Effect of ursodeoxycholic acid on preventing SARS-CoV-2 infection in patients with liver transplantation: a multicenter retrospective cohort study

BACKGROUND

Immunosuppressed recipients of liver transplantation (LT) are more likely to develop coronavirus disease 2019 (COVID-19) and may have an increased risk of developing worse outcomes.

AIM

To assess the effect of ursodeoxycholic acid (UDCA) on preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in LT recipients.

DESIGN

Adult patients (aged ≥ 18 years) who underwent LT between 1 January 2015 and 31 December 2022 were included and categorized into two groups according to their use of UDCA.

METHODS

The prevalence and severity of COVID-19 among transplantation patients between the UDCA and non-UDCA groups were estimated and compared.

RESULTS

Among the 897 LT patients who met the inclusion criteria, infection rate of SARS-CoV-2 was 78.4%, and the rate of severe illness was 5.1% from January 2022 to January 2023 in China. In the multivariate analysis, only UDCA treatment (P = 0.006) was found to be a protective factor against SARS-CoV-2 infection. After propensity score matching, the SARS-CoV-2 infection rate in the UDCA group was lower than that in the non-UDCA group (74.1% vs. 84.6%, P = 0.002). This rate was further reduced to 62.1% (P = 0.002) when the oral administration dose was >15 mg/kg/day. There was no difference in the rates of severe COVID-19 illness, ICU admission, or ventilation rate or length of hospital stay with or without UDCA treatment (all P > 0.05).

CONCLUSIONS

The use of UDCA in LT patients significantly reduced the SARS-CoV-2 infection rate and showed a dose-dependent protective effect.

Effectiveness of cannulated screw fixation for femoral neck fracture assisted by three-dimensional printing navigation template in middle-aged and elderly patients

OBJECTIVE

We sought to explore the effectiveness of cannulated screw fixation for femoral neck fractures in middle-aged and elderly patients assisted by a three-dimensional printing navigation template.

PATIENTS AND METHODS

A total of 98 middle-aged and elderly patients who underwent cannulated screw fixation for femoral neck fractures were retrospectively analyzed. They were allocated into two groups, each comprising 49 patients. Surgical indexes, hip function, and pain levels were compared between the two groups.

RESULTS

The study group, assisted by the three-dimensional printing navigation template, exhibited significantly reduced nail insertion, fewer instances of C-arm fluoroscopy, shorter operation time, quicker time to bone union, earlier initiation of walking exercise, shorter time to weight-bearing walking, and reduced hospital stay than those in the control group (all p<0.001). However, the study group also experienced higher blood loss compared to the control group (p<0.001). Postoperatively, at 3 months and 12 months, the study group demonstrated significantly higher scores compared to the control group (both p<0.001) and reported significantly lower pain scores than that in the other group at 1 week and 12 months post-surgery (both p<0.001). Furthermore, the study group experienced significantly fewer postoperative complications than the control group (p=0.029).

CONCLUSIONS

Cannulated screw fixation for femoral neck fractures assisted by a 3D printing navigation template is more effective and safer than traditional fixation methods. This approach represents a promising alternative for surgical management.

Efficacy and safety of intrathecal pemetrexed for TKI-failed leptomeningeal metastases from EGFR+ NSCLC: an expanded, single-arm, phase II clinical trial

BACKGROUND

This study aimed to evaluate the efficacy and safety of intrathecal pemetrexed (IP) for treating patients with leptomeningeal metastases (LM) from non-small-cell lung cancer (NSCLC) who progressed from epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) treatment in an expanded, prospective, single-arm, phase II clinical study (ChiCTR1800016615).

PATIENTS AND METHODS

Patients with confirmed NSCLC-LM who progressed from TKI received IP (50 mg, day 1/day 5 for 1 week, then every 3 weeks for four cycles, and then once monthly) until disease progression or intolerance. Objectives were to assess overall survival (OS), response rate, and safety. Measurable lesions were assessed by investigator according to RECIST version 1.1. LM were assessed according to the Response Assessment in Neuro-Oncology (RANO) criteria.

RESULTS

The study included 132 patients; 68% were female and median age was 52 years (31-74 years). The median OS was 12 months (95% confidence interval 10.4-13.6 months), RANO-assessed response rate was 80.3% (106/132), and the most common adverse event was myelosuppression (n = 42; 31.8%), which reversed after symptomatic treatment. The results of subgroup analysis showed that absence of brain parenchymal metastasis, good Eastern Cooperative Oncology Group score, good response to IP treatment, negative cytology after treatment, and patients without neck/back pain/difficult defecation had longer survival. Gender, age, previous intrathecal methotrexate/cytarabine, and whole-brain radiotherapy had no significant influence on OS.

CONCLUSIONS

This study further showed that IP is an effective and safe treatment method for the EGFR-TKI-failed NSCLC-LM, and should be recommended for these patients in clinical practice and guidelines.

