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Liu L, Guo Y, Lei I, Tian S, Gao W, Wang Z. Abstract P324: Brd4 Degradation Enhances Cardiac Reprogramming And Regeneration By Inhibiting JAK/STAT Pathway. Circ Res 2021. [DOI: 10.1161/res.129.suppl_1.p324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Reprogramming of fibroblasts into induced cardiomyocytes (iCMs) is a potentially promising strategy for regenerating a damaged heart. However, low conversion rate of fibroblasts to cardiomyocytes and poor in vivo application efficacy are major challenges in this reprogramming process. To address this issue, we attempted to identify small molecules related to histone acyl post-translational modifications that could enhance the reprogramming ability towards cardiac fate. Using α-muscle heavy chain-GFP-tagged mouse embryo fibroblasts as a starting cell type, we screened 46 inhibitors target histone acyl post-translational modifications and related epigenetic factors and identified an important role of Brd4 in modulating iCM reprogramming. In particular, we observed that a novel Brd4 degrader repressed many genes involved in immune responses especially JAK/STAT pathway. Mechanically, Brd4 degrader repressed JAK/STAT related gene expressions by affecting Brd4 binding to promoters of those genes. More importantly, Brd4 degrader treatment enhanced MGT induced cardiac regeneration in vivo and markedly improved myocardial performance after myocardial infarction. These findings shed new light on the molecular mechanisms underlying the cardiac conversion of fibroblasts and provide novel targets and small molecules to improve iCM reprogramming for clinical applications.
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Bois F, Tebby C, Gao W, Johannes Delp J, Carta G, van der Stel W, Leist M, Jennings P, van de Water B. Quantitative Bayesian Network Analyses of Mitochondrial Toxicity. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00303-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Zu J, Hu G, Peng D, Xie S, Gao W. Fair Scheduling and Rate Control for Service Function Chain in NFV Enabled Data Center. IEEE TRANSACTIONS ON NETWORK AND SERVICE MANAGEMENT 2021. [DOI: 10.1109/tnsm.2021.3070331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Freedland S, Sandin R, Tagawa S, Klaassen Z, Bitting R, Ramaswamy K, Emir B, Bland C, Hong A, Yang H, Gao W, Song W, George D. 609P Treatment patterns and overall survival (OS) in metastatic castration-sensitive prostate cancer (mCSPC) from 2006 to 2019. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Wikholm C, Ahmad A, Gao W, Vangimalla S, Pasieka H. LB758 Erythema nodosum in Crohn’s Disease is associated with lower risk of enteritis and surgery: A nationwide inpatient study. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.07.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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George D, Agarwal N, Ramaswamy K, Sandin R, Russell D, Hong A, Yang H, Gao W, Hagan K, Freedland S. 616P Real-world utilization of advanced therapies by metastatic site and age among patients with metastatic castration-sensitive prostate cancer (mCSPC): A Medicare database analysis. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Wikholm C, Gao W, Ahmad A, Vangimalla S, Pasieka H. LB757 Hospitalization for Chediak-Higashi Syndrome: A national inpatient sample analysis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.07.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cao Z, Aharonian F, An Q, Bai LX, Bai YX, Bao YW, Bastieri D, Bi XJ, Bi YJ, Cai H, Cai JT, Cao Z, Chang J, Chang JF, Chen BM, Chen ES, Chen J, Chen L, Chen L, Chen L, Chen MJ, Chen ML, Chen QH, Chen SH, Chen SZ, Chen TL, Chen XL, Chen Y, Cheng N, Cheng YD, Cui SW, Cui XH, Cui YD, D'Ettorre Piazzoli B, Dai BZ, Dai HL, Dai ZG, Della Volpe D, Dong XJ, Duan KK, Fan JH, Fan YZ, Fan ZX, Fang J, Fang K, Feng CF, Feng L, Feng SH, Feng YL, Gao B, Gao CD, Gao LQ, Gao Q, Gao W, Ge MM, Geng LS, Gong GH, Gou QB, Gu MH, Guo FL, Guo JG, Guo XL, Guo YQ, Guo YY, Han YA, He HH, He HN, He JC, He SL, He XB, He Y, Heller M, Hor YK, Hou C, Hou X, Hu HB, Hu S, Hu SC, Hu XJ, Huang DH, Huang QL, Huang WH, Huang XT, Huang XY, Huang ZC, Ji F, Ji XL, Jia HY, Jiang K, Jiang ZJ, Jin C, Ke T, Kuleshov D, Levochkin K, Li BB, Li C, Li C, Li F, Li HB, Li HC, Li HY, Li J, Li J, Li K, Li WL, Li XR, Li X, Li X, Li Y, Li YZ, Li Z, Li Z, Liang EW, Liang YF, Lin SJ, Liu B, Liu C, Liu D, Liu H, Liu HD, Liu J, Liu JL, Liu JS, Liu JY, Liu MY, Liu RY, Liu SM, Liu W, Liu Y, Liu YN, Liu ZX, Long WJ, Lu R, Lv HK, Ma BQ, Ma LL, Ma XH, Mao