Enhancing intraneural revascularization following peripheral nerve injury through hypoxic Schwann-cell-derived exosomes: an insight into endothelial glycolysis

BACKGROUND

Endothelial cell (EC)-driven intraneural revascularization (INRV) and Schwann cells-derived exosomes (SCs-Exos) both play crucial roles in peripheral nerve injury (PNI). However, the interplay between them remains unclear. We aimed to elucidate the effects and underlying mechanisms of SCs-Exos on INRV following PNI.

RESULTS

We found that GW4869 inhibited INRV, as well as that normoxic SCs-Exos (N-SCs-Exos) exhibited significant pro-INRV effects in vivo and in vitro that were potentiated by hypoxic SCs-Exos (H-SCs-Exos). Upregulation of glycolysis emerged as a pivotal factor for INRV after PNI, as evidenced by the observation that 3PO administration, a glycolytic inhibitor, inhibited the INRV process in vivo and in vitro. H-SCs-Exos more significantly enhanced extracellular acidification rate/oxygen consumption rate ratio, lactate production, and glycolytic gene expression while simultaneously suppressing acetyl-CoA production and pyruvate dehydrogenase E1 subunit alpha (PDH-E1α) expression than N-SCs-Exos both in vivo and in vitro. Furthermore, we determined that H-SCs-Exos were more enriched with miR-21-5p than N-SCs-Exos. Knockdown of miR-21-5p significantly attenuated the pro-glycolysis and pro-INRV effects of H-SCs-Exos. Mechanistically, miR-21-5p orchestrated EC metabolism in favor of glycolysis by targeting von Hippel-Lindau/hypoxia-inducible factor-1α and PDH-E1α, thereby enhancing hypoxia-inducible factor-1α-mediated glycolysis and inhibiting PDH-E1α-mediated oxidative phosphorylation.

CONCLUSION

This study unveiled a novel intrinsic mechanism of pro-INRV after PNI, providing a promising therapeutic target for post-injury peripheral nerve regeneration and repair.

The interpositional bypass with a parietal branch of superficial temporal artery graft for symptomatic atherosclerotic anterior cerebral artery stenosis or occlusion

Background

For nonmoyamoya patients with anterior cerebral artery (ACA) stenosis or occlusion, whether direct revascularization of the ACA territory can prevent stroke is still unclear. The objective of this study was to investigate the efficacy and safety of a parietal branch of superficial temporal artery-interposed superficial temporal artery-to-ACA bypass (PISAB) for preventing stroke in patients with symptomatic atherosclerotic ACA stenosis or occlusion (SAASO).

Methods

We retrospectively analyzed the data from patients with SAASO who had undergone PISAB in our center between April 2016 and November 2021. The rates of patency, satisfaction (revascularization grades A and B) of bypass, perioperative complications, recurrence of ischemic stroke, changes in bypass flow, and improvements in cerebral blood perfusion were analyzed.

Results

A total of 19 SAASO patients were involved in this study. Sixteen out of 19 (84.2%) patients were free from any cerebral ischemic events after surgery. Only 3 patients (15.8%) had recurrent stroke postoperatively. Two (10.5%) surgery-related complications occurred, including hyperperfusion syndrome and minor stroke. No skin ischemic complications occurred. The average follow-up period was 50.6 ± 18.3 months. The flow rate of the bypass was significantly increased half a year after surgery (56.2 ± 8.0 mL/min vs. 44.3 ± 5.3 mL/min, p < 0.001). The ratio of ipsilateral/contralateral mean transit time in the superior frontal gyrus was decreased significantly after bypass (1.08 ± 0.07 vs. 1.23 ± 0.05, p < 0.001) and continued to decrease 6 months after surgery (1.05 ± 0.04 vs. 1.08 ± 0.07, p = 0.002). The patency rate of PISAB was 94.7% (18/19) 2 years after surgery. The satisfaction rate of bypass was 89.5% (17/19).

Conclusion

The results of this study indicate that PISAB, as a safe superficial bypass, can effectively reduce the risk of stroke in SAASO patients. More precise conclusions will require randomized control studies.

Berberine inhibits NLRP3 inflammasome activation and proinflammatory macrophage M1 polarization to accelerate peripheral nerve regeneration

Berberine (BBR) has demonstrated potent anti-inflammatory effects by modulating macrophage polarization. Nevertheless, the precise mechanisms through which berberine regulates post-injury inflammation within the peripheral nerve system remain elusive. This study seeks to elucidate the role of BBR and its underlying mechanisms in inflammation following peripheral nerve injury (PNI). Adult male C57BL/6J mice subjected to PNI were administered daily doses of berberine (0, 60, 120, 180, 240 ​mg/kg) via gavage from day 1 through day 28. Evaluation of the sciatic function index (SFI) and paw withdrawal threshold revealed that BBR dose-dependently enhanced both motor and sensory functions. Immunofluorescent staining for anti-myelin basic protein (anti-MBP) and anti-neurofilament-200 (anti-NF-200), along with histological staining comprising hematoxylin-eosin (HE), luxol fast blue (LFB), and Masson staining, demonstrated that BBR dose-dependently promoted structural regeneration. Molecular analyses including qRT-PCR, Western blotting, enzyme-linked immunosorbent assay (ELISA), and immunofluorescence confirmed that inactivation of the NLRP3 inflammasome by MCC950 shifted macrophages from the pro-inflammatory M1 phenotype to the anti-inflammatory M2 phenotype, while also impeding macrophage infiltration. Furthermore, BBR significantly downregulated the expression of the NLRP3 inflammasome and its associated molecules in macrophages, thereby mitigating NLRP3 inflammasome activation-induced macrophage M1 polarization and inflammation. In summary, BBR's neuroprotective effects were concomitant with the suppression of inflammation after PNI, achieved through the inhibition of NLRP3 inflammasome activation-induced macrophage M1 polarization.

Nomogram to Predict the Outcome of Ventriculoperitoneal Shunt Among Patients with Non-HIV Cryptococcal Meningitis

BACKGROUND

The ventriculoperitoneal (VP) shunt is widely acknowledged as a treatment option for managing intracranial hypertension resulting from non-human immunodeficiency virus (HIV) cryptococcal meningitis (CM). Nonetheless, there is currently no consensus on the appropriate surgical indications for this procedure. Therefore, it is crucial to conduct a preoperative evaluation of patient characteristics and predict the outcome of the VP shunt to guide clinical treatment effectively.

METHODS

A retrospective analysis was conducted on data from 85 patients with non-HIV CM who underwent VP shunt surgery at our hospital. The analysis involved studying demographic data, preoperative clinical manifestations, cerebrospinal fluid (CSF) characteristics, and surgical outcomes and comparisons between before and after surgery. A nomogram was developed and evaluated.

RESULTS

The therapy outcomes of 71 patients improved, whereas 14 cases had worse outcomes. Age, preoperative cryptococcus count, and preoperative CSF protein levels were found to influence the surgical outcome. The nomogram exhibited exceptional predictive performance (area under the curve = 0.896, 95% confidence interval: 0.8292-0.9635). Internal validation confirmed the nomogram's excellent predictive capabilities. Moreover, decision curve analysis demonstrated the nomogram's practical clinical utility.

CONCLUSIONS

The surgical outcome of VP shunt procedures patients with non-HIV CM was associated with age, preoperative cryptococcal count, and preoperative CSF protein levels. We developed a nomogram that can be used to predict surgical outcomes in patients with non-HIV CM.

Construction of prediction model for fetal growth restriction during first trimester in an Asian population

OBJECTIVE

To construct a prediction model for fetal growth restriction (FGR) during the first trimester of pregnancy and evaluate its screening performance.

