[Research progress on the role of adipose-derived stem cell exosomes in skin scar formation]

The adipose-derived stem cell exosomes are subcellular structures of adipose stem cells. They are nano-sized membrane vesicles that can transport various cell components and act on target cells by paracrine, and they play an important role in the exchanges of substance and information between cells. Scar healing is the commonest way of healing after skin tissue injury. Pathological scar can not only cause movement dysfunction, but also lead to deformity, which affects the appearance of patients and brings life and mental pressure to the patients. In recent years, many researches have shown that the adipose-derived stem cell exosomes contain a variety of bioactive molecules, which play an important role in reducing scar formation and scar-free wound healing, by affecting the proliferation and migration of fibroblasts and the composition of extracellular matrix. This article reviewed the recent literature on the roles and mechanisms of adipose-derived stem cell exosomes in scar formation, and prospected the future application and development of adipose-derived stem cell exosomes in scar treatment.

[Comparison of leadless pacemaker and conventional pacemaker for quality of life improvement in patients with bradyarrhythmias]

Objective: To compare the improvement in quality of life (QoL) after implantation of leadless pacemakers (L-PM) with that of conventional pacemakers (C-PM) in patients with slow-onset arrhythmias. Methods: A total of 112 patients who received pacemaker implantation for the first time at Beijing Anzhen Hospital from January 2020 to July 2021 were selected, including 50 leadless pacemakers (L-PM) and 62 conventional pacemakers (C-PM). Clinical baseline data were collected, pacemaker-related complications and SF-36 scores were recorded and followed up at 1, 3, and 12 months post-operatively; SF-36 questionnaires and additional questionnaires were completed to compare the quality of life of the 2 groups; and factors associated with the change in QoL from baseline to 1, 3 and 12 months post-operatively were analyzed using multiple linear regression models. Results: The age of the 112 patients was (70.3±10.5) years, and 69 patients (61.6%) were male. The age of patients with L-PM and C-PM was (75.8±8.5) years and (67.5±10.4) years, respectively (P=0.004). In the L-PM group, 50 patients completed 1-, 3-, and 12-month follow-up. In the C-PM group, 62 patients completed the 1-month and 3-month follow-up, and 60 completed the 12-month follow-up. The C-PM group had a higher incidence of discomfort in the surgical area, impact of daily activities for the discomfort in the surgical area, and concern about heart or overall condition than the L-PM group on the additional questionnaire (all P values<0.05). After adjusting for age and SF-36 scores at baseline, at 12^th month of follow-up, patients implanted with C-PM had lower values for quality of life PF, RP, SF, RE, and MH scores compared to patients implanted with L-PM, with beta values (95%CI) of -24.500 (-30.010--18.981), -27.118 (-32.997--21.239), -8.085 (-12.536--3.633), -4.839 (-9.437--0.241), -12.430 (-18.558--6.301), respectively (all P values<0.05). Conclusions: L-PM is associated with better QoL in slow arrhythmias patients, and patients who received L-PM reported less activity limitations due to surgical discomfort and less emotional distress.

A BPNN-based ecologically extended input-output model for virtual water metabolism network management of Kazakhstan

In this study, a back-propagation-neural-network-based ecologically extended input-output model (abbreviated as BPNN-EIOM) is developed for virtual water metabolism network (VWMN) management. BPNN-EIOM can identify key consumption sectors, simulate performance of VWMN, and predict water consumption. BPNN-EIOM is then applied to analyzing VWMN of Kazakhstan, where multiple scenarios under different gross domestic production (GDP) growth rates, sectoral added values, and final demands are designed for determining the optimal management strategies. The major findings are (i) Kazakhstan typically relies on net virtual water import (reaching 1497.9 × 10⁶ m³ in 2015); (ii) agriculture is the major exporter and advanced manufacture is the major importer; (iii) by 2025, Kazakhstan's water consumption would increase to [19322, 22016] × 10⁶ m³ under multiple scenarios; (iv) when Kazakhstan's GDP growth rate, manufacturing's added value, and final demand are scheduled to 5.5%, 8.5%, and 5.8%, its VWMN can reach the optimum. The findings are useful for decision makers to optimize Kazakhstan's industrial structure, mitigate the national water scarcity, and promote its socio-economic sustainable development.

