Neural functional rehabilitation: Exploring neuromuscular reconstruction technology advancements and challenges

Neural machine interface technology is a pioneering approach that aims to address the complex challenges of neurological dysfunctions and disabilities resulting from conditions such as congenital disorders, traumatic injuries, and neurological diseases. Neural machine interface technology establishes direct connections with the brain or peripheral nervous system to restore impaired motor, sensory, and cognitive functions, significantly improving patients' quality of life. This review analyzes the chronological development and integration of various neural machine interface technologies, including regenerative peripheral nerve interfaces, targeted muscle and sensory reinnervation, agonist-antagonist myoneural interfaces, and brain-machine interfaces. Recent advancements in flexible electronics and bioengineering have led to the development of more biocompatible and high-resolution electrodes, which enhance the performance and longevity of neural machine interface technology. However, significant challenges remain, such as signal interference, fibrous tissue encapsulation, and the need for precise anatomical localization and reconstruction. The integration of advanced signal processing algorithms, particularly those utilizing artificial intelligence and machine learning, has the potential to improve the accuracy and reliability of neural signal interpretation, which will make neural machine interface technologies more intuitive and effective. These technologies have broad, impactful clinical applications, ranging from motor restoration and sensory feedback in prosthetics to neurological disorder treatment and neurorehabilitation. This review suggests that multidisciplinary collaboration will play a critical role in advancing neural machine interface technologies by combining insights from biomedical engineering, clinical surgery, and neuroengineering to develop more sophisticated and reliable interfaces. By addressing existing limitations and exploring new technological frontiers, neural machine interface technologies have the potential to revolutionize neuroprosthetics and neurorehabilitation, promising enhanced mobility, independence, and quality of life for individuals with neurological impairments. By leveraging detailed anatomical knowledge and integrating cutting-edge neuroengineering principles, researchers and clinicians can push the boundaries of what is possible and create increasingly sophisticated and long-lasting prosthetic devices that provide sustained benefits for users.

Effect of exercise training on modulating the TH17/TREG imbalance in individuals with severe COPD: A randomized controlled trial

BACKGROUND

Chronic obstructive pulmonary disease (COPD) induces an imbalance in T helper (Th) 17/regulatory T (Treg) cells that contributes to of the dysregulation of inflammation. Exercise training can modulate the immune response in healthy subjects.

OBJECTIVE

We aimed to evaluate the effects of exercise training on Th17/Treg responses and the differentiation of Treg phenotypes in individuals with COPD.

METHODS

This randomized controlled trial included 50 individuals with severe or very severe COPD who were allocated to the Exercise or Control groups. The Exercise group underwent eight weeks of aerobic and muscle strength training, whereas the Control group received usual care. The primary outcome was the change in the phenotypic characteristics of Tregs and Th17 profile differentiation in systemic inflammation.

RESULTS

Exercise training increased the frequency of total and activated Tregs and decreased the frequency of Th17 cells in between-group comparisons. Additionally, Th17/Treg responses were moderately correlated with improvements in the six-minute walking test, muscle strength of the upper and lower limbs, and daily life physical activity levels.

CONCLUSION

Exercise training improved functional exercise capacity, muscle strength, and physical fitness, which was associated with a decrease in the Th17 inflammatory response and an increase in Treg cell phenotypes immunosuppressive activity.

Eggerthella lenta down regulated flavone and flavonol biosynthesis promoted Kawasaki disease

Kawasaki Disease (KD) is a multisystemic vasculitis of unknown aetiology in children. The incidence of KD varies by geographic area and correlates with differences in gut microbiota patterns, with the highest incidence in Asian. This study aimed to investigate alterations in faecal microbiota and assess their relationship with systemic inflammation in KD patients. A total of 59 patients and 55 matched controls were included. Fecal samples were collected at the onset of KD. The V3/V4 regions of 16S rDNA were sequenced using the MiSeq platform. PICRUSt 2 was used to analyse the potential functional pathways involved in gut dysbiosis. Alpha (p < 0.042) and beta (p < 0.001) diversity in KD were significantly decreased when compared to the control group. After multivariate regression, among the seven critical microbes, increased Eggerthella lenta (p = 0.016) and decreased Bacteroides ovatus (p = 0.014) could also predict KD risk using receiver operating characteristic curve (ROC) analysis (Eggerthella lenta: area under the ROC curve, AUC = 0.841, odds ratio = 23.956; Bacteroides ovatus: AUC = 0.816, odds ratio = 31.365). Notably, Bacteroides ovatus was positively correlated with blood segment cells (p = 0.006), but negatively correlated with blood lymphocytes (p = 0.013). After multivariate regression, flavone and flavonol biosynthesis decreased in children with KD (p < 0.001). Our results indicated that both Bacteroides ovatus and Eggerthella lenta may deregulate flavone and flavonol biosynthesis, consequently modulating immune cells and potentially triggering KD. This study suggests that alterations in the gut microbiota are closely associated with immune responses and provides a new perspective on the aetiology, pathogenesis, and treatment of KD.

Various gases for the treatment of neuropathic pain: mechanisms, current status, and future perspectives

In recent years, medical gas therapy has emerged as a promising approach for treating neuropathic pain. This review article aimed to investigate the therapeutic effects of medical gas therapy on neuropathic pain and its underlying mechanisms, thereby providing a theoretical foundation for clinical practice. A literature search was conducted using the Web of Science Core Collection database. Co-occurrence analysis of keywords revealed that terms including "neuropathic pain," "nitric oxide," "nitric oxide synthase," "pain," and "ozone" frequently appeared. Cluster analysis grouped these keywords into four primary categories: intervertebral disc disease and gas therapy, mechanisms of neuropathic pain and gas interventions, the role of nitric oxide in modulating neuropathic pain and gas therapy, and the effects of gas therapy on mental disorders in the context of neuropathic pain treatment. The analysis of highly cited literature in the field of medical gas therapy for neuropathic pain emphasizes the crucial roles of nitric oxide and nitric oxide synthase in nerve injury and pain. Various types of gas therapy, including oxygen-ozone therapy and nitric oxide-related therapies, show promise in treating pain following peripheral nerve injury. Oxidative stress and nitric oxide are crucial regulatory factors in the pain signaling associated with trigeminal neuralgia. Ozone therapy alleviates trigeminal pain by inhibiting inflammatory responses, reducing oxidative stress, and modulating neurotransmitter release. Novel nanomaterials, such as manganese oxide nanoparticles, have also demonstrated potential in scavenging free radicals and alleviating sciatic nerve pain. Ozone therapy has shown good clinical efficacy in treating lumbar disc herniation and sciatica, whereas both ozone therapy and hyperbaric oxygen therapy have demonstrated effectiveness and safety in managing postherpetic neuralgia. In conclusion, medical gas therapy for neuropathic pain primarily includes oxygen-ozone therapy, nitric oxide-related therapies, hydrogen sulfide-related therapies, and hyperbaric oxygen therapy. While these therapies exhibit efficacy in managing neuropathic pain, further research is necessary to elucidate their mechanisms of action and safety profiles. Although hyperbaric oxygen therapy and ozone therapy have already been implemented in clinical research, other types of gas therapy are still in the animal testing phase. Therefore, future studies should focus on conducting more multicenter, large-sample randomized controlled trials to accelerate clinical translation and provide more effective treatment options for patients suffering from neuropathic pain.

The efficacy of platelet-rich plasma (PRP) alone or in combination with low intensity shock wave therapy (Li-SWT) in treating erectile dysfunction: a systematic review and meta-analysis of seven randomized controlled trials

BACKGROUND

The goal of this meta-analysis intended to identify the efficacy of platelet-rich plasma (PRP) alone or in combination with low intensity shock wave therapy (Li-SWT) as a therapy for erectile dysfunction (ED).

METHODS

This study integrated and analyzed the data using Cochrane method and GRADEpro GDT grading system. The registration number for this study was CRD42024618240.

RESULT

Seven randomized controlled trials with 660 patients were analyzed. The results indicated that compared with the control group, IIEF score of patients in the PRP group improved significantly at 12-week (p = 0.03) and 24-week (p = 0.0004), while there was no significant difference at 4-week. The PRP group had no significant advantages over the control group in terms of MCID and SEP Q3. For peak systolic velocity, patients in the PRP group demonstrated greater improvement than those in the control group (p < 0.00001). Subgroup analysis revealed that adding PRP regimen can considerably improve IIEF scores of ED patients compared to using Li-SWT alone (p < 0.0001).

CONCLUSION

PRP demonstrated a better efficacy in treating ED, especially during a follow-up period of 6 months. Compared with using Li-SWT alone, the addition of PRP can considerably improve the IIEF score of ED patients. These findings still required large-scale clinical trials for verification.

Establishment and Validation of Diagnostic Model of Microvascular Invasion in Solitary Hepatocellular Carcinoma

BACKGROUND

The microvascular invasion (MVI) score evaluates the presence of MVI in patients with hepatocellular carcinoma (HCC) by integrating multiple factors associated with MVI. We aimed to establish a MVI scoring system for HCC based on the clinical characteristics and serum biomarkers of patients with HCC.

