[Transoral robotic thyroidectomy via vestibular approach: a retrospective study of 107 cases in a single center]

Objective: To investigate the short-term outcome of transoral robotic thyroidectomy. Methods: This is a retrospective case series study. The clinicopathologic characteristics and postoperative results of 107 patients who underwent transoral robotic thyroidectomies in the Department of Thyroid and Breast Surgery of the 960th Hospital of People's Liberation Army from May 2020 to August 2023 were retrospectively analyzed. There were 12 males and 95 females, with an age of (31.8±9.4) years (range: 11 to 55 years), including 20 benign tumors and 87 thyroid papillary carcinoma. Postoperative follow-up was carried out through returning visit and telephone, mainly to observe the recovery of postoperative complications, cosmetic effects and recurrence results. Results: All transoral robotic thyroidectomy was successfully completed without conversion to open surgery. The tumor size of thyroid papillary carcinoma patients was (5.6±2.7) mm (range: 2 to 15 mm). Furthermore, central cervical lymph node metastasis was found in 45 cases. The number of central cervical lymph nodes retrieved and metastasized (M(IQR)) were 11 (8) (range: 3 to 26) and 1 (3) (range: 0 to 13), respectively. There was no recurrent laryngeal nerve injury and permanent hypoparathyroidism. The transient hypoparathyroidism after surgery was 8 cases. Other complications occurred as follows: postoperative infection (n=1), left submandibular perforation (n=1), skin scald (n=1), and perioral numbness (n=1), oral tear (n=2). The postoperative stay was 6 (2) days (range: 3 to 11 days). No local lymph node recurrence or metastasis occurred after a follow-up of (22.6±10.0) months (range: 1.0 to 37.4 months). All patients were satisfied with the postoperative cosmetic results, the aesthetic effect score was 9.3 (0.2) (range: 8.4 to 9.6) one month after surgery. Conclusion: For highly screened patients with early thyroid cancer, experienced surgeons can perform a transoral robotic thyroidectomy that has excellent cosmetic results.

Measurements of All-Particle Energy Spectrum and Mean Logarithmic Mass of Cosmic Rays from 0.3 to 30 PeV with LHAASO-KM2A

We present the measurements of all-particle energy spectrum and mean logarithmic mass of cosmic rays in the energy range of 0.3-30 PeV using data collected from LHAASO-KM2A between September 2021 and December 2022, which is based on a nearly composition-independent energy reconstruction method, achieving unprecedented accuracy. Our analysis reveals the position of the knee at 3.67±0.05±0.15  PeV. Below the knee, the spectral index is found to be -2.7413±0.0004±0.0050, while above the knee, it is -3.128±0.005±0.027, with the sharpness of the transition measured with a statistical error of 2%. The mean logarithmic mass of cosmic rays is almost heavier than helium in the whole measured energy range. It decreases from 1.7 at 0.3 PeV to 1.3 at 3 PeV, representing a 24% decline following a power law with an index of -0.1200±0.0003±0.0341. This is equivalent to an increase in abundance of light components. Above the knee, the mean logarithmic mass exhibits a power law trend towards heavier components, which is reversal to the behavior observed in the all-particle energy spectrum. Additionally, the knee position and the change in power-law index are approximately the same. These findings suggest that the knee observed in the all-particle spectrum corresponds to the knee of the light component, rather than the medium-heavy components.

Manganese dioxide nanosheet-modulated ratiometric fluoroprobe based on carbon quantum dots from okra for selective and sensitive dichlorvos detection in foods

Herein, we developed a ratiometric fluoroprobe by integrating okra-derived carbon quantum dots (CQDs) with amplex red (AR) using manganese dioxide nanosheets (MnO2 NSs) as a medium. Fluorescence intensities (FIs) of CQDs were sharply quenched by MnO2 NSs via an inner-filter effect processes, whereas the FIs of AR were significantly enhanced due to oxidation of AR to AR-ox by the oxidase-mimetic activity of MnO2 NSs. Acetyrylcholinesterase hydrolyzed acetylthiocholine to produce thiocholine, and the decomposition of MnO2 NSs to Mn2+ by thiocholine led to the FI recovery of CQDs, but decreased FIs of AR-ox. Based on the above phenomenon and the inhibitory effect of dichlorvos (DDVP) on acetyrylcholinesterase activity, a novel ratiometric fluoroprobe for DDVP quantification was pioneered. Under optimized conditions, this fluoroprobe gave a wide linear range (4-120 μg/L), low detection limit (1.2 μg/L), and satisfactory fortification recoveries (90.0-110.0%), thereby providing good prospects for routine DDVP monitoring in foods.

Efficacy and safety of Abelmoschus manihot capsule combined with ACEI/ARB on diabetic kidney disease: a systematic review and meta analysis

Background: Diabetic kidney disease (DKD) is one of the most serious microvascular complications of diabetes, with the incidence rate increasing yearly, which is the leading cause of chronic kidney disease (CKD) and end-stage kidney disease. Abelmoschus Manihot capsule, as a proprietary Chinese patent medicine, is widely used for treating CKD in China. Currently, the combination of Abelmoschus Manihot (AM) capsule and renin-angiotensin-aldosterone system inhibitor (RASI) has gained popularity as a treatment option for DKD, with more and more randomized control trials (RCTs) in progress. However, the high-quality clinical evidence supporting its application in DKD is still insufficient. Aim of the study: To comprehensively and systematically evaluate the efficacy and safety of AM capsule combined with RASI in the treatment of DKD. Materials and methods: English and Chinese databases such as Pubmed, Cochrane Library, Embase, CNKI, SinoMed, WF, and VIP were searched to collect the RCTs of AM capsule in treatment of DKD. Then Two investigators independently reviewed and extracted data from the RCTs which met the inclusion criteria. The quality of the data was assessed using the Cochrane risk of bias assessment tool, and meta-analysis was performed using RevMan 5.4 software. Results: 32 RCTs with a total of 2,881 DKD patients (1,442 in the treatment group and 1,439 in the control group) were included. The study results showed that AM capsule combined with RASI could be more effective in decreasing 24h-UTP [MD = -442.05, 95% CI (-609.72, -274.38), p < 0.00001], UAER [MD = -30.53, 95% CI (-39.10, -21.96), p < 0.00001], UACR [MD = -157.93, 95% CI (-288.60, -27.25), p < 0.00001], Scr [MD = -6.80, 95% CI (-9.85, -3.74), p < 0.0001], and BUN [MD = -0.59, 95% CI (-1.07, -0.12), p = 0.01], compared to using RASI alone. According to the subgroup analyses, the combination of AM and ARB seems to be more effective in reducing UAER than the combination of ACEI, and the addition of AM may achieve a more significant clinical effect on decreasing Scr for DKD patients with 24h-UTP>2 g or Scr>110-133 μmol/L and >133 μmol/L. Furthermore, no additional adverse reactions were observed in the combination group [OR = 1.06; 95%CI: (0.66, 1.69), p = 0.82]. Conclusion: Combining AM with RASI may be a superior strategy for DKD treatment compared to RASI monotherapy. However, due to significant heterogeneity, the results should be interpreted with great caution, and more high-quality RCTs with multi-centers, different stages of DKD, large sample sizes, and long follow-up periods are still needed to improve the evidence quality of AM for DKD in the future. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/#recordDetails; Identifier CRD42022351422.

Unraveling spatial metabolome of the aerial and underground parts of Scutellaria baicalensis by matrix-assisted laser desorption/ionization mass spectrometry imaging

BACKGROUND

Scutellaria baicalensis Georgi, a traditional Chinese medicine, is clinically applied mainly as the dried root of Scutellaria baicalensis, and the aerial parts of Scutellaria baicalensis, its stems and leaves, are often consumed as "Scutellaria baicalensis tea" to clear heat, dry dampness, reduce fire and detoxify, while few comparative analyses of the spatial metabolome of the aerial and underground parts of Scutellaria baicalensis have been carried out in current research.

METHODS

In this work, Matrix-assisted laser desorption ionization-mass spectrometry imaging (MALDI-MSI) was used to visualize the spatial imaging of the root, stem, and leaf of Scutellaria baicalensis at a high resolution of 10 μm, respectively, investigating the spatial distribution of the different secondary metabolites in the aerial and underground parts of Scutellaria baicalensis.

RESULTS

In the present results, various metabolites, such as flavonoid glycosides, flavonoid metabolites, and phenolic acids, were systematically characterized in Scutellaria baicalensis root, stem, and leaf. Nine glycosides, 18 flavonoids, one organic acid, and four other metabolites in Scutellaria baicalensis root; nine glycosides, nine flavonoids, one organic acid in Scutellaria baicalensis stem; and seven flavonoids and seven glycosides in Scutellaria baicalensis leaf were visualized by MALDI-MSI. In the underground part of Scutellaria baicalensis, baicalein, wogonin, baicalin, wogonoside, and chrysin were widely distributed, while there was less spatial location in the aerial parts. Moreover, scutellarein, carthamidin/isocarthamidin, scutellarin, carthamidin/isocarthamidin-7-O-glucuronide had a high distribution in the aerial parts of Scutellaria baicalensis. In addition, the biosynthetic pathways involved in the biosynthesis of significant flavonoid metabolites in aerial and underground parts of Scutellaria baicalensis were successfully localized and visualized.