Dexamethasone relieves the inflammatory response caused by inguinal hernia meshes through miR-155

BACKGROUND

Inguinal hernia is a relatively common condition. Most patients with inguinal hernia require surgery. At present, mesh repair is one of the most effective methods to treat inguinal hernia, but insertion of the mesh can cause inflammation. Dexamethasone (DEX) can treat inflammation, but the mechanism by which DEX alleviates inflammation caused by inguinal hernia mesh placement remains unclear.

METHOD

We randomly divided rats into groups: negative control (NC), inguinal hernia (IH), polypropylene mesh (PM), DEX treatment, and miR-155 treatment groups. RT-qPCR was performed to determine the expression of miR-155. ELISA was implemented to determine the secretion of IL-1β, IL-6, and IL-18. Western blotting was used to detect caspase-1, JAK1, p-JAK1, STAT3, and p-STAT3 expression. A dual-luciferase reporter gene array identified a connection between miR-155 and JAK1.

RESULTS

The results revealed that the expression of miR-155, IL-1β, IL-6, and IL-18 was upregulated in the PM group. After DEX treatment, the secretion of miR-155, caspase-1, IL-1β, IL-6, and IL-18 decreased. Dual luciferase results confirmed that miR-155 induced the targeted downregulation of JAK1, while a miR-155 mimic reversed the therapeutic effect of DEX, and the expression levels of p-JAK1 and p-STAT3 increased.

CONCLUSION

DEX regulates the JAK1/STAT3 signaling pathway through miR-155 to relieve inflammation caused by inguinal hernia meshes.

Injectable Mesh-Like Conductive Hydrogel Patch for Elimination of Atrial Fibrillation

Irregular electrical impulses in atrium are the leading cause of atrial fibrillation (AF), resulting in fatal arrhythmia and sudden cardiac death. Traditional medication and physical therapies are widely used, but generally suffer problems in serious physical damage and high surgical risks. Flexible and soft implants have great potential to be a novel approach for heart diseases therapy. A conductive hydrogel-based mesh cardiac patch is developed for application in AF elimination. The designed mesh patch with rhombic-shaped structure exhibits excellent flexibility, surface conformability, and deformation compliance, making it fit well with heart surface and accommodate to the deformation during heart beating. Moreover, the mechanical elastic and shape-memory properties of the mesh patch enable a minimally invasive injection of the patch into living animals. The mesh patch is implanted on the atrium surface for one month, indicating good biocompatibility and stability. Furthermore, the conductive patch can effectively eliminate AF owing to the conductivity and high charge storage capability (CSC) of the hydrogel. The proposed scheme of cardiac bioelectric signal modulation using conductive hydrogel brings new possibility for the treatment of arrhythmia diseases.

Epithelial SIRT6 governs IL-17A pathogenicity and drives allergic airway inflammation and remodeling

Dysregulation of IL-17A is closely associated with airway inflammation and remodeling in severe asthma. However, the molecular mechanisms by which IL-17A is regulated remain unclear. Here we identify epithelial sirtuin 6 (SIRT6) as an epigenetic regulator that governs IL-17A pathogenicity in severe asthma. Mice with airway epithelial cell-specific deletion of Sirt6 are protected against allergen-induced airway inflammation and remodeling via inhibiting IL-17A-mediated inflammatory chemokines and mesenchymal reprogramming. Mechanistically, SIRT6 directly interacts with RORγt and mediates RORγt deacetylation at lysine 192 via its PPXY motifs. SIRT6 promotes RORγt recruitment to the IL-17A gene promoter and enhances its transcription. In severe asthma patients, high expression of SIRT6 positively correlates with airway remodeling and disease severity. SIRT6 inhibitor (OSS_128167) treatment significantly attenuates airway inflammation and remodeling in mice. Collectively, these results uncover a function for SIRT6 in regulating IL-17A pathogenicity in severe asthma, implicating SIRT6 as a potential therapeutic target for severe asthma.

Immunity-and-matrix-regulatory cells enhance cartilage regeneration for meniscus injuries: a phase I dose-escalation trial

Immunity-and-matrix-regulatory cells (IMRCs) derived from human embryonic stem cells have unique abilities in modulating immunity and regulating the extracellular matrix, which could be mass-produced with stable biological properties. Despite resemblance to mesenchymal stem cells (MSCs) in terms of self-renew and tri-lineage differentiation, the ability of IMRCs to repair the meniscus and the underlying mechanism remains undetermined. Here, we showed that IMRCs demonstrated stronger immunomodulatory and pro-regenerative potential than umbilical cord MSCs when stimulated by synovial fluid from patients with meniscus injury. Following injection into the knees of rabbits with meniscal injury, IMRCs enhanced endogenous fibrocartilage regeneration. In the dose-escalating phase I clinical trial (NCT03839238) with eighteen patients recruited, we found that intra-articular IMRCs injection in patients was safe over 12 months post-grafting. Furthermore, the effective results of magnetic resonance imaging (MRI) of meniscus repair and knee functional scores suggested that 5 × 107 cells are optimal for meniscus injury treatment. In summary, we present the first report of a phase I clinical trial using IMRCs to treat meniscus injury. Our results demonstrated that intra-articular injection of IMRCs is a safe and effective therapy by providing a permissive niche for cartilage regeneration.