Nitric Oxide-Loaded Bioinspired Lipoprotein Normalizes Tumor Vessels To Improve Intratumor Delivery and Chemotherapy of Albumin-Bound Paclitaxel Nanoparticles

The disorganized vasculatures in tumors represent a substantial challenge of intratumor nanomedicine delivery to exert the anticancer effects. Herein, we rationally designed a glutathione (GSH)-activated nitric oxide (NO) donor loaded bioinspired lipoprotein system (NO-BLP) to normalize tumor vessels and then promote the delivery efficiency of sequential albumin-bound paclitaxel nanoparticles (PAN) in tumors. NO-BLP exhibited higher tumor accumulation and deeper penetration versus the counterpart liposomal formulation (NO-Lipo) in 4T1 breast cancer tumors, thus producing notable vascular normalization efficacy and causing a 2.33-fold increase of PAN accumulation. The sequential strategy of NO-BLP plus PAN resulted in an 81.03% inhibition of tumor growth in 4T1 tumors, which was better than the NO-BLP monotherapy, PAN monotherapy, and the counterpart NO-Lipo plus PAN treatment. Therefore, the bioinspired lipoprotein of NO-BLP provides an encouraging platform to normalize tumor vessels and promote intratumor delivery of nanomedicines for effective cancer treatment.

Removal of pharmaceutical and personal care products (PPCPs) by MOF-derived carbons: A review

Nowadays, the increasing demand for pharmaceuticals and personal care products (PPCPs) has resulted in the uncontrolled release of large amounts of PPCPs into the environment, which poses a great challenge to the existing wastewater treatment technologies. Therefore, novel materials for efficient treatment of PPCPs need to be developed urgently. MOF-derived carbons (MDCs), have many advantages such as high mechanical strength, excellent water stability, large specific surface area, excellent electron transfer capability, and environmental friendliness. These advantages give MDCs an excellent ability to remove PPCPs. In this review, the effects of different substances on the properties and functions of MDCs are discussed. In addition, representative applications of MDCs and composites for the removal of PPCPs in the field of adsorption and catalysis are summarized. Finally, the future challenges of MDCs and composites are foreseen.

Development of iron-based biochar for enhancing nitrate adsorption: Effects of specific surface area, electrostatic force, and functional groups

The problem of nitrate contamination in water has attracted widespread attention. Original biochar has a poor adsorption capacity for nitrate adsorption. Iron impregnation and acid protonation (base deprotonation) are common modification methods for biochar. In order to develop iron-mediated biochar containing multi-functional groups for enhancing nitrate adsorption, Fe-BC@H and Fe-BC@OH were prepared using a two-stage development process, including an iron-based carbon pyrolysis followed by acid protonation (or base deprotonation). The pseudo-second-order kinetic and Langmuir models can well describe the adsorption process which is a physicochemical complex monolayer adsorption. The data proved that Fe-BC@H (9.35 mg/g NO₃^--N) had a stronger adsorption capacity than Fe-BC@OH (2.95 mg/g NO₃^--N). Surface morphologies, functional groups, and mineral compositions of Fe-BC@H and Fe-BC@OH were analyzed through Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), X-ray diffraction (XRD), and X-ray photoelectron spectroscopy (XPS). Characterization results showed that acid protonation can further improve the specific surface area (SSA), pore volume, and Zeta potential of Fe-based biochar, providing more adsorption sites for nitrate and enhancing the electrostatic force between nitrate and biochar. However, these effects were suppressed through base deprotonation. In addition, acid protonation can significantly increase the type and number of functional groups of biochar to enhance the chemisorption of nitrate. Such results suggested that the acid protonation can further improve the adsorption capacity of Fe-based biochar for nitrate, while base deprotonation had an inhibitory effect on that of Fe-based biochar. Overall, this study reveals that specific surface area, electrostatic force, and functional groups are crucial effects of the nitrate adsorption on acid/base modified biochar.

Whole Genome Sequencing of Single-Circulating Tumor Cell Ameliorates Unraveling Breast Cancer Heterogeneity

Objective

Because tumor tissues are most frequently heterogeneous and hard to characterize, the resulting therapeutic strategy could be misled. The most active and invasive tumor cells are circulating tumor cells (CTCs). In this study, we investigated the feasibility of individualized treatment of breast cancer patients based on whole genome sequencing (WGS) of single cell CTC.

Methods

Twenty-four CTCs were identified in three breast cancer patients. For each patient, one polyploid CTC was captured, and on which the WGS was performed. WGS was considered due to its sequencing robustness compared to conventional sequencing approaches. Based on the histopathological Her-2 status in tumor tissue and the HER2 gene status in WGS results of CTC, we adjusted treatment strategies and monitored disease progression.

Results

Patients ID1 and ID2 are found to be Her-2 positive in primary tumors and HER2 gene amplification in the DNA of CTCs. In-patient ID3, histopathological examination of the primary tumor and liver metastases revealed Her-2 negative, but the WGS analysis of CTC showed HER2 gene amplification. After adjusting treatment by adding Her-2 inhibitors according to the results of CTC sequencing, liver metastases and pleural effusion were significantly reduced two months later, CTC number and ctDNA burden were decreased, and 18-months progression-free survival (PFS) was recorded. In addition, some potential therapeutic targets and mutations in drug-resistant genes were detected.

