Comparison of the short-term efficacy of different Amplatzer models and similar occluders in the treatment of patent foramen ovale

Objective

To compare the recent efficacy and safety of different Amplatzer models and similar occluder in the treatment of patent foramen ovale (PFO).

Methods

Patients with PFO complicated with cryptogenic stroke or migraine who underwent transcatheter closure of PFO in the First Affiliated Hospital of Nanjing Medical University from September 2019 to March 2021 were selected. Patients were grouped according to the type of occluder device. The basic data of the patients were collected and followed up within 1 year after occlusion. Effectiveness was defined as no recurrence of stroke/remission of migraine symptoms and a negative postoperative foaming test, and safety events were counted as the combined results of serious adverse events.

Results

A total of 92 patients were selected, including 45 cases in the symmetrical group and 47 cases in the asymmetric group. There were no serious adverse events in the 2 groups during follow-up. 3 days and 1 month after occlusion, the number of shunt patients in the asymmetric group was significantly less than that in the symmetric group (χ² = 5.484, P = 0.019; χ² = 5.146, P = 0.023). The negative rate of blocked residual shunts in the asymmetric group was higher than that in the symmetric group at 1, 3, 6 and 12 months after occlusion (χ² = 6.473, P = 0.011; χ² = 4.305, P = 0.038; χ² = 4.842, P = 0.027; χ² = 4.034, P = 0.045). Headache in migraine patients in the asymmetric group was significantly better than headache in patients in the symmetric group (P = 0.038; P = 0.049).

Conclusion

Asymmetric Amplatzer and similar occluders provide greater efficacy in short-term occlusion than symmetric ones.

Mixture of personality improved spiking actor network for efficient multi-agent cooperation

Adaptive multi-agent cooperation with especially unseen partners is becoming more challenging in multi-agent reinforcement learning (MARL) research, whereby conventional deep-learning-based algorithms suffer from the poor new-player-generalization problem, possibly caused by not considering theory-of-mind theory (ToM). Inspired by the ToM personality in cognitive psychology, where a human can easily resolve this problem by predicting others' intuitive personality first before complex actions, we propose a biologically-plausible algorithm named the mixture of personality (MoP) improved spiking actor network (SAN). The MoP module contains a determinantal point process to simulate the formation and integration of different personality types, and the SAN module contains spiking neurons for efficient reinforcement learning. The experimental results on the benchmark cooperative overcooked task showed that the proposed MoP-SAN algorithm could achieve higher performance for the paradigms with (learning) and without (generalization) unseen partners. Furthermore, ablation experiments highlighted the contribution of MoP in SAN learning, and some visualization analysis explained why the proposed algorithm is superior to some counterpart deep actor networks.

Impact of COVID-19 on the distribution of pathogenic bacteria in the lower respiratory tract of the elderly

BACKGROUND

To investigate the distribution of bacterial pathogens of lower respiratory tract infection (LRTI) in hospitalized elderly patients during the COVID-19 epidemic and to explore the influence of COVID-19 on the distribution of bacterial pathogens, to provide guidance for clinical diagnosis.

METHODS

Specimens of sputum from elderly LRTIs patients at Fuding Hospital of China were consecutively collected from October 2022 to January 2023. Cultures and identification were done, and RT-PCR was employed to detect SARS-Cov-2 nucleic acid.

RESULTS

A total of 195 isolates were characterized in 163 sputum samples of consecutive hospitalized elderly patients, of which 11.3% were Gram-positive bacteria and 88.7% were Gram-negative. The top of frequently isolated pathogens was Klebsiella pneumonia (30.3%), Pseudomonas aeruginosa (19.0%), Acinetobacter baumannii (12.8%), Stenotrophomonas maltophili, (7.7%), Escherichia coli (7.2%). According to the results of novel coronavirus nucleic acid detection, the 163 patients were divided into COVID-19 group and non-COVID control (CNT) group. The comparison of bacterial distribution between the groups revealed that Stenotrophomonas maltophilia was lower in the COVID-19 than in the CNT group, while A. baumannii was higher in the COVID-19 group, and the difference was statistically significant (p < .05).

CONCLUSION

The major bacteria identified in sputum culture of hospitalized elderly patients were K. pneumonia, P. aeruginosa, A. baumannii, S. maltophilia, and E. coli. Furthermore, the distribution of S. maltophilia and A. baumannii between the COVID-19 and CNT groups was found to be significantly different (p < .05), while there were no significant differences in the distribution of other bacteria.

Integrated biomarker profiling of the metabolome associated with type 2 diabetes mellitus among Tibetan in China

INTRODUCTION

Metabolomic signatures of type 2 diabetes mellitus (T2DM) in Tibetan Chinese population, a group with high diabetes burden, remain largely unclear. Identifying the serum metabolite profile of Tibetan T2DM (T-T2DM) individuals may provide novel insights into early T2DM diagnosis and intervention.

METHODS

Hence, we conducted untargeted metabolomics analysis of plasma samples from a retrospective cohort study with 100 healthy controls and 100 T-T2DM patients by using liquid chromatography-mass spectrometry.

RESULTS

The T-T2DM group had significant metabolic alterations that are distinct from known diabetes risk indicators, such as body mass index, fasting plasma glucose, and glycosylated hemoglobin levels. The optimal metabolite panels for predicting T-T2DM were selected using a tenfold cross-validation random forest classification model. Compared with the clinical features, the metabolite prediction model provided a better predictive value. We also analyzed the correlation of metabolites with clinical indices and found 10 metabolites that were independently predictive of T-T2DM.

CONCLUSION

By using the metabolites identified in this study, we may provide stable and accurate biomarkers for early T-T2DM warning and diagnosis. Our study also provides a rich and open-access data resource for optimizing T-T2DM management.

Accuracy of a Smartphone Software Application Compared With a Handheld Goniometer for Measuring Shoulder Range of Motion in Asymptomatic Adults

Background

Typically, shoulder range of motion (ROM) measurements are performed in a clinic setting, where physicians, physical therapists (PTs), and occupational therapists make use of a goniometer.

Purpose

To determine the accuracy of a smartphone-based ROM software application (app) in assessing active shoulder ROM and compare the measurements with traditional goniometry as measured by a PT.

Study Design

Cohort study (diagnosis); Level of evidence, 2.

Methods

This prospective, nonblinded study was conducted at a single institution with adult asymptomatic participants with full active ROM of both shoulders. Participants were enrolled between June 1 and 15, 2021. Each participant self-assessed their active shoulder ROM using the PeerWell smartphone app. A single PT concurrently measured each participant's active shoulder ROM using a handheld universal goniometer. Bilateral shoulder ROM (forward flexion, abduction [AB], external rotation, internal rotation [IR], and extension) was measured 2 times for each participant. Interrater reliability between the smartphone app and PT measurements as well as intrarater reliability for each method of measurement were assessed using the intraclass correlation coefficient (ICC), and limits of agreement were analyzed for the difference in measurement methods.

Results

Data were analyzed for 60 shoulders (30 right, 30 left) from 30 participants (mean age, 31.4 ± 11.7 years; 73% female). The interrater reliability between the 2 methods was excellent for all movements (ICCs, 0.90-0.96). For all movements except shoulder AB, the mean difference in the measurements between the 2 methods was <1.3°; the mean difference in AB ROM was 2.08°. For all movements except IR, both PTs and the app showed excellent intrarater reliability (ICCs >0.90); for IR, good intrarater reliability (ICC ≥0.75) was observed.

Conclusion

The PeerWell smartphone app provided measurements comparable with manual measurements taken by a PT using a goniometer. These data provide evidence that the smartphone app is a reliable and valid tool for measuring shoulder ROM and show promise for measuring and monitoring patient ROM remotely.

[IL-8 Links NF-κB and Wnt/β-Catenin Pathways in Persistent Inflammatory Response Induced by Chronic Helicobacter pylori Infection]

Helicobacter pylori (H. pylori) infection can cause persistent inflammatory response in human gastric mucosal epithelial cells, which may result in the occurrence of cancer. However, the underlying mechanism of carcinogenesis has not been elucidated yet. Herein, we established the models of chronic H. pylori infection in GES-1 cells and C57BL/6J mice. Interleukin 8 (IL-8) level was detected by ELISA. The expression of NF-κB p65, IL-8, Wnt2 and β-catenin mRNA and proteins was evaluated by real-time PCR, Western blotting, immunofluorescence staining, and immunohistochemistry. The infection of H. pylori in mice was evaluated by rapid urease test, H&E staining and Warthin-Starry silver staining. The morphological changes of gastric mucosa were observed by electron microscopy. Our results showed that in H. pylori infected gastric mucosal cells along with activation of NF-κB signaling pathway and increase of IL-8 level, the expression of Wnt2 was also increased significantly, which preliminarily indicates that IL-8 can positively regulate the expression of Wnt2. Studies in chronic H. pylori infected C57BL/6J mice models showed that there was an increased incidence of premalignant lesions in the gastric mucosa tissue. Through comparing changes of gastric mucosal cell ultrastructure and analyzing the relationship between NF-κB signaling pathway and Wnt2 expression, we found that H. pylori infection activated NF-κB signal pathways, and the massive release of IL-8 was positively correlated with the high expression of Wnt2 protein. Subsequently, the activated Wnt/β-catenin signal pathways may be involved in the malignant transformation of gastric mucosal cells. Collectively, H. pylori chronic infection may continuously lead to persistent inflammatory response: activate NF-κB pathway, promote IL-8 release and thereby activate Wnt/β-catenin pathway. IL-8 probably plays an important role of a linker in coupling these two signal pathways.

