Elevated serum HbA1c level, rather than previous history of diabetes, predicts the disease severity and clinical outcomes of acute pancreatitis

INTRODUCTION

The aim of our study is to explore the value of serum glycosylated hemoglobin A1c (HbA1c) in disease severity and clinical outcomes of acute pancreatitis (AP).

RESEARCH DESIGN AND METHODS

Patients with AP were included from January 2013 to December 2020, retrospectively, dividing into normal serum HbA1c level (N-HbA1c) group and high serum HbA1c level (H-HbA1c) group according to the criteria HbA1c <6.5%. We compared patient characteristics, biochemical parameters, disease severity, and clinical outcomes of patients with AP in two groups. Besides, we evaluated the efficacy of serum HbA1c to predict organ failure (OF) in AP patients by receiver operating curve (ROC).

RESULTS

We included 441 patients with AP, including 247 patients in N-HbA1c group and 194 patients in H-HbA1c group. Serum HbA1c level was positively correlated with Atlanta classification, systemic inflammatory response syndrome, local complication, and OF (all p<0.05). Ranson, BISAP (bedside index of severity in acute pancreatitis), and CT severity index scores in patients with H-HbA1c were markedly higher than those in patients with N-HbA1c (all p<0.01). ROC showed that the best critical point for predicting the development of OF in AP with serum HbA1c is 7.05% (area under the ROC curve=0.79). Logistic regression analysis showed H-HbA1c was the independent risk factor for the development of OF in AP. Interestingly, in patients with presence history of diabetes and HbA1c <6.5%, the severity of AP was significantly lower than that in H-HbA1c group. Besides, there was no significant difference between with and without history of diabetes in N-HbA1c group.

CONCLUSIONS

Generally known, diabetes is closely related to the development of AP, and strict control of blood glucose can improve the related complications. Thus, the level of glycemic control before the onset of AP (HbA1c as an indicator) is the key to poor prognosis of AP, rather than basic history of diabetes. Elevated serum HbA1c level can become the potential indicator for predicting the disease severity of AP.

Dysregulated B7H4/JAK2/STAT3 Pathway Involves in Hypertriglyceridemia Acute Pancreatitis and Is Attenuated by Baicalin

BACKGROUND

Patients with hypertriglyceridemia (HTG) are prone to develop more severe acute pancreatitis (AP). However, the specific molecular mechanism still has not been elaborated clearly, and effective drugs for treating HTG-AP are not yet readily available. Baicalin is an ingredient isolated from a natural product that with potential to attenuate inflammation and pain in AP.

AIMS

The aim of the present study was to explore the effect of baicalin on HTG-AP and the possible mechanism involved.

METHODS

A mouse model of HTG-AP was successfully established by administering Poloxamer 407 and L-arginine intraperitoneally. We analyzed pathological changes, and performed TUNEL staining, DHE staining, and western blot to detect apoptosis, inflammation, oxidative stress, and B7H4/JAK2/STAT3 signaling in the pancreas.

RESULTS

Treatment with baicalin decreased serum triglyceride, cholesterol, lipase, amylase levels, and attenuated pancreatic edema. After intervention with baicalin, apoptosis and inflammation in HTG-AP mice were alleviated, as indicated by the decrease of Bax, cleaved-caspase-3, IL-6, TNF-α, and IL-1β. Baicalin also alleviated oxidative stress by decreasing NOX2, increasing SOD2 protein expression, and regulating Nrf2/Keap1 signaling in HTG-AP mice. Furthermore, baicalin decreased the upregulated B7H4/JAK2/STAT3 pathway in HTG-AP.

CONCLUSIONS

In conclusion, our data suggested that baicalin could attenuate HTG-AP, possibly through regulating B7H4/JAK2/STAT3 signaling.

Age Related Functional Connectivity Signature Extraction Using Energy-Based Machine Learning Techniques

The study of brain connectivity plays an important role in understanding the functional organizations of the brain. It also helps to identify connectivity signatures that can be used for evaluating neural disorders and monitoring treatment efficacy. In this work, age-related changes in brain connectivity are studied to obtain aging signatures based on various modeling techniques. These include an energy-based machine learning technique to identify brain network interaction differences between two age groups with a large (30 years) age gap between them. Disconnectivity graphs and activation maps of the seven prominent resting-state networks (RSN) were obtained from functional MRI data of old and young adult subjects. Two-sample t-tests were performed on the local minimums with Bonferroni correction to control the family-wise error rate. These local minimums are connectivity states showing not only which brain regions but also how strong they are working together. They work as aging signatures that can be used to differentiate young and old groups. We found that the attention network's connectivity signature is a state with all the regions working together and young subjects have a stronger average connectivity among these regions. We have also found a common pattern between young and old subjects where the left and right brain regions of the frontal network are sometimes working separately instead of together. In summary, in this work, we combined machine learning and statistical approaches to extract connectivity signatures, which can be utilized to distinguish aging brains and monitor possible treatment efficacy.

TMEM196 inhibits lung cancer metastasis by regulating the Wnt/β-catenin signaling pathway

PURPOSE

The TMEM196 protein, which comprises four membrane-spanning domains, belongs to the TMEM protein family. TMEM196 was identified as a candidate tumor suppressor gene in lung cancer. However, its role and mechanism in lung cancer metastasis remain unclear. Here, we study the role of TMEM196 in tumor metastasis to further verify the function in lung cancer.

METHODS

In this study, we used qRT-PCR, western blot analysis and immunohistochemistry to examine the expression levels of TMEM196 and related proteins in lung cancer tissues and tumor cells. We utilized Transwell assays, xenograft nude mouse models, and TMEM196^-/- mouse models to evaluate the effects of TMEM196 on tumor invasion and metastasis. Finally, we used bioinformatics analysis and dual-luciferase reporter gene assays to explore the molecular mechanism of TMEM196 as a tumor suppressor.

RESULTS

We found that TMEM196 mRNA and protein expression levels were significantly decreased in lung cancer tissues and cells. Low expression of TMEM196 in clinical patients was associated with poor prognosis. TMEM196 strongly inhibited tumor metastasis and progression in vitro and in vivo. The primary lung tumors induced by tail vein-inoculated B16 cells in TMEM196^-/- mice were significantly larger than those in TMEM196^+/+ mice. Mechanistically, TMEM196 inhibited the Wnt signaling pathway and repressed β-catenin promoter transcription. TMEM196 silencing in lung cancer cells and mice resulted in significant upregulation of the expression of β-catenin and Wnt signaling pathway downstream target genes (MMP2 and MMP7). Decreasing β-catenin expression in TMEM196-silenced cancer cells attenuated the antimetastatic effect of TMEM196.

CONCLUSIONS

Our results revealed that TMEM196 acts as a novel lung cancer metastasis suppressor via the Wnt/β-catenin signaling pathway.

Free-breathing 3D CEST MRI of human liver at 3.0 T

PURPOSE

To develop a novel 3D abdominal CEST MRI technique at 3 T using MR multitasking, which enables entire-liver coverage with free-breathing acquisition.

METHODS

k-Space data were continuously acquired with repetitive steady-state CEST (ss-CEST) modules. The stack-of-stars acquisition pattern was used for k-space sampling. MR multitasking was used to reconstruct motion-resolved 3D CEST images of 53 frequency offsets with entire-liver coverage and 2.0 × 2.0 × 6.0 mm3 spatial resolution. The total scan time was 9 min. The sensitivity of amide proton transfer (APT)-CEST (magnetization transfer asymmetry [MTRasym ] at 3.5 ppm) and glycogen CEST (glycoCEST) (mean MTRasym around 1.0 ppm) signals generated with the proposed method were tested with fasting experiments.

RESULTS

Both APT-CEST and glycoCEST signals showed high sensitivity between post-fasting and post-meal acquisitions. APT-CEST and glycoCEST MTRasym signals from post-mean scans were significantly increased (APT-CEST: -0.019 ± 0.017 in post-fasting scans, 0.014 ± 0.021 in post-meal scans, p < 0.01; glycoCEST: 0.003 ± 0.009 in post-fasting scans, 0.027 ± 0.021 in post-meal scans, p < 0.01).

CONCLUSION

The proposed 3D abdominal steady-state CEST method using MR multitasking can generate CEST images of the entire liver during free breathing.