Conclusion

The results of CTC sequencing effectively guided the treatment of a patient with HER2 gene amplification in CTC but with Her-2 negative on tumor tissue. Therefore, CTC sequencing could help resolve the heterogeneity of tumors and provide precision medicine for patients.

[Clinical observation of superior rectus transposition with/without augmented suture and vertical rectus transposition for the treatment of strabismus caused by complete abducens nerve palsy]

Objective: To evaluate the efficacy and safety of superior rectus transposition (SRT) with/without augmented suture and vertical rectus transposition (VRT) for the treatment of strabismus caused by complete abducens nerve palsy. Methods: This was a retrospective cohort study. Forty-two patients (42 eyes) with complete abducens nerve palsy underwent strabismic surgeries from January 2015 to November 2020 in Tianjin Eye Hospital. According to the different procedures, the patients were divided into three groups: SRT group (16 cases, SRT with medial rectus recession), superior rectus transposition with augmented suture (SRTA) group (13 cases, SRT with Buckley suture and medial rectus recession) and VRT group (13 cases). The preoperative and postoperative (1, 6 and 12 months) data including deviations, ocular motility, binocular vision and surgical complications among three groups were analyzed and compared. χ² test was used for comparison of count data among three groups. The measurement data were compared among three groups by the repeated measures ANOVA. LSD-t test was used for within-group comparison and between-group comparison. Results: There was no difference in sex ratio, age and course of disease among the groups (all P>0.05). The horizontal deviations of the three groups at 1, 6 and 12 months after surgeries was lower than that before surgeries, and the difference was statistically significant (all P<0.001). The horizontal deviations of the SRT group, SRTA group and VRT group at 12 months after surgeries were (+0.8±5.8), (+0.8±4.5), (+1.2±2.5) prism diopters (PD), respectively, lower than that of the preoperative (+82.8±17.2), (+77.7±26.1), (+71.5±18.6) PD. However, there was no significant difference among different postoperative follow-up timepoints (all P>0.05). There was no difference in horizontal deviations before surgeries and at 1, 6 and 12 months after surgeries among three groups (P>0.05). There were significant differences in the scales of abduction motility among preoperative, postoperative 1, 6 and 12 months measurements for three group (all P<0.001). The scales of abduction before surgeries in the SRT group, SRTA group, and VRT group were (-4.4±0.5), (-4.4±0.5), (-4.5±0.5) scale and at 12 months after surgeries were (-2.3±0.7), (-2.2±0.5), (-2.1±0.6) scale respectively. But there was no change among different postoperative follow-up timepoints (all P>0.05). Preoperative and postoperative 1-, 6-and 12-month abduction motility was similar among three groups (P>0.05). There were significant differences in the scales of adduction limitation among preoperative, postoperative 1-, 6-and 12-months measurements for three group (all P<0.05). But there was no change among different postoperative follow-up timepoints (all P>0.05). There were significant differences between the SRT group [(-0.9±0.6), (-0.8±0.6) scale] and the SRTA groups [(-1.5±0.5), (-1.4±0.5) scale] (t=-2.62, -2.52) and between the SRTA group and the VRT group [(-0.8±0.8), (-0.6±0.7) scale] (t=2.62, 3.01) at 6 and 12 months after surgeries (all P<0.05). The outcomes of binocular vision at postoperative 12 months were similar among three groups (P>0.05). No patient had torsional diplopia and anterior segment ischemia. Only 2 patients from the SRTA group had hypotropia of 4 to 5 PD in the primary position associated with supraduction limitation. Conclusions: SRT with/without augmented suture and VRT are effective and safe procedures for the treatment of strabismus caused by complete abducens nerve palsy. They could correct deviations, improve abduction motility and restore binocular vision, with stable outcomes and a small risk of vertical and torsional diplopia.

[The correlation between plasma heat shock proteins 90α levels and white matter hyperintensity in patients with cerebral small vessel disease]