METHODS

A total of 1027 patients with HCC hospitalized at Shandong Provincial Hospital from January 2016 to August 2021 were included and randomly divided into the development group and validation group at a ratio of 3:1. Univariable and multivariable logistic regression analyses were conducted to identify independent risk factors for MVI in HCC patients. Based on these independent risk factors, the preoperative MVI scoring system (diagnostic model) for HCC was established and verified. The receiver operating characteristic (ROC) curves, calibration curves and decision curve analyses (DCA) were employed to evaluate the discrimination and clinical application of the diagnostic model.

RESULTS

Independent risk factors for MVI of HCC involved Hepatitis B virus infection (HBV), large tumor diameter, higher logarithm of Alpha-fetoprotein (Log AFP), higher logarithm of AFP-L3% (Log AFP-L3%), higher logarithm of protein induced by vitamin K absence or antagonist-II (Log PIVKA-II) and higher logarithm of Carbohydrate antigen 125 (Log CA125). The diagnostic model incorporating these six independent risk factors was finally established. The areas under the ROC curve (AUC) assessed by the nomogram in the development cohort and validation cohort were 0.806 (95% CI, 0.773-0.839) and 0.818 (95% CI, 0.763-0.874) respectively. The calibration curve revealed that the results predicted by our diagnostic model for MVI in HCC were highly consistent with the postoperative pathological outcomes. The DCA further indicated promising clinical application of the diagnostic model.

CONCLUSION

An effective preoperative diagnostic model for MVI of HCC based on readily available tumor markers and clinical characteristics has been established, which is both clinically significant and easy to implement for diagnosing MVI.

Global research progress in antibody-drug conjugates for solid tumors: Bibliometrics and visualized analysis

Recently, the use of antibody-drug conjugates (ADCs) in the research and management of solid tumors has increased, making them a key focus in the field of oncology. In this study, we performed a comprehensive literature review of ADCs use in solid tumor treatment. We retrieved data from the Web of Science Core Collection (WoSCC). Following literature retrieval, we conducted a thorough bibliometric and knowledge-mapping analysis of the collected articles. There was a rapid growth in the number of annual publications in this field. The United States had the highest publication volumes and led ADC research for solid tumors. Additionally, The Dana-Farber Cancer Institute had the highest output, and G. Curigliano was identified as the most productive author. The journal "Cancers" led in the publishing of ADC research on solid tumors. Furthermore, key clustering terms such as "breast cancer," "targeted therapy," "bladder cancer," "ovarian cancer," "expression," and "drug delivery" emerged in this field as the research progressed. We identified six key themes by literature co-citation analysis, involving the research on the application of four ADCs in breast cancer, as well as the analysis of ADCs design, mechanisms, and strategies for reducing cytotoxicity. At the same time, based on the analysis of papers that have experienced a citation burst recently, we explored the future development trends of this field. Overall, our inaugural bibliometric analysis of ADCs for solid tumor research provides a systematic framework to guide future studies in this field. Therefore, facilitating and promoting further development in this area.

Vitexin enhances mitophagy and improves renal ischemia-reperfusion injury by regulating the p38/MAPK pathway

Vitexin (VI) is a naturally occurring flavonoid derived from the leaves and seeds of Vitex, recognized for its strong antioxidant properties. This study aims to explore its effects on renal ischemia-reperfusion injury (IRI) and investigate the underlying mechanisms. We utilized hypoxia-reoxygenation (H/R) models with HK-2 cell lines and renal ischemia-reperfusion (I/R) models in mice, applying vitexin preconditioning to assess its influence on renal IRI. Our findings reveal that vitexin mitigated oxidative stress, decreased cell apoptosis, and reduced the expression of renal damage indicators such as kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL), along with an overall improvement in renal function. To further investigate the mechanism, we used network pharmacology and molecular docking techniques to predict potential vitexin targets in renal IRI. Results from Western blotting and immunofluorescence assays indicate that vitexin may promote mitophagy by suppressing the phosphorylation of the pivotal p38 protein in the p38/MAPK signaling pathway, offering protection against renal IRI. The findings indicate that vitexin could potentially be used as a therapeutic agent to alleviate renal IRI.

Bacterial extracellular vesicles in the initiation, progression and treatment of atherosclerosis

Atherosclerosis is the primary cause of cardiovascular and cerebrovascular diseases. However, current anti-atherosclerosis drugs have shown conflicting therapeutic outcomes, thereby spurring the search for novel and effective treatments. Recent research indicates the crucial involvement of oral and gastrointestinal microbiota in atherosclerosis. While gut microbiota metabolites, such as choline derivatives, have been extensively studied and reviewed, emerging evidence suggests that bacterial extracellular vesicles (BEVs), which are membrane-derived lipid bilayers secreted by bacteria, also play a significant role in this process. However, the role of BEVs in host-microbiota interactions remains insufficiently explored. This review aims to elucidate the complex communication mediated by BEVs along the gut-heart axis. In this review, we summarize current knowledge on BEVs, with a specific focus on how pathogen-derived BEVs contribute to the promotion of atherosclerosis, as well as how BEVs from gut symbionts and probiotics may mitigate its progression. We also explore the potential and challenges associated with engineered BEVs in the prevention and treatment of atherosclerosis. Finally, we discuss the benefits and challenges of using BEVs in atherosclerosis diagnosis and treatment, and propose future research directions to address these issues.

Effect of curcumin on methotrexate-induced ovarian damage and follicle reserve in rats: the role of PARP-1 and P53

BACKGROUND

Methotrexate (MTX) is an agent used in the treatment of many neoplastic and non-neoplastic diseases and is known to cause oxidative damage in normal tissues. Curcumin (Cur) is a natural polyphenol compound with powerful antioxidant and antiapoptotic effects. In this study we investigate the effects of Cur on MTX-induced ovarian damage.

MATERIALS AND METHODS

Thirty-two young adult female Wistar albino rats were divided into four groups: (1) Control (n = 8): only vehicle group, (2) Cur (n = 8): Cur-only group (200 mg/kg/day), (3) MTX (n = 8): MTX-only group (0.35 mg/kg/day), (4) MTX+Cur (n = 8): The group was given MTX (0.35 mg/kg/day) and Cur (200 mg/kg/day) for 28 days. Then, SOD, CAT, MDA, AMH levels were measured using ELISA kits. Follicle count was performed on H&E stained slides. In addition, the expressions of P53 and PARP-1 were analysed by immunohistochemistry.

RESULTS

MDA levels were seen to be higher in the MTX group than in the MTX+Cur group (p < 0.05). Cur treatment lowered MDA levels and increased SOD and CAT levels (p < 0.05 for all). In the MTX+Cur group, atretic follicle count decreased (p < 0,05), however, primordial follicle count increased (p < 0,01). Secondary follicle count and AMH levels were higher in MTX-treated groups (p < 0,05 and p < 0,01, respectively). Expressions of p53 and Poly [ADP-ribose] polymerase 1 (PARP-1) increased significantly in the MTX group compared to the other groups (p < 0,05).

CONCLUSION

Cur pretreatment prior to MTX administration may be an effective option in preserving the ovarian follicle pool by regulating P53 and PARP-1 expressions with its antioxidant effect.

Pathogenicity and virulence of Helicobacter pylori: A paradigm of chronic infection

Infection with Helicobacter pylori is one of the most common infections of mankind. Infection typically occurs in childhood and persists for the lifetime of the host unless eradicated with antimicrobials. The organism colonizes the stomach and causes gastritis. Most infected individuals are asymptomatic, but infection also causes gastric and duodenal ulceration, and gastric cancer. H. pylori possesses an arsenal of virulence factors, including a potent urease enzyme for protection from acid, flagella that mediate motility, an abundance of outer membrane proteins that can mediate attachment, several immunomodulatory proteins, and an ability to adapt to specific conditions in individual human stomachs. The presence of a type 4 secretion system that injects effector molecules into gastric cells and subverts host cell signalling is associated with virulence. In this review we discuss the interplay of H. pylori colonization and virulence factors with host and environmental factors to determine disease outcome in infected individuals.

Immunogenicity and vaccine efficacy of Actinobacillus pleuropneumoniae-derived extracellular vesicles as a novel vaccine candidate

Actinobacillus pleuropneumoniae (APP) is a significant pathogen in the swine industry, leading to substantial economic losses and highlighting the need for effective vaccines. This study evaluates the potential of APP-derived extracellular vesicles (APP-EVs) as a vaccine candidate compared to the commercial Coglapix vaccine. APP-EVs, isolated using tangential flow filtration (TFF) and cushioned ultracentrifugation, exhibited an average size of 105 nm and a zeta potential of -17.4 mV. These EVs demonstrated stability under external stressors, such as pH changes and enzymatic exposure and were found to contain 86 major metabolites. Additionally, APP-EVs induced dendritic cell (DC) maturation in a Toll-like receptor 4 (TLR4)-dependent manner without cytotoxicity. APP-EVs predominantly elicited Th1-mediated IgG responses in immunized mice without significant liver and kidney toxicity. Contrarily, unlike Coglapix, which induced stronger Th2-mediated responses and notable toxicity. In addition, APP-EVs triggered APP-specific Th1, Th17, and cytotoxic T lymphocyte (CTL) responses and promoted the activation of multifunctional T-cells. Notably, APP-EV immunization enhanced macrophage phagocytosis and improved survival rates in mice challenged with APP infection compared to those treated with Coglapix. These findings suggest that APP-EVs are promising vaccine candidates, capable of inducing potent APP-specific T-cell responses, particularly Th1, Th17, CTL, and multifunctional T-cells, thereby enhancing the protective immune response against APP infection.

