Case report: Pacemaker lost capture after acute myocardial infarction in a patient with left circumflex coronary artery occlusion

A 71-year-old female with a dual-chamber pacemaker presented to our hospital complaining of repeated chest pain. She was diagnosed with unstable angina. On day 7, the patient suddenly suffered cardiopulmonary arrest due to an inferior ST segment elevation myocardial infarction (STEMI). Pacemaker lost capture was suspected and was later confirmed by a pacemaker check with a high pacing threshold and a low sensing parameter. Emergency coronary angiography revealed that a large filling defect remained due to an extensive thrombus in the proximal left circumflex (LCX) with thrombolysis in myocardial infarction (TIMI) grade 2 flow, and then a repeat thrombus aspiration was performed. After reperfusion, the parameters of the right ventricular lead were gradually returned. We conclude that the loss of the right ventricular lead pacing occurred in this case of acute coronary syndrome (ACS) induced by an LCX thrombus due to an LCX supplying the right ventricular septal.

6-Shogaol protects against isoproterenol-induced cardiac injury in rats through attenutating oxidative stress, inflammation, apoptosis and activating nuclear respiratory factor-2/heme oxygenase-1 signaling pathway

The current study investigated the preventive effect of 6-Shogaol on isoproterenol hydrochloride (ISO)-induced myocardial cardiac injury. 6-Shogaol (50 mg/kg b.w.) was administered for 14 days at pretreatment and ISO-induction (85 mg/kg b.w.) for the last two days (13th and 14th days) by subcutaneous injection. Cardiac markers in serum like creatine kinase (CK), creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH), cardiac troponins T (cTn T) and I (cTn I) increased in ISO-induced rats. Moreover, lipid peroxidative markers like thiobarbituric acid reactive substances (TBARS) and lipid hydroperoxides (LOOH) were raised, and the activities/level of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and reduced glutathione (GSH) were diminished in ISO-treated heart tissue. In addition, inflammatory and nuclear respiratory factor (Nrf)-2 signalling molecules were upregulated in ISO-induced ischemic rats. 6-Shogaol pretreatment decreased the activities of cardiac and lipid peroxidative markers and enhanced the antioxidant status in ISO-induced cardiac injury rats. Further, 6-Shogaol pretreatment inhibited serum inflammatory markers: tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), nuclear factor-kappaB (NF-κB), Nrf-2 molecule and heme oxygenase (HO)-1 in ISO-induced cardial damage rats. We noticed the effect of 6-Shogaol inhibited pro-apoptotic genes like B-cell lymphoma 2 (Bcl-2)-associated X protein (Bax), Fas, caspase-3, -8, -9, cytochrome C, and inflammatory genes and increased Bcl-2 expression in ISO-treated rats. The cardioprotective activity of 6-Shogaol in rats with ISO-induced myocardial damage may be due to its ability to reduce oxidative stress, inflammation, and apoptosis, perhaps via the Nrf-2/HO-1 signalling pathway.

Metabolic Homeostasis-Regulated Nanoparticles for Antibody-Independent Cancer Radio-Immunotherapy

The special metabolic traits of cancer cells and tumor-associated macrophages (TAMs) in the tumor microenvironment (TME) are promising targets for developing novel cancer therapy strategies, especially the glycolysis and mitochondrial energy metabolism. However, therapies targeting a singular metabolic pathway are always counteracted by the metabolic reprogramming of cancer, resulting in unsatisfactory therapeutic effect. Herein, this work employs poly(ethylene glycol)-coated (PEGylated) liposomes as the drug delivery system for both mannose and levamisole hydrochloride to simultaneously inhibit glycolysis and restrain mitochondrial energy metabolism and thus inhibit tumor growth. In combination with radiotherapy, the liposomes can not only modulate the immunosuppressive TME by cellular metabolism regulation to achieve potent therapeutic effect for local tumors, but also suppress the M2 macrophage proliferation triggered by X-ray irradiation and thus enhance the immune response to inhibit metastatic lesions. In brief, this work provides a new therapeutic strategy targeting the special metabolic traits of cancer cells and immunosuppressive TAMs to enhance the abscopal effect of radiotherapy for cancer.

Medication non-adherence and associated factors among older adult stroke survivors in China

Aim: Medication non-adherence has remained a common and costly global health issue of growing importance among older adults. This study aims to determine the prevalence and associated factors related to medication non-adherence among older adult stroke survivors in China. Methods and results: In this cross-sectional study, a total of 402 older adult stroke survivors were recruited from three tertiary hospitals in China. The results of the survey showed that 61.4% exhibited medication non-adherence. The chances of medication non-adherence among older adult stroke survivors who had primary school or less educational levels were higher than those who had senior secondary and junior college educational levels [OR (95% CI) = 0.440(0.249, 0.778)] as well as those who had a bachelor's degree or above educational levels [OR (95%CI) = 0.367(0.202, 0.667)]. Moreover, the probability of medication non-adherence with 4-5 and ≥6 types of total prescription medications per day increased by 1.993 times [OR (95% CI) = 1.993(1.190, 3.339))] and 2.233 times [OR (95%CI) = 2.233(1.159, 4.300)], respectively, as compared to when there were ≤3 types. Furthermore, medication non-adherence decreased with the increase in health literacy scores (β = -0.641 (95% CI; (0.913, 0.965)) and BMQ specific-necessity scores (β = -0.131 (95% CI; 0.806, 0.995)). On the other hand, when the BMQ specific-concerns score increased by one unit, medication non-adherence increased by 11.1% [OR (95% CI) = 1.111(1.044, 1.182)]. Conclusion: The present study found that patient medication adherence among older adult stroke survivors in China is problematic and associated with educational levels, total prescribed drugs per day, beliefs about medication, and health literacy scores. This indicates that measures should be taken to enhance medication adherence among such higher-risk populations.

[Cadmium induces apoptosis of mouse spermatocytes (GC-2 spd) by promoting mitochondrial fission]

