Evaluating the efficacy of standardized pressure ulcer management protocols in the prevention of pressure injuries among patients undergoing neurosurgical procedures

Pressure injuries are a significant concern for patients undergoing neurosurgical procedures due to prolonged immobility and the complexity of care. This study evaluates the efficacy of standardized pressure ulcer management protocols in preventing pressure injuries and enhancing patient care in a neurosurgical context. A comprehensive retrospective analysis was conducted at a single institution from December 2020 to December 2023, comparing 50 patients who received standardized pressure ulcer management (intervention group) with 50 patients who received conventional care (control group). The study assessed the incidence of pressure ulcers, patient comfort levels using the Kolcaba Comfort Scale and sleep quality using the Richards-Campbell Sleep Questionnaire (RCSQ). Statistical analysis was performed using SPSS software, version 27.0, applying t-tests and chi-square tests as appropriate. The intervention group exhibited a significantly lower incidence of pressure ulcers at all measured time points post-surgery compared to the control group. Patient comfort levels in the intervention group were consistently higher across psychological, environmental, physiological and socio-cultural domains. Sleep quality metrics, including sleep depth, latency to sleep onset and overall sleep quality, were significantly improved in the intervention group. The implementation of standardized pressure ulcer management protocols in neurosurgical care significantly reduces the incidence of pressure injuries, enhances patient comfort and improves sleep quality. These findings highlight the importance of adopting structured care protocols to improve postoperative outcomes and patient well-being in neurosurgical settings.

Spatiotemporal-Controlled NIR-II Immune Agonist Sensitizes Cancer Immunotherapy

The integration of nanomedicine and immunotherapy has presented a promising opportunity for the treatment of cancer and diverse diseases. However, achieving spatiotemporal controllable immunotherapy with excellent efficacy and safety performances remains a significant challenge. This study develops a biodegradable near-infrared II (NIR-II) photothermal response polymer nanoparticle (PTEQ) system. This platform exhibits intrinsic immunostimulatory properties while concurrently delivering siRNA for Programmed Death-Ligand 1 (siPD-L1), leveraging enhanced immune responses and immune checkpoint blockade for safe and effective cancer therapy. In the CT26 tumor-bearing mouse model, PTEQ, as an immune stimulant, significantly boosts the infiltration of CD4+ and CD8+ T cells within the tumor microenvironment (TME). The PTEQ/siPD-L1+laser group not only initiates NIR-II photothermal therapy but also promotes the activation and infiltration of T cells, M1 macrophage polarization, and maturation of dendritic cells in the TME, resulting in the complete elimination of tumors in 7/10 cases, achieving a 100% survival rate. In another in vivo vaccine experiment, all tumors on the right side are completely eliminated in the PTEQ/siPD-L1+laser group, reaching a 100% tumor eradication rate. These findings underscore the potential of this strategy to overcome the current immunotherapeutic limitations and achieve immune therapy normalization.

A patient with multiple primary malignant neoplasms with high variant allele frequencies of RB1, TP53, and TERT

Multiple primary malignant neoplasms are a rare disease with tumors of different histology or morphology arising in various sites. Next-generation sequencing is essential in the etiology, diagnosis, treatment, and surveillance of this disease. No eight primary malignant neoplasm cases with high variant allele frequencies of RB1, TP53, and TERT have been reported. Herein, we report a 65-year-old male who exhibited eight primary malignancies of the vocal cord, pharynx, kidney, mouth floor, esophagus, and urinary bladder with different pathological types. The first seven tumors were early-stage tumors; the last tumor, small cell carcinoma of urinary bladder, showed liver metastasis at diagnosis. Next-generation sequencing results revealed extremely high somatic variant allele frequencies of RB1 c.1472 T > C, TP53 c.576A > G, and TERT c.-58-u66C > T (95.5%, 95.1%, and 51.0%, respectively). No germline mutations were detected. These findings denoted a heavy tumor burden and poor prognosis. This is the first report of eight primary malignant neoplasm cases with high variant allele frequencies of RB1, TP53, and TERT.

Non-volatile 2 × 2 optical switch using multimode interference in an Sb2Se3-loaded waveguide

We propose a non-volatile 2 × 2 photonic switch based on multimode interference in an Sb2Se3-loaded waveguide. The different modal symmetries of the TE0 and TE1 modes supported in the multimode region change their propagation constants distinctly upon the Sb2Se3 phase transition. Through careful optical design and FDTD optimization of the multimode waveguide dimensions, efficient switching is achieved despite the modest index contrast of Sb2Se3 relative to Ge2Sb2Te5. The fabricated optical switch demonstrates favorable characteristics, including low insertion loss of ∼1 dB, a compact length of ∼27 µm, and small cross talk below -15 dB across a 35 nm bandwidth. Such non-volatile and broadband components will be critical for future high-density programmable photonic-integrated circuits for optical communications and signal processing.

Nucleic-acid-triggered NADase activation of a short prokaryotic Argonaute

Argonaute (Ago) proteins mediate RNA- or DNA-guided inhibition of nucleic acids1,2. Although the mechanisms used by eukaryotic Ago proteins and long prokaryotic Ago proteins (pAgos) are known, that used by short pAgos remains elusive. Here we determined the cryo-electron microscopy structures of a short pAgo and the associated TIR-APAZ proteins (SPARTA) from Crenotalea thermophila (Crt): a free-state Crt-SPARTA; a guide RNA-target DNA-loaded Crt-SPARTA; two Crt-SPARTA dimers with distinct TIR organization; and a Crt-SPARTA tetramer. These structures reveal that Crt-SPARTA is composed of a bilobal-fold Ago lobe that connects with a TIR lobe. Whereas the Crt-Ago contains a MID and a PIWI domain, Crt-TIR-APAZ has a TIR domain, an N-like domain, a linker domain and a trigger domain. The bound RNA-DNA duplex adopts a B-form conformation that is recognized by base-specific contacts. Nucleic acid binding causes conformational changes because the trigger domain acts as a 'roadblock' that prevents the guide RNA 5' ends and the target DNA 3' ends from reaching their canonical pockets; this disorders the MID domain and promotes Crt-SPARTA dimerization. Two RNA-DNA-loaded Crt-SPARTA dimers form a tetramer through their TIR domains. Four Crt-TIR domains assemble into two parallel head-to-tail-organized TIR dimers, indicating an NADase-active conformation, which is supported by our mutagenesis study. Our results reveal the structural basis of short-pAgo-mediated defence against invading nucleic acids, and provide insights for optimizing the detection of SPARTA-based programmable DNA sequences.

Near-Infrared-II Nanoparticles for Vascular Normalization Combined with Immune Checkpoint Blockade via Photodynamic Immunotherapy Inhibit Uveal Melanoma Growth and Metastasis

Photodynamic therapy (PDT) has been widely employed in tumor treatment due to its effectiveness. However, the tumor hypoxic microenvironment which is caused by abnormal vasculature severely limits the efficacy of PDT. Furthermore, the abnormal vasculature has been implicated in the failure of immunotherapy. In this study, a novel nanoparticle denoted as Combo-NP is introduced, composed of a biodegradable NIR II fluorescent pseudo-conjugate polymer featuring disulfide bonds within its main chain, designated as TPA-BD, and the vascular inhibitor Lenvatinib. Combo-NP exhibits dual functionality by not only inducing cytotoxic reactive oxygen species (ROS) to directly eliminate tumor cells but also eliciting immunogenic cell death (ICD). This ICD response, in turn, initiates a robust cascade of immune reactions, thereby augmenting the generation of cytotoxic T lymphocytes (CTLs). In addition, Combo-NP addresses the issue of tumor hypoxia by normalizing the tumor vasculature. This normalization process enhances the efficacy of PDT while concurrently fostering increased CTLs infiltration within the tumor microenvironment. These synergistic effects synergize to potentiate the photodynamic-immunotherapeutic properties of the nanoparticles. Furthermore, when combined with anti-programmed death-ligand 1 (PD-L1), they showcase notable inhibitory effects on tumor metastasis. The findings in this study introduce an innovative nanomedicine strategy aimed at triggering systemic anti-tumor immune responses for the treatment of Uveal melanoma.