METHODS

This was a prospective cohort study of singleton pregnancies that underwent routine ultrasound screening at 11 to 13 + 6 weeks at the Affiliated Suzhou Hospital of Nanjing Medical University between January 2019 and April 2022. Basic clinical information, ultrasound indicators and serum biomarkers of pregnant women were collected. Fetal weight assessment was based on the fetal growth curve for the Southern Chinese population. FGR was diagnosed according to Delphi consensus criteria. Least absolute shrinkage and selection operator (lasso) regression was used to select variables for inclusion in the model. Discrimination, calibration and clinical effectiveness of the model were evaluated in training and validation cohorts.

RESULTS

A total of 1188 pregnant women were included, of whom 108 had FGR. Lasso regression identified seven predictive features, including history of maternal hypertension, maternal smoking or passive smoking, gravidity, uterine artery pulsatility index, ductus venosus pulsatility index and multiples of the median values of placental growth factor and soluble fms-like tyrosine kinase-1. The nomogram prediction model constructed from these seven variables accurately predicted FGR, and the area under the receiver-operating-characteristics curve in the validation cohort was 0.82 (95% CI, 0.74-0.90). The calibration curve and Hosmer-Lemeshow test demonstrated good calibration, and the clinical decision curve and clinical impact curve supported its practical value in a clinical setting.

CONCLUSION

The multi-index prediction model for FGR has good predictive value during the first trimester. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Comparison Between the Efficacy of a Flow Diverter and Interventional Trapping with Bypass in the Treatment of Unruptured Large- or Giant-Sized ICA Aneurysms

OBJECTIVE

Management of large- or giant-sized internal carotid artery aneurysms (LICAAs) remains challenging. Whether a flow diverter device (FDD) or interventional trapping with extracranial-intracranial bypass (ITB) is better, remains unclear.

METHODS

We conducted a multicenter retrospective analysis of unruptured LICAA patients treated with FDD or ITB at 3 medical centers. Both the effectiveness and safety results of FDD and ITB were compared.

RESULTS

In total, 101 aneurysms in 95 patients treated with FDDs and 36 aneurysms in 36 patients managed with ITBs were included (September 2014-June 2021). There was no significant difference between the groups in the complete obliteration rate 1 year after surgery (P = 0.101). There were 2 relapse cases (2.0%) and 4 retreated cases (4.0%) in the FDD group and 1 relapse case (2.8%) and 2 retreated cases (5.6%) in the ITB group. Neither the relapse rates nor retreat rates between groups were significantly different. The neurological morbidity rates were 4.0% (4/101) and 2.8% (1/36) in the FDD group and ITB group, respectively, and were not significantly different. There was 1 mortality case in each group, and the mortality rates were not significantly different (P = 0.443). Both the perioperative and overall (perioperative plus long-term) complication rates in the FDD group were significantly lower than those in the ITB group (P = 0.033, P = 0.039).

CONCLUSIONS

FDD had comparable surgical efficacy and a significantly lower postoperative complication rate to traditional ITB. FDD might be preferable to ITB as a treatment modality for LICAA.

Combined Double-Barrel Superficial Temporal Artery to M4 Bypass and Parent Artery Occlusion for the Treatment of Complex Intracranial Aneurysms in Internal Carotid Artery and Middle Cerebral Artery: A Retrospective Case Series

BACKGROUND

Very little research has been conducted to assess the efficacy of combined double-barrel superficial temporal artery (STA) to M4 bypass and parent artery occlusion (PAO) in the treatment of complex intracranial aneurysms.

OBJECTIVE

To determine whether this operation could become a reasonable flow replacement therapy and have longer-term benefits.

METHODS

A series of double-barrel STA-M4 bypasses performed between 2016 and 2021 were reviewed. Preoperative digital subtraction angiography (DSA), computed tomography angiography (CTA), computed tomography perfusion (CTP), and balloon test occlusion were routinely performed for a thorough evaluation of individual benefits and risks. After bypass, the proximal end of the parent artery was permanently occluded with the coil. Augmentation and patency of STA were reassessed by postoperative DSA, CTA, and CTP. The blood flow volume of STA was measured by ultrasound at admission and a 3-month follow-up.

RESULTS

This study included 12 consecutive patients (5 males, 7 females) who successfully underwent double-barrel STA-M4 bypass, including 8 complex aneurysms in the internal carotid artery (ICA) and 4 in the middle cerebral artery (MCA). Postoperative angiography and CTP suggested that all the STAs were patent, and there was a significant improvement in perfusion after the operation (P < .05). Ultrasonic measurement at the 3-month follow-up showed that the blood flow provided by STA was 76.3 to 190.5 mL/min. Postoperative ischemia was found in 1 patient, but she recovered after treatment.

CONCLUSION

Double-barrel STA to M4 bypass can provide adequate flow for the parent artery area, which may be a reasonable flow replacement therapy for some complex intracranial aneurysms in ICA and MCA.

An update on the therapeutic implications of long-chain acyl-coenzyme A synthetases in nervous system diseases

Long-chain acyl-coenzyme A synthetases (ACSLs) are a family of CoA synthetases that activate fatty acid (FA) with chain lengths of 12-20 carbon atoms by forming the acyl-AMP derivative in an isozyme-specific manner. This family mainly includes five members (ACSL1, ACSL3, ACSL4, ACSL5, and ACSL6), which are thought to have specific and different functions in FA metabolism and oxidative stress of mammals. Accumulating evidence shows that the dysfunction of ACSLs is likely to affect cell proliferation and lead to metabolic diseases in multiple organs and systems through different signaling pathways and molecular mechanisms. Hence, a central theme of this review is to emphasize the therapeutic implications of ACSLs in nervous system disorders.

The single-atom iron nanozyme mimicking peroxidase remodels energy metabolism and tumor immune landscape for synergistic chemodynamic therapy and photothermal therapy of triple-negative breast cancer

Chemotherapy, as one main strategy to relieve tumor progression, has a weak effect on triple-negative breast cancer (TNBC) chest wall metastasis. The development of near-infrared (NIR) light-responsive nanomaterials for chemodynamic therapy (CDT) and photothermal therapy (PTT) is a promising platform but still challenging in biomedicine. This study reports a peroxidase mimicking nanozyme (Fe-N-C SAzyme) against TNBC by CDT and PTT. Fe-N-C SAzyme generated reactive oxygen species (ROS) by decomposing H2O2 into hydroxyl radicals (•OH) and also induced light-to-heat conversion under the exposure of 808 nm laser irradiation. With these biological characteristics, the obtained Fe-N-C SAzymes displayed enhanced cell cytotoxicity and inhibition of cancer cell proliferation both in vitro and in vivo at a low dose of nanoagent and a moderate NIR laser power density. Besides, Fe-N-C nanoagent with its excellent ROS generation brought metabolic reprogramming of elevated glycolysis in tumor cells. In vivo experiments, when combined with PTT, the enhanced antitumor effect was found by the elimination of M-MDSC in tumor microenvironment. Fe-N-C SAzymes can serve as a new synergistic CDT and PTT nanoagent to simultaneously reprogram tumor metabolism and tumor microenvironment. It will provide prospects for chemodynamic/photothermal combined cancer therapy for TNBC chest wall metastasis based on the use of a single nanosystem.

Hierarchically hollow N-doped carbon-cobalt nanoparticle heterointerface for efficient bifunctional oxygen electrocatalysis

The rational design and fabrication of high-performance and durable bifunctional non-noble-metal electrocatalysts for both the oxygen reduction reaction (ORR) and oxygen evolution reaction (OER) are still a great challenge in the practical applications of rechargeable zinc-air (Zn-air) batteries. Herein, we report a simple yet robust route to synthesize cobalt nanoparticles rooted in the hierarchically hollow nitrogen-doped carbon frameworks (Co@HNCs). This strategy employs the pyrolysis of nanostructured hollow Co-based metal-organic framework (ZIF-67) precursors produced by selective linker cleaving with pyrazino(2,3-f)(1,10)phenanthroline-2,3-dicarboxylic acid molecules (H₂PPDA). The designed hierarchically architecture is favorable for the accessibility of the active sites in the catalyst, which affords enhanced bifunctional performance for ORR and OER. Moreover, when used as a cathode in liquid and all-solid-state Zn-air batteries, the resultant Co@HNCs delivers high efficiency and outstanding durability, even outperforming the benchmark Pt/C + RuO₂. This work provides a feasible design avenue to achieve advanced dual-phasic oxygen electrocatalyst and promotes the development of rechargeable Zn-air batteries.