Objective: To study the underlying mechanism of cadmium-induced apoptosis of mouse spermatocytes (GC-2 spd) . Methods: In March 2021, GC-2 spd cells were exposed to different concentrations of CdCl(2) for 24 hours, namely 5 μmol/L CdCl(2) (low-dose) group and 10 μmol/L CdCl(2) (high-dose) group, and unexposed GC-2 spd cells were used as control group. Mitochondrial morphology was observed in the cells stained with Mito-Track Red CMXRos fluorescent probes by confocal microscopy and the mitochrondrial membrane potential was measured by flow cytometry with JC-1 fluorescent probes. Mitochrondrial proteins, cytosolic proteins and total cellular proteins of GC-2 spd cells were extracted using cell mitochondria isolation kit and RIPA buffer, respectively. The expression of mitochondrial homeostasis regulatory proteins (FIS1 and OPA1), and apoptosis-related proteins (Cytochrome c and cleaved Caspase-3) were examined by Western blot. Results: Compared with the cells in the control group, the relative ratio of JC-1 red/green fluorescence signal in the cells of the low-dose and high-dose CdCl(2) groups decreased significantly (0.740±0.071, 0.570±0.028), with a statistically significant difference (P=0.017, 0.004) ; The morphology of mitochondria changed from long tube to point, and the proportion of cells containing point mitochondria increased significantly (45.1%±3.7% and 25.7%±4.9%), the difference was statistically significant (P=0.005, 0.001) ; The relative expression level of mitochondrial FIS1 in cells of low and high dose CdCl(2) groups was significantly higher (1.271±0.120, 1.693±0.155), the difference was statistically significant (P=0.046, 0.000) ; The relative expression level of OPA1 decreased significantly (0.838±0.050, 0.682±0.040), and the difference was statistically significant (P=0.049, 0.001). Compared with the control group, the relative expression level of cytochrome c protein in the cytoplasm of cells in the low dose group of CdCl(2) was not significantly increased (1.249±0.151), and the difference was not statistically significant (P=0.075). However, the relative expression level in the cytoplasm of cells in the high dose group of CdCl(2) was significantly increased (2.355±0.110), and the difference was statistically significant (P=0.000) ; The relative expression level of Cytochrome c in mitochondria of low and high dose CdCl(2) groups decreased significantly (0.681±0.043, 0.619±0.114), with a statistically significant difference (P=0.004, 0.001) ; Moreover, the level of cleaved Caspase-3 protein in cells gradually increased (5.486±0.544, 11.493±1.739), the difference was statistically significant (P=0.004, 0.000) . Conclusion: Cadmium induced cleaved Caspase-3 mediated apoptosis of GC-2 spd cells via promoting mitochrondrial fission and the release of Cytochrome c from the mitochrondria to the cytosol.

Inhibition of SPRY2 expression protects sevoflurane-induced nerve injury via ERK signaling pathway

Purpose: To investigate the effect of Sprouty2 (SPRY2) on sevoflurane (SEV) induced nerve injury in rats and its potential signaling pathway. Methods: Male Sprague-Dawley rats were divided into sham and SEV groups containing six rats per group. Neurological injury assessment and H & E staining were performed to evaluate the degree of nerve injury in the rats, while quantitative polymerase chain reaction (qPCR) and immunoblot assays were performed to confirm the expression levels of SPRY2 in hippocampus tissues. Morris water maze tests were performed to determine the degree of cognitive deficit in rats. TUNEL and immunoblot assays were performed to evaluate the effects of SPRY2 on the apoptosis of hippocampus tissues. Results: The SPRY2 expression was elevated in sevoflurane-induced hippocampus injury (p < 0.001). Ablation of SPRY2 inhibited sevoflurane-induced hippocampal neuron apoptosis (p < 0.001). In addition, depletion of SPRY2 promoted hippocampal neuron activity and decreased apoptosis (p < 0.001). Knockdown of SPRY2 promoted ERK signaling pathway, thereby protecting against sevoflurane-induced nerve injury and cognitive deficit in the rats (p < 0.001). Conclusion: Sevoflurane induces cognitive dysfunction and upregulates SPRY2 expression in brain tissues in rats. The SPRY2 knockdown improves SEV-induced neural injuries and cognitive deficits, inhibits hippocampal neuron apoptosis, and enhances its activity. Meanwhile, SPRY2 depletion protects SEV-induced nerve injury via the ERK pathway. Thus, Sprouty2 could serve as a promising drug target for the treatment of SEV-induced cognitive dysfunctions.

Inappropriate antibiotic prescribing in primary healthcare facilities in China: a nationwide survey, 2017-2019

OBJECTIVES

We aimed to generate comprehensive estimates of the appropriateness of outpatient antibiotic prescriptions at primary healthcare facilities (PHFs) in China.

METHODS

Between 2017 and 2019, we collected outpatient-visit prescriptions from 269 Chinese PHFs in 31 cities located in 6 provinces. Conditions that resulted in antibiotic use were classified into appropriate, potentially appropriate, and inappropriate using a well-established classification approach. We then assessed the magnitude, appropriateness, and costs of antibiotic prescribing, overall and by antibiotic classification group, diagnostic categories, and patient characteristics.

RESULTS

Of all eligible 209 662 antibiotic prescriptions, 147 758 (70.5%) were inappropriate, which accounted for 66.8% (558.0/835.3 thousand US dollars) of costs for antibiotics. Upper respiratory tract infections, acute bronchitis, and non-infectious gastroenteritis were responsible for 68.9% (101 744/147 758) of inappropriately antibiotic prescriptions. High inappropriate antibiotic prescribing rates were observed among children aged 0-5 years (78.5% (21 049/26 799)) and patients living in economically undeveloped areas (77.5% (38 430/49 587)). A total of 256 474 individual antibiotics were prescribed, of which 82.2% (210 885/256 474) were broad-spectrum antibiotics, with second-generation cephalosporins (15.1% (38 705/256 474)) and third-generation cephalosporins (14.6% (37 491/256 474)) being the most commonly prescribed subgroups.

DISCUSSION

Our findings highlight the excessive and inappropriate use of antibiotics in Chinese PHFs pending multidimensional efforts.

Electrocatalytic hydrodechlorination system with antiscaling and anti-chlorine poisoning features for salt-laden wastewater treatment

The high salinity and coexistence of scaling ions (Ca²⁺, Mg²⁺, HCO₃^-) in wastewater challenge the efficacy and durability of palladium (Pd)-mediated electrocatalytic hydrodechlorination (EHDC) reaction for chlorinated organic pollutant detoxification, due to the accompanying Cl^- poisoning at Pd sites and scaling on electrode. In a concentrated NaCl solution (5.8 g L ^- 1) with Ca²⁺ (80.0 mg L ^- 1), Mg²⁺ (30.0 mg L ^- 1) and HCO₃^- (180.0 mg L ^- 1), the EHDC efficiency of Pd towards 2,4-dichlorophenol decreases significantly from 67.8% to 33.1% in 72.0 h of reaction, and the electrode is covered with layers of fluffy aragonite precipitate. Herein we demonstrate the inclusion of a commercial antiscalant 2-phosphonobutane-1,2,4-tricarboxylic acid (PBTC) can prevent both scale formation and Cl^- poisoning, leading to an efficient and steady EHDC process. A mechanistic study reveals that the unique dual function of PBTC primarily originates from the bearing phosphonate and carboxyl groups. With the large affinity of these groups (especially the phosphonate group) for scaling cations and Pd, the PBTC can chelate and stabilize the scaling cations in water and replace Cl^- at Pd surface. It can also release protons, and trigger the formation of more electron-deficient Pd^δ+ species via PBTC-Pd binding, leading to an enhanced EHDC. This work provides effective solutions to the scaling/poisoning issues that commonly encountered in real wastewater and paves a solid road for EHDC application in pollution abatement.