JR, Masood A, Min Z, Mitthumsiri W, Montaruli T, Nan YC, Pang BY, Pattarakijwanich P, Pei ZY, Qi MY, Qi YQ, Qiao BQ, Qin JJ, Ruffolo D, Rulev V, Saiz A, Shao L, Shchegolev O, Sheng XD, Shi JY, Song HC, Stenkin YV, Stepanov V, Su Y, Sun QN, Sun XN, Sun ZB, Tam PHT, Tang ZB, Tian WW, Wang BD, Wang C, Wang H, Wang HG, Wang JC, Wang JS, Wang LP, Wang LY, Wang RN, Wang W, Wang W, Wang XG, Wang XJ, Wang XY, Wang Y, Wang YD, Wang YJ, Wang YP, Wang ZH, Wang ZX, Wang Z, Wang Z, Wei DM, Wei JJ, Wei YJ, Wen T, Wu CY, Wu HR, Wu S, Wu WX, Wu XF, Xi SQ, Xia J, Xia JJ, Xiang GM, Xiao DX, Xiao G, Xiao HB, Xin GG, Xin YL, Xing Y, Xu DL, Xu RX, Xue L, Yan DH, Yan JZ, Yang CW, Yang FF, Yang JY, Yang LL, Yang MJ, Yang RZ, Yang SB, Yao YH, Yao ZG, Ye YM, Yin LQ, Yin N, You XH, You ZY, Yu YH, Yuan Q, Zeng HD, Zeng TX, Zeng W, Zeng ZK, Zha M, Zhai XX, Zhang BB, Zhang HM, Zhang HY, Zhang JL, Zhang JW, Zhang LX, Zhang L, Zhang L, Zhang PF, Zhang PP, Zhang R, Zhang SR, Zhang SS, Zhang X, Zhang XP, Zhang YF, Zhang YL, Zhang Y, Zhang Y, Zhao B, Zhao J, Zhao L, Zhao LZ, Zhao SP, Zheng F, Zheng Y, Zhou B, Zhou H, Zhou JN, Zhou P, Zhou R, Zhou XX, Zhu CG, Zhu FR, Zhu H, Zhu KJ, Zuo X. Peta-electron volt gamma-ray emission from the Crab Nebula. Science 2021; 373:425-430. [PMID: 34261813 DOI: 10.1126/science.abg5137] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 06/23/2021] [Indexed: 11/03/2022]
Abstract
The Crab Nebula is a bright source of gamma rays powered by the Crab Pulsar's rotational energy through the formation and termination of a relativistic electron-positron wind. We report the detection of gamma rays from this source with energies from 5 × 10-4 to 1.1 peta-electron volts with a spectrum showing gradual steepening over three energy decades. The ultrahigh-energy photons imply the presence of a peta-electron volt electron accelerator (a pevatron) in the nebula, with an acceleration rate exceeding 15% of the theoretical limit. We constrain the pevatron's size between 0.025 and 0.1 parsecs and the magnetic field to ≈110 microgauss. The production rate of peta-electron volt electrons, 2.5 × 1036 ergs per second, constitutes 0.5% of the pulsar spin-down luminosity, although we cannot exclude a contribution of peta-electron volt protons to the production of the highest-energy gamma rays.
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Xu LL, Gao W, Chen ZM, Shao KK, Wang YG, -L Cui L, Guo NZ. Relationships between diabetic nephropathy and insulin resistance, inflammation, Trx, Txnip, CysC and serum complement levels. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2021; 24:11700-11706. [PMID: 33275238 DOI: 10.26355/eurrev_202011_23815] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To investigate the relationships between diabetic nephropathy (DN) and insulin resistance, inflammation, thioredoxin (Trx), thioredoxin-interacting protein (Txnip), Cystatin C (CysC) and serum complement levels. PATIENTS AND METHODS A total of 119 patients with type 2 diabetes mellitus (T2DM) treated in the Endocrinology Department of our hospital from January 2017 to December 2017 were enrolled as the experiment group, while 30 healthy volunteers were selected as the control group. The expression levels of inflammatory factors, Trx, Txnip, CysC and serum complements in every subject were detected. In addition, the type 2 diabetic nephropathy rat model was established via high-fat diet and injection of low-dose streptozotocin. Blood glucose, insulin resistance indexes and 24h-urinary albumin excretion were measured, and the histomorphological characteristics of the kidney in animals were observed. RESULTS In clinical subjects, Trx level was notably lower in the simple DM group, early DN group and clinical DN group in comparison with that in the control group. The levels of Txnip and CysC in the simple DM group, early DN group and clinical DN group were remarkably higher than those in the control group. Moreover, the expression levels of TNF-α and IL-6 in the clinical DN group were significantly elevated compared with those in the simple DM group and early DN group. In addition, C1q expression in the clinical DN group was higher than that in the simple DM group and early DN group. In model rats, HOMA-IR was distinctly higher in the DM group and DN group than that in the control group. The ratio of kidney weight to body weight (KW/BW) was evidently higher in the DN group in comparison with that in the control group and DM group. CONCLUSIONS Insulin resistance, inflammatory factors, and levels of Trx, Txnip, CysC and serum complement C1q are related to the progression of DM.