Comprehensive analysis of faecal metagenomic and serum metabolism revealed the role of gut microbes and related metabolites in detecting colorectal lateral spreading tumours

Colorectal lateral spreading tumours (LST), early-stage lesions of colorectal cancer (CRC), are associated with gut microbiota dysbiosis. However, the functional alterations in gut microbiota and their metabolic pathways remain inadequately understood. This study employed propensity score matching to compare 35 LST patients with 35 healthy controls. Metagenomic and metabolomic analyses revealed notable differences in gut microbiota composition and metabolic pathways. LST patients exhibited a marked reduction in short-chain fatty acid (SCFA)-producing probiotics, such as Roseburia, Clostridium, and Butyricicoccus sp-OF13-6, alongside anti-inflammatory metabolites. In contrast, potential intestinal pathogens linked to inflammatory bowel disease (IBD), including Escherichia and Citrobacter amalonaticus, were significantly enriched. Orthogonal partial least squares discriminant analysis (OPLS-DA) highlighted significant metabolic disparities between the groups, with enrichment in pathways associated with cholesterol metabolism, choline metabolism in cancer, and amino acid metabolism - all relevant to cancer progression. Key biomarkers identified for LST included fumarate, succinate, glutamic acid, glycine, and L-aspartic acid, which were closely linked to these pathways. Functional studies demonstrated that these metabolites promoted the proliferation and invasion of HCT-116 and SW480 human colorectal cancer cells in vitro. Metagenomic and metabolomic analysis revealed a strong positive correlation between Escherichia and Ruminococcus sp-AM41-2AC abundance and the enriched pathways, whereas reductions in Roseburia species, including Roseburia-OF03-24 and Roseburia intestinalis_CAG13-exhibited negative correlations. These results suggest that gut microbiota and metabolite alterations in LST contribute to intestinal inflammation and CRC development, underscoring their potential as biomarkers for early detection and therapeutic targets.

Diverse processes in rotavirus vaccine development

Rotavirus is a major cause of severe diarrhea and mortality in children under five years of age, leading to approximately 128,500 deaths annually.1-3 Vaccination is the most effective strategy for preventing rotavirus infection. While two widely used vaccines, Rotarix and RotaTeq, have shown good efficacy in high-income countries, their effectiveness is lower in low- and middle-income countries due to factors such as malnutrition and poor sanitation.4-6 These challenges include complex vaccination schedules and high production costs. Researchers are working on novel vaccines, including inactivated virus and viral protein-based options, as well as virus-like particles and recombinant proteins.7-9 Improving vaccine stability and applicability is crucial for resource-limited settings, and global vaccination strategies are expected to significantly reduce infection burdens, improve child health, and contribute to the achievement of global health goals.10-14.

Comorbidities and anthropometric parameters in obstructive sleep apnea syndrome: a phenotype-based study

PURPOSE

Obstructive Sleep Apnea Syndrome (OSAS) is a heterogeneous syndrome and shows different phenotypic, clinical and physiopathological features. The aim of this study was to examine the relationships between OSAS phenotypes and comorbidities and anthropometric measurements and to identify OSAS phenotypes that should be referred for early diagnosis and treatment.

MATERIALS AND METHODS

We retrospectively reviewed 600 patients who underwent polysomnography (PSG) in our sleep center. Seven phenotypes were defined as Simple Snoring (SS)-Control, Mild, Moderate and Severe OSAS, Rem Dependent OSAS (RDO), Position Dependent OSAS (PDO) and Rem+Position dependent OSAS (R+PDO). Demographic data, anthropometric measurements and comorbid diseases of the patients were obtained retrospectively from their files. OSAS phenotypes were compared with comorbidities and anthropometric measurements.

RESULTS

Severe OSAS was the most common phenotype. Oxygen desaturation index (ODI) and anthropometric measurements showed significant differences between phenotypes (p < .001). Hypertension (HT) (43.7%) and ischemic heart disease (CHD) (14.2%) were the most common comorbidities and were most commonly associated with severe OSAS. In logistic regression analysis, neck circumference (NC) and body mass index (BMI) were the anthropometric measures that predicted OSAS phenotypes. NC and BMI predicted severe OSAS, NC predicted PDO and R+PDO, and BMI predicted RDO.

CONCLUSION

This study revealed that OSAS phenotypes exhibit different clinical and anthropometric characteristics and differ in comorbidity risks. HT was found to be higher in severe OSAS, moderate OSAS and R+PDO, and CHD was higher in severe OSAS and RDO. Our study emphasized the importance of phenotypic characteristics as well as AHI in the management of comorbidities in OSAS.

Machine learning models for prediction of NPVR ≥80% with HIFU ablation for uterine fibroids

BACKGROUND

Currently high-intensity focused ultrasound (HIFU) is widely used to treat uterine fibroids (UFs). The aim of this study is to develop a machine learning model that can accurately predict the efficacy of HIFU ablation for UFs, assisting the preoperative selection of suitable patients with UFs.

METHODS

This study collected data from 1,000 patients with UFs who underwent ultrasound-guided high-intensity focused ultrasound. The least absolute shrinkage and selection operator (LASSO) regression was used for multidimensional feature screening. Five machine learning algorithms such as logistic regression, random forest, extreme gradient boosting (XGBoost), artificial neural network, and gradient boosting decision tree were utilized to predict ablation efficacy. The efficacy was quantified by the non-perfused volume ratio (NPVR), which was classified into two categories: NPVR <80% and NPVR ≥80%.

RESULTS

The XGBoost model proved to be the most effective, showing the highest AUC of 0.692 (95% CI: 0.622-0.762) in the testing data set. The four key predictors were T2 weighted image, the distance from ventral side of UFs to skin, platelet count, and contrast-enhanced T1 weighted image.

CONCLUSIONS

The machine learning prediction model in this study showed significant potential for accurately predicting the preoperative efficacy of HIFU ablation for UFs. These insights were important for clinicians in the preoperative assessment and selection of patients, which could enhance the precision of treatment planning.

Identification and validation of programmed cell death related biomarkers for the treatment and prevention COVID-19

PURPOSE

Programmed cell death (PCD) plays a key role in the progression of coronavirus disease 2019 (COVID-19). However, PCD-relevant biomarkers have not been fully discovered. The aim of this study was to explore the PCD-relevant biomarkers for the treatment and prevention of COVID-19.

METHODS

Bioinformatic analyses were performed to explore the clinical relevant PCD genes with differential expression (DE) in COVID-19 compared with matched controls. PPI network was used for hub genes screening and machine learning methods were employed for filtering feature genes. The biomarker genes were screened by Venn diagram. The correlations between biomarkers with clinical features and immune microenvironment were further explored. Biomarker validation was performed in clinical samples by real-time reverse transcriptase-polymerase chain reaction (RT-qPCR).

RESULTS

In total, 118 clinically relevant and PCD associated differential expressed genes (DEGs) were screened, which were mainly related with apoptosis related pathways, among which six biomarkers (Cyclin B1 (CCNB1), cyclin-dependent kinase 1 (CDK1), interferon regulatory factor 4 (IRF4), lipoteichoic acid (LTA), matrix metallopeptidase 9 (MMP9) and Oncostatin M (OSM)) were identified. The excellent or good diagnostic performance of biomarkers was determined by receiver operating characteristic (ROC) curve analysis. The biomarkers showed diverse correlations with clinical indicators, such as age, sex and Intensive Care Unit (ICU) admission. Total 14 types of immune cells exerted differential infiltration between COVID-19 and controls. Biomarkers were correlated with immune cells at varying levels. COVID-19 was classified in three clusters, which showed differential expression of biomarker genes and significant associations with clinical information, such as sex, age and ICU admission. The DEGs of biomarkers were determined in COVID-19 patients relative to controls.

CONCLUSION

The six biomarkers (CCNB1, CDK1, IRF4, LTA, MMP9 and OSM) can be served as the biomarkers for the treatment and prevention of COVID-19.

Amplification of cGAS-STING pathway with "single-molecule multitarget" nanoparticles for chemo-immunotherapy of ovarian cancer

With a low autoimmune risk and dedicated induction of type Ⅰ interferon production in immunotherapy, "STING therapy" holds broad prospects in the treatment of aggressive and metastatic cancers such as ovarian cancer (OC). Inducing pyroptosis constitutes a promising approach for activating the anti-tumor immune response. Nevertheless, compared to combination therapies, "single-molecule multitarget" drugs possess the merits of a lower interaction risk, more predictable pharmacokinetics and a lower cost of clinical trials. Therefore, the present study was conducted to construct a structurally stable nanoparticles (TPAQu-Pt@HA NPs) with controlled drug release behavior and active targeting ability based on a self-designed and synthesized photo-platinum compound (TPAQu-Pt) with aggregation-induced emission (AIE) effect without excipients. The NPs attained "single-molecule multitarget" effect via three mechanisms: 1) causing nuclear and mitochondrial DNA damage and cytoplasmic leakage of double-stranded DNA (dsDNA), effectively activating cGAS-STING pathway; 2) inducing pyroptosis benefited from the AIE effect conferring a stronger ROS-generating capacity; 3) photothermal therapy worsened mitochondrial dysfunction and intensified pyroptosis, amplifying activation of cGAS-STING pathway and the subsequent anti-tumor immune response. In conclusion, this study provided a scientific basis for the molecular modification of cisplatin, which was expected to improve the treatment status of OC.