Objective: To investigate the relationship between plasma heat shock proteins 90α(Hsp90α) levels and the white matter hyperintensity(WMH) in patients with cerebral small vessel disease(SVD). Methods: Patients admitted to the Department of Neurology, the First Affiliated Hospital of Zhengzhou University from March to August 2021 and diagnosed with WMH by magnetic resonance examination (MRI) were selected as the case group, matched with physical examination patients who visited the Department of Medical Examination during the same period and showed no WMH on MRI and no history of neurological diseases as the control group, and the level of plasma Hsp90α was quantitatively detected by enzyme-linked immunosorbent assay. Mann-Whitney U test was used to compare whether there was a difference in plasma Hsp90α levels between the control group and the case group.Multivariate logistic regression analysis was used to explore the related factors of WMH in patients with SVD. Results: Of the 183 subjects, the control group (n=73) consisted of 28 males and 45 females, aged (54±10) years, while the case group (n=110) consisted of 71 males and 39 females, aged (64±10) years old. Plasma Hsp90α level was higher in the case group than that of the control group [53.33(35.33, 70.09) ng/ml vs 35.02(18.51, 54.95) ng/ml, P<0.001]. After adjusting for confounding factors by multivariate analysis, the results showed that plasma Hsp90α levels greater than 58.34 ng/ml was associated with WMH (P=0.002, OR=5.931, 95%CI:1.955-17.995). Conclusion: Higher level of plasma Hsp90α is associated with WMH in patients with SVD.

Photocatalytic disinfection for point-of-use water treatment using Ti3+ self-doping TiO2 nanoparticle decorated ceramic disk filter

The challenge from pathogenic infections still threatens the health and life of people in developing areas. An efficient, low-cost, and abundant-resource disinfection method is desired for supplying safe drinking water. This study aims to develop a novel Ti³⁺ doping TiO₂ nanoparticle decorated ceramic disk filter (Ti³⁺/TiO₂@CDF) for point-of-use (POU) disinfection of drinking water. The production of Ti³⁺/TiO₂@CDF was optimized to maximize disinfection efficiency and flow rate. Under optimal conditions, the log reduction value (LRV) could reach up to 7.18 and the flaw rate was 108 mL/h. The influences of environmental factors were also investigated. Natural or slightly alkaline conditions, low turbidity, and low concentration of humic acid were favorable for the disinfection of Ti³⁺/TiO₂@CDF, while co-existing HCO₃^- ions and diatomic cations (Ca²⁺ and Mg²⁺) exhibited the opposite effect. Furthermore, the practicability and stability of Ti³⁺/TiO₂@CDF was demonstrated. Ti³⁺/TiO₂@CDF showed high disinfection efficiency for E. coli and S. aureus under a range of concentrations. Long-term experiment indicated that Ti³⁺/TiO₂@CDF was stable. The underlying disinfection mechanisms were investigated and concluded as the combination of retention, adsorption, and photocatalytic disinfection. The developed Ti³⁺/TiO₂@CDF can provide an effective and reliable disinfection tool for POU water treatment in remote area.

[Investigation of small airway function of occupational asthma at different stages]

Objective: To analyze the characteristics of small airway dysfunction in patients with occupational asthma, and explore the significance of small airway function indicators in the evaluation of occupational asthma. Methods: A total of 53 patients with occupational asthma diagnosed in our hospital from December 2008 to December 2018 were retrospectively collected in May 2020. 55 healthy people were included as the control group (NC group) and 58 bronchial asthma patients as BA group. The general information and baseline pulmonary function (FVC、FEV(1)、PEF) of the subjects were collected, the pulmonary function were reexamined and small airway function (FEF(25%)pred、FEF(50%)pred、FEF(75%)pred、MMEF(25-75%)pred) were tested at the time of diagnosis and remission. Results: There was no significant difference in pulmonary function and asthma control score (ACT) between OA group and BA group (P=0.356, 0.610, 0.364, 0.430, 0.533, 0.759, 0.426, 0.632) . The incidence of small airway dysfunction in OA group was 77.4%. The indexes of small airway function (FEF(25%)pred, FEF(50%)pred, FEF(75%)pred, MMEF(25-75%)pred) were lower than those in the NC group (P<0.001) . The small airway function indexes of mild and moderate OA patients in remission stage were improved (P=0.029, 0.182) , but the abnormal rate of small airway function was still 62.3%, and there was no significant difference compared with those at the time of diagnosis (P=0.091) . Small airway function (MMEF(25-75%)pred, FEF(50%)pred) was correlated with large airway function (FEV(1)% pred, PEF% pred) (P=0.001) . Conclusion: Small airway dysfunction often occurs and persists in patients with occupational asthma, and has a certain correlation with large airway function indexes.

