Cardiac magnetic resonance imaging (MRI) for detecting acute myocardial injury of fulminant myocarditis survivors after extracorporeal membrane oxygenation (ECMO) treatment in adults

AIMS

To detect the acute myocardial injury in fulminant myocarditis (FM) survivors after extracorporeal membrane oxygenation (ECMO) and to demonstrate its significant differences from non-FM patients by cardiac magnetic resonance (CMR).

MATERIALS AND METHODS

This retrospective study enrolled 59 patients with acute myocarditis (AM), including 35 non-FM patients, 24 FM patients, and 54 controls. The peak value of cardiac troponin T (cTnT) was recorded. Tissue parameters, including native T1, extracellular volume (ECV), late gadolinium-enhancement (LGE)%, and T2 by CMR were assessed.

RESULTS

The mean age was 35 ± 14 years, and 45.8% of the population were males in the AM group. Patients had higher levels of peak cTnT, peak NT-proBNP and peak C-reactive protein in the FM group (all p<0.05). Comparing with non-FM, the values of T1-based imaging parameters were significantly higher in the FM group (all p<0.05). In contrast, no difference was observed among the two groups in terms of T2 value (p=0.707). The septal area was more frequently involved in FM survivors after ECMO treatment, both in T1 and T2-based images. In addition, the cubic relationship was the relative best fit of LGE% against logcTnT and indicated that cTnT value exceeding 300ng/L exhibited a rapid upward trend of LGE%.

CONCLUSION

Comparing to non-FM, higher myocardial necrosis and fibrosis but similar edema determined by T1 and T2 based imaging was found in FM survivors after ECMO treatment. Furthermore, the inter-ventricular septal area was more frequently involved by acute myocardial injury in FM survivors after ECMO treatment. In addition, LGE% showed an overall increasing trend with cTnT values elevating with rapidly increasing with cTnT exceeding 300 ng/L.

Low-temperature behaviors of the dipolar magnet Dy3Sb3Zn2O14with a strongly site-mixing disordered kagome lattice

Interesting behaviors may emerge in the magnetic frustrated materials with significant site-mixing disorder. We present the results of the structural, magnetic susceptibility, and specific heat measurements of Dy3Sb3Zn2O14with ∼20%Dy/Zn site-mixing disorder, which results in either a diluted 2D triangular lattice, or an intermediate structure between the kagome and pyrochlore lattice. In addition to the sharp anomaly of the temperature dependence of specific heat atT∼0.35 K, which was attributed to the emergent charge order state for the sample with less disorder, a broad peak atT∼1.5 K, and a small hump belowT∼0.1 K are observed. The measured temperature dependence of specific heat and the Monte Carlo simulation suggest that the magnetic frustration persists despite of a strong site-mixing disorder.

Determination of Spin-Parity Quantum Numbers of X(2370) as 0^{-+} from J/ψ→γK_{S}^{0}K_{S}^{0}η^{'}

Based on (10087±44)×10^{6}  J/ψ events collected with the BESIII detector, a partial wave analysis of the decay J/ψ→γK_{S}^{0}K_{S}^{0}η^{'} is performed. The mass and width of the X(2370) are measured to be 2395±11(stat)_{-94}^{+26}(syst)  MeV/c^{2} and 188_{-17}^{+18}(stat)_{-33}^{+124}(syst)  MeV, respectively. The corresponding product branching fraction is B[J/ψ→γX(2370)]×B[X(2370)→f_{0}(980)η^{'}]×B[f_{0}(980)→K_{S}^{0}K_{S}^{0}]=(1.31±0.22(stat)_{-0.84}^{+2.85}(syst))×10^{-5}. The statistical significance of the X(2370) is greater than 11.7σ and the spin parity is determined to be 0^{-+} for the first time. The measured mass and spin parity of the X(2370) are consistent with the predictions of the lightest pseudoscalar glueball.

Novel alternative tools for metastatic pheochromocytomas/paragangliomas prediction

OBJECTIVE

The existing prediction models for metastasis in pheochromocytomas/paragangliomas (PPGLs) showed high heterogeneity in different centers. Therefore, this study aimed to establish new prediction models integrating multiple variables based on different algorithms.

DESIGN AND METHODS

Data of patients with PPGLs undergoing surgical resection at the Peking Union Medical College Hospital from 2007 to 2022 were collected retrospectively. Patients were randomly divided into the training and testing sets in a ratio of 7:3. Subsequently, decision trees, random forest, and logistic models were constructed for metastasis prediction with the training set and Cox models for metastasis-free survival (MFS) prediction with the total population. Additionally, Ki-67 index and tumor size were transformed into categorical variables for adjusting models. The testing set was used to assess the discrimination and calibration of models and the optimal models were visualized as nomograms. Clinical characteristics and MFS were compared between patients with and without risk factors.