Hypertension and cystatin C account for sex differences in serum homocysteine levels in acute coronary syndrome subjects with normal serum creatinine

BACKGROUND

Hyperhomocysteinemia is one of cardiovascular disease risk factors and fasting homocysteine levels are significantly elevated in male compared to female acute coronary syndrome (ACS) patients with normal renal function. However, it is not known the sex related determinants of plasma homocysteine levels in ACS subjects without renal dysfunction.

METHODS

A total of 165 ACS participants with normal plasma creatinine who underwent coronary angiography were included in the present study. Clinical parameters, homocysteine, fasting glucose and lipid profile, hemoglobin, white blood cell, platelets, creatinine, cystatin C, blood urea nitrogen, uric acid (UA), and albumin were measured. Multivariate linear regression analyses were used to recognize the predictive factors for homocysteine.

RESULTS

The levels of plasma homocysteine were significantly higher in men than in women (P < 0.0001). In males, homocysteine (log10) was positively associated with hypertension (r = 0.569, P < 0.001), creatinine (r = 0.367, P < 0.001) and cystatin C (log10) (r = 0.333, P = 0.001). In females, homocysteine (log10) was positively correlated with age (r = 0.307, P = 0.107), hypertension (r = 0.456, P < 0.001), creatinine (r = 0.341, P = 0.008), cystatin C (log10) (r = 0.429, P = 0.001) and UA (r = 0.569, P < 0.001) whereas was negatively associated with LDL-C (r =  - 0.298, P = 0.021) and ApoB (r =  - 0.273, P = 0.033). Parameters up to statistical significance in males or females were incorporated into the stepwise linear regression models. In men, hypertension (P < 0.001) and creatinine (P = 0.031) were independently related to homocysteine. Most of the variability of homocysteine levels in males were only determined by hypertension. In women, cystatin C (log10) (P = 0.004) and hypertension (P = 0.005) were independently related to homocysteine (log10). Plasma cystatin C had a higher explanatory value than hypertension in females.

CONCLUSIONS

Hypertension and cystatin C could explain most of the sex differences in serum homocysteine levels in ACS subjects with normal serum creatinine. This finding suggested the importance of making different strategies in males and females to manage hyperhomocysteinemia effectively in ACS subjects without renal dysfunction.

3-Methyladenine ameliorates surgery-induced anxiety-like behaviors in aged mice by inhibiting autophagy-induced excessive oxidative stress

BACKGROUND

Postoperative anxiety is a common surgical complication in older patients. Research has recently linked excessive autophagy to several neurological disorders, including anxiety. This study aimed to determine whether 3-Methyladenine (3-MA) administration reduced anxiety-like behaviors in a mouse model following abdominal exploratory laparotomy.

METHODS

An abdominal exploratory laparotomy model of postoperative anxiety was established using male C57BL/6 mice aged 20 months. 3-MA (6, 30, and 150 mg/ml) was administered via intracerebroventricular immediately following surgery. The mice were assessed 14 days after surgery using the marble burying, elevated plus maze tests, and local field potential recording in the amygdala. The levels of expression of phosphorylated-Akt, Beclin-1, LC3B, nuclear factor erythroid 2-related factor 2 (Nrf2)-occupied regions in NeuN-positive cells, superoxide dismutase (SOD) activity, malondialdehyde (MDA), and glutathione (GSH) were measured at 24 h after surgery.

RESULTS

The injection of 3-MA reversed the increased number of marbles buried, decreased time spent in the open arm, and enhanced θ oscillation power after 14 days of abdominal exploratory laparotomy. In addition, administration of 3-MA reduced the ratio of phosphorylated- to total-Akt, decreased expression in Beclin-1 and LC3B, attenuated MDA levels, and increased the ratio of Nrf2-occupied areas in NeuN-positive cells, SOD activity, and GSH levels under abdominal exploratory laparotomy conditions.

CONCLUSIONS

3-MA improved anxiety-like behaviors in aged mice undergoing abdominal exploratory laparotomy by inhibiting excessive autophagy-induced oxidative stress. These results suggest that 3-MA could be an effective treatment for postoperative anxiety.

Clearance of intracellular bacterial infections by hyaluronic acid-based ROS responsive drug delivery micelles

Pathogenic bacteria residing inside cells could cause disruption of cellular metabolic balance. Therefore, basing on high oxidative stress response of the intracellular bacteria infected micro-environment, a novel amphipathic micelle (HATAD-TCS) was developed consisting of hyaluronic acid-derivative and reactive oxygen species (ROS) - responsive group and antibacterial agent triclosan (TCS). ROS-generating cinnamaldehyde (CA) was incorporated into ROS-cleavable linkages which are future linked to the 1-decylamine to form hydrophobicity. The cinnamaldehyde released did not just killed bacteria however, also maintained intracellular ROS levels. In this study, the HATAD-TCS micelles have been characterized by scanning electron microscopy (SEM) and dynamic light scattering (DLS). The HATAD-TCS micelles could release drug gradually upon exposure to endogenous ROS being caused by infected intracellular bacteria. Furthermore, the more promising therapeutic effect of the HATAD-TCS micelles was observed in a mouse pneumonia model. These results might highlight a ROS-responsive hyaluronic acid-based nanoparticle, which could effectively treat intracellular bacterial infections.

Immune-enhancing activity of polysaccharides and flavonoids derived from Phellinus igniarius YASH1

Introduction: Phellinus igniarius (P. igniarius) (Sanghuang) is a widely used traditional Chinese medicine fungus, and its natural products have great potential for clinical application in immune enhancement. This study aimed to explore the immune-enhancing activity and underlying mechanisms of the polysaccharides and flavonoids derived from Phellinus igniarius (P. igniarius) and to provide a theoretical and experimental basis for the development of novel drugs. Methods: Wild P. igniarius YASH1 from the Loess Plateau in Yan'an region was collected, and polysaccharides and total flavonoids were extracted, isolated and identified from mycelium and sporophore. In vitro antioxidant activity was detected through the scavenging activity of hydroxyl radicals and total antioxidant capacity. Cell Counting Kit-8 and trypan blue detection kit were used to detect the effect of extract polysaccharides and flavonoids on the proliferation and phagocytosis ability of immune cells. To assess the effect of the drugs on cytokine secretion by immune cells and immune recovery in immunocompromised mice, the expression of interleukin (IL)-2, IL-6, interferon (IFN)-γ, and tumor necrosis factor (TNF)-α were examined at the cellular and animal levels. The species composition, abundance of gut microbiota and the altered content of short-chain fatty acids in the feces were analyzed to elucidate the possible mechanisms of drugs by 16S ribosomal RNA (rRNA) amplifiers sequencing and liquid chromatography-tandem mass spectrometry (LC-MS/MS). Results: Both polysaccharides and flavonoids derived from mycelium or sporophore had antioxidant activity and may stimulate the expression and secretion of IL-2, IL-6, and IFN-γ in immune cells while inhibiting TNF-α expression and secretion and increasing IL-2, IL-6, and IFN- γ expression levels in mice. Furthermore, polysaccharides and flavonoids from mycelium and sporophore showed different effects on the metabolic response of intestinal short-chain fatty acids (SCFAs) in mice, and the use of these drugs remarkably changed the species composition and abundance of intestinal flora in mice. Discussion: Polysaccharides and flavonoids from P. igniarius YASH1 mycelium and sporophore have in vitro antioxidant activity, and they affect the promotion of cell proliferation, stimulation of IL-2, IL-6, and IFN-γ secretion, and inhibition of TNF-α expression in immune cells. Polysaccharides and flavonoids from P. igniarius YASH1 may enhance immunity in immunocompromised mice and remarkably affect the intestinal flora and content of SCFAs.

