist of DPPs nanorods on a graphene network. In relation to the DPPs part, embedding DPPs nanorods into graphene aerogels can effectively reduce the dissolution of DPPs in the electrolyte. It can serve to prevent electrode rupture and improve electron transport and lithium-ion diffusion rate, by partially connecting DPPs nanorods through graphene. The composite not only has a high reversible capacity, but also shows excellent cycling stability and performance, due to the densely distributed graphene nanosheets forming a three-dimensional conductive network. The TDPP₆₀ electrode exhibits high reversible capacity and excellent performance, showing an initial discharge capacity of 835 mA h g^-1 at a current density of 100 mA g^-1. Even at a current density of 1000 mA g^-1, after 500 cycles, it still demonstrates a discharge capacity of 303 mA h g^-1 with a capacity retention of 80.7%.

Development of a reporter gene method to measure the bioactivity of anti-CD38 × CD3 bispecific antibody

Background

A T cell-redirecting bispecific antibody (bsAb) consisting of a tumor-binding unit and a T cell-binding unit is a large group of antibody-based biologics against death-causing cancer diseases. The anti-CD38 × anti-CD3 bsAb (Y150) is potential for treating multiple myeloma (MM). When developing a cell-based reporter gene bioassay to assess the activities of Y150, it was found that the expression of CD38 on the human T lymphocyte cells (Jurkat) caused the nonspecific activation, which interfered with the specific T cells activation of mediated by the Y150 and CD38(+) tumor cells.

Methods

Here, we first knocked-out the CD38 expression on Jurkat T cell line by CRISPR-Cas9 technology, then developed a stable monoclonal CD38(−) Jurkat T cell line with an NFAT-RE driving luciferase expressing system. Further based on the CD38(−) Jurkat cell, we developed a reporter gene method to assess the bioactivity of the anti-CD38 × anti-CD3 bsAb.

Results

Knocking out CD38 expression abolished the nonspecific self-activation of the Jurkat cells. The selected stable monoclonal CD38(−) Jurkat T cell line assured the robustness of the report genes assay for the anti-CD38 × anti-CD3 bsAb. The relative potencies of the Y150 measured by the developed reporter gene assay were correlated with those by the flow-cytometry-based cell cytotoxicity assay and by the ELISA-based binding assay.

Conclusions

The developed reporter gene assay was mechanism of action-reflective for the bioactivity of anti-CD38 × anti-CD3 antibody, and suitable for the quality control for the bsAb product.

Residual SYNTAX score in relation to culprit-plaque characteristics and cardiovascular risk in acute myocardial infarction:an optical coherence tomography study

Introduction

The residual SYNTAX score (rSS) as the SYNTAX remaining after completion of percutaneous coronary intervention (PCI) was proved to be related to poor outcomes.

Purpose

This study aimed to investigate the association of culprit-plaque morphology with rSS and the predictive value of rSS for major adverse cardiac events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI).

Methods

A total of 274 STEMI patients undergoing preintervention optical coherence tomography examination were included and divided into 3 groups – rSS=0 (n=72), 0&lt;rss≤8&gt;8 (n=68). Baseline clinical data and culprit-plaque characteristics were compared. MACE was defined as the composite of all-cause death, recurrence of myocardial infarction (MI), stroke and unplanned revascularization of any coronary artery.

Results

There was a significant difference in the prevalence of plaque ruptures, lipid-rich plaques, and calcification among the three groups (plaque rupture: 44.4% versus 59.0% versus 64.7%, lowest to highest rSS, p=0.04; lipid-rich plaque: 40.3% versus 54.5% versus 69.1%, lowest to highest rSS, p=0.003; calcification: 38.9% versus 52.5% versus 61.8%, lowest to highest rSS, p=0.024). Multivariate logistic regression analysis indicated that rSS&gt;8 was an independent predictor for plaque rupture (OR: 2.21, 95% CI: 1.19–4.19, P=0.013). During a mean follow-up of 2.2 years, MACE occurred in 47 (17.2%) patients. In fully adjusted analyses, rSS was independently associated with MACE (HR: 1.06, 95% CI: 1.02–1.10, P=0.005); patients with rSS &gt;8 had higher MACE risk compared to rSS=0 (HR: 2.68, 95% CI: 1.11–6.5, P=0.029).

Conclusion

In STEMI patients, culprit-plaque morphology was significantly correlated with rSS, and elevated rSS was independently associated with cardiovascular risk.&lt;/rss≤8&gt;

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences OCT findingsSurvival curves according to rSS

Adipose-derived exosomes impairs endothelial transient receptor potential vanilloid 4 channels and elevates blood pressure in abdominal obesity

Aim

Large epidemiological studies have found that abdominal obesity is a strong risk factor for hypertension. Impaired endothelium-dependent vasodilation is a hallmark of obesity-induced hypertension. Adipose-derived exosomes can regulate distant tissues as novel adipokines, providing a new mechanism for cell-cell interactions. However, the effects of adipose-derived exosomes on obesity-induced hypertension are unknown.

Methods

We extracted three adipose-derived exosomes, including high-fat diet (HFD) mouse serum exosome, adipose tissue exosome, and adipose-derived stem cell exosome, and further explored their effects on endothelium-dependent vasodilation in vivo and in vitro.