RESULTS

A total of 198 patients with 59 cases of metastasis were included and classified into the training set (n = 138) and testing set (n = 60). Among all models, the logistic regression model showed the best discrimination for metastasis prediction with an AUC of 0.891 (95% CI, 0.793-0.990), integrating SDHB germline mutations [OR: 96.72 (95% CI, 16.61-940.79)], S-100 (-) [OR: 11.22 (95% CI, 3.04-58.51)], ATRX (-) [OR: 8.42 (95% CI, 2.73-29.24)] and Ki-67 ≥ 3% [OR: 7.98 (95% CI, 2.27-32.24)] evaluated through immunohistochemistry (IHC), and tumor size ≥ 5 cm [OR: 4.59 (95% CI, 1.34-19.13)]. The multivariate Cox model including the above risk factors also showed a high C-index of 0.860 (95% CI, 0.810-0.911) in predicting MFS after surgery. Furthermore, patients with the above risk factors showed a significantly poorer MFS (P ≤ 0.001).

CONCLUSIONS

Models established in this study provided alternative and reliable tools for clinicians to predict PPGLs patients' metastasis and MFS. More importantly, this study revealed for the first time that IHC of ATRX could act as an independent predictor of metastasis in PPGLs.

Spatial-temporal trends in leprosy burden and its associations with socioeconomic and physical geographic factors: results from the Global Burden of Disease Study 2019

OBJECTIVES

The purpose of our study was to assess the multiscalar changes in leprosy burden and its associated risk factors over the last three decades.

STUDY DESIGN

We conducted an in-depth examination of leprosy's spatial-temporal trends at multiple geographical scale (global, regional, and national), utilizing information from Global Burden of Disease, Injuries, and Risk Factors Study (GBD 2019).

METHODS

Incidence and the estimated annual percentage change (EAPC) in age-standardized incidence rate (ASIR) of leprosy were determined, with countries categorized based on leprosy incidence changes. We examined socioeconomic and physical geography influences on leprosy incidence via Spearman correlation analysis, using ternary phase diagrams to reveal the synergetic effects on leprosy occurrence.

RESULTS

Globally, incident cases of leprosy decreased by 27.86% from 1990 to 2019, with a reduction in ASIR (EAPC = -2.53), yet trends were not homogeneous across regions. ASIR and EAPC correlated positively with sociodemographic index (SDI), and an ASIR growth appeared in high SDI region (EAPC = 3.07). Leprosy burden was chiefly distributed in Tropical Latin America, Oceania, Central Sub-Saharan Africa, and South Asia. Negative correlations were detected between the incidence of leprosy and factors of SDI, GDP per capita, urban population to total population, and precipitation, whereas the number of refugee population, temperature, and elevation showed opposite positive results.

CONCLUSIONS

Despite a global decline in leprosy over the past three decades, the disparities of disease occurrence at regional and national scales still persisted. Socioeconomic and physical geographic factors posed an obvious influence on the transmission risk of leprosy. The persistence and regional fluctuations of leprosy incidence necessitate the ongoing dynamic and multilayered control strategies worldwide in combating this ancient disease.

Spatiotemporal Evolution of Developing Palate in Mice

The intricate formation of the palate involves a series of complex events, yet its mechanistic basis remains uncertain. To explore major cell populations in the palate and their roles during development, we constructed a spatiotemporal transcription landscape of palatal cells. Palate samples from C57BL/6 J mice at embryonic days 12.5 (E12.5), 14.5 (E14.5), and 16.5 (E16.5) underwent single-cell RNA sequencing (scRNA-seq) to identify distinct cell subsets. In addition, spatial enhanced resolution omics-sequencing (stereo-seq) was used to characterize the spatial distribution of these subsets. Integrating scRNA-seq and stereo-seq with CellTrek annotated mesenchymal and epithelial cellular components of the palate during development. Furthermore, cellular communication networks between these cell subpopulations were analyzed to discover intercellular signaling during palate development. From the analysis of the middle palate, both mesenchymal and epithelial populations were spatially segregated into 3 domains. The middle palate mesenchymal subpopulations were associated with tooth formation, ossification, and tissue remodeling, with initial state cell populations located proximal to the dental lamina. The nasal epithelium of the palatal shelf exhibited richer humoral immune responses than the oral side. Specific enrichment of Tgfβ3 and Pthlh signals in the midline epithelial seam at E14.5 suggested a role in epithelial-mesenchymal transition. In summary, this study provides high-resolution transcriptomic information, contributing to a deeper mechanistic understanding of palate biology and pathophysiology.