Development and Perspectives of Thermal Conductive Polymer Composites

With the development of electronic appliances and electronic equipment towards miniaturization, lightweight and high-power density, the heat generated and accumulated by devices during high-speed operation seriously reduces the working efficiency and service life of the equipment. The key to solving this problem is to develop high-performance thermal management materials and improve the heat dissipation efficiency of the equipment. This paper mainly summarizes the research progress of polymer composites with high thermal conductivity and electrical insulation, including the thermal conductivity mechanism of composites, the factors affecting the thermal conductivity of composites, and the research status of thermally conductive and electrical insulation polymer composites in recent years. Finally, we look forward to the research focus and urgent problems that should be addressed of high-performance thermal conductive composites, which will provide strategies for further development and application of advanced thermal and electrical insulation composites.

Circadian nuclear receptor Rev-erbalpha is expressed by platelets and potentiates platelet activation and thrombus formation

Background

Adverse cardiovascular events have day/night patterns with peaks in the morning, potentially related to endogenous circadian clock control of platelet activation. Circadian nuclear receptor Rev-erbα is an essential and negative component of the circadian clock.

Purpose

We aim to investigate the expression profile and biological function of Rev-erbα in platelets.

Methods and results

Here we report the presence and functions of circadian nuclear receptor Rev-erbα in human and mouse platelets. Both human and mouse platelet Rev-erbα showed a circadian rhythm that positively correlated with platelet aggregation. Global Rev-erbα knockout and platelet-specific Rev-erbα knockout mice exhibited defective in hemostasis as assessed by prolonged tail-bleeding times. Rev-erbα deletion also reduced ferric chloride-induced carotid arterial occlusive thrombosis, prevented collagen/epinephrine-induced pulmonary thromboembolism, and protected against microvascular microthrombi obstruction and infarct expansion in an acute myocardial infarction model. In vitro thrombus formation assessed by CD41-labeled platelet fluorescence intensity was significantly reduced in Rev-erbα knockout mouse blood. Platelets from Rev-erbα knockout mice exhibited impaired agonist-induced aggregation responses, integrin αIIbβ3 activation and α-granule release. Consistently, pharmacological inhibition of Rev-erbα by specific antagonists decreased platelet activation markers in both mouse and human platelets. Mechanistically, mass spectrometry and co-immunoprecipitation analyses revealed that Rev-erbα potentiated platelet activation via oligophrenin-1-mediated RhoA/ERM (ezrin/radixin/moesin) pathway.

Conclusion

We provide the first evidence that circadian protein Rev-erbα is functionally expressed in platelets and potentiates platelet activation and thrombus formation. Rev-erbα may serve as a novel therapeutic target for managing thrombosis-based cardiovascular disease.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): This work was supported by grants from the National Science Fund for Distinguished Young Scholars (81625002), the National Natural Science Foundation of China (81930007).

[Recombinant human interleukin 35 (rhIL-35) alleviates the damage of coronary artery endothelial cells in Kawasaki disease by inhibiting NF-κB pathway]

Objective To investigate the protective effect and mechanism of recombinant human interleukin 35(rhIL-35) on coronary artery injury in Kawasaki disease (KD). Methods Human coronary artery endothelial cells (HCAECs) were cultured in vitro to establish KD vascular model. Tumor necrosis factor α(TNF-α) and the serum of KD patients stimulated HCAECs were used to mimic the local inflammatory lesions of KD. The cells were divided into control group, TNF-α and KD serum stimulation group, (25, 50) ng/mL rhIL-35 treatment group. Cell proliferation was detected by CCK-8 assay; mRNA levels of IL-1β, IL-6, IL-17A and zonula occludens-1(ZO-1) of HCAECs were detected by real-time quantitative PCR; IL-35 expression in plasma and IL-1β, IL-6 and IL-17A content in HCAEC supernatant were tested by ELISA; Western blot was performed to detect the expression of nuclear factor κB p65 (NF-κB p65) and ZO-1. Results TNF-α and KD serum inhibited the proliferation of HCAECs, while rhIL-35 significantly reversed the above effects. RhIL-35 significantly down-regulated the expression of IL-1β, IL-6 and IL-17A after preconditioning HCAECs. Compared with TNF-α and KD serum stimulation group, rhIL-35 pretreated cells could significantly increase ZO-1 protein expression and inhibit NF-κB p65 expression. Conclusions rhIL-35 can alleviate the damage of KD coronary artery endothelial cells by inhibiting NF-κB pathway.

The hypoxia-related signature predicts prognosis, pyroptosis and drug sensitivity of osteosarcoma

Osteosarcoma (OS) is one of the most common types of solid sarcoma with a poor prognosis. Solid tumors are often exposed to hypoxic conditions, while hypoxia is regarded as a driving force in tumor recurrence, metastasis, progression, low chemosensitivity and poor prognosis. Pytoptosis is a gasdermin-mediated inflammatory cell death that plays an essential role in host defense against tumorigenesis. However, few studies have reported relationships among hypoxia, pyroptosis, tumor immune microenvironment, chemosensitivity, and prognosis in OS. In this study, gene and clinical data from Therapeutically Applicable Research to Generate Effective Treatments (TARGET) and Gene Expression Omnibus (GEO) databases were merged to develop a hypoxia risk model comprising four genes (PDK1, LOX, DCN, and HMOX1). The high hypoxia risk group had a poor prognosis and immunosuppressive status. Meanwhile, the infiltration of CD8⁺ T cells, activated memory CD4⁺ T cells, and related chemokines and genes were associated with clinical survival outcomes or chemosensitivity, the possible crucial driving forces of the OS hypoxia immune microenvironment that affect the development of pyroptosis. We established a pyroptosis risk model based on 14 pyroptosis-related genes to independently predict not only the prognosis but also the chemotherapy sensitivities. By exploring the various connections between the hypoxic immune microenvironment and pyroptosis, this study indicates that hypoxia could influence tumor immune microenvironment (TIM) remodeling and promote pyroptosis leading to poor prognosis and low chemosensitivity.

Toward emerging contaminants removal using acclimated activated sludge in the gravity-driven membrane filtration system

The occurrence of emerging contaminants is attracting widespread attention due to its potential threat to aquatic organisms and public health. Gravity-driven membrane (GDM) filtration can effectively eliminate water contamination with pathogenic microorganisms in rural areas while being challenged by various micro-pollutants (MPs). This study investigated the removal and transformation of sulfamethoxazole (SMX) in GDM for the first time, and pre-adding acclimated activated sludge was proposed to improve the removal of MPs. More rapid and higher SMX degradation was observed with pre-adding domestication sludge, and the system had better tolerance to SMX shocks. Besides, in the presence of domesticated sludge, more SMX metabolic pathways and better mineralization rates were obtained, which was related to more SMX-resistant bacteria and easier biodegradable carbon sources in the system. Pre-adding sludge also increased the richness and diversity of bacterial community, which provided higher removal efficiencies of conventional pollutants. Thus, the removal rates of DOC (14.7%), NH₄⁺-N (5.6%) and fluorescent substances were obviously improved compared with the control group. In this study, the crisis of MPs was tackled and the removal of conventional pollutants was enhanced by pre-adding domesticated sludge in GDM, which ensured the water quality in rural areas.