Nano-calcium silicate mineralized fish scale scaffolds for enhancing tendon-bone healing

Tendon-bone healing is essential for an effective rotator cuff tendon repair surgery, however, this remains a significant challenge due to the lack of biomaterials with high strength and bioactivity. Inspired by the high-performance exoskeleton of natural organisms, we set out to apply natural fish scale (FS) modified by calcium silicate nanoparticles (CS NPs) as a new biomaterial (CS-FS) to overcome the challenge. Benefit from its “Bouligand” microstructure, such FS-based scaffold maintained excellent tensile strength (125.05 MPa) and toughness (14.16 MJ/m³), which are 1.93 and 2.72 times that of natural tendon respectively, allowing it to well meet the requirements for rotator cuff tendon repair. Additionally, CS-FS showed diverse bioactivities by stimulating the differentiation and phenotypic maintenance of multiple types of cells participated into the composition of tendon-bone junction, (e.g. bone marrow mesenchymal stem cells (BMSCs), chondrocyte, and tendon stem/progenitor cells (TSPCs)). In both rat and rabbit rotator cuff tear (RCT) models, CS-FS played a key role in the tendon-bone interface regeneration and biomechanical function, which may be achieved by activating BMP-2/Smad/Runx2 pathway in BMSCs. Therefore, natural fish scale -based biomaterials are the promising candidate for clinical tendon repair due to their outstanding strength and bioactivity.

•

Nano-calcium silicate mineralized fish scale scaffold was first developed for tendon defect repair.

•CS-FS exhibited excellent mechanical properties superior to those of natural tendon.

•CS-FS showed diverse bioactivities by stimulating the differentiation of multiple types of cells.

•CS NPs accelerated tendon-bone interface tendon-bone healing enhancement and biomechanical recovery.

Anatomical variations in the Circle of Willis and the formation and rupture of intracranial aneurysms: A systematic review and meta-analysis

Background

The anterior (AcomA) and posterior communicating arteries (PcomA) are two of the most frequent sites for intracranial aneurysms. Anatomical variations in the Circle of Willis (COW) are frequently observed in patients with AcomA and PcomA aneurysms. Strong evidence is needed to determine the pooled estimate of the effect of COW variations on the formation and rupture of these aneurysms.

Aim

This systematic review and meta-analysis aimed to establish the effect of COW variations on the formation and rupture of AcomA and PcomA aneurysms using available studies.

Summary of review

PubMed, Embase, and Web of Science databases were systematically searched for studies published in English before September 21, 2022. Studies investigating AcomA aneurysms and the hypoplastic/aplastic A1 segment of the anterior cerebral artery and PcomA aneurysms and hypoplastic/aplastic PcomA or fetal-type posterior cerebral artery (FTP) were included. The heterogeneity of the studies was assessed using Cochran Q-test and I² statistic. Pooled estimate was assessed using either a random- or fixed-effects model based on the heterogeneity of the studies. Among the 4,932 studies, 21 were eligible and included in the analysis. The presence of hypoplastic/aplastic A1 was significantly correlated with the formation [OR (95% confidence interval [CI]) = 7.97 (5.58, 11.39), P < 0.001] and rupture [OR (95%CI) = 1.87 (1.29, 2.72), P < 0.001] of AcomA aneurysms. Significant associations between FTP and both the formation [OR (95%CI) = 2.15 (1.41, 3.30), P < 0.001] and rupture [OR (95%CI) = 1.72 (1.26, 2.36), P < 0.001] of PcomA aneurysms were observed.

Conclusions

Significant associations were observed between COW variations and both the formation and rupture of AcomA and PcomA aneurysms. This can help in determining interventions for patients with aneurysms.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=225149, identifier: CRD42021225149.

Validation of the Antineutrophil Cytoplasmic Antibody Renal Risk Score and Modification of the Score in a Chinese Cohort With a Majority of Myeloperoxidase-Positive Patients

OBJECTIVE

We aimed to validate and modify the renal risk score for antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (AAGN) in a Chinese cohort with a majority of myeloperoxidase (MPO)-positive patients.

METHODS

A total of 285 patients with biopsy-proven AAGN in our center were retrospectively included. Patients were randomly assigned to the development set (n = 201) and the validation set (n = 84). We calculated the renal risk score and analyzed the clinicopathological characteristics and follow-up data. The nomogram was constructed based on the independent prognostic factors identified by the multivariable Cox regression and then compared with the renal risk score.

RESULTS

Over a median follow-up period of 41.3 (range 20.0-63.8) months, 84 (29.5%) patients reached end-stage kidney disease (ESKD). In the development set, hypertension (hazard ratio [HR] 2.16, 95% CI 1.08-4.32, P = 0.03), high serum creatinine (HR 1.002, 95% CI 1.001-1.003, P < 0.001), high daily urine protein (HR 1.34, 95% CI 1.15-1.57, P < 0.001), high glomerular sclerosis (HR 13.98, 95% CI 3.50-55.92, P < 0.001), and interstitial fibrosis > 50% (HR 4.18, 95% CI 1.90-9.19, P < 0.001) were independent risk factors for ESKD, and these indicators were included in the nomogram. The C-indices of the nomogram model in the development set, validation set, and all-data set were 0.838 (range 0.785-0.891), 0.794 (range 0.774-0.814), and 0.822 (range 0.775-0.869), respectively, which were higher than those of the renal risk score model, 0.801 (range 0.748-0.854), 0.746 (range 0.654-0.838) and 0.783 (range 0.736-0.830), respectively. The net reclassification improvement and the integrated discrimination improvement further illustrated the higher predictive ability of the nomogram.

CONCLUSION

We present a nomogram as a practical tool to predict renal outcomes in Chinese patients with MPO-ANCA glomerulonephritis.

Development and validation of a GRGPI model for predicting the prognostic and treatment outcomes in head and neck squamous cell carcinoma

Background

Head and neck squamous cell carcinoma (HNSCC) is among the most lethal and most prevalent malignant tumors. Glycolysis affects tumor growth, invasion, chemotherapy resistance, and the tumor microenvironment. Therefore, we aimed at identifying a glycolysis-related prognostic model for HNSCC and to analyze its relationship with tumor immune cell infiltrations.

Methods

The mRNA and clinical data were obtained from The Cancer Genome Atlas (TCGA), while glycolysis-related genes were obtained from the Molecular Signature Database (MSigDB). Bioinformatics analysis included Univariate cox and least absolute shrinkage and selection operator (LASSO) analyses to select optimal prognosis-related genes for constructing glycolysis-related gene prognostic index(GRGPI), as well as a nomogram for overall survival (OS) evaluation. GRGPI was validated using the Gene Expression Omnibus (GEO) database. A predictive nomogram was established based on the stepwise multivariate regression model. The immune status of GRGPI-defined subgroups was analyzed, and high and low immune groups were characterized. Prognostic effects of immune checkpoint inhibitor (ICI) treatment and chemotherapy were investigated by Tumor Immune Dysfunction and Exclusion (TIDE) scores and half inhibitory concentration (IC50) value. Reverse transcription-quantitative PCR (RT-qPCR) was utilized to validate the model by analyzing the mRNA expression levels of the prognostic glycolysis-related genes in HNSCC tissues and adjacent non-tumorous tissues.

Results

Five glycolysis-related genes were used to construct GRGPI. The GRGPI and the nomogram model exhibited robust validity in prognostic prediction. Clinical correlation analysis revealed positive correlations between the risk score used to construct the GRGPI model and the clinical stage. Immune checkpoint analysis revealed that the risk model was associated with immune checkpoint-related biomarkers. Immune microenvironment and immune status analysis exhibited a strong correlation between risk score and infiltrating immune cells. Gene set enrichment analysis (GSEA) pathway enrichment analysis showed typical immune pathways. Furthermore, the GRGPIdel showed excellent predictive performance in ICI treatment and drug sensitivity analysis. RT-qPCR showed that compared with adjacent non-tumorous tissues, the expressions of five genes were significantly up-regulated in HNSCC tissues.

Conclusion

The model we constructed can not only be used as an important indicator for predicting the prognosis of patients but also had an important guiding role for clinical treatment.