Results

Impairment of endothelial transient receptor potential vanilloid 4 (TRPV4) channel activity and vasodilation were observed in the arteries from abdominal obesity patients. Ca2+ influx through TRPV4 channels at myoendothelial projections to smooth muscle cells decreases resting blood pressure in nonobese mice, a response that is diminished in HFD mice. Administration of three exosomes elevated blood pressure by promoting artery endothelial barrier permeability, impairing the expression of adherens junctions, and aggravating inflammatory response in vivo and in vitro, accompanied by TRPV4/Ca2+ pathway inhibition.

Conclusions

Impairment of endothelial TRPV4 channels contributes to obesity-induced hypertension and imply that HFD-induced obesity plays a role in blood pressure by aggravating the artery endothelial barrier injury and inflammatory response via adipose-derived exosomes, at least partially, through inhibiting the TRPV4/Ca2+ pathway.

Funding Acknowledgement

Type of funding sources: None. Main funding source(s): This research was supported by grants from the National Natural Science Foundation of China (81970262) (P.J.W.), Innovation Team Project Department of Education of Sichuan Province (18TD0030) (PJW), Central Funds Guiding the Local Science and Technology Development of Sichuan Province (2020ZYD036, P.W.), and grants from the Scientific Research Fund of Chengdu Medical College (CYZYB20-07) (J.W.).

Prevalence and impact of metabolic syndrome in patients with multivessel coronary artery disease and acute coronary syndrome

Background

Metabolic syndrome is associated with increased incidence of diabetes and cardiovascular diseases in patients initially free from these diseases. However, its prognostic value in patients with established coronary artery diseases remains controversial.

Purpose

Therefore, we aimed to illustrate the prevalence and investigate the impact of metabolic syndrome in patients with multivessel coronary artery disease and acute coronary syndrome.

Methods

We conducted a large registry of consecutive patients with acute coronary syndrome referred to primary percutaneous coronary intervention and those with multivessel diseases were eligible for this analysis. Metabolic syndrome was defined using modified criteria based on the Adult Treatment Panel III definition from the National Cholesterol Education Program. The primary outcome was major adverse cardiovascular events (MACE), a composite of all-cause death, myocardial infarction, and stroke.

Results

A total of 2532 patients were included in current analysis and 993 (39.2%) of them had metabolic syndrome while 1539 (60.8%) did not. The prevalence of metabolic syndrome increased over the study period (p for trend = 0.005). There was a significant decline of metabolic syndrome prevalence in patients over 60 years old (p for trend = 0.002) and females had a higher prevalence than their male counterparts (61.5% verse 32.9%, p&lt;0.001). Over a median follow-up of 2.3 years, metabolic syndrome was not significantly associated with MACE (adjusted 95% CI 0.92 to 1.54). In addition, there was no significant difference observed between two groups in other individual outcomes, namely all-cause death, cardiac death, stroke, myocardial infarction, and any revascularization.

Conclusions

Metabolic syndrome was frequently observed in patients with multivessel coronary artery disease and acute coronary syndrome. Patients with metabolic syndrome were more likely to be young and female. However, it was not an independent predictor for MACE after primary percutaneous coronary intervention in those patients.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences Metabolic syndrome distribution in MVDOutcome according to metabolic syndrome

Qualifying Certainty in Radiology Reports through Deep Learning-Based Natural Language Processing

BACKGROUND AND PURPOSE

Communication gaps exist between radiologists and referring physicians in conveying diagnostic certainty. We aimed to explore deep learning-based bidirectional contextual language models for automatically assessing diagnostic certainty expressed in the radiology reports to facilitate the precision of communication.

MATERIALS AND METHODS

We randomly sampled 594 head MR imaging reports from an academic medical center. We asked 3 board-certified radiologists to read sentences from the Impression section and assign each sentence 1 of the 4 certainty categories: "Non-Definitive," "Definitive-Mild," "Definitive-Strong," "Other." Using the annotated 2352 sentences, we developed and validated a natural language-processing system based on the start-of-the-art bidirectional encoder representations from transformers (BERT), which can capture contextual uncertainty semantics beyond the lexicon level. Finally, we evaluated 3 BERT variant models and reported standard metrics including sensitivity, specificity, and area under the curve.

RESULTS

A κ score of 0.74 was achieved for interannotator agreement on uncertainty interpretations among 3 radiologists. For the 3 BERT variant models, the biomedical variant (BioBERT) achieved the best macro-average area under the curve of 0.931 (compared with 0.928 for the BERT-base and 0.925 for the clinical variant [ClinicalBERT]) on the validation data. All 3 models yielded high macro-average specificity (93.13%-93.65%), while the BERT-base obtained the highest macro-average sensitivity of 79.46% (compared with 79.08% for BioBERT and 78.52% for ClinicalBERT). The BioBERT model showed great generalizability on the heldout test data with a macro-average sensitivity of 77.29%, specificity of 92.89%, and area under the curve of 0.93.

CONCLUSIONS

A deep transfer learning model can be developed to reliably assess the level of uncertainty communicated in a radiology report.

Development of Perovskite Oxide-Based Electrocatalysts for Oxygen Evolution Reaction

Perovskite oxides are studied as electrocatalysts for oxygen evolution reactions (OER) because of their low cost, tunable structure, high stability, and good catalytic activity. However, there are two main challenges for most perovskite oxides to be efficient in OER, namely less active sites and low electrical conductivity, leading to limited catalytic performance. To overcome these intrinsic obstacles, various strategies are developed to enhance their catalytic activities in OER. In this review, the recent developments of these strategies is comprehensively summarized and systematically discussed, including composition engineering, crystal facet control, morphology modulation, defect engineering, and hybridization. Finally, perspectives on the design of perovskite oxide-based electrocatalysts for practical applications in OER are given.