Numerical investigation of the rider's head injury in typical single-electric self-balancing scooter accident scenarios

As the use of electric self-balancing scooters (ESSs) increases, so does the number of related traffic accidents. Because of the special control method, mechanical structure and driving posture, ESSs are prone to various single-vehicle accidents, such as collisions with fixed obstacles and falls due to mechanical failures. In various ESS accident scenarios, the rider's head injury is the most frequent injury type. In this study, several typical single-ESS accident scenarios are reconstructed via computational methods, and the risk of riders' head/brain injury is assessed in depth using various injury criteria. Results showed that two types of ESSs (solo- and two-wheeler) do not have clear differences in head kinematics and head injury risks; the head kinematics (or falling posture) and ESS accident scenario exhibit a distinct effect on the head injury responses; half of the analysed ESS riders have a 50% probability of skull fracture, a few riders have a 50% risk of abbreviated injury scale (AIS) 4+ brain injury, and none has a diffuse axonal injury; the ESS speed plays an important role in producing the head/brain injury in ESS riders, and generally, higher ESS speed generates higher level of predicted head injury parameters. These findings will provide theoretical support for preventing head injury among ESS riders and data support for developing and legislating ESSs.

Transgenic expression of rice OsPHR2 increases phosphorus uptake and yield in wheat

Oryza sativa PHOSPHATE RESPONSE2 (OsPHR2) can promote the uptake and use of phosphorus (P) in rice. We introduced OsPHR2 into the winter wheat (Triticum aestivum L.) variety "Zhengmai0856." OsPHR2 was integrated into the wheat genome with two copy numbers and could be correctly transcribed and expressed. OsPHR2 was mainly expressed in the leaves at the seedling stage. From the jointing to filling stage, OsPHR2 was mainly expressed in the roots, followed by the leaves, with a low expression level in detected the tassels and stems. The transgenic lines exhibited higher P accumulation at each growth stage and increased P uptake intensity in comparison to the wild type under low P and high P conditions. Analysis of the root characteristics showed that the transgenic expression of OsPHR2 increased the maximum root length, total root length, root-to-shoot ratio, and root volume under the conditions of P deficiency or low P. A field experiment showed that the transgenic lines had a higher grain yield than the wild type under low P and high P conditions. The yield of the transgenic lines increased by 6.29% and 3.73% on average compared with the wild type under low P and high P conditions, respectively. Thus, the transgenic expression of OsPHR2 could increase P uptake and yield in wheat, but the effect was more prominent under low P conditions.

[Clinical characteristics of 272 437 patients with different histopathological subtypes of primary esophageal malignant tumors]

Objective: To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT). Methods: A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ² test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results: A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment. Conclusion: ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

A two-dimensional conductive polymer/V2O5 composite with rapid zinc-ion storage kinetics for high-power aqueous zinc-ion batteries

Vanadium oxides represent a promising cathode material for aqueous zinc ion batteries (ZIBs) owing to their abundant valences and versatile cation-storage capacities. However, the sluggish Zn²⁺ diffusion kinetics in the V₂O₅ framework and poor intrinsic conductivity result in inferior rate capability and unsatisfactory cycling performance of the V₂O₅ cathode, and thus limits its commercial-scale deployment. Herein, a unique conducting polymer intercalation strategy is developed to optimize the ion/electron transport simultaneously based on the rational design of the composite structure and morphology. The poly(3,4-ethylenedioxythiophene) (PEDOT) intercalated V₂O₅ not only remarkably enlarges the interlayer distance for facile Zn²⁺ diffusion, but also diminishes the electron transport resistance by the π-conjugated structure of PEDOT. Additionally, the two-dimensional (2D) morphology enables shorter ion diffusion paths as well as a larger number of exposed sites for Zn²⁺ insertion. As a result, the PEDOT-intercalated V₂O₅ (PEDOT/V₂O₅) exhibits a good high-rate performance (154 mA h g^-1 at an ultrahigh current density of 50 A g^-1) and a long-term cycling life (maintains 170 mA h g^-1 even after 2500 cycles at 30 A g^-1). This universal strategy provides a design principle for constructing efficient Zn²⁺ and electron transport pathways within cathode materials, holding great potential for the development of high-performance and durable ZIB cathodes.

ANGPTL8 accelerates liver fibrosis mediated by HFD-induced inflammatory activity via LILRB2/ERK signaling pathways

INTRODUCTION

High calorie intake is known to induce nonalcoholic fatty liver disease (NAFLD) by promoting chronic inflammation. However, the mechanisms are poorly understood.

OBJECTIVES

This study examined the roles of ANGPTL8 in the regulation of NAFLD-associated liver fibrosis progression induced by high fat diet (HFD)-mediated inflammation.

METHODS

The ANGPTL8 concentration was measured in serum samples from liver cancer and liver cirrhosis patients. ANGPTL8 knockout mice were used to induce disease models (HFD, HFHC and CCL4) followed by pathological staining, western blot and immunohistochemistry. Hydrodynamic injection of an adeno-associated virus 8 (AAV8) was used to establish a model for restoring ANGPTL8 expression specifically in ANGPTL8 KO mice livers. RNA-sequencing, protein array, Co-IP, etc. were used to study ANGPTL8's mechanisms in regulating liver fibrosis progression, and drug screening was used to identify an effective inhibitor of ANGPTL8 expression.

RESULTS

ANGPTL8 level is associated with liver fibrogenesis in both cirrhosis and hepatocellular carcinoma patients. Mouse studies demonstrated that ANGPTL8 deficiency suppresses HFD-stimulated inflammatory activity, hepatic steatosis and liver fibrosis. The AAV-mediated restoration of liver ANGPTL8 expression indicated that liver-derived ANGPTL8 accelerates HFD-induced liver fibrosis. Liver-derived ANGPTL8, as a proinflammatory factor, activates HSCs (hepatic stellate cells) by interacting with the LILRB2 receptor to induce ERK signaling and increase the expression of genes that promote liver fibrosis. The FDA-approved drug metformin, an ANGPTL8 inhibitor, inhibited HFD-induced liver fibrosis in vivo.

CONCLUSIONS

Our data support that ANGPTL8 is a proinflammatory factor that accelerates NAFLD-associated liver fibrosis induced by HFD. The serum ANGPTL8 level may be a potential and specific diagnostic marker for liver fibrosis, and targeting ANGPTL8 holds great promise for developing innovative therapies to treat NAFLD-associated liver fibrosis.