High-fidelity and clean nanotransfer lithography using structure-embedded and electrostatic-adhesive carriers

Metallic nanostructures are becoming increasingly important for both fundamental research and practical devices. Many emerging applications employing metallic nanostructures often involve unconventional substrates that are flexible or nonplanar, making direct lithographic fabrication very difficult. An alternative approach is to transfer prefabricated structures from a conventional substrate; however, it is still challenging to maintain high fidelity and a high yield in the transfer process. In this paper, we propose a high-fidelity, clean nanotransfer lithography method that addresses the above challenges by employing a polyvinyl acetate (PVA) film as the transferring carrier and promoting electrostatic adhesion through triboelectric charging. The PVA film embeds the transferred metallic nanostructures and maintains their spacing with a remarkably low variation of <1%. When separating the PVA film from the donor substrate, electrostatic charges are generated due to triboelectric charging and facilitate adhesion to the receiver substrate, resulting in a high large-area transfer yield of up to 99.93%. We successfully transferred the metallic structures of a variety of materials (Au, Cu, Pd, etc.) with different geometries with a <50-nm spacing, high aspect ratio (>2), and complex 3D structures. Moreover, the thin and flexible carrier film enables transfer on highly curved surfaces, such as a single-mode optical fiber with a curvature radius of 62.5 μm. With this strategy, we demonstrate the transfer of metallic nanostructures for a compact spectrometer with Cu nanogratings transferred on a convex lens and for surface-enhanced Raman spectroscopy (SERS) characterization on graphene with reliable responsiveness.

Bone marrow mesenchymal stem cells derived exosomal miRNAs can modulate diabetic bone-fat imbalance

Background

Diabetes mellitus is a chronic metabolic disease with systemic complications. Patient with diabetes have increased risks of bone fracture. Previous studies report that diabetes could affect bone metabolism, however, the underlying mechanism is still unclear.

Methods

We isolated exosomes secreted by bone marrow mesenchymal stem cells of normal and diabetic mice and test their effects on osteogenesis and adipogenesis. Then we screened the differential microRNAs by high-throughput sequencing and explored the function of key microRNA in vitro and in vivo.

Results

We find that lower bone mass and higher marrow fat accumulation, also called bone-fat imbalance, exists in diabetic mouse model. Exosomes secreted by normal bone marrow mesenchymal stem cells (BMSCs-Exos) enhanced osteogenesis and suppressed adipogenesis, while these effects were diminished in diabetic BMSCs-Exos. miR-221, as one of the highly expressed miRNAs within diabetic BMSCs-Exos, showed abilities of suppressing osteogenesis and promoting adipogenesis both in vitro and in vivo. Elevation of miR-221 level in normal BMSCs-Exos impairs the ability of regulating osteogenesis and adipogenesis. Intriguingly, using the aptamer delivery system, delivery normal BMSCs-Exos specifically to BMSCs increased bone mass, reduced marrow fat accumulation, and promoted bone regeneration in diabetic mice.

Conclusion

We demonstrate that BMSCs derived exosomal miR-221 is a key regulator of diabetic osteoporosis, which may represent a potential therapeutic target for diabetes-related skeletal disorders.

Effects of severe obstructive sleep apnea on functional prognosis in the acute phase of ischemic stroke and quantitative electroencephalographic markers

OBJECTIVE

To investigate the effect of severe obstructive sleep apnea (OSA) on functional prognosis in the acute phase and quantitative electroencephalography (EEG) markers during sleep in ischemic stroke patients.

METHODS

This study included 125 mild-to-moderate acute ischemic stroke patients with OSA who underwent polysomnography (PSG) within one week of stroke onset between January 2015 and June 2020. Patients were grouped according to their apnea-hypopnea index (</≥ 30/h). Poor functional prognosis was defined as modified Rankin Scale score ≥3. The EEG recorded by PSG was extracted during different sleep stages for power spectrum analysis. The delta/alpha power ratio (DAR), (delta + theta)/(alpha + beta) ratio (the slowing ratio, TSR), and the relative power (RP) of each frequency band were calculated. Differences in clinical, PSG, and quantitative EEG characteristics were compared between the groups. Additionally, we explored predictors of poor functional prognosis.

RESULTS

Patients with severe OSA had a higher proportion of hypertension, lower relative power of high-frequency bands, and higher delta RP, TSR, and DAR (p < 0.05). Severe OSA was associated with a 3.6-fold increase in risk of poor prognosis (p < 0.05). Increased delta RP and TSR, as well as decreased alpha, beta, and sigma RP, may be independent predictors of a poor functional prognosis.

CONCLUSIONS

Severe OSA is an independent risk factor for a poor functional prognosis in patients with acute ischemic stroke, and quantitative EEG during sleep showed a significant slow wave enhancement, suggesting more severe brain dysfunction. The treatment of severe OSA may improve functional prognosis.

Transmembrane protein 88 suppresses hepatocellular carcinoma progression and serves as a novel prognostic factor

Background

Transmembrane protein 88 (TMEM88) is known to be involved in the canonical Wnt signaling pathway and is implicated in several malignancies. However, the expression, function, and prognostic significance of TMEM88 in hepatocellular carcinoma (HCC) remain unclear.

Methods

In this study, we analyzed mRNA levels of TMEM88 in HCC specimens from the TCGA dataset (n=374) to explore the correlation between TMEM88 and HCC. We also overexpressed TMEM88 in the Huh7 human HCC cell line to investigate its tumor-related role in HCC. Additionally, we conducted in vivo experiments using a mouse model to further validate the critical function of TMEM88 in modulating HCC growth.

Results

Our results showed that TMEM88 is negatively correlated with the T stage, TNM stage, and pathological grade of HCC. Higher levels of TMEM88 can help predict better overall survival of HCC in both univariate and multivariate analyses. Similarly, higher TMEM88 is a novel prognostic factor for better disease-specific survival of HCC. Overexpression of TMEM88 in Huh7 cells led to a decreased cell proliferation capacity. Xenograft experiments in a mouse model showed that TMEM88 overexpression can remarkably suppress HCC progression.

Conclusions

Transmembrane protein 88 suppresses HCC growth both in vitro and in vivo, which can act as a potential prognostic factor with clinical application potential.

Wearable Hydrogel-Based Epidermal Sensor with Thermal Compatibility and Long Term Stability for Smart Colorimetric Multi-Signals Monitoring

Hydrogel-based wearable epidermal sensors (HWESs) have attracted widespread attention in health monitoring, especially considering their colorimetric readout capability. However, it remains challenging for HWESs to work at extreme temperatures with long term stability due to the existence of water. Herein, a wearable transparent epidermal sensor with thermal compatibility and long term stability for smart colorimetric multi-signals monitoring is developed, based on an anti-freezing and anti-drying hydrogel with high transparency (over 90% transmittance), high stretchability (up to 1500%) and desirable adhesiveness to various kinds of substrates. The hydrogel consists of polyacrylic acid, polyacrylamide, and tannic acid-coated cellulose nanocrystals in glycerin/water binary solvents. When glycerin readily forms strong hydrogen bonds with water, the hydrogel exhibits outstanding thermal compatibility. Furthermore, the hydrogel maintains excellent adhesion, stretchability, and transparency after long term storage (45 days) or at subzero temperatures (-20 °C). For smart colorimetric multi-signals monitoring, the freestanding smart colorimetric HWESs are utilized for simultaneously monitoring the pH, T and light, where colorimetric signals can be read and stored by artificial intelligence strategies in a real time manner. In summary, the developed wearable transparent epidermal sensor holds great potential for monitoring multi-signals with visible readouts in long term health monitoring.

Comprehensive diagnosis and treatment of ductal carcinoma of the submandibular gland: case report and literature review

Salivary duct carcinoma (SDC) is a rare malignant tumor of the salivary gland and is most commonly found in the parotid gland, followed by the submandibular gland. Due to its rarity, there is no consensus on its treatment. Surgical resection is currently the only curative treatment. Considering its high degree of malignancy, extensive tumor resection and postoperative adjuvant radiotherapy are recommended. We report a rare case of SDC of the submandibular gland. A 62-year-old man presented to our hospital with complaints of swelling in the right submaxillary area for 4 months, rapidly growing, with pain for 10 days. After admission, fine needle aspiration (FNA) revealed right submandibular gland ductal carcinoma. Considering its aggressiveness, large size, and invasion of parapharyngeal and oral floor soft tissues, the patient received two cycles of neoadjuvant chemotherapy followed by extended surgical resection. Postoperatively, the patient received four cycles of concurrent chemoradiotherapy, followed by afatinib targeted therapy. No recurrence or metastasis was observed in a 45-month follow-up. Thus we present a comprehensive treatment for salivary duct carcinoma combining neoadjuvant chemotherapy with surgery, postoperative concurrent radiotherapy, and chemotherapy followed by afatinib targeted therapy.

Insights into COVID-19-associated critical illness: a narrative review

Background and Objective

Since the outbreak of the 2019 novel coronavirus disease (COVID-19), acute respiratory distress syndrome (ARDS) and sepsis resulting from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have surged in intensive care units around the world. The heterogeneity of ARDS and sepsis has long been observed, and multiple subphenotypes and endotypes correlated with different outcomes and treatment response have been identified in the search for treatable traits. Despite their similarity to typical ARDS and sepsis, COVID-19-associated ARDS and sepsis harbor distinct features, raising the question as to whether they could be considered as subphenotypes or endotypes of the historical syndromes and, accordingly, benefit from specific therapeutic strategies. This review aimed to summarize and discuss the current knowledge of COVID-19-associated critical illness and the intrinsic subphenotypes or endotypes.

