DLP fabrication of customized porous bioceramics with osteoinduction ability for remote isolation bone regeneration

Currently, various bioceramics have been widely used in bone regeneration. However, it remains a huge challenge to remote isolation bone regeneration, such as severed finger regeneration. The remote isolation bone tissue has a poor regenerative microenvironment that lacks enough blood and nutrition supply. It is very difficult to repair and regenerate. In this study, well-controlled multi-level porous 3D-printed calcium phosphate (CaP) bioceramic scaffolds with precision customized structures were fabricated by high-resolution digital light projection (DLP) printing technology for remote isolation bone regeneration. In vitro results demonstrated that optimizing material processing procedures could achieve multi-level control of 3D-printed CaP bioceramic scaffolds and enhance the osteoinduction ability of bioceramics effectively. In vivo results indicated that 3D-printed CaP bioceramic scaffolds constructed by optimized processing procedure exhibited a promising ability of bone regeneration and osteoinduction in ectopic osteogenesis and in situ caudal vertebrae regeneration in beagles. This study provided a promising strategy based on 3D-printed CaP bioceramic scaffolds constructed by optimized processing procedures for remote isolation bone regeneration, such as severed finger regeneration.

CMTM6 overexpression confers trastuzumab resistance in HER2-positive breast cancer

Human epidermal growth factor receptor 2-positive (HER2+) breast cancer is characterized by invasive growth, rapid metastasis and chemoresistance. Trastuzumab is an effective treatment for HER2+ breast cancer; however, trastuzumab resistance leads to cancer relapse and metastasis. CKLF-like MARVEL transmembrane domain-containing 6 (CMTM6) has been considered as a new immune checkpoint for tumor-induced immunosuppression. The role of CMTM6 in trastuzumab resistance remains unknown. Here, we uncover a role of CMTM6 in trastuzumab-resistant HER2+ breast cancer. CMTM6 expression was upregulated in trastuzumab-resistant HER2+ breast cancer cell. Patients with high CMTM6 expressing HER2+ breast cancer had worse overall and progression-free survival than those with low CMTM6 expression. In vitro, CMTM6 knockdown inhibited the proliferation and migration of HER2+ breast cancer cells, and promoted their apoptosis, while CMTM6 overexpression reversed these effects. CMTM6 and HER2 proteins were co-localized on the surface of breast cancer cells, and CMTM6 silencing reduced HER2 protein levels in breast cancer cells. Co-immunoprecipitation revealed that CMTM6 directly interacted with HER2 in HER2+ breast cancer cells, and CMTM6 overexpression inhibited HER2 ubiquitination. Collectively, these findings highlight that CMTM6 stabilizes HER2 protein, contributing to trastuzumab resistance and implicate CMTM6 as a potential prognostic marker and therapeutic target for overcoming trastuzumab resistance in HER2+ breast cancer.

Surgical treatment and functional outcome of bilateral symmetrical hip dislocation and Pipkin type II femoral head fracture: a 5-year follow-up case report and literature review

Background

Bilateral posterior hip dislocation and femoral head fracture are rare injuries, which may be the earliest case report that focuses on treatment with open reduction via the direct anterior approach (DAA) for bilateral symmetrical Pipkin type II fracture within 5 years of the follow-up period.

Case report

We present a case of bilateral posterior dislocation with a femoral head fracture (Pipkin II) of the hip in 47-year-old woman caused by a high-velocity accident. The dislocation was successfully reduced under general anesthesia at a local hospital and transferred to a tertiary center for surgical management. She was surgically treated with internal fixation using three Herbert screws on the bilateral hips. The DAA was used during surgery. Follow-up for 5 years was performed, and functional outcomes were evaluated using the D'Aubigné range of motion and modified Harris hip score. The range of motion in the bilateral hip was satisfactory, with no signs of post-traumatic arthritis, heterotopic ossification, or avascular necrosis of the femoral head.

Conclusion

Surgical management of bilateral Pipkin type II fractures was performed successfully with open reduction and internal fixation using a safe and reliable direct anterior approach, with good functional outcomes at 5-year follow-up.