[Evaluation of arthroscopic ATFL and CFL repair separately for chronic lateral ankle instability in conjunction with subtalar instability]

Objective: To investigate the clinical efficacy of simultaneous arthroscopic repair of anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) for treating chronic lateral ankle instability (CLAI) in conjunction with subtalar instability (STI). Methods: This study is a retrospective case series study. The clinical data of 15 patients with ankle arthroscopic in the Department of Hand and Foot Surgery, the Second Affiliated Hospital of Soochow University from January 2019 to December 2022 were analyzed retrospectively. There were 11 male cases and 4 female cases, aged (28.6±1.5) years (range: 19 to 39 years). All the patients were evaluated by manual inversion stress X-ray and MRI before operation. Arthroscopically observing and then repairing the ATFL and CFL separately after further diagnostic confirmation. One year after operation, MRI was performed, and visual analogue (VAS) pain scores, American Orthopedic Foot and Ankle Society ankle hindfoot scale (AOFAS-AH) and Karlsson ankle functional scale(KAFS) were evaluated. Data were compared using paired sample t test. Results: The follow-up period was (22.6±2.3) months (range: 12 to 30 months). At last follow-up,the VAS decreased from 6.1±1.4 preoperatively to 1.4±1.2(t=9.482, P<0.01). The AOFAS-AH improved from 50.5±11.7 preoperatively to 94.2±6.1(t=-13.132, P<0.01), and the KAFS improved from preoperatively 44.3±10.8 to 90.8±6.4 (t=-12.510, P<0.01). There were no complications such as recurred instability or joint stiffness. Conclusions: Arthroscopically repairing the ATFL and CFL separately can effectively restore the stability of the ankle and subtalar joint with small trauma. Patients can recover quickly after surgery. It provides a new idea for the clinical treatment of CLAI combined with STI.

Emergence of Long-Range Angular Correlations in Low-Multiplicity Proton-Proton Collisions

This Letter presents the measurement of near-side associated per-trigger yields, denoted ridge yields, from the analysis of angular correlations of charged hadrons in proton-proton collisions at sqrt[s]=13  TeV. Long-range ridge yields are extracted for pairs of charged particles with a pseudorapidity difference of 1.4<|Δη|<1.8 and a transverse momentum of 1 Collapse

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[The Miao medicine Sidaxue alleviates rheumatoid arthritis in rats possibly by downregulating matrix metalloproteinases]

OBJECTIVE

To explore the inhibitory effect of Sidaxue, a traditional Miao herbal medicine formula, on articular bone and cartilage destruction and synovial neovascularization in rats with collagen-induced arthritis (CIA).

METHODS

In a SD rat model of CIA, we tested the effects of daily gavage of Sidaxue at low, moderate and high doses (10, 20, and 40 g/kg, respectively) for 21 days, with Tripterygium glycosides (GTW) as the positive control, on swelling in the hind limb plantar regions by arthritis index scoring. Pathologies in joint synovial membrane of the rats were observed with HE staining, and serum TNF-α and IL-1β levels were detected with ELISA. The expressions of NF-κB p65, matrix metalloproteinase 1 (MMP1), MMP2 and MMP9 at the mRNA and protein levels in the synovial tissues were detected using real-time PCR and Western blotting. Network pharmacology analysis was conducted to identify the important target proteins in the pathways correlated with the therapeutic effects of topical Sidaxue treatment for RA, and the core target proteins were screened by topological analysis.

RESULTS

Treatment with GTW and Sidaxue at the 3 doses all significantly alleviated plantar swelling, lowered arthritis index scores, improved cartilage and bone damage and reduced neovascularization in CIA rats (P<0.05), and the effects of Sidaxue showed a dose dependence. Both GTW and Sidaxue treatments significantly lowered TNF-α, IL-1β, NF-κB p65, MMP1, MMP2, and MMP9 mRNA and protein expressions in the synovial tissues of CIA rats (P<0.05). Network pharmacological analysis identified MMPs as the core proteins associated with topical Sidaxue treatment of RA.

CONCLUSION

Sidaxue alleviates articular bone and cartilage damages and reduces synovial neovascularization in CIA rats possibly by downregulating MMPs via the TNF-α/IL-1β/NF-κB-MMP1, 2, 9 signaling pathway, and MMPs probably plays a key role in mediating the effect of Sidaxue though the therapeutic pathways other than oral administration.

First Measurement of the |t| Dependence of Incoherent J/ψ Photonuclear Production

The first measurement of the cross section for incoherent photonuclear production of J/ψ vector mesons as a function of the Mandelstam |t| variable is presented. The measurement was carried out with the ALICE detector at midrapidity, |y|<0.8, using ultraperipheral collisions of Pb nuclei at a center-of-mass energy per nucleon pair of sqrt[s_{NN}]=5.02  TeV. This rapidity interval corresponds to a Bjorken-x range (0.3-1.4)×10^{-3}. Cross sections are given in five |t| intervals in the range 0.04<|t|<1  GeV^{2} and compared to the predictions by different models. Models that ignore quantum fluctuations of the gluon density in the colliding hadron predict a |t| dependence of the cross section much steeper than in data. The inclusion of such fluctuations in the same models provides a better description of the data.