Test and Analysis of Vegetation Coverage in Open-Pit Phosphate Mining Area around Dianchi Lake Using UAV-VDVI

This work aimed to detect the vegetation coverage and evaluate the benefits of afforestation and ecological protection. Unmanned aerial vehicle (UAV) aerial survey was adopted to obtain the images of tailings area at Ma'anshan near the Dianchi Lake estuary, so as to construct a high-resolution Digital Orthophoto Map (DOM) and high-density Dense Image Matching (DIM) point cloud. Firstly, the optimal scale was selected for segmentation by considering the terrain. Secondly, the visible-band difference vegetation index (VDVI) of the classified vegetation information of the tail mining area was determined from the index gray histogram, ground class error analysis, and the qualitative and quantitative analysis of the bimodal index. Then, the vegetation information was extracted by combining the random forest (RF) classification algorithm. Finally, the extracted two-dimensional (2D) vegetation information was mapped to the three-dimensional (3D) point cloud, and the redundant data was eliminated. Fractional vegetation cover (FVC) was counted in the way of surface to point and human-machine combination. The experimental results showed that the vegetation information extracted from the 2D image was mapped to the 3D point cloud in the form of surface to point, and the redundant bare ground information was eliminated. The statistical FVC was 36.06%. The field survey suggested that the vegetation information in the turf dam area adjacent to the open phosphate deposit accumulation area research area was sparse. Relevant measures should be taken in the subsequent mining to avoid ecological damage caused by expanded phosphate mining. In general, applying UAV measurement technology and related 2D and 3D products to detect the vegetation coverage in an open phosphate mine area was of practical significance and unique technical advantages.

Family-based improvement for health literacy among the Yi nationality (FAMILY) in Liangshan: protocol of an open cohort stepped wedge cluster randomized controlled trial

BACKGROUND

Improvement of health literacy constitutes a cornerstone to improving public health. However, the overall health literacy of Liangshan Yi Autonomous Prefecture (Liangshan Prefecture) in the southwest Sichuan Province of China has kept extremely low for a long time. How to improve health literacy of the Yi nationality residents is key to be urgently solved. Notably, Family Branch System is a distinctive patrilineal bloodline organization of Yi nationality, which plays an important role in the daily life of Yi nationality. Meanwhile, Contracted Family Doctor Services is conducted in Liangshan Prefecture. Therefore, this study proposes an intervention model of health education based on Family Branch System and Contracted Family Doctor Services, which is a Family-based Improvement for Health Literacy among the Yi nationality (FAMILY) in Liangshan, when improving traditional Innovative Care for Chronic Conditions Framework (ICCC) framework.

METHODS

An open cohort stepped wedge cluster randomized trial design is used to implement health literacy education interventions including project preparation, core group building, promotion within family branch and competition between family branches while using Contracted Family Doctor Services as control measure. The study will be conducted among Yi nationality residents in Meigu County and Yanyuan County, with health literacy level of residents as the primary outcome. Finally, mixed-effects model and causal inference method will be used to evaluate intervention effect.

DISCUSSION

This study highlights family, using the unique Family Branch System and Contracted Family Doctor Services in Liangshan Prefecture to design intervention among improved ICCC framework, and combines the mixed-effects model with complier average causal effects (CACE) to estimate the intervention effect under non-compliance for the first time. Besides, other key technologies to be adopted include construction of electronic questionnaire quality control system, with quality control based on artificial intelligence. This trial contributes to exploring an effective way to improve health literacy of Yi nationality residents in Liangshan Prefecture, which will provide reference for other areas, especially poor areas, to improve residents' health literacy.

TRIAL REGISTRATION

ISRCTN11299863 on June 1, 2022; https://www.isrctn.com/ .

Should anthropometric differences between the commonly used pedestrian computational biomechanics models and Chinese population be taken into account when predicting pedestrian head kinematics and injury in vehicle collisions in China?

Computational biomechanics models play a key role in predicting/evaluating pedestrian head kinematics and injury risk in car-to-pedestrian collisions. The human multibody models most commonly used in car-to-pedestrian collision reconstruction, such as pedestrian model by The Netherlands Organisation for Applied Scientific Research TNO, are built using the anthropometry of Western European population as defined in TNO (2013) human multibody model database. In this study, we investigate the effects of the anthropometric differences between the Western European and Chinese populations on the pedestrian head kinematics and injury responses predicted using multibody models. The comparison was conducted through car-to-pedestrian collision simulations using pedestrian multibody models representing anthropometric characteristics of Western European and Chinese populations, three typical vehicle shapes (sedan, SUV and minivan), five initial vehicle impact speeds (30, 35, 40, 45, 50 km/h), and six pedestrian walking postures. The results indicate that the change of pedestrian model anthropometry (from Western European to Chinese) exerts appreciable effects on both the predicted initial boundary conditions of the head-to-windscreen impact (in particular the head-to-windscreen impact angle) and the head injury indices in the impact with the road surface (secondary impact).

GmTDN1 improves wheat yields by inducing dual tolerance to both drought and low-N stress

Genetically enhancing drought tolerance and nutrient use efficacy enables sustainable and stable wheat production in drought-prone areas exposed to water shortages and low soil fertility, due to global warming and declining natural resources. In this study, wheat plants, exhibiting improved drought tolerance and N-use efficacy, were developed by introducing GmTDN1, a gene encoding a DREB-like transcription factor, into two modern winter wheat varieties, cv Shi4185 and Jimai22. Overexpressing GmTDN1 in wheat resulted in significantly improved drought and low-N tolerance under drought and N-deficient conditions in the greenhouse. Field trials conducted at three different locations over a period of 2-3 consecutive years showed that both Shi4185 and Jimai22 GmTDN1 transgenic lines were agronomically superior to wild-type plants, and produced significantly higher yields under both drought and N-deficient conditions. No yield penalties were observed in these transgenic lines under normal well irrigation conditions. Overexpressing GmTDN1 enhanced photosynthetic and osmotic adjustment capacity, antioxidant metabolism, and root mass of wheat plants, compared to those of wild-type plants, by orchestrating the expression of a set of drought stress-related genes as well as the nitrate transporter, NRT2.5. Furthermore, transgenic wheat with overexpressed NRT2.5 can improve drought tolerance and nitrogen (N) absorption, suggesting that improving N absorption in GmTDN1 transgenic wheat may contribute to drought tolerance. These findings may lead to the development of new methodologies with the capacity to simultaneously improve drought tolerance and N-use efficacy in cereal crops to ensure sustainable agriculture and global food security.

Highly efficient and stable ZnO-based perovskite solar cells enabled by a self-assembled monolayer as the interface linker

2-TA and 3-TA were introduced for the first time on the surface of ZnO, and used as SAMs for interfacial modification. A highest PCE of 20.6% was achieved for 2-TA PSCs with improved energy alignment and perovskite film quality, and reduced defect density. The modified ZnO exhibited better thermostability of the perovskite and resultant device stability.

Case Report: A Huge Calabash Heart: A Rare Case of Supracardiac Total Anomalous Pulmonary Venous Return

A 46-year-old woman was admitted to the cardiovascular department because of a 3-month history of palpitations and exertional dyspnea. She had a history of a successful pregnancy at a very young age. The chest radiograph presented a “calabash” configuration. Echocardiogram discovered a large atrial septal defect with a suspected pulmonary vein abnormality. Cardiac CT revealed supracardiac total anomalous pulmonary venous return, whereby, all the pulmonary veins drain into a vertical vein and, finally, to the superior vena cava. Cardiac catheterization was consistent with anomalous pulmonary venous drainage without pulmonary hypertension. Finally, she underwent a successful surgical repair and appeared asymptomatic before her discharge.