CONCLUSIONS

MALDI-MSI offers a favorable approach for investigating the spatial distribution and effective utilization of metabolites of Scutellaria baicalensis. The detailed spatial chemical information can not only improve our understanding of the biosynthesis pathways of flavonoid metabolites, but more importantly, suggest that we need to fully exert the overall medicinal value of Scutellaria baicalensis, strengthening the reuse and development of the resources of Scutellaria baicalensis aboveground parts.

[Evaluating the efficiency of endoscope-assisted septo-rhinoplasty via intranasal approach]

Objective: To observe the functional and esthetic results of endoscope-assisted septo-rhinoplasty via intranasal approach. Methods: The clinical data of 12 patients with septal deviation and nasal deformity in the University of Hong Kong-Shenzhen Hospital from June 2021 to June 2022 were analyzed, including 8 males and 4 females, aging 28 to 58 years. All patients were operated under general anesthesia. The septal deviation was corrected by hemitransfixion incision, combined with intercartilaginous incision and other intranasal or extranasal incisions to perform osteotomy, hump resection and saddle nose correction. Patient satisfaction with postoperative functional and aesthetic improvements was assessed through Nasal Obstruction Symptom Evaluation (NOSE), Rhinoplasty Outcome Evaluation (ROE), and Visual Analogue Scale (VAS).SPSS 25 software was used for statistical analysis. Results: The correction of nasal septum deviation was satisfactory in all 12 patients. Nasal obstruction was relieved, with NOSE score and VAS score of nasal ventilation decreased [(21.67±10.30) vs (70.83±14.12), (1.83±1.03) vs (8.33±0.89), t value was 9.49 and 16.30, respectively, both P<0.05]. The nasal appearance of 10 patients with crooked nose deformity was improved, with ROE score and VAS score of nasal appearance increased [(21.30±2.31) vs (8.10±3.31), (8.90±0.99) vs (3.80±1.62), t value was -11.85 and -9.33, respectively, both P<0.05];The nasal vestibule morphology of 2 patients with abnormal nasal vestibule was improved. During the follow-up of 12 to 24 months, no postoperative complication such as nasal septum perforation, nasal cavity adhesion or nasal dorsal collapse occurred in all patients. Conclusion: Endoscope-assisted septo-rhinoplasty via intranasal approach can resolve both functional and esthetic problems at the same time, improving outcomes while reducing surgical trauma.

Fructose sweetens the adipocyte-T cell alliance against tumors

Dietary fructose is implicated in tumorigenesis, but whether dietary fructose regulates antitumor immunity remains elusive. In this issue of Cell Metabolism, Zhang et al. show that dietary fructose promotes adipocyte-derived leptin production, which attenuates terminal exhaustion programming and boosts the effector function of CD8+ T cells for improved tumor control.

Single-cell CRISPR screens in vivo map T cell fate regulomes in cancer

CD8+ cytotoxic T cells (CTLs) orchestrate antitumour immunity and exhibit inherent heterogeneity1,2, with precursor exhausted T (Tpex) cells but not terminally exhausted T (Tex) cells capable of responding to existing immunotherapies3-7. The gene regulatory network that underlies CTL differentiation and whether Tex cell responses can be functionally reinvigorated are incompletely understood. Here we systematically mapped causal gene regulatory networks using single-cell CRISPR screens in vivo and discovered checkpoints for CTL differentiation. First, the exit from quiescence of Tpex cells initiated successive differentiation into intermediate Tex cells. This process is differentially regulated by IKAROS and ETS1, the deficiencies of which dampened and increased mTORC1-associated metabolic activities, respectively. IKAROS-deficient cells accumulated as a metabolically quiescent Tpex cell population with limited differentiation potential following immune checkpoint blockade (ICB). Conversely, targeting ETS1 improved antitumour immunity and ICB efficacy by boosting differentiation of Tpex to intermediate Tex cells and metabolic rewiring. Mechanistically, TCF-1 and BATF are the targets for IKAROS and ETS1, respectively. Second, the RBPJ-IRF1 axis promoted differentiation of intermediate Tex to terminal Tex cells. Accordingly, targeting RBPJ enhanced functional and epigenetic reprogramming of Tex cells towards the proliferative state and improved therapeutic effects and ICB efficacy. Collectively, our study reveals that promoting the exit from quiescence of Tpex cells and enriching the proliferative Tex cell state act as key modalities for antitumour effects and provides a systemic framework to integrate cell fate regulomes and reprogrammable functional determinants for cancer immunity.

Identification and validation of ubiquitination-related signature and subgroups in immune microenvironment of tuberculosis

BACKGROUND

Mycobacterium tuberculosis (Mtb) is the bacterial pathogen responsible for causing tuberculosis (TB), a severe public health concern that results in numerous deaths worldwide. Ubiquitination (Ub) is an essential physiological process that aids in maintaining homeostasis and contributes to the development of TB. Therefore, the main objective of our study was to investigate the potential role of Ub-related genes in TB.

METHODS

Our research entailed utilizing single sample gene set enrichment analysis (ssGSEA) in combination with several machine learning techniques to discern the Ub-related signature of TB and identify potential diagnostic markers that distinguish TB from healthy controls (HC).

RESULTS

In summary, we used the ssGSEA algorithm to determine the score of Ub families (E1, E2, E3, DUB, UBD, and ULD). Notably, the score of E1, E3, and UBD were lower in TB patients than in HC individuals, and we identified 96 Ub-related differentially expressed genes (UbDEGs). Employing machine learning algorithms, we identified 11 Ub-related hub genes and defined two distinct Ub-related subclusters. Notably, through GSVA and functional analysis, it was determined that these subclusters were implicated in numerous immune-related processes. We further investigated these Ub-related hub genes in four TB-related diseases and found that TRIM68 exhibited higher correlations with various immune cells in different conditions, indicating that it may play a crucial role in the immune process of these diseases.

CONCLUSION

The observed enrichment of Ub-related gene expression in TB patients emphasizes the potential involvement of ubiquitination in the progression of TB. These significant findings establish a basis for future investigations to elucidate the molecular mechanisms associated with TB, select suitable diagnostic biomarkers, and design innovative therapeutic interventions for combating this fatal infectious disease.

No evident causal association between Helicobacter pylori infection and colorectal cancer: a bidirectional mendelian randomization study

Observational studies have reported a correlation between Helicobacter pylori infection and colorectal cancer (CRC); however, the underlying cause has remained unclear. This research was aimed at determining whether there is a correlation between H. pylori infection and CRC by measuring the prevalence of H. pylori CagA antibodies and VacA antibodies. Using data from many genome-wide association studies (GWAS), we conducted a Mendelian randomization (MR) study with two sample GWAS. Then, we used bidirectional MR to evaluate the association between H. pylori infection and CRC for identifying causation. The most common method of analysis was the inverse variance-weighted technique. In addition, we performed supplementary analyses using the weighted median technique and MR-Egger regression. Horizontal pleiotropic outliers were identified and corrected using the MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) method. Genetically predicted anti-H. pylori IgG seropositivity was not causally associated with CRC [odds ratio (OR): 1.12; 95% confidence interval (CI): 0.98-1.27, P = 0.08] and neither were H. pylori VacA antibody levels (OR = 0.96, 95% CI: 0.90-1.02, P = 0.25) or H. pylori CagA antibody levels (OR = 1.00, 95% CI: 0.93-1.07, P = 0.92). Furthermore, reverse MR analysis did not reveal evidence for a causal effect of CRC on H. pylori infection. The weighted median, the MR-Egger method, and MR-PRESSO yielded identical results. Using genetic data, MR analysis showed there was no evidence for a causal association between seroprevalence of H. pylori infection and CRC. The relationship between H. pylori infection and CRC requires further research.

Measurement of Ultra-High-Energy Diffuse Gamma-Ray Emission of the Galactic Plane from 10 TeV to 1 PeV with LHAASO-KM2A

The diffuse Galactic γ-ray emission, mainly produced via interactions between cosmic rays and the interstellar medium and/or radiation field, is a very important probe of the distribution, propagation, and interaction of cosmic rays in the Milky Way. In this Letter, we report the measurements of diffuse γ rays from the Galactic plane between 10 TeV and 1 PeV energies, with the square kilometer array of the Large High Altitude Air Shower Observatory (LHAASO). Diffuse emissions from the inner (15°10  TeV). The energy spectrum in the inner Galaxy regions can be described by a power-law function with an index of -2.99±0.04, which is different from the curved spectrum as expected from hadronic interactions between locally measured cosmic rays and the line-of-sight integrated gas content. Furthermore, the measured flux is higher by a factor of ∼3 than the prediction. A similar spectrum with an index of -2.99±0.07 is found in the outer Galaxy region, and the absolute flux for 10≲E≲60  TeV is again higher than the prediction for hadronic cosmic ray interactions. The latitude distributions of the diffuse emission are consistent with the gas distribution, while the longitude distributions show clear deviation from the gas distribution. The LHAASO measurements imply that either additional emission sources exist or cosmic ray intensities have spatial variations.