Methods

Literature on the pathogenesis of COVID-19 and the subphenotyping of COVID-19-associated critical illness was derived from the PubMed database and reviewed.

Key Content and Findings

Accumulating evidence, varying from clinical observation to basic research, has contributed to revealing the fundamental pathophysiological features of severe COVID-19 and has advanced our knowledge of the disease. COVID-19-associated ARDS and sepsis exhibit some distinctive features compared to the classic syndromes, including remarkable vascular abnormality and coagulopathy, and distinct respiratory mechanics and immune response. Some conventional subphenotypes derived from classic ARDS and sepsis have been validated in COVID-19, while novel subphenotypes and endotypes have also been identified in patients with this disease, who experience variable clinical outcomes and treatment responses.

Conclusions

Subphenotyping of COVID-19-associated ARDS and sepsis can provide new insights into the development and management of these illnesses.

High circulating fibroblast growth factor-21 levels as a screening marker in fatty pancreas patients

Background

The study aimed to detect the serum levels of fibroblast growth factor-21 (FGF-21) in fatty pancreas (FP) patients and to investigate their potential clinical value.

Methods

We screened patients with FP using transabdominal ultrasound. The anthropometric, biochemical and serum levels of FGF-21 were compared between the FP group and the normal control (NC) group. A receiver operating characteristic (ROC) curve was used to evaluate the predictive value of serum FGF-21 for FP patients.

Results

Compared with the NC group, body mass index, fasting blood glucose levels, uric acid levels and cholesterol levels of the FP group were significantly higher, while the high-density lipoprotein level was lower. In addition, levels of serum FGF-21, resistin, leptin and tumor necrosis factor-α were significantly higher than those in the NC group, while the serum adiponectin level was lower. Pearson analysis showed serum FGF-21 levels in FP patients were negatively correlated with leptin. The ROC curve showed the best critical value of the serum FGF-21 level in FP patients was 171 pg/mL (AUC 0.744, P = 0.002, 95% confidence intervals 0.636-0.852).

Conclusion

Serum FGF-21 was closely related to fatty pancreas. Detecting serum FGF-21 levels may help identify the population susceptible to FP.

Polyphenols Can Improve Resin-Dentin Bond Durability by Promoting Amorphous Calcium Phosphate Nanoparticles to Backfill the Dentin Matrix

Objective

To investigate the effects of proanthocyanidins (PA), myricetin, resveratrol, and kaempferol on the modification of dentin collagen and the inhibition of matrix metalloproteinase (MMP) activity, and to evaluate their contributions to the biomimetic remineralization and resin-dentin bonding performance.

Methods

Attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR) and in situ zymography were applied to verify the collagen modification and MMP activity inhibition induced by these four polyphenols. Scanning electron microscopy/energy dispersive spectrometer (SEM/EDS) analysis, X-ray diffraction (XRD), ATR-FTIR, Vickers hardness numbers (VHN), and micro-computed tomography (micro-CT) were performed to characterize the remineralized dentin. Microtensile bond strength (μTBS) and nanoleakage were investigated to evaluate the effects of the four polyphenols on resin-dentin bonding durability.

Results

ATR-FTIR and in situ zymography confirmed that these four polyphenols could modify dentin collagen and inhibit MMP activity, respectively. Chemoanalytic characterization exhibited the efficacies of the four polyphenols in promoting dentin biomimetic remineralization. The surface hardness of PA-pretreated dentin was the greatest. Micro-CT results demonstrated that the PAs group possessed the highest amount of dentin surface minerals and the lowest amount of deep-layer minerals. The surface and deep-layer mineral contents of the Myr group were higher than Res and Kae groups. Treatment with these four polyphenols significantly increased the initial μTBS compared with the control group without primer conditioning. μTBS decreased significantly during aging, and the decrease was more severe in the PAs and Kae groups than in the Myr and Res groups. With or without aging, the polyphenol groups exhibited relatively less fluorescence. However, the Myr and Res groups showed less serious nanoleakage after aging.

Conclusion

PA, myricetin, resveratrol, and kaempferol can modify dentin collagen, inhibit MMP activity, promote biomimetic remineralization, and improve resin-dentin bond durability. Compared with PA and kaempferol, myricetin and resveratrol are more effective in improving resin-dentin bonding.

DEPDC1B promotes colorectal cancer via facilitating cell proliferation and migration while inhibiting apoptosis

Colorectal cancer (CRC) is a common malignant tumor with strong invasiveness. Given the reported involvement of DEP domain-containing protein 1B (DEPDC1B) in the progression of some cancers, its role in CRC was explored in this study. DEPDC1B expression in CRC was assessed based on database and tissue microarray (TMA). In addition, the knockdown and overexpression of DEPDC1B in CRC cell lines were constructed using small hairpin RNA (shRNA) interference. The biological function of DEPDC1B in CRC was evaluated in vitro and in vivo through loss/gain-of-function assays. The results demonstrated that DEPDC1B was highly expressed in CRC. Furthermore, DEPDC1B had the ability to promote CRC proliferation and migration coupled by cell apoptosis. In vivo results showed that DEPDC1B knockdown significantly inhibited the growth of xenograft tumors. Additionally, the results of antibody array indicated increased apoptosis-promoting proteins and decreased apoptosis-inhibiting proteins in DEPDC1B-knockdown CRC cells. In conclusion, DEPDC1B played a key driver role in CRC progression, and inhibition of its expression may be a potential target for precision medicine in CRC.

Cortical thinning in male obstructive sleep apnoea patients with excessive daytime sleepiness

Background and purpose

Obstructive sleep apnoea is associated with excessive daytime sleepiness due to sleep fragmentation and hypoxemia, both of which can lead to abnormal brain morphology. However, the pattern of brain structural changes associated with excessive daytime sleepiness is still unclear. This study aims to investigate the effects of excessive daytime sleepiness on cortical thickness in patients with obstructive sleep apnoea.

Materials and methods

61 male patients with newly diagnosed obstructive sleep apnoea were included in the present study. Polysomnography and structural MRI were performed for each participant. Subjective daytime sleepiness was assessed using the Epworth Sleepiness Scale score. Surface-based morphometric analysis was performed using Statistical Parametric Mapping 12 and Computational Anatomy 12 toolboxes to extract cortical thickness.

Results

Using the median Epworth Sleepiness Scale score, patients were divided into the non-sleepiness group and the sleepiness group. The cortical thickness was markedly thinner in the sleepiness group in the left temporal, frontal, and parietal lobe and bilateral pre- and postcentral gyri (pFWE < 0.05). There was a significant negative correlation between the cortical thickness and the Epworth Sleepiness Scale score. After adjusting for age, body mass index, and obstructive sleep apnoea severity, the Epworth Sleepiness Scale score remained an independent factor affecting the cortical thickness of the left middle temporal lobe, transverse temporal and temporal pole.

Conclusion

Subjective daytime sleepiness is associated with decreased cortical thickness, and the Epworth Sleepiness Scale score may be of utility as a clinical marker of brain injury in patients with obstructive sleep apnoea.

Reversing ferroptosis resistance by MOFs through regulation intracellular redox homeostasis

As a non-apoptotic cell death form, ferroptosis offers an alternative approach to overcome cancer chemotherapy resistance. However, accumulating evidence indicates cancer cells can develop ferroptosis resistance by evolving antioxidative defense mechanisms. To address this issue, we prepared a Buthionine-(S,R)-sulfoximine (BSO) loaded metal organic framework (MOF) of BSO-MOF-HA (BMH) with the combination effect of boosting oxidative damage and inhibiting antioxidative defense. MOF nanoparticle was constructed by the photosensitizer of [4,4,4,4-(porphine-5,10,15,20-tetrayl) tetrakis (benzoic acid)] (TCPP) and the metal ion of Zr6, which was further decorated with hyaluronic acid (HA) in order to impart active targeting to CD44 receptors overexpressed cancer cells. BMH exhibited a negative charge and spherical shape with average particle size about 162.5 nm. BMH was found to restore the susceptibility of 4T1 cells to ferroptosis under irradiation. This was attributed to the combination of photodynamic therapy (PDT) and γ-glutamylcysteine synthetase inhibitor of BSO, shifting the redox balance to oxidative stress. Enhanced ferroptosis also induced the release of damage associated molecular patterns (DAMPs) to maturate dendritic cells and activated T lymphocytes, leading to superior anti-tumor performance in vivo. Taken together, our findings demonstrated that boosting oxidative damage with photosensitizer serves as an effective strategy to reverse ferroptosis resistance.