Phoenixin-14 alleviates inflammatory smooth muscle cell-induced endothelial cell dysfunction in vitro

BACKGROUND

Intracranial aneurysm (IA) is cerebrovascular disorder which refers to local vessel wall damage to intracranial arteries, forming abnormal bulge. Both endothelial cells (ECs) and vascular smooth muscle cells (VSMCs) are closely associated with IA formation and rupture. Inflammatory SMCs (iSMCs) were reported to induce EC dysfunction and result in IA progression. Phoenixin-14 (PNX-14) is a recently discovered brain peptide with pleiotropic roles, which participates in reproduction, cardio protection, lipid deposition and blood glucose metabolism. PNX-14 was previously reported to protect brain endothelial cells against oxygen-glucose deprivation/reoxygenation (OGD/R)-induced cell injury. Therefore, our study was designed to investigate the influence of PNX-14 on iSMCs-induced endothelial dysfunction.

METHODS

Inflammation in SMCs was induced by cyclic mechanical stretch. Human umbilical vein endothelial cells (HUVECs) were exposed to SMC- or iSMC-conditioned medium and then treated with 100 nM PNX-14 for 24 h. The levels of proinflammatory cytokines (IL-1β, IL-6 and TNF-α) in cell supernatants were analyzed by ELISA. Cell viability, apoptosis, angiogenesis and migration were subjected to CCK-8 assay, flow cytometry analysis, tube formation assay and Transwell migration assay. The protein levels of proinflammatory cytokines and apoptosis markers (Bcl-2 and Bax) were evaluated by western blotting.

RESULTS

Cyclic mechanical stretch upregulated IL-1β, IL-6 and TNF-α levels in SMCs. Treatment with SMC- or iSMC-conditioned medium HUVECs inhibited cell viability, angiogenesis and migration and induced apoptosis in HUVECs. iSMC-conditioned medium has more significant effects on cell functions. However, the influence of SMC- or iSMC-conditioned medium treatment on HUVEC biological functions were reversed by PNX-14 treatment. PNX-14 exerts no significant influence on the biological functions of HUVECs treated with SMC medium.

CONCLUSION

PNX-14 alleviates iSMCs-induced endothelial cell dysfunction in vitro.

Delta-like factor 1 negatively regulates angiogenesis as a target gene of miR-126-5p after indirect revascularization surgery in patients with moyamoya disease

Promoting endothelial cell (EC) proliferation and angiogenesis after indirect revascularization surgery is crucial for decreasing the stroke rate in moyamoya patients. However, the role of delta-like factor 1 (DLK1) in regulating EC proliferation in chronically ischaemic brains and the specific mechanisms remain unclear. Therefore, we compared the expression levels of DLK1 in the dura mater (DM) tissues of  patients with moyamoya disease and patients with aneurysms, and dual luciferase reporter and RNA binding protein immunoprecipitation assays were conducted to determine whether DLK1 is a target gene of miR-126-5p. The effect of DLK1 on EC proliferation and the interaction between DLK1 and miR-126-5p were explored in vitro. Then, we established an animal model of two-vessel occlusion together with encephalo-myo-synangiosis (2VO+EMS). The temporalis muscles (TMs) of the animals were transfected with DLK1 lentiviral RNA (Lv-DLK1) and short hairpin RNA (sh-DLK1) to compare the DLK1 expression, angiogenesis (CD31 count), and numbers of vacuoles and impaired tight junctions in the ECs of TM-covered chronically ischaemic brains as well as the cognitive improvement in each group. DLK1 expression was lower in the DM tissues of moyamoya patients than in those of the aneurysm patients, and DLK1 was identified as a target gene of miR-126-5p. In vitro, DLK1 inhibited EC proliferation, migration and angiogenesis and exerted effects opposite those of miR-126-5p. In 2VO+EMS rats, compared to the control transfection, the TM transfection of Lv-DLK1 induced significantly higher DLK1 expression and worse angiogenesis in the TM-covered ischaemic brain as well as less extensive cognitive improvement, while the transfection of sh-DLK1 into the TM had the opposite effects. In summary, DLK1, a target gene of miR-126-5p, negatively regulates angiogenesis in chronically ischaemic brains and is expected to be a new target to improve the efficacy of indirect revascularization surgery and the prognosis of moyamoya patients.

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

BACKGROUND

Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications.

METHODS

We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC).

FINDINGS

In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]).

INTERPRETATION

In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required.

FUNDING

British Journal of Surgery Society.

Multimodal recanalization for subacute symptomatic internal carotid artery occlusion due to atherosclerosis: Outcomes and notes on hybrid techniques

OBJECTIVES

Subacute internal carotid artery occlusion (ICAO) is associated with ipsilateral recurrent stroke, and successful recanalization of ICAO can improve cerebral blood perfusion (CBP) and prevent stroke. However, the optimal treatment remains controversial.

METHODS

We conducted a retrospective analysis of patients with subacute symptomatic ICAO due to atherosclerosis treated at our center. The hybrid surgical procedures included carotid endarterectomy, Fogarty balloon catheter embolectomy, aspiration thrombectomy and percutaneous transluminal angioplasty/stenting. Recanalization rates, CBP improvement, stroke recurrence and restenosis/reocclusion were investigated.

RESULTS

Fourteen symptomatic atherosclerotic ICAO patients (type A, 4; type C, 10; men, 11; women, 3; average age, 68.1 ± 7.9 years) in the subacute phase were treated with a multimodal recanalization technique. Symptoms included mild cerebral infarction, transient ischemic attack (TIA) and amaurosis fugax. The average onset-to-treatment time was 18.1 ± 4.8 days. The successful recanalization (thrombolysis in cerebral ischemia grade 2 or 3) rate was 100%. The ipsilateral-to-contralateral mean transit time ratio was significantly lower at the 1-year follow-up than preoperatively (1.01 ± 0.05 vs. 1.26 ± 0.09, P < 0.0001). There was one case of restenosis detected 1 year after surgery and no cases of reocclusion. During the 28.3 ± 10.0 months of follow-up, only 2 cases of TIA occurred. The average modified Rankin Scale score and National Institute of Health Stroke Scale score were significantly lower at themost recent follow-up than before recanalization (1.21 ± 0.89 vs. 1.86 ± 0.66, P = 0.0003; 1.36 ± 1.55 vs. 2.00 ± 1.88, P = 0.0066).

CONCLUSION

Multimodal recanalization techniques performed in a hybrid operation theater can safely achieve high recanalization rates in atherosclerotic ICAO patients in the subacute phase, which can be beneficial for recovering CBP and preventing stroke.

Interfacial TiN bonding of a g-C3N4/TiH1.92 type-II heterojunction photocatalyst significantly enhanced photocatalytic hydrogen evolution from water splitting

An efficient interfacial TiN interaction of g-C3N4/TiH1.92 type-II heterojunctions photocatalyst facilitates an enhanced photocatalytic hydrogen evolution from water splitting with improved photoinduced electron-hole pairs separation and transport ability.