Interpretable Deep Learning Identified the Significance of 1 Gy Volume on Lymphopenia after Radiotherapy in Breast Cancer

PURPOSE/OBJECTIVE(S)

Lymphopenia is common after radiotherapy (RT) and is known for its significance on poor survival outcomes in patients with breast cancer. Previous work has demonstrated the significance of point dosimetric factors like the volume receiving 5 Gy. Considering the full dosimetric data together, this study aimed to develop and validate predictive models for lymphopenia after RT in breast cancer.

MATERIALS/METHODS

Patients with breast cancer treated with radiation therapy in adjuvant setting and with complete dosimetric data were eligible. Combining dose-volume histogram (DVH) dosimetric and clinical factors, dense neural network (DNN) models were developed to predict both the reduction in lymphocyte counts and the graded lymphopenia in breast cancer patients after adjuvant RT. A Shapley additive explanation was applied to explain each feature's directional contributions. The generalization of DNN models was validated in both internal and independent external validation cohorts. P<0.05 was considered to be significant.

RESULTS

A total of 928 consecutive patients with invasive breast cancer were eligible for this study. Treatment volumes of nearly all irradiation dose levels of DVH were significant predictors for lymphopenia after RT, including volumes at very low-dose 1 Gy (V1) of all structures considered including the lung, heart and body. DNN models using full DVH dosimetric and clinical factors were built and a simplified model was further established and validated in both internal and external validation cohorts. This simplified DNN AI model, combining full DVH dosimetric parameters of all OARs and five key clinical factors including baseline lymphocyte counts, tumor stage, RT technique, RT fields and RT fractionation, showed a predictive accuracy of 77% and above.

CONCLUSION

This study demonstrated and externally validated the significance of an AI model of combining clinical and full dosimetric data, especially the volume of low dose at as low as 1 Gy of all critical structures on lymphopenia after RT in patients with breast cancer. The significance of V1 deserves special attention, as modern arc RT technology often has relatively high value of this parameter. Further study warranted for breast cancer RT plan optimization.

Effects of Niaoduqing granules on inflammatory response of diabetic kidney disease: A meta‑analysis

Diabetic kidney disease (DKD) is one of the most severe chronic microvascular complications of diabetes and the leading cause of end-stage kidney disease worldwide. The mechanism of inflammation underlying DKD has been attracting attention over recent years, but effective therapeutic strategies have remained elusive. Niaoduqing (NDQ) granules are one of the most commonly used drugs for the treatment of DKD in China, and it has therapeutic effects against inflammation in DKD. Therefore, the aim of the present analysis was to evaluate the inflammatory response outcomes and safety of NDQ granules for the treatment of DKD. The following databases were searched from their inception to 31st of May 2023 to obtain published accounts of relevant randomized controlled trials: China National Knowledge Infrastructure, China Science and Technology Journal, Wanfang, The Chinese Biomedicine, PubMed, Web of Science and Cochrane Library. The 'risk of bias' evaluation tool produced by the Cochrane Collaboration Handbook was used for evaluating the quality, whereas Revman software (version 5.3) was used for meta-analysis. In total, 16 studies were included into the present study according to criteria, with a total of 1,526 patients. Compared with those in the control group, the results of the meta-analysis revealed that the combination of conventional treatment and NDQ granules may further decrease C-reactive protein [standardized mean difference (SMD), -1.33; 95% confidence interval (CI), -1.76, -0.91; P<0.00001], TNF-α (SMD, -1.90; 95% CI, -2.35,-1.45; P<0.00001) and IL-6 (SMD, -1.72; 95% CI, -2.52,-0.91; P<0.0001) levels, whilst increasing the clinical effective rate (risk ratio, 1.22; 95% CI, 1.14,1.29; P<0.00001), in patients with DKD. In terms of safety, a total of 34 and 39 patients included in the intervention and in the control group, respectively, developed adverse reactions. Results from the present analysis suggest that NDQ granules may be beneficial in suppressing inflammation caused by DKD when used in combination with conventional treatment, potentially guiding future directions in clinical practice. However, further high-quality studies are needed to confirm the anti-inflammation response in the future.

Outcomes of gracilis muscle interposition for rectourethral fistulas caused by treatment of prostate cancer

BACKGROUND

Gracilis muscle interposition (GMI) has been associated with favorable outcomes in treating complex perianal fistulas. Outcomes of GMI may vary according to the fistula etiology, particularly between rectovaginal fistulas in women and rectourethral fistulas (RUF) in men. The aim of this study was to assess the outcome of GMI to treat RUF acquired after prostate cancer treatment.

METHODS

This retrospective cohort study included male patients treated with GMI for RUF acquired after prostate cancer treatment between January 2000 and December 2018 in the Department of Colorectal Surgery, Cleveland Clinic Florida. The primary outcome was the success of GMI, defined as complete healing of RUF without recurrence. Secondary outcomes were length of hospital stay and postoperative complications.

RESULTS

This study included 53 male patients with a median age of 68 (range, 46-85) years. Patients developed RUF after treatment of prostate cancer with radiation (52.8%), surgery (34%), or transurethral resection of the prostate (TURP) (13.2%). Median hospital stay was 5 (IQR, 4-7) days. Twenty (37.7%) patients experienced 25 complications, the most common being wound infection and dehiscence. Primary healing after GMI was achieved in 28 (52.8%) patients. Fifteen additional patients experienced successful healing of RUF after additional procedures, for a total success rate of 81.1%. Median time to complete healing was 8 (range, 4-56) weeks. The only significant factor associated with outcome of GMI was wound dehiscence (p = 0.008).

CONCLUSIONS

Although the initial success rate of GMI was approximately 53%, it increased to 81% after additional procedures. Complications after GMI were mostly minor, with wound complications being the most common. Perianal wound dehiscence was significantly associated with failure of healing of RUF after GMI.

Classification and characterisation of extracellular vesicles-related tuberculosis subgroups and immune cell profiles

Around the world, tuberculosis (TB) remains one of the most common causes of morbidity and mortality. The molecular mechanism of Mycobacterium tuberculosis (Mtb) infection is still unclear. Extracellular vesicles (EVs) play a key role in the onset and progression of many disease states and can serve as effective biomarkers or therapeutic targets for the identification and treatment of TB patients. We analysed the expression profile to better clarify the EVs characteristics of TB and explored potential diagnostic markers to distinguish TB from healthy control (HC). Twenty EVs-related differentially expressed genes (DEGs) were identified, and 17 EVs-related DEGs were up-regulated and three DEGs were down-regulated in TB samples, which were related to immune cells. Using machine learning, a nine EVs-related gene signature was identified and two EVs-related subclusters were defined. The single-cell RNA sequence (scRNA-seq) analysis further confirmed that these hub genes might play important roles in TB pathogenesis. The nine EVs-related hub genes had excellent diagnostic values and accurately estimated TB progression. TB's high-risk group had significantly enriched immune-related pathways, and there were substantial variations in immunity across different groups. Furthermore, five potential drugs were predicted for TB using CMap database. Based on the EVs-related gene signature, the TB risk model was established through a comprehensive analysis of different EV patterns, which can accurately predict TB. These genes could be used as novel biomarkers to distinguish TB from HC. These findings lay the foundation for further research and design of new therapeutic interventions aimed at treating this deadly infectious disease.

Integrated brain and plasma dual-channel metabolomics to explore the treatment effects of Alpinia oxyphyllaFructus on Alzheimer's disease

Alpinia oxyphylla Fructus, called Yizhi in Chinese, is the dried fruit of Alpinia oxyphylla Miquel. It has been used in traditional Chinese medicine to treat dementia and memory defects of Alzheimer's disease for many years. However, the underlying mechanism is still unclear. In this study, we used a rat Alzheimer's disease model on intrahippocampal injection of aggregated Aβ1-42 to study the effects of Alpinia oxyphylla Fructus. A brain and plasma dual-channel metabolomics approach combined with multivariate statistical analysis was further performed to determine the effects of Alpinia oxyphylla Fructus on Alzheimer's disease animals. As a result, in the Morris water maze test, Alpinia oxyphylla Fructus had a clear ability to ameliorate the impaired learning and memory of Alzheimer's disease rats. 11 differential biomarkers were detected in AD rats' brains. The compounds mainly included amino acids and phospholipids; after Alpinia oxyphylla Fructus administration, 9 regulated biomarkers were detected compared with the AD model group. In the plasma of AD rats, 29 differential biomarkers, primarily amino acids, phospholipids and fatty acids, were identified; After administration, 23 regulated biomarkers were detected. The metabolic pathways of regulated metabolites suggest that Alpinia oxyphylla Fructus ameliorates memory and learning deficits in AD rats principally by regulating amino acid metabolism, lipids metabolism, and energy metabolism. In conclusion, our results confirm and enhance our current understanding of the therapeutic effects of Alpinia oxyphylla Fructus on Alzheimer's disease. Meanwhile, our work provides new insight into the potential intervention mechanism of Alpinia oxyphylla Fructus for Alzheimer's disease treatment.