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Aharonian F, An Q, Bai LX, Bai YX, Bao YW, Bastieri D, Bi XJ, Bi YJ, Cai H, Cai JT, Cao Z, Cao Z, Chang J, Chang JF, Chang XC, Chen BM, Chen J, Chen L, Chen L, Chen L, Chen MJ, Chen ML, Chen QH, Chen SH, Chen SZ, Chen TL, Chen XL, Chen Y, Cheng N, Cheng YD, Cui SW, Cui XH, Cui YD, Dai BZ, Dai HL, Dai ZG, Della Volpe D, D'Ettorre Piazzoli B, Dong XJ, Fan JH, Fan YZ, Fan ZX, Fang J, Fang K, Feng CF, Feng L, Feng SH, Feng YL, Gao B, Gao CD, Gao Q, Gao W, Ge MM, Geng LS, Gong GH, Gou QB, Gu MH, Guo JG, Guo XL, Guo YQ, Guo YY, Han YA, He HH, He HN, He JC, He SL, He XB, He Y, Heller M, Hor YK, Hou C, Hou X, Hu HB, Hu S, Hu SC, Hu XJ, Huang DH, Huang QL, Huang WH, Huang XT, Huang ZC, Ji F, Ji XL, Jia HY, Jiang K, Jiang ZJ, Jin C, Kuleshov D, Levochkin K, Li BB, Li C, Li C, Li F, Li HB, Li HC, Li HY, Li J, Li K, Li WL, Li X, Li X, Li XR, Li Y, Li YZ, Li Z, Li Z, Liang EW, Liang YF, Lin SJ, Liu B, Liu C, Liu D, Liu H, Liu HD, Liu J, Liu JL, Liu JS, Liu JY, Liu MY, Liu RY, Liu SM, Liu W, Liu YN, Liu ZX, Long WJ, Lu R, Lv HK, Ma BQ, Ma LL, Ma XH, Mao JR, Masood A, Mitthumsiri W, Montaruli T, Nan YC, Pang BY, Pattarakijwanich P, Pei ZY, Qi MY, Ruffolo D, Rulev V, Sáiz A, Shao L, Shchegolev O, Sheng XD, Shi JR, Song HC, Stenkin YV, Stepanov V, Sun QN, Sun XN, Sun ZB, Tam PHT, Tang ZB, Tian WW, Wang BD, Wang C, Wang H, Wang HG, Wang JC, Wang JS, Wang LP, Wang LY, Wang RN, Wang W, Wang W, Wang XG, Wang XJ, Wang XY, Wang YD, Wang YJ, Wang YP, Wang Z, Wang Z, Wang ZH, Wang ZX, Wei DM, Wei JJ, Wei YJ, Wen T, Wu CY, Wu HR, Wu S, Wu WX, Wu XF, Xi SQ, Xia J, Xia JJ, Xiang GM, Xiao G, Xiao HB, Xin GG, Xin YL, Xing Y, Xu DL, Xu RX, Xue L, Yan DH, Yang CW, Yang FF, Yang JY, Yang LL, Yang MJ, Yang RZ, Yang SB, Yao YH, Yao ZG, Ye YM, Yin LQ, Yin N, You XH, You ZY, Yu YH, Yuan Q, Zeng HD, Zeng TX, Zeng W, Zeng ZK, Zha M, Zhai XX, Zhang BB, Zhang HM, Zhang HY, Zhang JL, Zhang JW, Zhang L, Zhang L, Zhang LX, Zhang PF, Zhang PP, Zhang R, Zhang SR, Zhang SS, Zhang X, Zhang XP, Zhang Y, Zhang Y, Zhang YF, Zhang YL, Zhao B, Zhao J, Zhao L, Zhao LZ, Zhao SP, Zheng F, Zheng Y, Zhou B, Zhou H, Zhou JN, Zhou P, Zhou R, Zhou XX, Zhu CG, Zhu FR, Zhu H, Zhu KJ, Zuo X, Huang XY. Extended Very-High-Energy Gamma-Ray Emission Surrounding PSR J0622+3749 Observed by LHAASO-KM2A. PHYSICAL REVIEW LETTERS 2021; 126:241103. [PMID: 34213924 DOI: 10.1103/physrevlett.126.241103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/23/2021] [Accepted: 05/10/2021] [Indexed: 06/13/2023]
Abstract
We report the discovery of an extended very-high-energy (VHE) gamma-ray source around the location of the middle-aged (207.8 kyr) pulsar PSR J0622+3749 with the Large High-Altitude Air Shower Observatory (LHAASO). The source is detected with a significance of 8.2σ for E>25 TeV assuming a Gaussian template. The best-fit location is (right ascension, declination) =(95.47°±0.11°,37.92°±0.09°), and the extension is 0.40°±0.07°. The energy spectrum can be described by a power-law spectrum with an index of -2.92±0.17_{stat}±0.02_{sys}. No clear extended multiwavelength counterpart of the LHAASO source has been found from the radio to sub-TeV bands. The LHAASO observations are consistent with the scenario that VHE electrons escaped from the pulsar, diffused in the interstellar medium, and scattered the interstellar radiation field. If interpreted as the pulsar halo scenario, the diffusion coefficient, inferred for electrons with median energies of ∼160 TeV, is consistent with those obtained from the extended halos around Geminga and Monogem and much smaller than that derived from cosmic ray secondaries. The LHAASO discovery of this source thus likely enriches the class of so-called pulsar halos and confirms that high-energy particles generally diffuse very slowly in the disturbed medium around pulsars.