Transcriptome-wide Gene Expression Analysis in Peri-implantitis Reveals Candidate Cellular Pathways

OBJECTIVE

Peri-implantitis is a condition resulting in destructive inflammation in the peri-implant soft tissue barrier. Clinically, it demonstrates vast clinical differences to periodontitis that suggest distinct inflammatory mechanisms. Implant-derived titanium particles (i-TiPs) frequently found around diseased implants appear to alter the microenvironment and confer resistance to antibiotic treatments. Studies in orthopedic implants have demonstrated potent inflammatory responses to i-TiPs involving a variety of cell types in aseptic conditions. Nonetheless, the genetic programs of cells surveilling and supporting the peri-implant soft tissue barrier in response to the combined challenges of biomaterial degradation products and oral bacteria are poorly defined. Thus, we studied gene expression specific to oral peri-implant inflammatory disease.

METHODS

Peri-implant tissues were collected from healthy or diseased implants (N = 10) according to the 2018 classification criteria. Following RNA extraction and purification, a gene-level view of the transcriptome was obtained via a next-generation transcriptome-wide microarray profiling workflow (Clariom S; Applied Biosystems) that covers >20,000 well-annotated genes. A discovery analysis assessed global differential expression of genes and identified pathways in peri-implant health versus disease.

RESULTS

Genes involved in the endosomal-lysosomal pathway, such as actin polymerization, were strongly upregulated in diseased tissues (P < .05), proposing increased intracellular activities in response to bacteria and i-TiPs. Cellular respiration pathways involved in oxidative stress were highly transcribed in all peri-implant samples, suggesting that implant-specific factors may trigger a constant state of oxidative stress.

CONCLUSION

Within the limitations of this discovery study, expressive upregulation of genes in the endosomal-lysosomal and oxidative stress pathway suggests that inflammation related to receptor-driven responses to extracellular signals, such as i-TiPs and pathogens, may have a crucial role in peri-implantitis. Results warrant external replication in validation cohorts.

KNOWLEDGE TRANSFER STATEMENT

Our findings regarding physiologic processes affected by peri-implantitis could advance knowledge of the mechanisms and consequences of the disease. Understanding the cellular programs that partake in peri-implant inflammation has the potential to translate to novel treatment strategies for patients with peri-implantitis.

Combine and conquer: manganese synergizing anti-TGF-β/PD-L1 bispecific antibody YM101 to overcome immunotherapy resistance in non-inflamed cancers

BACKGROUND

Our previous work showed that the anti-TGF-β/PD-L1 bispecific antibody YM101 effectively overcame anti-PD-L1 resistance in immune-excluded tumor models. However, in immune-desert models, the efficacy of YM101 was limited. Bivalent manganese (Mn2+) is identified as a natural stimulator of interferon genes (STING) agonist, which might enhance cancer antigen presentation and improve the therapeutic effect of YM101.

METHODS

The effect of Mn2+ on STING pathway was validated by western blotting and enzyme-linked immunosorbent assay. Dendritic cell (DC) maturation was measured by flow cytometry. The synergistic effect between Mn2+ and YM101 in vitro was determined by one-way mixed lymphocyte reaction, CFSE dilution assay, and cytokine detection. The in vivo antitumor effect of Mn2+ plus YM101 therapy was assessed in CT26, EMT-6, H22, and B16 tumor models. Flow cytometry, RNA-seq, and immunofluorescent staining were adopted to investigate the alterations in the tumor microenvironment.

RESULTS

Mn2+ could activate STING pathway and promote the maturation of human and murine DC. The results of one-way mixed lymphocyte reaction showed that Mn2+ synergized YM101 in T cell activation. Moreover, in multiple syngeneic murine tumor models, Mn2+ plus YM101 therapy exhibited a durable antitumor effect and prolonged the survival of tumor-bearing mice. Relative to YM101 monotherapy and Mn2+ plus anti-PD-L1 therapy, Mn2+ plus YM101 treatment had a more powerful antitumor effect and a broader antitumor spectrum. Mechanistically, Mn2+ plus YM101 strategy simultaneously regulated multiple components in the antitumor immunity and drove the shift from immune-excluded or immune-desert to immune-inflamed tumors. The investigation in the TME indicated Mn2+ plus YM101 strategy activated innate and adaptive immunity, enhanced cancer antigen presentation, and upregulated the density and function of tumor-infiltrating lymphocytes. This normalized TME and reinvigorated antitumor immunity contributed to the superior antitumor effect of the combination therapy.

CONCLUSION

Combining Mn2+ with YM101 has a synergistic antitumor effect, effectively controlling tumor growth and prolonging the survival of tumor-bearing mice. This novel cocktail strategy has the potential to be a universal regimen for inflamed and non-inflamed tumors.

RBD-homodimer, a COVID-19 subunit vaccine candidate, elicits immunogenicity and protection in rodents and nonhuman primates

The pandemic of COVID-19 caused by SARS-CoV-2 has raised a new challenges to the scientific and industrious fields after over 1-year spread across different countries. The ultimate approach to end the pandemic is the timely application of vaccines to achieve herd immunity. Here, a novel SARS-CoV-2 receptor-binding domain (RBD) homodimer was developed as a SARS-CoV-2 vaccine candidate. Formulated with aluminum adjuvant, RBD dimer elicited strong immune response in both rodents and non-human primates, and protected mice from SARS-CoV-2 challenge with significantly reducing viral load and alleviating pathological injury in the lung. In the non-human primates, the vaccine could prevent majority of the animals from SARS-CoV-2 infection in the respiratory tract and reduce lung damage. In addition, antibodies elicited by this vaccine candidate showed cross-neutralization activities to SARS-CoV-2 variants. Furthermore, with our expression system, we provided a high-yield RBD homodimer vaccine without additional biosafety or special transport device supports. Thus, it may serve as a safe, effective, and low-cost SARS-CoV-2 vaccine candidate.