Effects of glucosamine hydrochloride combined with non-steroidal anti-inflammatory drugs on symptoms and HSS scores in patients with knee osteoarthritis

To investigate the effects of glucosamine hydrochloride combined with non-steroidal anti-inflammatory drugs on symptoms and HSS scores in patients with knee osteoarthritis (KOA). Totally 80 cases of patients with KOA admitted to Cangzhou Hospital of integrated TCM-WM from February 2016 to December 2019 were selected and divided into the Control Group and Observation Group by Random Number Table Method, with 40 cases in each group. After treatment, the Observation Group tends to have lower VAS scores and WOMAC scores than the Control Group (P<0.05). The Observation Group tends to perform better than the Control Group on symptom improvement rate and HSS scores (P<0.05). The expression levels of related inflammatory factors and matrix metalloproteinase (MMPs) are similar before and after treatment in the Control Group (P>0.05). The expression levels of related inflammatory factors and MMPs get lower after treatment in the Observation Group (P<0.05). The evaluation indexes and total scores of the Observation Group are better than those of the Control Group (P<0.05). Glucosamine hydrochloride combined with non-steroidal anti-inflammatory drugs treatment could decrease the expression levels of inflammatory cytokines, relieve knee pain and arthritis symptoms, improve knee function and improve the HSS scores in patients with KOA.

Comparison of injury severity between E-bikes-related and other two-wheelers-related accidents: Based on an accident dataset

This study aims to compare the accident injury severity of e-bikes with that of other types of two-wheelers based on accident data and to analyze the factors influencing them. Using 1015 police accident records from Zhangjiakou City in 2020 and 2021, the accident injury severity of e-bikes was firstly compared with that of other two-wheelers based on five levels of accident injury severity classified according to the records. Two ordered Probit regression models were secondly used to compare the factors influencing the accident injury severity of e-bikes with that of other two-wheelers and the magnitude of their effects. At the same time, the contributions of each influential factor to the degree of accident injury of two-wheelers were estimated with the assistance of classification trees. Results show that e-bikes are closer to bicycles than motorcycles in terms of injury severities and the factors influencing them, in which the factors "accident configuration," "division of responsibility for the accident," and "collision with a heavy vehicle or four-wheeled vehicle" are significant. Based on the findings, potential measures are suggested to reduce e-bike accident casualties, such as improving rider education, ensuring speed limit enforcement, promoting safety equipment wearing, and making road design friendly to non-motorized and elderly riders. The results of this study can provide an essential reference for traffic management and rider education measures on e-bikes.

Prevalence of frailty and pre-frailty and related factors in older adults with cardio-cerebral vascular disease in China: a national cross-sectional study

Objective

Frailty increases adverse clinical outcomes in older patients with cardio-cerebral vascular disease (CCVD). The aim of this study was to investigate the prevalence of frailty and pre-frailty in older adults with CCVD in China and the factors associated with it.

Research design and methods

In this cross-sectional study, we used data from the fourth Sample Survey of Aged Population in Urban and Rural China. We used the frailty index for frailty and pre-frailty assessment, and the diagnosis of CCVD in older adults was self-reported.

Results

A total of 53,668 older patients with CCVD were enrolled in the study. The age-standardized prevalence of frailty and pre-frailty in older patients with CCVD was 22.6% (95% CI 22.3-23.0%) and 60.1% (95% CI 59.7-60.5%). Multinomial logistic regression analyses showed that being female, increasing age, rural residence, illiteracy, widowhood, ethnic minority, living alone, no health screening during the last year, hospitalization during the last year, difficult financial status, comorbid chronic conditions, and disability in activities of daily living were associated with frailty and pre-frailty in older patients with CCVD.

Conclusion

CCVD is strongly associated with frailty and pre-frailty in older Chinese people, and assessment of frailty should become routine in the management of older CCVD patients. Appropriate public health prevention strategies should be developed based on identified risk factors for frailty in older CCVD patients, which can help prevent, ameliorate or reverse the development of frailty in CCVD in the older population.

[A case of Oliver-McFarlane syndrome caused by PNPLA6 gene mutation]

Oliver-McFarlane syndrome is a rare genetic disorder characterized by long eyelashes, choroidoretinal atrophy, and multiple pituitary hormone deficiencies. The patient in this case is a 29-year-old female who has suffered from night blindness, low vision, and long eyelashes since childhood. Through genetic sequencing, she was diagnosed with compound heterozygous variaton in the PNPLA6 gene, indicating Oliver-McFarlane syndrome based on her comprehensive clinical presentation.

Nagimycins A and B, Antibacterial Ansamycin-Related Macrolactams from Streptomyces sp. NA07423

Chemical investigation of Streptomyces sp. NA07423 led to the discovery of two unreported macrolactams, nagimycins A (1) and B (2). Their structures were elucidated by NMR, HRESIMS, X-ray crystallography, and comparison of experimental and theoretical ECD spectra. The nagimycins have a unique butenolide moiety rarely found in ansamycin antibiotics. Genome analysis revealed the putative biosynthetic gene cluster for nagimycins, and a likely biosynthetic pathway was proposed. Notably, compounds 1 and 2 exhibited potent antibacterial activity against two pathogenic Xanthomonas bacteria.

First Measurement of Quasielastic Λ Baryon Production in Muon Antineutrino Interactions in the MicroBooNE Detector

We present the first measurement of the cross section of Cabibbo-suppressed Λ baryon production, using data collected with the MicroBooNE detector when exposed to the neutrinos from the main injector beam at the Fermi National Accelerator Laboratory. The data analyzed correspond to 2.2×10^{20} protons on target running in neutrino mode, and 4.9×10^{20} protons on target running in anti-neutrino mode. An automated selection is combined with hand scanning, with the former identifying five candidate Λ production events when the signal was unblinded, consistent with the GENIE prediction of 5.3±1.1 events. Several scanners were employed, selecting between three and five events, compared with a prediction from a blinded Monte Carlo simulation study of 3.7±1.0 events. Restricting the phase space to only include Λ baryons that decay above MicroBooNE's detection thresholds, we obtain a flux averaged cross section of 2.0_{-1.7}^{+2.2}×10^{-40}  cm^{2}/Ar, where statistical and systematic uncertainties are combined.

White matter abnormalities are associated with the declined ability of reasoning and problem-solving in major depressive disorder

OBJECTIVES

Executive function in people with depression is linked to the integrity of white matter fibers in the brain. We hypothesized that the maze tests in neuropsychological tests assessed reasoning and problem-solving abilities dependent on the integrity of brain white matter fibers, and assessed this relationship using diffusion tensor imaging (DTI) in depressed patients and healthy controls.

METHODS

Participants aged from 18 to 50 years were recruited from Zhumadian Second People's Hospital from July 2018 to August 2019. The sample included 33 clinically diagnosed individuals with major depressive disorder (MDD) and 24 healthy volunteers (HVs). All subjects underwent Neuropsychological assessment battery (NAB) maze tests and DTI. Tract-based spatial statistics technology in FSL software was used to process DTI data, and threshold-free cluster enhancement (TFCE) was used to perform multiple comparison corrections. The fractional anisotropy (FA) of white matter fibers in the MDD group and HVs group were compared and extracted. Pearson correlation was used to analyze the relationship between FA and NAB scores and HAMD scores.

RESULTS

The mean NAB maze test score for the MDD group was lower than the HVs group, and the difference was statistically significant (F = 11.265, p = .037). The FA value of the body of corpus callosum and cerebral peduncle right in the depression group was lower than that in the healthy control group, and the difference was statistically significant (p < .05). FA value of the body of corpus callosum was positively correlated with NAB score (r = 0.400, p = .036), but not with the HAMD score (r = 0.065, p = .723).

CONCLUSIONS

The decreased ability of reasoning and problem-solving in MDD may be due to the decreased integrity of the white matter fibers of the body of the corpus callosum.

Mitochondrial genome comparison reveals the evolution of cnidarians

Cnidarians are the most primitive metazoans, but their evolutionary relationships are poorly understood, although recent studies present several phylogenetic hypotheses. Here, we collected 266 complete cnidarian mitochondrial genomes and re-evaluated the phylogenetic relationships between the major lineages. We described the gene rearrangement patterns of Cnidaria. Anthozoans had significantly greater mitochondrial genome size and lower A + T content than medusozoans. Most of the protein-coding genes in anthozoans such as COX 13, ATP6, and CYTB displayed a faster rate of evolution based on selection analysis. There were 19 distinct patterns of mitochondrial gene order, including 16 unique gene orders in anthozoans and 3 mtDNA gene orders pattern in medusozoans, were identified among cnidarians. The gene order arrangement suggested that a linearized mtDNA structure may be more conducive to Medusozoan mtDNA stability. Based on phylogenetic analyses, the monophyly of the Anthozoa was strongly supported compared to previous mitochondrial genome-based analyses rather than octocorals forming a sister group relationship with medusozoans. In addition, Staurozoa were more closely related to Anthozoa than to Medusozoa. In conclusion, these results largely support the traditional phylogenetic view of the relationships of cnidarians and provide new insights into the evolutionary processes for studying the most ancient animal radiations.