LINC01116 boosts the progression of pituitary adenoma via regulating miR-744-5p/HOXB8 pathway

Pituitary adenoma (PA) is one of the common intracranial tumors. In order to optimize status quo, seeking out potential biomarkers for pituitary adenoma diagnosis and treatment is urgent and important. Long non-coding RNAs (lncRNAs) have been related with progression of various cancers. Based on this reason and unknown role of long intergenic non-protein coding RNA 1116 (LINC01116) in pituitary adenoma, we aimed to explore the function and molecular mechanism of LINC01116 in pituitary adenoma. The RT-qPCR analysis showed that LINC01116 was abnormally overexpressed in pituitary adenoma cells. Down-regulated LINC01116 effectively suppressed cell proliferation and migration as well as epithelial-mesenchymal transition (EMT) progression in pituitary adenoma. Additionally, LINC01116 could competitively sponge miR-744-5p as shown by RIP, RNA pull down and luciferase reporter assays. Similarly, we also proved that homeobox B8 (HOXB8) was the target gene of miR-744-5p in pituitary adenoma cells. In the end, the rescue assays unmasked that HOXB8 could effectually reverse inhibition effect of LINC016 knockdown on pituitary adenoma cells proliferation, migration and EMT, further suggesting that LINC01116 expedited the pituitary adenoma progression by up-regulating HOXB8. Taken together, LINC01116 boosted the progression of pituitary adenoma cells via regulating miR-744-5p/HOXB8 pathway.

Postoperative neovascularization, cerebral hemodynamics, and clinical prognosis between combined and indirect bypass revascularization procedures in hemorrhagic moyamoya disease

OBJECTIVE

We evaluated what few studies emphasized the postoperative collateral formation and cerebral hemodynamics of hemorrhagic moyamoya disease (MMD).

METHODS

Hemorrhagic MMD patients treated surgically were retrospectively collected and dichotomized into combined bypass (CB) and indirect bypass (IB) groups. CB used superficial temporal artery-to-middle cerebral artery anastomosis combined with encephaloduroarteriomyosynangiosis (STA-MCA+EDAMS), and IB used encephaloduroarteriomyosynangiosis (EDAMS) for revascularization. Postoperative complications and clinical prognosis, as well as pre- and post-operative Modified Rankin Scale (mRS), collateral circulation status, and cerebral hemodynamics were observed and compared between the CB and IB groups.

RESULTS

A total of 37 patients with hemorrhagic MMD were identified. Of the 68 cerebral hemispheres, 47(69.1%) were combined revascularization, and the rest were indirect. During an average follow-up of 16.5 ± 8.7 months, the recurrent stroke events were significantly lower, as well as having a postoperative mRS scores≤ 2. A satisfactory postoperative collateral formation, and an improved dilation or extension of the anterior choroidal/posterior communication artery (AchA/PcoA) were significantly higher in the CB group than in the IB group (all P < .05). Compared with preoperative cerebral hemodynamics, relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), mean transit time (MTT), and relative time to peak (rTTP) in the CB group; rCBF, rCBV, and MTT in the IB group were significantly improved (all P < .001). The CB group's postoperative rCBF was significantly improved compared with the IB group (P < .001).

CONCLUSIONS

STA-MCA bypass combined with EDAMS can obtain better postoperative collateral formation, cerebral hemodynamics, and clinical prognosis than EDAMS alone.

Integrating a metal framework with Co-confined carbon nanotubes as trifunctional electrocatalysts to boost electron and mass transfer approaching practical applications

A facile and large-scale construction of robust and inexpensive trifunctional self-supporting electrodes for the oxygen reduction reaction (ORR), oxygen evolution reaction (OER) and hydrogen evolution reaction (HER) in metal-air batteries and water splitting is crucial but remains challenging. Herein, we report a direct and up-scalable all-solid-phase strategy for the synthesis of a porous three-dimensional electrode consisting of cobalt nanoparticles wrapped in nitrogen-doped carbon tubes (Co/N-CNTs), which are in situ planted onto the surface of a cobalt foam. The resultant Co/N-CNTs can directly serve as a self-supporting and adhesive-free electrode with excellent and durable catalytic performances for the ORR, OER and HER. The metal framework substrate with an open-pore architecture is favorable for electron and mass transfer and allows fast catalytic kinetics. More importantly, when used in Zn-air batteries and overall water splitting, the as-prepared Co/N-CNT electrode displays a remarkable performance, implying bright perspects for practical application.

Phoenixin-14 regulates proliferation and apoptosis of vascular smooth muscle cells by modulation of KCNQ1OT1/miR-183-3p/CTNNB1 axis

Phoenixin-14 has been reported to be implicated in the process of blood glucose metabolism, reproduction, lipid deposition and cardioprotection. However, the role of phoenixin-14 in vascular smooth muscle cells (VSMCs) remains unkown. In this study, we focused on the effects of phoenixin-14 on VSMCs under oxidized low-density lipoprotein (ox-LDL) treatment. The experimental results demonstrated that phoenixin-14 inhibited mRNA level and nuclear translocation of β-catenin. Functionally, phoenixin-14 inhibited cell proliferation and facilitated apoptosis of VSMCs under ox-LDL stimulation, and CTNNB1 overexpression reversed these effects. Mechanistically, KCNQ1OT1 interacted with miR-183-3p to upregulate CTNNB1 in VSMCs. Furthermore, CTNNB1 expression was negatively correlated with miR-183-3p but positively associated with KCNQ1OT1. Rescue assays indicated that KCNQ1OT1 overexpression or Lithium chloride (LiCl) treatment reversed the effects of phoenixin-14 on proliferation and apoptosis of ox-LDL-stimulated VSMCs. In summary, phoenixin-14 regulates proliferation and apoptosis of ox-LDL-treated VSMCs by regulating the KCNQ1OT1/miR-183-3p/CTNNB1 axis.

How to Construct Polar Codes for Ring-LWE-Based Public Key Encryption

There exists a natural trade-off in public key encryption (PKE) schemes based on ring learning with errors (RLWE), namely: we would like a wider error distribution to increase the security, but it comes at the cost of an increased decryption failure rate (DFR). A straightforward solution to this problem is the error-correcting code, which is commonly used in communication systems and already appears in some RLWE-based proposals. However, applying error-correcting codes to those cryptographic schemes is far from simply installing an add-on. Firstly, the residue error term derived by decryption has correlated coefficients, whereas most prevalent error-correcting codes with remarkable error tolerance assume the channel noise to be independent and memoryless. This explains why only simple error-correcting methods are used in existing RLWE-based PKE schemes. Secondly, the residue error term has correlated coefficients leaving accurate DFR estimation challenging even for uncoded plaintext. It can be found in the literature that a tighter DFR estimation can effectively create a DFR margin. Thirdly, most error-correcting codes are not well designed for safety considerations, e.g., syndrome decoding has a nonconstant time nature. A code good at error correcting might be weak under a variety of attacks. In this work, we propose a polar coding scheme for RLWE-based PKE. A relaxed “independence” assumption is used to derive an uncorrelated residue noise term, and a wireless communication strategy, outage, is used to construct polar codes. Furthermore, some knowledge about the residue noise is exploited to improve the decoding performance. With the parameterization of NewHope Round 2, the proposed scheme creates a considerable DRF margin, which gives a competitive security improvement compared to state-of-the-art benchmarks. Specifically, the security is improved by 28.8%, while a DFR of 2−149 is achieved a for code rate pf 0.25, n=1024,q= 12,289, and binomial parameter k=55. Moreover, polar encoding and decoding have a quasilinear complexity O(Nlog2N) and intrinsically support constant-time implementations.