Mineral deposition intervention through reduction of phosphorus intake suppresses osteoarthritic lesions in temporomandibular joint

OBJECTIVE

To explore the suppressing impact of low phosphorus intake on osteoarthritic temporomandibular joint and the possible mechanisms of nuclear acid injury in the insulted chondrocytes.

DESIGN

Chondrocytes were loaded with fluid flow shear stress (FFSS) with or without low phosphorus medium. Seventy-two mice (sampled at 3-, 7- and 11-wk, n = 6) and forty-eight rats (sampled at 12-wks for different testing purpose, n = 6) were applied with unilateral anterior crossbite (UAC) with or without low phosphorus diet. In the FFSS model, the Ca and P content, molecules related to nucleic acid degradation and the mineral-producing responses in chondrocytes were detected. The effect of culture dish stiffness on chondrocytes osteogenic differentiation was measured. In the UAC model, the content of Ca and P in serum were tested. The condylar cartilage ossification and stiffness were detected using micro-CT, scanning electron microscope and atomic force microscope.

RESULTS

FFSS induced nucleic acid degradation, Pi accumulation and mineral-producing responses in the cultured chondrocytes, all were alleviated by low P medium. Stiffer dish bottoms promoted the osteogenic differentiation of the cultured chondrocytes. UAC stimulated cartilage degeneration and chondrocytes nucleic acid damage, increased PARP 1 and serum P content, and enhanced ossification and stiffening of the cartilage, all were suppressed by low phosphorus diet (all, P < 0.05).

CONCLUSION

Nucleic acid damage takes a role in phosphorus production in osteoarthritic cartilage, contributing to the enhanced mineralization and stiffness of the cartilage that in turn promotes cartilage degradation, which can be alleviated by low phosphorus intake.

A Diastereodivergent and Enantioselective Approach to syn- and anti-Diamines: Development of 2-Azatrienes for Cu-Catalyzed Reductive Couplings with Imines That Furnish Allylic Amines

We introduce a new reagent class, 2-azatrienes, as a platform for catalytic enantioselective synthesis of allylic amines. Herein, we demonstrate their promise by a diastereodivergent synthesis of syn- and anti-1,2-diamines through their Cu-bis(phosphine)-catalyzed reductive couplings with imines. With Ph-BPE as the supporting ligand, anti-diamines are obtained (up to 91% yield, >20:1 dr, and >99:1 er), and with the rarely utilized t-Bu-BDPP, syn-diamines are generated (up to 76% yield, 1:>20 dr, and 97:3 er).

Design, synthesis and antitumor evaluation of novel chiral diaryl substituted azetidin-2-one derivatives as tubulin polymerization inhibitors

A novel class of diaryl substituted azetidin-2-one derivatives were designed, asymmetrically synthesized, and evaluated for antiproliferative activities. The in vitro antitumor assay revealed that among the 4-aryl-substituted 1-(3,4,5-trimethoxyphenyl)azetidin-2-ones (B series), most possessed moderate to strong activities, with compound B7c that bears a 2-naphthyl substituent being the most potent one (IC₅₀ 0.16-0.40 μM) against a panel of human cancer cell lines. In contrast, none of the 3-(arylmethylene)-substituted 1-(3,4,5-trimethoxyphenyl)azetidin-2-ones (L series) showed significant activities in the assay. Further studies indicated that B7c inhibited tubulin polymerization, disrupted in vitro vascularization, blocked cell cycle progression at G₂/M phase, induced cell apoptosis, decreased mitochondrial membrane potential, and increased the intracellular reactive oxygen species level in a dose-dependent way. Compound B7c also inhibited significantly tumor growth in a xenograft mice model with no obvious drop in the mice body weights. Collectively, these results suggested that B7c and its analogues should merit further investigation as new promising antitumor agents.

P–757 The risk of aspirin and prednisone using in women with antithyroid antibodies undergoing assisted reproductive technology

Study question

Is it safe using aspirin (A) and prednisone (P) before pregnancy among women with antithyroid antibodies (ATAbs) undergoing assisted reproductive technology?

Summary answer

Combination therapy of aspirin and prednisone didn’t improve likelihood of clinical pregnancy, but increased miscarriage rate.

What is known already

Compared with women with negative-ATAb, women with positive-ATAb had a lower live birth rate and a higher miscarriage rate. Insufficient evidence existed to determine whether aspirin and prednisone therapy improved the success of pregnancy following assisted reproductive technology (ART) in ATAb-positive euthyroid women. Aspirin and prednisone were used frequently in clinical practice, but the use of these medicines before pregnancy during ART process is still controversial, and the risks of these medicines were not well understood.

Study design, size, duration

A prospective study involving 268 women with unexplained reason for infertility who tested positive for antithyroperoxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb) were being treated for infertility at the Second Affiliated Hospital of Zhejiang University School of Medicine, Ningbo Women and Children’s Hospital and People’s Hospital of Jinhua from October 2017 to July 2020. Their TSH level ranged from 0.35–4.0mIU/ml and they all underwent fresh embryo transfer.