Pooled analysis of oral vinorelbine as single agents in patients with advanced NSCLC

OBJECTIVES

This was a pooled analysis of data from weekly vinorelbine (VNR) treatment arms of four individual open-label, phase II studies to assess and refine the efficacy and tolerance of weekly oral VNR in a larger cohort of patients with advanced NSCLC.

MATERIALS AND METHODS

All patients included in this pooled analysis received oral VNR at the dose of 60 mg/m2 weekly at cycle 1 (3-week cycle), followed by an increase to 80 mg/m2 weekly for subsequent cycles until disease progression or toxicity. Efficacy was based on objective response rate (ORR), progression-free survival (PFS), and disease control rate (DCR).

RESULTS

A total of 247 patients were included. The ORR and DCR were 8.9% and 57.5% respectively, median PFS and OS were 3.3 and 8.5 months, respectively. Less than half (40.7%) of patients reported ≥1 serious AE (regardless of causality), with 12.3% reporting ≥1 treatment-related serious AE (grade ≥3: 11.1%). The most reported grade ≥3 AEs were neutropenia (17.6%), fatigue (5.8%), and decreased appetite (4.9%).

CONCLUSION

This pooled analysis showed that weekly oral VRN is a valid option, with an acceptable safety profile, in this population of patients with advanced NSCLC, confirming results from previous individual studies.

Novel prognostic scoring models for hepatitis B virus-related acute-on-chronic liver failure: A comparison with classical models

Early diagnosis and accurate prognostic evaluation are important for guiding clinical treatment and reducing mortality in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF). The present study established novel prognostic scoring models to guide the clinical treatment of patients with HBV-ACLF. We performed a retrospective analysis of clinical data from two cohorts of patients diagnosed with HBV-ACLF. By comparing differences in baseline characteristics and clinical indicators between the survival (n = 102) and dead (n = 64) groups in the derivation cohort(n = 166), four laboratory indicators (age, INR, TBIL, and HBeAg status) and three clinical signs (extrahepatic infection, ascites, and hepatic encephalopathy) were identified as independent risk factors. Logistic regression and nomogram models were used to construct three novel predictive models. By comparing the death and survival groups, we found that the three new models had higher predictions for AUROC (average of 0.856) than the three old models (average of 0.773). Model 1 had the strongest predictive power for the short-term survival rate of HBV-ACLF patients. Finally, we verified the predictive value of the new models for HBV-ACLF in a validation cohort (n = 42), and the Model 2 demonstrated good predictive accuracy for the 30-day survival rate of patients. The novel model based on seven predictors could accurately predict short-term mortality in patients with HBV-ACLF, which is promising for guiding clinical management and addressing the aetiological differences in Asian populations.

Oxidative stress and reactive oxygen species in otorhinolaryngological diseases: insights from pathophysiology to targeted antioxidant therapies

Oxidative stress, characterized by an imbalance between excessive reactive oxygen species (ROS) production and impaired antioxidant defenses, is closely linked to the pathogenesis of various otorhinolaryngological disorders. Mitochondria, as the primary site of cellular energy production, play a crucial role in modulating oxidative stress. Mitochondrial dysfunction exacerbates ROS generation, leading to cellular damage and inflammatory responses. In otorhinolaryngological diseases, oxidative stress is strongly associated with conditions such as hearing loss, allergic rhinitis, and chronic sinusitis, where oxidative damage and tissue inflammation are key pathological features. Recent studies have highlighted the potential of antioxidant therapies to mitigate oxidative stress and restore homeostasis, offering promising avenues for alleviating symptoms in these diseases. However, despite the encouraging results from early-stage research, the clinical efficacy of antioxidant interventions remains to be fully established. This review provides an overview of the role of oxidative stress in otorhinolaryngological diseases and evaluates the therapeutic potential of antioxidant strategies.

Microbial diversity and fitness in the gut-brain axis: influences on developmental risk for Alzheimer's disease

The gut-brain axis (GBA) denotes the dynamic and bidirectional communication system that connects the gastrointestinal tract and the central nervous system (CNS). This review explored this axis, focusing on the role of microbial diversity and fitness in maintaining gastrointestinal health and preventing neurodegeneration, particularly in Alzheimer's disease (AD). Gut dysbiosis, characterized by the imbalance in populations of beneficial and harmful bacteria, has been associated with increased systemic inflammation, neuroinflammation, and the progression of AD through pathogenic mechanisms involving amyloid deposition, tauopathy, and increased blood-brain barrier (BBB) permeability. Emerging evidence highlighted the therapeutic potential of probiotics, dietary interventions, and intermittent fasting in restoring microbial balance, reducing inflammation, and minimizing neurodegenerative risks. Probiotics and synbiotics are promising in helping improve cognitive function and metabolic health, while dietary patterns like the Mediterranean diet were linked to decreased neuroinflammation and enhanced gut-brain communication. Despite significant advancement, further research is needed to elucidate the specific microbial strains, metabolites, and mechanisms influencing brain health. Future studies employing longitudinal designs and advanced omics technologies are essential to developing targeted microbiome-based therapies for managing AD-related disorders.

Epigenetic regulation of the inflammatory response in stroke

Stroke is classified as ischemic or hemorrhagic, and there are few effective treatments for either type. Immunologic mechanisms play a critical role in secondary brain injury following a stroke, which manifests as cytokine release, blood-brain barrier disruption, neuronal cell death, and ultimately behavioral impairment. Suppressing the inflammatory response has been shown to mitigate this cascade of events in experimental stroke models. However, in clinical trials of anti-inflammatory agents, long-term immunosuppression has not demonstrated significant clinical benefits for patients. This may be attributable to the dichotomous roles of inflammation in both tissue injury and repair, as well as the complex pathophysiologic inflammatory processes in stroke. Inhibiting acute harmful inflammatory responses or inducing a phenotypic shift from a pro-inflammatory to an anti-inflammatory state at specific time points after a stroke are alternative and promising therapeutic strategies. Identifying agents that can modulate inflammation requires a detailed understanding of the inflammatory processes of stroke. Furthermore, epigenetic reprogramming plays a crucial role in modulating post-stroke inflammation and can potentially be exploited for stroke management. In this review, we summarize current findings on the epigenetic regulation of the inflammatory response in stroke, focusing on key signaling pathways including nuclear factor-kappa B, Janus kinase/signal transducer and activator of transcription, and mitogen-activated protein kinase as well as inflammasome activation. We also discuss promising molecular targets for stroke treatment. The evidence to date indicates that therapeutic targeting of the epigenetic regulation of inflammation can shift the balance from inflammation-induced tissue injury to repair following stroke, leading to improved post-stroke outcomes.

Impact of cognitive rehabilitation interventions on memory improvement in patients after stroke: A systematic review

BACKGROUND

Cognitive impairment is a major cause of disability in patients who have suffered from a stroke, and cognitive rehabilitation interventions show promise for improving memory.

AIM

To examine the effectiveness of virtual reality (VR) and non-VR (NVR) cognitive rehabilitation techniques for improving memory in patients after stroke.

METHODS

An extensive and thorough search was executed across five pertinent electronic databases: Cumulative Index to Nursing and Allied Health Literature; MEDLINE (PubMed); Scopus; ProQuest Central; and Google Scholar. This systematic review was conducted following the preferred reporting items for systematic reviews and meta-analyses guideline. Studies that recruited participants who experienced a stroke, utilized cognitive rehabilitation interventions, and published in the last 10 years were included in the review.

RESULTS

Thirty studies met the inclusion criteria. VR interventions significantly improved memory and cognitive function (mean difference: 4.2 ± 1.3, P < 0.05), whereas NVR (including cognitive training, music, and exercise) moderately improved memory. Compared with traditional methods, technology-driven VR approaches were particularly beneficial for enhancing daily cognitive tasks.

CONCLUSION

VR and NVR reality interventions are beneficial for post-stroke cognitive recovery, with VR providing enhanced immersive experiences. Both approaches hold transformative potential for post-stroke rehabilitation.

Nutritional and lifestyle predictors of rectal bleeding in functional constipation: A machine learning approach

BACKGROUND

Rectal bleeding among young adults is an increasingly common clinical concern often linked with chronic constipation and unhealthy lifestyle habits. Early identification of at-risk individuals through machine learning models-based approach may help in prevention and targeted intervention.

OBJECTIVES

We aim to identify dietary and lifestyle risk factors for rectal bleeding and to develop machine learning-based models for risk prediction.

METHODS

A descriptive observational study was conducted on 875 Indian college going participants. A structured questionnaire assessed fiber intake, physical activity, constipation symptoms, and body mass index (BMI). Multiple machine learning algorithms were evaluated, and their performance was assessed using accuracy and area under the receiver operating characteristic curve (ROC-AUC).

RESULTS

Low intake of boiled vegetables or oatmeal (<50 g/day) was associated with a 43.92 % bleeding rate (p < 0.001). Participants consuming inadequate whole grains (>25 g/day) showed a 44.81 % bleeding rate. Overweight or obese individuals exhibited a significantly higher bleeding incidence (12.26 %) than those with normal BMI (5.55 %; p = 0.008). The KNeighbors Classifier showed the highest accuracy (98.86 %) and ROC-AUC (0.994). Variables related to symptoms had greater predictive importance than those related to lifestyle.