Prenatal exome sequencing analysis in fetuses with central nervous system anomalies

OBJECTIVE

To evaluate the utility of prenatal exome sequencing (pES) in fetuses with central nervous system (CNS) abnormalities.

METHODS

This was a retrospective cohort study of fetuses identified to have CNS abnormality on prenatal ultrasound and/or magnetic resonance imaging. All fetuses were first analyzed by chromosomal microarray analysis (CMA). Fetuses with a confirmed aneuploidy or causal pathogenic copy-number variant (CNV) on CMA did not undergo pES analysis and were excluded, while those with a negative CMA result were offered pES testing.

RESULTS

Of the 167 pregnancies included in the study, 42 (25.1%) were identified to have a pathogenic or likely pathogenic (P/LP) variant. The diagnostic rate was significantly higher in fetuses with a non-isolated CNS abnormality than in those with a single CNS abnormality (35.7% (20/56) vs 14.5% (8/55); P = 0.010). Moreover, when a fetus had three or more CNS abnormalities, the positive diagnostic rate increased to 42.9%. A total of 25/42 (59.5%) cases had de-novo mutations, while, in the remaining cases, mutations were inherited and carried a significant risk of recurrence. Families whose fetus carried a P/LP mutation were more likely to choose advanced pregnancy termination than those with a variant of uncertain significance, secondary/incidental finding or negative pES result (83.3% (25/30) vs 41.3% (38/92); P < 0.001).

CONCLUSION

pES improved the identification of genetic disorders in fetuses with CNS anomalies without a chromosomal abnormality or CNV identified on CMA, regardless of the number of CNS anomalies and presence of extracranial abnormality. We also demonstrated that pES findings can significantly impact parental decision-making. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

Host response of Nicotiana benthamiana to the parasitism of five populations of root-lesion nematode, Pratylenchus coffeae, from China

In a recent survey of nematodes associated with tobacco in Shandong, China, the root-lesion nematode Pratylenchus coffeae was identified using a combination of morphology and molecular techniques. This nematode species is a serious parasite that damages a variety of plant species. The model plant benthi, Nicotiana benthamiana, is frequently used to study plant-disease interactions. However, it is not known whether this plant species is a host of P. coffeae. The objectives of this study were to evaluate the parasitism and pathogenicity of five populations of the root-lesion nematode P. coffeae on N. benthamiana.N. benthamiana seedlings with the same growth status were chosen and inoculated with 1,000 nematodes per pot. At 60 days after inoculation, the reproductive factors (Rf = final population densities (Pf)/initial population densities (Pi)) for P. coffeae in the rhizosphere of N. benthamiana were all more than 1, suggesting that N. benthamiana was a good host plant for P. coffeae.Nicotiana. benthamiana infected by P. coffeae showed weak growth, decreased tillering, high root reduction, and noticeable brown spots on the roots. Thus, we determined that the model plant N. benthamiana can be used to study plant-P. coffeae interactions.

CNN-Bi-LSTM: A Complex Environment-Oriented Cattle Behavior Classification Network Based on the Fusion of CNN and Bi-LSTM

Cattle behavior classification technology holds a crucial position within the realm of smart cattle farming. Addressing the requisites of cattle behavior classification in the agricultural sector, this paper presents a novel cattle behavior classification network tailored for intricate environments. This network amalgamates the capabilities of CNN and Bi-LSTM. Initially, a data collection method is devised within an authentic farm setting, followed by the delineation of eight fundamental cattle behaviors. The foundational step involves utilizing VGG16 as the cornerstone of the CNN network, thereby extracting spatial feature vectors from each video data sequence. Subsequently, these features are channeled into a Bi-LSTM classification model, adept at unearthing semantic insights from temporal data in both directions. This process ensures precise recognition and categorization of cattle behaviors. To validate the model's efficacy, ablation experiments, generalization effect assessments, and comparative analyses under consistent experimental conditions are performed. These investigations, involving module replacements within the classification model and comprehensive analysis of ablation experiments, affirm the model's effectiveness. The self-constructed dataset about cattle is subjected to evaluation using cross-entropy loss, assessing the model's generalization efficacy across diverse subjects and viewing perspectives. Classification performance accuracy is quantified through the application of a confusion matrix. Furthermore, a set of comparison experiments is conducted, involving three pertinent deep learning models: MASK-RCNN, CNN-LSTM, and EfficientNet-LSTM. The outcomes of these experiments unequivocally substantiate the superiority of the proposed model. Empirical results underscore the CNN-Bi-LSTM model's commendable performance metrics: achieving 94.3% accuracy, 94.2% precision, and 93.4% recall while navigating challenges such as varying light conditions, occlusions, and environmental influences. The objective of this study is to employ a fusion of CNN and Bi-LSTM to autonomously extract features from multimodal data, thereby addressing the challenge of classifying cattle behaviors within intricate scenes. By surpassing the constraints imposed by conventional methodologies and the analysis of single-sensor data, this approach seeks to enhance the precision and generalizability of cattle behavior classification. The consequential practical, economic, and societal implications for the agricultural sector are of considerable significance.