Huobahuagen tablet improves renal function in diabetic kidney disease: a real-world retrospective cohort study

Objective

We aimed to explore the value of Huobahuagen tablet (HBT) in improving decreased renal function for patients with diabetic kidney disease (DKD) over time.

Methods

This was a single-center, retrospective, real-world study on eligible 122 DKD patients who continued to use HBT + Huangkui capsule (HKC) therapy or HKC therapy without interruption or alteration in Jiangsu Province Hospital of Chinese Medicine from July 2016 to March 2022. The primary observation outcomes included estimated glomerular filtration rate (eGFR) at baseline and 1-, 3-, 6-, 9-, and 12-month follow-up visits and changes in eGFR from baseline (ΔeGFR). Propensity score (PS) and inverse probability treatment weighting (IPTW) were used to control for confounders.

Results

eGFR was significantly higher in the HBT + HKC group than in the HKC alone group at the 6-, 9-, and 12-month follow-up visits (p = 0.0448, 0.0002, and 0.0037, respectively), indicating the superiority of HBT + HKC over HBT alone. Furthermore, the ΔeGFR of the HBT + HKC group was significantly higher than that of the HKC alone group at the 6- and 12-month follow-up visits (p = 0.0369 and 0.0267, respectively). In the DKD G4 patients, eGFR was higher in the HBT + HKC group at the 1-, 3-, 6-, 9-, and 12-month follow-up visits compared with baseline, with statistically significant differences at the 1-, 3-, and 6- month follow-up visits (p = 0.0256, 0.0069, and 0.0252, respectively). The fluctuations in ΔeGFR ranged from 2.54 ± 4.34 to 5.01 ± 5.55 ml/min/1.73 m². Change in the urinary albumin/creatinine ratio from baseline did not exhibit a significant difference between the two groups at any of the follow-up visits (p > 0.05 for all). Adverse event incidence was low in both groups.

Conclusion

The findings of this study based on real-world clinical practice indicate that HBT + HKC therapy exhibited better efficacy in improving and protecting renal function with a favorable safety profile than HKC therapy alone. However, further large-scale prospective randomized controlled trials are warranted to confirm these results.

[The prognostic value of free triiodothyronine/free thyroxine ratio in patients hospitalized with heart failure]

Objective: To investigate the effect of free triiodothyronine/free thyroxine (FT3/FT4) ratio on the prognosis of patients with heart failure (HF). Methods: A total of 3 527 patients hospitalized in the Heart Failure Center of Fuwai Hospital from March 2009 to June 2018 were analyzed in our study. Patients were divided into two groups according to median of FT3/FT4 ratio: low FT3/FT4 group (n=1 764, FT3/FT4<2.15) and high FT3/FT4 group (n=1 763, FT3/FT4≥2.15). The primary endpoint was defined as a composite endpoint of all-cause death or heart transplantation or implantation of a left ventricular assist device. The baseline characteristics of patients with different FT3/FT4 ratio groups were compared, and a multivariate Cox proportional hazard regression model was used to analyze the relationship between FT3/FT4 ratio and the prognosis of hospitalized patients with HF. Results: The age of the total population was (56.8±16.0) years, and 2 544 cases (72.1%) were males. The median follow-up time was 2.79 (1.00, 5.03) years, and a total of 1 542 end-point events were recorded at the final follow-up. The mean ages of patients in the low FT3/FT4 group and high FT3/FT4 group were (58.8±16.5) and (54.8±15.2) years (P<0.001), respectively; and the cumulative survival rates were 38.4% and 61.9%, respectively (P<0.001). FT3 (HR=0.72, 95%CI: 0.63-0.84, P<0.001), FT3/FT4 (HR=0.76, 95%CI: 0.65-0.87, P<0.001) was associated with all-cause death, heart transplantation, or LVAD implantation in patients with heart failure. HR values (95%CI) of FT3/FT4 ratio predicting the risk of composite endpoint in the subgroup of left ventricular ejection fraction (LVEF)<40%, 40% to 49%, and≥50% were 0.91 (0.77-1.08), 0.83 (0.50-1.39), and 0.65 (0.50-0.85), respectively (P interaction=0.045). Conclusions: Low FT3 and low FT3/FT4 are important correlative factors for poor prognosis in hospitalized HF patients, especially in patients with LVEF≥50%.

A tera-electron volt afterglow from a narrow jet in an extremely bright gamma-ray burst

Some gamma-ray bursts (GRBs) have a tera-electron volt (TeV) afterglow, but the early onset of this has not been observed. We report observations with the Large High Altitude Air Shower Observatory of the bright GRB 221009A, which serendipitously occurred within the instrument field of view. More than 64,000 photons >0.2 TeV were detected within the first 3000 seconds. The TeV flux began several minutes after the GRB trigger, then rose to a peak about 10 seconds later. This was followed by a decay phase, which became more rapid ~650 seconds after the peak. We interpret the emission using a model of a relativistic jet with half-opening angle ~0.8°. This is consistent with the core of a structured jet and could explain the high isotropic energy of this GRB.

Wavelength-tailored light-emitting diodes reduce damage to sensory properties of light-exposed milk

Photooxidation has long been affecting nutrient and sensory quality of fluid milk. Light oxidation starts from the activation of photosensitive compounds, followed by generation of singlet oxygen that reacts with vitamins, proteins, and lipids in milk. It is hypothesized that wavelength-tailored light schemes possessing spectral properties capable of avoiding excitation maxima of common photosensitizers in milk could slow the chemical degradation of light-exposed milk and thus preserve consumer acceptability. A series of 6 consumer tests with sample sizes from 95 to 119 participants tested hedonic responses to fluid milk samples exposed to light of varying wavelength spectra. For milk in clear plastic bottles (polyethylene terephthalate or high-density polyethylene), consumer panels generally liked milk exposed to light-emitting diodes eliminating wavelengths below 520 or 560 nm more than standard white light, or those eliminating other wavelength bands. This higher degree of liking coincided with panelists citing fewer off-flavors or aromas from these samples. Taken together, these observations suggest such light schemes can protect milk from light damage to some extent. Wavelength-tailored light schemes used in this study did not offer effective protection for milk in glass bottles. Dissolved oxygen, color, riboflavin loss, and hexanal content were instrumentally evaluated, but results failed to indicate significant signatures of light damage in milk compared with sensory measures. The appearance of milk bottles illuminated by the slightly greenish or yellowish light were less liked by consumers, suggesting further efforts on consumer education may be necessary if these light schemes were to be installed in retail dairy coolers.

Radiomic analysis of MRI for prediction of response to induction chemotherapy in nasopharyngeal carcinoma patients

AIM

To establish and validate radiomic models for response prediction to induction chemotherapy (IC) in nasopharyngeal carcinoma (NPC) using the radiomic features from pretreatment MRI.

MATERIALS AND METHODS

This retrospective analysis included 184 consecutive NPC patients, 132 in the primary cohort and 52 in the validation cohort. Radiomic features were derived from contrast-enhanced T1-weighted imaging (CE-T1) and T2-weighted imaging (T2-WI) for each subject. The radiomic features were then selected and combined with clinical characteristics to build radiomic models. The potential of the radiomic models was evaluated based on its discrimination and calibration. To measure the performance of these radiomic models in predicting the treatment response to IC in NPC, the area under the receiver operating characteristic curve (AUC), and sensitivity, specificity, and accuracy were used.

RESULTS

Four radiomic models were constructed in the present study including the radiomic signature of CE-T1, T2-WI, CE-T1 + T2-WI, and the radiomic nomogram of CE-T1. The radiomic signature of CE-T1 + T2-WI performed well in distinguishing response and non-response to IC in patients with NPC, which yielded an AUC of 0.940 (95% CI, 0.885-0.974), sensitivity of 83.1%, specificity of 91.8%, and accuracy of 87.1% in the primary cohort, and AUC of 0.952 (95% CI, 0.855-0.992), sensitivity of 74.2%, specificity of 95.2%, and accuracy of 82.7% in the validation cohort.

CONCLUSION

MRI-based radiomic models could be helpful for personalised risk stratification and treatment in NPC patients receiving IC.