CONCLUSIONS

The findings support the role of dietary fiber and BMI in the development of rectal bleeding in constipated individuals. The predictive models demonstrate strong potential for identifying at-risk individuals and is considered a simple and useful tool for predicting rectal bleeding in functional constipation, suggesting preventive health strategies and dietary modifications. This novel algorithm might enable clinicians to perform personalized dietary strategies with improved clinical outcomes. Further validation across larger and more diverse populations is recommended.

Umbilical cord-derived mesenchymal stem cells secretomes promote embryo development and implantation

AIMS

Successful implantation relies on high-quality blastocysts, uterine receptivity, and effective embryo-endometrium communication. This study investigated the effects of umbilical cord-derived mesenchymal stem cells (UC-MSC) secretomes on embryo development and implantation.

MAIN METHODS

Trophoblastic spheroids and murine embryos were used to evaluate the impact of UC-MSC secretomes. Embryos obtained through superovulation were cultured in vitro and divided into five groups: a control group and four experimental groups treated with varying concentrations of UC-MSC secretomes (2.5, 5, 10, and 50 μg/mL). Embryo development competence and implantation potential were assessed in each group, and the expression levels of related genes were analyzed.

KEY FINDINGS

Supplementation with UC-MSC secretomes significantly enhanced trophoblast cell migration. It also stimulated endometrial cell proliferation and upregulated key implantation-related genes (LIF, LIFR, VEGFA, ITGB3, and ITGAV), improving endometrial receptivity and adhesion in trophoblastic spheroid co-cultures. While morulation rates of murine embryos remained unchanged, UC-MSC secretomes supplement significantly increased blastulation, pluripotency gene expression, and hatching rates. Supplementation with 10 and 50 μg/mL significantly increased blastocyst diameter and blastomere number, as well as embryo adhesion, outgrowth areas, and implantation rates. Additionally, growth factor analysis showed elevated VEGF-A and PDGF-AA levels in the culture media.

SIGNIFICANCE

This study demonstrates that UC-MSC secretomes enhance both embryo development and endometrial cell function, facilitating implantation potential. These findings suggest their potential utility in supporting preimplantation embryos and improving maternal endometrial receptivity in ART.

Exploring the impact of barberry extract and grilling on oxidative and nitrosative reactions in fermented sausages: Insights into lipid-protein oxidation, nitrosamine, and 3-nitrotyrosine as a potential biomarker

This study examines the effect of barberry extract (BE) on the oxidative and nitrosative stability, as well as the quality, of meat batter, fermented sausages, and grilled sausages. Four groups were tested: Control (no BE), B200 (200 mg/kg BE), B300 (300 mg/kg BE), and B400 (400 mg/kg BE). BE exhibited high total phenolic content (46.33 mg GAE/g) and antioxidant activity (92.93 %), with a pH of 3.80. LC-QTOF-MS identified key compounds such as chlorogenic acid, quercetin, and canadine, known for their antioxidative properties. BE significantly reduced nitrite content, demonstrating pH-dependent nitrite-scavenging activity. Higher concentrations (B300, B400) led to reduced redness (a*), indicating slight changes in color stability. BE also inhibited lipid-protein oxidation, with lower peroxide values, TBARS, carbonyls, and sulfhydryls, and significantly reduced 3-nitrotyrosine (3-NT) and nitrosamine concentrations (P < 0.05). Despite cooking-induced increases in nitrosamines, BE minimized this rise, keeping nitrosamine levels lower than the control (P < 0.05). The correlation between 3-NT levels and oxidation products suggests 3-NT as a potential biomarker for oxidative stress. These findings suggest that BE enhances antioxidant properties, mitigates nitrosative stress, and improves the quality of meat products.

Anoikis resistance in Cancer: Mechanisms, therapeutic strategies, potential targets, and models for enhanced understanding

Anoikis, defined as programmed cell death triggered by the loss of cell-extracellular matrix (ECM) and cell-cell interactions, is crucial for maintaining tissue homeostasis and preventing aberrant cell migration. Cancer cells, however, display anoikis resistance (AR) which in turn enables cancer metastasis. AR results from alterations in apoptotic signaling, metabolic reprogramming, autophagy modulation, and epigenetic changes, allowing cancer cells to survive in detached conditions. In this review we describe the mechanisms underlying both anoikis and AR, focusing on intrinsic and extrinsic pathways, disrupted cell-ECM interactions, and autophagy in cancer. Recent findings (i.e., between 2014 and 2024) on epigenetic regulation of AR and its role in metastasis are discussed. Therapeutic strategies targeting AR, including chemical inhibitors, are highlighted alongside a network analysis of 122 proteins reported to be associated with AR which identifies 53 hub proteins as potential targets. We also evaluate in vitro and in vivo models for studying AR, emphasizing their role in advancing metastasis research. Our overall goal is to guide future studies and therapeutic developments to counter cancer metastasis.

Stage-dependent efficacy of short-chain fatty acids in amyotrophic lateral sclerosis: Insights into autophagy and neuroprotection

AIMS

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease with limited therapeutic options. Previously, we have shown that a combination of multiple probiotic strains can regulate intestinal flora, increase serum short-chain fatty acids (SCFAs), reduce abnormal protein accumulation in the spinal cord, and protect neurons. It is necessary to explore the mechanism to provide therapeutic targets for ALS.

MATERIALS AND METHODS

This study utilizes live cell imaging, mouse behavioral research, immunofluorescence, Electron microscopy, Western Blot, and polymerase chain reaction to explore the impact of various SCFAs on ALS animal and cell models, as well as their underlying mechanisms.

KEY FINDINGS

We found SCFAs, including butyrate and propionate can increase the levels of acetylated histones, enhance the expression of autophagy-related genes and regulate autophagy, leading to a decrease in abnormal SOD1 aggregation, reduction of cell damage, and enhancement of cell proliferation in NSC34-SOD1G93A cells. Furthermore, systemic administration of butyrate and propionate can regulate autophagy, reduce SOD1 aggregation, and protect spinal cord neurons in SOD1G93A mice. However, these favorable effects of butyrate and propionate are greatly decreased at later stages of the disease process in SOD1G93A mice.

SIGNIFICANCE

Our study revealed that the positive impact of SCFAs in autophagy could be a promising focus for ALS therapy. However, this effect might have different impacts in different stages of ALS.

The effects of selected phytochemicals on schizophrenia symptoms: A review

There are suggested treatment options for schizophrenia (SZ), including antipsychotic medications. Unfortunately, these drugs mostly ameliorate only the positive symptoms of SZ, and patients have less tendency for compliance due to the drug's side effects. Hence, there is a need for additional or adjunct therapeutic options. This review considers selected phytochemicals with anti-schizophrenic activity as an alternative therapy. We searched the scientific literature and reviewed the evidence from pre-clinical (animal) and clinical studies using some phytochemicals in SZ. The reviewed phytochemicals provided varying potential beneficial effects on SZ. Of particular interest, berberine may provide additional ameliorative advantages against the disorder. Although still nascent in scientific research, these studies suggest a potential adjunct therapeutic option against the pathophysiological pathways implicated in SZ. We recommend robust, carefully performed randomized controlled trials evaluating the role of these phytochemicals in SZ.

Nanotherapeutic strategies exploiting biological traits of cancer stem cells

Cancer stem cells (CSCs) represent a distinct subpopulation of cancer cells that orchestrate cancer initiation, progression, metastasis, and therapeutic resistance. Despite advances in conventional therapies, the persistence of CSCs remains a major obstacle to achieving cancer eradication. Nanomedicine-based approaches have emerged for precise CSC targeting and elimination, offering unique advantages in overcoming the limitations of traditional treatments. This review systematically analyzes recent developments in nanomedicine for CSC-targeted therapy, emphasizing innovative nanomaterial designs addressing CSC-specific challenges. We first provide a detailed examination of CSC biology, focusing on their surface markers, signaling networks, microenvironmental interactions, and metabolic signatures. On this basis, we critically evaluate cutting-edge nanomaterial engineering designed to exploit these CSC traits, including stimuli-responsive nanodrugs, nanocarriers for drug delivery, and multifunctional nanoplatforms capable of generating localized hyperthermia or reactive oxygen species. These sophisticated nanotherapeutic approaches enhance selectivity and efficacy in CSC elimination, potentially circumventing drug resistance and cancer recurrence. Finally, we present an in-depth analysis of current challenges in translating nanomedicine-based CSC-targeted therapies from bench to bedside, offering critical insights into future research directions and clinical implementation. This review aims to provide a comprehensive framework for understanding the intersection of nanomedicine and CSC biology, contributing to more effective cancer treatment modalities.

The role of the tumor microenvironment and inflammatory pathways in driving drug resistance in gastric cancer: A systematic review and meta-analysis

Tumor microenvironment (TME) plays a pivotal role in progression and low responsiveness to chemotherapy of gastric cancer (GC). The cascade of events that culminate with a sustained and chronic activation of inflammatory pathways underlies gastric tumorigenesis. Infiltrating immune cells enrolling in crosstalk with cancer cells that regulate inflammatory and immune status, generating an immunosuppressive TME that influences the response to therapy. Here we discuss the role of TME and the activation of inflammatory pathways to comprehend strategies to improve drug response. Furthermore, we provides systematic insight the role of TME cytotypes and related signatures reinforcing the critical roles of TAMs and Tregs, in promoting GC chemoresistance and tumor progression.