Laser Additive Manufacturing of TC4/AlSi12 Bimetallic Structure via Nb Interlayer

The TC4/AlSi12 bimetallic structures (BS) with Nb interlayer transition were fabricated by laser additive manufacturing (LAM). The results showed that the TC4/AlSi12 BS with Nb interlayer prepared with optimized process parameters can be divided into three regions (the TC4 region, Nb region and the AlSi12 region) and two interfaces (the TC4/Nb interface and the Nb/AlSi12 interface). The high melting point (Ti, Nb) solid solution formed in the Nb region acted as a diffusion barrier between the TC4 alloy and the AlSi12 alloy, thereby effectively inhibiting the formation of Ti-Al intermetallic compounds (IMCs). With the decrease of the laser output power for AlSi12 deposition, the NbAl₃ IMC changed from layered to dispersed distribution, while γ-TiAl and Ti₅Si₃ IMC disappeared, thus significantly reducing the crack susceptibility of the BS deposited layer. The tensile strength of TC4/AlSi12 BS with Nb interlayer was about 128MPa, and the fracture was located near the Nb/AlSi12 interface.

Exosomal miR-1304-3p promotes breast cancer progression in African Americans by activating cancer-associated adipocytes

Breast cancer displays disparities in mortality between African Americans and Caucasian Americans. However, the exact molecular mechanisms remain elusive. Here, we identify miR-1304-3p as the most upregulated microRNA in African American patients. Importantly, its expression significantly correlates with poor progression-free survival in African American patients. Ectopic expression of miR-1304 promotes tumor progression in vivo. Exosomal miR-1304-3p activates cancer-associated adipocytes that release lipids and enhance cancer cell growth. Moreover, we identify the anti-adipogenic gene GATA2 as the target of miR-1304-3p. Notably, a single nucleotide polymorphism (SNP) located in the miR-1304 stem-loop region shows a significant difference in frequencies of the G allele between African and Caucasian American groups, which promotes the maturation of miR-1304-3p. Therefore, our results reveal a mechanism of the disparity in breast cancer progression and suggest a potential utility of miR-1304-3p and the associated SNP as biomarkers for predicting the outcome of African American patients.

Five-Year Survivors from Brain Metastases Treated with Stereotactic Radiosurgery: Biology, Improving Treatments or Just Plain Luck?

Background

Improvements in therapies have led to an increasing number of long-term survivors of brain metastases. The present series compares a population of five-year survivors of brain metastases to a generalized brain metastases population to assess for factors attributable to long-term survival.

Methods

A single institution retrospective review was performed to identify five-year survivors of brain metastases who received stereotactic radiosurgery (SRS). A historical control population of 737 patients with brain metastases was used to assess similarities and differences between the long-term survivor population and the general population treated with SRS.

Results

98 patients with brain metastases were found to have survived over 60 months. No differences between long term survivors and controls were identified with regards to age at first SRS (P=0.19), primary cancer distribution (P=0.80), and number of metastases at first SRS (P=0.90). Cumulative incidence of neurologic death at six, eight and ten years for the long-term survivor cohort was 4.8%, 16%, and 16% respectively. In the historical controls, cumulative incidence of neurologic death reached a plateau at 40% after 4.9 years. A significant difference in the distribution of burden of disease at the time of first SRS was found between the five-year survivors and the control (P=0.0049). 58% of five-year survivors showed no evidence of clinical disease at the last follow-up.

Conclusion

Five-year survivors of brain metastases represent a diverse histologic population, suggesting a small population of oligometastatic and indolent cancers exist for each cancer type.

Intraoperative Intravenous Infusion of Esmketamine Has Opioid-Sparing Effect and Improves the Quality of Recovery in Patients Undergoing Thoracic Surgery: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

BACKGROUND

Postoperative thoracic surgery is often accompanied by severe pain, and opioids are a cornerstone of postoperative pain management, but their use may be limited by many adverse events. Several studies have shown that the perioperative application of esketamine adjuvant therapy can reduce postoperative opioid consumption. However, whether esketamine has an opioid-sparing effect after thoracic surgery is unclear.

OBJECTIVES

To explore the opioid-sparing effect of different doses of esketamine infusion during thoracic surgery and its impact on patient recovery.

STUDY DESIGN

Randomized controlled study.

SETTING

A single-center study with a total of 120 patients.

METHODS

Patients were randomly allocated to 1 or 3 groups receiving intraoperative intravenous infusions of esketamine 0.15 mg · kg-1· h-1 (group K1), esketamine 0.25 mg · kg-1· h-1(group K2), or placebo (group C). Postoperative opioid consumption, and postoperative indicators like extubation time, PACU stay time, and adverse events were recorded for each group.