SLC27A2 mediates FAO in colorectal cancer through nongenic crosstalk regulation of the PPARs pathway

BACKGROUND

Peroxisome proliferator activated receptors (PPARs) are a nuclear hormone receptors superfamily that is closely related to fatty acid (FA) metabolism and tumor progression. Solute carrier family 27 member 2 (SLC27A2) is important for FA transportation and metabolism and is related to cancer progression. This study aims to explore the mechanisms of how PPARs and SLC27A2 regulate FA metabolism in colorectal cancer (CRC) and find new strategies for CRC treatment.

METHODS

Biological information analysis was applied to detect the expression and the correlation of PPARs and SLC27A2 in CRC. The protein-protein interaction (PPI) interaction networks were explored by using the STRING database. Uptake experiments and immunofluorescence staining were used to analyse the function and number of peroxisomes and colocalization of FA with peroxisomes, respectively. Western blotting and qRT‒PCR were performed to explore the mechanisms.

RESULTS

SLC27A2 was overexpressed in CRC. PPARs had different expression levels, and PPARG was significantly highly expressed in CRC. SLC27A2 was correlated with PPARs in CRC. Both SLC27A2 and PPARs were closely related to fatty acid oxidation (FAO)‒related genes. SLC27A2 affected the activity of ATP Binding Cassette Subfamily D Member 3 (ABCD3), also named PMP70, the most abundant peroxisomal membrane protein. We found that the ratios of p-Erk/Erk and p-GSK3β/GSK3β were elevated through nongenic crosstalk regulation of the PPARs pathway.

CONCLUSIONS

SLC27A2 mediates FA uptake and beta-oxidation through nongenic crosstalk regulation of the PPARs pathway in CRC. Targeting SLC27A2/FATP2 or PPARs may provide new insights for antitumour strategies.

Soil copper concentration map in mining area generated from AHSI remote sensing imagery

Hyperspectral remote sensing has the advantages to predict and map soil heavy metal concentration over conventional monitoring methods and multispectral remote sensing. In quantitative applications of hyperspectral remote sensing imagery, the contribution of hyperspectral bands is different, and abnormal prediction values resulted from incorrectly classified bare soil images are a major problem. In this study, a variable weighting method was proposed to weight the hyperspectral bands, and a probability threshold was used to improve the classification to mitigate the problem of abnormal prediction values. The variable weighting was conducted by using the absorption depths obtained by continuum removal. Soil samples were collected from a mining area in southwestern China. Hyperspectral remote sensing imagery was acquired by the Advanced Hyperspectral Imager (AHSI) abroad on Geofen-5 (GF-5) satellite. Genetic algorithm and partial least squares regression (PLSR) were adopted to calibrate prediction models. In prediction of soil copper (Cu) concentration, root mean square error (RMSE) and coefficient of determination (R²) were 21.59 mg kg^-1 and 0.60 for the prediction using raw reflectance spectra, and the values were improved to 18.33 mg kg^-1 and 0.71 by using the weighted reflectance spectra. The developed prediction model was applied to the AHSI imagery to predict Cu concentration in bare soil areas. In prediction of Cu concentration using the AHSI imagery, negative prediction values were eliminated by using the bare soil image extracted by the improved classification. Based on the prediction, soil Cu concentration map was generated by kriging spatial interpolation. The result indicates that the proposed variable weighting method is effective and the problem of abnormal prediction values could be mitigated by using improved bare soil images. Further analysis indicates that some indices with proper thresholds also could be used to get improved bare soil images.

Disulfide-containing polymer delivery of C527 and a Platinum(IV) prodrug selectively inhibited protein ubiquitination and tumor growth on cisplatin resistant and patient-derived liver cancer models

USP1 (Ubiquitin-specific protease 1) is closely related to the prognosis of patients with liver cancer and plays an important role in DNA damage repair. C527 is a selective USP1 inhibitor (USP1i), which can regulate the protein ubiquitination to effectively inhibit the proliferation of cancer cells. However, its clinical application is hindered due to the poor water solubility and lack of tumor targeting. Moreover, the efficacy of single use of USP1i is still limited. Herein, a glutathione (GSH) sensitive amphiphilic polymer (poly (2-HD-co-HPMDA)-mPEG, PHHM) with disulfide bonds in the main chain was designed to encapsulate the USP1i as well as platinum (IV) prodrug (Pt (IV)-C12), resulting in the formation of composite nanoparticles, i.e., NP-Pt-USP1i. NP-Pt-USP1i can inhibit the DNA damage repair by targeting USP1 by the encapsulated USP1i, which ultimately increases the sensitivity of tumor cells to cisplatin and enhances the anti-cancer efficacy of cisplatin. Finally, an intraperitoneal tumor mice model and a patient-derived xenograft (PDX) of liver cancer mice model were established to prove that NP-Pt-USP1i could effectively inhibit the tumor growth. This work further validated the possibility of therapeutically target USP1 by USP1i in combination with DNA damaging alkylating agents, which could become a promising cancer treatment modality in the future.

Glutathione-Responsive Nanoparticles of Camptothecin Prodrug for Cancer Therapy

Camptothecin (CPT) is a potent chemotherapeutic agent for various cancers, but the broader application of CPT is still hindered by its poor bioavailability and systemic toxicity. Here, a prodrug that releases CPT in response to glutathione (GSH), which is commonly overexpressed by cancer cells is reported. Through assembling with PEGylated lipids, the prodrug is incorporated within as-assembled nanoparticles, affording CPT with a prolonged half-life in blood circulation, enhanced tumor targetingability, and improved therapeutic efficacy. Furthermore, such prodrug nanoparticles can also promote dendritic cell maturation and tumor infiltration of CD8⁺ T cells, providing a novel strategy to improve the therapeutic efficacy of CPT.

[Relationship of the kallistatin gene expression with male spermatogenic dysfunction and its possible mechanism]

OBJECTIVE

To explore the role of the kallistatin gene in male spermatogenesis and its possible mechanism, and provide some new ideas for the clinical treatment of spermatogenic dysfunction.

METHODS

We collected semen samples from the patients with oligospermia (OS) or non-obstructive azoospermia (NOAS) as well as testis tissue from testicular puncture. We detected the differential expression of kallistatin in the seminal plasma and the mRNA and protein expression levels of kallistatin, KLK1, B2R, Bcl-2, casepase-3, Bax and other molecules in the testis tissue, assessed the testicular spermatogenic function using Johnsen's scores, examined the interstitial fibrosis in the testis by Masson and Sirius staining, and analyzed the correlation of the expression level of kallistatin with spermatogenesis, apoptosis and fibrosis.

RESULTS

Kallistatin was highly expressed in the seminal plasma and testis tissue. The expression of kallistatin was significantly decreased in the seminal plasma (P < 0.05) and so were those of kallistatin, KLK1 and B2R in the testis tissue of the NOAS and OS patients compared with those in the normal controls (P < 0.01), but no statistically significant difference was found between the expression levels of kallistatin and KLK1 within the same group (P > 0.05). The expression of Bcl-2 in the testis tissue was significantly lower (P < 0.01) and those of Bax and Casepase-3 dramatically higher in the OS and NOAS patients than in the normal males (P < 0.01). Cell apoptosis was negatively correlated with the expression of kallistatin. The results of Masson and Sirius staining showed that the fibrosis of the testis tissue and the ratio of type I/III collagen fibers were markedly increased in the OS and NOAS patients in comparison with the normal controls, even more significantly in the NOAS than in the OS group.