Observation of Structures in the Processes e^{+}e^{-}→ωχ_{c1} and ωχ_{c2}

We present measurements of the Born cross sections for the processes e^{+}e^{-}→ωχ_{c1} and ωχ_{c2} at center-of-mass energies sqrt[s] from 4.308 to 4.951 GeV. The measurements are performed with data samples corresponding to an integrated luminosity of 11.0  fb^{-1} collected with the BESIII detector operating at the Beijing Electron Positron Collider storage ring. Assuming the e^{+}e^{-}→ωχ_{c2} signals come from a single resonance, the mass and width are determined to be M=(4413.6±9.0±0.8)  MeV/c^{2} and Γ=(110.5±15.0±2.9)  MeV, respectively, which is consistent with the parameters of the well-established resonance ψ(4415). In addition, we also use one single resonance to describe the e^{+}e^{-}→ωχ_{c1} line shape and determine the mass and width to be M=(4544.2±18.7±1.7)  MeV/c^{2} and Γ=(116.1±33.5±1.7)  MeV, respectively. The structure of this line shape, observed for the first time, requires further understanding.

[Clinical value of the implication of extracorporeal carbon dioxide removal in patients with acute respiratory distress syndrome]

Extracorporeal carbon dioxide removal (ECCO2R) is a respiratory support technique based on extra-pulmonary gas exchange, which can effectively remove carbon dioxide generated in-vivo, reducing the requirements of respiratory support from mechanical ventilation. With improvements in extracorporeal life support technologies and increasing clinical experience, ECCO2R has potential value in clinical application with acute respiratory distress syndrome (ARDS). This review article discusses the principles of ECCO2R, its relevant indications for ARDS, clinical evidence, existing issues, and future directions, aiming to provide more references for the application in ARDS.

[Techniques for quantifying endotypes of obstructive sleep apnea]

Obstructive sleep apnea (OSA) is the frequent occurrence of apnea and/or hypopnea during sleep, leading to intermittent hypoxia, hypercapnia, and disruption of sleep architecture, further resulting in multisystem damage. The pathophysiological mechanisms include abnormal anatomical structure, low arousal threshold, high loop gain, and poor muscle reactivity, etc. As there are individual differences in the underlying mechanisms of OSA (i.e. endotypes), the effectiveness of treatment and prognosis may also vary according to these characteristics. Understanding the endotype of OSA is critical to understanding which patients are most likely to benefit from non-invasive ventilation therapy. Quantification of endotypes is central to the precision treatment of OSA and may provide the basis for accurate clinical treatment of OSA based on endotypes.

Coupled-Channel Analysis of the χ_{c1}(3872) Line Shape with BESIII Data

We perform a study of the χ_{c1}(3872) line shape using the data samples of e^{+}e^{-}→γχ_{c1}(3872), χ_{c1}(3872)→D^{0}D[over ¯]^{0}π^{0}, and π^{+}π^{-}J/ψ collected with the BESIII detector. The effects of the coupled channels and the off-shell D^{*0} are included in the parametrization of the line shape. The line shape mass parameter is obtained to be M_{X}=(3871.63±0.13_{-0.05}^{+0.06})  MeV. Two poles are found on the first and second Riemann sheets corresponding to the D^{*0}D[over ¯]^{0} branch cut. The pole location on the first sheet is much closer to the D^{*0}D[over ¯]^{0} threshold than the other, and is determined to be 7.04±0.15_{-0.08}^{+0.07}  MeV above the D^{0}D[over ¯]^{0}π^{0} threshold with an imaginary part -0.19±0.08_{-0.19}^{+0.14}  MeV.

Early-life risk factors, accelerated biological aging and the late-life risk of mortality and morbidity

BACKGROUND

Early-life exposure increases health risks throughout an individual's lifetime. Biological aging is influenced by early-life risks as a key process of disease development, but whether early-life risks could accelerate biological aging and elevate late-life mortality and morbidity risks remains unknown. Knowledge is also limited on the potential moderating role of healthy lifestyle.

METHODS

We investigate associations of three early-life risks around birth, breastfeeding, maternal smoking and birth weight, with biological aging of 202 580 UK Biobank participants (54.9 ± 8.1 years old). Biological aging was quantified as KDM-BA, PhenoAge and frailty. Moderate alcohol intake, no current smoking, healthy diet, BMI <30 kg/m2 and regular physical activity were considered as healthy lifestyles. Mortality and morbidity data were retrieved from health records.

RESULTS

Individual early-life risk factors were robustly associated with accelerated biological aging. A one-unit increase in the 'early-life risk score' integrating the three factors was associated with 0.060 (SE=0.0019) and 0.036-unit (SE = 0.0027) increase in z-scored KDM-BA acceleration and PhenoAge acceleration, respectively, and with 22.3% higher odds (95% CI: 1.185-1.262) of frailty. Increased chronological age and healthy lifestyles could mitigate the accelerations of KDM-BA and PhenoAge, respectively. Associations of early-life risk score with late-life mortality and morbidity were mediated by biological aging (proportions: 5.66-43.12%). KDM-BA and PhenoAge accelerations could significantly mediate the impact on most outcomes except anxiety, and frailty could not mediate the impact on T2D.