RESULTS

The consumption of hydromorphone during the first 24 and 48 postoperative hours was significantly reduced in patients of group K2 compared to those of group C and group K1. The time to extubation and post anesthesia care unit (PACU) stay were significantly shorter in group K2 than in group K1 and group C. The time to first feed and off the bed time after surgery were shorter in groups K1 and K2 than in group C. Patients in group K2 were significantly satisfied with patient controlled intravenous analgesia (PCIA) than in groups K1 and C.

LIMITATIONS

The sample size calculation was based mainly on the index of hydromorphone consumption.

CONCLUSIONS

Intraoperative intravenous esketamine at 0.25 mg · kg-1 · h-1 reduced postoperative opioids consumption by 34% in postoperative 24 hours and 30% in postoperative 48 hours in patients undergoing thoracic surgery. It also improved the quality of perioperative recovery.

Large-Scale Integrated Flexible Tactile Sensor Array for Sensitive Smart Robotic Touch

In the long pursuit of smart robotics, it has been envisioned to empower robots with human-like senses, especially vision and touch. While tremendous progress has been made in image sensors and computer vision over the past decades, tactile sense abilities are lagging behind due to the lack of large-scale flexible tactile sensor array with high sensitivity, high spatial resolution, and fast response. In this work, we have demonstrated a 64 × 64 flexible tactile sensor array with a record-high spatial resolution of 0.9 mm (equivalently 28.2 pixels per inch) by integrating a high-performance piezoresistive film (PRF) with a large-area active matrix of carbon nanotube thin-film transistors. PRF with self-formed microstructures exhibited high pressure-sensitivity of ∼385 kPa^-1 for multi-walled carbon nanotubes concentration of 6%, while the 14% one exhibited fast response time of ∼3 ms, good linearity, broad detection range beyond 1400 kPa, and excellent cyclability over 3000 cycles. Using this fully integrated tactile sensor array, the footprint maps of an artificial honeybee were clearly identified. Furthermore, we hardware-implemented a smart tactile system by integrating the PRF-based sensor array with a memristor-based computing-in-memory chip to record and recognize handwritten digits and Chinese calligraphy, achieving high classification accuracies of 98.8% and 97.3% in hardware, respectively. The integration of sensor networks with deep learning hardware may enable edge or near-sensor computing with significantly reduced power consumption and latency. Our work could empower the building of large-scale intelligent sensor networks for next-generation smart robotics.

Dual-pixel tracking of the fast-moving target based on window complementary modulation

Real-time tracking of fast-moving targets has been utilized in various fields. However, the tracking performance of image-based systems for fast-moving targets is still limited by the huge data throughput and computation. In this study, an image-free target tracking system utilizing a digital micromirror device (DMD) is proposed. The proposed system effectively combines the dual-pixel measurement and window complementary modulation, and the alternating interpolation Kalman filter is implemented to fully use the performance of the DMD and maximize the update rate of the system. The accuracy of the proposed system at the maximum update rate of 22.2 kHz can achieve 0.1 pixels according to the experimental results. Meanwhile, we experimentally demonstrated that the accuracy of the proposed image-free target tracking system is within 0.3 pixels at a maximal velocity of 2 × 10⁴ pixel/s at 22.2 kHz by evaluating the performance of the proposed image-free target tracking system when tracking fast-moving targets with different maximal velocity.

A novel signature model based on mitochondrial-related genes for predicting survival of colon adenocarcinoma

Background

Colon cancer is the foremost reason of cancer-related mortality worldwide. Colon adenocarcinoma constitutes 90% of colon cancer, and most patients with colon adenocarcinoma (COAD) are identified until advanced stage. With the emergence of an increasing number of novel pathogenic mechanisms and treatments, the role of mitochondria in the development of cancer, has been studied and reported with increasing frequency.

Methods

We systematically analyzed the effect of mitochondria-related genes in COAD utilizing RNA sequencing dataset from The Cancer Genome Atlas database and 1613 mitochondrial function-related genes from MitoMiner database. Our approach consisted of differentially expressed gene, gene set enrichment analysis, gene ontology terminology, Kyoto Encyclopedia of Genes and Genomes, independent prognostic analysis, univariate and multivariate analysis, Kaplan–Meier survival analysis, immune microenvironment correlation analysis, and Cox regression analysis.