Interferon Regulatory Factor 4 (IRF4) Promotes Lipopolysaccharide-Induced Colonic Mucosal Epithelial Cell Proliferation by Regulating Macrophage Polarization

INTRODUCTION

Ulcerative colitis (UC) is a chronic disease characterized by diffuse inflammation of the mucosa of colon and rectum. Interferon regulatory factor 4 (IRF4) mediates macrophage anti-inflammatory phenotype (alternatively activated macrophages [M2]). This study aimed to investigate the mechanism of IRF4 in lipopolysaccharide (LPS)-induced colonic mucosal epithelial cell proliferation via the regulation of macrophage polarization.

METHODS

Human bone marrow-derived macrophages were subjected to interleukin 4 (IL-4) induction. M2 macrophages were identified using flow cytometry and quantitative real-time polymerase chain reaction (qRT-PCR). IRF4 expression in M2 macrophages was detected using Western blot and qRT-PCR. IRF4 expression was silenced in M2 macrophages. IL-10 mRNA expression and protein level were detected using qRT-PCR and Western blot. The binding relation between IRF4 and IL-10 was verified using dual-luciferase and chromatin immunoprecipitation assays. Macrophages under different treatments were cocultured with LPS-induced human colonic mucosal epithelial cells. The levels of inflammatory factors (TNF-α, IL-6, and IL-1β) were detected using enzyme-linked immunosorbent assay. The proliferation of inflammatory cells was measured using Cell Counting Kit-8 assay, and the healing of inflammatory cells was detected using wound healing assay.

RESULTS

M2 macrophages alleviated LPS-induced inflammatory responses. IRF4 bound to IL-10 and promoted IL-10 expression. Inhibition of IRF4 reduced IL-10 expression and attenuated the alleviating effect of M2 macrophages on inflammatory responses. Inhibition of IRF4 combined with IL-10 overexpression enhanced the promoting effect of M2 macrophages on inflammatory healing.

CONCLUSION

IRF4 promoted colonic mucosal epithelial cell proliferation by increasing IL-10 expression and regulating macrophage polarization to M2 phenotype, which might be related to UC mucosal healing.

The Impact of Sanming Healthcare Reform on Antibiotic Appropriate Use in County Hospitals in China

Background

The excessive use of resources and poor quality of care are great concerns worldwide, particularly in China. In 2013, a model of systematic reforms was developed in Sanming to address the inefficiency and waste in public hospitals. However, limited empirical studies have evaluated the effect of Sanming healthcare reform on antibiotic appropriate use. This study aims to evaluate the impact of the healthcare reform on the appropriate use of antibiotics in county-level public hospitals in Sanming, China.

Methods

We conducted a retrospective observational study exploring trends in antibiotic use with an interrupted time series design. We selected three county-level hospitals in Sanming and extracted outpatient prescriptions of the Departments of Internal Medicine and the Department of Pediatrics between January 2011 and December 2017. Acute Upper Respiratory Tract Infection (AURI), Acute Bronchitis (AB) and Community Acquired Pneumonia (CAP) were selected as the sample diseases for our analysis. The primary outcome was the percentage of prescriptions conformed with standard treatment guidelines (STGs).

Results

A total of 142,180 prescriptions were included in the analysis. During the study period, the percentage of antibiotics prescriptions conformed with STGs boosted from 32.4% in 2011 to 82.3% in 2017. Moreover, after the reform, the rate of prescriptions that conformed with STGs showed significant increasing trends in children with AURI (β = 1.624, p < 0.001), children with AB (β = 3.123, p < 0.001), adult with AB (β = 1.665, p < 0.001), children with CAP (β = 3.123, p < 0.001), adult with CAP (β = 4.385, p < 0.001), but not in adult patients with AURI (β = −0.360, p = 0.022).

Conclusion

Our study confirmed that the Sanming healthcare reform helped to promote the appropriate use of antibiotics in county-level hospitals. This systematic approach to healthcare reform, characterized by an effective governance structure, dynamic financial compensation mechanisms, and specialized drug stewardship, is promising for future public hospital reforms.

Novel dopant-free hole transport materials enabling 20.9% efficiency in perovskite solar cells

Two novel donor-acceptor-donor (D-A-D) type dopant-free hole transport materials (HTMs), named BDD-T and BTT-T, were developed and applied in perovskite solar cells. An impressive power conversion efficiency (PCE) of 20.9% was acquired, which is one of the highest PCEs for D-A-D type dopant-free HTMs.

Computational approach to decode the mechanism of curcuminoids against neuropathic pain

BACKGROUND

Curcumin (CUR), demethoxycurcumin (DMC) and bisdemethoxycurcumin (BDMC) are the main components of turmeric that commonly used to treat neuropathic pain (NP). However, the mechanism of the therapy is not sufficiently clarified. Herein, network pharmacology, molecular docking and molecular dynamics (MD) approaches were used to investigate the mechanism of curcuminoids for NP treatment.

METHODS

Active targets of curcuminoids were obtained from the Swiss Target database, and NP-related targets were retrieved from GeneCards, OMIM, Drugbank and TTD databases. A protein-protein interaction (PPI) network was built to screen the core targets. Furthermore, DAVID was used for GO and KEGG pathway enrichment analyses. Interactions between potential targets and curcuminoids were assessed by molecular docking and the MD simulations were run for 100ns to validate the docking results on the top six complexes.

RESULTS

CUR, DMC, and BDMC had 100, 99 and 100 targets respectively. After overlapping with NP there were 33, 33 and 31 targets respectively. PPI network analysis of TOP 10 core targets, TNF, GSK3β were common targets of curcuminoids. Molecular docking and MD results indicated that curcuminoids bind strongly with the core targets. The GO and KEGG showed that curcuminoids regulated nitrogen metabolism, the serotonergic synapse and ErbB signaling pathway to alleviate NP. Furthermore, specific targets in these three compounds were also analysed at the same time.

CONCLUSIONS

This study systematically explored and compared the anti-NP mechanism of curcuminoids, providing a novel perspective for their utilization.

[Development and validation of a prognostic model based on SEER data for patients with esophageal carcinoma after esophagectomy]

OBJECTIVE

To develop a nomogram to predict the long-term survival of patients with esophageal cancer following esophagectomy.

METHODS

We collected the data of 7215 patients with esophageal carcinoma from the Surveillance, Epidemiology, and End Results (SEER) database during the period from 2004 and 2016. Of these patients, 5052 were allocated to the training cohort and the remaining 2163 patients to the internal validation cohort using bootstrap resampling, with another 435 patients treated in the Department of Cardiothoracic Surgery of Jinling Hospital between 2014 and 2016 serving as the external validation cohort.