Structural insights into the transcription activation mechanism of the global regulator GlnR from actinobacteria

In actinobacteria, an OmpR/PhoB subfamily protein called GlnR acts as an orphan response regulator and globally coordinates the expression of genes responsible for nitrogen, carbon, and phosphate metabolism in actinobacteria. Although many researchers have attempted to elucidate the mechanisms of GlnR-dependent transcription activation, progress is impeded by lacking of an overall structure of GlnR-dependent transcription activation complex (GlnR-TAC). Here, we report a co-crystal structure of the C-terminal DNA-binding domain of GlnR (GlnR_DBD) in complex with its regulatory cis-element DNA and a cryo-EM structure of GlnR-TAC which comprises Mycobacterium tuberculosis RNA polymerase, GlnR, and a promoter containing four well-characterized conserved GlnR binding sites. These structures illustrate how four GlnR protomers coordinate to engage promoter DNA in a head-to-tail manner, with four N-terminal receiver domains of GlnR (GlnR-RECs) bridging GlnR_DBDs and the RNAP core enzyme. Structural analysis also unravels that GlnR-TAC is stabilized by complex protein-protein interactions between GlnR and the conserved β flap, σAR4, αCTD, and αNTD domains of RNAP, which are further confirmed by our biochemical assays. Taken together, these results reveal a global transcription activation mechanism for the master regulator GlnR and other OmpR/PhoB subfamily proteins and present a unique mode of bacterial transcription regulation.

Defect Dipole Behaviors on the Strain Performances of Bismuth Sodium Titanate-Based Lead-Free Piezoceramics

Bismuth sodium titanate (BNT)-based, lead-free piezoelectric materials have been extensively studied due to their excellent strain characteristics and environmental friendliness. In BNTs, the large strain (S) usually requires a relatively large electric field (E) excitation, resulting in a low inverse piezoelectric coefficient d₃₃* (S/E). Moreover, the hysteresis and fatigue of strain in these materials have also been bottlenecks impeding the applications. The current common regulation method is chemical modification, which mainly focuses on forming a solid solution near the morphotropic phase boundary (MPB) by adjusting the phase transition temperature of the materials, such as BNT-BaTiO₃, BNT-Bi_0.5K_0.5TiO₃, etc., to obtain a large strain. Additionally, the strain regulation based on the defects introduced by the acceptor, donor, or equivalent dopant or the nonstoichiometry has proven effective, but its underlying mechanism is still ambiguous. In this paper, we review the generation of strain and then discuss it from the domain, volume, and boundary effect perspectives to understand the defect dipole behavior. The asymmetric effect caused by the coupling between defect dipole polarization and ferroelectric spontaneous polarization is expounded. Moreover, the defect effect on the conductive and fatigue properties of BNT-based solid solutions is described, which will affect the strain characteristics. The optimization approach is appropriately evaluated while there are still challenges in the full understanding of the defect dipoles and their strain output, in which further efforts are needed to achieve new breakthroughs in atomic-level insight.

Effects of atrazine on microbial metabolic limitations in black soils: Evidence from enzyme stoichiometry

Long-term input of agricultural chemicals such as pesticides into the soil can increase soil pollution, thereby affecting the productivity and quality of black soil. Triazine herbicide atrazine has been shown to have long-lasting residual effects in black soil. The atrazine residues affected soil biochemical properties, further leading to microbial metabolism restriction. It is necessary to explore the strategies to mitigate the limitations on microbial metabolism in atrazine-contaminated soils. Here, we evaluated the effect of the atrazine on microbial nutrient acquisition strategies as indicated by extracellular enzyme stoichiometry (EES) in four black soils. Atrazine degradation in soil followed the first-order kinetics model across various concentrations ranging from 10 to 100 mg kg^-1. We found that the atrazine was negatively correlated with the EES for C-, N-, and P-acquisition. Vector lengths and angles decreased and increased significantly with an increase of atrazine concentration in tested black soils except for Lishu soils. Moreover, the vector angles were >45° for tested four black soils, indicating that atrazine residue had the greatest P-limitation on soil microorganisms. Interestingly, microbial C- and P-limitations with different atrazine concentrations showed a strong linear relationship, especially in Qiqihar and Nongan soils. Atrazine treatment significantly negatively affected microbial metabolic limitation. Soil properties and EES interaction explained up to 88.2% for microbial C-/P-limitation. In conclusion, this study confirms the EES as a useful method in evaluating the effects of pesticides on microbial metabolic limitations.

Analysis of the status of social frailty in Chinese older adults with cardiovascular and cerebrovascular diseases: a national cross-sectional study

Background

Social frailty is one type of frailty. Physical frailty with cardiovascular and cerebrovascular diseases (CCVD) have been studied a lot, but less research on social frailty.

Objectives

To study the prevalence, related risk factors and regional differences of social frailty with CCVD in Chinese older adults.

Methods

SSAPUR was a national cross-sectional survey. Participants aged 60 years or older were recruited in August 2015. Demographic data and information regarding family, health and medical conditions, living environment conditions, social participation, spiritual and cultural life, and health condition were obtained. Social frailty was assessed in five areas (HALFE Social Frailty Index) including inability to help others, limited social participation, loneliness, financial difficulty, and living alone. The prevalence of CCVD with social frailty, related risk factors and regional differences in CCVD with social frailty were studied.

Results

A total of 222,179 participants were enrolled. 28.4% of them had CCVD history. The prevalence of social frailty in the CCVD group was 16.03%. In CCVD participants, compared with the group without social frailty, there were significant differences in gender, age, urban-rural distribution, ethnicity, marital status, and education levels in the social frailty group. Significant differences were also found in physical exercise participation, health status, cataract, hypertension, diabetes mellitus, hospitalization within 1 year, self-assessed health status, crutch or wheelchair usage, urinary and fecal incontinence, need for care from others, fall history, housing satisfaction, and self-assessed happiness in the social frailty group. Women with CCVD had a higher prevalence of social frailty than men. By age in CCVD with social frailty, the highest prevalence was found in participants 75-79 years old. The prevalence of CCVD was significant difference between social frailty in urban and rural group. The prevalence of social frailty with CCVD was significantly different in different regions. The highest prevalence was 20.4% in southwest area, and the lowest prevalence was 12.5% in northeast with area.

Conclusion

The prevalence of social frailty among the CCVD older adults is high. Factors such as gender, age, region, urban-rural residence, and the state of the disease may be associated with social frailty.

Densified graphene-like carbon nanosheets with enriched heteroatoms enabling superior gravimetric and volumetric potassium storage capacities

Constructing carbon electrodes with abundant heteroatoms and appropriate graphitic interlayer spacing remains a major challenge for achieving high gravimetric and volumetric potassium storage capacities with fast kinetics. Herein, we constructed 3D graphene-like N, F dual-doped carbon sheets induced by Ni template (N, F-CNS-Ni) with dense structure and rich active sites, providing a promising approach to address the facing obstacles. Highly reversible K-ion insertion/extraction is realized in the graphitic carbon structure, and K-adsorption capability is enhanced by introducing N/F heteroatoms. As a result, the N, F-CNS-Ni electrode exhibits ultrahigh gravimetric and volumetric capacities of 404.5 mA h g^-1 and 281.3 mA h cm^-3 at 0.05 A/g, respectively, and a superb capacity of 259.3 mA h g^-1 with a capacity retention ratio of 90 % even after 600 cycles at 5 A/g. This work presents a simple Ni-based template method to prepare graphene-like carbon nanosheets with high packing density and rich heteroatoms, and offers mechanism insight for achieving superior K-ion storage.

The role of anti-HMGB1 antibody and anti-moesin antibody in ANCA-associated vasculitis

OBJECTIVE

The study aims to evaluate the role of anti-high mobility group box 1 (HMGB1) antibody and anti-moesin antibody in the diagnosis of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and its possible relationship with the different clinical manifestations.

METHODS

The study involved 60 AAV patients, 58 patients with autoimmune disease other than AAV and 50 healthy subjects. The serum levels of anti-HMGB1 and anti-moesin antibodies were determined by enzyme-linked immunosorbent assay (ELISA), and the second determination was made 3 months after treatment of AAV patients.

RESULTS

Serum levels of anti-HMGB1 and anti-moesin antibodies in AAV group were significantly higher than those in non-AAV group and HC group. The area under the curve (AUC) of anti-HMGB1 and anti-moesin in diagnosing AAV were 0.977 and 0.670, respectively. Anti-HMGB1 levels were significantly elevated in AAV patients with pulmonary involvement, while the concentrations of anti-moesin were significantly increased in patients with renal damage. Anti-moesin were positively correlated with BVAS (r=0.261, P=0.044), creatinine (r=0.296, P=0.024) and negatively correlated with complement C3 (r=-0.363, P=0.013). Besides, anti-moesin levels of active AAV patients were significantly higher than those in inactive patients. The concentrations of serum anti-HMGB1 could be significantly decreased after induction remission treatment (P<0.05).