An interval two-stage fuzzy fractional programming model for planning water resources management in the coastal region - A case study of Shenzhen, China

In this study, an interval two-stage fuzzy fractional programming (TFFP) method is developed to facilitate collaborative governance of economy and water resources. Methods of interval programming, fuzzy programming, two-stage programming, and fractional programming are integrated within a general system optimization framework. The main contribution of TFFP is simultaneously addressing various uncertainties and tackling trade-offs between environmental and economic objectives in the optimized schemes for water resources allocation. A case study of a highly urbanized coastal city (i.e., Shenzhen) in China is provided as an example for demonstrating the proposed approach. According to the results, industrial sectors should receive 34.8% of total water supply, while agricultural sectors should receive 1.5%. For the spatial allocation of water resources, Bao An, Long Gang, and Fu Tian districts should be allocated 21.6%, 20.5%, and 14.8% water to promote the economic development. The discharge analysis indicates that chemical oxygen demand (COD_cr) and total phosphorus (TP) would be key pollutants. Moreover, the optimized seawater desalination volume would be negligibly influenced by price, while the upper bounds of desalination would be increased with the raising acceptable credibility levels in the period of 2031-2035. Analysis of desalination prices also reveals that the decision-makers should increase the scale of desalination in the period of 2021-2025. In addition, the effectiveness and applicability of TFFP would be evaluated under economic maximization scenarios. The result showed that the economic maximization scenario could obtain higher economic benefits, but it would be accompanied by a larger number of pollutant discharges. It is expected that this study will provide solid bases for planning water resources management systems in coastal regions.

[Advances in clinical prediction scores for prognosis of coronavirus disease-2019]

Coronavirus Disease-2019 (COVID-19) has been a major public health issue all over the world, placing a significant burden on available healthcare resources. The most common types of COVID-19 are the mild and common forms. Although the proportion of the severe-critical types is smaller, the rate of death is significantly higher and the medical resources required tend to be greater. Thus, a variety of scores based on other disease and COVID-19 were used to assess the risk of poor prognosis on the COVID-19, including the common scores for community-acquired pneumonia, sepsis and viral pneumonia. Unfortunately, the above scores often lacked an adequate description of the applicable population or were at high risk of bias with unknown applicability. Therefore, the article summarized the existing scores, aiming to provide a reference for clinical prognostic risk assessment.

[Application of indocyanine green iris angiography in the evaluation of anterior segment blood supply in different strabismus patients]

Objective: To evaluate the perfusion features of the anterior segment in patients with different types of strabismus. Methods: A cross-sectional study. Sixteen strabismus patients (16 eyes) who received the examination of iris indocyanine green angiography (ICGA) in Tianjin Eye Hospital from November 2016 to December 2021 were enrolled and divided into two groups according to whether they had a history of extraocular muscle injury/rectus muscle surgery. All patients underwent routine ophthalmic examinations. Angiographic images were obtained by the anterior segment camera, and indicators such as arm to iris circulation time, whole iris filling time, regression onset time, and complete regression time were recorded. The independent sample t test or Mann-Whitney U test was used to compare iris perfusion aspects of the two groups, and the Pearson/Spearman correlation tests was used to analyze the correlation of arm to iris circulation time and whole iris filling time with age and course of strabismus. Results: Among the 16 patients, there were 10 males and 6 females. The mean age was (49.2±13.2) years, and the course of strabismus ranged from 2 to 31 months. There were 7 patients in the group of without extraocualr muscle injury and 9 patients in the extraocular muscle injury/surgery group. There was no significant difference in age and course of strabismus between the two groups (both P>0.05). The arm to iris circulation time [M (Q₁, Q₃)] of the group without extraocular muscle injury and the group with extraocular muscle injury/surgery were 18 (18, 21) and 22 (20, 24) s, respectively. The average whole iris filling time was (13.86±1.95) and (12.22±3.60) s, respectively. There was no statistical significance between the two groups (both P>0.05). Correlation analysis showed that arm to iris circulation time was not correlated with age and course of strabismus (r=-0.033, -0.079; both P>0.05). And the whole iris filling time was not correlated with age and course of disease (r=0.057, -0.119; both P>0.05). The matrix scatter plots showed that in the group of extraocular muscle injury/surgery, there were three patients who were older than the average (49.2 years) and above the median of arm to iris circulation time (20 s) (two cases with the vertical muscle involved), meanwhile, there were three patients (all with the vertical muscle involved) whose course of strabismus was longer than 6 months and above the median of arm to iris circulation time, which were more than those in the group of without extraocular muscle injury (1 case, respectively). Conclusions: ICGA in patients with strabismus show that a history of injury to the extraocular muscle or surgical treatment beyond 2 months had no effect on iris perfusion. Age and course have no correlation with iris reperfusion. The vertical muscle involvement has more effects on the blood supply to the anterior segment.