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Han C, Meng XC, Sun C, Dong C, Zheng WP, Wang K, Qin H, Yang Y, Zhang FB, Xu M, Cao SQ, Gao W. [Risk factors of blood loss during liver transplantation in children with biliary atresia and its influence on prognosis]. ZHONGHUA WAI KE ZA ZHI [CHINESE JOURNAL OF SURGERY] 2021; 59:491-496. [PMID: 34102733 DOI: 10.3760/cma.j.cn112139-20200810-00626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objectives: To study the risk factors for massive intraoperative blood loss in children with biliary atresia who underwent liver transplantation for the first time,and to analyze their impacts on graft survival,hospital stay and postoperative complications. Methods: The data of 613 children with biliary atresia who underwent liver transplantation at Department of Pediatric Organ Transplantation,Tianjin First Central Hospital from January 2015 to December 2018 were collected and analyzed. There were 270 males and 343 females, aged 7.4 (3.9) months (range: 3.2 to 148.4 months), the body weight of the recipients were (7.8±3.5) kg (range: 4.0 to 43.3 kg).According to the 85th quad of estimated blood loss(EBL),they were divided into two groups:massive EBL group(96 cases) and non massive EBL group(517 cases). The age,height,weight and other factors between the two groups were analyzed and compared. Univariate Logistic regression and multiple stepwise regression were used to determine the risk factors of massive EBL. Then,the postoperative complications of the two groups,including portal vein thrombosis and portal vein anastomotic stenosis etc.,were analyzed and compared by chi square test. Kaplan Meier curve and log rank test were used to analyze the recipient and graft survival rate of the two groups. Results: During the study period,713 transplants were performed and 613 patients were enrolled in the study. Ninety-six patients(15.7%) had massive EBL,and the postoperative hospital stay was 21(16) days(range:2 to 116 days),the hospital stay of non-massive EBL group was 22(12)days(range:3 to 138 days)(U=24 224.0,P=0.32). Univariate Logistic regression analysis showed that the recipient's weight,Kasai portoenterostomy,platelet count,operation time and cold ischemia time were the risk factors of massive EBL during biliary atresia transplantation. Multiple regression analysis showed that cold ischemia time ≥10 hours,prolonged operation time(≥8 hours) and body weight<5.5 kg were important independent risk factors for massive EBL.The incidence of portal vein thrombosis,hepatic vein stenosis,intestinal leakage and pulmonary infection in patients with massive EBL were significantly higher than those without massive EBL(3.1% vs. 0.8%,9.4% vs. 2.1%,6.3% vs. 0.8%,30.2% vs. 20.1%,all P<0.05). The 3-year overall graft and recipient survival rate were significantly lower in patients with massive EBL than those without massive EBL(87.5% vs. 95.7%,P=0.001;84.4% vs. 95.4%,P<0.01,respectively). Conclusions: In children with biliary atresia who underwent liver transplantation for the first time,the effective control of intraoperative bleeding should shorten the operation time and reduce the cold ischemia time as far as possible,on the premise of ensuring the safety of operation. For children without growth disorder,the weight of children should be increased to more than 5.5 kg as far as possible to receive the operation. Reducing intraoperative bleeding is of great significance to the prognosis of children.
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Cao Z, Aharonian FA, An Q, Axikegu, Bai LX, Bai YX, Bao YW, Bastieri D, Bi XJ, Bi YJ, Cai H, Cai JT, Cao Z, Chang J, Chang JF, Chang XC, Chen BM, Chen J, Chen L, Chen L, Chen L, Chen MJ, Chen ML, Chen QH, Chen SH, Chen SZ, Chen TL, Chen XL, Chen Y, Cheng N, Cheng YD, Cui SW, Cui XH, Cui YD, Dai BZ, Dai HL, Dai ZG, Danzengluobu, Della Volpe D, D Ettorre Piazzoli B, Dong XJ, Fan JH, Fan YZ, Fan ZX, Fang J, Fang K, Feng CF, Feng L, Feng SH, Feng YL, Gao B, Gao CD, Gao Q, Gao W, Ge MM, Geng LS, Gong GH, Gou QB, Gu MH, Guo JG, Guo XL, Guo YQ, Guo YY, Han YA, He HH, He HN, He JC, He SL, He XB, He Y, Heller M, Hor YK, Hou C, Hou X, Hu HB, Hu S, Hu SC, Hu XJ, Huang DH, Huang QL, Huang WH, Huang XT, Huang ZC, Ji F, Ji XL, Jia HY, Jiang K, Jiang ZJ, Jin C, Kuleshov D, Levochkin K, Li BB, Li C, Li C, Li F, Li HB, Li HC, Li HY, Li J, Li K, Li WL, Li X, Li X, Li XR, Li Y, Li YZ, Li Z, Li Z, Liang EW, Liang YF, Lin SJ, Liu B, Liu C, Liu D, Liu H, Liu HD, Liu J, Liu JL, Liu JS, Liu JY, Liu MY, Liu RY, Liu SM, Liu W, Liu YN, Liu ZX, Long WJ, Lu R, Lv HK, Ma BQ, Ma LL, Ma XH, Mao JR, Masood A, Mitthumsiri W, Montaruli T, Nan YC, Pang BY, Pattarakijwanich P, Pei ZY, Qi MY, Ruffolo D, Rulev V, Sáiz A, Shao L, Shchegolev O, Sheng XD, Shi JR, Song HC, Stenkin YV, Stepanov V, Sun QN, Sun XN, Sun ZB, Tam PHT, Tang ZB, Tian WW, Wang BD, Wang C, Wang H, Wang HG, Wang JC, Wang JS, Wang LP, Wang LY, Wang RN, Wang W, Wang W, Wang XG, Wang XJ, Wang XY, Wang YD, Wang YJ, Wang YP, Wang Z, Wang Z, Wang ZH, Wang ZX, Wei DM, Wei JJ, Wei YJ, Wen T, Wu CY, Wu HR, Wu S, Wu WX, Wu XF, Xi SQ, Xia J, Xia JJ, Xiang GM, Xiao G, Xiao HB, Xin GG, Xin YL, Xing Y, Xu DL, Xu RX, Xue L, Yan DH, Yang CW, Yang FF, Yang JY, Yang LL, Yang MJ, Yang RZ, Yang SB, Yao YH, Yao ZG, Ye YM, Yin LQ, Yin N, You XH, You ZY, Yu YH, Yuan Q, Zeng HD, Zeng TX, Zeng W, Zeng ZK, Zha M, Zhai XX, Zhang BB, Zhang HM, Zhang HY, Zhang JL, Zhang JW, Zhang L, Zhang L, Zhang LX, Zhang PF, Zhang PP, Zhang R, Zhang SR, Zhang SS, Zhang X, Zhang XP, Zhang Y, Zhang Y, Zhang YF, Zhang YL, Zhao B, Zhao J, Zhao L, Zhao LZ, Zhao SP, Zheng F, Zheng Y, Zhou B, Zhou H, Zhou JN, Zhou P, Zhou R, Zhou XX, Zhu CG, Zhu FR, Zhu H, Zhu KJ, Zuo X. Ultrahigh-energy photons up to 1.4 petaelectronvolts from 12 γ-ray Galactic sources. Nature 2021; 594:33-36. [PMID: 34002091 DOI: 10.1038/s41586-021-03498-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/26/2021] [Indexed: 02/04/2023]