LncRNA SNHG1: A novel biomarker and therapeutic target in hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality globally. Increasing evidence suggests that long non-coding RNAs play a critical role in cancer development, with the small nucleolar RNA host gene family being a key participant in multiple types of carcinogenesis, including HCC. Small nucleolar RNA host gene 1 (SNHG1) is a significant member of the SNHG family. SNHG1 expression consistently increases in various HCC-associated processes, such as cell proliferation, apoptosis, angiogenesis, migration, invasion, and treatment resistance. Higher SNHG1 expression levels predict worse prognosis by positively correlating with clinicopathological features, including larger tumour size, poor differentiation, and advanced stages in patients with HCC. Nevertheless, the precise role of SNHG1 in the initiation and progression of HCC remains unclear. Therefore, this review aims to summarise the current investigations on the pathogenesis of SNHG1 in HCC, highlighting its potential as a molecular marker for early prediction and prognostic assessment. As a multifunctional modulator, SNHG1 is extensively involved in molecular signalling pathways in HCC progression and is valuable for therapeutic targeting.

Strategic attenuation of Cd accumulation in rice through stage-specific flooding: Synergistic coordination of rhizospheric Cd bioavailability, microbial communities, and iron plaque speciation

Continuous flooding (CF) effectively mitigates rice cadmium (Cd) contamination but raises concerns about water scarcity and greenhouse gas emissions, limiting sustainability. Therefore, there is a need for water management strategies that can reduce Cd accumulation in rice without the substantial resource demands of CF. Field trials conducted in Cd-contaminated paddy fields in southern China compared eight water management strategies, including continuous drainage (CD), stage-specific flooding, and CF, to identify alternatives for reducing rice Cd accumulation. Delaying flooding stages and extending flooding duration progressively decreased Cd levels in rice tissues. Although CF achieved the lowest brown rice Cd levels (0.04-0.06 mg/kg), it also caused yield reductions. Among the alternatives, grain-filling stage flooding resulted in a reduction of Cd levels in brown rice compared to vegetative-stage flooding, decreasing the health risks of Cd from intake of brown rice. Specifically, grain-filling stage flooding for 20 days (FG20) was particularly effective, reducing Cd concentrations in brown rice by 82.74 % (YA) and 28.61 % (HG) compared to CD, and by 3.67 %-74.82 % compared to vegetative-stage flooding. FG20 significantly reduced soil Cd bioavailability to levels comparable to CF, while also similarly increasing soil pH and promoting iron plaque formation compared to CD. Additionally, FG20 modulated the soil microbial community, stimulating Cd-immobilizing bacteria (e.g., Clostridium_sensu_stricto_13, Oxobacter) while suppressing Cd-mobilizing bacteria (e.g., Porphyrobacter, Anaerolinea), stabilizing Cd in soil. Collectively, extending the grain-filling stage flooding duration (e.g., to 20 days) in Cd-contaminated rice production areas can both significantly reduce water resource consumption and facilitate practical implementation for farmers.

TRAF1 promotes the progression of Helicobacter pylori-associated gastric cancer through EGFR/STAT/OAS signalling

AIMS

Helicobacter pylori (H. pylori) is associated with various gastric diseases and is one of the pathogenic factors of gastric cancer (GC). We found that H. pylori induce the expression of TRAF1, but its mechanism of action is still unclear. Therefore, we wanted to determine whether TRAF1 is involved in the mechanism of H. pylori-related GC progression.

MATERIALS AND METHODS

In this study, we analysed TRAF1 expression and its prognostic significance using clinical specimens, performed functional studies involving TRAF1 overexpression or knockdown in cellular models, identified downstream signalling pathways regulated via RNA-seq, validated these mechanisms through pathway blockade and rescue experiments, and further confirmed the findings in an H. pylori-infected gastritis mouse model.

KEY FINDINGS

TRAF1 expression was significantly elevated in GC tissues and served as a poor prognostic biomarker. TRAF1 promoted GC cell proliferation, migration and invasion. RNA-seq analysis revealed that TRAF1 activated the EGFR/STAT/OAS signalling axis, upregulated STAT3 expression and increased the transcription of the OAS gene family. Pharmacological inhibition with ruxolitinib and AG490 effectively blocked EGFR/STAT/OAS signalling. In H. pylori-treated cell models, H. pylori infection activated the EGFR/STAT/OAS signalling axis. In vivo, we established an H. pylori-induced gastritis mouse model to validate the activation of this signalling pathway during the gastritis-carcinoma transition.

SIGNIFICANCE

TRAF1 may promote the proliferation, migration and invasion of H. pylori-associated GC by activating the EGFR/STAT/OAS signalling axis, suggesting that TRAF1 is a promising novel prognostic biomarker and therapeutic target for this malignancy.

Co-exposure to microplastics enhances the allergenic potentials of house dust mite allergen Der p 1

Air pollution is believed to exacerbate the prevalence of allergic diseases. But the underlying processes and mechanisms are not fully understood. In this study, the effects of polystyrene microplastics (PS-MPs) with a diameter of 0.1 μm, 1 μm, and 5 μm were investigated on the allergenic potentials of house dust mite allergen Der p 1. The results reveal that co-exposure to PS-MPs promoted the IgE-binding capacity of Der p 1 by altering the conformation, elevating the ligand-binding activity, and strengthening the aggregation of Der p 1. PS-MPs also exacerbated the damage to airway epithelial barrier by increasing the permeability of bronchial epithelial cells. Ultimately, co-exposure to PS-MPs aggravated the Th2-mediated immune responses and allergic sensitization induced by Der p 1. These evidences indicate that co-exposure to PS-MPs enhanced the allergenic potentials of Der p 1. Moreover, the PS-MPs-induced enhancement of the allergenic potential of Der p 1 is size-dependent, with smaller PS-MPs exhibiting greater promotion on the allergenic potential of Der p 1. Given the ubiquitous occurrence of PS-MPs in the environment, the co-exposure of allergens and PS-MPs should be seriously considered when assessing the allergenic risk of allergens in the real environment, especially for the PS-MPs with smaller size.

CD44 identified as a diagnostic biomarker for highly malignant CA19-9 negative pancreatic cancer

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive cancer with limited diagnostic biomarkers. Carbohydrate antigen 19-9 (CA19-9) is a widely used clinical biomarker and is generally considered to correlate with PDAC malignancy. However, the relationship between CA19-9 expression levels and tumor aggressiveness remains underexplored. In this study, we report a biphasic relationship between CA19-9 expression levels and PDAC malignancy, where both negative (<5 U/mL) and high (>37 U/mL) CA19-9 levels are associated with increased tumor aggressiveness. We defined CA19-9 negative PDAC as tumors that lack CA19-9 expression intracellulary, on the cell membrane, and in secreted form. In PDAC cell lines and patient-derived organoids, CA19-9 negativity, confirmed by immunofluorescence, flow cytometry and ELISA, correlated with more aggressive behaviors. In PDAC patients, tumors from those with serum CA19-9 levels below 5 U/mL exhibited stronger metabolically activity, more immunosuppressive tumor microenvironment, and worse survival than CA19-9 positive tumors, with over 90 % showing absent CA19-9 expression by immunohistochemistry (IHC). Glycoproteomics profiling identified CD44 as a highly expressed biomarker in CA19-9 negative PDAC. Elevated CD44 expression effectively distinguished CA19-9 negative PDAC from both CA19-9 positive PDAC and CA19-9 negative benign pancreatic diseases, suggesting its potential as a diagnostic tool. Furthermore, we developed a radionuclide-labeled CD44 antibody 89Zr-1M2E3, which specifically recognized CA19-9 negative PDAC tumors in preclinical models using PET-CT imaging. These findings highlight CD44 as a promising biomarker and therapeutic target for diagnosing and treating CA19-9 negative PDAC.

The interplay between gut microbiome, epigenetics, and substance use disorders: from molecular to clinical perspectives

Substance use disorders (SUDs) involve a complex series of central and peripheral pathologies, leading to impairments in cognitive, behavioral, and physiological processes. Emerging evidence indicates a more significant role for the microbiome-gut-brain axis (MGBA) in SUDs than previously recognized. The MGBA is interconnected with various body systems by producing numerous metabolites, most importantly short-chain fatty acids (SCFAs), cytokines, and neurotransmitters. These mediators influence the human body's epigenome and transcriptome. While numerous epigenetic alterations in different brain regions have been reported in SUD models, the intricate relationship between SUDs and the MGBA suggests that the gut microbiome may partially contribute to the underlying mechanisms of SUDs. Promising results have been observed with gut microbiome-directed interventions in patients with SUDs, including prebiotics, probiotics, antibiotics, and fecal microbiota transplantation. Nonetheless, the long-term epigenetic effects of these interventions remain unexplored. Moreover, various confounding factors and study limitations have hindered the identification of molecular mechanisms and clinical applications of gut microbiome interventions in SUDs. In the present review, we will (i) provide a comprehensive discussion on how the gut microbiome influences SUDs, with an emphasis on epigenetic alterations; (ii) discuss the current evidence on the bidirectional relationship of gut microbiome and SUDs, highlighting potential targets for intervention; and (iii) review recent advances in gut microbiome-directed therapies, along with their limitations and future directions.