Results

Consequently, 8 genes were identified to construct 8 mitochondrial-related gene model by applying Cox regression analysis, CDC25C, KCNJ11, NOL3, P4HA1, QSOX2, Trap1, DNAJC28, and ATCAY. Meanwhile, we assessed the connection between this model and clinical parameters or immune microenvironment. Risk score was an independent predictor for COAD patients’ survival with an AUC of 0.687, 0.752 and 0.762 at 1-, 3- and 5-year in nomogram, respectively. The group with the highest risk score had the lowest survival rate and the worst clinical stages. Additionally, its predictive capacity was validated in GSE39582 cohort.

Conclusion

In summary, we established a prognostic pattern of mitochondrial-related genes, which can predict overall survival in COAD, which may enable a more optimized approach for the clinical treatment and scientific study of COAD. This gene signature model has the potential to improve prognosis and treatment for COAD patients in the future, and to be widely implemented in clinical settings. The utilization of this mitochondrial-related gene signature model may be benefit in the treatments and medical decision-making of COAD.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12911-022-02020-3.

Temperature Dependence of Electrical Resistance in Carbon Nanotube Composite Film during Curing Process

Carbon nanotube (CNT) film possesses excellent mechanical and piezoresistivity, which may act as a sensor for process monitoring and reinforcement of the final composite. This paper prepared CNT/epoxy composite film via the solution dipping method and investigated the electrical resistance variation (ΔR/R₀) of CNT/epoxy composite film during the curing process. The temperature dependence of electrical resistance was found to be closely related to resin rheological properties, thermal expansion, and curing shrinkage. The results show that two opposing effects on electrical resistivity occur at the initial heating stage, including thermal expansion and condensation caused by the wetting tension of the liquid resin. The lower resin content causes more apparent secondary impregnation and electrical resistivity change. When the resin viscosity remains steady during the heating stage, the electrical resistance increases with an increase in temperature due to thermal expansion. Approaching gel time, the electrical resistance drops due to the crosslink shrinkage of epoxy resin. The internal stress caused by curing shrinkage at the high-temperature platform results in an increase in electrical resistance. The temperature coefficient of resistance becomes larger with an increase in resin content. At the isothermal stage, an increase in ΔR/R₀ value becomes less obvious with a decrease in resin content, and ΔR/R₀ even shows a decreasing tendency.

Three-dimensional printed polylactic acid and hydroxyapatite composite scaffold with urine-derived stem cells as a treatment for bone defects

Bone defects still pose various challenges in osteology. As one treatment method for bone defects, tissue engineering requires biomaterials with good biocompatibility and stem cells with good differentiation. This study aimed to fabricate a 3D-printed polylactic acid and hydroxyapatite (PLA/HA) composite scaffold with urine-derived stem cells (USCs) to study its therapeutic effect in a rat model of skull defects. USCs were isolated and extracted from the urine of healthy adult males and inoculated onto PLA/HA and PLA scaffolds fabricated by 3D printing technology. A total of 36 skull defect models in eighteen Sprague-Dawley rats were randomly divided into a control group (no treatment of the defects), PLA group (treated with PLA scaffolds with USCs), and PLA/HA group (treated with PLA/HA scaffolds with USCs). The therapeutic efficacy was evaluated by real-time PCR, microcomputed tomography (micro-CT), and immunohistochemistry at 4, 8, and 12 weeks. We found that the PLA/HA scaffold loaded with USCs effectively promoted new bone regeneration in the defect area. CT images showed that in the PLA/HA group, the defect area was almost entirely covered by newly formed bone (coverage of 96.7 ± 1.6%), and the coverage was greater than that in the PLA group (coverage of 74.6 ± 1.9%) at 12 weeks. Histology and immunohistochemical staining showed the highest new bone formation on the PLA/HA scaffolds containing USCs in the defect site at 12 weeks. These findings demonstrate the broad application prospects of PLA/HA scaffolds with USCs in bone tissue engineering. Graphical abstract.