Participants/materials, setting, methods

Overall, a total of 268 ATAb-positive women were divided 2 groups: group A: no treatment; B: A+P. Both medicines were used in the lowest effective dose. Between the two groups, we measured oocytes retrieved, fertilization rate, high-quality embryo rate, blastulation rate, cleavage rate,implantation rate, likelihood of clinical pregnancy and miscarriage rate. Kruskal-Wallis test was used in nonnormally distributed variables, and the χ2 test or Fisher exact test was used to compare categorical variables.

Main results and the role of chance

A total of 268 infertile women with unexplained reason who tested positive for TPOAb and/or TgAb were recruited in our study. According to assignment, they were divided into two groups. All women in different groups had the similar age, BMI, number of miscarriage and duration of infertility. Levels of FSH, AMH, TSH, FT4, FT3, fibrinogen and d-dimer were similar in all groups. The use of A+P reduced cleavage rate (F = 23.982, P &lt; 0.001) and implantation rate (F = 4.388, P = 0.036). The fertilization rate (P = 0.407), high-quality embryo rate (P = 0.208) and blastulation rate (P = 0.157) were not influenced by the use of medication. In this study, likelihood of clinical pregnancy (P = 0.066) did not change significantly after therapy, and miscarriage rate (P = 0.042) increased after medical treatment.

Limitations, reasons for caution

Firstly, Aspirin is just one representation of anticoagulation therapy, so additional consideration of low molecular heparin should also be considered. Secondly, further randomized controlled trials of aspirin and prednisone alone are needed.

Wider implications of the findings: In this study, use of A+P showed no positive effect, and reduced cleavage rate and implantation rate, while increased miscarriage rate. So, the use of medication for interfile women should be cautious.

Trial registration number

n/a

Peta-electron volt gamma-ray emission from the Crab Nebula

The Crab Nebula is a bright source of gamma rays powered by the Crab Pulsar's rotational energy through the formation and termination of a relativistic electron-positron wind. We report the detection of gamma rays from this source with energies from 5 × 10^-4 to 1.1 peta-electron volts with a spectrum showing gradual steepening over three energy decades. The ultrahigh-energy photons imply the presence of a peta-electron volt electron accelerator (a pevatron) in the nebula, with an acceleration rate exceeding 15% of the theoretical limit. We constrain the pevatron's size between 0.025 and 0.1 parsecs and the magnetic field to ≈110 microgauss. The production rate of peta-electron volt electrons, 2.5 × 10³⁶ ergs per second, constitutes 0.5% of the pulsar spin-down luminosity, although we cannot exclude a contribution of peta-electron volt protons to the production of the highest-energy gamma rays.

Tandem Character of Liquid Hot Water and Deep Eutectic Solvent to Enhance Lignocellulose Deconstruction

Pretreatment with efficient fractionation, eco-friendliness, and low-cost brings high security to future biorefinery systems. Synergistic pretreatment is a compelling blueprint to tackle the compact structure of lignocellulose towards a high-level valorization. Here, a stepwise approach was designed using hydrothermal and deep eutectic solvent (DES) pretreatments to hierarchically extract hemicelluloses and lignin from poplar, while delivering a cellulose-rich substrate that could easily undergo enzymatic hydrolysis to obtain fermentable glucose and residual lignin. The lifetime of recyclable DES showed that the pretreatment efficiency was still largely maintained after the fourth recycling. An enhancement of enzymatic digestibility from 13.9 to 90.4 % was initiated by the deconstruction of amorphous portions and robust cell wall. 23.7 % Xylooligosaccharides (degree of polymerization 2-6), 47.5 % DES-isolated lignin, and 19.2 % cellulose enzymatic lignin were harvested via this coupled process. This study could promote the precise design of sustainable tandem pretreatment that can boost the frontier of highly available biorefinery.

Impacts of COVID-19 on the electric vehicle industry: Evidence from China

Electric vehicle development is critical to achieve the sustainable goals, while the hit of COVID-19 strikes the market and brings challenges to the whole industry. China, among one of the earliest regions affected by COVID-19 and takes a great part in the global electric vehicle market, is attracting growing attention on its post-pandemic trends in the electric vehicle industry. This paper provides a comprehensive analysis of COVID-19 impacts on China's electric vehicle industry from both the demand side and the supply side. Both challenges and opportunities for China's electric vehicle development are revealed with emerging trend analysis. It is found that the COVID-19 outbreak has reduced electric vehicle sales in the short-term, but may also stimulate future electric vehicle demand especially for large electric cars with better performance. Meanwhile, travel restrictions caused by COVID-19 have interrupted electric vehicle material supplies that relying on imports, accelerating domestic substitute exploitation and inventory improvement for critical parts. Additionally, massive lockdowns for controlling COVID-19 have disrupted productions and operations, which tends to expel small brands out of the competitive market, concentrating China's electric vehicle industry to the leading brands. Finally, the social distancing trend after pandemic is bringing challenges to traditional EV distribution channels with dealers, pushing automakers to develop innovative online selling channels. These impacts are likely to lead to a reformation of China's electric vehicle industry towards a more advanced and reliable future.