Abstract
The extension of the cosmic-ray spectrum beyond 1 petaelectronvolt (PeV; 1015 electronvolts) indicates the existence of the so-called PeVatrons-cosmic-ray factories that accelerate particles to PeV energies. We need to locate and identify such objects to find the origin of Galactic cosmic rays1. The principal signature of both electron and proton PeVatrons is ultrahigh-energy (exceeding 100 TeV) γ radiation. Evidence of the presence of a proton PeVatron has been found in the Galactic Centre, according to the detection of a hard-spectrum radiation extending to 0.04 PeV (ref. 2). Although γ-rays with energies slightly higher than 0.1 PeV have been reported from a few objects in the Galactic plane3-6, unbiased identification and in-depth exploration of PeVatrons requires detection of γ-rays with energies well above 0.1 PeV. Here we report the detection of more than 530 photons at energies above 100 teraelectronvolts and up to 1.4 PeV from 12 ultrahigh-energy γ-ray sources with a statistical significance greater than seven standard deviations. Despite having several potential counterparts in their proximity, including pulsar wind nebulae, supernova remnants and star-forming regions, the PeVatrons responsible for the ultrahigh-energy γ-rays have not yet been firmly localized and identified (except for the Crab Nebula), leaving open the origin of these extreme accelerators.
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Huang D, Gao W, Lu H, Qian JY, Ge JB. Oxidized low-density lipoprotein stimulates dendritic cells maturation via LOX-1-mediated MAPK/NF-κB pathway. ACTA ACUST UNITED AC 2021; 54:e11062. [PMID: 34076144 PMCID: PMC8186376 DOI: 10.1590/1414-431x2021e11062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/20/2021] [Indexed: 11/22/2022]
Abstract
Dendritic cells (DCs) play a crucial role as central orchestrators of immune system response in atherosclerosis initiation and progression. Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) is involved in the immune maturation of DCs, but the underlying mechanisms remain unclear. We isolated mouse bone marrow progenitors and stimulated them with granulocyte-macrophage colony-stimulating factor and interleukin (IL)-4 to induce immature DCs. We then treated DCs with oxidized low-density lipoprotein (oxLDL) to induce maturation. LOX-1 siRNA was used to investigate the modulation of LOX-1 on the development of DCs and the underlying signal pathways. CD11c-positive DCs were successfully derived from mouse bone marrow progenitors. OxLDL promoted the expressions of DCs maturation markers and pro-inflammatory cytokines. OxLDL also upregulated LOX-1 expression and activated MAPK/NF-κB pathways. LOX-1 siRNA could attenuate the expression of MAPK/NF-κB pathways and inflammatory cytokines. In conclusion, oxLDL induced the maturation of DCs via LOX-1-mediated MAPK/NF-κB pathway, which contributed to the initiation and progression of atherosclerosis.
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Wu Y, Wu Y, Chen XY, Niu YX, Lv FZ, Gao W. MiRNA-488-3p inhibits malignant progression of NSCLC by modulating ADAM9. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2021; 24:8893-8901. [PMID: 32964979 DOI: 10.26355/eurrev_202009_22830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the role of microRNA-488-3p in the proliferation, invasion and migration of lung cancer cells and to further explore the potential regulatory mechanisms. PATIENTS AND METHODS MicroRNA-488-3p expression in 46 pairs of tumor tissue and paracancerous tissue specimens collected from non-small cell lung cancer (NSCLC) patients were measured through quantitative real-time polymerase chain reaction (qRT-PCR) method, and the interplay between microRNA-488-3p expression and some clinical indicators of these subjects was also analyzed. In addition, microRNA-488-3p overexpression models were constructed in NSCLC cell lines, and then Cell Counting Kit-8 (CCK-8) test and transwell assays were carried out to evaluate the effect of microRNA-488-3p on the NSCLC cell functions. Furthermore, bioinformatics analysis and luciferase reporter gene assay were carried out to uncover the potential interaction between microRNA-488-3p and its downstream gene ADAM9. RESULTS QPCR results revealed that microRNA-488-3p showed a significant lower expression in NSCLC tissue samples than in adjacent normal ones. In comparison to patients with high expression of microRNA-488-3, patients with low expression of microRNA-488-3 exhibited higher incidence of lymph node or distant metastasis and lower survival rate. In vitro cell experiments showed that, in comparison to control group, overexpression of microRNA-488-3p significantly weakened the proliferation ability as well as the invasion and migration of NSCLC cells. Subsequently, a significant increase in ADAM9 expression in NSCLC tissue samples was found, which indicated its negative correlation with microRNA-488-3p. In addition, cell recovery experiment demonstrated that overexpression of ADAM9 could counteract the impact of microRNA-488-3p upregulation on the proliferation and invasion ability of NSCLC cells, and the two may thus together affect the malignant progression of NSCLC. CONCLUSIONS It can be concluded that microRNA-488-3p, which is associated with the incidence of metastasis in NSCLC patients, can inhibit the malignant progression of NSCLC cells by modulating ADAM9 expression.