CONCLUSION

Decreased expression of kallistatin may be related to spermatogenic dysfunction, and the kallistatin expression plays a regulatory role in the testicular spermatogenesis, probably by regulating cell apoptosis and fibrosis in the testis tissue, but the specific mechanism needs to be confirmed by further studies.

Isoborneol as a natural sporulation quenching agent to control Aspergillus flavus

In an effort to seek natural antisporulating agents used in the control of Aspergillus flavus, 54 essential oil compounds were employed to evaluate their antisporulating activity against A. flavus at the concentration of 100 μg/mL. The results indicated that isoborneol could inhibit spore production at 100 μg/mL. The light microscopy and scanning electron microscopy (SEM) observations revealed that A. flavus did not produce any conidia, vesicles, phialides and conidiophores after treatment with isoborneol at 80 μg/mL, confirming the effectiveness of isoborneol. The in vivo bioassay results demonstrated that isoborneol could prevent the peanuts from A. flavus contamination by inhibiting the sporulation when treated with isoborneol at concentrations higher than 100 μg/mL. RT-qPCR results suggested that isoborneol exerts its antisporulating activity by suppressing the fluG expression. These results proved that isoborneol could be used as a natural and safe antisporulating agent for commercial applications to control spore infections of A. flavus.

LC-MS/MS Method Assay for Simultaneous Determination of the Apixaban and Metformin in Rat Plasma: Assessment of Pharmacokinetic Drug-Drug Interaction Study

A simple, sensitive and accurate LC-MS/MS method was developed and validated for the simultaneous quantification of apixaban (APB) and metformin (MET) in rat plasma using rivaroxaban as internal standard (IS). An Inertsil ODS3 C18 column (150 × 4.6 mm, 5 μm) was used for chromatographic separation with isocratic elution. Multiple reaction monitoring (MRM) using positive-ion ESI mode to monitor ion transitions of m/z 459.8 → 442.8 for APB, m/z 130.2 → 71.2 for MET, m/z 436.8 → 144.9 for IS. The procedure of method validation included selectivity, linearity, precision, accuracy, matrix effect, extraction recovery and stability were conducted according to the guidelines of EMA and FDA. The method was validated over the concentration range of 0.5-250 ng/mL for APB and 8-8000 ng/mL for MET. The intra- and inter-day precision and accuracy of the quality control samples exhibited relative standard deviations (RSD) < 12.5% and the accuracy values ranged from -8.6 to 12.4%. Recovery and matrix effect values variations were all less than 15%. After oral administration APB and MET to rats, the comparison of pharmacokinetic parameters of APB in the single and co-administrated groups showed significant difference in AUC(0-t) from 730.71 ± 121.31 to 573.07 ± 90.13 ng/mL·h, t1/2 from 5.86 ± 3.21 to 4.24 ± 1.15 h and Cmax from113.54 ± 24.04 to 159.42 ± 54.6 ng/mL. The comparison of pharmacokinetic parameters of MET in the single and co-administrated groups showed significant difference in t1/2 from 2.83 ± 1.81 to 3.97 ± 0.57 h and Cmax from 4015.76 ± 873.23 to 3153.6 ± 1012.51 ng/mL. The results indicated that drug-drug interactions (DDI) occurred might be owing to APB affect one or all of OCTs, MATE1, MATE2-K.

Drug therapy for bone metastasis of malignant tumor: theory, progress, and potential

Bone is a common metastatic site of malignancies, caused by the complex interaction between tumor cells and the bone microenvironment. The complicated procedure covers multiple targets for therapeutic strategies against bone metastasis. At the present, only bisphosphonates and denosumab are currently approved for the prevention of skeletal-related events. But it is still ineffective for some patients, and none of them are proven to prolong the overall survival of patients with bone metastasis. Thus, new bone-modifying agents and therapeutic strategies are required. The review aimed to generalize the basic theory of bone metastasis and major put emphasis on the development of fundamental and potential target drugs in the behavior of bone metastasis. The summary of the drug development process helps to provide ideas for finding new and effective treatments for bone metastasis.

The Prognostic Value of Albumin-Globulin Ratio and Eosinophil-Neutrophil Ratio in Patients with Advanced Tumors Undergoing Treatment with PD-1/PD-L1 Inhibitors

We investigated the prognostic value of peripheral serum biomarkers, including albumin-globulin ratio (AGR) and eosinophil-neutrophil ratio (ENR), in patients with advanced tumors treated with PD-1/PD-L1 inhibitors. We also retrospectively analyzed the clinical efficacy of PD-1/PD-L1 inhibition in 95 patients with advanced tumors treated at our center. The prognostic value of baseline AGR, baseline ENR, and baseline neutrophil-lymphocyte ratio (NLR) in the serum were evaluated. We also developed a risk scoring tool to stratify patients based on their prognosis. Univariate Cox regression analysis revealed that age, NLR, Eastern Cooperative Oncology Group (ECOG) performance status (PS), platelet-neutrophil ratio (PLR), ENR, AGR, lactate dehydrogenase levels, treatment line, and treatment type were correlated with progression-free survival (PFS). Multivariate Cox regression analysis showed that age, AGR, ENR, and treatment type were independent prognostic factors for PFS. Patients in the low-risk group had significantly longer PFS than those in the high-risk group. The nomogram concordance index (C-index) was 0.716. Patients with a decrease in AGR of over 20% after the first and second treatment cycles had significantly worse PFS than those without decreased AGR. These findings suggest that baseline AGR and ENR may be useful prognostic biomarkers for patients with advanced tumors treated with PD-1/PD-L1 inhibitors.

Safety and efficacy of spleen aminopeptide oral lyophilized powder for improving quality of life and immune response in patients with advanced breast cancer: a multicenter, randomized, double-blind, placebo-controlled clinical trial

Health-related quality of life (HRQoL) is an important consideration in managing patients. Spleen aminopeptide oral lyophilized powder (SAOLP) has been used to enhance cellular immunity in a patient. This multicenter, randomized, double-blind, placebo-controlled clinical trial was designed to evaluate the safety and efficacy of SAOLP for improving HRQoL in patients with breast cancer. Patients diagnosed with advanced breast cancer were included, and were administered SAOLP or placebo 4 mg qd for two cycles. The primary endpoint was improvement in HRQoL on day 42 measured by the EORTC QLQ-C30 and EORTC QLQ-BR23. Secondary endpoints included immunologic function, improvement in HRQoL on day 21 and 84, objective response rate, disease control rate, BMI and adverse events. On day 42, on the EORTC QLQ-C30 or EORTC QLQ-BR23, scores on the functional scales and QoL scale were significantly higher and scores on symptom scales were significantly lower in patients who received SAOLP compared to placebo (P < 0.05). On day 84, the number of CD3, CD4 and CD8 cells were significantly higher in patients who received SAOLP. There were no significant differences in objective response rate, disease control rate or BMI. SAOLP may improve HRQoL and the immune response in patients with advanced breast cancer, represents a convenient and safe adjuvant therapy.

Tumor-Associated Macrophage-Derived Exosomes Promote the Progression of Gastric Cancer by Regulating the P38MAPK Signaling Pathway and the Immune Checkpoint PD-L1

Objective: To investigate the effects of M2 macrophage-derived exosomes (M2-Exos) on proliferation, migration, and apoptosis of gastric cancer cells in the tumor microenvironment and to further explore their possible molecular mechanism. Materials and Methods: M2 macrophages were induced from THP-1 cells and identified by qRT-PCR. Exosomes were extracted by ultracentrifugation and identified by transmission electron microscopy (TEM), nanoparticle tracking analysis (NTA), and Western blot analysis. Fluorescence labeling was used to detect the internalization of exosomes in receptors. The proliferation, migration, and invasion of AGS and HGC27 cells were determined by EdU and MTS, wound healing and Transwell assay, and flow cytometry, respectively. Proteins in the related pathway of M2-Exos affecting the progression of gastric cancer were detected by Western blot analysis. Results: In this study, M2 macrophages and M2-Exos were successfully obtained. The purified M2-Exos were observed as small round vesicles with diameters of 50-90 nm and positive expression of CD63, CD9, and TSG101. Besides, M2-Exos can be effectively taken up and internalized by AGS and HGC27 cells. Cell behavior studies showed that M2-Exos promoted proliferation and migration and inhibited the apoptosis of AGS and HGC27. Further research illustrated that M2-Exos promoted the phosphorylation of P38 and high expression of programmed death ligand 1 (PD-L1). Conclusions: This study demonstrated that M2-Exos promoted proliferation and migration and inhibited the apoptosis of gastric cancer cells. Mechanically, M2-Exos may promote gastric cancer progression through the P38MAPK signaling pathway and achieve immune escape through elevating the expression of PD-L1.