[Analysis of the characteristics of HIV-1 molecular transmission network among people aged 50 years and above in Pengzhou city of Sichuan province]

Objective: To describe the characteristics of molecular transmission network of newly diagnosed HIV-1 infected patients, analyze their risk factors related to network access and provide a scientific basis for precise prevention of HIV infection. Methods: For 340 blood samples collected from confirmed HIV-1 infection cases aged ≥50 years in Pengzhou city of Sichuan province from April 2019 to August 2021, nested PCR amplification was used to amplify, clean up and splice clips the pol gene region. The phylogenetic tree was constructed by multi-sequence comparison to distinguish subtypes, and the pairwise genetic distance was calculated. When the genetic distance threshold was 0.90%, the number of clusters was the largest (41), and the molecular transmission network was constructed.The χ² test and logistic regression analysis were performed.The software SPSS 19.0 was used for statistical analysis. Results: A total of 340 samples were successfully amplified (97.06%, 330/340) in 330 samples. 6 HIV-1 subtypes identified, including:CRF01_AE(56.67%,187/330), CRF07_BC(27.88%,92/330), B(11.21%,37/330), CRF08_BC(3.33%,11/330), CRF55_01B(0.61%,2/330) and C(0.30%,1/330).The network entry rate was 58.79% (194/330).The results of logistic regression analysis of the risk factors of HIV-1 molecular transmission network in the research subjects showed that compared with illiteracy, junior high school (OR=0.35, 95%CI:0.13-0.97) and high school/technical secondary school (OR=0.14, 95%CI: 0.02-0.97) had lower possibility of network entry. Compared with farmers, unknown occupations (OR=0.40,95%CI: 0.17-0.95) are less likely to enter the network .Compared with CRF01_AE, CRF07_BC (OR=0.20, 95%CI: 0.11-0.35) and CRF08_BC subtype (OR=0.09, 95%CI: 0.02-0.45) were less likely to enter the network. Conclusions: The sources of AIDS transmission among middle-aged and elderly people of rural areas are diversified in Pengzhou city of Sichuan province. AIDS intervention should focus on middle-aged and elderly farmers with low educational level, and strengthen detection and traceability investigation.

A fixed-mix stochastic fractional programming method for optimizing agricultural irrigation and hydropower generation in Central Asia

In this study, a fixed-mix stochastic fractional programming (FSFP) method is developed for balancing the water-allocation conflict between upstream hydropower generation and downstream agricultural irrigation. FSFP has advantages in dealing with ratio-objective problem under uncertainty, reflecting the dynamic and stochastic characteristics over a long-term planning context, as well as analyzing interrelationships between system efficiency and violation risk of water-allocation target. Then, FSFP is firstly applied to Tuyamuyun reservoir in the lower reach of Amu Darya River basin (Central Asia), where multiple scenarios based on different hydropower-generation targets and inflow levels are examined for identifying the complex relationship between hydropower generation and crop irrigation. Major findings and managerial insights can be summarized as: (i) with the reduction of reservoir inflow, water allocation for downstream agricultural irrigation would decrease by 30.4% once the minimum demand is satisfied, and hydropower generation should be higher priority for pursuing higher marginal benefit; (ii) with the shrinking water supply and rising hydropower-generation target, cotton planting should be firstly restrained due to its high water demand and grape planting is encouraged; (iii) under extreme water scarcity (i.e., low and very-low inflow levels), low-level hydropower generation target (i.e., α = 0.45) is desired for meeting the food requirement in the study basin; (iv) for alleviating the water shortage during dry seasons, it is recommended that water storage should be conducted in autumn and winter, and water release for crop irrigation should be implemented during spring and summer. These findings can help managers identify sustainable water-allocation schemes for agricultural irrigation and hydropower generation against water shortage, environmental destruction and energy insecurity in arid regions.

Optimal design of two-dimensional water trading based on risk aversion for sustainable development of Daguhe watershed, China

Water related problems, including water scarcity and pollution, have become increasingly urgent challenges especially in arid and semiarid regions. Two-dimensional water trading (2DWT) mechanism has been designed to unify the quantity and quality of water for relieving the water crisis. This study aims to develop a risk aversion optimization-two dimensional water trading model (RAO-2DWTM) for planning the regional-scale water resources management system (RWMS). This is the first attempt on planning RWMS through risk aversion optimization within the two-dimensional water trading framework. RAO-2DWTM cannot only support in-depth analysis regarding the effect of decision maker's preferences on system risk in different trading scenarios, but also reflect the interaction between water right trading and effluent trading, as well as disclose the optimal scheme of water resource management under uncertainties. Twenty four scenarios associated with different trading scenarios and robust levels are analyzed. The optimization scheme under the optimal risk control level is determined based on TOPSIS. Results revealed that 2DWT would bring high benefit with reduced risk cost, water deficit and emissions, implying the effectiveness of 2DWT mechanism. The results also disclosed that risk aversion behavior can mitigate water scarcity and pollution, as well as reduce risk cost, but may lead to some losses of system benefit. Consequently, decision makers should make trade-offs between system benefit and risk in identifying desired trading schemes.