Successful retrieval of a retained J guidewire from the right atrium and aorta arch using a self-invented snare device

Guidewire retention during an interventional treatment is a very rare complication that can lead to possible serious complications, such as thrombosis, embolization, sepsis, and perforation. Hence, a retained guidewire must be retrieved as soon as possible. Here, we provide the first report of a case of accidental retention of a 0.035” J guidewire in the right atrium and aortic arch during basilar artery aneurysm embolization. We found that due to the heavier weight of the J guidewire and its hydrophilic-coated layer, it could not be removed using previously reported methods for micro-guidewire retention. Therefore, we constructed a self-invented snare device consisting of a 0.014” micro-guidewire and a 4-Fr MP-A1 catheter and successfully retrieved the J guidewire, thus avoiding open surgery and its associated serious complications. According to our experience, this novel technique described here is quite easy to perform, safe and effective and can avoid serious complications and prevent the need for open surgery.

Removal ability of different underlying surfaces to near-surface particulate matter

Atmospheric particulate matter is a wide-ranging environmental pollutant that can cause serious harm and poses a serious threat to public health. In this study, the near-surface particulate matter removal ability was quantitatively analyzed and compared for different land types under different pollution levels. The results showed that the concentrations of particulate matter 10 μm or less in diameter (PM10) and 2.5 μm or less in diameter (PM2.5) were higher in the morning and lower in the afternoon and that the seasonal variation was autumn > winter > spring > summer at a forest site. The diurnal concentration of particulate matter at a wetland site decreased continuously, with a seasonal variation of winter > autumn > spring > summer. The annual variation in the particulate matter concentration was higher in 2017 than in 2016 at both the forest and wetland sites. Forests remove particulate matter via plant leaves and root absorption, and wetlands rely on the enhancement of the relative air humidity to promote the absorption and accumulation of particles. For different air pollution levels, the deposition flux of PM2.5 increased with the pollution gradient. For the same air quality pollution level, the deposition flux of PM2.5 at the forest site was approximately 1.29 times higher than that at the wetland site. Data concerning PM10 in forests and wetlands are lacking. The results show that the deposition effect of the forest on particulate matter was better than that of the wetland.

Is location of urethral kinking a confounder of association between urethral closure pressure and stress urinary incontinence?

OBJECTIVES

Intact urethral support and normal sphincter function are deemed important for urinary continence. We aimed to test whether the location of urethral kinking (as the probable anatomical correlate of maximal pressure transmission) is associated with stress urinary incontinence and/or urodynamic stress incontinence.

METHODS

This was a retrospective study of women seen at a tertiary urogynecological center in 2017. Patients had undergone an interview, multichannel urodynamic testing and four-dimensional translabial ultrasound examination. Those with a history of anti-incontinence surgery, absence of urethral kinking on ultrasound and/or missing or inadequate ultrasound volume data were excluded. Volume data were used to assess urethral mobility using a semi-automated Excel® urethral motion profile program. Mobility vectors were calculated using the formula √((x _valsalva  - x _rest )² + (y _valsalva  - y _rest )² ), where x and y are the coordinates of six equidistant points along the length of the urethra from the bladder neck to the external urethral meatus. The location of urethral kinking was identified as a concave contour of the urethra on the vaginal side in the midsagittal plane on maximum Valsalva maneuver. The distance between the center of the kink and the bladder neck was measured and expressed as a centile in relation to the total length of the urethra, using the formula: (distance from bladder neck/total length of urethra) × 100. Univariate and multivariate analyses were performed to test the associations of stress urinary incontinence and urodynamic stress incontinence with age, maximum urethral pressure, urethral mobility vectors and location of urethral kinking.

RESULTS

Of 450 women seen during the study period, 61 were excluded owing to previous incontinence surgery and 82 owing to absence of urethral kinking, inadequate volume data or missing data, leaving 307 women included, of whom 227 (74%) complained of stress urinary incontinence and 211 (69%) complained of urgency urinary incontinence. 190 (62%) of the women were diagnosed with urodynamic stress incontinence. On multivariate analysis, maximum urethral pressure (36 vs 50 cmH₂ O; P < 0.001), mid-urethral mobility (2.27 vs 2.03 cm; P = 0.003) and location of urethral kinking (63.1^st vs 59.7^th centile; P = 0.002) were associated significantly with urodynamic stress incontinence. The location of urethral kinking was associated with stress urinary incontinence on univariate analysis (P = 0.026) but not on multivariate analysis (P = 0.21).

CONCLUSIONS

The location of urethral kinking is associated with urodynamic stress incontinence. The further urethral kinking is from the mid urethra, the more likely is urodynamic stress incontinence. This provides circumstantial evidence for the pressure-transmission theory of stress urinary continence. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.

Superficial Temporal Artery-Posterior Cerebral Artery Bypass for the Treatment of Chronic Basilar Artery Occlusion

OBJECTIVE

To investigate the effect of superficial temporal artery-posterior cerebral artery (STA-PCA) bypass on chronic basilar artery occlusion (CBAO).

METHODS

A total of 4 patients who underwent STA-PCA bypass between January 2018 and October 2019 were enrolled in this study. Cerebral blood perfusion, ischemic events, STA diameter and blood flow changes, modified Rankin scale score (mRS), and National Institutes of Health Stroke Scale (NIHSS) score changes were recorded before and after bypass surgery.

RESULTS

The average time from basilar artery occlusion (confirmed by cerebral angiography or computed tomography angiography) to operation was 76 ± 38.89 days (range: 30-120 days). Average scores on the NIHSS were 6.8 ± 1.26 (5-8) and 5.2 ± 2.06 (3-7) before and after treatment, respectively. mRS scores averaged 1.8 ± 0.5 (1-2) and 1.5 ± 0.58 (1-2) points, respectively. There were no obvious complications or further stroke during the follow-up. The STA diameter and flow rate were significantly increased at 12 months after operation (P < 0.05).

CONCLUSIONS

STA-PCA bypass can improve cerebral blood flow perfusion in CBAO patients. The diameter and flow of the superficial temporal artery can be increased to meet the demand of blood supply.

Identifying Needs and Barriers to Diabetes Dietary Education in Chinese People with Type 2 Diabetes and Their Family Members in Guangzhou: A Qualitative Study

PURPOSE

The purpose of this exploratory qualitative study was to identify the needs and barriers to diabetes dietary education issues in a Chinese context among people with type 2 diabetes and also their family members.

PATIENTS AND METHODS

Nineteen patients with type 2 diabetes and 15 family members were randomly selected from a larger study in Guangzhou. Descriptive phenomenological qualitative inquiry guided this study.

RESULTS

Both patients and their family members claimed a variety of needs regarding diabetes dietary information and that it should be patient-centered. In addition, both groups identified the effectiveness and helpfulness of diabetes diet-related health education, but family members reported a lack of professional education. Patients reported that the barriers to diabetes diet-related health education were: 1) patients' different faculties of memory and acceptance, 2) educators' methods of explaining the information, 3) lack of advertising and intensity of publicity both inside and outside of the hospital. Family members identified that diabetes diet-related health education assisted them with taking care of patients with diabetes and it was also beneficial for themselves to gain more dietary knowledge and develop healthy dietary habits.

CONCLUSION

It is necessary to make some adjustment to traditional diabetes dietary education. It may be a good strategy to investigate the needs and faculties of memory and acceptance of people with diabetes before starting a diabetes education program. Hospitals should intensify their publicity of diabetes education and make it more attractive to patients with diabetes and their family members. Educators should add information specifically for family members while conducting diabetes education. Tertiary hospitals could provide standardized training regarding diabetes-related health education to community family physicians; in this way, diabetes education could gradually be transferred to them and both groups of clinicians could share in the education.

Cognitive Impairment and Related Factors Among Middle-Aged and Elderly Patients with Type 2 Diabetes from a Bio-Psycho-Social Perspective

OBJECTIVE

This study investigated the biomedical, psychological, and social behavior risk factors for cognitive impairment in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM).