CONCLUSION

Anti-HMGB1 and anti-moesin antibodies play important roles in the diagnosis and prognosis of AAV, which may act as potential disease markers for AAV.

Mechanism of trophoblast cell-derived microparticles mediated immunocontraceptive response

PROBLEM

Immunomodulation profoundly affects the process of human implantation. Trophoblast cell-derived microparticles (Tr-MPs) may activate specific T cells to attack trophoblast cells, thus potentially acting as an immunocontraceptive vaccine. The safety and persistence of Tr-MP vaccine are needed to address.

METHOD OF STUDY

Flow cytometry and confocal fluorescent microscopy were conducted to detect cellular absorptivity and localization of Tr-MPs in bone marrow-derived dendritic cells (BMDCs). The phenotype and cytokine secretion of BMDC and T cells were performed by flow cytometry and enzyme-linked immuno sorbent assay (ELISA). The constructed vaccine female moused model were used to observe the infertile effect and safety of Tr-MPs.

RESULTS

As compared with non-irradiation exposure groups, the number of MPs released by trophoblast cells in ultraviolet immunized groups significantly increased. The phagocytosis of Tr-MPs led to the maturation of dendritic cells (DCs), which, in turn, activate T cells. Then cytotoxic T cells attacking trophoblast cells. In mouse model, female mice were infertile after receiving Tr-MPs, and the effect of contraception is transient and safety.

CONCLUSION

Using Tr-MPs to initiate an adaptive immune response against alloantigens in trophoblast cells. Tr-MPs may be a new candidate for the development of contraceptive vaccines due to its effectiveness, safety, and reversibility.

Effects of glucosamine hydrochloride combined with non-steroidal anti-inflammatory drugs on symptoms and HSS scores in patients with knee osteoarthritis

To investigate the effects of glucosamine hydrochloride combined with non-steroidal anti-inflammatory drugs on symptoms and HSS scores in patients with knee osteoarthritis (KOA). Totally 80 cases of patients with KOA admitted to Cangzhou Hospital of integrated TCM-WM from February 2016 to December 2019 were selected and divided into the Control Group and Observation Group by Random Number Table Method, with 40 cases in each group. After treatment, the Observation Group tends to have lower VAS scores and WOMAC scores than the Control Group (P<0.05). The Observation Group tends to perform better than the Control Group on symptom improvement rate and HSS scores (P<0.05). The expression levels of related inflammatory factors and matrix metalloproteinase (MMPs) are similar before and after treatment in the Control Group (P>0.05). The expression levels of related inflammatory factors and MMPs get lower after treatment in the Observation Group (P<0.05). The evaluation indexes and total scores of the Observation Group are better than those of the Control Group (P<0.05). Glucosamine hydrochloride combined with non-steroidal anti-inflammatory drugs treatment could decrease the expression levels of inflammatory cytokines, relieve knee pain and arthritis symptoms, improve knee function and improve the HSS scores in patients with KOA.

The correlation of serum musclin with diabetic nephropathy

OBJECTIVE

Musclin is a recently found myokine involved in the process of glucose metabolism. The purpose of the present investigation is to evaluate the relationship between serum musclin levels and diabetic nephropathy (DN).

METHODS

The current investigation included 175 (T2DM) cases and 62 controls. T2DM patients were divided into three subgroups: normoalbuminuria (DN0), microalbuminuria (DN1), and macroalbuminuria (DN2) on the basis of the values of urine albumin to creatinine ratio (ACR).

RESULTS

T2DM group displayed higher serum musclin than the controls. Serum musclin were remarkably elevated in DN2 subgroup compared with DN0 and DN1 subgroups. In addition, elevated serum musclin was observed in DN1 subgroup than in the DN0 subgroup. Serum musclin was correlated with an increased risk of having T2DM and DN using a logistic regression model. Linear regression analysis showed that serum musclin was negatively related with gender, and positively related with body mass index, systolic blood pressure, blood urea nitrogen, creatinine, and ACR.

CONCLUSION

Serum musclin increases with the progressed stages of DN. Serum musclin is associated with renal function parameters and ACR.

Analysis of risk factors for postoperative bleeding and recurrence after laparoscopic myomectomy in patients with uterine fibroids: a retrospective cohort study

Background

In Asia, the incidence of uterine fibroids (UFs) in women is as high as 1.278%. However, there are few analyses of the prevalence and independent risk factors for bleeding and recurrence after laparoscopic myomectomy (LM). This study aimed to analyze the clinical characteristics of patients with UF and identify the independent risk factors for postoperative bleeding and recurrence after LM, so as to provide a reference basis for improving the quality of life of patients.

Methods

Based on our exclusion and inclusion criteria, we retrospectively analyzed a total of 621 patients who developed UF from April 2018 to June 2021. The t-test, analysis of variance (ANOVA), and chi-square test were used to analyze the relationship between the clinical characteristics of the patients and postoperative bleeding as well as recurrence. Binary logistic regression was used to analyze the independent risk factors for the occurrence of postoperative bleeding and fibroid recurrence in patients.

Results

The rates of postoperative bleeding and recurrence after LM for uterine fibroids were 4.5% and 7.1%, respectively. Binary logistic regression analysis showed that fibroid size [odds ratio (OR) =5.502, P=0.003], maximum fibroid type (OR =0.293, P=0.048), pathological type (OR =3.673, P=0.013), preoperative prothrombin time level (OR =1.340, P=0.003), preoperative hemoglobin level (OR =0.227, P=0.036), surgery time (OR =1.066, P=0.022), intraoperative bleeding (OR =1.145, P=0.007), and postoperative infection (OR =9.540, P=0.010) were independent risk factors for postoperative bleeding; meanwhile, body mass index (BMI) (OR =1.268, P=0.001), age of menarche (OR =0.780, P=0.013), fibroid size (OR =4.519, P=0.000), fibroid number (OR =2.381, P=0.033), maximum fibroid type (OR =0.229, P=0.001), pathological type (OR =2.963, P=0.008), preoperative delivery (OR =3.822, P=0.003), preoperative C-reactive protein (CRP) level (OR =1.162, P=0.005), intraoperative ultrasonography (OR =0.271, P=0.002), postoperative gonadotropin-releasing hormone agonist treatment (OR =2.407, P=0.029), and postoperative infection (OR =7.402, P=0.005) were independent risk factors for recurrence.

Conclusions

At present, there is still a high probability of postoperative bleeding and recurrence after LM for UF. Clinical work should pay close attention to clinical features. Adequate preoperative examination to improve surgical precision, and strengthen postoperative care and education, thus reducing the probability of postoperative bleeding and recurrence in patients.

[Long-term outcome of EVAHEART I implantable ventricular assist device for the treatment of end stage heart failure: clinical 3-year follow-up results of 15 cases]

Objective: To evaluate the long-term efficacy and safety of the implantable ventricular assist system EVAHEART I in clinical use. Methods: Fifteen consecutive patients with end-stage heart failure who received left ventricular assist device therapy in Fuwai Hospital from January 2018 to December 2021 were enrolled in this study, their clinical data were retrospectively analyzed. Cardiac function, liver and kidney function, New York Heart Association (NYHA) classification, 6-minute walk distance and quality of life were evaluated before implantation and at 1, 6, 12, 24 and 36 months after device implantation. Drive cable infection, hemolysis, cerebrovascular events, mechanical failure, abnormally high-power consumption and abnormal pump flow were recorded during follow up. Results: All 15 patients were male, mean average age was (43.0±7.5) years, including 11 cases of dilated cardiomyopathy, 2 cases of ischemic cardiomyopathy, and 2 cases of valvular heart disease. All patients were hemodynamically stable on more than one intravenous vasoactive drugs, and 3 patients were supported by preoperative intra aortic balloon pump (IABP). Compared with before device implantation, left ventricular end-diastolic dimension (LVEDD) was significantly decreased ((80.93±6.69) mm vs. (63.73±6.31) mm, P<0.05), brain natriuretic peptide (BNP), total bilirubin and creatinine were also significantly decreased ((3 544.85±1 723.77) ng/L vs. (770.80±406.39) ng/L; (21.28±10.51) μmol/L vs. (17.39±7.68) μmol/L; (95.82±34.88) μmol/L vs. (77.32±43.81) μmol/L; P<0.05) at 1 week after device implantation. All patients in this group were in NYHA class Ⅳ before implantation, and 9 patients could recover to NYHA class Ⅲ, 3 to class Ⅱ, and 3 to class Ⅰ at 1 month after operation. All patients recovered to class Ⅰ-Ⅱ at 6 months after operation. The 6-minute walk distance, total quality of life and visual analogue scale were significantly increased and improved at 1 month after implantation compared with those before operation (P<0.05). All patients were implanted with EVAHEART I at speeds between 1 700-1 950 rpm, flow rates between 3.2-4.5 L/min, power consumption of 3-9 W. The 1-year, 2-year, and 3-year survival rates were 100%, 87%, and 80%, respectively. Three patients died of multiple organ failure at 412, 610, and 872 d after surgery, respectively. During long-term device carrying, 3 patients developed drive cable infection on 170, 220, and 475 d after surgery, respectively, and were cured by dressing change. One patient underwent heart transplantation at 155 d after surgery due to bacteremia. Three patients developed transient ischemic attack and 1 patient developed hemorrhagic stroke events, all cured without sequelae. Conclusion: EVAHEART I implantable left heart assist system can effectively treat critically ill patients with end-stage heart failure, can be carried for long-term life and significantly improve the survival rate, with clear clinical efficacy.