[Aesthetic reconstruction of the scar contracture deformity in chin and neck with expanded flaps based on the "MRIS" principle]

Objective: The surgical reconstruction strategy for scar contracture deformity in chin and neck was explored, aiming to obtain better aesthetic outcome. Methods: A retrospective observational study was conducted. From December 2017 to April 2021, 34 patients with scar contracture deformity in chin and neck after burns were hospitalized in the Department of Plastic Surgery of the First Affiliated Hospital of Army Medical University (the Third Military Medical University), aged 12-54 years, including 13 males and 21 females, 4 cases with chin affected only, 7 cases with neck affected only, and 23 cases with both chin and neck affected. The scar areas were 48-252 cm2. All the patients were treated by operation with expanded flaps, following the "MRIS" principle of matching of the color and thickness of the repair flaps (match), reconstructing of the aesthetic features of subunits (reconstruction), design of incision according to the plastic principle (incision), and prevention of the surgical incision scar (scar). The rectangular or kidney shaped skin and soft tissue expander (hereinafter referred to as the expander) with rated capacity of 80-400 mL was embedded in the first stage, which was routinely expanded to 3-5 times of the rated capacity of the expander. In the second stage, scar resection and expanded flap excision were performed to repair the secondary wound, and the flap donor site was sutured directly. The expansion ratio of the expander (with average value being calculated), the type of flaps used, the reconstruction of local aesthetic morphology, the appearance of postoperative incision, the survival of flap, and the situation of donor and recipient sites observed during follow-up were recorded. Results: Among the 34 patients, the average expansion ratio of the implanted expander was 3.82 times of the rated capacity of the expander. Three cases were repaired by the expanded local pedicled flap only, 19 cases by the expanded shoulder and/or chest perforator pedicled flap only, 10 cases by the expanded local pedicled flap combined with the expanded shoulder and/or chest perforator pedicled flap, and 2 cases by the expanded local pedicled flap combined with the expanded free flap of the second intercostal perforator of internal thoracic artery. After scar resection, the shapes of lower lip and chin-lip groove were reconstructed in 10 cases, chin process reconstruction and chin lengthening were performed in 16 cases, and the cervico-mental angle and mandibular margin contour were reconstructed in 28 cases. The surgical incision was concealed, most of which were located at the natural junction or turning point of the chin and neck subunits. The vertical incision of neck was Z-shaped or fishtail-shaped. All the expanded flaps in 34 patients survived after operation, of which 8 patients had minor necrosis at the edge or tip of the expanded flaps 1-3 days after operation and healed after dressing change. During the follow-up of 3-18 months, little difference in color and thickness between the expanded flap and the skin of chin and neck was observed, and the aesthetic shape of chin and neck was significantly improved, with mild scar hyperplasia of surgical incision. Conclusions: Reconstruction of scar contracture deformity in chin and neck by using expanded flaps based on the "MRIS" principle is beneficial to improve the quality of surgery and achieve better aesthetic outcome.

Bioinspired Lipoproteins of Furoxans-Oxaliplatin Remodel Physical Barriers in Tumor to Potentiate T-Cell Infiltration

The infiltration of cytotoxic T lymphocytes (CTLs) in tumors is critically challenged by the intricate intratumor physical barriers, which is emerging as an important issue of anticancer immunotherapy. Herein, a reduction-sensitive nitric oxide donor conjugate of furoxans-oxaliplatin is synthesized and a stroma-cell-accessible bioinspired lipoprotein system (S-LFO) is designed, aiming to facilitate CTL infiltration in tumors for anticancer immunotherapy. S-LFO treatment significantly promotes tumor vessel normalization and eliminates multiple components of tumor stroma, ultimately producing a 2.96-fold, 5.02-fold, and 8.65-fold increase of CD3⁺ CD8⁺ T cells, their interferon-γ- and granzyme B-expressing subtypes when comparing to the negative control, and considerably facilitating their trafficking to the cancer cell regions in tumors. Moreover, the combination of S-LFO with an antiprogrammed death ligand-1 produces notable therapeutic benefits of retarded tumor growth and extends survivals in three murine tumor models. Therefore, this study provides an encouraging strategy of remodeling the intratumor physical barriers to potentiate CTL infiltration for anticancer immunotherapy.

Physiology and metabonomics reveal differences in drought resistance among soybean varieties

BACKGROUND

The soybean is an important food crop worldwide. Drought during the first pod stage significantly affects soybean yield, and understanding the metabolomic and physiological changes in soybeans under drought stress is crucial. This study identified the differential metabolites in initial pod stage soybean leaves under polyethylene glycol-simulated drought stress, using ultra performance liquid chromatography and tandem mass spectrometry, and the physiological indexes related to drought resistance.