CONCLUSION

Biological aging could capture and mediate the late-life health risks stemming from the early-life risks, and could be potentially targeted for healthy longevity promotion.

Observation of the Anomalous Shape of X(1840) in J/ψ→γ3(π^{+}π^{-}) Indicating a Second Resonance Near pp[over ¯] Threshold

Using a sample of (10087±44)×10^{6}  J/ψ events, which is about 45 times larger than that was previously analyzed, a further investigation on the J/ψ→γ3(π^{+}π^{-}) decay is performed. A significant distortion at 1.84  GeV/c^{2} in the line shape of the 3(π^{+}π^{-}) invariant mass spectrum is observed for the first time, which could be resolved by two overlapping resonant structures, X(1840) and X(1880). The new state X(1880) is observed with a statistical significance larger than 10σ. The mass and width of X(1880) are determined to be 1882.1±1.7±0.7  MeV/c^{2} and 30.7±5.5±2.4  MeV, respectively, which indicates the existence of a pp[over ¯] bound state.

[Analysis of prevalence status and influencing factors of e-cigarette use among secondary school students in Heilongjiang Province]

Objective: To describe the current situation and influencing factors of e-cigarette use among secondary school students in Heilongjiang Province to provide evidence for formulating provincial youth e-cigarette prevention and control strategies. Methods: A multi-stage stratified cluster probability sampling method was adopted in 2021, with 8 340 students in 180 classes from 56 primary and high schools in 10 monitoring districts and counties in Heilongjiang Province. The students in the selected classes filled out a unified questionnaire by themselves. SAS 9.4 software was used for data cleansing, sample weighting, and analysis. Chi-squared tests were used to compare the differences between groups, and a two-level logistic regression model was used to analyze the influencing factors of e-cigarette use among secondary school students. Results: A total of 8 329 survey questionnaires were included in the analysis. The prevalence rates of ever and current e-cigarette use among secondary school students in Heilongjiang Province were 18.27% and 5.46%, respectively. In terms of ever e-cigarette use, the rate of boys (23.94%) was higher than that of girls (12.35%). The rate of vocational high school students (39.18%) was higher than that of general high school students (24.11%) and than that of junior school students (11.27%). In terms of current e-cigarette use, the rate of boys (7.08%) was higher than that of girls (3.76%). The rate of vocational high school students (14.56%) was higher than that of general high school students (7.70%) and than that of junior school students (2.67%). The rates of ever and current e-cigarette use were relatively higher in each subgroup, including "weekly allowance more than 40 Yuan" "one of the student's parents, friends or teachers was smoker" "smoked cigarettes now" and "saw e-cigarette advertisements". A two-level logistic regression model showed that the following factors were the influencing factors of current use of e-cigarettes among secondary school students, including gender, whether they were current cigarette smokers, the smoking status of their close friends, if they saw teachers smoked in the school, noticed e-cigarette advertisements, and e-cigarette addictive cognition. Conclusions: The prevalence rates of ever and current e-cigarette use among secondary school students in Heilongjiang Province were high. E-cigarette advertisements, the smoking status of their close friends, and whether they saw teachers smoking in the school were the main factors affecting e-cigarette use among secondary school students in Heilongjiang Province. It is necessary to focus on constructing smoke-free environments and increase health education related to e-cigarette knowledge on risk in developing a smoke-free campus in the whole province.

[Comparison of efficacy between short-term personalized vestibular rehabilitation supervised by special personnel and fixed vestibular rehabilitation on recurrent peripheral vertigo]