The HDAC10 instructs macrophage M2 program via deacetylation of STAT3 and promotes allergic airway inflammation

Background: Perturbation of macrophage homeostasis is one of the key mechanisms of airway inflammation in asthma. However, the exact mechanisms remain poorly understood. Objectives: We sought to examine the role of histone deacetylase (HDAC) 10 as an epigenetic regulator that governs macrophage M2 program and promotes airway inflammation in asthma, and to elucidate the underlying mechanisms. Methods: Peripheral blood and airway biopsies were obtained from healthy individuals and asthmatic patients. Asthma was induced by exposure to allergen in mice with myeloid-specific deletion of Hdac10 (Hdac10^fl/fl-LysMCre) mice. HDAC10 inhibitor Salvianolic acid B (SAB), STAT3 selective agonist Colivelin, and the specific PI3K/Akt activator 1,3-Dicaffeoylquinic acid (DA) were also used in asthmatic mice. For cell studies, THP1 cells, primary mouse bone marrow derived macrophage (BMDMs) were used and related signaling pathways was investigated. Results: HDAC10 expression was highly expressed by macrophages and promoted M2 macrophage activation and airway inflammation in asthmatic patients and mice. Hdac10^fl/fl-LysMCre mice were protected from airway inflammation in experimental asthma model. Hdac10 deficiency significantly attenuated STAT3 expression and decreased M2 macrophage polarization following allergen exposure. Mechanistically, HDAC10 directly binds STAT3 for deacetylation in macrophages, by which it promotes STAT3 expression and activates the macrophage M2 program. Importantly, we identified SAB as a HDAC10 inhibitor that had protective effects against airway inflammation in mice. Conclusions: Our results revealed that HDAC10-STAT3 interaction governs macrophage polarization to promote airway inflammation in asthma, implicating HDAC10 as a therapeutic target.

Myeloid-Specific SIRT6 Deletion Protects Against Particulate Matter (PM2.5)-Induced Airway Inflammation

Purpose

Particulate matter (PM_2.5) is a common risk factor for airway inflammation. Alveolar macrophages play a critical role in airway inflammation. Sirtuin 6 (SIRT6) is a class Ill histone deacetylase that exerts an anti-inflammatory effect in airway diseases. However, the role of SIRT6 on PM2.5-induced airway inflammation in macrophages remains unclear. We aimed to determine whether SIRT6 protects against PM_2.5-induced airway inflammation in macrophages.

Methods

The effect of SIRT6 on PM_2.5-induced airway inflammation was assessed by using THP1 cells or bone marrow-derived macrophages (BMDMs) exposed to PM_2.5 in vitro and myeloid cell-specific SIRT6 conditional knockout mice (Sirt6^fl/fl-LysMCre) in vivo.

Results

PM2.5 increased SIRT6 expression in THP1 cells, but SIRT6 gene silencing decreased PM2.5 induced inflammatory cytokines in THP1 cells. Moreover, the expression of SIRT6 and inflammatory cytokines was also decreased in BMDMs with myeloid-specific deletion of SIRT6 after stimulation of PM_2.5. In vivo, Sirt6^fl/fl-LysMCre mice substantially decreased airway inflammation in response to PM_2.5 exposure.

Conclusion

Our results revealed that SIRT6 promotes the PM_2.5-induced airway inflammation in macrophages and indicated that inhibition of SIRT6 in macrophages may represent therapeutic strategy for airway disorders induced by airborne particulate pollution.

Prediction of the Efficacy of Lumbar Sympathetic Block in Patients with Lower Extremity Complex Regional Pain Syndrome Type 1 Based on the Sympathetic Skin Response

INTRODUCTION

Complex regional pain syndrome type 1 (CRPS-1) is prevalent after trauma, with intractable pain being the most prominent clinical symptom. The impact of sympathetic block on CRPS is unclear. The goal of this study was to explore the characteristics that predict successful symptom relief with lumbar sympathetic block (LSB) in patients with lower extremity CRPS-1.

METHODS

The study was designed as a prospective cohort study. Ninety-eight patients diagnosed with lower extremity CRPS-1 between March 2021 and March 2022 were enrolled as participants. All of the patients received two LSB treatments within a month. Sympthetic skin response (SSR) and numeric rating scale (NRS) were recorded before and after LSB treatment. The procedure was judged as a clinically positive response if the patients a 50% or greater reduction in NRS scores. Patients were divided into positive response and negative response groups after LSB treatment: LSB (+) and LSB (-), and the different characteristics and examination findings of the two groups of patients were compared. Furthermore, a multivariable logistic regression model was utilized to evaluate the predictors of successful symptom relief following LSB treatment.