An SI3-σ arch stabilizes cyanobacteria transcription initiation complex

Multisubunit RNA polymerases (RNAPs) associate with initiation factors (σ in bacteria) to start transcription. The σ factors are responsible for recognizing and unwinding promoter DNA in all bacterial RNAPs. Here, we report two cryo-EM structures of cyanobacterial transcription initiation complexes at near-atomic resolutions. The structures show that cyanobacterial RNAP forms an "SI3-σ" arch interaction between domain 2 of σ^A (σ₂) and sequence insertion 3 (SI3) in the mobile catalytic domain Trigger Loop (TL). The "SI3-σ" arch facilitates transcription initiation from promoters of different classes through sealing the main cleft and thereby stabilizing the RNAP-promoter DNA open complex. Disruption of the "SI3-σ" arch disturbs cyanobacteria growth and stress response. Our study reports the structure of cyanobacterial RNAP and a unique mechanism for its transcription initiation. Our data suggest functional plasticity of SI3 and provide the foundation for further research into cyanobacterial and chloroplast transcription.

uRP: An integrated research platform for one-stop analysis of medical images

Introduction

Medical image analysis is of tremendous importance in serving clinical diagnosis, treatment planning, as well as prognosis assessment. However, the image analysis process usually involves multiple modality-specific software and relies on rigorous manual operations, which is time-consuming and potentially low reproducible.

Methods

We present an integrated platform - uAI Research Portal (uRP), to achieve one-stop analyses of multimodal images such as CT, MRI, and PET for clinical research applications. The proposed uRP adopts a modularized architecture to be multifunctional, extensible, and customizable.

Results and Discussion

The uRP shows 3 advantages, as it 1) spans a wealth of algorithms for image processing including semi-automatic delineation, automatic segmentation, registration, classification, quantitative analysis, and image visualization, to realize a one-stop analytic pipeline, 2) integrates a variety of functional modules, which can be directly applied, combined, or customized for specific application domains, such as brain, pneumonia, and knee joint analyses, 3) enables full-stack analysis of one disease, including diagnosis, treatment planning, and prognosis assessment, as well as full-spectrum coverage for multiple disease applications. With the continuous development and inclusion of advanced algorithms, we expect this platform to largely simplify the clinical scientific research process and promote more and better discoveries.

Blood eosinophils to direct oral corticosteroid treatment for patients with nasal polyps - an open label, non-inferiority, randomized control trial

BACKGROUND

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous disorder. We aimed to evaluate the value of blood eosinophil count (BEC) for guiding oral corticosteroid therapy for CRSwNP.

METHODS

Subjects with CRSwNP were entered into a 2:1 randomized biomarker-directed corticosteroid versus standard therapy study base on the principle of potential benefits to patients. Subjects in the standard arm received oral prednisone (30mg/day) alone for 7 days, whereas in the biomarker-directed arm, prednisone (30mg/day), or nasal steroid spray (budesonide 256ug/day) was given according to the BEC which was measured to define eosinophil-high and -low CRSwNP (BEC ≥ and &lt; 0.37×109/L, respectively). The primary outcome was the total nasal symptom scores (TNSS) of the two arms with the non-inferiority margin of 1.8. Secondary outcomes included nasal polyp size scores (NPSS) and SNOT-22. Patients were followed up the day after last dose of treatment.

RESULTS

A total of 105 subjects with CRSwNP were randomized into the biomarker-directed therapy group or the standard care group. The biomarker therapy demonstrated non-inferiority compared to standard care. There were no between-group differences for TNSS, NPSS and SNOT-22 improvements after treatment. Comparisons of TNSS, SNOT-22 and NPSS revealed no significant difference in terms of the effectiveness ratios of the biomarker-directed therapy and the standard care.

CONCLUSION

A biomarker-directed strategy using the BEC can be used to direct corticosteroid therapy without increasing treatment failure or worsening of symptoms in patients with CRSwNP.

The association between combustible/electronic cigarette use and stroke based on national health and nutrition examination survey

AIMS

This study aims to analyze the association between combustible/electronic cigarettes and the risk of stroke.

METHODS

We obtained data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES). The stroke history and combustible/electronic cigarette use were acquired by questionnaires. Considering the sole or dual use of combustible cigarettes and electronic cigarettes (e-cigarettes), we divided all the individuals into four subgroups, including nonsmokers (reference group), sole combustible cigarette, sole e-cigarette, and dual use of both combustible cigarettes and e-cigarettes. We performed multivariable logistic regression to determine the association between cigarette use with the prevalence of stroke. We used odds ratios (ORs) with 95% confidence intervals (CIs) to show the effect size. Finally, we developed a prediction model to evaluate the risk of stroke for individuals with combustible or electronic cigarette use based on a random forest model.

RESULTS

We included a total of 4022 participants in the study. The median age was 55, and 48.3% of the participants were males. When we adjusted for age, gender, education attainment, race, total-to-HDL cholesterol (< 5.9 or ≥ 5.9), diabetes, hypertension, and alcohol consumption, the groups of sole e-cigarette use, sole combustible cigarette use, and dual use of combustible and electronic cigarettes were significantly associated with the prevalence of stroke with ORs (with 95%CI) of 2.07 (1.04-3.81), 2.36 (1.52-3.59), 2.34 (1.44-3.68), respectively. In the testing set, the AUC was 0.74 (95%CI = 0.65-0.84), sensitivity was 0.68, and specificity was 0.75.

CONCLUSION

Sole e-cigarettes and dual use of e-cigarettes with combustible cigarettes might increase the risk of stroke.

[Concordance between three integrated scores based on prostate biopsy and grade-grouping of radical prostatectomy specimen]

Objective: To analyze three different integrated scoring schemes of prostate biopsy and to compare their concordance with the scoring of radical prostatectomy specimens. Methods: A retrospective analysis of 556 patients with radical prostatectomy performed in Nanjing Drum Tower Hospital, Nanjing, China from 2017 to 2020. In these cases, whole organ sections were performed, the pathological data based on biopsy and radical prostatectomy specimens were summarized, and 3 integrated scores of prostate biopsy were calculated, namely the global score, the highest score and score of the largest volume. Results: Among the 556 patients, 104 cases (18.7%) were classified as WHO/ISUP grade group 1, 227 cases (40.8%) as grade group 2 (3+4=7); 143 cases (25.7%) as grade group 3 (4+3=7); 44 cases (7.9%) as grade group 4 (4+4=8) and 38 cases (6.8%) as grade group 5. Among the three comprehensive scoring methods for prostate cancer biopsy, the consistency of global score was the highest (62.4%). In the correlation analysis, the correlation between the scores of radical specimens and the global scores was highest (R=0.730, P<0.01), while the correlations of the scores based on radical specimens with highest scores and scores of the largest volume based on biopsy were insignificant (R=0.719, P<0.01; R=0.631, P<0.01, respectively). Univariate and multivariate analyses showed tPSA group and the three integrated scores of prostate biopsy were statistically correlated with extraglandular invasion, lymph node metastasis, perineural invasion and biochemical recurrence. Elevated global score was an independent prognostic risk factor for extraglandular invasion and biochemical recurrence in patients; increased serum tPSA was an independent prognostic risk factor for extraglandular invasion; increased hjighest score was an independent risk factor for perineural invasion. Conclusions: In this study, among the three different integrated scores, the overall score is most likely corresponded to the radical specimen grade group, but there is difference in various subgroup analyses. Integrated score of prostate biopsy can reflect grade group of radical prostatectomy specimens, thereby providing more clinical information for assisting in optimal patient management and consultation.

[Expression of GPNMB in renal eosinophilic tumors and its value in differential diagnosis]