Objective: To explore the efficacy of short-term personalized vestibular rehabilitation supervised by special personnel (ST-PVR) versus fixed vestibular rehabilitation (FVR) on decompensated recurrent peripheral vertigo. Methods: A randomized controlled trial was carried out. Patients diagnosed with decompensated recurrent vertigo in the clinic of Eye & ENT Hospital, Fudan University from January to December 2018 were randomly allocated into FVR and ST-PVR groups via computer-generated randomization. The FVR group received fixed scheme involving gaze stabilization exercises, habituation exercises, balance and gait training, while the ST-PVR group received individualized training programs based on symptoms and vestibular function examination results, with adjustments made according to the progress of recovery. Patient symptoms and vestibular function improvement were assessed using the dizziness handicap inventory (DHI), activities-specific balance confidence (ABC), self-rating anxiety scale (SAS), caloric test, and sensory organization test (SOT) at 2, 4, and 8 weeks of treatment. Results: A total of 44 patients were included, including 16 males and 28 females, with an average age of (50.6±13.5) years. There were 21 cases in the FVR group and 23 cases in the ST-PVR group. In the ST-PVR group, DHI score (49.5±26.8 vs 61.3±21.4, P=0.046) and SAS score (39.1±7.8 vs 44.3±6.6, P=0.021) significantly improved after 2 weeks of treatment, while significant improvement occurred only after 8 weeks of treatment in the FVR group (DHI score: 28.1±15.9 vs 53.1±18.5, P=0.001; SAS score: 35.3±6.7 vs 43.1±8.4, P=0.010). There was no significant change of ABC score in the FVR group after 8 weeks of treatment (86.5±12.9 vs 83.4±18.1, P=0.373), while a significant improvement was observed in the ST-PVR group after 4 weeks of treatment (83.6±15.2 vs 78.4±15.1, P=0.015). The caloric test results showed that after 8 weeks of treatment, the proportion of patients with unilateral weakness<25% increased in both groups [FVR group: 57.1% (12/21) vs 9.5% (2/21), P=0.001; ST-PVR group: 52.2% (12/23) vs 17.4% (4/23), P=0.014]. In the ST-PVR group, the proportion of patients with dominant preference≤25% significantly increased [91.3% (21/23) vs 60.9% (14/23), P=0.016], while there was no significant change in the FVR group [61.9 (13/21) vs 57.1% (12/21), P=0.500]. The proportion of patients with SOT score≥70 in the ST-PVR group increased significantly after 2 weeks of treatment [69.6% (16/23) vs 30.4% (7/23), P=0.009], while the FVR group showed a significant increase only after 8 weeks of treatment [81.0% (17/21) vs 42.9% (9/21), P=0.012]. Conclusion: Both FVR and ST-PVR effectively promote vestibular compensation by improving objective vestibular functions and relieving subjective symptoms and anxiety of the patients with decompensation recurrent vertigo, while ST-PVR might shorten the recovery time and increase balance confidence.

[Clinical features of patients with metastatic pheochromocytoma/paraganglioma]

Objective: To analyze the clinical features of patients with metastatic pheochromocytoma/paraganglioma (PPGL). Methods: A follow-up study. The clinical data of 250 patients with metastatic PPGL treated at Peking Union Medical College Hospital from January 2018 to August 2023 were retrospectively analyzed, including 124 males and 126 females. The clinical features and treatment status of patients with metastatic PPGL were summarized and analyzed. Kaplan-Meier survival curve was used to evaluate patients' prognosis. Results: The age of onset, age of diagnosis, and age of tumor metastasis in patients with metastatic PPGL were (33.1±14.2) years, (35.4±15.2) years, and (40.7±15.3) years, respectively. Metastasis occurred in 26.4%(66/250) of patients at the time of initial diagnosis. Among patients without metastases at the time of initial diagnosis, the time from primary tumor resection to metastasis[M(Q1, Q3)] was 5.0 (3.0, 9.0) years, among which 20.1%(37/184) of patients had metastases more than 10 years after surgery. Most patients showed increased 24-hour urinary norepinephrine and plasma normetanephrine, accounting for 78.2%(176/225) and 78.7%(85/108), respectively. 42.3%(69/163) of patients had increased neuron specific enolase (NSE)levels. Germline mutations were screened in 201 patients, of which 55.2%(111/201) had germline pathogenic mutations. In patients with gene mutations, 76.5%(85/111) had SDHB mutations. 52.0%(130/250) of metastatic PPGL patients had primary sites outside the adrenal gland, with the Ki-67 index of 5% (3%, 8%). There were 85.6%(214/250) patients had multisystem metastasis, with bone metastasis being the most common site of metastasis, accounting for 60.8%(152/250). In terms of treatment, 32.8%(75/229) of patients underwent two treatment regimens and 8.7%(20/229) of patients underwent three treatment regimens. Most patients had a good prognosis, with a 5-year and 10-year survival rate of 88.0% and 84.0%, respectively. However, some patients had rapid disease progression, and as of August 2023, 30 patients died, and the time from diagnosis to death in deceased patients was 2.0 (1.0, 4.0) years. Conclusions: Patients with metastatic PPGL have a high rate of germline mutations, especially those with SDHB mutations. The metastatic PPGL is usually multisystem metastasis with the characteristics of mostly paraganglioma, large lesion diameter and high Ki-67 index.