METHODS

This cross-sectional study included 240 patients with T2DM. A questionnaire was used to collect demographic and disease-related data on patients, and the Self-rating Depression Scale (SDS), Diabetes Self-care Scale (DSCS), and Social Support Rating Scale (SSRS) were used to assess patients' depression status, self-management behavior, and social support, respectively. The Chinese version of the Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive function, with a score <26 set as the threshold for cognitive impairment.

RESULTS

The prevalence of cognitive dysfunction in middle-aged and elderly patients with T2DM was 52.5%. Multivariate logistic regression analysis showed that older age, a history of hypoglycemia within 1 month, and depression were independent risk factors for cognitive impairment. Education for >12 years, urban living, and a higher total score on the DSCS were independent protective factors against cognitive impairment.

CONCLUSION

T2DM patients with high risk of cognitive impairment can be identified early from the bio-psycho-social perspective. Patients with T2DM who are older, less educated, living in rural areas, have hypoglycemia history, and have poor self-management of diabetes are at increased risk of cognitive impairment. Closer monitoring of patients with hypoglycemia, early detection of depression, and improving patients' self-management capacity can prevent cognitive impairment in middle-aged and elderly patients with T2DM.

Sulfur doped ruthenium nanoparticles as a highly efficient electrocatalyst for the hydrogen evolution reaction in alkaline media

Sulfur-doped ruthenium ultrafine nanoparticles is obtained via a simple solvothermal procedure, which shows excellent hydrogen evolution performance in alkaline media.

Biomolecular l-tryptophan as a hole mediator anchored on g-C3N4 exhibits remarkably enhanced photocatalytic H2 evolution

A novel g-C₃N₄-based composite coupled with levorotatory-tryptophan restrains the recombination of photogenerated holes and electrons, exhibiting enhanced photocatalytic H₂ production.

Efficacy and Safety of a Decision Support Intervention for Basal Insulin Self-Titration Assisted by the Nurse in Outpatients with T2DM: A Randomized Controlled Trial

OBJECTIVE

The main aim of this study was to evaluate a combined fasting blood glucose based dosage self-titration setting and decision supported telephone coaching intervention on glycemic control and diabetes self-management skills, compared to the conventional care.

METHODS

A 12-week, single-blinded, randomized controlled trial was conducted on adults with type 2 diabetes (T2DM) primarily treated with basal insulin. After randomization, the intervention group (IG, n = 426) received a basal insulin self-titration decision support intervention administered by the Diabetes Specialty Nurses while the control group (CG, n = 423) received conventional care for 12 weeks, both included five telephone interviews. The primary efficacy endpoint was the effect of intervention on glycemic control, measured as the change in glycated hemoglobin (HbA1c) from baseline to Week 12 (after intervention) compared to the control group. Other endpoints included comparisons of the effects of intervention on fasting plasma glucose (FPG), postprandial plasma glucose (PPG), body weight, Michigan diabetes knowledge test (MDKT), diabetes empowerment scale-short Form (DES-DSF), and summary of diabetes self-care activities (SDSCA). Changes in the primary and secondary outcomes were compared using the t-test for continuous variables with a normal distribution and χ ²-test for categorical variables.

RESULTS

The IG showed more improvements on mean HbA1c, compared to the CG (-2.8% vs -1.8%), so did the FPG, PPG, MDKT, DES-DSF and SDSCA (all P<0.01) after the 12-week follow up. Though the final mean insulin dose in the IG was higher than the CG at the end of the study (0.32 U/kg vs 0.28 U/kg), the changes of body weight were similar between the two groups (0.46kg vs 0.40kg, P=0.246), and the proportion of patients with hypoglycemia events during the whole trial were similar (20.65% vs 17.73%, P=0.279).

CONCLUSION

Decision supporting of basal insulin glargine self-titration assisted by Diabetes Specialty Nurses is effective and safe in patients with T2DM. Decision supported telephone coaching intervention offers ongoing encouragement, guidance, and determination of relevant sources of decisional conflict, facilitating adjusting the insulin dose.

A Case of Cushing Disease Masked by Symptoms of Bipolar Disorder

BACKGROUND

Cushing disease is a rare but serious endocrine disorder. It involves increased cortisol levels, which can damage the function of various systems throughout the body, including the central nervous system, affecting cognition, memory, and emotion. However, it is rare that Cushing disease presents as a mental disorder. This paper reports the complete diagnosis, treatment process, and follow-up of a patient with Cushing disease whose main symptom was bipolar disorder.

CASE PRESENTATION

A 31-year-old woman was diagnosed with bipolar disorder 9 years ago and was admitted to hospital several times due to repeated episodes of depression and mania. In October 2017, after careful examination and consideration by doctors, the patient was diagnosed with Cushing syndrome and underwent transsphenoidal pituitary microadenoma resection. Glucocorticoid replacement therapy and antipsychotic therapy were administered postoperatively. After careful treatment and care by the medical staff, the patient's cortisol levels returned to normal, and her mental symptoms were significantly improved.

CONCLUSION

This is a rare case of Cushing disease marked by psychiatric symptoms. Neuropsychiatric symptoms can precede the onset of Cushing disease, making diagnosis challenging.

Comparison of the Effectiveness of Ring-Stripping Retrograde Endarterectomy and Carotid Artery Crossover Bypass in the Treatment of Patients with Symptomatic Riles Type 1A Common Carotid Artery Occlusion

OBJECTIVE

The surgical procedure most appropriate for treating symptomatic Riles type 1A common carotid artery occlusion (CCAO) is unclear. This study compares the effects of ring-stripping retrograde endarterectomy (RSRE) and carotid artery crossover bypass (CACB) on cerebral perfusion improvement in patients with symptomatic Riles type 1A CCAO.

METHODS

We conducted a retrospective analysis of symptomatic Riles type 1A CCAO patients treated at our centre. Postoperative improvements in the ipsilateral internal carotid artery (ICA) flow rate, ipsilateral cerebral blood perfusion (CBP) and the stroke recurrence rate were compared between patients who underwent RSRE and those who underwent CACB.

RESULTS

A total of 20 CCAO patients were surgically treated at our centre from 2011 to 2018. Nine of these patients underwent RSRE, and eleven underwent CACB. No significant differences were identified between the groups in the ipsilateral blood flow rate of the ICA immediately after surgery and the ipsilateral-to-contralateral mean transit time ratios 1 day after surgery. However, the flow rate in the ICA was significantly higher in the RSRE group than in the CACB group 1 year after surgery (135.44 ± 19.22 ml/min vs. 116.36 ± 17.70 ml/min, p = 0.033). For CBP, the ipsilateral-to-contralateral mean transit time ratios were significantly lower in RSRE patients than in CACB patients 1 year after surgery (1.005 ± 0.052 vs. 1.064 ± 0.066, p = 0.044). In addition, the postoperative modified Rankin scale (mRS) score at the latest follow-up point (p = 0.884) and the stroke recurrence rate during the follow-up (88.9% vs. 90.9%, p > 0.999) were not significantly different between the two groups.

CONCLUSIONS

Although the postoperative mRS score and the stroke recurrence rate were not significantly different between RSRE and CACB patients, compared to CACB, RSRE was better for improving the ipsilateral ICA flow rate and cerebral perfusion in symptomatic Riles type 1A CCAO patients.