RESULTS

Physiologically, drought resistance also generates enzyme and antioxidant activity; levels of superoxide dismutase, peroxidase, and catalase first increased and subsequently decreased, while those of soluble sugar, soluble protein, malondialdehyde, and proline content increased in both varieties. The contents of CAT, proline and soluble sugar in Heinong 44 (HN44) were higher than those in Heinong 65 (HN65), and the contents of MDA were lower than those in HN65. In metabolomics, the OPLS-DA model was used to screen different metabolites. KEGG analysis showed that the two varieties resisted drought through different ways. Amino acid metabolism and lipid metabolism play a key role in drought resistance of the two varieties, respectively. TCA cycle was one of the core pathways of drought resistance in two varieties. Changes in the content of L-Asparagine and citric acid may be one of the reasons for the difference in drought resistance between the two varieties.

CONCLUSIONS

We think that the reasons of drought resistance among soybean varieties are as follows: the main metabolic pathways are different under drought stress; the contents of metabolites in these metabolic pathways are different; some physiological indexes are different, such as MDA, CAT, proline content and so on. Our study enhances the understanding of the metabolomic soybean drought stress response and provides a reference for soybean drought resistance breeding.

Sustainable conjunctive water management model for alleviating water shortage

Water shortage poses a great challenge to the health of population and environment and impedes socio-economic development. Therefore, a comprehensive model is necessary to promote the adaptation of the whole socio-economic system to limited water resources. To achieve it, a sustainable conjunctive water management model (SCWM) was developed. In SCWM, direct (physical) and indirect (virtual or embodied) water consumptions of multiple water resources in future scenarios are projected, and the sustainable performances of various water-saving scenarios are quantified from the perspectives of water resources, economy, and ecosystem under water capping policy. A case study of Shaanxi, a typical water shortage province in central-eastern China, is conducted aimed at conquering the irrational use of surface- and ground-water subjected to the constraint of future total water use quota. Key findings contain optimal possibility of adapting water shortage via saving water through increasing industrial water efficiency to 11.12 m³/10,000 CNY and reducing 40% of agricultural final demand (Summation of direct and indirect water savings of the two scenarios are 41.57 × 10⁸ m³ and 20.27 × 10⁸ m³, respectively.) and nonsynergistic effects of simultaneous decreasing final demand of multiple sectors on water consumption intensity (WCI) of total (all kinds of water) water, surface- and ground-water. To devise effective policies for conjunctive management of surface- and ground-water, positive utility, economic structure and water productivity should be heeded, and proposals emphasize trade-offs between surface water saving and groundwater conservation, water metabolic and socio-economic systems sustainability and negative interaction of multiple sectors on economy and WCI should be framed. The innovation of this study is the development of SCWM, which can provide sustainable solution for future multiple-source water saving management measures thoroughly concerning direct and indirect water and sectorial interactions. The model not only brings insights to Shaanxi's water management but also can be used for other similar arid area.

3BDO inhibits the proliferation, epithelial-mesenchymal transition (EMT), and stemness via suppressing survivin in human glioblastoma cells

Background: Glioblastoma (GBM) is a tumor of the central nervous system with an extremely poor prognosis. Stemness and EMT play important roles in GBM progression. 3-benzyl-5-((2-nitrophenoxy) methyl) dihydrofuran-2(3H)-one (3BDO), an autophagy inhibitor, has been reported to exert anti-cancer activities on lung carcinoma. However, the effects of 3BDO on GBM remain unknown. Therefore, the purpose of this study was to explore the effects of 3BDO on GBM and to investigate the underlying molecular mechanisms.

Method: CCK-8 experiments and clone formation assays were conducted to determine the level of cell proliferation. Transwell assay was conducted to examine cell migration and invasion abilities. Western blotting and immunofluorescence staining were used to analyze protein expression levels. A xenograft mouse model was used to evaluate the effect of 3BDO in vivo.

Results: We found that 3BDO inhibited U87 and U251 cell proliferation in a dose-dependent manner. Additionally, 3BDO decreased the degree of sphere formation and levels of stemness markers (sox2, nestin, and CD133) in GSCs. 3BDO also inhibited migration and invasion abilities and suppressed EMT markers (N-cadherin, vimentin, and snail) in GBM cells. Moreover, we found that 3BDO downregulated the expression of survivin in both GBM cells (U87, U251) and GSCs. Furthermore, overexpression of survivin decreased the therapeutic effect of 3BDO on EMT, invasion, migration, and proliferation of GBM cells, as well as decreased the stemness of GSCs. Finally, we demonstrated that 3BDO could inhibit tumor growth in a tumor xenograft mouse model constructed using U87 cells. Similar to the in vitro findings, 3BDO decreased the expression of survivin, EMT makers, and the degree of stemness in vivo.

Conclusions: Our results demonstrate that 3BDO can repress GBM both in vitro and in vivo via downregulating survivin-mediated stemness and EMT.