Extended Very-High-Energy Gamma-Ray Emission Surrounding PSR J0622+3749 Observed by LHAASO-KM2A

We report the discovery of an extended very-high-energy (VHE) gamma-ray source around the location of the middle-aged (207.8 kyr) pulsar PSR J0622+3749 with the Large High-Altitude Air Shower Observatory (LHAASO). The source is detected with a significance of 8.2σ for E>25  TeV assuming a Gaussian template. The best-fit location is (right ascension, declination) =(95.47°±0.11°,37.92°±0.09°), and the extension is 0.40°±0.07°. The energy spectrum can be described by a power-law spectrum with an index of -2.92±0.17_{stat}±0.02_{sys}. No clear extended multiwavelength counterpart of the LHAASO source has been found from the radio to sub-TeV bands. The LHAASO observations are consistent with the scenario that VHE electrons escaped from the pulsar, diffused in the interstellar medium, and scattered the interstellar radiation field. If interpreted as the pulsar halo scenario, the diffusion coefficient, inferred for electrons with median energies of ∼160  TeV, is consistent with those obtained from the extended halos around Geminga and Monogem and much smaller than that derived from cosmic ray secondaries. The LHAASO discovery of this source thus likely enriches the class of so-called pulsar halos and confirms that high-energy particles generally diffuse very slowly in the disturbed medium around pulsars.

The production of single cell protein from biogas slurry with high ammonia-nitrogen content by screened Nectaromyces rattus

In this study, a novel method was proposed to obtain single cell protein (SCP) in yeast by using biogas slurry as culture medium. The results show that Nectaromyces rattus was the most efficient at producing SCP among the 7 different yeasts studied. Acetic acid was a better pH regulator than hydrochloric acid. After culture with the initial NH₄⁺-N concentration 2,000 mg/L, C/N ratio 6:1, the initial pH 5.50 and rotation speed of 200 rpm, a total cell dry weight of 12.58 g/L with 35.96% protein content was obtained. Nineteen amino acids accounted for 46.85% of cell dry weight, and proline content was as high as 12.0% of the cell dry weight. However, sulfur-containing amino acids, including methionine and cystine, were deficient. Further research should focus on the high cell density culture to increase SCP production.

Ultrahigh-energy photons up to 1.4 petaelectronvolts from 12 γ-ray Galactic sources

The extension of the cosmic-ray spectrum beyond 1 petaelectronvolt (PeV; 10¹⁵ electronvolts) indicates the existence of the so-called PeVatrons-cosmic-ray factories that accelerate particles to PeV energies. We need to locate and identify such objects to find the origin of Galactic cosmic rays¹. The principal signature of both electron and proton PeVatrons is ultrahigh-energy (exceeding 100 TeV) γ radiation. Evidence of the presence of a proton PeVatron has been found in the Galactic Centre, according to the detection of a hard-spectrum radiation extending to 0.04 PeV (ref. ²). Although γ-rays with energies slightly higher than 0.1 PeV have been reported from a few objects in the Galactic plane^3-6, unbiased identification and in-depth exploration of PeVatrons requires detection of γ-rays with energies well above 0.1 PeV. Here we report the detection of more than 530 photons at energies above 100 teraelectronvolts and up to 1.4 PeV from 12 ultrahigh-energy γ-ray sources with a statistical significance greater than seven standard deviations. Despite having several potential counterparts in their proximity, including pulsar wind nebulae, supernova remnants and star-forming regions, the PeVatrons responsible for the ultrahigh-energy γ-rays have not yet been firmly localized and identified (except for the Crab Nebula), leaving open the origin of these extreme accelerators.

Do marginal abatement costs matter for improving air quality? Evidence from China's major cities

This paper performs a two-stage analysis to investigate the trade-off between economic growth and pollution abatement. We first estimate the marginal abatement costs (MACs) of CO₂, SO₂, NO_x, and particulate matter (PM) for 30 major Chinese cities from 2006 to 2015 via the shadow price approach under the directional distance function framework. The results show that the optimal directional vector is (11, -1, -1, -1, -1), which may indicate that increasing economic output is much more important than reducing the above undesirable outputs in these cities. Then, having examined the relationship between MACs and air quality by panel regression and dose-response analyses, we found ranges of positive and statistically significant treatment effects for the MACs of SO₂ and PM on their respective concentrations. The overall results suggest that government officials in these cities may give precedence to economic growth over environmental protection.

Bispecific Antibody PD-L1 x CD3 Boosts the Anti-Tumor Potency of the Expanded Vγ2Vδ2 T Cells

Vγ2Vδ2 T cell-based immunotherapy has benefited some patients in clinical trials, but the overall efficacy is low for solid tumor patients. In this study, a bispecific antibody against both PD-L1 and CD3 (PD-L1 x CD3), Y111, could efficiently bridge T cells and PD-L1 expressing tumor cells. The Y111 prompted fresh CD8+ T cell-mediated lysis of H358 cells, but spared this effect on the fresh Vδ2+ T cells enriched from the same donors, which suggested that Y111 could bypass the anti-tumor capacity of the fresh Vγ2Vδ2 T cells. As the adoptive transfer of the expanded Vγ2Vδ2 T cells was approved to be safe and well-tolerated in clinical trials, we hypothesized that the combination of the expanded Vγ2Vδ2 T cells with the Y111 would provide an alternative approach of immunotherapy. Y111 induced the activation of the expanded Vγ2Vδ2 T cells in a dose-dependent fashion in the presence of PD-L1 positive tumor cells. Moreover, Y111 increased the cytotoxicity of the expanded Vγ2Vδ2 T cells against various NSCLC-derived tumor cell lines with the releases of granzyme B, IFNγ, and TNFα in vitro. Meanwhile, the adoptive transferred Vγ2Vδ2 T cells together with the Y111 inhibited the growth of the established xenografts in NPG mice. Taken together, our data suggested a clinical potential for the adoptive transferring the Vγ2Vδ2 T cells with the Y111 to treat PD-L1 positive solid tumors.