Embryonic exposure to prednisone induces bone developmental toxicity in zebrafish: Characteristics and molecular mechanisms

As a synthetic glucocorticoid, prednisone has been widely used in autoimmune diseases, recurrent abortion and asthma during pregnancy. Although studies suggested that glucocorticoid exposure during pregnancy have developmental toxicity, systematic research on the characteristics of the developmental toxicity of prednisone is lacking. This study intends to construct embryonic prednisone exposure (EPE) model to observe its bone developmental toxicity characteristics of prednisone and explore the mechanism. The results showed that EPE can shortened body and head length, reduced eye and head area, decreased operculum mineralization area, reduced mineralized vertebrae number, shortened ceratohyal and palatoquadrate cartilage length, and decreased expression of key osteogenic differentiation and cartilage development genes. The toxicity to osteogenesis is more severe than chondrogenesis. The toxicity caused by exposure in the middle and terminal stages of embryogenesis is more serious and shows a concentration-effect relationship. We confirmed that Gr/Hdac6 signaling activation mediates prednisone-induced inhibition of osteoblast differentiation by epigenetically regulating the Postnb/Wnt/β-catenin signaling pathway. The results of this study systematically demonstrate the characteristics of prednisone-induced systemic, bone, and cartilage developmental toxicity, and clarify the epigenetic mechanism of its osteogenic developmental toxicity. This provides theoretical and experimental evidence for the safe use of prednisone during pregnancy and the determination of early monitoring targets for bone developmental toxicity.

Hand, foot and mouth disease with encephalomyelitis in adult: A case report

Hand, foot and mouth disease (HFMD) complications rarely develop in adults. We present a case of a 21-year-old woman with an acute onset of impaired consciousness, ptosis, and limb weakness. She had a history of close contact with an HFMD patient, fever, vesicles on her hands and nasopharynx, and decreased limb muscle power. The results of the head and spinal cord MRI and RT-PCR of cerebrospinal fluid and throat, skin lesion, and anal swabs confirmed enterovirus 71-induced encephalomyelitis. She received a single dose of IVIG therapy and fully recovered. Our report further confirms the possibilities of HFMD with severe neurological complications in adults. A history of contact with HFMD patients and lesions on the skin and mucosa, even unobvious, help diagnose the disease. Confirming central nervous system involvement requires cerebrospinal fluid analysis and brain and spinal cord MRI. Prompt IVIG treatment could help reduce fever, skin lesions, and recovery time.

Periprosthetic osteolysis: Mechanisms and potential treatment strategies

Periprosthetic osteolysis is a common bone-related disorder that often occurs after total hip arthroplasty. The implants can cause damage to bone and bone-related cells due to mechanical stress and micromotions, resulting in the generation of a large number of wear particles. These wear particles trigger inflammation and oxidative stress in the surrounding tissues, disrupting the delicate balance maintained by osteoblasts and osteoclasts, ultimately leading to bone loss around the implant. Clinical investigations have demonstrated that Epimedium prenylflavonoids, miR-19a-3p, stem cell-derived exosomes, and certain non-PPO category pharmaceuticals have regulatory effects on bone homeostasis through distinct molecular pathways. Notably, this phenomenon reflects inherent biological rationality rather than stochastic occurrence. Extensive research has revealed that multiple natural compounds, non-coding RNAs, exosomes, and non-PPO therapeutics not only exert modulatory influences on critical pathophysiological processes including inflammatory cascades, oxidative stress responses, and tissue regeneration mechanisms, but also effectively regulate bone-related cellular functions to inhibit PPO progression. Therefore, this review comprehensively and systematically summarizes the main pathogenic mechanisms of periprosthetic osteolysis. Furthermore, it delves deeper into the research progress on the applications of currently reported natural products, ncRNAs, exosomes, and non-PPO medications in the treatment of periprosthetic osteolysis. Based on this, we hope that this paper can provide new perspectives and references for the future development of drugs targeting periprosthetic osteolysis.

Molecular dissection of the role of ACE2 in glucose homeostasis

Angiotensin-converting enzyme 2 (ACE2) was discovered 25 years ago as a negative regulator of the renin-angiotensin system, opposing the effects of angiotensin II. Beyond its well-demonstrated roles in cardiovascular regulation and COVID-19 pathology, ACE2 is involved in a plethora of physiopathological processes. In this review, we summarize the latest discoveries on the role of ACE2 in glucose homeostasis and regulation of metabolism. In the endocrine pancreas, ACE2 is expressed at low levels in β-cells, but loss of its expression inhibits glucose-stimulated insulin secretion and impairs glucose tolerance. Conversely, overexpression of ACE2 improved glycemia, suggesting that recombinant ACE2 might be a future therapy for diabetes. In the skeletal muscle of ACE2-deficient mice a progressive triglyceride accumulation was observed, whereas in diabetic kidney the initial increase in ACE2 is followed by a chronic reduction of expression in kidney tubules and impairment of glucose metabolism. At the intestinal level dysregulation of the enzyme alters the amino acid absorption and intestinal microbiome, whereas at the hepatic level ACE2 protects against diabetic fatty liver disease. Not least, ACE2 is upregulated in adipocytes in response to nutritional stimuli, and administration of recombinant ACE2 decreased body weight and increased thermogenesis. In addition to tissue-specific regulation of ACE2 function, the enzyme undergoes complex cellular posttranslational modifications that are changed during diabetes evolution, with at least proteolytic cleavage and ubiquitination leading to modifications in ACE2 activity. Detailed characterization of ACE2 in a cellular and tissue-specific manner holds promise for improving therapeutic outcomes in diabetes and metabolic disorders.

Comprehensive analysis of a palmitoylation-related prognostic signature in colorectal cancer: Implications for immune therapy and personalized treatment

Colorectal cancer (CRC) remains one of the leading causes of cancer-associated mortality worldwide. While immune checkpoint inhibitors have shown promise in treatment, there is a need for reliable biomarkers to predict patient prognosis and guide personalized therapies. Palmitoylation, a post-translational modification, has been implicated in various cancer processes, yet its role in CRC prognosis remains unclear. Transcriptome, survival, somatic mutation and copy number variation data were retrieved from The Cancer Genome Atlas, and the GSE17538 dataset was used for external validation. A palmitoylation-related risk signature was developed using univariate Cox regression, Least Absolute Shrinkage and Selection Operator and multivariate Cox regression analyses. Patients were stratified into high- and low-risk groups based on the median risk score. Prognostic accuracy was assessed using receiver operating characteristic curves and Kaplan-Meier overall survival (OS) analysis with validation in an independent cohort. Functional enrichment, immune cell infiltration and drug sensitivity analyses were performed to explore underlying mechanisms and therapeutic implications. Subsequently, keratin 8 pseudogene 12 (KRT8P12) overexpression was evaluated in HT29 cells, and knockdown HT29 cell lines were generated using lentivirus. Cell proliferation was assessed using Cell Counting Kit-8 and 5-ethynyl-2'-deoxyuridine assays, cell migration was evaluated by Transwell assay and cell apoptosis was assessed using Annexin-V/propidium iodide staining. A palmitoylation-related risk signature consisting of six genes (KRT8P12, ZDHHC3, PCOLCE2, MPP2, LARS2 and MMAA) was identified. High-risk patients exhibited significantly worse OS (HR=3.19; P<0.001) compared with low-risk patients. Immune cell infiltration analysis revealed enhanced immune activity in the low-risk group, which was associated with higher expression of immune checkpoint genes. Immunotherapy prediction models indicated that low-risk patients might benefit more from immune checkpoint inhibitors. Drug sensitivity analysis identified distinct drug response profiles between the high- and low-risk groups. Furthermore, in vitro, KRT8P12 promoted tumor cell proliferation and migration while inhibiting apoptosis. In conclusion, the present study confirmed the role of KRT8P12 as a palmitoylation-related gene in regulating CRC. In addition, the palmitoylation-associated risk signature may offer a promising tool for prognostic prediction in CRC and could guide personalized treatment strategies, including immune checkpoint inhibitors and targeted therapies.

Sintilimab‑induced acute erosive hemorrhagic gastritis as an adverse reaction of third‑line therapy in a nasopharyngeal carcinoma patient: A case report

Immune checkpoint inhibitors (ICIs) have become an important treatment option for patients with nasopharyngeal carcinoma. With the increasing use of such agents, immune-related adverse events (irAEs) have become a concern. Identifying and managing the toxicity and side effects of ICIs is crucial, since it not only has implications for their safety but also the intensity and efficacy of subsequent use by patients. The present case report documents a 40-year-old male patient with acute erosive hemorrhagic gastritis associated with sintilimab treatment. In particular, the clinical manifestations, treatment, side effects and prognosis of this case was focused upon. The patient was diagnosed with locally advanced nasopharyngeal carcinoma (cT4N3M0 stage IVa) and developed bone metastases after 1 year of standard radiotherapy and adjuvant chemotherapy. After the first- and second-line treatments, pulmonary metastases occurred and sintilimab monotherapy was used as the third-line therapy. During the course of treatment, the optimal outcome for this patient was partial response according to the Response Evaluation Criteria in Solid Tumors (version 1.1). However, after 14 cycles of sintilimab the patient developed melena and epigastric pain and was diagnosed with acute erosive hemorrhagic gastritis, which was treated with methylprednisolone therapy. Progression-free survival with the third-line treatment was 542 days. Sintilimab-associated hemorrhagic gastritis is not fully recognized as an irAE. Therefore, early identification, diagnosis and management of irAEs are critical for subsequent therapy and progression-free survival of patients.