Objective: To investigate the expression of glycoprotein non metastatic melanoma protein B (GPNMB) in renal eosinophilic tumors and to compare the value of GPNMB with CK20, CK7 and CD117 in the differential diagnosis of renal eosinophilic tumors. Methods: Traditional renal tumor eosinophil subtypes, including 22 cases of renal clear cell carcinoma eosinophil subtype (e-ccRCC), 19 cases of renal papillary cell carcinoma eosinophil subtype (e-papRCC), 17 cases of renal chromophobe cell carcinoma eosinophil subtype (e-chRCC), 12 cases of renal oncocytoma (RO) and emerging renal tumor types with eosinophil characteristics [3 cases of eosinophilic solid cystic renal cell carcinoma (ESC RCC), 3 cases of renal low-grade eosinophil tumor (LOT), 4 cases of fumarate hydratase-deficient renal cell carcinoma (FH-dRCC) and 5 cases of renal epithelioid angiomyolipoma (E-AML)], were collected at the Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2017 to March 2022. The expression of GPNMB, CK20, CK7 and CD117 was detected by immunohistochemistry and statistically analyzed. Results: GPNMB was expressed in all emerging renal tumor types with eosinophil characteristics (ESC RCC, LOT, FH-dRCC) and E-AML, while the expression rates in traditional renal eosinophil subtypes e-papRCC, e-chRCC, e-ccRCC and RO were very low or zero (1/19, 1/17, 0/22 and 0/12, respectively); the expression rate of CK7 in LOT (3/3), e-chRCC (15/17), e-ccRCC (4/22), e-papRCC (2/19), ESC RCC (0/3), RO (4/12), E-AML(1/5), and FH-dRCC (2/4) variedly; the expression of CK20 was different in ESC RCC (3/3), LOT(3/3), e-chRCC(1/17), RO(9/12), e-papRCC(4/19), FH-dRCC(1/4), e-ccRCC(0/22) and E-AML(0/5), and so did that of CD117 in e-ccRCC(2/22), e-papRCC(1/19), e-chRCC(16/17), RO(10/12), ESC RCC(0/3), LOT(1/3), E-AML(2/5) and FH-dRCC(1/4). GPNMB had 100% sensitivity and 97.1% specificity in distinguishing E-AML and emerging renal tumor types (such as ESC RCC, LOT, FH-dRCC) from traditional renal tumor types (such as e-ccRCC, e-papRCC, e-chRCC, RO),respectively. Compared with CK7, CK20 and CD117 antibodies, GPNMB was more effective in the differential diagnosis (P<0.05). Conclusion: As a new renal tumor marker, GPNMB can effectively distinguish E-AML and emerging renal tumor types with eosinophil characteristics such as ESC RCC, LOT, FH-dRCC from traditional renal tumor eosinophil subtypes such as e-ccRCC, e-papRCC, e-chRCC and RO, which is helpful for the differential diagnosis of renal eosinophilic tumors.

Integrated QTL Mapping, Meta-Analysis, and RNA-Sequencing Reveal Candidate Genes for Maize Deep-Sowing Tolerance

Synergetic elongation of mesocotyl and coleoptile are crucial in governing maize seedlings emergence, especially for the maize sown in deep soil. Studying the genomic regions controlling maize deep-sowing tolerance would aid the development of new varieties that are resistant to harsh conditions, such as drought and low temperature during seed germination. Using 346 F2:3 maize population families from W64A × K12 cross at three sowing depths, we identified 33 quantitative trait loci (QTLs) for the emergence rate, mesocotyl, coleoptile, and seedling lengths via composite interval mapping (CIM). These loci explained 2.89% to 14.17% of phenotypic variation in a single environment, while 12 of 13 major QTLs were identified at two or more sowing environments. Among those, four major QTLs in Bin 1.09, Bin 4.08, Bin 6.01, and Bin 7.02 supported pleiotropy for multiple deep-sowing tolerant traits. Meta-analysis identified 17 meta-QTLs (MQTLs) based on 130 original QTLs from present and previous studies. RNA-Sequencing of mesocotyl and coleoptile in both parents (W64A and K12) at 3 cm and 20 cm sowing environments identified 50 candidate genes expressed differentially in all major QTLs and MQTLs regions: six involved in the circadian clock, 27 associated with phytohormones biosynthesis and signal transduction, seven controlled lignin biosynthesis, five regulated cell wall organization formation and stabilization, three were responsible for sucrose and starch metabolism, and two in the antioxidant enzyme system. These genes with highly interconnected networks may form a complex molecular mechanism of maize deep-sowing tolerance. Findings of this study will facilitate the construction of molecular modules for deep-sowing tolerance in maize. The major QTLs and MQTLs identified could be used in marker-assisted breeding to develop elite maize varieties.

S100A6 Activates Kupffer Cells via the p-P38 and p-JNK Pathways to Induce Inflammation, Mononuclear/macrophage Infiltration Sterile Liver Injury in Mice

Noninfectious liver injury, including the effects of chemical material, drugs and diet, is a major cause of liver diseases worldwide. In chemical and drugs-induced liver injury, innate inflammatory responses are mediated by extracellular danger signals. The S100 protein can act as danger signals, which can promote the migration and chemotaxis of immune cells, promote the release of various inflammatory cytokines, and regulate the body's inflammatory and immune responses. However, the role of S100A6 in inflammatory response in chemical and drugs-induced sterile liver injury remains unclear. We constructed the model of sterile liver injury induced by carbon tetrachloride (CCl₄)/Paracetamol (APAP) and performed RNA sequencing (RNA-seq) on the liver tissues after injury (days 2 and 5). We analyzed inflammatory protein secretion in the liver tissue supernatant by enzyme-linked immunosorbent assay (ELISA), determined the inflammation response by bioinformatic analysis during sterile liver injury, and assessed mononuclear/macrophage infiltration by immunohistochemistry and flow cytometry. Immunohistochemistry was used to analyze the location of S100A6. We conducted inflammatory factor expression analysis and molecular mechanistic studies in Kupffer cells (KCs) induced by S100A6 using quantitative reverse transcription-polymerase chain reaction (qRT-PCR), ELISA, and western blot in vitro experiments. We performed chemokine CCL2 expression analysis and molecular mechanism studies using the same method. We used a Transwell assay to show the infiltration of mononuclear/macrophage. We here observed that aggravated inflammatory response was shown in CCl₄ and APAP-administrated mice, as evidenced by enhanced production of inflammatory cytokines (TNF-α, IL-1β), and elevated mononuclear/macrophage infiltration and activation of immunity. The expression of S100A6 was significantly increased on day 2 after sterile liver injury, which is primarily produced by injured liver cells. Mechanistic studies established that S100A6 activates Kupffer cells (KCs) via the p-P38, p-JNK and P65 pathways to induce inflammation in vitro. Furthermore, TNF-α can stimulate liver cells via the p-P38 and p-JNK pathways to produce CCL2 and promote the infiltration of mononuclear/macrophage. In summary, we showed that S100A6 plays an important role in regulating inflammation, thus influencing sterile liver injury. Our findings provide novel evidence that S100A6 can as a danger signal that contributes to pro-inflammatory activation through p-P38 and p-JNK pathways in CCl₄ and APAP-induced sterile liver injury in mice. In addition, the inflammatory factor TNF-α induces a large amount of CCL2 production in normal liver cells surrounding the injured area through a paracrine action, which is chemotactic for blood mononuclear/macrophage infiltration.

Oral Chinese Medicine for the treatment of targeted therapy-induced diarrhea: a systematic review and meta-analysis

OBJECTIVE

The treatment of targeted therapy-induced diarrhea, a common adverse reaction of targeted therapy, with traditional Chinese medicine (TCM) has unique advantages; however, a unified TCM prescription is currently missing in clinical practice, and objective outcome indicators are lacking. Here, we aimed to provide medical evidence for the use of oral TCM in the treatment of targeted therapy-induced diarrhea. To this end, we systematically reviewed the literature evaluating the clinical efficacy of oral TCM for the treatment of targeted therapy-induced diarrhea.

MATERIALS AND METHODS

The Chinese National Knowledge Infrastructure, China Biology Medicine disc, Technology Journal Database, Wanfang Medical Network, PubMed, Cochrane Library, EMBASE, MEDLINE, and OVID databases were used for a literature search of clinical randomized controlled trials examining the use of oral TCM in the treatment of targeted therapy-induced diarrhea until February 2022. A meta-analysis was performed using RevMan 5.3 software.

RESULTS

In total, 490 relevant studies were screened, 480 were excluded based on the inclusion and exclusion criteria, and 10 clinical studies were finally included. The 10 studies included a total of 555 patients: 279 in the treatment group and 276 in the control group. The improvements in total clinical efficiency, TCM syndrome score, and graded efficacy of diarrhea in the treatment group were better than those in the control group (p<0.01); however, there was no difference in the Karnofsky Performance Scale score between the groups. The funnel plot for total clinical efficiency was symmetrical, and the publication bias was found to be low.

CONCLUSIONS

Oral TCM is an effective treatment for targeted therapy-induced diarrhea and can significantly improve the clinical symptoms and quality of life of patients.

Insights on the isolation, identification, and degradation characteristics of three bacterial strains against mandipropamid and their application potential for polluted soil remediation

Bacteria-induced biodegradation techniques have become an effective approach for removing pesticide residues from polluted soils. However, their effect on chiral fungicides must be systematically evaluated and the efficiency and risk of each chiral enantiomer must be better understood. In this study, we isolated and enriched seven bacterial strains that are able to degrade mandipropamid from contaminated soil samples. Three bacterial strains with high degradation efficiency (63.6%-73.4%) were screened and identified as Pseudomonas sp. (M01), Mycolicibacterium parafortuitum (MW05), and Stenotrophomonas maltophilia (MW09) by morphological and 16S rRNA gene sequencing analyses. The degradation characteristics of three strains (M01, MW05, and MW09) was investigated and it was revealed that pH, temperature, and initial concentration of mandipropamid significantly impacted their degradation efficiency. The optimal conditions for degradation were a nutrient source of mandipropamid and an inoculation amount of 5%. We used a Box-Behnken model experiment and an analysis of variance to determine the most suitable conditions for degrading mandipropamid at various pH, temperature, and initial concentration levels. A response surface methodology analysis showed that the three strains had the highest mandipropamid degradation efficiency (> 96%) under various conditions (pH: 7.15-7.71, temperature: 28.61-30.76 °C, initial concentration: 5.524-5.934 mg/L). Mycelial, intracellular, and extracellular enzymes also had an impact on the degradation of mandipropamid enantiomers by the three strains. In soil remediation trials, the three bacterial strains could effectively enantioselectively degrade rac-mandipropamid residues in polluted sterilized and natural soil samples (R-enantiomer was degraded faster) and influence the activity of urease and β-glucosidase in the soil. The results revealed several candidate bacterial strains for mandipropamid biodegradation and provide information on mandipropamid biological detoxification in soil environments.