RESULTS

A total of 43.9% (43/98) of patients experienced successful symptom relief, while 56.1% (55/98) had unsuccessful symptom relief. After LSB treatment of all subjects, the overall NRS score decreased, the SSR amplitude increased, and the SSR latency shortened in the affected extremity (P < 0.05). There was a significant difference in the change in SSR amplitude between the LSB (-) and LSB (+) groups (P = 0.000). A 12-month disease duration had an OR (odds ratio) of 4.477 (P = 0.009), and a 510-µV baseline SSR amplitude of the affected extremity had an OR of 7.508 (P = 0.000) in the multivariable analysis that included these explanatory variables.

CONCLUSIONS

Patients with lower extremity CRPS-1 can experience significant pain relief after LSB treatment. The predictors of successful symptom relief after LSB treatment were a baseline SSR amplitude of the affected extremity < 510 µV and a disease duration < 12 months.

TRIAL REGISTRATION

The study was registered in the Chinese Clinical Trial Registry (ID: ChiCTR2000037755, date of registration: September 4, 2020).

Radiomics Nomogram Model Based on TOF-MRA Images: A New Effective Method for Predicting Microaneurysms

Objective

To develop a radiomics nomogram model based on time-of-flight magnetic resonance angiography (TOF-MRA) images for preoperative prediction of true microaneurysms.

Methods

118 patients with Intracranial Aneurysm Sac (40 positive and 78 negative) were enrolled and allocated to training and validation groups (8:2 ratio). Findings of clinical characteristics and MRA features were analyzed. A radiomics signature was built on the basis of reproducible features by using the least absolute shrinkage and selection operator (LASSO) regression algorithm in the training group. The radiomics nomogram model was constructed by combining clinical risk factors and radiomics signature. In order to compare the classification performance of clinical models, radiomics model and radiomics nomogram model, AUC was used to evaluate them. The performance of the radiomics nomogram model was evaluated by calibration curve and decision curve analysis.

Results

Eleven features were selected to develop radiomics model with AUC of 0.875 (95% CI 0.78-0.97), sensitivity of 0.84, and specificity of 0.68. The radiomics model achieved a better diagnostic performance than the clinic model (AUC = 0.75, 95% CI: 0.53-0.97) and even radiologists. The radiomics nomogram model, which combines radiomics signature and clinical risk factors, is effective too (AUC = 0.913, 95% CI: 0.87-0.96). Furthermore, the decision curve analysis demonstrated significantly better net benefit in the radiomics nomogram model.

Conclusion

Radiomics features derived from TOF-MRA can reliably be used to build a radiomics nomogram model for effectively differentiating between pseudo microaneurysms and true microaneurysms, and it can provide an objective basis for the selection of clinical treatment plans.

The effect of surgical repair of hiatal hernia (HH) on pulmonary function: a systematic review and meta-analysis

PURPOSE

Hiatal hernia is renowned for the symptom of reflux, and few physicians associate a hiatal hernia with pulmonary issues. It is widely acknowledged that a hiatal hernia can be treated with surgery. However, less is known about how the surgical procedure would benefit pulmonary function. Thus, the aim of this study was to determine whether surgical repair can improve pulmonary function in patients with hiatal hernias.

METHODS

We registered the protocol on the PROSPERO (International Prospective Register of Systematic Reviews) platform (no. CRD42022369949). We searched the PubMed, Embase, Cochrane Library, and ClinicalTrials.gov databases for cohort studies that reported on the pulmonary function of patients with hiatal hernias. The quality of each cohort study was evaluated using the Newcastle-Ottawa scale (NOS). We then calculated mean differences (MDs) with 95% confidence intervals for these continuous outcomes. Each study's consistency was appraised using the I² statistic. The sensitivity analysis was performed using the trim-and-fill method. Publication bias was confirmed using the funnel plot visually and Egger regression test statistically.

RESULTS

A total of 262 patients from 5 cohorts were included in the meta-analysis. The quality evaluation revealed that, of these 5 papers, 3 received 8 NOS stars out of 9 stars, 1 received 9, and the other received 7, meaning all included cohort studies were of high quality. The results showed that surgical repair for a hiatal hernia significantly improved forced expiratory volume in 1 s (FEV1; weighted mean difference [WMD]:0.200; 95% CI 0.047-0.353; I² = 71.6%; P = 0.010), forced vital capacity (FVC; WMD: 0.242; 95% CI 0.161-0.323; I² = 7.1%; P = 0.000), and total lung capacity (TLC; WMD: 0.223; 95% CI 0.098-0.348; I² = 0.0%; P = 0.000) but had little effect on residual volume (RV; WMD: -0.028; 95% CI -0.096 to 0.039; I² = 8.7%; P = 0.411) and the diffusing capacity carbon monoxide (DLCO; WMD: 0.234; 95% CI -0.486 to 0.953; I² = 0.0%; P = 0.524).