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Wu M, Hong G, Chen Y, Ye L, Zhang K, Cai K, Yang H, Long X, Gao W, Li H. Personalized drug testing in a patient with non-small-cell lung cancer using cultured cancer cells from pleural effusion. J Int Med Res 2021; 48:300060520955058. [PMID: 32954884 PMCID: PMC7509736 DOI: 10.1177/0300060520955058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective Patients with non-small-cell lung cancer (NSCLC) and primary or acquired resistance do not respond to targeted drugs. We explored whether cancer cells can be cultured from liquid biopsies from patients with primary resistance to tyrosine kinase inhibitors (TKIs). We aimed to predict patients’ responses to drugs according to in vitro drug testing results. Methods Cancer cell cultures were established from the pleural effusion of a patient with TKI-resistant NSCLC using a conditional reprogramming technique. Phenotypic drug sensitivity tests were performed using the Cell Counting Kit-8 assay. We tested individual drugs and compared the synergistic and inhibitory effects of drug combinations. Results The results of our in vitro sensitivity test using the combination of cisplatin and pemetrexed were correlated with the patient’s response. Conclusion This represents the first successful report of predictive testing for combination therapy in patients with epidermal growth factor receptor-mutant NSCLC and primary TKI resistance. This strategy should be applicable to both chemotherapies and targeted therapies, and it will significantly improve the clinical treatment and management of patients with NSCLC and primary or acquired resistance to targeted therapies, as well as patients lacking targetable mutations.
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Tian DZ, Teng DH, Yu Y, Li JJ, Jiang WT, Gao W, Cai JZ, Zhang YM, Ma N, Yu WL, Weng YQ, Li DH, Liu W, Zhou YH, Zheng H. [Initial exploration of transfusion-free liver transplantation]. ZHONGHUA WAI KE ZA ZHI [CHINESE JOURNAL OF SURGERY] 2021; 59:348-352. [PMID: 33915624 DOI: 10.3760/cma.j.cn112139-20200525-00410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the effect of transfusion-free techniques on the prognosis of liver transplant patients. Methods: The recipients of adult liver transplantation at Tianjin First Central Hospital from August to December 2019 were included in the clinical observation. Liver transplantation without allogeneic blood transfusion was performed through anesthesia management techniques such as acute hemodilution or phlebotomy without volume replacement,maintaining decreased baseline central venous pressure and cell saver. According to the actual results,the patients were divided into two groups: transfusion-free group(n=21) and allogeneic transfusion group(n=28). There were 13 males and 8 females aged of (56.3±11.6) years in the transfusion-free group;and there were 16 males and 12 females aged (54.3±14.2)years in the allogeneic transfusion group. The transplant recipients who had not adopted transfusion management strategy from January to July 2019 were included as control group(27 males and 13 females,aged of (58.9±14.1)years). The clinical data of patients in perioperative period were collected to compare whether there were differences in the recovery of liver function and early complications among the three groups, one-way ANOVA test, rank-sum test, and χ2 test were used for data analysis. Results: The amount of intraoperative blood loss in both the transfusion-free group and the transfusion group was less than that in the control group((454.2±271.3)ml vs.(673.6±333.4)ml vs.(890.3±346.7)ml;q=-6.342,-5.286,both P<0.05).The duration of stay in ICU of the transfusion-free group was less than that of the transfusion group and control group((36.4±9.1)hours vs.(44.3±14.9)hours vs.(58.2±21.1)hours;q=-4.432,-3.824,both P<0.05).The mean ALT level at 7 days after operation was significantly lower in the transfusion-free group than in the control group((56.8±32.1)U/L vs.(89.6±45.6)U/L;q=-3.358,P<0.05). Conclusions: The improvement of multi-disciplinary transfusion management technology aimed at transfusion-free liver transplantation can effectively reduce intraoperative hemorrhage and help to avoid surgical transfusion. Transfusion-free liver transplantation is beneficial to the early postoperative recovery,and its long-term clinical significance is worthy of further clinical research.
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Zhu ZY, Liu YL, Gou GQ, Gao W, Chen J. Effect of heat input on interfacial characterization of the butter joint of hot-rolling CP-Ti/Q235 bimetallic sheets by Laser + CMT. Sci Rep 2021; 11:10020. [PMID: 33976259 PMCID: PMC8113572 DOI: 10.1038/s41598-021-89343-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 04/19/2021] [Indexed: 11/10/2022] Open
Abstract
Composite structures made of 2 mm-thick titanium and 10 mm-thick carbon steel are widely used in infrastructures such as long-distance gas transportation. However, cracking, which is caused by intermetallic compounds (ICs), is a dominate failure mode in welds of this structure. Thus, a common way to improve the in-service life of is reduce the number of ICs. In this paper, we employ a novel hybrid welding method to fabricate composite structures of TA2 titanium and Q235 carbon steel. Specifically, Ti and carbon steel is welded by laser and double Cold Metal Transfer (CMT) welding, respectively. The microstructure near the interface of Ti and steel is then examined using SEM, EBSD, EDS, with emphasis on the ICs in terms of chemical elements and morphologies. Results show that FeTi and Fe2Ti are the main ICs near the interface, and responsible for the failure of the welds. The effect of welding heat input on the formation of ICs is investigated as well. Results show that ICs are smaller when the heat input is low. Under low heat input circumstance, the tensile strength of the weld can reach up to 420 MPa.