Three-dimensional nanofabrication via ultrafast laser patterning and kinetically regulated material assembly

A major challenge in nanotechnology is the fabrication of complex three-dimensional (3D) structures with desired materials. We present a strategy for fabricating arbitrary 3D nanostructures with a library of materials including metals, metal alloys, 2D materials, oxides, diamond, upconversion materials, semiconductors, polymers, biomaterials, molecular crystals, and inks. Specifically, hydrogels patterned by femtosecond light sheets are used as templates that allow for direct assembly of materials to form designed nanostructures. By fine-tuning the exposure strategy and features of the patterned gel, 2D and 3D structures of 20- to 200-nm resolution are realized. We fabricated nanodevices, including encrypted optical storage and microelectrodes, to demonstrate their designed functionality and precision. These results show that our method provides a systematic solution for nanofabrication across different classes of materials and opens up further possibilities for the design of sophisticated nanodevices.

A crack compensation strategy for highly stretchable conductors based on liquid metal inclusions

Crack control strategies have been proven very useful for enhancing the stretchability of metal film-based stretchable conductors. However, existing strategies often suffer from the drawbacks of complicated preparation and predefined effective directions. Here, we propose a crack compensation strategy for preparing conductors featured with high stretchability by using liquid metal microparticles (LMMPs)-embedded polydimethylsiloxane (PDMS) as the substrate with a thin film of gold (Au) sputtered on the surface. LMMPs can be elongated to connect the cracked Au film upon stretching, which can form a conductive "island-tunnel" (IT) architecture to compensate for the cracks and maintain the conductivity. The high performance of the stretchable conductor is demonstrated by using it as electrodes to record surface electromyography of human brachioradialis and monitor electrocorticography signals of a rat in normal and epileptic states. The developed strategy shows the potential to provide a new perspective for the fabrication of flexible electronics.

Succinylation and redox status in cancer cells

Succinylation is a post-translational modification (PTM) event that associates metabolic reprogramming with various pathological disorders including cancers via transferring a succinyl group to a residue of the target protein in an enzymic or non-enzymic manner. With our incremental knowledge on the roles of PTM played in tumor initiation and progression, relatively little has been focused on succinylation and its clinical implications. By delineating the associations of succinylation with cancer hallmarks, we identify the, in general, promotive roles of succinylation in manifesting cancer hallmarks, and conceptualize two working modes of succinylation in driving oncogenic signaling, i.e., via altering the structure and charge of target proteins towards enhanced stability and activity. We also characterize succinylation as a reflection of cellular redox homeostatic status and metabolic state, and bring forth the possible use of hyper-succinylated genome for early cancer diagnosis or disease progression indication. In addition, we propose redox modulation tools such as cold atmospheric plasma as a promising intervention approach against tumor cells and cancer stemness via targeting the redox homeostatic environment cells established under a pathological condition such as hypoxia. Taken together, we emphasize the central role of succinylation in bridging the gap between cellular metabolism and redox status, and its clinical relevance as a mark for cancer diagnosis as well as a target in onco-therapeutics.

Outer membrane vesicles from bacteria: Role and potential value in the pathogenesis of chronic respiratory diseases

Infectious diseases are the leading cause of death in both adults and children, with respiratory infections being the leading cause of death. A growing body of evidence suggests that bacterially released extracellular membrane vesicles play an important role in bacterial pathogenicity by targeting and (de)regulating host cells through the delivery of nucleic acids, proteins, lipids, and carbohydrates. Among the many factors contributing to bacterial pathogenicity are the outer membrane vesicles produced by the bacteria themselves. Bacterial membrane vesicles are being studied in more detail because of their potential role as deleterious mediators in bacterial infections. This review provides an overview of the most current information on the emerging role of bacterial membrane vesicles in the pathophysiology of pneumonia and its complications and their adoption as promising targets for future preventive and therapeutic approaches.

Dairy fortification as a good option for dietary nutrition status improvement of 676 preschool children in China: A simulation study based on a cross-sectional diet survey (2018-2019)

Background

Chinese children are deficient in several essential nutrients due to poor dietary choices. Dairy products are a source of many under-consumed nutrients, but preschool children in China consume dairy products significantly less than the recommended level.

Methods

From the cross-sectional dietary intake survey of infants and young children aged 0-6 years in China (2018-2019), preschool children (age: 3-6 years) (n = 676) were selected. The four-day dietary data (including 2 working days and 2 weekends) collected through an online diary with reference to the food atlas were used for analysis and simulation. In scenario 1, individual intake of liquid milk equivalents was substituted at a corresponding volume by soymilk, cow's milk, or formulated milk powder for preschool children (FMP-PSC). In scenario 2, the amount of cow's milk or FMP-PSC increased to ensure each child's dairy intake reached the recommended amount (350 g/day). In both scenarios, the simulated nutrient intakes and nutritional inadequacy or surplus were compared to the survey's actual baseline data.

Results

It was suggested suggested that replacing dairy foods with FMP-PSC at matching volume is better than replacing them with soymilk or cow's milk to increase the intake of DHA, calcium, iron, zinc, iodine, vitamin A, vitamin B₁, vitamin B₃, vitamin B₁₂, vitamin C and vitamin D. Moreover, our results suggested that adding FMP-PSC to bring each child's dairy intake to the recommended amount can bring the intakes of dietary fiber, DHA, calcium, iron, zinc, iodine, vitamin A, vitamin B₁, vitamin B₃, vitamin B₉, vitamin B₁₂, vitamin C and vitamin D more in line with the recommendations when compared with cow's milk.

Conclusion

Accurate nutrition information should be provided to the parents of preschool children so as to guide their scientific consumption of dairy products and the usage and addition of fortified dairy products can be encouraged as needed.

Recent functional insights into the magic role of (p)ppGpp in growth control

Rapid growth and survival are two key traits that enable bacterial cells to thrive in their natural habitat. The guanosine tetraphosphate and pentaphosphate [(p)ppGpp], also known as "magic spot", is a key second messenger inside bacterial cells as well as chloroplasts of plants and green algae. (p)ppGpp not only controls various stages of central dogma processes (replication, transcription, ribosome maturation and translation) and central metabolism but also regulates various physiological processes such as pathogenesis, persistence, motility and competence. Under extreme conditions such as nutrient starvation, (p)ppGpp-mediated stringent response is crucial for the survival of bacterial cells. This mini-review highlights some of the very recent progress on the key role of (p)ppGpp in bacterial growth control in light of cellular resource allocation and cell size regulation. We also briefly discuss some recent functional insights into the role of (p)ppGpp in plants and green algae from the angle of growth and development and further discuss several important open directions for future studies.

Machine-Learning Spectral Indicators of Topology

Topological materials discovery has emerged as an important frontier in condensed matter physics. While theoretical classification frameworks have been used to identify thousands of candidate topological materials, experimental determination of materials' topology often poses significant technical challenges. X-ray absorption spectroscopy (XAS) is a widely used materials characterization technique sensitive to atoms' local symmetry and chemical bonding, which are intimately linked to band topology by the theory of topological quantum chemistry (TQC). Moreover, as a local structural probe, XAS is known to have high quantitative agreement between experiment and calculation, suggesting that insights from computational spectra can effectively inform experiments. In this work, computed X-ray absorption near-edge structure (XANES) spectra of more than 10 000 inorganic materials to train a neural network (NN) classifier that predicts topological class directly from XANES signatures, achieving F₁ scores of 89% and 93% for topological and trivial classes, respectively is leveraged. Given the simplicity of the XAS setup and its compatibility with multimodal sample environments, the proposed machine-learning-augmented XAS topological indicator has the potential to discover broader categories of topological materials, such as non-cleavable compounds and amorphous materials, and may further inform field-driven phenomena in situ, such as magnetic field-driven topological phase transitions.

Aspirin relieves the calcification of aortic smooth muscle cells by enhancing the heat shock response

CONTEXT

Vascular calcification is a major complication of chronic renal failure, which has been identified as an active process partly driven by osteogenic transition of vascular smooth muscle cells (VSMCs). Aspirin could prevent cardiomyocyte damage by inducing heat shock response.

OBJECTIVE

This study investigates the effect of aspirin on alleviating VSMC calcification.