Leojaponin inhibits NLRP3 inflammasome activation through restoration of autophagy via upregulating RAPTOR phosphorylation

ETHNOPHARMACOLOGICAL RELEVANCE

Duan Teng Yimu decoction is a Chinese herbal medicine compound with proven therapeutic effects on inflammasome-related diseases, such as rheumatoid arthritis. This decoction consists of three Chinese herbal medicines, including Leonurus japonicus (L. japonicus), which promotes the blood circulation and exhibits detumescence activity, traditionally curing gynecologic and inflammasome diseases.

AIM OF THE STUDY

To explore the anti-inflammasome activity and the underlying mechanisms of action of the compounds from L. japonicus.

MATERIALS AND METHODS

A series of compounds were isolated from L. japonicus. Their anti-inflammasome activities were evaluated in macrophages that were co-stimulated by lipopolysaccharide (LPS) and NLRP3 inflammasome inducers. NLRP3 inflammasome formation and apoptosis speck like containing a CARD (ASC) oligomerization were evaluated by immunofluorescent microscopy and Western blot analysis. The regulation of autophagy after treatment of this compound was also evaluated. Lastly, in vivo activity of Leojaponin was analyzed in a mouse acute gouty arthritis model.

RESULTS

Here we show that Leojaponin, a diterpenoid compound from L. japonicus, suppressed lactate dehydrogenase and IL-1β release in Nigericin-stimulated macrophages in a pyroptosis model. Leojaponin inhibits NLRP3 inflammasome activation in both J774A.1 cells and bone marrow-derived macrophages in a dose dependent manner. Moreover, Leojaponin suppressed NLRP3-mediated ASC specks formation and ASC oligomerization. These activities of Leojaponin depend on restoration of autophagy via promoting RAPTOR phosphorylation. Furthermore, Leojaponin ameliorated monosodium urate (MSU)-induced acute gouty arthritis in vivo.

CONCLUSION

Our findings suggest that Leojaponin inhibits NLRP3 inflammasome activation through enhancing autophagy via RAPTOR phosphorylation, thereby highlighting Leojaponin as a potent drug for inflammasome-related diseases.

Macrocyclic Photoinitiator Based on Prism[5]arene Matching LEDs Light with Low Migration

In this work, a naphthalene-based macrocycle prism[5]arene (NP₅ OCH₃ ) is developed as a novel kind of photoinitiator. When NP₅ OCH₃ is irradiated under light, the bond between methylene and naphthalene can be quickly broken owning to the existence of ring tension. The macrocycle is cleaved to linear oligomer biradicals, which can effectively initiate the free radical photopolymerization of acrylate monomers. Compared with conventional photoinitiators, NP₅ OCH₃ has strong light absorption in the wavelength range of 365-405 nm, so it can well match the environment-friendly light-emitting diodes (LEDs) light source to realize highly efficient initiation. In addition, there is no small molecule fragment generated during NP₅ OCH₃ fracture, and the resulted linear oligomer biradicals can be immobilized in the polymer after initiating polymerization, so NP₅ OCH₃ photoinitiators show much lower migration rate and cytotoxicity. Cleavable macrocycle prismarene may provide a new idea for the design of safe and efficient photoinitiators matching long wavelength light.

Application of 2D Materials to Potassium-Ion Hybrid Capacitors

Metal-ion hybrid supercapacitors (MICs) are a new type of electrochemical energy storage (EES) device, consisting of a battery-type electrode and a supercapacitor (SC)-type electrode. Exhibiting the advantages of both batteries and SCs (e. g., good energy density, excellent power density and long cycle life), these advanced energy storage devices have considerable commercial application prospects. Among MICs, potassium-ion hybrid supercapacitors (PICs) have several further advantages, including abundancy of resources, low standard electrode potential, and low cost. PICs are regarded as potential substitutes for lithium- or sodium-ion hybrid supercapacitors. However, the practical applications of PICs remain limited, owing to the imbalance of kinetics and capacity between the electrodes, the slow ion/electron diffusion rate, and the poor electrode structural stability. Recently, 2D materials with distinct structures and fascinating features have elicited widespread attention for application in PICs, thus achieving significant enhancements, ranging from charge storage capacity to reaction kinetics. This Review discusses research progress in 2D materials for PICs. Firstly, the energy storage principle and development requirements of MICs are introduced. The pivotal advantages and significant roles of 2D materials in the fabrication of PICs are then discussed in detail. Lastly, the challenges and prospects of the application of 2D materials to high-performance PICs are presented.

Decreased expression of Dlg5 is associated with a poor prognosis and epithelial-mesenchymal transition in squamous cell lung cancer

Background

Discs large homolog 5 (Dlg5) is a newly discovered member of the membrane-associated guanylate kinase superfamily (MAGUK) that is involved in several important processes, including the maintenance of epithelial cell polarity, cell proliferation control, and cell migration and invasion. Decreased expression of Dlg5 has been reported in malignancies arising from different organs. In the present study, we analyzed Dlg5 expression and its prognostic value in squamous cell lung cancer (SqCLC).

Methods

Tumor tissue and adjacent normal tissue sections were collected from 98 patients with SqCLC. The expression levels of Dlg5 and epithelial-mesenchymal transition (EMT) biomarkers in the tissue sections were examined by immunohistochemistry and western blot.

Results

There were 80 males and 18 females in the study cohort. Patients at pathological stages I and IIIA accounted for 64.3% and 35.7% of the cohort, respectively. Western blot showed that Dlg5 expression differed between SqCLC and healthy tissues. Western blot also revealed low Dlg5 expression to be associated with low E-cadherin expression and high vimentin expression, which was consistent with the findings of immunohistochemical staining. Dlg5 expression was significantly correlated with lymph node (LN) metastasis (P=0.001) and disease recurrence (P<0.001), as well as with E-cadherin and vimentin expression (P=0.025 and P=0.001, respectively). Univariate analysis showed that overall survival was significantly correlated with the tumor-node-metastasis (P<0.001) and T (P=0.001) stages, LN metastasis (P<0.001), Dig5 expression (P<0.001), β-catenin expression (P=0.004), and vimentin expression (P=0.002). Patients with overexpression of Dlg5 and β-catenin had a more favorable prognosis than those without. Multivariate analysis revealed that tumor-node-metastasis stage [hazard ratio (HR) =2.124; 95% confidence interval (CI), 1.195–3.777; P=0.010], Dlg5 expression (HR =0.548; 95% CI, 0.313–0.959; P=0.035), β-catenin expression (HR =0.545; 95% CI, 0.312–0.953; P=0.033), and vimentin expression (HR =1.850; 95% CI, 1.050–3.258; P=0.033) could all independently predict the overall survival of patients with SqCLC.

Conclusions

Dlg5 is an important player in EMT which may have potential predictive value for SqCLC prognosis after surgery.