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Möller S, Ding R, Xie H, Gao B, Wang B, Peng J, Liu S, Gao W, Kirschner A, Brezinsek S. Symmetries of 13C tracer deposition in EAST D and He plasmas investigated on the sub-mm to 100 mm scale by deuteron nuclear reaction analysis. FUSION ENGINEERING AND DESIGN 2021. [DOI: 10.1016/j.fusengdes.2021.112292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gao W, Guo W, Guo Y, Shi M, Dong G, Wang G, Ge Q, Zhu J, Zhou X. Thyroid hormone concentrations in severely or critically ill patients with COVID-19. J Endocrinol Invest 2021; 44:1031-1040. [PMID: 33140379 PMCID: PMC7605732 DOI: 10.1007/s40618-020-01460-w] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 10/22/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE COVID-19 is a new coronavirus infectious disease. We aimed to study the characteristics of thyroid hormone levels in patients with COVID-19 and to explore whether thyroid hormone predicts all-cause mortality of severely or critically ill patients. METHODS The clinical data of 100 patients with COVID-19, who were admitted to Wuhan Tongji Hospital from February 8 to March 8, 2020, were analyzed in this retrospective study. The patients were followed up for 6-41 days. Patients were grouped into non-severe illness and severe or critical illness, which included survivors and non-survivors. Multivariate Cox proportional hazards analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality in association with continuous and the lower two quartiles of thyroid hormone concentrations in severely or critically ill patients. RESULTS The means of free T3 (FT3) were 4.40, 3.73 and 2.76 pmol/L in non-severely ill patients, survivors and non-survivors, respectively. The lower (versus upper) two quartiles of FT3 was associated with all-cause mortality HR (95% CI) of 9.23 (2.01, 42.28). The HR (95% CI) for all-cause mortality in association with continuous FT3 concentration was 0.41 (0.21, 0.81). In the multivariate-adjusted models, free T4 (FT4), TSH and FT3/FT4 were not significantly related to all-cause mortality. Patients with FT3 less than 3.10 pmol/L had increased all-cause mortality. CONCLUSION FT3 concentration was significantly lower in patients with severe COVID-19 than in non-severely ill patients. Reduced FT3 independently predicted all-cause mortality of patients with severe COVID-19.
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Gunasekera K, Cohen T, Gao W, Ayles H, Godfrey-Faussett P, Claassens M. Smoking and HIV associated with subclinical tuberculosis: analysis of a population-based prevalence survey. Int J Tuberc Lung Dis 2021; 24:340-346. [PMID: 32228765 DOI: 10.5588/ijtld.19.0387] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Despite multiple tuberculosis (TB) prevalence surveys reporting a relatively high frequency of bacteriologically confirmed, active TB among individuals reporting no typical symptoms of disease, our understanding of this phenomenon is limited.OBJECTIVE: To quantify the epidemiological burden and estimate associations between individual-level variables and this "subclinical" presentation.METHODS: We performed a secondary analysis of TB prevalence survey data from the South African communities of the Zambia, South Africa Tuberculosis and AIDS Reduction trial. Generalized estimating equations were used to estimate the association between individual-level demographic, behavioral, socio-economic, and medical variables and the risk of bacteriologically positive TB among participants not reporting any symptoms consistent with active TB.RESULTS: The crude prevalence of TB was 2222.1 cases per 100 000 population (95% CI 2053.4-2388.5); 44.7% (295/660) of all documented prevalent cases of TB were subclinical. Current tobacco smoking (OR 2.37, 95% CI 1.41-3.99) and HIV-positive status (OR 3.26, 95% CI 2.31-4.61) were significantly associated with subclinical TB.CONCLUSION: Individuals who smoke or have HIV may be at increased risk of active TB and not report typical symptoms consistent with disease. This suggests possible shortcomings of symptom-based case finding which may need to be addressed in similar settings.
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He YT, Liu YY, Gao W, Hu JJ, Ma XY, Xia CJ, Chen SH, Wang J, Liang D, Shi J, Shan BE. [Analysis for the breast cancer screening among urban population in Hebei province, 2018-2019]. ZHONGHUA YU FANG YI XUE ZA ZHI [CHINESE JOURNAL OF PREVENTIVE MEDICINE] 2021; 55:535-538. [PMID: 33858068 DOI: 10.3760/cma.j.cn112150-20201210-01445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
From 2018 to 2019, 3 453 cases of high-risk population were screened by the Cancer Screening Program in Urban China (CanSPUC) in Hebei Province, with the age of (53.94±8.00). 147 and 686 cases of breast cancer positive and suspicious positive patients were found, with the positive rate and suspicious positive rate of 4.26% and 19.87% respectively. The suspicious positive rate of 45-49 years old age group was the highest (28.32%), and the positive rate of over 70 years old age group was the highest (7.32%). The positive detection rate of mammography combined with ultrasound was 5.16%, which was higher than that of ultrasound alone (2.46%) (χ²=30.28,P<0.001) or mammography alone (3.06%) (χ²=14.56,P<0.001).