MATERIALS AND METHODS

An in vitro VSMC calcification model was established by 10-day calcification induction in osteogenic medium. VSMCs were grouped as following: control group (normal medium), calcified group (osteogenic medium) and treated group (osteogenic medium with 1 or 4 mmol/L aspirin). VSMC calcification was evaluated by calcified nodules formation, intracellular calcium concentration and osteoblastic marker (OPN and Runx2) expression.

RESULTS

After 10-day culture, the intracellular calcium concentration in calcified group was significantly higher than that in control group (1.16 ± 0.04 vs. 0.14 ± 0.01 μg/mg, p < 0.01), but significantly reduced in 1 mmol/L aspirin treated group (0.74 ± 0.05 μg/mg, p < 0.01), and 4 mmol/L aspirin treated group (0.93 ± 0.03 μg/mg, p < 0.01). The elevated expression of OPN and Runx2 induced by osteogenic medium was significantly relieved after 1 or 4 mmol/L aspirin treatment. The expression of HSF1, HSP70 and HSP90 was decreased in calcification-induced VSMCs, but significantly increased after treatment of aspirin. Furthermore, inhibition of HSP70 (or HSP90) by small-molecule inhibitor or small interfering RNA could partially abolish the anti-calcification effect of aspirin, proved by the changes of intracellular calcium concentration and osteoblastic marker expression.

DISCUSSION AND CONCLUSIONS

Aspirin could relieve the calcification of VSMCs partially through HSP70- or HSP90-mediated heat shock response. These findings expanded the understanding of aspirin pharmacology, and imply that local induction expression of HSPs might be a potential therapeutic strategy for the prevention and therapy of vascular calcification.

Association between Anatomical Variations of the Circle of Willis and Covert Vascular Brain Injury in the General Population

BACKGROUND AND PURPOSE

The circle of Willis (COW) is a circulatory anastomosis located at the base of the brain. Little is known about the association between covert vascular brain injury and COW configurations in the general population. We explored this relationship in a community-based Chinese sample.

METHODS

A total of 1,055 patients (mean age, 54.8 ± 8.9 years; 36.0% men) without intracranial arterial stenosis were included in the analysis. Magnetic resonance imaging was performed to evaluate the presence of imaging markers of covert vascular brain injury, including white matter hyperintensities (WMHs), lacunes, cerebral microbleeds (CMBs), enlarged perivascular spaces, and brain atrophy. Magnetic resonance angiography was used to classify the COW configurations according to the completeness, symmetry, and presence of the fetal posterior cerebral artery (FTP). The association between vascular lesions and variations in COW was analyzed.

RESULTS

Among the 1,055 patients, 104 (9.9%) had a complete COW. Completeness correlated with age (p = 0.001). Incomplete COW was positively associated with WMH severity (OR = 2.071; 95% CI, 1.004-4.270) and CMB presence (OR = 1.542; 95% CI, 1.012-2.348), independent of age and sex. The presence of FTP was associated with lacunes (OR = 1.878; 95% CI, 1.069-3.298), more severe WMHs (OR = 1.739; 95% CI, 1.064-2.842), and less severe enlarged perivascular spaces (OR = 0.562; 95% CI, 0.346-0.915).

CONCLUSIONS

COW configuration was significantly related to various covert vascular brain injuries.

Cooperation of heterotrophic bacteria enables stronger resilience of halophilic assimilation biosystem than nitrification system under long-term stagnation

Long-term stagnation of biosystems (with no or very little wastewater) owing to seasonal downtime or failure maintenance brings great challenges to the performance recovery after system restart. In particular, the reduction of microbial activity and change of dissolved organic matter (DOM) affect the effluent quality and subsequent treatment procedures. Monitoring the dynamics and resilience of biosystems after long-term stagnation is important to formulate targeted countermeasures for system stability. However, the influence of long-term stagnation on autotrophic nitrification (AN) and heterotrophic assimilation (HA) biosystems has not been systematically explored. Here, we used halophilic AN and HA systems to study the stability and resilience of two nitrogen removal consortia after long-term stagnation. The results showed that 97.5 % and 93 % of ammonium and 47.0 % and 90.1 % of total nitrogen were removed using the halophilic AN and HA systems, respectively, in the stable period. After four weeks of stagnation, the HA system showed stronger resilience than AN system, in terms of faster recovery of treatment performance, and less fluctuations in sludge settleability and extracellular polymeric substances. In addition, after the stagnation period, the DOM of AN system was rich in low-molecular refractory humic acid, whereas that of HA system was rich in high-molecular proteins. The stagnation period led to the replacement of the dominant heterotrophic functional microorganisms, Paracoccus and Halomonas, with Muricauda and Marinobacterium in the HA system. The microbial network results revealed that the cooperation of heterotrophic bacteria enables stronger resilience of the HA system from prolonged stagnation than the AN system. In addition, the nitrogen removal efficiency, protein to polysaccharide ratio of EPS and fluorescence intensity of DOM were significantly correlated with the microbial community composition. These results suggest that AN system has greater risks in terms of treatment performance and sludge stability than the system after long-term stagnation.

Photosynthetic and yield responses of rotating planting strips and reducing nitrogen fertilizer application in maize-peanut intercropping in dry farming areas

Improving cropping systems together with suitable agronomic management practices can maintain dry farming productivity and reduce water competition with low N inputs. The objective of the study was to determine the photosynthetic and yield responses of maize and peanut under six treatments: sole maize, sole peanut, maize-peanut intercropping, maize-peanut rotation-intercropping, 20% and 40% N reductions for maize in the maize-peanut rotation-intercropping. Maize-peanut intercropping had no land-use advantage. Intercropped peanut is limited in carboxylation rates and electron transport rate (ETR), leading to a decrease in hundred-grain weight (HGW) and an increase in blighted pods number per plant (N_BP). Intercropped peanut adapts to light stress by decreasing light saturation point (I_sat) and light compensation point (I_comp) and increasing the electron transport efficiency. Intercropped maize showed an increase in maximum photosynthetic rate (Pn_max) and I_comp due to a combination of improved intercellular CO₂ concentration, carboxylation rates, PSII photochemical quantum efficiency, and ETR. Compare to maize-peanut intercropping, maize-peanut rotation-intercropping alleviated the continuous crop barriers of intercropped border row peanut by improving carboxylation rates, electron transport efficiency and decreasing I_sat, thereby increasing its HGW and N_BP. More importantly, the land equivalent ratio of maize-peanut rotation-intercropping in the second and third planting years were 1.05 and 1.07, respectively, showing obvious land use advantages. A 20% N reduction for maize in maize-peanut rotation-intercropping does not affect photosynthetic character and yield for intercropped crops. However, a 40% N reduction decreased significantly the carboxylation rates, ETR, I_comp and Pn_max of intercropped maize, thereby reducing in a 14.83% HGW and 5.75% lower grain number per spike, and making land-use efficiency negative.

Aggregation-induced fluorescence 'turn on' imaging for fingerprints by an amphiphilic probe: Synthesis and performance

Fingerprints are important biological details and play an important role in identifying personal information. To assist the identification of latent fingerprints (LFPs) which are the frequently-met cases in practical application, LFPs are usually made visible/detectable by development (imaging) techniques. In this work, an amphiphilic probe (denoted as HNP) was designed and synthesized. Its amphiphilic nature was confirmed by its single crystal structure and lipid-water partition coefficient (P = 1.38). It showed good solubility in water and bright red AIE (aggregation-induced emission) emission upon visible light excitation (∼410 nm), which satisfied the requirements for LFPs development/imaging. Photophysical parameters (absorption spectrum, emission spectrum, and emission quantum yield), LFPs imaging performance and bio-safety of probe HNP were discussed and reported. It was found that HNP showed efficient AIE effect in aggregated state. After meeting the lipids in LFPs, HNP AIE effect was activated, showing emission "turn-on" phenomenon and LFPs pattern. This mechanism was confirmed by micromorphology analysis. Corresponding dynamics were discussed as well. Good stability and durability were observed for HNP development/imaging. Details down to level 3 were successfully retrieved with high contrast.