Epigenetic regulation of insulin action and secretion - role in the pathogenesis of type 2 diabetes

The prevalence of type 2 diabetes (T2D) is rapidly increasing worldwide. Obesity, physical inactivity and ageing increase the risk of T2D. Epigenetic modifications can change due to environmental exposures and may thereby predispose to disease. This review aims at summarizing recent advances in epigenetics related to T2D, with a special focus on impaired insulin action and secretion in humans. There will be an emphasis on analyses in human tissues; both from T2D case-control cohorts and intervention studies. Current data support an important role for epigenetics in the pathogenesis of T2D. Numerous studies have found differential DNA methylation and gene expression in skeletal muscle, adipose tissue, the liver and pancreatic islets from subjects with T2D compared with nondiabetic controls. For example, PDX1 has increased DNA methylation and decreased expression in pancreatic islets from patients with T2D compared with nondiabetic controls. Nongenetic risk factors for T2D such as ageing, unhealthy diets and physical activity do also impact the epigenome in human tissues. Interestingly, physical activity altered DNA methylation of candidate genes for T2D such as THADA in muscle and FTO, KCNQ1 and TCF7L2 in adipose tissue. There is also a strong interaction between genetic and epigenetic factors that together seem to affect T2D. mQTL studies in human adipose tissue and pancreatic islets showed that SNPs associated with DNA methylation levels in numerous sites. Several of these SNPs are also associated with T2D. Recent data also support that DNA methylation of some sites in blood may be developed into biomarkers that predict T2D since methylation of, for example TXNIP, ABCG1 and SREBF1 associated with future T2D. Future studies should use this information for development of new therapies and biomarkers and thereby improve prediction, prevention and treatment of T2D and its complications.

Silencing of Long Non-Coding RNA (LncRNA) Non-Coding RNA Activated by DNA Damage (NORAD) Inhibits Proliferation, Invasion, Migration, and Promotes Apoptosis of Glioma Cells via Downregulating the Expression of AKR1B1

Background

We aimed to investigate the functions of long non-coding RNA (lncRNA) non-coding RNA activated by DNA damage (NORAD) in glioma and identify the potential mechanisms.

Material/Methods

The expression of NORAD and AKR1B1 in human glioma cell lines were examined using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Then, cell proliferation, invasion, and migration were tested by Cell Counting Kit-8 (CCK-8), colony formation assay, Transwell, and scratch wound healing assay after NORAD silencing. Meanwhile, western blotting was utilized to measure the expression of migration-related proteins. Apoptosis of glioma cells was detected using flow cytometry and apoptosis-related proteins expression was determined. Moreover, the correlation between NORAD and AKR1B1 was verified by RNA-binding protein immunoprecipitation (RIP assay). After co-transfection with AKR1B1 overexpressed plasmid and NORAD siRNA, cell proliferation, invasion, migration, and apoptosis were examined again. Furthermore, the expression of proteins in extracellular signal-regulated kinase (ERK) signaling was tested using western blotting.

Results

The results revealed that NORAD and AKR1B1 were highly expressed in glioma cells. NORAD silencing inhibited proliferation, invasion and migration but promoted apoptosis of glioma cells, accompanied by the expression changes of migration- and apoptosis-related proteins. However, after co-transfection with AKR1B1 pcDNA3.1 in NORAD silencing cells, the effects of NORAD silencing on proliferation, invasion, migration, and apoptosis were attenuated. Consistently, the expression of phosphorylated ERK (p-ERK) was decreased after NORAD silencing, which were reversed following AKR1B1 overexpression.

Conclusions

These findings demonstrated that NORAD silencing suppressed proliferation, invasion, and migration and boosted apoptosis of glioma cells via downregulating the AKR1B1 expression, which may provide a potential therapeutic target for glioma treatment.

Brachybacterium nesterenkovii isolated from a human blood culture-a first report

Brachybacterium is a genus of Gram-positive bacteria that rarely causes infections in humans. Here we report the case of an 8-month-old infant who presented with an acute febrile illness. During the diagnostic process, a blood culture was positive with Gram-positive cocci that were identified as Brachybacterium nesterenkovii by MALDI-TOF. As a result of the unclear clinical significance of this isolate and the continuous febrile state, a second blood culture was taken and returned B. nesterenkovii once more. To our knowledge this is the first time that B. nesterenkovii has been isolated from human blood cultures during the course of a systemic infection.

Surgical procedures including carotid-carotid crossover bypass and ring-stripping hybrid operation for Rile's type 1A common carotid artery occlusion: an experience of 6 cases

Background

At present, there is no consensus on the treatment of common carotid artery occlusion (CCAO). We explored the surgical indications and observed the therapeutic effects of carotid-carotid crossover bypass and ring-stripping hybrid operation for treatment of Rile’s type 1A CCAO.

Methods

The imaging data, clinical manifestations, surgical complications and postoperative ischemic events were retrospectively collected from the 6 cases with Rile’s type 1A CCAO that underwent surgery in our department from 2011 to 2018. Of the 6 cases, 4 received carotid-carotid crossover bypass and 2 ring-stripping hybrid operation.

Results

Of the 6 cases, 4 were male and 2 females, with a mean age of 62.7 years. All cases had the left CCAO combined with decreased computed tomography perfusion (CTP) in the left internal carotid artery blood supply area. In the 4 cases receiving carotid-carotid crossover bypass, the mean operation time was 186±13 min, the mean hospital stay was 17±1 d, postoperative CTP improved, one case had swallowing foreign body sensation, synthetic vascular grafts were patent and no ischemic events occurred during the mean follow-up of 62.3±26.3 months. In the 2 cases receiving ring-stripping hybrid operation, the mean operation time was 118±11 min, the mean hospital stay was 5.5±0.7 d, postoperative CTP improved, and the opened common carotid arteries (CCA) were patent and no ischemic events occurred during the mean follow-up of 17.5±3.5 months.

Conclusions

Rile’s type 1A CCAO with related symptoms and decreased CTP should be treated by revascularization. The carotid-carotid crossover bypass is a good choice in bypass schemes because of its easy operation and good long-term patency. The ring-stripping hybrid operation may be an ideal surgical scheme for Rile’s type 1A CCAO.

A Hybrid VOx Incorporated Hexacyanoferrate Nanostructured Hydrogel as a Multienzyme Mimetic via Cascade Reactions

Inspired by the cascade reactions occurring in micro-organelles of living systems, we have developed a hybrid hydrogel, a nanozyme that mimics three key enzymes including peroxidase, superoxide dismutase, and catalase. The organic/inorganic nanostructured hydrogel constituting VO_x incorporated hexacyanoferrate Berlin green analogue complex (VO_xBG) is prepared by a simple one-step hydrothermal process, and its composition, structure, and properties are thoroughly investigated. Polyvinylpyrrolidone, a low-cost and biocompatible polymer, was utilized as a scaffold to increase the surface area and dispersion of the highly active catalytic centers of the nanozyme. Compared to the widely used horseradish peroxidase in enzyme-linked immunosorbent assay, our VO_xBG analogue hydrogel displays an excellent affinity toward the chromogenic substrate that is used in these peroxidase-based assays. This higher affinity makes it a competent nanozyme for detection and oxidation of biomolecules, including glucose, in a cascade-like system which can be further used for hydrogel photolithography. The VO_xBG analogue hydrogel also holds a good ability for the rapid and efficient oxidative degradation of environmentally unfriendly recalcitrant substrates under light irradiation. Detailed mechanistic studies of this multifaceted material suggest that different complex catalytic processes and routes are involved in these photo-Fenton and Fenton reactions that are responsible for the generation as well as consumption of reactive oxygen species, which are effectively activated by a multienzyme mimetic of the VO_xBG analogue hydrogel.

Development and Validation of a Hypoglycemia Risk Model for Intensive Insulin Therapy in Patients with Type 2 Diabetes

AIMS

To develop a simple hypoglycemic prediction model to evaluate the risk of hypoglycemia during hospitalization in patients with type 2 diabetes treated with intensive insulin therapy.

METHODS

We performed a cross-sectional chart review study utilizing the electronic database of the Third Affiliated Hospital of Sun Yat-sen University, and included 257 patients with type 2 diabetes undergoing intensive insulin therapy in the Department of Endocrinology and Metabolism. Logistic regression analysis was used to derive the clinical prediction rule with hypoglycemia (blood glucose ≤ 3.9 mmol/L) as the main result, and internal verification was performed.