Highly efficient nanocomposites based on molecularly imprinted magnetic covalent organic frameworks for selective extraction of bisphenol A from liquid matrices

Highly efficient nanocomposites, hydrophobic molecularly imprinted magnetic covalent organic frameworks (MI-MCOF), have been farbricated by a facile Schiff-base reaction. The MI-MCOF was based on terephthalaldehyde (TPA) and 1,3,5-tris(4-aminophenyl) benzene (TAPB) as functional monomer and crosslinker, anhydrous acetic acid as catalyst, bisphenol AF as dummy template, and NiFe₂O₄ as magnetic core. This organic framework significantly reduced the time consumption of conventional imprinted polymerization and avoided the use of traditional initiator and cross-linking agents. The synthesized MI-MCOF exhibited superior magnetic responsivity and affinity, as well as high selectivity and kinetics for bisphenol A (BPA) in water and urine samples. The equilibrium adsorption capacity (Q_e) of BPA on the MI-MCOF was 50.65 mg g^-1, which was 3-7-fold higher than of its three structural analogues. The imprinting factor of BPA reached up to 3.17, and the selective coefficients of three analogues were all > 2.0, evidencing the excellent selectivity of fabricated nanocomposites to BPA. Based on the MI-MCOF nanocomposites, the magnetic solid-phase extraction (MSPE), combined with HPLC and fluorescence detection (HPLC-FLD), offered superior analytical performance: wide linear range of 0.1-100 μg L^-1, high correlation coefficient of 0.9996, low limit of detection of 0.020 μg L^-1, good recoveries of 83.5-110%, and relative standard deviations (RSDs) of 0.5-5.7% in environmental water, beverage, and human urine samples. Consequently, the MI-MCOF-MSPE/HPLC-FLD method provides a good prospect in selective extraction of BPA from complex matrices while replacing traditional magnetic separation and adsorption materials.

[Clinical features and prognosis of patients hospitalized with heart failure and low T3 syndrome]

Objective: To investigate the association between triiodothyronine (T₃) and inflammatory factors, and its potential effect on long-term outcomes in hospitalized patients with heart failure (HF). Methods: A total of 2 475 patients with HF admitted in Heart Failure Care Unit were consecutively enrolled in this retrospective cohort study from December 2006 to June 2018. Patients were divided into low T₃ syndrome group (n=610, 24.6%) and normal thyroid function group (n=1 865, 75.4%). The median follow-up time was 2.9 (1.0, 5.0) years. A total of 1 048 all-cause deaths were recorded at the final follow-up. The effects of free T₃ (FT₃) and high-sensitivity C-reactive protein (hsCRP) on the risk of all-cause death were evaluated by Cox regression analysis and Kaplan-Meier analysis. Results: The age of the total population was 19-95 (57±16) years, 1 823 cases (73.7%) were male. Compared to those with normal thyroid function, albumin [(36.5±5.4) vs. (40.7±4.7) g/L], hemoglobin [(129.4±25.1) vs. (140.6±20.6) g/L], total cholesterol [3.6 (3.0, 4.4) vs. 4.2 (3.5, 4.9) mmol/L] (all P<0.001) were lower, Whereas age [(60.5±16.0) vs. (55.2±15.4) years], creatinine [105.0 (83.6, 137.0) vs. 87.8 (75.6, 106.3) mmol/L], log N-terminal B-type natriuretic peptide [(8.2±1.3) vs. (7.2±1.4) ng/L] were higher in LT₃S patients (all P<0.001). In Kaplan-Meier survival analysis, patients with lower FT₃ and higher hsCRP had significantly lower cumulative survival (P<0.001), lower FT₃ combined with higher hsCRP subgroup had the highest risk of all-cause death (P_trend<0.001). In multivariate Cox regression analysis, LT₃S was an independent predictor of all-cause mortality (HR=1.40, 95%CI 1.16-1.69, P<0.001). Conclusion: LT₃S is an independent predictor of poor prognosis in patients with heart failure. FT₃ combined with hsCRP improve the predictive value of all-cause death in hospitalized patients with heart failure.

[Analysis of 14 cases of melanosis caused by 1, 8-dinitronaphthalene and 1, 8-diaminonaphthalene]

14 workers in the 1, 8-diaminonaphthalene workshop of a chemical company in Nantong City had symptoms or signs of varying degrees of pruritus and pigmentation of the face, neck and waist. Pathological examination of skin biopsies showed hyperkeratosis, the basal cells were liquefied and denatured. Seven workers were eventually diagnosed with occupational melanosis. To explore the causes of occupational melanosis caused by exposure to 1, 8-dinitronaphthalene and 1, 8-diaminonaphthalene, and to provide reference for the prevention and treatment of occupational melanosis in the future, this paper reported 14 cases of melanosis in the skin of workers in chemical industry.

Abstract 1778: B7-H3-CAR T-cell therapy in immune-competent osteosarcoma models: Regnase-1 KO overcomes limited CAR T-cell expansion

Chimeric antigen receptor (CAR) T-cell therapy offers promise to improve outcomes for pediatric patients with recurrent/refractory osteosarcoma (OS), a ‘poor-prognosis’ cancer. However, early-phase clinical studies have shown limited activity despite potent antitumor activity in preclinical xenograft models, highlighting the need to develop better preclinical models. B7-H3 has emerged as a promising immunotherapeutic target for pediatric solid tumors including OS, and we and other investigators are actively exploring B7-H3-CAR T cell therapies in early-phase clinical studies. Our goal was to develop a murine immunocompetent OS model (F331) for the realistic pre-clinical evaluation of B7-H3-CAR T cells and to explore additional genetic modifications to improve their effector function. We generated murine B7-H3-CAR T cells expressing a 2nd generation B7-H3-CD28.ζ CAR by retroviral transduction. In vitro, B7-H3-CAR T cells recognized B7-H3-positive F331 cells as judged by IFNγ production and cytolytic activity in contrast to B7-H3-negative tumor cells; Control (ctrl) CAR T-cells recognizing an irrelevant antigen (SP6) did not recognize or kill B7-H3-positive tumor cells confirming specificity. Since lung is the primary OS metastasis site, we focused on the intravenous (i.v.) disseminated lung F331 OS metastasis model. In this model, a single i.v. infusion of 5x106 CD8+ B7-H3-CAR T cells demonstrated significant antitumor activity compared to CD8+ ctrl CAR T cells, resulting in a significant survival advantage (median: 70 vs 38 days respectively). Unfortunately, tumors invariably recurred. We found limited B7-H3-CAR T cell expansion and persistence, even though recurring tumors still expressed B7-H3, excluding tumor antigen escape mechanism. We therefore embarked on a comprehensive screen to knock out (KO) known negative regulators of T-cell function, starting with Regnase-1 (Reg-1). Reg-1 is known to have RNase activity and to regulate activation of immune cells. KO of Reg-1 in CD8+ B7-H3-CAR T cells improved their expansion post-infusion in spleen and lungs as judged by flow cytometric analysis without systemic toxicities based on mice body weight assessment. This resulted in a significant improvement in overall survival in comparison to control KO B7-H3-CAR T cells at a cell dose (1x106) at which ctrl-KO CD8+ B7-H3-CAR T cells were ineffective. Reg1-KO ctrl CAR T cells had no therapeutic benefit, excluding nonspecific effects. In summary, we have established an immune-competent OS model to evaluate the effector function of B7-H3-CAR T cells and have demonstrated the advantage given by 2nd genetic modifications to enhance their antitumor activity. We are currently using this model to define mechanisms of immune resistance with the goal of further enhancing OS-redirected CAR T-cell therapy.

Citation Format: Adeleye O. Adeshakin, Peipei Zhou, Jean-Yves Métais, Phuong Nguyen, Scott Perry, Heather Sheppard, Xiang Sun, Trevor Cunningham, Hao Shi, Jessica Wagner, Jason T. Yustein, Christopher DeRenzo, Giedre Krenciute, Hongbo Chi, Stephen Gottschalk. B7-H3-CAR T-cell therapy in immune-competent osteosarcoma models: Regnase-1 KO overcomes limited CAR T-cell expansion [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1778.

Enhanced charge transport across molecule-nanoparticle-molecule sandwiches

The electrical properties of large area molecular devices consisting of gold nanoparticles (GNPs) sandwiched between a double layer of alkanedithiol linkers have been examined. These devices have been fabricated by a facile bottom-up assembly in which an alkanedithiol monolayer is first self-assembled on an underlying gold substrate followed by nanoparticle adsorption and then finally assembly of the top alkanedithiol layer. These devices are then sandwiched between the bottom gold substrates and a top eGaIn probe contact and current-voltage (I-V) curves recorded. Devices have been fabricated with 1,5-pentanedithiol, 1,6-hexanedithiol, 1,8-octanedithiol and 1,10-decanedithiol linkers. In all cases the electrical conductance of the double SAM junctions with GNPs is higher than the corresponding and much thinner single alkanedithiol SAM. Competing models for this enhanced conductance are discussed and it is suggested to have a topological origin arising from how the devices assemble or structure during the fabrication, which gives more efficient cross device electron transport pathways without the GNPs producing short circuits.