Validity and reliability of a novel iPhone method to rapidly measure cervical sagittal parameters

We introduced a novel method based on the iPhone's intrinsic photo edit function to measure sagittal parameters of the cervical spine. This study aimed to assess the validity of this new method compared with the picture archiving and communication system (PACS) method (the gold standard) and to test the reliability of this novel technique. One hundred consecutive patients admitted to our hospital diagnosed with cervical spondylotic myelopathy or cervical spondylotic radiculopathy were retrospectively reviewed. Four angles, including the C0-2 Cobb angle, C2-7 Cobb angle, T1S and neck tilt (NT), were assessed by iPhone and PACS. The validity and reliability were evaluated, and the time taken by both methods was compared. The ICCs of the validity of the C0-2 Cobb angle, C2-7 Cobb angle, T1S and NT were 0.960, 0.976, 0.980 and 0.946, respectively. The ICCs of the intraobserver reliability of the C0-2 Cobb angle, C2-7 Cobb angle, T1S and NT were 0.966, 0.983, 0.971 and 0.951, respectively. The ICCs of the interobserver reliability of the C0-2 Cobb angle, C2-7 Cobb angle, T1S and NT were 0.953, 0.972, 0.957 and 0.929, respectively. The Bland‒Altman plot of validity of the four angles revealed mean differences of 0.3, 0.2, 0.1, and 0.1 degrees with 95% CIs of 4.1, 4.1, 2.9, and 4.3 degrees, respectively. The iPhone measurement time (58.55 ± 4.17 s) was significantly less than that by the PACS (70.40 ± 2.92 s) when compared by the independent-samples T test (P < 0.001). This novel method using the iPhone's intrinsic photo edit function is accurate, reliable, fast and convenient when measuring cervical sagittal parameters.

Stable Negative Optical Torque in Optically Bound Nanoparticle Dimers

Negative optical torque is a counterintuitive optomechanical phenomenon that can emerge in light-assembled nanoparticle (NP) clusters (i.e., optical matter) under circular polarization. However, in experiments, stable negative torque was limited to optical matter with 3 or more NPs. Here, we show that by increasing the particle size, the sign of optical torque can be reversed in optical matter dimers, where stable negative torque arises in dimers of 300 nm diameter Au or 490 nm diameter polystyrene NPs. Our computational analysis reveals that the multipolar resonances in large NPs can enhance the forward scattering along the spin angular momentum (SAM) direction of light, creating a recoil negative torque due to momentum conservation. The observation of stable negative torque in dimers pushes the limit to the smallest optical matter, demonstrating the universal existence of negative torque in such a system. The underlying principle also provides new strategies for making light-driven nanomotors.

Creating a re-expanded prefabricated island flap constructed with an anastomosed vascular pedicle for burned ear reconstruction: a case report

Background

The combined use of various flap techniques has rapidly improved the reconstruction quality of auricle defects that are complicated by a scarcity of periauricular skin after severe burns. Nevertheless, there is still no preferable method when the optimal alternative skin to cover the auricular framework is unavailable and the periauricular vascular network is devastated.

Case Description

Copious scars were observed in the periauricular region, neck, forearm, and supraclavicular region of a 19-year-old man. He had been burned by high-voltage electricity and exhibited a right auricular defect. We innovatively created a prefabricated expanded island flap constructed with an anastomosed vascular pedicle buried in the anterior thoracic chest, followed by flap transfer, tissue re-expansion, and sculpted autologous costal cartilage implantation. The remnant ear was successfully reconstructed in a three-stage surgical procedure.

Conclusions

All the flaps survived well without any complications. The reconstructed right ear had a natural shape and a clear structure without apparent displacement and deformation during follow-up. The patient was satisfied with the final appearance, and his neck mobility markedly improved. Advantages and disadvantages were discussed. This procedure explored a novel solution to construct an auricular framework covering for patients who do not have high-quality donor skin and lack anastomotic vessels in the recipient area.

Genome-wide alternation and effect of DNA methylation in the impairments of steroidogenesis and spermatogenesis after PM2.5 exposure

The effects of ambient fine particles on male reproductive health have raised widespread concern. The particular underlying mechanisms of the damage remain largely unclear and demand more research in new directions. Previous research has revealed that DNA methylation plays an important role in male reproductive development and is also vulnerable to environmental influences. However, there hasn't been enough investigation into the involvement of DNA methylation in PM_2.5-induced male reproductive toxicity. Here, we establish a real-time PM_2.5 exposure model and revealed that PM_2.5 exposure could lead to testicular dysfunction including spermatogenesis impairment and steroid hormone dysfunction. In particular, the decrease in the testicular global level of 5-methylcytosine (5mC) indicated a possible association of DNA methylation with testicular injury induced by PM_2.5 exposure. Further genome-wide methylation analysis revealed genomic hypomethylation of testicular DNA and identified more than 1000 differentially methylated regions in both CAP and UA versus FA, indicating that PM_2.5 exposure, even low-dose, could modulate the testicular methylome. Furthermore, integrated analysis of methylome and transcriptome identified some key methylated genes and networks, which may be involved in spermatogenesis and synthesis of steroid hormone. The testicular methylation levels of key genes especially Cyp11a1 and Pax8 raised, and their consequent reduced expression may impair the testosterone and sperm production process. Our research provides fundamental knowledge as well as novel insights into the possible involvement of DNA methylation in PM_2.5-induced male reproductive harm.

Nitrogen recovery from wastewater by microbial assimilation - A review

The increased nitrogen (N) input with low utilization rate in artificial N management has led to massive reactive N (Nr) flows, putting the Earth in a high-risk state. It is essential to recover and recycle Nr during or after Nr removal from wastewater to reduce N input while simultaneously mitigate Nr pollution in addressing the N stress. However, mechanisms for efficient Nr recovery during or after Nr removal remain unclear. Here, the occurrence of N risk and progress in wastewater treatment in recent years as well as challenges of the current technologies for N recovery from wastewater were reviewed. Through analyzing N conversion fluxes in biogeochemical N-cycling networks, microbial N assimilation through photosynthetic and heterotrophic microorganisms was highlighted as promising alternative for synergistic N removal and recovery in wastewater treatment. In addition, the prospects and gaps of Nr recovery from wastewater through microbial assimilation are discussed.

Silencing eL31 suppresses the progression of colorectal cancer via targeting DEPDC1

Background

Colorectal cancer (CRC) is one of the most commonly diagnosed human malignancies. Ribosomal protein L31 (RPL31, aka eL31) is a component of the 60S large ribosomal subunit, and its expression pattern and functional role in CRC have not been reported.

Methods

Herein, we identified that eL31 protein level was dramatically increased in CRC tissues through using IHC analysis. More notably, elevated eL31 was associated with larger tumor size and shorter overall survival. Besides, we evaluated the effects of eL31 depletion on CRC cell phenotypes in vitro.

Results

The data indicated that eL31 knockdown restricted CRC cell proliferation, migration and colony formation whilst enhancing cell apoptosis. Importantly, eL31 was also essential for CRC tumor growth in vivo, as demonstrated by impaired tumor growth markers and reduced Ki67 levels in xenografts from eL31-depleted cells. In addition, our evidence indicated that DEP domain containing 1 (DEPDC1) was a potential downstream target of eL31 in regulating CRC. Consistently, DEPDC1 depletion restrained CRC cell proliferation and migration, as well as facilitated cell apoptosis. More interestingly, DEPDC1 depletion could reverse the promotion effects of eL31 elevation on CRC cells.

Conclusions

Identification of eL31’s function in CRC may pave the way for future development of more specific and more effective targeted therapy strategies against CRC.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12967-022-03663-6.

Morphological and electrophysiological changes of retina after different light damage in three patients: Three case reports

BACKGROUND

Light-induced retinal damage is a serious vision-threatening disease, resulting from unsuitable laser irradiation, high-power light and sustaining light exposure. Therefore, effectively evaluate the morphological and functional of retinal damage is urgently needed. Now, we mainly reported three patients suffered from typical light irradiations.

CASE SUMMARY

Patient 1 suffered from old laser pointer irradiation and followed with amblyopia treatment. Patient 2 suffered from acute high-energy light irradiation. Patient 3 suffered from sustaining optical fiber irradiation. Detailed morphological and functional examinations of the retina revealed that the lesions of the three patients had many similar characteristics, such as macular morphological changes, patent pattern visual monitoring amplitude or peak time abnormalities, multi-fucus electroretinograms macular central amplitude density decreased.

CONCLUSION

In conclusion, light-induced retinopathy has many common features, which can help clinical medical staff to diagnose retinal photodamage diseases.