White matter network disorder in mesial temporal epilepsy: An fMRI study

Mesial temporal lobe epilepsy (mTLE) has been considered a network disorder disease in which brain regions extending beyond the epileptogenic zones are always affected. However, abnormalities in white matter (WM) functional networks and their associations with widespread network dysfunction are still being identified in mTLE. Accordingly, we investigated the altered functional activities in WM networks in mTLE using fMRI, which has recently been used to probe WM function. We collected resting-state fMRI data from 39 unilateral mTLE patients with hippocampal sclerosis and 29 healthy controls. Eleven WM networks were clustered according to temporal correlation profile. The functional connectivity (FC) of the WM networks were evaluated and compared between the two groups. Furthermore, we assessed the capacity of WM FC for seizure lateralization. According to our analysis, mTLE led to decreased FC within deep WM networks. In addition, the cortical regions involved in seizure propagation and several brain regions displaying interhemispheric disruption showed enhanced functional coupling with deep WM networks. FCs between the ipsilateral deep WM networks and the insula, temporal lobe, and supramarginal gyrus demonstrated positive correlation with seizure frequency. Moreover, the seizure onset zones of 33 patients out of 39 patients could be correctly lateralized. Our findings reveal functional disruptions in WM networks extending to extratemporal regions, supporting the network disorder hypothesis and suggesting that deep WM networks are key network nodes associated with massive dysfunction in mTLE. Moreover, the FC of the WM represents a potentially useful functional imaging measure for the diagnosis of mTLE.

Voxel-based morphometric MRI post-processing and PET/MRI co-registration reveal subtle abnormalities in cingulate epilepsy

OBJECTIVE

Diagnostic challenges exist in the presurgical evaluation of patients with magnetic resonance imaging (MRI) negative cingulate epilepsy (CE) because of the heterogeneity in clinical semiology and lack of localizing findings on scalp electroencephalographic (EEG) recordings. We aimed to examine the neuroimaging characteristics in a consecutive cohort of patients with MRI-negative CE with a focus on two image post-processing methods, including the MRI post-processing morphometric analysis program (MAP) and ¹⁸F-fluorodeoxyglucose-positron emission tomography-MRI (PET/MRI) co-registration.

METHODS

Included in this retrospective study were patients with MRI-negative CE who met the following criteria: negative on preoperative MRI, invasive EEG (iEEG) confirmed cingulate gyrus-onset seizures, surgical resection of the cingulate gyrus with/without adjacent cortex, and seizure-free for more than 12 months. MAP and PET/MRI co-registration were performed and investigated by comparison to ictal intracranial EEG findings. Other characteristics obtained from scalp EEG, magnetoencephalography (MEG), iEEG, and pathological study were also reported.

RESULTS

Ten patients were included, of which eight were diagnosed with anterior CE, one with middle CE, and one with posterior CE. The semiology included fear, embarrassment, vocalization, ictal pouting, asymmetric tonic posture, hypermotor, and automatism. Scalp EEG revealed unilateral or bilateral frontal-temporal onset. MEG localized the dipoles correctly in one patient (1/10). MAP detected subtle abnormalities in regions concordant with iEEG onset in seven patients (7/10) while PET/MRI co-registration revealed focal concordant hypometabolism in five patients (5/10). Combining MAP with PET/MRI co-registration improved the detection rate to 90 % in this cohort. The pathology was focal cortical dysplasia (FCD), including FCD type IIA in three, type IIB in three, and type I in four.

CONCLUSION

MAP and PET/MRI co-registration show promising results in identifying subtle FCD abnormalities in CE with negative results on conventional MRI, which can be otherwise challenging. More importantly, a combination of MRI post-processing and PET/MRI co-registration can greatly improve the identification of epileptic abnormalities, which can be used as surgical target. MAP and PET/MRI co-registration should be incorporated into the routine presurgical evaluation.

Perioperative Deep Vein Thrombosis in Patients With Lower Extremity Fractures: An Observational Study

This study aimed to investigate deep vein thrombosis (DVT) in patients with lower extremity fractures who received anticoagulation treatment in the perioperative stage. We collected the patients’ clinical data and diagnosed DVT using Doppler ultrasonography. Preoperative, postoperative, and 1-month postoperative examinations were performed. The patients were divided into thrombosis and non-thrombosis groups according to ultrasonographic findings. A total of 404 patients were included in the study. The preoperative, postoperative, and 1-month postoperative incidence rates were, respectively, 35%, 55%, and 40% for DVT and 12%, 22%, and 20% for DVT in the uninjured contralateral lower extremity. The incidence of perioperative DVT decreased over time from 223 (55%) to 161 (40%). Multivariate analysis revealed that the independent risk factors for preoperative that of DVT were age (odds ratio [OR]: 1.03; 95% CI: 1.01-1.04; P = .000); postoperative that of DVT were age (OR: 1.04; 95% CI: 1.03-1.05; P = .000), blood loss (OR: 1.001; 95% CI: 1.000-1.002; P = .018), and American Society of Anesthesiologists classification (OR: 2.07; 95% CI: 1.16-3.72; P = .014); and 1-month postoperative that of DVT were age (OR: 1.05; 95% CI: 1.03-1.07; P = .000), respectively. In conclusion, the incidence of perioperative DVT decreased over time in patients who received anticoagulation treatment. Age was an important risk factor for perioperative DVT.

Deep Vein Thrombosis in the Uninjured Lower Extremity: A Retrospective Study of 1454 Patients With Lower Extremity Fractures

The purpose of this study was to identify patients at higher risk of deep venous thrombosis (DVT) in the uninjured lower extremity both preoperatively and postoperatively in patients with lower extremity fractures. We collected the clinical data of patients with lower extremities fractures who presented at Xi’an Honghui Hospital between 1 July, 2015 and 31 October, 2017. Doppler ultrasonography was used to diagnose the DVT. Patients were examined pre- and postoperatively. The patients were divided into thrombosis group and no thrombosis group according to the preoperative and postoperative ultrasonography results. The thrombosis group was defined as patients with DVT in the uninjured lower extremity and the no thrombosis group was defined as patients without DVT in the uninjured lower extremity. This study enrolled 1454 patients who met the inclusion criteria. The incidence of preoperative DVT in the uninjured lower extremity was 9.63% whereas the postoperative incidence was 20.29%. Age (OR = 0.965, 95 CI%: 0.954-0.977; P ≤ 0.001) and female (OR = 0.667, 95% CI: 0.451-0.986, P = 0.042) were independent risk factors for preoperative DVT in the uninjured lower extremity. Blood loss (OR = 0.997, 95 CI%: 0.995-1.000; P = 0.020), D-dimer level at admission (OR = 0.941, 95 CI%: 0.887-0.999; P = 0.045), and postoperative day 5 D-dimer level (OR = 0.889, 95 CI%: 0.819-0.965; P = 0.005), were independent risk factors for postoperative DVT in the uninjured lower extremity. For the patients with lower extremity fractures, age and female were associated with the preoperative DVT in the uninjured lower extremity. Blood loss, D-dimer at admission and postoperative day 5 D-dimer were associated with the postoperative DVT in the uninjured lower extremity.

Cataract formation in transgenic HO-1 G143H mutant mice: Involvement of oxidative stress and endoplasmic reticulum stress

Oxidative stress and endoplasmic reticulum (ER) stress are the key contributing factors for cataract progression. In our previous studies, we demonstrated that the nuclear factor erythroid 2-like-2 (Nrf-2)/heme oxygenase-1 (HO-1)/carbon monoxide (CO) axis protects lens epithelial cells (LECs) against oxidants and ER stress. In the present study, transgenic FVB/N mice overexpressing the negative dominant mutant HO-1 G143H (TgHO-1 G143H) were generated to evaluate the crosstalk among HO-1, oxidative stress and ER stress in maintaining lens transparency. Slit-lamp examination revealed that nuclear cataracts occurred at 4 months in the TgHO-1 G143H mice, which was 5 months earlier than that of the control mice. The lenses of the transgenic mice showed an accumulation of malondialdehyde and protein carbonyl with a decrease in glutathione and protein sulfhydryl levels. Elevated concentrations of ER stress biomarkers (Bip, PERK, ATF6, IRE1, CHOP, caspase-12 and caspase-3) in the lenses of the TgHO-1 G143H mice were identified by western blotting. Furthermore, we confirmed that overexpressed HO-1 G143H in LECs resulted in oxidative insult and apoptosis in vitro. All of these data suggested that HO-1 enzymatic activity loss induces early-onset nuclear cataracts by activating oxidative stress and ER stress.