CONCLUSION

For individuals with hiatal hernias, surgical repair is an efficient technique to improve respiratory function as measured by FEV1, FVC, and TLC.

Musical therapy attenuates neuroma pain by modifying leptin expression

BACKGROUND

Accumulating evidence reveals that music therapy appears to help patients with pain. However, there is a limited understanding of the underlying mechanisms. Several studies indicate that leptin level has a crucial relationship with acute and chronic pain. Herein, we evaluated the effects of music stimulation and the potential roles of adipokines (leptin) in pain behaviors.

METHODS

We used a tibial neuroma transposition (TNT) rat model to mimic neuroma pain. Adult male Sprague-Dawley rats were randomly assigned to one of the three groups (n = 6):group 1 (GC), TNT with white noise; group 2(GM), TNT with music; and group 3(GH), TNT. White noise and music stimulation was given once a day following surgery until the end of the study (42^nd day). Pain behavioral tests were carried out before surgery and on the 3^rd, 10^th, 14^th, 21^st, 28^th, 35^th, and 42^nd days after surgery. At the end of the observation period, we analyzed the histological samples of blood, spinal cord, and prefrontal cortex to investigate the role of leptin in pain behaviors modulated by white noise and sound stimulation.

RESULT

Music therapy might improve the pain of TNT rats. Music stimulation ameliorated paw withdrawal thermal latency (PWTL) from the 3^rd day after the surgery while the mechanical pain was improved 21 days after the operation.Music stimulation also increased leptin expression in the spinal cord, prefrontal cortex.White noise had no obvious effect.

CONCLUSION

Music therapy might improve the pain of TNT rats. Besides, music stimulation ameliorated TNT-induced pain behaviors and affected leptin expression.

High-Rate Organic Cathode Constructed by Iron-Hexaazatrinaphthalene Tricarboxylic Acid Coordination Polymer for Li-Ion Batteries

The sluggish ion-transport in electrodes and low utilization of active materials are critical limitations of organic cathodes, which lead to the slow reaction dynamics and low specific capacity. In this study, the hierarchical tube is constructed by iron-hexaazatrinaphthalene tricarboxylic acid coordination polymer (Fe-HATNTA), using HATNTA as the self-engaged template to coordinate with Fe²⁺ ions. This Fe-HATNTA tube with hierarchical porous structure ensures the sufficient contact between electrolyte and active materials, shortens the diffusion distance, and provides more favorable transport pathways for ions. When employed as the cathode for rechargeable Li-ion batteries, Fe-HATNTA delivers a high specific capacity (244 mAh g^-1 at 50 mA g^-1 , 91% of theoretical capacity), excellent rate capability (128 mAh g^-1 at 9 A g^-1 ), and a long-term cycle life (73.9% retention over 3000 cycles at 5 A g^-1 ). Moreover, the Li⁺ ions storage and conduction mechanisms are further disclosed by the ex situ and in situ characterizations, kinetic analyses, and theoretical calculations. This work is expected to boost further enthusiasm for developing the hierarchical structured metal-organic coordination polymers with superb ionic storage and transport as high-performance organic cathodes.

Establishment of a medical device adverse event management system for hospitals

Background

The management of medical device adverse event (MDAE) is one of the most important aspects of improving medical quality and safety management. Nonetheless, hospitals still lack standardized and unified initiatives to improve MDAE management.

Methods

This study, thus, established a MDAE monitoring system on May 1 in 2011 for suspected adverse events and designed a hospital-based dynamic warning system, aiming to standardize the process of MDAE handling and provide real-time monitoring for MDAEs in a hospital. This system was used in the First Affiliated Hospital of Zhejiang University School of Medicine. Numbers and the compound growth rate of MDAE reports from 2010 to 2020 were compared to test the effectiveness of the MDAE monitoring system. Numbers of MDAE reported to the National Adverse Event Monitoring System were also compared over 2013 to 2020, due to the loss of data before 2013 after shutdown of the old system. Efficacy and usability of the hospital-based dynamic warning system was then verified by analyzing risk and warning levels of MDAEs in 2020. Descriptive statistics was used for data analysis in this study.

Results

Results showed that the compound annual growth rates of MDAE reports and those submitted to the National Adverse Event Monitoring System from 2013 to 2020 were 35.0% and 31.5%, respectively. A standardized management of MDAE with full participant, timely response and effective feedback was formed in the hospital by establishment of the MDAE system.

Conclusions

This system effectively improved the monitoring level of MDAEs, helping to improve early detection, early warning, and early intervention of risk of medical device. This study may provide suggestions for medical institutions to establish a MDAE monitoring system, and may promote development of medical quality and safety management for hospitals to some extent.