Study of the f_{0}(980) and f_{0}(500) Scalar Mesons through the Decay D_{s}^{+}→π^{+}π^{-}e^{+}ν_{e}

Using e^{+}e^{-} collision data corresponding to an integrated luminosity of 7.33  fb^{-1} recorded by the BESIII detector at center-of-mass energies between 4.128 and 4.226 GeV, we present an analysis of the decay D_{s}^{+}→π^{+}π^{-}e^{+}ν_{e}, where the D_{s}^{+} is produced via the process e^{+}e^{-}→D_{s}^{*±}D_{s}^{∓}. We observe the f_{0}(980) in the π^{+}π^{-} system and the branching fraction of the decay D_{s}^{+}→f_{0}(980)e^{+}ν_{e} with f_{0}(980)→π^{+}π^{-} measured to be (1.72±0.13_{stat}±0.10_{syst})×10^{-3}, where the uncertainties are statistical and systematic, respectively. The dynamics of the D_{s}^{+}→f_{0}(980)e^{+}ν_{e} decay are studied with the simple pole parametrization of the hadronic form factor and the Flatté formula describing the f_{0}(980) in the differential decay rate, and the product of the form factor f_{+}^{f_{0}}(0) and the c→s Cabibbo-Kobayashi-Maskawa matrix element |V_{cs}| is determined for the first time to be f_{+}^{f_{0}}(0)|V_{cs}|=0.504±0.017_{stat}±0.035_{syst}. Furthermore, the decay D_{s}^{+}→f_{0}(500)e^{+}ν_{e} is searched for the first time but no signal is found. The upper limit on the branching fraction of D_{s}^{+}→f_{0}(500)e^{+}ν_{e}, f_{0}(500)→π^{+}π^{-} decay is set to be 3.3×10^{-4} at 90% confidence level.

GLUT4 localisation with the plasma membrane is unaffected by an increase in plasma free fatty acid availability

BACKGROUND

Insulin-stimulated glucose uptake into skeletal muscle occurs via translocation of GLUT4 from intracellular storage vesicles to the plasma membrane. Elevated free fatty acid (FFA) availability via a lipid infusion reduces glucose disposal, but this occurs in the absence of impaired proximal insulin signalling. Whether GLUT4 localisation to the plasma membrane is subsequently affected by elevated FFA availability is not known.

METHODS

Trained (n = 11) and sedentary (n = 10) individuals, matched for age, sex and body mass index, received either a 6 h lipid or glycerol infusion in the setting of a concurrent hyperinsulinaemic-euglycaemic clamp. Sequential muscle biopsies (0, 2 and 6 h) were analysed for GLUT4 membrane localisation and microvesicle size and distribution using immunofluorescence microscopy.

RESULTS

At baseline, trained individuals had more small GLUT4 spots at the plasma membrane, whereas sedentary individuals had larger GLUT4 spots. GLUT4 localisation with the plasma membrane increased at 2 h (P = 0.04) of the hyperinsulinemic-euglycemic clamp, and remained elevated until 6 h, with no differences between groups or infusion type. The number of GLUT4 spots was unchanged at 2 h of infusion. However, from 2 to 6 h there was a decrease in the number of small GLUT4 spots at the plasma membrane (P = 0.047), with no differences between groups or infusion type.

CONCLUSION

GLUT4 localisation with the plasma membrane increases during a hyperinsulinemic-euglycemic clamp, but this is not altered by elevated FFA availability. GLUT4 appears to disperse from small GLUT4 clusters located at the plasma membrane to support glucose uptake during a hyperinsulinaemic-euglycaemic clamp.

Seedlings of Poncirus trifoliata exhibit tissue-specific detoxification in response to NH4 + toxicity

Ammonium nitrogen (NH4 +-N) is essential for fruit tree growth, but the impact of excess NH4 +-N from fertilizer on evergreen citrus trees is unclear. In a climate chamber, 8-month-old citrus plants were exposed to five different hydroponic NH4 +-N concentrations (0, 5, 10, 15 and 20 mm) for 1 month to study effects of NH4 +-N on growth characteristics, N uptake, metabolism, antioxidant enzymes and osmotic regulatory substances. Application of 10 mm NH4 +-N adversely affected root plasma membrane integrity, root physiological functions, and plant biomass. MDA, CAT, POD, APX and SOD content were significantly correlated with leaf N metabolic enzyme activity (GOGAT, GDH, GS and NR). GDH was the primary enzyme involved in NH4 +-N assimilation in leaves, while the primary pathway involved in roots was GS-GOGAT. Under comparatively high NH4 + addition, roots were the main organs involved in NH4 + utilization in citrus seedlings. Our results demonstrated that variations in NH4 + concentration and enzyme activity in various organs are associated with more effective N metabolism in roots than in leaves to prevent NH4 + toxicity in evergreen woody citrus plants. These results provide insight into the N forms used by citrus plants that are important for N fertilizer management.