Two Stable Sodalite-Cage-Based MOFs for Highly Gas Selective Capture and Conversion in Cycloaddition Reaction

Stable metal-organic frameworks, containing periodically arranged nanosized cages or pores and active Lewis acid-base sites, are considered ideal candidates for efficient heterogeneous catalysis. Herein, based on the light of reticular chemistry design principles, the ingenious assembly of two pyridine N-rich multifunctional triangular linkers, H₃TBA [3,5-di (1h-tetrazol-5-yl) benzoic acid] and H₂TZI [5-(1H-tetrazol-5-yl)isophthalic acid], with Mn^II formed PCP-33(Mn) and PCP-34(Mn), respectively. PCP-33(Mn) and PCP-34(Mn) are typical sod topology zeolitic metal-organic frameworks (ZMOFs) with hierarchical tetragonal micropores and metal organic polyhedral sodalite-like cages. The inner walls of these cages are modified by open metal sites Mn^II and Lewis acid-base sites of halide ions and N pyridine atoms. The characteristics of the cages' structures make two MOFs exhibit high surface area and a small window, which promote their outstanding gas capture ability (C₂H₂, 131.8 cm³ g^-1; CO₂, 77.9 cm³ g^-1 at 273 K) and selective separation performance (C₂H₂/CH₄, 226.2, CO₂/CH₄, 50.3 at 298 K), and are also suitable as catalytic reactors for metal/solvent-free chemical fixation of CO₂ with epoxides to achieve high-efficiency CO₂ conversion. Furthermore, they are greatly recyclable for several cycles while retaining their structural rigidity and catalytic activity.

[A retrospective comparative study between robotic thyroidectomy through transoral vestibular approach and bilateral breast-axillary approach]

Objective: To compare the surgical outcome of robotic thyroidectomy through transoral approach and the bilateral breast-axillary approach. Methods: Retrospective analysis was made on the clinical data of patients who performed transoral robotic thyroidectomy (TORT group) or bilateral breast-axillary approach (BABA group) in the Department of Thyroid and Breast Surgery, the 960th Hospital of People's Liberation Army from July 2020 to May 2022. Both groups received lobectomy with lymph node dissection of the central region. A total of 100 cases were included in the study, including 48 cases in the TORT group and 52 cases in the BABA group. The propensity score matching method was used for 1∶1 matching of patients between the 2 groups, with a match tolerance of 0.03. There were 31 patients in each group successfully matched. In the TORT group, there were 5 males and 26 females, aged (33.2±7.9) years (range: 21 to 53 years). While there were 4 males and 27 females in the BABA group, aged (34.6±9.2) years (range: 19 to 58 years). The t test, Mann-Whitney U test, χ² test or Fisher exact test were used to compare the clinical efficacy between the two groups. Results: All the patients successfully completed robotic thyroid surgery without conversion to open surgery. Compared with BABA group, the TORT group had longer operation time ((211.3±57.2) minutes vs. (126.2±37.8) minutes, t=6.915, P<0.01), shorter drainage tube retention time ((5.4±1.0) days vs. (6.4±1.2) days, t=-3.544, P=0.001), shorter total hospital stay ((6.6±1.2) days vs. (7.4±1.3) days, t=-2.353, P=0.022), and higher cosmetic score (9.46±0.25 vs. 9.27±0.26, t=2.925, P=0.005). There was no significant difference between the two groups in the number of lymph nodes dissection, metastasis in the central compartment, and the incidence of postoperative complications (all P>0.05). Conclusions: Compared with the bilateral breast-axillary approach, the transoral vestibular approach of robotic thyroidectomy is also safe and effective. It shows similar surgical results to the bilateral breast-axillary approach in strictly selected patients, but the postoperative recovery speed is much faster, and the hospital stay is shorter. Transoral robotic thyroidectomy is a more recommended surgical method for patients with high aesthetic demand.

[Type III secretory protein SINC of Chlamydia psittaci promotes host cell autophagy by activating the MAPK/ERK signaling pathway]

OBJECTIVE

To investigate the effects of SINC, a secreted protein of Chlamydia psittaci, on autophagy of host cells and the role of MAPK/ERK signaling pathway in mediating SINC-induced autophagy.

METHODS

RAW 264.7 cells treated with recombinant SINC were examined for changes in expression levels of LC3-II, Beclin-1, phosphorylated and total ERK1/2 using Western blotting. The expression level of LC3 in the treated cells was detected using immunofluorescence analysis, and the formation of autophagosomes and autolysosomes was observed with transmission electron microscopy (TEM). The effect of pretreatment with U0126 (a specific ERK inhibitor) on the expression levels of LC3-II and Beclin-1 in RAW 264.7 cells exposed to different concentrations of SINC was examined using Western blotting, and LC3 puncta in the cells was detected with immunofluorescence analysis.

RESULTS

The expression levels of LC3-II and Beclin-1 were the highest in RAW 264.7 cells treated with 2 μg/mL SINC for 12h. Immunofluorescence analysis showed exposure to SINC significantly increased the number of cells containing LC3 puncta, where the presence of autophagosomes and autolysosomes was detected. Exposure to 2 μg/mL SINC for 15 min resulted in the most significant increase of the ratios of p-ERK1/2/ERK1/2 in RAW 264.7 cells. Pretreatment of the cells with U0126 prior to SINC exposure significantly decreased the ratio of p-ERK1/2/ERK1/2, lowered the expression levels of LC3-II and Beclin-1, and decreased LC3 aggregation in the cells.

CONCLUSIONS

SINC exposure can induce autophagy in RAW 264.7 cells by activating the MAPK/ERK signaling pathway.

Pharmacokinetic comparison of sitagliptin and metformin HCl extended-release tablets versus JANUMET® XR in healthy volunteers under fasting and fed conditions

Background and Objectives: Janumet^® XR is the combination of sitagliptin and extended metformin hydrochloride produced by Merck Sharp & Dohme. It is specially designed for diabetes mellitus patients taking both drugs already. Janumet^® XR exhibited clinically significant blood glucose lowering efficacy and long-term use safety. However, no generic form of Janumet^® XR has been approved in western countries. The relatively high cost made the medication less prescribed. A more affordable form of this drug may benefit an immense diabetes mellitus population. The current study compared the bioequivalence (BE) of sitagliptin 100 mg and metformin 1000 mg produced by Nanjing Chia-Tai Tianqing Pharmaceutical Company to Janumet^® XR in healthy Chinese subjects. Methods: Twenty-eight healthy Chinese subjects were enrolled in Study 1 and 2, respectively. Both studies were conducted with an open, randomized, two-period crossover design using the test (T) or the reference (R) drug. Study 1 is conducted under the fasting state, and Study 2 is under the fed state. Subjects received an oral dose of sitagliptin 100 mg and metformin 1000 mg, and plasma concentrations of sitagliptin and metformin were determined up to 72 h post-dose. Pharmacokinetic (PK) parameters, including maximum serum concentration (C_max) and area under the concentration-time curve up to the last quantifiable concentration (AUC_0-t) of both sitagliptin and metformin, were calculated and compared between the T and R treatments. Results: In the fasting study, the geometric mean ratios of C_max, AUC_0-t, and AUC_0-∞ for sitagliptin were 109.42%, 101.93%, and 101.95%, respectively; the corresponding ratios for metformin were 98.69%, 94.12%, and 93.42%, respectively. In the fed study, the geometric mean ratios of C_max, AUC_0-t, and AUC_0-∞ for sitagliptin were 98.41%, 100.30%, and 100.24%, respectively; the corresponding ratios for metformin were 97.79%, 99.28%, and 100.69%, respectively. The 90% CIs of C_max, AUC_0-t, and AUC_0-∞ in both studies were all within acceptance limits (80.00%-125.00%). Conclusion: The results demonstrated for the first time that sitagliptin 100 mg and metformin 1000 mg produced by Nanjing Chia-Tai Tianqing Pharmaceutical Company was bioequivalent to the branded Janumet^® XR, and both drugs were well tolerated.

Effects of SGLT2 inhibitors on hepatic fibrosis and steatosis: A systematic review and meta-analysis

OBJECTIVE

Clinical trials have shown that sodium-glucose cotransporter 2 inhibitors (SGLT2i) are closely associated with hepatic fibrosis and steatosis by FibroScan. This paper aimed at evaluating the effects of SGLT2i on hepatic fibrosis and steatosis, which are presented as liver stiffness measurement (LSM) and controlled attenuation parameter (CAP).

METHODS

PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure Database, China Science and Technology Journal Database, and Wanfang Database were searched for randomized clinical trials from database establishment to 30 November 2022 with no language restrictions. The risk of bias was evaluated by Collaboration Handbook. Software Stata 17 and Review Manager (version 5.3) were used for meta-analysis.

RESULTS

A total of eight articles including 686 patients were included. Compared with the control group, our results showed that SGLT2i could lower levels of LSM [MD = -0.82, 95%CI (-1.38, -0.25), p = 0.005] and CAP [MD = -12.80, 95%CI (-20.57, -5.03), p = 0.001]. Further subgroup analyses indicated that SGLT2i presented more advantages on longer treatment duration and more serious steatosis in decreasing LSM. For CAP, SGLT2i exhibited a clear advantage in subgroup analyses of longer treatment duration, younger people, dapagliflozin, worse fibrosis, and steatosis.