Verification of the Protective Effects of Poplar Phenolic Compounds Against Poplar Anthracnose

Poplar anthracnose caused by Colletotrichum gloeosporioides is one of the most important diseases widely distributed in poplar-growing areas in China, causing serious economic and ecological losses. In this study, three poplar species showed different resistance to poplar anthracnose: Populus × canadensis was resistant, Populus tomentosa was susceptible, and P. × beijingensis showed intermediate resistance. However, it remains uncertain whether phenolic compounds in poplar are involved in this resistance. Therefore, we determined the concentrations of phenolic compounds and their antifungal activity. Before and after the C. gloeosporioides inoculation, 20 phenolic compounds were detected in P. × canadensis and the number increased from 12 to 14 in P. × beijingensis but decreased from seven to four in P. tomentosa. Thus, phenolic compounds may be positively correlated with the degree of disease resistance. We selected seven phenolic compounds for further analysis, which varied considerably in content after inoculation with C. gloeosporioides. These seven compounds were salicin, arbutin, benzoic acid, salicylic acid, chlorogenic acid, ferulic acid, and naringenin, which helped poplar trees to limit the growth of C. gloeosporioides and differed in their antifungal effects, with phenolic acids having the strongest inhibitory effect. In addition, the optimal concentrations of different substances varied. We demonstrate that these phenolic compounds produced by poplar do play a certain role in the process of poplar resistance to anthracnose. These findings lay a foundation for future research into the antifungal mechanism of poplar trees and may be useful for enhancing the prevention and control of poplar anthracnose.

Efficacy and safety of tranexamic acid for patients with intertrochanteric fractures treated with intramedullary fixation: A systematic review and meta-analysis of current evidence in randomized controlled trials

Background: Tranexamic acid (TXA) has been widely applied to reduce perioperative bleeding. Recently, several studies focused on the administration of TXA in the treatment for with intertrochanteric fracture patients treated with intramedullary fixation. However, the efficacy and safety of TXA in these studies remain controversial. Therefore, we performed this systematic review and meta-analysis to investigate the efficacy and safety of TXA in intertrochanteric fracture patients treated with intramedullary fixation.

Methods: We systematically searched electronic databases, including Cochrane, PubMed, and EMBASE, up to 16 May 2022. The efficacy and safety of TXA was evaluated in four aspects, which were bleeding-related outcomes, non-bleeding-related outcomes, thromboembolic events, and other complications. The outcomes of these studies were extracted and analyzed by RevMan Manager 5.4.

Results: Finally, nine randomized controlled trials, involving nine hundred and seventy-two intertrochanteric fracture patients treated with TXA, were enrolled in this study. In the bleeding-related outcomes, TXA group was significantly lower than the control group in terms of total blood loss (MD = −219.42; 95% CI, −299.80 to −139.03; p < 0.001), intraoperative blood loss (MD = −36.81; 95% CI, −54.21 to −19.41; p < 0.001), hidden blood loss (MD = −189.23; 95% CI, −274.92 to −103.54; p < 0.001), and transfusion rate (RR = 0.64; 95% CI, 0.49 to 0.85; p = 0.002). Moreover, the postoperative hemoglobin on day 3 of the TXA group was significantly higher than that of the control group (MD = 5.75; 95% CI, 1.26 to 10.23; p = 0.01). In the non-bleeding-related outcomes, the length of hospital stays was significantly shorter in the TXA group (MD = −0.67; 95% CI, −1.12 to −0.23; p = 0.003). In terms of thromboembolic events, there was no significant differences between the TXA group and control group in deep vein thrombosis, pulmonary embolism, myocardial infarction, and ischemic stroke. As for complications and mortality, there was no significant differences between the TXA group and control group in respiratory infection, renal failure, and postoperative mortality within 1 year.

Conclusion: TXA is an effective and safe drug for perioperative bleeding control in intertrochanteric fracture patients treated with intramedullary fixation. However, the long-term efficacy of TXA still needs to be investigated by large-scale multicenter randomized controlled trials.

Level of evidence: II, Systematic review and Meta-analysis.