[Complications of Da Vinci robot thyroid surgery by bilateral axillo-breast approach]

Objective: To evaluate the complications of Da Vinci robotic thyroid surgery by bilateral axillo-breast approach. Methods: A retrospective analysis of complications was conducted on 1, 198 cases of Da Vinci robotic thyroid surgery by bilateral axillo-breast approach of the 960 th Hospital of the People's Liberation Army from February 2014 to March 2020. There were 263 men and 935 women, age ranged from 9 to 68 years old, and included 288 benign lesions and 910 malignancies according to preoperative imaging examination, FNAC, and intraoperative frozen pathology. Results: Surgical complications occurred in 187 (15.61%) patients, including 10 cases of temporary larynx nerve injury (0.83%), 1 case of permanent larynx nerve injury (0.08%), and 152 cases of temporary hypoparathyroidism (12.69%), no permanent hypoparathyroidism, 1 case of hypoglossal injury (0.08%), 2 cases of facial nerve jaw branch damage (0.17%), 2 cases of trachea injury (0.17%), no esophagus damage, 5 cases of celiac leakage (0.42%), 3 cases of neck skin adhesion (0.25%), 2 cases of subdermal bleeding (0.17%), 2 cases of skin burns (0.17%), 5 cases of hematoma (0.42%), 1 case of cephalic artery rupture (0.08%), 1 case of jugular vein rupture (0.08%), no tumor cultivation, no arm plex nerve, accessory nerve or phrenic nerve damage. Conclusion: Da Vinci robot thyroid surgery by bilateral axillo-breast approach is safe, with less severe complications.

Multi-Phase Heterostructure of CoNiP/Cox P for Enhanced Hydrogen Evolution Under Alkaline and Seawater Conditions by Promoting H2 O Dissociation

Hydrogen evolution reaction (HER) is a key step for electrochemical energy conversion and storage. Developing well defined nanostructures as noble-metal-free electrocatalysts for HER is promising for the application of hydrogen technology. Herein, it is reported that 3D porous hierarchical CoNiP/Co_x P multi-phase heterostructure on Ni foam via an electrodeposition method followed by phosphorization exhibits ultra-highly catalytic activity for HER. The optimized CoNiP/Co_x P multi-phase heterostructure achieves an excellent HER performance with an ultralow overpotential of 36 mV at 10 mA cm^-2 , superior to commercial Pt/C. Importantly, the multi-phase heterostructure shows exceptional stability as confirmed by the long-term potential cycles (30,000 cycles) and extended electrocatalysis (up to 500 h) in alkaline solution and natural seawater. Experimental characterizations and DFT calculations demonstrate that the strong electronic interaction at the heterointerface of CoNiP/CoP is achieved via the electron transfer from CoNiP to the heterointerface, which directly promotes the dissociation of water at heterointerface and desorption of hydrogen on CoNiP. These findings may provide deep understanding on the HER mechanism of heterostructure electrocatalysts and guidance on the design of earth-abundant, cost-effective electrocatalysts with superior HER activity for practical applications.

Special AT-rich sequence-binding protein 2 (Satb2) synergizes with Bmp9 and is essential for osteo/odontogenic differentiation of mouse incisor mesenchymal stem cells

OBJECTIVES

Mouse incisor mesenchymal stem cells (MSCs) have self-renewal ability and osteo/odontogenic differentiation potential. However, the mechanism controlling the continuous self-renewal and osteo/odontogenic differentiation of mouse incisor MSCs remains unclear. Special AT-rich sequence-binding protein 2 (SATB2) positively regulates craniofacial patterning, bone development and regeneration, whereas SATB2 deletion or mutation leads to craniomaxillofacial dysplasia and delayed tooth and root development, similar to bone morphogenetic protein (BMP) loss-of-function phenotypes. However, the detailed mechanism underlying the SATB2 role in odontogenic MSCs is poorly understood. The aim of this study was to investigate whether SATB2 can regulate self-renewal and osteo/odontogenic differentiation of odontogenic MSCs.

MATERIALS AND METHODS

Satb2 expression was detected in the rapidly renewing mouse incisor mesenchyme by immunofluorescence staining, quantitative RT-PCR and Western blot analysis. Ad-Satb2 and Ad-siSatb2 were constructed to evaluate the effect of Satb2 on odontogenic MSCs self-renewal and osteo/odontogenic differentiation properties and the potential role of Satb2 with the osteogenic factor bone morphogenetic protein 9 (Bmp9) in vitro and in vivo.

RESULTS

Satb2 was found to be expressed in mesenchymal cells and pre-odontoblasts/odontoblasts. We further discovered that Satb2 effectively enhances mouse incisor MSCs self-renewal. Satb2 acted synergistically with the potent osteogenic factor Bmp9 in inducing osteo/odontogenic differentiation of mouse incisor MSCs in vitro and in vivo.

CONCLUSIONS

Satb2 promotes self-renewal and osteo/odontogenic differentiation of mouse incisor MSCs. Thus, Satb2 can cooperate with Bmp9 as a new efficacious bio-factor for osteogenic regeneration and tooth engineering.