Comparative genomics of Myxococcus and Pyxidicoccus, including the description of four novel species: Myxococcus guangdongensis sp. nov., Myxococcus qinghaiensis sp. nov., Myxococcus dinghuensis sp. nov., and Pyxidicoccus xibeiensis sp. nov

Myxobacteria are recognized for fascinating social behaviors and producing diverse extracellular active substances. Isolating novel myxobacteria is of great interest in the exploitation of new antibiotics and extracellular enzymes. Herein, four novel strains were isolated from Dinghu Mountain Biosphere Reserve, Guangdong province, and Qinghai virgin forest soils, Qinghai province, China. The phylogenetic analysis based on 16S rRNA gene and genomic sequences indicated that the four strains belong to the genera Myxococcus and Pyxidicoccus, sharing the highly similarities of 16S rRNA gene with the genera Myxococcus and Pyxidicoccus (99.3-99.6%, respectively). The four strains had average nucleotide identity (ANI) values of 82.8-94.5%, digital DNA-DNA hybridization (dDDH) values of 22.2-56.6%, average amino acid identity (AAI) values of 75.8-79.1% and percentage of conserved protein (POCP) values of 66.4-74.9% to members of the genera Myxococcus and Pyxidicoccus. Based on phylogenetic analyses, physiological and biochemical characteristics, and comparative genomic analyses, we propose four novel species of the genera Myxococcus and Pyxidicoccus and further supported the two genera above represented the same genus. Description of the four novel species is Myxococcus guangdongensis sp. nov. (K38C18041901T = GDMCC 1.2320T = JCM 39260T), Myxococcus qinghaiensis sp. nov. (QH3KD-4-1T = GDMCC 1.2316T = JCM 39262T), Myxococcus dinghuensis sp. nov. (K15C18031901T = GDMCC 1.2319T = JCM 39259T), and Pyxidicoccus xibeiensis sp. nov. (QH1ED-7-1T = GDMCC 1.2315T = JCM 39261T), respectively. Furthermore, comparative genomics of all 15 species of the genera Myxococcus and Pyxidicoccus revealed extensive genetic diversity. Core genomes enriched more genes associated with housekeeping functional classes while accessory genomes enriched more genes related to environmental interactions, indicating the former is relatively indispensable compared to signaling pathway genes. The 15 species of Myxococcus and Pyxidicoccus also exhibited great gene diversity of carbohydrate-active enzymes (CAZymes) and secondary metabolite biosynthesis gene clusters (BGCs), especially related to glycosyl transferases (GT2 and GT4), glycoside hydrolases (GH13 and GH23), non-ribosomal peptide synthetases (NRPS), and Type I polyketide synthase (PKS)/NRPS hybrids.

Parachryseolinea silvisoli gen. nov., sp. nov., isolated from forest soil, and reclassification of Chryseolinea flava as Pseudochryseolinea flava gen. nov., comb. nov

A lemon-chiffon strain, designated QH1ED-6-2^T, was isolated from a soil sample collected from Qinghai Virgin Forests, Qinghai Province, PR China. The strain was Gram-stain-negative, aerobic, rod-shaped and motile by gliding. Phylogenetic analysis of 16S rRNA gene sequences revealed that strain QH1ED-6-2^T belongs to the family Fulvivirgaceae, and has the highest similarity values of 93.6-92.0 % to Ohtaekwangia koreensis CCUG 58939^T, Ohtaekwangia kribbensis CCUG 58938^T, Chryseolinea flava SDU1-6^T and Chryseolinea serpens DSM 24574^T, respectively. The major cellular fatty acids included iso-C_15 : 0, C_16 : 1  ω5c, iso-C_17 : 0 3-OH and summed feature 3. The major polar lipid was phosphatidylethanolamine. The predominant respiratory quinone was menaquinone-7. The average amino acid identity values and percentages of conserved proteins between QH1ED-6-2^T and its closely related genera were 66.4-69.6 % and 58.9-64.9 %, respectively, which are interspersed in the intra-genera cutoff values. The digital DNA-DNA hybridization values were 17.6-19.2 %. The draft genome size of strain QH1ED-6-2^T was 7.98 Mbp with a DNA G+C content of 51.4 mol%. Based on phenotypic, chemotaxonomic, phylogenetic data, genomic DNA G+C content, as well as AAI, POCP and dDDH results, strain QH1ED-6-2^T represents a novel species of a new genus in the family Fulvivirgaceae, for which the name Parachryseolinea silvisoli sp. nov. is proposed. The type strain is QH1ED-6-2^T (=GDMCC 1.2318^T=JCM 35041^T). We also propose the reclassification of Chryseolinea flava as Pseudochryseolinea flava gen. nov., comb. nov. (type strain SDU1-6^T=CGMCC 1.13492^T=JCM 32520^T).

The association of coffee consumption with the risk of osteoporosis and fractures: a systematic review and meta-analysis

To elucidate the association of coffee and bone health would help fracture risk reduction via dietary intervention. Although those who had higher coffee consumption were less likely to have osteoporosis, the associations between coffee consumption and fracture risk need further investigations with better study designs.