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Wilson R, Gaughran F, Whitburn T, Higginson IJ, Gao W. Acute care utilisation towards the end of life and the place of death for patients with serious mental disorders: a register-based cohort study in South London. Public Health 2021; 194:79-85. [PMID: 33866148 DOI: 10.1016/j.puhe.2021.02.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 01/26/2021] [Accepted: 02/05/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of the study was to explore acute care utilisation towards end of life by and the place of death for patients with serious mental disorders and to demonstrate any inequalities in end-of-life care faced by this patient group. STUDY DESIGN This is a retrospective cohort study using linked, routinely collected data. METHODS This study used linked data extracted from mental health records, Hospital Episode Statistics and mortality data. Adult cases (≥18 years old) were included if they had a serious mental disorder and died between 2007 and 2015. Multiple imputation was used to manage missing data, and generalised linear models were used to assess multiple adjusted associations between sociodemographic and clinical explanatory variables and acute service use at the end of life and in-hospital deaths. RESULTS A cohort of 1350 adults was analysed. More than half visited the accident and emergency (A&E) department in the last 90 days of life, and a third had a burdensome transition (multiple hospital admissions in the last 90 days of life or at least one in the last three days); the median number of days spent in the hospital was 4 (range: 0-86). Having more comorbidities was a strong correlate of more A&E visits (adjusted odds ratio [OR] = 1.03 [95% confidence interval = 1.02-1.04]), burdensome transitions (adjusted OR = 1.06 [1.04-1.08]) and days spent in the hospital (adjusted OR = 1.04 [1.03-1.05]). Having a diagnosis of schizophrenia spectrum disorder, compared with other serious mental disorder diagnoses, was associated with fewer A&E visits (adjusted OR = 0.78 [0.71-0.88]) and fewer days in the hospital (adjusted OR = 0.77 [0.66-0.89]). Younger age was associated with more A&E visits (adjusted OR = 1.28 [1.07-1.53]) and fewer days spent in the hospital (adjusted OR = 0.70 [0.52-0.95]). Hospital deaths were high (51%), and in a fully adjusted model, they were associated with having more comorbidities (adjusted OR = 1.02 [1.01-1.03]) and accessing acute care at the end of life (including more A&E visits; adjusted OR = 1.07 [1.05-1.10]), burdensome transitions (adjusted OR = 1.53 [1.37-1.71]) and days spent in the hospital (adjusted OR = 2.05 [1.70-247]). CONCLUSION People with comorbidities are more likely to use more burdensome acute health care at the end of life and are more likely to die in the hospital. Hospital deaths could be reduced, and end-of-life care could be improved by targeting patients with comorbidities and who are accessing more acute healthcare services.
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Ma J, Gong S, He Y, Gao W, Hao W, Lan X. Effects of oral sialic acid on gut development, liver function and gut microbiota in mice. Lett Appl Microbiol 2021; 73:20-25. [PMID: 33386625 DOI: 10.1111/lam.13447] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/27/2020] [Accepted: 12/28/2020] [Indexed: 12/27/2022]
Abstract
Sialic acid (N-acetylneuraminic acid), a 9-carbon monosaccharide, has been widely studied in immunology, oncology and neurology. However, the effects of sialic acid on organ and intestinal development, liver function and gut microbiota were rarely studied. In this study, we found that oral sialic acid tended to increase the relative weight of liver and decreased the serum aspartate aminotransferase (GPT) activity. In addition, sialic acid treatment markedly reduced gut villus length, depth, the ratio of villus length/depth (L/D), areas, width and the number of goblet cells. Furthermore, gut microbes were changed in response to oral sialic acid, such as Staphylococcus lentus, Corynebacterium stationis, Corynebacterium urealyticum, Jeotgalibaca sp_PTS2502, Ignatzschineria indica, Sporosarcina pasteurii, Sporosarcina sp_HW10C2, Facklamia tabacinasalis, Oblitimonas alkaliphila, Erysipelatoclostridium ramosum, Blautia sp_YL58, Bacteroids thetaiotaomicron, Morganella morganii, Clostridioides difficile, Helicobacter tryphlonius, Clostridium sp_Clone47, Alistipes finegoldii, [pseudomonas]_geniculata and Pseudomonas parafulva at the species level. In conclusion, oral sialic acid altered the intestinal pathological state and microbial compositions, and the effect of sialic acid on host health should be further studied.
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Li X, Gao Q, Sun L, Gao W. Effect of self-control on health promotion behavior in patients with coronary heart disease: mediating effect of ego-depletion. PSYCHOL HEALTH MED 2021; 27:1268-1276. [PMID: 33813978 DOI: 10.1080/13548506.2020.1867316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The present study used a cross-sectional survey design to explore the role of ego-depletion in the relationship between self-control and health-promoting behaviors in patients with coronary heart disease (CHD). This study recruited 277 patients with CHD to measure the levels of ego-depletion, self-control and health-promotion (HP) behavior using Self-Regulatory Fatigue Scale (SRF-s), Dual-Mode of Self-Control Scale (DMSD-s) and Health Promotion Lifestyle Profile-II (HPLP-II) to examine the relationship between the three. Study found that self-control improved the patients' HP behaviors to some extent. Self-control in patients with CHD uses ego-depletion as the mediating variable to indirectly and positively predict the level of HP behavior, and the mediating effects account for 47.76% (impulsive system) and 15.6% (control system) of the total effects, respectively.
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Guo R, Gao W, Li J, Liu Y, Liu X. 190TiP Anlotinib plus carboplatin/pemetrexed in treatment-naïve advanced non-squamous NSCLC: An open-label, randomized, phase II study. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)02032-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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