H2O2/HOCl-based fluorescent probes for dynamically monitoring pathophysiological processes

Serving as representative reactive oxygen species (ROS), H2O2 and HOCl play crucial roles in biological metabolism and intercellular oxidation-reduction dynamic equilibrium. The overexpression of H2O2/HOCl may cause a variety of diseases, such as acute and chronic inflammation, cancer and neurodegenerative disorders. A major question in H2O2/HOCl-based pathological diagnosis is knowing how H2O2/HOCl concentrations can be accurately regulated to initiate a diagnosis and subsequently guarantee therapeutic effects in the course of medical advances. Fluorescent probes, with their great spatial and temporal resolutions, have been used in diverse pathophysiological processes and developed rapidly in the last five years. We summarise in this review the optical properties of H2O2/HOCl-responsive fluorescent probes and focus on effective distribution and dynamic monitoring by using pathophysiological models.

Semantic - based service discovery in grid environment

In the process of informatization, there are also some new problems, mainly information can’t be shared and integrated, distributed resources can’t be used effectively, these problems make the industry face new challenges. The goal of this paper is to combine the grid technology and ontology organically, to build a unified information system integration and interoperation platform based on semantics, to realize information sharing and accelerate the pace of informatization. The method is to construct the whole structure of the system according to the actual needs of the system. This paper firstly analyzes the current research status and existing problems of semantic grid service matching, and proposes a semantic layered matching algorithm based on Massimo Paolucci elastic matching algorithm. To verify the feasibility and effectiveness of the hierarchical matching algorithm based on semantics, a prototype system named SGSM was designed and its functional model, matching process and performance were studied. Experimental results show that for the semantic-based hierarchical matching algorithm proposed in this paper, the threshold value of service semantic correlation degree is 0.84, the threshold value of service basic concept matching degree is 0.89, the threshold value of service comprehensive similarity degree is 0.66, and the threshold value of service quality matching degree is 0.78. Statistics through the experiment, the above three methods of recall, respectively, 33%, 62%, 85%, the precision is respectively: 29%, 57%, 88%, and illustrate the hierarchical matching algorithm based on semantic is feasible in practical application, compared with the traditional service based on keyword matching algorithm and Massimo Paolucci elastic matching algorithm on the recall and precision are improved significantly.

Angiogenesis is promoted by exosomal DPP4 derived from 5-fluorouracil-resistant colon cancer cells

Cancer cells can communicate with the tumor microenvironment and contribute to tumor progression. However, the effects of drug-resistant tumor cells on angiogenesis are unclear. Current anti-angiogenic strategies also have limitations and it would be useful to develop novel targets and treatment strategies. Here, our study showed that the conditioned medium and exosomes from 5-FU-resistant colon cancer cells promoted angiogenesis, and we observed that exosomal dipeptidyl peptidase IV (DPP4) was a potent inducer of this angiogenesis. DPP4-enriched exosomes increased periostin (POSTN) expression in human umbilical vein endothelial cells via Twist1 nuclear translocation or activating Smad signaling pathway, while silencing or inhibition of DPP4 neutralized those effects. The in vivo and clinical data indicated that high DPP4 expression was related to tumor progression. These findings indicate that DPP4 may be a target for inhibiting angiogenesis in 5-FU-resistant colon cancer. Furthermore, exosomal DPP4 concentrations may be a useful prognostic marker for colon cancer.

Positive relationship of hypertensive retinopathy with carotid intima--media thickness in hypertensive patients

OBJECTIVES

We aimed to explore the relationship of hypertensive retinopathy with carotid intima--media thickness (CIMT), and to examine the possible effect modifiers in Chinese adults with hypertension.

METHODS

We conducted a cross-sectional study of 12 342 hypertensive patients with complete exit site visit data from the China Stroke Primary Prevention Trial. CIMT was measured by carotid ultrasonography. Hypertensive retinopathy was diagnosed according to the Keith--Wagener--Barker classification.

RESULTS

The mean (SD) CIMT among study participants was 739.9 (111.4) μm. Compared with patients with grade 1 hypertensive retinopathy or without hypertensive retinopathy, a significantly higher CIMT level (β, 7.63, 95% CI: 2.54--12.73) was observed in patients with grade 2-4 hypertensive retinopathy. Moreover, the association between hypertensive retinopathy (grade 2-4 versus grade 1 or normal) and CIMT was stronger in participants of younger age (<60 years; β, 13.70, 95% CI: 5.65--21.75; versus ≥60 years; β, 1.03, 95% CI: -5.58 to 7.63; P interaction = 0.006); or with lower total homocysteine levels [<12.1 μmol/l (median); β, 12.70, 95% CI: 5.98--19.42; versus ≥12.1 μmol/l; β, 2.07, 95% CI: -5.63 to 9.78; P interaction = 0.030). None of the other variables, including sex, BMI, study centers, treatment group, SBP, triglycerides, total cholesterol, fasting blood glucose, folate, serum creatinine, current smoking and alcohol drinking, significantly modified the relation of hypertensive retinopathy with CIMT levels.

CONCLUSION

Hypertensive retinopathy (grade 2 and higher) was significantly associated with increased CIMT in hypertensive patients. The association was stronger in those of younger age or with lower total homocysteine levels.

Deep vein thrombosis in the lower extremities after femoral neck fracture: A retrospective observational study

PURPOSE

The actual incidence of deep vein thrombosis (DVT) in femoral neck fractures is underestimated. This study aimed to investigate the incidence of DVT in the lower extremities after femoral neck fracture before and after operation.

METHODS

The clinical data of patients with femoral neck fractures treated at Xi'an Honghui Hospital between July 1, 2016, and December 31, 2018, were collected. The patients were examined with ultrasonography before and after operation and divided into thrombosis and non-thrombosis groups according to their ultrasonographic results. The incidence of DVT was reported as a percentage.

RESULTS

The incidence rates of preoperative and postoperative DVT were 32% and 56%, respectively. DVT on the uninjured side constituted 45% of all preoperative DVT and 43% of all postoperative DVT. Peripheral DVT constituted 90% and 84% of all preoperative and postoperative DVT, respectively. Diabetes was an independent risk factor of preoperative DVT. Blood loss was an independent risk factor of postoperative DVT, and open reduction and internal fixation surgical procedure was independent protective factor of postoperative DVT as compared with hemiarthroplasty and total hip replacement.

CONCLUSIONS

The incidence rates of preoperative and postoperative DVT in the patients with femoral neck fracture were high, and orthopedists should pay more attention to DVT as a complication.

Altered coupling between resting-state glucose metabolism and functional activity in epilepsy

OBJECTIVE

Altered functional activities and hypometabolism have been found in medial temporal lobe epilepsy patients with hippocampal sclerosis (mTLE-HS). Hybrid PET/MR scanners provide opportunities to explore the relationship between resting-state energy consumption and functional activities, but whether repeated seizures disturb the bioenergetic coupling and its relationship with seizure outcomes remain unknown.