INTRODUCTION

The associations between coffee consumption and the risk of osteoporosis and fracture remain inconclusive. We aimed to better quantify these associations by conducting meta-analyses of observational studies.

METHODS

Relevant studies were systematically searched on PubMed, Web of Science, Cochrane library, and Embase Database up to November 25, 2021. The odds ratio (OR) or relative risk (RR) with 95% confidence intervals (CI) was pooled and a dose-response analysis was performed.

RESULTS

Four studies with 7114 participants for osteoporosis and thirteen studies with 391,956 participants for fracture incidence were included in the meta-analyses. High versus low coffee consumption was associated with a lower risk of osteoporosis [pooled OR (95% CI): 0.79 (0.65-0.92)], while it was non-significantly associated with fracture incidence [pooled OR (95% CI): 0.86 (0.67-1.05) at hip and 0.89 (0.42-1.36) at non-hip]. A non-linear association between the level of coffee consumption and hip fracture incidence was shown (P = 0.004). The pooled RR (95% CI) of hip fracture risk in those who consumed 1, 2-3, 4, and ≥ 9 cups of coffee per day was 0.92 (0.87-0.97), 0.89 (0.83-0.95), 0.91 (0.85-0.98), and 1.10 (0.76-1.59), respectively. The significance in the association between coffee consumption and the hip fracture incidence decreased in those studies that had larger sample size, higher quality, and more adjustments.

CONCLUSIONS

A dose-dependent relationship may exist between coffee consumption and hip fracture incidence. The effect of high versus low coffee consumption was influenced by study designs. Further studies with dedicated designs are needed to confirm the independent effects of coffee consumption on bone health.

Multi-channel AgNWs-doped interdigitated organic electrochemical transistors enable sputum-based device towards noninvasive and portable diagnosis of lung cancer

Biochemical monitoring of bodily fluidics such as sweat, urine, and tears have been extensively developed, but reliable biochemical analysis of sputum biospecimens remains limited and challenging due to the low abundance of biomarkers in intrinsically viscous sputum. We reported a portable multi-channel sputum-based interdigitated organic electrochemical transistors (SiOECTs) device for noninvasive sputum diagnosis. We tailored the AgNWs-doped organic electrochemical transistors, integrating with multiplexed aptamer-antigen assays, to realize the signal amplification and simultaneous detection of biomarkers in raw sputum biospecimens from lung cancer patients. Clinical validation studies demonstrated favorable correlation coefficients between the sputum and serum biospecimens. By utilizing our portable multi-channel iOECTs devices, lung cancer patients were differentiated from health control with an optimum area under the curve (AUC) of 0.931, sensitivity of 87.0%, and specificity of 86.5%. Our miniaturized and portable device could even realize the continuous in-home tracking of the biomarkers change for lung cancer patients after radiotherapy/chemotherapy. It is envisaged that the SiOECTs will shed light on noninvasive diagnostics platforms for sputum-related diseases.

The Tourniquet Ischemia Test Effectively Predicts the Efficacy of Lumbar Sympathetic Block in Patients with Lower Extremity Complex Regional Pain Syndrome Type 1

Background

Neuropathic pain is the most common clinical sign of complex regional pain syndrome (CRPS). Currently, lumbar sympathetic block (LSB) is commonly utilized in lower extremity CRPS that has failed to respond to medication therapy and physical therapy, but its effectiveness is unknown. The tourniquet ischemia test (IT) can distinguish between two types of CRPS: IT-positive CRPS and IT-negative CRPS.

Objective

The aim of the study was to investigate whether LSB improves pain scores in patients with lower extremity CRPS-1 and to screen factors to predict its efficacy.

Study Design

Prospective clinical observational study.

Setting

Pain management center.

Subjects

Forty-three patients diagnosed with lower extremity CRPS-1 using the Budapest criteria were included as participants.

Methods

Forty-three CRPS-1 patients were treated with LSB therapy, and all of them underwent a tourniquet ischemia test (IT) before undergoing LSB therapy. LSB therapy was performed using a combination of ultrasonography and fluoroscopy. Then, numeric rating scale (NRS) scores and the symptom relief rates of patients were evaluated at 1, 4, and 12 weeks. Finally, peripheral blood inflammatory cytokine samples were collected before and after the LSB treatment.

Results

At 4 weeks after the treatment, the total effective symptom relief rate of LSB on CRPS-1 was 25.6% (11/43), with 52.6% (10/19) of IT(+) patients and 4.2% (1/24) of IT(-) patients. There was a significant difference between the IT(-) and IT(+) groups (P = 0.001). The multivariate binary logistic regression analysis revealed that the response to the tourniquet IT was the only significant independent predictor of sympathetic block success (p = 0.007).

Conclusion

Tourniquet IT is a simple, safe and effective test to distinguish patients with lower extremity CRPS-1. The response to the tourniquet IT is a reliable predictor of LSB effectiveness in lower extremity CRPS-1 patients.