Mechanism of Antifungal Activity of Piperine against Botrytis cinerea

P iperine is a major component of plants of the Piperaceae family which is widely used in medical science. Botrytis cinerea is one of the most important phytopathogenic fungi causes postharvest losses in fruits and vegetables. To verify the possibility of using piperine as a botanical fungicide against B. cinerea, we determined the in vivo and in vitro antifungal activity of piperine against B. cinerea and investigated its antifungal mechanism effects on the mycelial surface, membrane integrity, soluble protein content, superoxide dismutase, catalase, succinate dehydrogenase and the malondialdehyde content of B. cinerea. The in vitro antifungal activity assay indicated that the EC50 value of piperine against B. cinerea was 58.66 μg/mL and the in vivo antifungal assay showed that piperine at 400 μg/mL suppressed 93.88% growth of B. cinerea on Lycopersic esculentum. The antifungal mechanism assay showed that piperine could inhibit mycelial growth of B. cinerea by reducing antioxidant activity, inhibiting the tricarboxylic acid pathway, and lysing the cell membrane. All these results indicated that piperine as a natural component has the potential to control B. cinerea and can be considered as a botanical fungicide for postharvest disease control of gray mold.

[Associations between various lipid components and premature myocardial infarction: a cross-sectional study]

Objective: Hyperlipidemia is closely related to premature acute myocardial infarction (AMI). The present study was performed to explore the correlation between various blood lipid components and the risk of premature AMI. Methods: This is a cross-sectional retrospective study. Consecutive patients with acute ST-segment elevation myocardial infarction (STEMI), who completed coronary angiography from October 1, 2020 to September 30, 2022 in our hospital, were enrolled and divided into premature AMI group (male<55 years old, female<65 years old) and late-onset AMI group. Total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), non-HDL-C, lipoprotein (a) (Lp (a)), apolipoprotein B (ApoB), apolipoprotein A-1 (ApoA-1), non-HDL-C/HDL-C and ApoB/ApoA-1 were analyzed. The correlation between the above blood lipid indexes and premature AMI was analyzed and compared by logistic regression, restricted cubic spline and receiver operating characteristic curve (ROC). Results: A total of 1 626 patients with STEMI were enrolled in this study, including 409 patients with premature AMI and 1 217 patients with late-onset AMI. Logistic regression analysis showed that the risk of premature AMI increased significantly with the increase of TG, non-HDL-C/HDL-C, non-HDL-C, ApoB/ApoA-1, TC and ApoB quintiles; while LDL-C, ApoA-1 and Lp (a) had no significant correlation with premature AMI. The restricted cubic spline graph showed that except Lp (a), LDL-C, ApoA-1 and ApoB/ApoA-1, other blood lipid indicators were significantly correlated with premature AMI. The ROC curve showed that TG and non-HDL-C/HDL-C had better predictive value for premature AMI. Inconsistency analysis found that the incidence and risk of premature AMI were the highest in patients with high TG and high non-HDL-C/HDL-C. Conclusion: TG, non-HDL-C/HDL-C and other blood lipid indexes are significantly increased in patients with premature AMI, among which TG is the parameter, most closely related to premature AMI, and future studies are needed to explore the impact of controlling TG on incidence of premature AMI.

Effect of focused power ultrasound-mediated perirenal fat modification on primary hypertension: protocol of a multicenter, randomized, double-blinded, sham-controlled study

Background

Perirenal fat plays a key role in sustaining pathological high blood pressure. We aim to investigate the efficacy of intervention for perirenal fat mediated by focused power ultrasound (FPU) on primary hypertension.

Methods

A multicenter, randomized, sham-controlled, double-blinded trial will be implemented in 200 participants with mild to moderate hypertension. All enrolled participants will be randomly allocated to perirenal fat modification (PFM) intervention using FPU or sham-procedure at a ratio of 1:1 and will be followed up at 24 h, 14 days, 30 days, and 90 days after the intervention. The primary endpoint is changes in office systolic blood pressure (SBP) at 30 days compared with baseline. The secondary endpoints include the changes in office SBP from baseline to 90 days, changes in 24-h mean SBP from baseline to 30 days and 90 days, and changes in heart rate from baseline to 30 days. Safety endpoint is defined as any severe adverse events related to the intervention.

Discussion

The present study is the first to use noninvasive FPU to intervene in perirenal fat to achieve the goal of reducing blood pressure for patients with essential hypertension. Our study is expected to provide a new treatment strategy to control high blood pressure.

Trial registration

ClinicalTrials.gov. NCT05049096. Registered on September 7, 2021.

Protocol version: Version 1.3.1, data 23 August 2021.

Sponsor: Prof. Xiangqing Kong is the principal investigator of this trial.

Cell-liposome delivery system based on neuroinflammation to target the amygdala for ameliorating depressive-like behaviors

Depression is a serious psychiatric disorder with unsatisfactory outcomes due to difficulties in delivering therapeutic molecules from the periphery to the brain. Neuroinflammation plays a key role in neurobiology and the treatment of depression. Neutrophils can cross the blood-brain barrier (BBB) and infiltrate key brain regions related to the pathophysiology of depression during neuroinflammation. N-Acetyl Pro-Gly-Pro (PGP) peptides efficiently bind to CXCR2 receptors on the surface of neutrophils. The neuropeptide oxytocin demonstrated antidepressant properties in preclinical and clinical studies, but its inability to penetrate the BBB hampers its therapeutic applications. In this study, we established a novel drug delivery system based on neutrophil infiltration in key brain regions during neuroinflammation. PGP was used to modify oxytocin-loaded liposomes (PGP-OTL) as the target ligand. Systematic administration of PGP-OTL exhibited enhanced antidepressant properties resulting from elevated oxytocin concentrations, especially in the amygdala, a crucial depression-implicated brain region. Enhanced antidepressant effects of PGP-OTL, similar to the ones caused by central oxytocin infusion, were observed in behavioral measurement including forced swim and tail suspension tests. Our study demonstrated that PGP-OTL can "hitchhike" neutrophils and enhance delivery of therapeutics into the brain, thus providing the means for developing novel cell-liposome-based drug delivery strategies for depression therapy.

Total Biosynthesis of Mutaxanthene Unveils a Flavoprotein Monooxygenase Catalyzing Xanthene Ring Formation

Flavoprotein monooxygenases (FPMOs) play important roles in generating structural complexity and diversity in natural products biosynthesized by type II polyketide synthases (PKSs). In this study, we used genome mining to discover novel mutaxanthene analogues and investigated the biosynthesis of these aromatic polyketides and their unusual xanthene framework. We determined the complete biosynthetic pathway of mutaxathene through in vivo gene deletion and in vitro biochemical experiments. We show that a multifunctional FPMO, MtxO4, catalyzes ring rearrangement and generates the required xanthene ring through a multistep transformation. In addition, we successfully obtained all necessary enzymes for in vitro reconstitution and completed the total biosynthesis of mutaxanthene in a stepwise manner. Our results revealed the formation of a rare xanthene ring in type II polyketide biosynthesis, and demonstrate the potential of using total biosynthesis for the discovery of natural products synthesized by type II PKSs.

Role of the human solute carrier family 14 member 1 gene in hypoxia-induced renal cell carcinoma occurrence and its enlightenment to cancer nursing

BACKGROUND

Hypoxia is considered a critical contributor to renal cell carcinoma progression, including invasion and metastasis. However, the potential mechanisms by which it promotes invasion and metastasis have not yet been clarified. The purpose of this study was to investigate the role and mechanism of hypoxia-induced renal cell carcinoma and provide evidence-based medical proof for improvements to postoperative nursing of renal cell carcinoma patients. A total of 64 patients with renal cell carcinoma were divided into the observation group (nursing based on oxygen administration) and the control group (conventional nursing). Renal function indexes, serum inflammatory factors, and tumor markers were evaluated. The human renal cell carcinoma cell line A498 under hypoxia/normoxia was used as an experimental model in vitro and the biological characteristics and mitochondrial function of the cells were assessed.

RESULTS

Nursing based on oxygen administration decreased the value of renal function indexes, serum inflammatory factors, and tumor markers in renal cell carcinoma patients. Hypoxia was found to induce A498 cell invasion, migration, and the release of inflammatory cytokines, while repressing human solute carrier family 14 member 1 gene expression. Elevated levels of solute carrier family 14 member 1 expression induced mitochondrial reactive oxygen species accumulation, diminished the intracellular adenosine triphosphate level, and destroyed both mitochondrial membrane potential integrity and mitochondrial morphology. Overexpression of the solute carrier family 14 member 1 gene could abolish hypoxia-induced invasion, reduce the migration of A498 cells, inhibit the hypoxia-induced release of inflammatory cytokines, and arrest the cell cycle at the G1/S checkpoint.