METHODS

¹⁸ F-FDG PET and resting-state functional MRI (rs-fMRI) scans were performed with hybrid PET/MR in 26 patients with mTLE-HS and in healthy controls. Energy consumption was quantified by ¹⁸ F-FDG standardized uptake value ratio(SUVR) relative to cerebellum. Spontaneous neural activities were estimated using regional homogeneity (ReHo), fractional amplitude of low frequency fluctuations (fALFF) from rs-fMRI. Between-group differences in SUVR and rs-fMRI derived metrics were evaluated by two-sample t test. Voxel-wise spatial correlations were explored between SUVR and ReHo, fALFF across gray matter and compared between groups. Furthermore, the relationships between altered fALFF/SUVR and ReHo/SUVR coupling and surgical outcomes were evaluated.

RESULTS

Both the patients and healthy controls showed significant positive correlations between SUVR and rs-fMRI metrics. Spatial correlations between SUVR and fMRI-derived metrics across gray matter were significantly higher in patients with mTLE-HS compared with healthy controls (fALFF/SUVR, P < 0.001; ReHo/SUVR, P = 0.022). Higher fALFF/SUVR couplings were found in patients who had Engel class IA after surgery than all other (P = 0.025), while altered ReHo/SUVR couplings (P = 0.097) were not.

CONCLUSION

These findings demonstrated altered bioenergetic coupling across gray matter and its relationship with seizure outcomes, which may provide novel insights into pathogenesis of mTLE-HS and potential biomarkers for epilepsy surgery planning.

Nonoperative treatment versus volar locking plate fixation for elderly patients with distal radial fracture: a systematic review and meta-analysis

Background

This systematic review and meta-analysis assessed the role of nonoperative treatment and volar locking plate (VLP) fixation in elderly patients with distal radial fracture.

Methods

The systematic literature review identified randomized controlled trials (RCTs) and observational studies using VLP and nonoperative treatment for distal radial fractures in the elderly. Two investigators independently extracted data and evaluated the quality of the studies. A meta-analysis was performed using RevMan version 5.3.

Results

The five RCTs and six observational studies included 585 and 604 patients in the VLP and nonoperation groups, respectively. The quality of these 11 studies was moderate. Compared to nonoperation treatment, VLP did not improve the disabilities of the arm, shoulder and hand (DASH) score (weighted mean difference [WMD] = −1.67; 95% confidence interval [CI], −3.58–−0.24; P = 0.09), decrease complications (odds ratio = 1.05; 95% CI, 0.51–2.19; P = 0.89), or improve range of motion in flexion, extension, pronation, supination, and radial deviation. The VLP group had better grip strength (WMD = 10.52; 95% CI, 6.19–14.86; P < 0.0001) and radiographic assessment than the nonoperation group.

Conclusions

Although insufficient, the study evidence shows that VLP does not improve DASH scores, complications, or range of motion, but it might provide better grip strength and radiographic assessment than nonoperation treatment.

Long non-coding RNA H19, a novel therapeutic target for pancreatic cancer

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy with high mortality, which threats peoples’ health. Unfortunately, the pathogenesis of PDAC remains unclear. Recent studies have indicated that long non-coding RNAs (lncRNAs) can regulate the development and progression of malignant tumors through varying mechanisms. LncRNA H19 has a unique expression profile and can act as a sponger of specific miRNAs to regulate the pathogenic process of many diseases, including PDAC and several other types of cancers. Here, we review the research approaches to understanding the regulatory role of H19 and potential mechanisms in the progression of PDAC and other types of cancers and diseases. These studies suggest that H19 may be a novel therapeutic target for PDAC and our findings may open new revenues for scientific researches and development of valuable therapies for these diseases in the future.

Feasibility of anterior pelvic ring fixation alone for treating lateral compression type 1 pelvic fractures with nondisplaced complete sacral fractures: a retrospective study

Purpose

The aim of this study was to evaluate the feasibility of anterior pelvic ring fixation alone for treating lateral compression type 1 (LC-1) fractures with nondisplaced complete sacral fractures.

Methods

Patients with LC-1 type pelvic fractures with nondisplaced complete sacral fractures in the Xi’an Honghui Hospital were screened. Those who underwent surgical treatment for the anterior pelvic ring fractures and conservative treatment for the sacral factures were included in the analysis. The Majeed and Short Form-12 (SF-12) functional scores were used to evaluate these patients.

Results

Of the 123 patients enrolled, 108 (88%) responded to our enquiries regarding the outcome. The mean follow-up period was 18.37 months for the 108 patients who responded. The mean SF-12 functional score was 48.22 ± 9.68. The mean Majeed score was 83.47 ± 9.23, including 52 with excellent, 47 with good, seven with fair, two with poor outcomes. The SF-12 functional and Majeed scores were significantly higher in those aged <45 years or without lower limb injury than in those aged ≥45 years or with lower limb injury (P < 0.05).

Conclusion

Acceptable functional outcomes can be obtained for LC-1 pelvic fractures with nondisplaced complete sacral fractures by using anterior pelvic ring fixation alone.

[Expression of the kallistatin gene in rat corpus cavernosum]

OBJECTIVE

To investigate the expression of the kallistatin gene in the corpus cavernosum and search for some new molecular targets for the regulation of penile erectile function and treatment of ED.

METHODS

Using reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR), Western blot and immunofluorescence staining, we detected the expression of kallistatin in the rat corpus cavernosum and compared it with that in the aorta.

RESULTS

The results of RT-qPCR and Western blot revealed both mRNA and protein expressions of kallistatin in the rat corpus cavernosal tissue, with no statistically significant difference from those in the aorta (P > 0.05). Immunofluorescence staining showed that kallistatin was expressed in both endothelial and smooth muscle cells in the corpus cavernosum and localized in the cytoplasm, with no statistically significant difference from its expression in the aorta (P > 0.05) either.

CONCLUSIONS

The kallistatin gene is highly expressed in the corpus cavernosum and localized in cavernosal endothelial and smooth muscle cells, suggestive of its involvement in the cellular function of cavernosal endothelial and smooth muscle cells and its participation in the regulation of penile erectile function.

Complete Genome Sequence of Strain YCSC6, a Marine Bacterium Isolated from Saturated Saltpan with Activity Against Uronema marinum

Salinivibrio proteolyticus strain YCSC6 was isolated from a saturated saltpan and demonstrated to have strong insecticidal activity against turbot's pathogenic ciliate-Uronema marinum. In this study, we sequenced its complete genome. Results showed that it consists of two circular chromosomes: 2.49 Mbps and 0.74 Mbps, respectively. It encodes 3429 protein-coding sequences. Biosynthetic gene clusters predicted to synthesize bacteriocins and antimicrobial peptides were discovered, which might be the key factors to lyse and kill U. marinum. The complete genome sequence of strain YCSC6 provides insights into the fundamental genetic potential for elucidating its insecticidal mechanism against U. marinum.

Fabrication of Carbohydrate Chips Based on Polydopamine for Real-Time Determination of Carbohydrate⁻Lectin Interactions by QCM Biosensor

A novel approach for preparing carbohydrate chips based on polydopamine (PDA) surface to study carbohydrate⁻lectin interactions by quartz crystal microbalance (QCM) biosensor instrument has been developed. The amino-carbohydrates were immobilized on PDA-coated quartz crystals via Schiff base reaction and/or Michael addition reaction. The resulting carbohydrate-chips were applied to QCM biosensor instrument with flow-through system for real-time detection of lectin⁻carbohydrate interactions. A series of plant lectins, including wheat germ agglutinin (WGA), concanavalin A (Con A), Ulex europaeus agglutinin I (UEA-I), soybean agglutinin (SBA), and peanut agglutinin (PNA), were evaluated for the binding to different kinds of carbohydrate chips. Clearly, the results show that the predicted lectin selectively binds to the carbohydrates, which demonstrates the applicability of the approach. Furthermore, the kinetics of the interactions between Con A and mannose, WGA and N-Acetylglucosamine were studied, respectively. This study provides an efficient approach to preparing carbohydrate chips based on PDA for the lectin⁻carbohydrate interactions study.