Systematic Review Registration:https://inplasy.com/, identifier [INPLASY202280027]

Optical Biosensor Based on Graphene and Its Derivatives for Detecting Biomolecules

Graphene and its derivatives show great potential for biosensing due to their extraordinary optical, electrical and physical properties. In particular, graphene and its derivatives have excellent optical properties such as broadband and tunable absorption, fluorescence bursts, and strong polarization-related effects. Optical biosensors based on graphene and its derivatives make nondestructive detection of biomolecules possible. The focus of this paper is to review the preparation of graphene and its derivatives, as well as recent advances in optical biosensors based on graphene and its derivatives. The working principle of face plasmon resonance (SPR), surface-enhanced Raman spectroscopy (SERS), fluorescence resonance energy transfer (FRET) and colorimetric sensors are summarized, and the advantages and disadvantages of graphene and its derivatives applicable to various types of sensors are analyzed, and the methods of surface functionalization of graphene and its derivatives are introduced; these optical biosensors can be used for the detection of a range of biomolecules such as single cells, cellular secretions, proteins, nucleic acids, and antigen-antibodies; these new high-performance optical sensors are capable of detecting changes in surface structure and biomolecular interactions with the advantages of ultra-fast detection, high sensitivity, label-free, specific recognition, and the ability to respond in real-time. Problems in the current stage of application are discussed, as well as future prospects for graphene and its biosensors. Achieving the applicability, reusability and low cost of novel optical biosensors for a variety of complex environments and achieving scale-up production, which still faces serious challenges.

Preparation and Characterization of 3D Printed Porous 45S5 Bioglass Bioceramic for Bone Tissue Engineering Application

Three-dimensional (3D) printing technology provides advanced technical support for designing personalized bone tissue engineering scaffold. In this study, two porous diffusing models, namely, average and layered perforated cylindrical scaffolds, were designed for bone tissue engineering scaffold. The designed models were fabricated by liquid crystal display mask stereolithography printing. Structural design and finite element mechanical analysis were conducted. 45S5 bioglass was selected as the raw material for preparing the printing inks for bone tissue engineering scaffolds. By adjusting the viscosity and temperature of the slurry, the maximum proportion of 45S5 bioglass (40 wt%) was added into the photosensitive resin for preparing 3D printing slurry. Our results indicated that an optimized sintering condition includes the debinding rate (0.5°C/min), and temperature raising rate (5°C/min) and sintering temperature (1100°C) were proposed to sinter 45S5 bioceramic scaffolds. The amorphous 45S5 bioglass showed good crystallization after sintering, and the scaffold porous structure showed good integrity. Micropores were observed in the struts which interconnected with each other. Moreover, the porosities were tested as 57% and 45% with a uniform pore distribution. The shrinkage rate was about 10% during sintering process due to binder burning and crystallization shrinkage. The compressive strength of the sintered scaffold was 0.71 ± 0.048 MPa and 2.13 ± 0.054 MPa, respectively, which are consistent with the finite element mechanical analysis simulation results. In conclusion, the layered perforated 45S5 bioglass scaffold shows good mechanical properties and porosity, indicating that it could be a promising candidate for bone tissue engineering.

Sleep deprivation and recovery sleep affect healthy male resident’s pain sensitivity and oxidative stress markers: The medial prefrontal cortex may play a role in sleep deprivation model

Sleep is essential for the body’s repair and recovery, including supplementation with antioxidants to maintain the balance of the body’s redox state. Changes in sleep patterns have been reported to alter this repair function, leading to changes in disease susceptibility or behavior. Here, we recruited healthy male physicians and measured the extent of the effect of overnight sleep deprivation (SD) and recovery sleep (RS) on nociceptive thresholds and systemic (plasma-derived) redox metabolism, namely, the major antioxidants glutathione (GSH), catalase (CAT), malondialdehyde (MDA), and superoxide dismutase (SOD). Twenty subjects underwent morning measurements before and after overnight total SD and RS. We found that one night of SD can lead to increased nociceptive hypersensitivity and the pain scores of the Numerical Rating Scale (NRS) and that one night of RS can reverse this change. Pre- and post-SD biochemical assays showed an increase in MDA levels and CAT activity and a decrease in GSH levels and SOD activity after overnight SD. Biochemical assays before and after RS showed a partial recovery of MDA levels and a basic recovery of CAT activity to baseline levels. An animal study showed that SD can cause a significant decrease in the paw withdrawal threshold and paw withdrawal latency in rats, and after 4 days of unrestricted sleep, pain thresholds can be restored to normal. We performed proteomics in the rat medial prefrontal cortex (mPFC) and showed that 37 proteins were significantly altered after 6 days of SD. Current findings showed that SD causes nociceptive hyperalgesia and oxidative stress, and RS can restore pain thresholds and repair oxidative stress damage in the body. However, one night of RS is not enough for repairing oxidative stress damage in the human body.