RESULTS

In the overall cohort, the 1-, 3-, and 5-year cancer-specific mortality rates were 14.6%, 35.7% and 41.6%, respectively. Age (≥80 years vs < 50 years, P < 0.001), gender (male vs female, P < 0.001), tumor site (lower vs middle segment, P=0.013), histology (EAC vs ESCC, P=0.012), tumor grade (poorly vs well differentiated, P < 0.001), TNM stage (Ⅳ vs Ⅰ, P < 0.001), tumor size (> 50 mm vs 0-20 mm, P < 0.001), chemotherapy (yes vs no, P < 0.001), and LNR (> 0.25 vs 0, P < 0.001) were identified as independent risk factors affecting long-term survival of the patients. The nomograms established based on the model for predicting the survival probability of the patients at 1, 3 and 5 years after operation showed a C-index of 0.726 (95% CI: 0.714-0.738) for predicting the overall survival (OS) and of 0.735 (95% CI: 0.727-0.743) for cancer-specific survival (CSS) in the training cohort. In the internal validation cohort, the C-index of the nomograms was 0.752 (95% CI: 0.738-0.76) for OS and 0.804 (95% CI: 0.790-0.817) for CSS, as compared with 0.749 (95% CI: 0.736-0.767) and 0.788 (95%CI: 0.751-0.808), respectively, in the external validation cohort. The nomograms also showed a higher sensitivity than the TNM staging system for predicting long-term prognosis.

CONCLUSION

This prognostic model has a high prediction efficiency and can help to identify the high-risk patients with esophageal carcinoma after surgery and serve as a supplement for the current TNM staging system.

AB0784 Symptoms compatible with Rome IV functional bowel disorder in patients with ankylosing spondylitis

Background

Clinical manifestations of gut problems except for inflammatory bowel disease (IBD) have not been well-established in patients with ankylosing spondylitis (AS). One study investigated that 30% patients with axial spondyloarthritis (axSpA) had irritable bowel syndrome (IBS) symptoms meeting Rome III criteria.[1]

Objectives

To determine the frequency of symptoms meeting Rome IV functional bowel disorder (FBD) in patients with AS, investigate factors associated with FBD symptoms, and assess whether having FBD symptoms might influence AS disease activity.

Methods

In this cross-sectional study, we consecutively enrolled 153 AS patients without known colonic ulcer and 56 sex- and age-matched controls to evaluate FBD (or its subtypes) symptoms.[2] In AS group, logistic regression models were used to explore whether demographic data, disease activity, level of gut inflammation, drug use, and fibromyalgia [3] were associated with presence of gut symptoms. Finally, potential impacts of gut symptoms on AS disease status were assessed in linear regression models.

Results

Sixty (39.2%) of 153 AS patients had FBD symptoms, which was more prevalent than controls (23.2%). Besides, symptoms compatible with IBS and chronic diarrhea were detected in 18 and 43 AS patients respectively. For AS group, multivariable logistic regression analyses showed that symptoms of FBD, IBS, and chronic diarrhea were negatively associated with using non-steroidal anti-inflammatory drug (NSAID), and positively associated with comorbid fibromyalgia, respectively. In exploration about effects of FBD (or its subtypes) symptoms on AS disease activity by multivariable linear regression analyses, FBD symptoms and chronic diarrhea had positive associations with assessments of AS respectively.

Conclusion

Patients with AS had frequent symptoms compatible with FBD, IBS, and chronic diarrhea, proportions of which were lower in those with NSAID-use. The improvement of FBD symptoms, especially chronic diarrhea, might be conducive to disease status of AS patients.

References

[1]Wallman JK, et al. Ann Rheum Dis. 2020;79:159-61.

[2]Mearin F, et al. Gastroenterology. 2016;18:S0016-5085(16)00222-5.

[3]Wolfe F, et al. J Rheumatol. 2011;38:1113-22.

Figure 1.

Frequencies with symptoms meeting FBD criteria

Table 1.

Univariable and multivariable associations between gut symptoms and assessments of AS

Gut symptomsUnivariableMultivariableβpβpASDAS-CRPaFBD symptoms0.2340.1120.294< 0.001IBS symptoms0.0390.863Chronic diarrhea0.2170.1720.3010.002BASDAIbFBD symptoms0.747< 0.0010.764< 0.001IBS symptoms0.2020.560Chronic diarrhea0.7610.0020.845< 0.001BAS-GcFBD symptoms0.936< 0.0010.979< 0.001IBS symptoms0.0590.889Chronic diarrhea0.9030.0030.9490.001ASAS HIdFBD symptoms1.941< 0.0011.6730.003IBS symptoms2.2630.0081.7690.046Chronic diarrhea1.5000.0151.3430.030BASFIeFBD symptoms0.4330.0490.4280.048IBS symptoms0.2960.376Chronic diarrhea0.4480.0600.4250.069BASMIfFBD symptoms-0.3730.190-0.4930.075IBS symptoms-0.4420.304Chronic diarrhea-0.1790.564　　

Besides gut symptoms, other clinical variables (Block-1) being chosen into hierarchical multivariable models were as follows: aHLA-B27, lnCRP, and lnESR; bHLA-B27 and lnESR; cHLA-B27 and lnCRP; dsex and TNFi; eHLA-B27, lnESR, and TNFi; fage and lnESR. Missing data ranging from 1-7%.

Disclosure of Interests

None declared

Right-sided Mahaim-mediated tachycardia combined with atypical atrioventricular nodal reentrant tachycardia and left free wall accessory pathway: A case report

A 37-year-old man was admitted to our hospital with paroxysmal palpitation for half year. A previous electrogram showed a narrow complex tachycardia. Electrophysiologic study (EPS) found a concealed left-sided free wall pathway accessory. In addition, a transseptal approach was used for radiofrequency ablation. After successful ablation, EPS induced a wide complex tachycardia and a narrow complex tachycardia. The wide complex tachycardia was diagnosed as a right-sided Mahaim fiber atriofascicular accessory pathway, and the narrow complex tachycardia was diagnosed as atypical atrioventricular nodal reentrant tachycardia (AVNRT). Then, the right-sided Mahaim fiber atriofascicular accessory pathway and atypical AVNRT were successfully ablated. Herein, we report a rare case of a concealed left-sided accessory pathway combined with a right atriofascicular Mahaim fiber and atypical AVNRT.

Comparison of the Fungal Community, Chemical Composition, Antioxidant Activity, and Taste Characteristics of Fu Brick Tea in Different Regions of China

In this study, the fungal community structure, metabolites, antioxidant ability, and taste characteristics of five Fu brick tea (FBT) from different regions of China were determined and compared. A total of 69 operational taxonomic units (OTUs) were identified and assigned into 5 phyla and 27 genera, with Eurotium as the predominant genus in all samples. Hunan (HN) sample had the strongest fungal diversity and richness, followed by Guangxi (GX) sample, and Zhejiang (ZJ) sample had the lowest. GX sample had higher amounts of gallic acid (GA), total catechins, gallocatechin (GC), and epicatechin gallate (ECG) as well as antioxidant activity than the other samples. The levels of total phenolics, total flavonoids, epigallocatechin (EGC), catechin, epicatechin (EC), thearubigins (TRs), and theaflavins (TFs) were the highest in the ZJ sample. Guizhou (GZ) and Shaanxi (SX) samples contained the highest contents of epigallocatechin gallate (EGCG) and gallocatechin gallate (GCG), respectively. Total phenolics, GA, EC, CG, and TFs were positively associated with most of fungal genera. Total phenolic content (TPC), total flavonoid content (TFC), and most of catechins contributed to the antioxidant activities of FBT. HN sample had the strongest sourness and sweetness, ZJ sample had the strongest saltiness, SX sample had the strongest umami, and GZ sample had the strongest astringency, which was ascribed to the varied metabolites. This work reveals that FBT in different regions vary greatly in fungal community, metabolites, antioxidant activity, and taste characteristics, and provides new insight into the quality characteristics formation of FBT in different regions.