CONCLUSIONS

These data reveal that nursing based on oxygen administration can improve the clinical efficacy of renal cell carcinoma therapies, being safe and effective. The results elucidate a mechanism wherein the solute carrier family 14 member 1 gene participates in the occurrence and development of hypoxia-induced renal cell carcinoma in a mitochondria-dependent manner.

Baseline predictors of short-term visual outcomes after intravitreal conbercept injection for neovascular age-related macular degeneration

PURPOSE

Neovascular age-related macular degeneration is the leading cause of vision loss in the elderly. We aimed to identify baseline predictors of visual prognosis after intravitreal conbercept injection for neovascular age-related macular degeneration.

METHODS

We conducted a retrospective review of 58 patients with neovascular age-related macular degeneration who were treated with intravitreal injections of conbercept 0.5 mg in routine clinical practice. Basic information such as age, sex, intraocular pressure, and disease course was collected. Best-corrected visual acuity, mean retinal sensitivity, and optical coherence tomography findings were recorded at baseline and 6 months after treatment. Logistic regression analysis was used to identify independent predictors of best-corrected visual acuity at 6 months after treatment.

RESULTS

After the 6-month treatment, the mean best-corrected visual acuity improved from 1.10 ± 0.42 logarithm of the minimum angle of resolution (logMAR) to 0.41 ± 0.18 logMAR, the mean retinal sensitivity increased from 5.13 ± 0.86 dB to 7.32 ± 1.21 dB, the mean central retinal thickness decreased from 440.38 ± 61.05 μm to 260.01 ± 24.86 μm, and the total number of hyperreflective dots and the number of hyperreflective dots in each retina layer were significantly reduced as compared with those before treatment (all p<0.05). Twenty-two patients showed improved vision, and 36 had unimproved vision. Multivariate analyses revealed that the number of subretinal hyperreflective dots, the state of external limiting membrane, baseline best-corrected visual acuity, and age were independent predictors of best-corrected visual acuity (all p<0.05).

CONCLUSION

Poor recovery of patients after intravitreal conbercept injection may be related to the number of subretinal hyperreflective dots, the state of external limiting membrane, baseline best-corrected visual acuity, and age, which may be used as predictors of short-term visual outcomes and should be fully evaluated before operation.

CircSMAD2 accelerates endometrial cancer cell proliferation and metastasis by regulating the miR-1277-5p/MFGE8 axis

OBJECTIVE

Endometrial cancer (EC) is a common gynecological malignant tumor. CircRNAs play crucial roles in cancer progression and metastasis. However, the biological functions of circRNAs in EC remain largely unknown.

METHODS

CircSMAD2, miR-1277-5p, MFGE8 and relative maker protein expression in EC tissues or cell lines were analyzed by quantitative real-time polymerase chain reaction and Western blot. In vitro and in vivo functional assays, including EDU, CCK8, colony formation, transwell, tube formation and tumor xenograft assays, were conduct to explore the effects of circSMAD2 on EC. Mechanism assays were conducted to confirm the binding between miR-1277-5p and circSMAD2 or MFGE8 expression.

RESULTS

Upregulation of circSMAD2 was uncovered in both EC tissues and cell lines. Functionally, silencing of circSMAD2 apparently inhibited the proliferation, migration, invasion and angiogenesis of EC cell lines in vitro. Mechanistically, circSMAD2 sponged miR-1277-5p to upregulate MFGE8 expression. The decrease of miR-1277-5p and increase of MFGE8 were observed both in EC tissues and cell lines. Then MFGE8 knockdown or miR-1277-5p upregulation suppressed EC cell oncogenic biological behavior. Rescue experiments showed that miR-1277-5p mimics countervailed the anticancer effects of circSMAD2 silencing on EC. Besides that, MFGE8 overexpression also attenuated the inhibitory action of miR-1277-5p mimic in EC. Moreover, knockdown of circSMAD2 inhibited EC growth in vivo.

CONCLUSION

CircSMAD2 functions as an oncogene in promoting the progression of EC through miR-1277-5p/MFGE8 axis.

Hysteroscopic myomectomy with the IBS® Intrauterine Bigatti Shaver: A Retrospective Comparative Analysis of the impact of rotational speed and aspiration flow rate

Background: Myoma removal remains a challenge hysteroscopically including for the “IBS®” Intrauterine Bigatti Shaver technique. Objective: To evaluate whether the Intrauterine IBS® instrument settings and the myoma size and type are prognostic factors for the complete removal of submucous myomas using this technology. Materials and methods: This study was conducted at the San Giuseppe University Teaching Hospital Milan, Italy; Ospedale Centrale di Bolzano - Azienda Ospedaliera del Sud Tirolo Bolzano, Italy (Group A) and the Sino European Life Expert Centre-Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China (Group B). In Group A: surgeries were performed between June 2009 and January 2018 on 107 women using an IBS device set to a rotational speed of 2,500 rpm and an aspiration flow rate of 250ml/min. In Group B: surgeries were performed between July 2019 and March 2021 on 84 women with the instrument setting to a rotational speed of 1,500 rpm and aspiration flow rate of 500 ml/min. Further subgroup analysis was performed based on fibroid size:<3 cm and 3-5 cm. Both Groups A and B were similar in terms of patient age, parity, symptoms, myoma type and size. Submucous myomas were classified according to the European Society for Gynaecological Endoscopy classification. All patients underwent a myomectomy with the IBS® under general anaesthesia. The conventional 22 Fr. Bipolar Resectoscope was used in cases requiring conversion to the resection technique. All surgeries were planned, performed and followed by the same surgeon in both institutions. Main outcome measures: Complete resection rates, total operation time, resection time and used fluid volume. Results: Complete resection with the IBS® Shaver was seen in 93/107 (86.91%) in Group A versus 83/84 (98.8 %) in Group B (P=0.0021). Five patients (5.8%) in Subgroup A1 (<3 cm) and nine patients (42.9%) in Subgroup A2 (3cm~5cm) could not be finished with the IBS (P<0.001, RR=2.439), while in Group B only one case (8.3%) in Subgroup B2 (3cm~5cm) underwent a conversion to bipolar resectoscope (Group A: 14/107=13.08% vs. Group B: 1/84=1.19%, P=0.0024). For <3cm myomas (subgroup A1 versus B1) there was a statistically significant difference in terms of resection time (7.75±6.363 vs. 17.28±12.19, P<0.001), operation time (17.81 ± 8.18 vs. 28.19 ±17.614, P<0.001) and total amount of fluid used (3365.63 ± 2212.319 ml vs. 5800.00 ± 8422.878 ml, P<0.05) in favour of Subgroup B1. For larger myomas, a statistical difference was only observed for the total operative time (51.00±14.298 min vs. 30.50±12.122 min, P=0.003). Conclusion: For hysteroscopic myomectomy using the IBS®, 1,500rpm rotational speed and 500ml/min aspiration flow rate are recommended as these settings result in more complete resections compared to the conventional settings. In addition, these settings are associated with a reduction in total operating time. What is new? Reducing the rotational speed rate from 2500 rpm to 1500 rpm and increasing the aspiration flow rate from 250 ml/min to 500 ml/min improve complete resection rates and reduce operating times.

Transcriptome analysis reveals molecular pathways in the iron-overloaded Tibetan population

Iron overload can lead to chronic complications, serious organ dysfunction or death in the body. Under hypoxic conditions, the body needs more iron to produce red blood cells to adapt to the hypoxic environment. The prevalence of iron overload in the Tibetan population is higher than that in the Han population. To explore the molecular mechanism of iron-overload in the Tibetan population, this study investigated the transcriptome of the Tibetan iron overload population to obtain differentially expressed genes (DEGs) between the iron-overloaded population and the normal iron population. Functional enrichment analysis identified key related pathways, gene modules and coexpression networks under iron-overload conditions, and the 4 genes screened out have the potential to become target genes for studying the development of iron overload. A total of 28 pathways were screened to be closely related to the occurrence and development of iron overload, showing that iron overload is extremely related to erythrocyte homeostasis, cell cycle, oxidative phosphorylation, immunity, and transcriptional repression.

Densification of Two Forms of Nanostructured TATB under Uniaxial Die Pressures: A USAXS-SAXS Study

Sequential ultra-small-angle and small-angle and X-ray scattering (USAXS and SAXS) measurements of hierarchical microstructure of a common energetic material, the high explosive 2,4,6-Triamino-1,3,5-trinitrobenzene (TATB), were performed to follow the microstructure evolution upon applied pressure. The pellets were prepared by two different routes-die pressed from a nanoparticle form and a nano-network form of TATB powder. The derived structural parameters, such as void size, porosity, and the interface area, reflected the response of TATB under compaction. Three populations of voids were observed in the probed q range from 0.007 to 7 nm^-1. The inter-granular voids with size larger than 50 nm were sensitive to low pressures and had a smooth interface with the TATB matrix. The inter-granular voids with size of ~10 nm exhibited a less volume-filling ratio at high pressures (>15 kN) as indicated by a decrease of the volume fractal exponent. The response of these structural parameters to external pressures implied that the main densification mechanisms under die compaction were the flow, fracture, and plastic deformation of the TATB granules. Compared to the nanoparticle TATB, the applied pressure strongly influenced the nano-network TATB due to its more uniform structure. The findings and research methods of this work provide insights into the structural evolution of TATB during densification.