Effect of food on orally-ingested titanium dioxide and zinc oxide nanoparticle behaviors in simulated digestive tract

Nanomaterials have been widely utilized in human daily life. The interaction between nanoparticles (NPs) and food matrices through oral ingestion is important for fate and potential toxicity of NPs. In this study, the interaction between NPs (i.e., titanium dioxide (TiO₂) and zinc oxide (ZnO)) and food matrices (namely sucrose, protein powder, and corn oil) was investigated by use of an in vitro physiological model. Measurement using asymmetrical flow field-flow fractionation (AF₄) showed that particle size of TiO₂ NPs in saliva fluid decreased from 102 ± 6.21 nm (control) to 69.2 ± 6.90 and 81.9 ± 4.30 nm in protein powder and corn oil. Similar trend was also observed for ZnO. Compared with gastric fluid, micelles formed by corn oil in intestinal fluid further dispersed NPs, as indicated by approximately 11.1% and 13.2% decrease in particle size of TiO₂ and ZnO NPs, respectively. Characterization of TEM, FTIR and AFM showed that a layer of biological corona was attached on surface of NPs in protein and oil. The XPS demonstrated that oil bound with NPs through forming covalent bonds, while protein bound with NPs through van der Waals force and electrostatic force for TiO₂ and ZnO NPs, respectively. The result here demonstrated the importance of considering food effect when investigating the morphology and behavior of NPs after oral ingestion. This understanding was valuable in assessment of environmental fate and biological effects of NPs.

Electrosprayed minocycline hydrochloride-loaded microsphere/SAIB hybrid depot for periodontitis treatment

Minocycline hydrochloride (MINO) has been one of the most frequently used antibiotics in the treatment of periodontitis due to its antibacterial activity and osteogenesis effects; however, high levels of MINO administered during the treatment halt the formation of new bone. Therefore, the purpose of the present study was to prepare a MINO-microsphere/sucrose acetate isobutyrate (SAIB) hybrid depot to reduce the burst release of MINO and ensure antibacterial and osteogenesis effects of MINO in the treatment of periodontitis. Uniform microspheres, approximately 5 µm size, with a slightly rough surface and different MINO loading (10, 12, and 14%) were prepared, and the microspheres were added into SAIB, after which the burst release significantly decreased from 66.18 to 2.92%, from 71.82 to 3.82%, and from 73.35 to 4.45%, respectively, and the release from all the MINO-microspheres/SAIB hybrid depots lasted for 77 days. In addition, cytotoxicity test showed that the MINO-microsphere with 12% drug loading promoted the proliferation of osteoblasts the most and was subsequently used in vivo experiments. Moreover, in the model of ligatured-induced periodontitis in SD rats, the MINO-microsphere/SAIB hybrid depot not only significantly increased the alveolar bone height and bone volume but also reduced the inflammation of the periodontal tissue. Additionally, it also inhibited the expression of the receptor activator of nuclear factor-kappa B ligand (RANKL) and promoted the expression of osteoprotegerin (OPG).. These results indicated that the MINO-microsphere/SAIB hybrid depot might be promising in the treatment of periodontitis.

[Treatment of lumbar degenerative diseases with recapping laminoplasty and nerve root canal's decompression preserving the continuity of supraspinous ligament]

Objective: To explore the clinical effect of lumbar discectomy and nerve root canal's enlargement preserving the continuity of supraspinous ligament in the treatment of lumbar degenerative disease. Methods: The data of patients with lumbar degenerative disease who underwent operation from 2016 to 2018 were analyzed retrospectively, and the patients were divided into two groups according to the different operation. The treatment group (17 cases) was treated with recapping laminoplasty, lumbar discectomy and nerve root canal's enlargement, and the control group (28 cases) was treated with total laminectomy, nerve root canal's enlargement, lumbar discectomy, interbody fusion and internal fixation (PLIF). All patients were followed up for 12 to 27 months (mean 17.8 months). Japanese Orthopaedic Association Scores(JOA) and visual analogue scale(VAS) of pain were used to evaluate the clinical effect before and after the operation, lumbar dynamical X-ray and Cobb angle were collecting for imaging evaluation, and the adjacent segment degeneration at the last follow-up was recorded. Results: There was no significant difference in preoperative JOA score, VAS score and Lumbar Cobb angle between the two groups (all P>0.05). The operation time in the treatment group was shorter than that in the control group, and the blood loss during operation in the treatment group was lower than that in the control group, the bed rest time of the treatment group after operation was shorter than that in the control group ((79±14) vs (118±17) min, (151±38) vs (324±70) ml and (3.4±0.7) vs (4.3±1.0) d,respectively; t=-8.508, -10.724, -3.244, all P<0.01). In addition, compared with the control group, the volume of postoperative drainage in the treatment group also decreased significantly (t=-5.637, P<0.01). There was no significant difference in JOA score between the two groups 1 year after the operation (P>0.05), but there was significant difference in VAS score between the two groups, the treatment group was better than the control group (P<0.05). Compared with the control group, the lumbar Cobb angle in the treatment group increased significantly one year after the operation (55.3°±3.2° vs 38.4°±6.2°, t=10.391, P<0.05). During the follow-up, no loosening or fracture of the implants was found in all patients. Conclusion: Treatment of lumbar degenerative diseases with recapping laminoplasty and nerve root canal's decompression preserving the continuity of supraspinous ligament by ultrasound osteotome has the same clinical effect as PLIF. It has the advantages of shortening operation time, less bleeding, better maintenance of lumbar lordosis after operation and reduction of adjacent segment degeneration.