CONCLUSION

SGLT2i could reduce LSM and CAP in contrast to other antihyperglycemic drugs. However, the included studies are not definitive, and well-designed, more multi-centered, blinded randomized clinical trials are warranted to definitively establish reliable evidence.

Classification of tuberculosis-related programmed cell death-related patient subgroups and associated immune cell profiling

Background

Tuberculosis (TB) is the deadliest communicable disease in the world with the exception of the ongoing COVID-19 pandemic. Programmed cell death (PCD) patterns play key roles in the development and progression of many disease states such that they may offer value as effective biomarkers or therapeutic targets that can aid in identifying and treating TB patients.

Materials and methods

The Gene Expression Omnibus (GEO) was used to gather TB-related datasets after which immune cell profiles in these data were analyzed to examine the potential TB-related loss of immune homeostasis. Profiling of differentially expressed PCD-related genes was performed, after which candidate hub PCD-associated genes were selected via a machine learning approach. TB patients were then stratified into two subsets based on the expression of PCD-related genes via consensus clustering. The potential roles of these PCD-associated genes in other TB-related diseases were further examined.

Results

In total, 14 PCD-related differentially expressed genes (DEGs) were identified and highly expressed in TB patient samples and significantly correlated with the abundance of many immune cell types. Machine learning algorithms enabled the selection of seven hub PCD-related genes that were used to establish PCD-associated patient subgroups, followed by the validation of these subgroups in independent datasets. These findings, together with GSVA results, indicated that immune-related pathways were significantly enriched in TB patients exhibiting high levels of PCD-related gene expression, whereas metabolic pathways were significantly enriched in the other patient group. Single cell RNA-seq (scRNA-seq) further highlighted significant differences in the immune status of these different TB patient samples. Furthermore, we used CMap to predict five potential drugs for TB-related diseases.

Conclusion

These results highlight clear enrichment of PCD-related gene expression in TB patients and suggest that this PCD activity is closely associated with immune cell abundance. This thus indicates that PCD may play a role in TB progression through the induction or dysregulation of an immune response. These findings provide a foundation for further research aimed at clarifying the molecular drivers of TB, the selection of appropriate diagnostic biomarkers, and the design of novel therapeutic interventions aimed at treating this deadly infectious disease.

Constraints on Heavy Decaying Dark Matter from 570 Days of LHAASO Observations

The kilometer square array (KM2A) of the large high altitude air shower observatory (LHAASO) aims at surveying the northern γ-ray sky at energies above 10 TeV with unprecedented sensitivity. γ-ray observations have long been one of the most powerful tools for dark matter searches, as, e.g., high-energy γ rays could be produced by the decays of heavy dark matter particles. In this Letter, we present the first dark matter analysis with LHAASO-KM2A, using the first 340 days of data from 1/2-KM2A and 230 days of data from 3/4-KM2A. Several regions of interest are used to search for a signal and account for the residual cosmic-ray background after γ/hadron separation. We find no excess of dark matter signals, and thus place some of the strongest γ-ray constraints on the lifetime of heavy dark matter particles with mass between 10^{5} and 10^{9}  GeV. Our results with LHAASO are robust, and have important implications for dark matter interpretations of the diffuse astrophysical high-energy neutrino emission.

Rapid determination of illegally added Sudan I in cake by triphenylamine functionalized polyhedral oligomeric silsesquioxane fluorescence sensor

Triphenylamine functionalized polyhedral oligomeric silsesquioxane (POSS@TPA) was prepared using the Friedel-Crafts reaction with tris(4-bromophenyl)amine (TPA) as the functional monomer and polyhedral oligomeric silsesquioxane (POSS) as the framework. The as-prepared POSS@TPA has a stable structure and accomplished pore performance, allowing for the selective adsorption of Sudan I and result in the fluorescence quenches of POSS@TPA. Thus, the POSS@TPA could be used as sensors to fluorescence detect 0.12-7.4 mg/L Sudan I, with a detection limit of 0.091 mg/L. Moreover, the POSS@TPA have good reuseability can be reused more than 5 cycles after washing. Noteworthily, the response time of POSS@TPA for determination was as short as 1 min. Furthermore, the sensor was effectively used to determine Sudan I in cakes with excellent recoveries (86.4-108.8 %) and relative standard deviations (2.5-4.9 %). The results matched those of high-performance liquid chromatography (HPLC). Our work shows great potential in terms of the rapid detection of food safety.

Efficacy and safety of Abelmoschus moschatus capsules combined with tripterygium glycoside tablets on diabetic nephropathy: A systematic review and meta-analysis

Background: Diabetic nephropathy (DN) is one of the most serious chronic micro-vascular complications of diabetes and the leading cause of end-stage kidney disease (ESRD) worldwide, with reduced expectancy and quality of life and colossal financial and social burden worldwide. In spite of emerging treatments on DN, effective therapy on delaying the progression of DN is still lacking. In clinical practice, there are many studies focusing on Abelmoschus moschatus (AM) capsules together with Tripterygium glycoside (TG) tablets in the treatment of DN, and excellent results have been obtained.

Objective: The study aimed to evaluate the efficacy and safety of AM combined with TG in the treatment of DN.

Methods: Databases including PubMed, Web of Science, Cochrane Library, Embase, CNKI, WF, and VIP were searched from their inception to 1 March 2022. The “risk of bias” evaluation tool produced by the Cochrane Collaboration Handbook was used for evaluating the quality of the included studies. Revman 5.3 software was used for meta-analysis.

Results: Here, 11 studies with a total of 1,072 participants were included for this meta-analysis. Our results showed that AM combined with TG plus basic treatment could lower levels of 24 h-UP [MD = -0.18; 95% CI: (-0.21, -0.14); p < 0.00001], Scr [MD = -15.29; 95% CI: (-28.69, -1.88); p = 0.03], and BUN [MD = -1.18; 95% CI: (-1.69, -0.68); p < 0.00001]. Meanwhile, the adverse reaction rate increased in the combination group [RR = 1.88; 95% CI (1.26, 2.82); p = 0.002].

Conclusion: Current evidence suggests that AM combined with TG may be more effective in the treatment of DN, which will be highly beneficial to further theoretical discussion and practical clinical applications. However, the safety cannot be ignored because of nearly increasing 2-fold adverse events, although they can be mitigated through systematic treatment. Meanwhile, due to low quality of the included studies, great possibility of publication bias, and large heterogeneity among different studies, the results of our review should be evaluated with more prudence and high-quality RCTs are warranted to confirm this in the future.

Systematic review Registration:www.crd.york.ac.uk, identifier CRD42022344359.

Triphenylbenzene functionalized polyhedral oligomeric silsesquioxane fluorescence sensor for the selective analysis of trace nitrofurazone in aquatic product and cosmetics

Nitrofurazone (NFZ) is carcinogenic and mutagenic to human in long-term ingestion, and it is prohibited to be added in food. In this work, a novel triphenylbenzene (TPB) functionalized fluorescent hybrid porous polymers (POSS@TPB) was constructed by using polyhedral oligomeric silsesquioxane (POSS) as the rigid group and TPB as the core unit of high fluorescence. The morphology and physicochemical properties of POSS@TPB were characterized in detail. Moreover, the synergistic effect of inner filter effect and photoinduced electron transfer is verified by experimental and simulation results. After condition optimization, a NFZ analysis method based on POSS@TPB probe was established with a linear range of 0.4-16.5 mg/L and a detection limit of 0.13 mg/L. In addition, the fluorescent probe has good stability, anti-interference and considerable reusability. At the same time, the selective analysis of trace NFZ in aquatic product and cosmetics was carried out with satisfied recoveries of 87%-110.6% and relative standard deviation less than 4.1%. And the results were verified by high-performance liquid chromatography method. Overall, this fluorescence sensor has excellent performance in NFZ analysis, which provides a broad application prospect for the repeatable and selective residue NFZ analysis in aquatic product and cosmetics.

Pregnancy of cryopreserved ovine embryos at different developmental stages

BACKGROUND

Developmental stage and cryopreservation method have significant impact on the pregnancy rate after transfer of embryos produced in vivo.

OBJECTIVE

To determine the pregnancy outcomes from ovine embryos cryopreserved at different developmental stages.

MATERIALS AND METHODS

Embryos at different developmental stages were obtained from donor ewes through simultaneous estrus treatment and laparoscopic artificial insemination. Embryos, either cryopreserved via vitrification or slow freezing method, were implanted into recipient ewes. The pregnancy rate was determined 35 days after transfer.

RESULTS

The pregnancy rate of developing embryos increases after transfer from the morula stage, early blastocyst to expanded blastocyst stages (64.9%, 73.9% and 81.3%, respectively). However, cryopreservation significantly decreases the pregnancy rate of embryos at all three developmental stages, and there is no significant difference among developmental stages (43.9%, 43.7%, 52.9%, respectively). There is also no significant difference in the pregnancy rate between slowly-frozen embryos and vitrified embryos.