RESULTS

In the derivation cohort, the incidence of hypoglycemia was 51%. The final model selected included three variables: fasting insulin, fasting blood glucose, and total treatment time. The area under the curve (AUC) of this model was 0.666 (95% CI: 0.594-0.738, P < 0.001).

CONCLUSIONS

The model's hypoglycemia prediction and the actual occurrence are in good agreement. The variable data was easy to obtain and the evaluation method was simple, which could provide a reference for the prevention and treatment of hypoglycemia and screen patients with a high risk of hypoglycemia.

Metal–organic framework derived nitrogen-doped carbon-RhNi alloys anchored on graphene for highly efficient hydrogen evolution reaction

Nitrogen-doped carbon-RhNi alloy nanoparticles anchored on reduced graphene oxide nanosheet hybrid structure (NC-RhNi/rGO) exhibit high HER performance.

[Study on purification effect of formaldehyde in cleanroom by new return air device]

Objective: To effectively reduce the concentration of poisons in cleanroom, protect the health of workers, realize the optimization and automatic control of the new return air device. And the influence of initial concentration, air volume, temperature and relative humidity of formaldehyde on the purification effect of the new return air device was explored. Methods: The purification effect of the new return air device installed with the activated carbon and the photocatalyst purification net or ordinary activated carbon purification network was tested in a 60 m(3) simulated cleanroom. The concentration of formaldehyde was determined by solution absorption-phenol reagent spectrophotometry. Based on the single factor experiment to determine the combination of two purification nets. The effects of air volume, initial formaldehyde concentration, temperature and relative humidity on the purification effect of the new return air device were investigated by orthogonal test. Then, the performance parameters of the return air device to purify formaldehyde were determined. Results: The formaldehyde purification efficiency of the two types of purification nets in the new return air device was higher than that of the ordinary activated carbon purification network (P<0.05) . The combination of activated carbon and photocatalyst purification net has no effect on the formaldehyde purification efficiency of the return air device (P>0.05) . According to the direct analysis and variance analysis, air volume was the most sensitive factor (F value is 18.894, P<0.05) , followed by initial concentration (F value is 16.128, P<0.05) , while temperature and relative humidity have little effect (F value is 0.041 and 0.599, respectively, P>0.05) . LSD analysis showed that there was no significant difference in the purification efficiency of formaldehyde between 475 m(3)/h and 626 m(3)/h (P>0.05) . From the perspective of formaldehyde purification efficiency and energy saving, when the air volume is set to 475 m(3)/h, the new return air device has higher purification efficiency for high concentration of formaldehyde. Conclusion: The new return air device consisting of activated carbon and photocatalyst purification net can play a good purification role in cleanroom with different temperatures and different humidity. Its formaldehyde purification efficiency is affected by air volume and initial concentration.

Triptolide induces mitochondrial apoptosis through modulating dual specificity phosphatase 1/mitogen-activated protein kinases cascade in osteosarcoma cells

Due to chemoresistance and metastasis, the overall prognosis of osteosarcoma (OS) has not improved over the last two decades. Exploring novel therapeutic agents that can circumvent theses malignant phenotypes of OS would be essential to improve the survival of OS patients. Triptolide is a unique diterpene triepoxide that possesses potent antitumor activities.However, the effects and mechanism of triptolide on OS cells remain unknown. The effects of triptolide on viability, apoptosis, cell cycle distribution and migratory ability of OS cells were measured using MTT, flow cytometry and wound healing and transwell invasion assays. And an OS tumor xenograft mouse model was produced to further study the in vivo antitumor effects of triptolide. The expression of DUSP1 at the protein and mRNA level in OS cells was detected by western blot and qPCR. We report that triptolide exhibits multidimensional antitumor activities in OS cells, including the induction of apoptosis and G1 phase accumulation, inhibition of cell viability, migration, and invasion. We further demonstrate that triptolide inhibits the expression of dual-specificity protein phosphatase1 (DUSP1) through inhibiting its promoter activity, which causes sustained activation of three subfamilies of mitogen-activated protein kinase (MAPK). And the modulation of DUSP1/MAPK cascade is associated with the apoptosis of OS cells, since the ectopic expression of DUSP1 or the inhibition of MAPK using specific inhibitors can counteract triptolide-induced apoptosis. In addition, triptolide enhances doxorubicin-induced apoptosis. In summary, our study suggests that DUSP1 is an important cellular target of triptolide, and triptolide may be a promising treatment option for OS as a single agent or combined with other chemotherapeutics.

The surgical approach for clipping anterior communicating artery Aneurysm

Anterior communicating artery (ACoA) aneurysm, accounts for 30%-35% of all the aneurysm making it one of the most common intracranial aneurysms. Although the Pterional approach is considered as the safe and appropriate method in ACoA aneurysm surgery, temporalis atrophy and injury to a frontal branch of the facial nerve are few inexorable complications. With the advancement of minimally invasive surgery several modified approaches, such as the supraorbital eyebrow incision approach, the minipterional approach, the mini-supraorbital approach, and the lateral supraorbital approach has been recently introduced and has been used as an alternative.

Percutaneous transluminal angioplasty for radial artery graft stenosis after high-flow superficial temporal artery trunk to middle cerebral artery interposition bypass

Due to its higher patency rate, a radial artery graft (RAG) is used as an interposition graft for internal-external high-flow bypass more frequently than a saphenous vein graft (SAG). Nevertheless, there are still a few cases of RAG stenosis after bypass surgery. Unfortunately, these reports do not elaborate on the treatment for RAG stenosis. Here, we report the first case of severe RAG stenosis after high-flow STAt-RA-MCA bypass, which was successfully treated with PTA. We speculated that RAG stenosis is associated with the over-length and kinking of the intracranial segment of the RAG instead of vasospasm. We elaborated on the surgical procedure and treatment experience in this particular case in detail. According to our experience, PTA is a type of surgical procedure that can be considered for treating RAG stenosis after high-flow bypass. As long as the surgical procedure can be performed well according to the distance between the stenosis and the anastomosis and the characteristics of the RA tissue, PTA is able to achieve satisfactory long-term results.

Superficial Temporal Artery Trunk-to-Middle Cerebral Artery Bypass with Short Radial Artery Interposition Graft for Symptomatic Internal Carotid Artery Occlusion

OBJECTIVE

We investigated the use of high-flow superficial temporal artery trunk-to-radial artery-to-middle cerebral artery (STAt-RA-MCA) bypass to prevent ischemic stroke in patients with symptomatic internal carotid artery occlusion (SICAO).

METHODS

We retrospectively analyzed the data from patients with SICAO who had undergone high-flow STAt-RA-MCA bypass in our center from October 2014 to November 2017. The incidence of ischemic stroke, changes in cerebral blood flow, characteristics of perioperative complications, and related factors determining the blood flow rate in the graft were analyzed.

RESULTS

From October 2014 to November 2017, we treated 21 patients with SICAO using high-flow STAt-RA-MCA bypass. A total of 42 ischemic stroke events had been reported within 6 months before surgery. The ipsilateral/contralateral mean transit time (I/C MTT) ratio before surgery was 1.24 ± 0.10 (range, 1.14-1.51). During a median follow-up period of 692 days (range, 212-1114), 3 transient ischemic attacks occurred in 3 patients; 18 patients (85.7%) did not experience recurrent stroke. The patency rate of the bypass graft was 95.2% (20 of 21). The I/C MTT ratio was 1.06 ± 0.11 on postoperative day 1 in all patients and was significantly different from the preoperative I/C MTT ratio (P < 0.001). The surgical complication rate was 9.5% (2 of 21), and no reoperation was required.

CONCLUSION

Our results suggest that high-flow STAt-RA-MCA bypass can effectively reduce the risk of stroke in patients with SICAO. Moreover, the surgical procedure is a highly safe procedure. Further randomized controlled studies are required to draw more precise conclusions.