Investigating the severity of non-urban road traffic accidents in typical regions of Sichuan and Guizhou, China

OBJECTIVE

The traffic characteristics of Sichuan and Guizhou differ from those of other regions due to its unique geographical features. In addition, accident studies in China mainly focus on urban roads in the eastern and central regions. However, studies on western regions, especially non-urban roads, are scarce. Thus, this study aims to explore the factors that influence the severity of accidents on non-urban roads in typical regions of Sichuan and Guizhou.

METHODS

A total of 541 cases from 2014 to 2020 were selected from the database of the China In-Depth Accident Study, where 18 variables, which may exert an impact on accident severity, were extracted after screening. First, heterogeneity of data was eliminated through latent class analysis (LCA). The ordered probit (OP) model was then conducted for each class to obtain significant variables that exert an impact on accident severity. The study quantified the degree of influence of the significant variables using marginal effect analysis.

RESULTS

The LCA results demonstrate that data were categorized into the following classes, namely, (a) two-vehicle accidents involving trucks, (b) pedestrian and multiple-vehicle accidents, (c) two-wheeler accidents, and (d) single-vehicle accidents. The OP results show that most variables could exert impact on accident severity, and some of them exerted varying levels of influence on the severity of different classes, whereas others only influence a specific class.

CONCLUSION

According to this study, we obtained the accident characteristics of these regions and put forward some targeted suggestions to further improve the level of road traffic safety. The findings can provide support for the construction of transportation in line with the regional characteristics in China.

Inadvertent malposition of a permanent ventricular lead into the middle cardiac vein was misdiagnosed as lead perforation

A 54‐year‐old man had a dual‐chamber pacemaker implantation 9 years ago because of sick sinus syndrome at a different facility. The patient did not undergo any evaluation of his pacemaker for a long time with cardiologist. The patient was admitted to another hospital manifesting dyspnea and palpitation with atrial fibrillation for 1 month, and he was diagnosed with ventricular lead perforation. For further treatment, he was referred to our hospital, and an elective replacement indicator (ERI) of the battery state and a malpositioned ventricular lead into the middle cardiac vein were found. Finally, the pacing lead was left in the primary place and the pacemaker was replaced.

Ultrasmall Cu Nanocrystals Dispersed in Nitrogen-Doped Carbon as Highly Efficient Catalysts for CO2 Electroreduction

The electroreduction of carbon dioxide (CO₂) to a liquid product is a viable method for establishing an artificial carbon cycle. Unfortunately, most electrocatalysts' low efficiency and instability prevent them from being used in practical applications. In the current study, we developed ultrasmall Cu nanocrystals embedded in nitrogen-doped carbon nanosheets (Cu/NC-NSs) for selective CO₂ electroreduction by adjusting the potential. Cu/NC-NSs had 43.7 and 63.5% Faradaic efficiencies for the synthesis of ethanol and formate with applied potentials of -0.37 and -0.77 V vs reversible hydrogen electrode (RHE) using a flow cell architecture, respectively. Moreover, these Cu/NC-NSs show a steady catalytic performance up to 16 h. Density functional theory (DFT) calculations were performed to investigate the reaction mechanism. Furthermore, the synergistic effect formed by nitrogen-doped carbon and highly dispersed copper atoms led to their excellent performance in CO₂ electroreduction.

Morphometric analysis of the nasal septum in normal Chinese individuals using a three-dimensional model of the nasal septum with facial CT scanning

OBJECTIVES

Three-dimensional (3D) models were reconstructed based on computed tomography (CT) scan data and to analyze the morphometric characteristics of the nasal septum in Chinese individuals.

METHODS

Ninety-six healthy adults aged 20-83 years old without confirmed nasal disorders were enrolled in this study from 2014 to 2015. 3D models of the nasal septum were reconstructed based on their CT scan data, and 7 indices were used for the evaluation of the spacial structure of the nasal septum.

RESULTS

Data of the nasal septum revealed larger nasal septum volumes in males than those in females (P<0.01). The ratio of the cartilage volume to the total septal volume significantly decreased with age (P=0.010), whereas the ratio of the vomer volume to the total volume significantly increased with age (P=0.018). There were no significant correlations of the nasal septum with age (P=0.666) and gender (P=0.55).

CONCLUSIONS

The reconstructed 3D model of the nasal septum demonstrates that the septal volume was larger in males than in females, and the ratio of vomer volume and cartilage volume to total septal volume changed with age, which may provide a reference for clinical treatment.

The Effects of Migration and Limited Medical Resources of the Transmission of SARS-CoV-2 Model with Two Patches

The sudden outbreak of SARS-CoV-2 has caused the shortage of medical resources around the world, especially in developing countries and underdeveloped regions. With the continuous increase in the duration of this disease, the control of migration of humans between regions or countries has to be relaxed. Based on this, we propose a two-patches mathematical model to simulate the transmission of SARS-CoV-2 among two-patches, asymptomatic infected humans and symptomatic infected humans, where a half-saturated detection rate function is also introduced to describe the effect of medical resources. By applying the methods of linearization and constructing a suitable Lyapunov function, the local and global stability of the disease-free equilibrium of this model without migration is obtained. Further, the existence of forward/backward bifurcation is analyzed, which is caused by the limited medical resources. This means that the elimination or prevalence of the disease no longer depends on the basic reproduction number but is closely related to the initial state of asymptomatic and symptomatic infected humans and the supply of medical resources. Finally, the global dynamics of the full model are discussed, and some numerical simulations are carried to explain the main results and the effects of migration and supply of medical resources on the transmission of disease.

ZIF-8 derived defect-rich nitrogen-doped carbon with enhanced catalytic activity for efficient non-radical activation of peroxydisulfate

The non-radical oxidation processes of persulfate activation by carbon materials have shown great potential for industrial and saline wastewater treatment. Recently, metal-organic frameworks (MOFs) as an emerging precursor have been widely used for fabricating functional carbon materials. Herein, we reported ZIF-8 derived defect-rich nitrogen-doped carbon (ZCNs) via NaCl-assisted pyrolysis for efficient non-radical activation of peroxydisulfate to degrade rhodamine B (RB). All samples exhibited excellent catalytic activity, and ZCN-900 (pyrolyzed at 900 °C) was found to be the most active, able to degrade 96 % of RB quickly within 10 min. Quenching tests and electron paramagnetic resonance (EPR) analyses suggested that the singlet oxygen (¹O₂) dominated the degradation process by a non-radical pathway. Furthermore, the effect of anions and water quality on RB oxidation were investigated, and ZCN-900/PDS system showed great resistance to the anions and natural organic matters (NOM). This work may provide a significant addition to MOF-based functional materials for environmental remediation based on the results above.