IL7RA single nucleotide polymorphisms are associated with the size and function of the MAIT cell population in treated HIV-1 infection

MAIT cells are persistently depleted and functionally exhausted in HIV-1-infected patients despite long-term combination antiretroviral therapy (cART). IL-7 treatment supports MAIT cell reconstitution in vivo HIV-1-infected individuals and rescues their functionality in vitro. Single-nucleotide polymorphisms (SNPs) of the IL-7RA gene modulate the levels of soluble(s)IL-7Rα (sCD127) levels and influence bioavailability of circulating IL-7. Here we evaluate the potential influence of IL-7RA polymorphisms on MAIT cell numbers and function in healthy control (HC) subjects and HIV-1-infected individuals on long-term cART. Our findings indicate that IL-7RA haplotype 2 (H2*T), defined as T-allele carriers at the tagging SNP rs6897932, affects the size of the peripheral blood MAIT cell pool, as well as their production of cytokines and cytolytic effector proteins in response to bacterial stimulation. H2*T carriers had lower sIL-7Rα levels and higher MAIT cell frequency with enhanced functionality linked to higher expression of MAIT cell-associated transcription factors. Despite an average of 7 years on suppressive cART, MAIT cell levels and function in HIV-1-infected individuals were still significantly lower than those of HC. Notably, we observed a significant correlation between MAIT cell levels and cART duration only in HIV-1-infected individuals carrying IL-7RA haplotype 2. Interestingly, treatment with sIL-7Rα in vitro suppressed IL-7-dependent MAIT cell proliferation and function following cognate stimulations. These observations suggest that sIL-7Rα levels may influence MAIT cell numbers and function in vivo by limiting IL-7 bioavailability to MAIT cells. Collectively, these observations suggest that IL-7RA polymorphisms may play a significant role in MAIT cell biology and influence MAIT cells recovery in HIV-1 infection. The potential links between IL7RA polymorphisms, MAIT cell immunobiology, and HIV-1 infection warrant further studies going forward.

Adjuvant Capecitabine Following Concurrent Chemoradiotherapy in Locoregionally Advanced Nasopharyngeal Carcinoma: A Randomized Clinical Trial

Importance

Induction or adjuvant chemotherapy with concurrent chemoradiotherapy (CCRT) are first-line treatment options for treatment of locoregionally advanced nasopharyngeal carcinoma (LA-NPC). Adjuvant platinum regimens are, however, poorly tolerated, highlighting the unmet need for an efficacious, tolerable adjuvant regimen.

Objective

To investigate the efficacy and safety of adjuvant capecitabine with CCRT for the treatment of patients with LA-NPC.

Design, Setting, and Participants

This open-label randomized clinical trial recruited patients from March 31, 2014, to July 27, 2018, at 3 institutions in China, with at least 3 years of follow-up. The data collection cutoff date was February 9, 2022. Eligibility included stage III-IVb nasopharyngeal carcinoma and at least 1 of the following: T3-4N2 or T1-4N3; plasma Epstein-Barr virus DNA titer higher than 20 000 copies/mL; primary gross tumor volume larger than 30.0 cm3; fluorodeoxyglucose F 18 positron emission tomography/computed tomography maximum standard uptake value of the primary gross tumor volume larger than 10.0; or multiple nodal metastases and any larger than 4.0 cm.

Interventions

Patients were randomly assigned 1:1 to receive either capecitabine (1000 mg/m2 twice daily for 14 days every 3 weeks for 8 cycles) or observation following CCRT (100 mg/m2 cisplatin every 3 weeks for 2 to 3 cycles, depending on duration of radiotherapy).

Main Outcomes and Measures

Failure-free survival in the intention-to-treat cohort was assessed using Kaplan-Meier survival curves compared with the log-rank test. Unstratified Cox proportional hazards regression models were used to estimate hazard ratios, with corresponding 95% CIs based on the Wald test.

Results

There were 180 patients enrolled (median [IQR] age, 47 [40-55] years; 143 [79.4%] men). Among 90 patients in the capecitabine group, 76 (84.4%) had at least 2 high-risk factors; among 90 patients in the control group, 80 (88.9%) had at least 2 high-risk factors. All patients completed CCRT, except 1 patient in the capecitabine group who received 1 cycle of cisplatin. Of the 90 patients in the capecitabine group, 85 (94.4%) received capecitabine, with 71 (78.9%) completing 8 cycles. With a median (IQR) follow-up of 58.0 (49.5-80.1) months, 18 events were recorded in the capecitabine group vs 31 events in the control group. Failure-free survival was improved with adjuvant capecitabine (3 years, 83.3% vs 72.2%; 5 years, 78.5% vs 65.9%; hazard ratio, 0.53 [95% CI, 0.30-0.94]; P = .03). The incidence of grade 3 treatment-related adverse events (TRAEs) was higher in the capecitabine group than in the control group (54 of 90 patients [60.0%] vs 46 of 90 patients [51.1%]). Treatment-related adverse events included xerostomia (17 [18.9%] vs 9 [10.0%] patients), mucositis (21 [23.3%] vs 15 [16.7%] patients), and anorexia (8 [8.9%] vs 4 [4.4%] patients). The incidence of grade 3 delayed treatment-related adverse events was comparable in both groups (9 of 83 [10.8%] vs 7 of 81 [8.6%] patients).

Conclusions and Relevance

In this randomized clinical trial, adjuvant capecitabine at the full dose following CCRT was well tolerated and improved failure-free survival among patients with LA-NPC and high-risk factors. Further investigations assessing optimal dose and duration are warranted.

Trial Registration

ClinicalTrials.gov Identifier: NCT02143388.

Multi-scale hybrid spherical graphite composites: a light weight thermal interface material with high thermal conductivity and simple processing technology

In consideration of low density and high intrinsic thermal conductivity, spherical graphite powders can act as promising fillers for light weight thermal interface materials. Herein, spherical artificial graphite derived composites exhibit a similar thermal conductivity and significantly reduced bulk density compared with traditional Al₂O₃-derived composites. Further, based on the particle packing theory, an innovatively optimized calculation method has been proposed by introducing the quadratic programming method into the traditional calculation method to acquire the optimum formulation of multi-scale spherical graphite particles. The thermal conductivity of the optimum formulation-derived composites attains 1.994 W m⁻¹ K⁻¹, which is 1.72 times higher than that of the single particle size-derived composites (1.156 W m⁻¹ K⁻¹), accompanied by a low density of 1.812 g cm⁻³vs. the 2.31 g cm⁻³ of the traditional Al₂O₃-derived composites. Besides, the relationships between the tap density of the graphite powders, thermal conductivity and maximum filling content of the composites are creatively established, which are available for predicting the thermal conductivities of composites by simply testing the tap density of the fillers. This present work provides an instructional strategy to optimize spherical filler particles for thermal management of electronic devices.

A new carbon-based thermal conductive filler, a new calculation method of multi-scale spherical particle mixing and a model for predicting thermal conductivity by tap density.

The effects of dexmedetomidine for patient-controlled analgesia on postoperative sleep quality and gastrointestinal motility function after surgery: A prospective, randomized, double-blind, and controlled trial

Background: Postoperative poor sleep quality and decreased gastrointestinal motility function are common clinical problems. This study investigated the effects of dexmedetomidine (DEX) combined with sufentanil for patient-controlled analgesia (PCA) on postoperative sleep quality and gastrointestinal motility function after surgery in patients with colorectal cancer.

Methods: Patients undergoing colorectal cancer surgery were randomly divided into three groups, DEX 0, 200, or 400 μg, each combined with sufentanil 150 μg for PCA immediately after surgery. The primary outcome was sleep quality in the first 7 days after surgery based on the Athens Insomnia Scale (AIS) score. The secondary outcome was postoperative gastrointestinal motility recovery evaluated by the time of first flatus, first feces and first diet. Postoperative pain intensity, side effects and the length of postoperative hospital stay were also compared among groups. The study was registered with the Chinese Clinical Trial Registry (https://www.chictr.org.cn/enIndex.aspx, ChiCTR2000032601).

Results: Ultimately, 210 cases were included. Sleep quality was better in the DEX 200 μg group and DEX 400 μg group than in the DEX 0 μg group. Overall, in the DEX 200 μg group and DEX 400 μg group, the AIS score (p < 0.05) and the incidence of sleep disturbance (7.3%, 4.5% vs. 19.6%, p < 0.001) were lower than those in the DEX 0 μg group in the first 7 days after surgery. There were no significant differences in postoperative gastrointestinal motility among the three groups in the total surgical categories (p > 0.05). In the laparoscopic surgery patients of each group, the time of postoperative first flatus (p = 0.02) and first feces (p = 0.01) was significantly longer in the DEX 400 μg group than in the DEX 0 μg group. There were no differences in postoperative pain intensity, side effects or length of postoperative hospital stay (p > 0.05).

Conclusion: The continuous infusion of DEX (200 or 400 μg) for PCA significantly improved postoperative sleep quality after colorectal cancer surgery. DEX (200 μg) was better at improving postoperative sleep quality without affecting gastrointestinal motility function than DEX (400 μg) in patients who underwent laparoscopic colorectal cancer surgery.