FGFR1/MAPK-directed brachyury activation drives PD-L1-mediated immune evasion to promote lung cancer progression

Immune checkpoint inhibitors provide promising benefits for patients with cancer. However, efficacy has been encumbered by high resistance rates. It is critical to understand the basic mechanisms of tumor-mediated resistance to this treatment modality. Previous studies have found that the transcription factor brachyury is highly expressed in lung cancer. Here, we show that brachyury activation induces the upregulation of PD-L1 leading to inactivation of T cell proliferation in vitro and inhibited infiltration of CD8⁺ and CD3⁺ T cells into tumor in an immunocompetent mouse model. We further demonstrate that FGFR1/MAPK activation regulates brachyury and PD-L1 expressions and promotes immunosuppression. Blocking FGFR1/MAPK suppresses brachyury and PD-L1 expressions, revives immune activity, and reverses the resistance to anti-PD-1 treatment to produce a durable therapeutic response. We also find that lung cancer patients with high activation of the FGFR1-MAPK-brachyury-PD-L1 signature and low expression of CD8A, CD3D, or PDCD1 have worse survival outcomes. These findings elucidate a novel mechanism of immune escape from immune checkpoint therapy and provide an opportunity to enhance its therapeutic efficacy in the treatment of a subset of FGFR1/MAPK/brachyury/PD-L1-driven lung cancer.

Role of intraoperative patients positioning in endoscopic full-thickness resection of large gastric tumors under general anesthesia

Full thickness endoscopic resection of large submucosal gastric tumors (>3 cm) is a big challenge for endoscopists. Issues include how to efficiently resect the lesion, obtain homeostasis, and suture the defect. There are no guidelines regarding the importance of patient position on the success of endoscopic resections in anesthetized patients. Typically, the patient is placed in left lateral position for the endoscopic therapy and during the procedure patient’s position is changed to maintain the tumor above the gastric fluids to prevent gastric juices and tumor or tumor fragments from falling into the peritoneal cavity in the event of perforation. This study emphasized the importance of planning the procedure to ensure that the patient’s position and anesthetist’s concerns are met and allow optimal access to the lesion for endoscopic resection. Prior to sedation the patient should be positioned so that the tumor is in the up position which also prevents blood obscuring the operative field, helps detect bleeding points for immediately hemostasis. In addition, due to gravitational effect, the resected tumor will fall into the gastric cavity exposing the root of the tumor making resection easier and reduce procedure time. Preplanning avoids unnecessary readjustment of positioning and improves the ease and safety of the procedure.

Breast cancer extracellular vesicles-derived miR-1290 activates astrocytes in the brain metastatic microenvironment via the FOXA2→CNTF axis to promote progression of brain metastases

Mechanisms underlying breast cancer brain metastasis (BCBM) are still unclear. In this study, we observed that extracellular vesicles (EVs) secreted from breast cancer cells with increased expression of tGLI1, a BCBM-promoting transcription factor, strongly activated astrocytes. EV-derived microRNA/miRNA microarray revealed tGLI1-positive breast cancer cells highly secreted miR-1290 and miR-1246 encapsulated in EVs. Genetic knockin/knockout studies established a direct link between tGLI1 and both miRNAs. Datamining and analysis of patient samples revealed that BCBM patients had more circulating EV-miRs-1290/1246 than those without metastasis. Ectopic expression of miR-1290 or miR-1246 strongly activated astrocytes whereas their inhibitors abrogated the effect. Conditioned media from miR-1290- or miR-1246-overexpressing astrocytes promoted mammospheres. Furthermore, miRs-1290/1246 suppressed expression of FOXA2 transcription repressor, leading to CNTF cytokine secretion and subsequent activation of astrocytes. Finally, we conducted a mouse study to demonstrate that astrocytes overexpressing miR-1290, but not miR-1246, enhanced intracranial colonization and growth of breast cancer cells. Collectively, our findings demonstrate, for the first time, that breast cancer EV-derived miR-1290 and miR-1246 activate astrocytes in the brain metastatic microenvironment and that EV-derived miR-1290 promotes progression of brain metastases through the novel EV-miR-1290→FOXA2→CNTF signaling axis.