CONCLUSION

The pregnancy outcomes of embryo transfer is better at the expanded blastocyst stage than at earlier stages. However, no difference is observed in the pregnancy rate of embryos at different developmental stage after cryopreservation, either by slow freezing and vitrification. Cryopreservation methods for ovine embryos, both slow freezing and vitrification, need further improvement. doi.org/10.54680/fr22510110512.

Two Solvent-Induced In(III)-Based Metal-Organic Frameworks with Controllable Topology Performing High-Efficiency Separation of C2H2/CH4 and CO2/CH4

For pure acetylene manufacturing and natural gas purification, the development of porous materials displaying highly selective C₂H₂/CH₄ and CO₂/CH₄ separation is greatly important but remains a major challenge. In this work, a plausible strategy involving solvent-induced effects and using the flexibility of the ligand conformation to make two In(III) metal-organic frameworks (MOFs) is developed, showing topological diversity and different stability. The X-shaped tetracarboxylic ligand H₄TPTA ([1,1':3',1″-terphenyl]-4,4',4″,6'-tetracarboxylic acid) was selected to construct two new heteroid In MOFs, namely, {[CH₃NH₃][In(TPTA)]·2(NMF)} (MOF 1) and {[In₂(TPTA)(OH)₂]·2(H₂O)·(DMF)} (MOF 2). MOF 1 is a (4, 4)-connected net showing a pts topology with a large channel that is not conducive to fine gas separation. By contrast, with the reduction of SBU from uninucleated In to an {In-OH-In}_n chain, MOF 2 has a (4, 6)-connected net with the fsc topology with an ∼5 Å suitable micropore to confine matching small gas. The permanent porosity of MOF 2 leads to the preferential adsorption of C₂H₂ over CO₂ with superior C₂H₂/CH₄ (332.3) and CO₂/CH₄ (31.2) separation selectivities. Meanwhile, the cycling dynamic breakthrough experiments showed that the high-purity C₂H₂ (>99.8%) capture capacities of MOF 2 were >1.92 mmol g^-1 from a binary C₂H₂/CH₄ mixture, and its separation factor reached 10.

POSS-based fluorescence sensor for rapid analysis of β-carotene in health products

Recent years, fluorescent organic-inorganic hybrid nanomaterials have received a lot of interest as potential fluorescent sensor materials. In this study, fluorescent organic-inorganic hybrid nanomaterials (POSS@ANT) were created utilizing polyhedral oligomeric silsesquioxane as the precursor and 9,10-bromoanthracene as the monomer. The morphology and composition of POSS@ANT, as well as its pore characteristics and fluorescence properties were studied. And POSS@ANT displayed steady fluorescence emission at an excitation wavelength of 374 nm. Then a β-carotene fluorescence sensor was developed using the capacity of β-carotene to quench the fluorescence of POSS@ANT. The quenching process is linked to acceptor electron transfer and energy transfer, and the sensor has a high selectivity for β-carotene. This β-carotene fluorescence analysis method we established has a linear range of 0.2-4.3 mg/L and a detection limit of 0.081 mg/L. Finally, it was used to quantify β-carotene in health products, the recovery rate was 91.1% - 109.9%, the RSD was 2.2% - 4.3%, and the results were compatible with the results of high-performance liquid chromatography. The approach is reliable and can be used to determine β-carotene in health products.

[Activation of cGAS/STING signaling pathway and its immunological role in the progression of nonalcoholic fatty liver disease]

Today, nonalcoholic fatty liver disease remains the most dominant chronic liver disease. Cyclic guanosine monophosphate-adenosine monosphosphate synthase (cGAS) is a cytosolic DNA sensor that catalyzes the synthesis of cyclic guanosine monophosphate, activates stimulator of interferon genes (STING), and releases type-I interferon cytokines to trigger immune responses. Exogenous or endogenous DNA acts as a cGAS ligand to activate the cGAS-STING signaling pathway, which plays a role in hepatitis, nonalcoholic fatty liver disease, liver cancer and other diseases, and affects liver disease progression and metabolism through mechanisms such as autophagy. This article reviews the activation of cGAS-STING pathway and its molecular immunological role in nonalcoholic fatty liver disease progression.

Overexpression of REST Causes Neuronal Injury and Decreases Cofilin Phosphorylation in Mice

Background: RE1-silencing transcription factor (REST) is known to silence target genes involved in synaptic plasticity and neuronal differentiation. Although previous studies implicate REST in neurodegenerative diseases, its function in the progression of Alzheimer’s disease (AD) is uncertain. Objective: The aim of the present work was to explore the mechanisms of AD and determine whether and how REST was involved in the pathogenesis of AD. Methods: We investigated the differentially expressed genes and key transcription factors in AD using bioinformatics analysis. In addition, we assessed the expression of REST under the influence of AD-related factors. Mice overexpressing REST were generated and analyzed by proteomics analysis. We used transmission electron microscopy, Golgi-cox staining, immunohistochemistry, and western blotting to examine the impact of REST on neurons. Results: The results of bioinformatics analysis revealed REST as a hub transcriptional regulator in AD. We demonstrate that the mRNA expression of REST was significantly upregulated compared with that in the control groups, not only in AD patients but also in APP/PS1 transgenic mice, lipopolysaccharide-induced neuroinflammatory mice, and oxidative and glutamate stressed neurons. Using proteomics analysis, we showed that the upregulation of REST increased the expression of genes involved in apoptotic and mitochondrial pathways. Long-term overexpression of REST significantly reduced the number of dendritic spines and increased the mitochondrial defect and apoptosis. Reduction of the cofilin phosphorylation may be one of its mechanisms, and cofilin activity could be affected through the P38 MAPK/CREB signaling pathway. Conclusion: These results demonstrated the possible mechanism underlying AD and indicated REST as a potential therapeutic target for AD.

Reuse of waste Myrica rubra for green synthesis of nitrogen-doped carbon dots as an "on-off-on" fluorescent probe for Fe3+ and ascorbic acid detection

As one kind of high nutrition fruits, abandoned Myrica rubra causes great waste due to short storage period. For resource utilization, we herein fabricated the Myrica rubra-based N-doped carbon dots (MN-CDs) by a facile/green hydrothermal method. MN-CDs, fabricated from four regions of China, displayed significant differences in their corresponding fluorescence intensities (FIs). Interestingly, different batches of waxberry samples from the same region (Wenzhou, China) exhibited slight differences in their FIs, and also an excellent anti-photobleaching and anti-salt capacity. Based on Fe³⁺-triggered quenching effect and fluorescent recovery by redox reaction of AA and Fe³⁺, MN-CDs were employed to construct an "on-off-on" switch probe for sequential detection of Fe³⁺ and ascorbic acid (AA). Through Zeta potential, UV spectrum, Stern-Volmer equation, and valence-conduction band theory, the Fe³⁺-triggered quenching belonged to a static quenching process, which resulted from the synergistic contribution of inner filtering effect and photo-induced electron transfer mechanisms. The linear ranges for Fe³⁺ and AA detections were 1-1000 and 0.1-1000 mM. The limits of detection were 0.3 μM for Fe³⁺ in environmental waters, and 0.03 μM for AA in pharmaceutical tablets and fruit juice samples. Under 365-nm UV lamp, the color changes of test papers were easily observed from dark blue and bright blue in the presence of Fe³⁺ and AA, and thus the MN-CDs-based switch probe could be satisfactorily used for visually qualitative detection of Fe³⁺ and AA outdoor with our naked eyes. To sum up, MN-CDs not only realize resource reutilization of abandoned Myrica rubra, but also offer an convenient outdoor approach for qualitative detection of Fe³⁺ and AA in complex matrices.

MLL5 is involved in retinal photoreceptor maturation through facilitating CRX-mediated photoreceptor gene transactivation

Histone methylation, particularly at the H3K4 position, is thought to contribute to the specification of photoreceptor cell fate; however, the mechanisms linking histone methylation with transcription factor transactivation and photoreceptor gene expression have not yet been determined. Here, we demonstrate that MLL5 is abundantly expressed in the mouse retina. Mll5 deficiency impaired electroretinogram responses, alongside attenuated expression of a number of retina genes. Mechanistic studies revealed that MLL5 interacts with the retina-specific transcription factor, CRX, contributing to its binding to photoreceptor-specific gene promoters. Moreover, depletion of MLL5 impairs H3K4 methylation and H3K79 methylation, which subsequently compromises CRX-CBP assembly and H3 acetylation on photoreceptor promoters. Our data support a scenario in which recognition of H3K4 methylation by MLL5 is required for photoreceptor-specific gene transcription through maintaining a permissive chromatin state and proper CRX-CBP recruitment at promoter sites.

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MLL5 is essential for the expression of critical photoreceptor genes

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MLL5 depletion reduces H3K4/K79 methylation at photoreceptor gene promoters

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MLL5 interacts with CRX via its CD4 domain

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Recognition of H3K4me2/3 by MLL5 is a prerequisite for CRX recruitment to chromatin