Campothecin suppresses cell proliferation and migration in head and neck squamous cell carcinoma by blocking RAB27A-mediated phosphatidylinositol 3 kinase (PI3K)/protein kinase B (AKT) pathway

Camptothecin (CPT), a naturally occurring alkaloid derived from the Camptotheca acuminate plant, exerts anti-tumor properties. However, its specific impact on head and neck squamous cell carcinoma (HNSCC) remains uncertain. The study was to explore the action and mechanism of CPT on HNSCC cells. First, two HNSCC cell lines (FaDu and TU686) and a normal immortalized keratinocyte (HEK001) cell line, were exposed to a spectrum of CPT concentrations (ranging from 10 to 50 μM) for durations of 24 h and 48 h. Cell viability, proliferation, migration, and invasion were assessed by CCK-8 assay, EdU incorporation assay, wound healing assay and transwell assay. Subsequently, si-RAB27A or negative control (NC) was introduced into FaDu and TU686 cells through transfection, and the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway was manipulated with L740Y-P, an activator of this pathway. The expression of proliferating cell nuclear antigen (PCNA), E-cadherin, PI3K/AKT signaling factors and RAB27A were determined by Western blot analysis. RAB27A was detected by immunofluorescence assay. It was found that CPT significantly hindered the viability, proliferation (p<0.01), migration (p<0.001), and invasion (p<0.001) of FaDu and TU686 cells. At the molecular level, administration of CPT caused a decline in the expression of PCNA, P-PI3K, P-AKT, and RAB27A, alongside an elevation in E-cadherin levels within HNSCC cells (p<0.05, p<0.01 and p<0.001). Reducing RAB27A expression enhanced the suppressive impacts of CPT on HNSCC cell viability (p<0.05 and p<0.01), migration (p<0.001) and invasion (p<0.01), these effects that were reversed upon treatment with L740Y-P in HNSCC cells (p<0.001). In summary, our study highlights the efficacy of CPT in HNSCC, demonstrating its influence on cell processes via the RAB27A-mediated PI3K/AKT pathway.

The value of quantitative contrast-enhanced ultrasonography analysis in evaluating central retinal artery microcirculation in patients with diabetes mellitus: comparison with colour Doppler imaging

AIM

To compare the efficacy of quantitative contrast-enhanced ultrasonography (CEUS) analysis and colour Doppler ultrasound (CDU) in evaluating central retinal artery (CRA) microcirculation in patients with diabetes mellitus (DM).

MATERIALS AND METHODS

In this prospective study, a total of 55 patients (98 eyes) with DM were enrolled as the study group. They were compared to 46 age-matched healthy volunteers (92 eyes) who were selected as the control group. Each patient underwent CDU and subsequent CEUS examination. CDU and quantitative CEUS parameters were evaluated. The diagnostic efficiency of the diagnostic performance of CEUS and CDU was evaluated and compared, and the scale thresholds of predictive indicators for the diagnosis of proliferative diabetic retinopathy (PDR) were evaluated using receiver operating characteristics (ROC) curve analyses.

RESULTS

Group pairwise comparisons showed that the end diastolic velocity (EDV) and arrival time (AT) of CRA were significant predictors for PDR by CDU and by quantitative CEUS analysis, respectively (all p<0.05). The ROC curve analysis showed that the area under the curve value of AT was significantly higher than that of EDV (0.875 versus 0.634, p=0.0002). Accordingly, an AT cut-off value of 1.07 seconds resulted a sensitivity of 90.62 % and a specificity of 79.31 %.

CONCLUSION

Quantitative CEUS analysis can improve the accuracy of clinical staging of diabetic retinopathy for the patients with DM, and the AT showed the best diagnostic efficiency.

The safety signal detection and analysis of monoclonal antibodies against SARS-CoV-2 based on real-world evidence - the suitable selectivity for different populations

OBJECTIVE

Bebtelovimab (BEB), Tixagevimab/Cilgavimab (TIX/CIL), and Sotrovimab (SOT) are important agents against the severe acute respiratory syndrome coronavirus 2-Omicron strain. However, due to their short duration of application, little is known about their safety profiles. This research aimed to explore the safety profile of these monoclonal antibodies (mAbs) via real-world evidence databases and data mining tools.

MATERIALS AND METHODS

Safety reports were retrieved from the database of the U.S. Food and Drug Administration (FDA) Adverse Event Reporting System from April 2022 to March 2023. To detect the safety signal, the disproportionality analysis was performed using the reporting odds ratio method.

RESULTS

SOT had the greatest proportion of "skin and subcutaneous tissue disorders" and "disorders of investigations"; BEB showed significant associations with "gastrointestinal disorders" and "nervous system disorders"; TIX/CIL had the weakest correlation with "skin and subcutaneous tissue disorders" and "general disorders and administration site conditions". Furthermore, there were still other signals related to nervous system disorders, gastrointestinal disorders only caused by BEB. TIX/CIL has been reported solely to be associated with multiple types of cardiovascular disorders. As for SOT alone, signals were strongly related to infusion reactions and hypersensitivity.

CONCLUSIONS

In summary, SOT may be unsuitable for allergic patients and may lead to abnormal test results. BEB showed the highest correlations with gastrointestinal and neuropsychiatric events. In addition, its infusion reactions should also be noted. TIX/CIL can lead to a variety of cardiovascular events.