Brain-derived textiloma post glioblastoma resection and application of oxidized regenerated cellulose: A pilot, bedside-to-bench, translational study

Oxidized regenerated cellulose (ORC; marketed as Surgicel® and Tabotamp®) is routinely used as an intraoperative hemostatic agent. Rarely, residual ORC has been associated with a foreign body reaction generating cystic or granulomatous lesions (i.e., textilomas) at the surgical site. Here, we report a bedside-to-bench, translational report of an intracranial mass after neurosurgical resection of glioblastoma with ORC application. As part of patient care, we performed magnetic resonance imaging and histopathological analysis of the mass. We then performed in vitro studies to evaluate the effect of ORC on cytokine production and viability of BV-2 murine microglial cells by using quantitative PCR along with live cell microscopy and crystal violet staining, respectively. Magnetic resonance imaging demonstrated a recurrent mass pressing on the adjacent right ventricle, which was removed in a second surgery for diagnostic and therapeutic purposes. Unexpectedly, histopathological examination of the resected mass revealed abundant ORC arising from the site with inflammation, microglial activation, and collagenization. Mechanistically, we show an ORC-induced modest increase in inflammatory cytokines with a subsequent decrease in microglial cell viability. These findings suggest that ORC may mediate microglial immune response and viability, and serve to raise awareness and guide interpretation of post-treatment surveillance imaging findings in the instance of foreign body reaction.

Association between phase angle and body composition: New equations to predict fat mass and skeletal muscle mass

OBJECTIVE

The aim of this cross-sectional study was to develop new regression equations for estimating fat mass (FM) and skeletal muscle mass (SMM) in a heterogeneous Caucasian population, using the phase angle (PhA) as a bioelectrical parameter and DXA as the reference method. We also aimed to cross-validate the new equations, and to compare them with the manufacturers' equations.

METHODS

The 212 healthy Caucasian participants aged 20-65 years were randomly distributed into two groups: development group (n = 141) and validation group (n = 71). Bioelectrical parameters were obtained with a 50 kHz foot-to-hand phase-sensitive body composition analyzer. The new FM percentage (FM%) and SMM percentage (SMM%) equations were developed by performing multiple forward regression analyses. Agreement between DXA and the different equations was assessed by mean differences, coefficient of determination, standard error of the estimate (SEE), concordance correlation coefficient (CCC), and Bland-Altman plots.

RESULTS

The proposed equations explained 89.2% of the variance in the DXA-derived FM% and 91.8% in the DXA-derived SMM%, with low random errors (SEE = 3.04% and 1.92%, respectively), and a very strong agreement (CCC = 0.93 and 0.94, respectively). In addition, they demonstrated no fixed bias and a relatively low individual variability. However, the manufacturer's equations described a lower percentage of the variance, with higher random errors, obtained fixed bias of -5.77% for FM% and 4.91% for SMM%, as well as higher individual variability.

CONCLUSIONS

The new regression equations, which include the PhA as a bioelectrical parameter, can accurately predict DXA-derived FM% and SMM% in a heterogeneous Caucasian population, and are better options than the manufacturer's equations.

Changes in the functional brain networks and graph theory analysis of patients with epilepsy and comorbid migraine without aura

PURPOSE

This study aims to evaluate the changes in the functional brain networks and graph theory analysis of patients with epilepsy and comorbid migraine without aura (EM).

METHODS

We included 30 patients with EM, 20 healthy controls (HC) and 30 epilepsy controls (EC) without migraine. Resting-state functional magnetic resonance imaging was performed to obtain imaging data.

RESULTS

The fractional amplitude of low-frequency fluctuations (fALFF) value of the left superior temporal gyrus was higher in the EM group than in the HC group. The regional homogeneity (ReHo) values of the right orbital superior frontal gyrus were higher in the EM group than in the EC group. The functional connectivity between left superior occipital gyrus and left orbital part of the superior frontal gyrus, left middle temporal gyrus, right orbital part of middle frontal gyruss, left medial superior frontal gyrus (cluster 2), right middle frontal gyrus, left middle frontal gyrus, left median cingulate and paracingulate gyri was enhanced in the EM group compared with the HC group; the functional connectivity between the left superior occipital and left medial superior frontal gyri (cluster 1) was weakened. The functional connectivity was weakened between the posterior default mode network (pDMN) and dorsal sensorimotor network (dSMN) and the left frontoparietal network (LFPN) and right frontoparietal network. The functional connectivity between pDMN and LFPN was enhanced in the EM group compared with the EC group. Graph theory analysis revealed that the area under the curve of the standardized characteristic path length of the EM group was smaller than that of the HC and EM groups.

CONCLUSION

The abnormal functional brain networks associated with pain regulation, and changes in topological properties may be involved in the mechanisms underlying migraine without aura occurrence in patients with epilepsy.

A shellfish-inspired bionic microstructure design for biological implants: Enhancing protection of antibacterial silver-loaded coatings and promoting osseointegration

Implants incorporating multi-level micro-nano structures and antibacterial coatings offer a promising approach to overcoming the shortcomings of titanium and its alloys in stimulating bone growth and preventing bacterial infections. Silver ions have been identified as promising antibacterial agents. However, silver-loaded surface coatings are susceptible to damage from direct friction, and excessive release of silver ions can lead to cytotoxicity, thereby limiting their practical application. Inspired by the wear-resistant surface structure of natural shellfish, this study developed a biomimetic micro/nano multi-level structure on the titanium alloy (TC4) surfaces. The structure incorporated a biomimetic microgroove structure (BMS) with alkaline heat treatment (AH) of sodium titanate and chitosan/silver (CS/Ag) micro-nanostructured coatings (BMS/AH/CS/Ag). The microstructural armor effectively reduced external mechanical friction, safeguarding the coatings from damage. Compared to the unstructured sample, the biomimetic micro-groove armor group with a large micro-groove angle (θ) exhibited significantly reduced wear volume and only a marginal decrease of 1.86% in inhibition against Staphylococcus aureus (S. aureus) post-wear, highlighting the protective effect of this microstructure on the coating. The outstanding improvement was primarily attributed to the increased micro-groove angle, which enhanced the stability of the microstructure and effectively mitigated the friction. Additionally, the biomimetic micro-nano multi-level structure and coating have shown a significant ability to improve the bioactivity for the implant, promoting the adhesion, proliferation, collagen secretion, and extracellular matrix mineralization of human mesenchymal stem cells (hMSCs), which suggests the potential for enhanced osteogenic differentiation and indicates that this method can effectively improve the clinical performance of the implant.

Using large language models as decision support tools in emergency ophthalmology

BACKGROUND

Large language models (LLMs) have shown promise in various medical applications, but their potential as decision support tools in emergency ophthalmology remains unevaluated using real-world cases.

OBJECTIVES

We assessed the performance of state-of-the-art LLMs (GPT-4, GPT-4o, and Llama-3-70b) as decision support tools in emergency ophthalmology compared to human experts.

METHODS

In this prospective comparative study, LLM-generated diagnoses and treatment plans were evaluated against those determined by certified ophthalmologists using 73 anonymized emergency cases from the University Hospital of Split. Two independent expert ophthalmologists graded both LLM and human-generated reports using a 4-point Likert scale.

RESULTS

Human experts achieved a mean score of 3.72 (SD = 0.50), while GPT-4 scored 3.52 (SD = 0.64) and Llama-3-70b scored 3.48 (SD = 0.48). GPT-4o had lower performance with 3.20 (SD = 0.81). Significant differences were found between human and LLM reports (P < 0.001), specifically between human scores and GPT-4o. GPT-4 and Llama-3-70b showed performance comparable to ophthalmologists, with no statistically significant differences.

CONCLUSION

Large language models demonstrated accuracy as decision support tools in emergency ophthalmology, with performance comparable to human experts, suggesting potential for integration into clinical practice.

High metastatic tumor-derived CXCL16 mediates liver colonization metastasis by inducing Kupffer cell polarization via the PI3K/AKT/FOXO3a pathway

Liver metastases represent a late-stage manifestation of numerous cancers, often associated with poor patient prognosis. Kupffer cells (KCs), resident liver macrophages, play a critical role in liver metastasis (LM). However, the mechanisms by which the polarization of KCs facilitate colorectal cancer (CRC) liver metastases remain elusive. Here, we established a CRC liver metastasis mouse model and employed a co-culture system, found that KCs were recruited and polarized to M2 phenotype. We isolated and purified highly metastatic cell lines to reveal potential changes in CRC cells during metastasis. Through bulk RNA sequencing, we identified and validated CXCL16 as a positive mediator in liver-metastatic CT26-LM cells that induced an M2-like KC phenotype. Knock down of CXCL16 reduced the M2 polarization of KCs and inhibited the formation of liver metastasis lesions. Next, this polarization process was shown to be achieved through the PI3K/AKT/FOXO3a pathway. Further investigation revealed FOXO3a transcriptionally activates CD206(MRC1) in this process. Pharmacological inhibition of the CXCL16-PI3K-FOXO3a axis to disrupt the polarization of KCs attenuated CRC liver metastasis in vivo. Our findings collectively indicate that targeting the CXCL16/PI3K/AKT/FOXO3a pathway in KCs may represent a promising therapeutic strategy for preventing CRC liver metastasis.