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.

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.

Revisiting the role of steroidal therapeutics in the 21st century: an update on FDA approved steroidal drugs (2000-2024)

Steroids are biologically active polycyclic compounds that have garnered significant scientific attention due to their distinct physiochemical properties and diverse medical applications. Since their invention more than 90 years ago, steroids have remained the most important and necessary class of regulatory molecules in the evolution process of living creatures and have fascinated scientists due to their broad-spectrum biological activities. Over time, scientific innovations and expanded understanding of mechanisms related to diversified biological activities of steroids have made them cheaper, efficient and more specific therapeutic agents which could be effective in the prevention and cure of numerous diseases like cancer, inflammation, asthma, microbial infection, and many more. However, steroidal drugs remain a double-edged sword having significant therapeutic benefits but with incidence of several adverse effects if used for a longer duration and/or with incorrect dose. Nevertheless, novel treatment approaches such as nanoparticles or liposomal drug delivery, real-time monitoring and the use of artificial intelligence in steroidal therapy outweigh their risk factors and provide an effective and safe treatment with minimum adverse effects. Furthermore, the repurposing of steroids in different diseases, e.g. successful use of dexamethasone or hydrocortisone during COVID-19 pandemic has renewed the interest in steroidal therapeutics. The present review provides an update on FDA approved steroidal drugs during the years 2000-2024, the status of their clinical studies, the challenges offered by steroidal therapy and the future perspectives to counterbalance all these challenges. Moreover, this review also delivers useful data on the repurposing of steroidal drugs against various diseases along with the novel techniques used for improved steroid delivery.

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.

Autophagy in cancer and protein conformational disorders

Autophagy is a catabolic process by which cells maintain cellular homeostasis through the degradation of dysfunctional cytoplasmic components, such as toxic misfolded proteins and damaged organelles, within the lysosome. It is a multistep process that is tightly regulated by nutrient, energy, and stress-sensing mechanisms. Autophagy plays a pivotal role in various biological processes, including protein and organelle quality control, defense against pathogen infections, cell metabolism, and immune surveillance. As a result, autophagy dysfunction is linked to a variety of pathological conditions. The role of autophagy in cancer is complex and dynamic. Depending on the context, autophagy can have both tumor-suppressive and pro-tumorigenic effects. In contrast, its role is more clearly defined in protein conformational disorders, where autophagy serves as a mechanism to reduce toxic protein aggregation, thereby improving cellular homeostasis. Because autophagy-based therapies hold promising potential for the treatment of cancer and protein conformational disorders, this review will highlight the latest findings and advancements in these areas.

Effects of Dexmedetomidine Combined With Lidocaine Topical Administration on Cough Reflex During Extubation in Thyroidectomy Patients: A Randomized Clinical Trial

BACKGROUND

Cough reflex during extubation can lead to complications such as increased bleeding and hemodynamic instability, especially in thyroidectomy, therefore, effective suppression of cough reflex is clinically important. The aim of the study was to investigate the inhibitory effect of dexmedetomidine combined with lidocaine on the cough reflex during extubation in thyroidectomy.

METHODS

A total of 180 female patients, aged 18 to 65 years, undergoing elective thyroidectomy under general anesthesia, were randomized into 3 groups: dexmedetomidine combined with lidocaine (Dex-Lido group, n = 60), lidocaine alone (Lido group, n = 60), or normal saline (Control group, n = 60). Before tracheal intubation, patients in the Dex-Lido group received dexmedetomidine combined with 2% lidocaine spray, those in the Lido group received 2% lidocaine spray, and those in the Control group received 0.9% normal saline spray, applied to the supraglottic, glottic, and subglottic areas. The primary outcome was the incidence of cough reflex at extubation. Secondary outcomes included cough severity, postoperative sore throat, hoarseness, nausea, and vomiting, as well as the need for analgesics and antiemetics, pain levels, sedation scores, and length of hospital stay.

RESULTS

The incidence of cough reflex during extubation was significantly lower in both the Dex-Lido and Lido groups compared to the Control group (23% vs 70%; odds ratio [OR], 0.13; 95% confidence interval [CI], 0.06-0.29; P < .001 for Dex-Lido; 47% vs 70%; OR, 0.38; 95% CI, 0.18-0.79]; P = .010 for Lido), with a statistically significant difference between the Dex-Lido and Lido groups (23% vs 47%; OR, 0.35; 95% CI, 0.16-0.76; P = .007). Additionally, the severity of the cough reflex was markedly lower in the Dex-Lido group compared to the Control group (8/60 vs 26/60; OR, 0.20; 95% CI, 0.08-0.50; P < .001).

CONCLUSIONS

The combination of dexmedetomidine and lidocaine laryngopharynx spray effectively suppresses the cough reflex during extubation, reduces postoperative sore throat, and stabilizes hemodynamics in female patients undergoing thyroid surgery.

Integrative sleep management: from molecular pathways to conventional and herbal treatments

Sleep is regarded as one of the most crucial factors in keeping a healthy lifestyle. To function normally, a person needs at least 6-8 h of sleep per day. Sleep influences not only our mood but also the efficiency with which we complete tasks. Sleep disorders exhibit diverse etiologies across different conditions and populations, with genetic and environmental factors playing a significant role in their development. Many issues emerge as a result of inadequate sleep. Unhealthy food and lifestyle choices have increased our susceptibility to sleep disorders. A well-balanced diet rich in essential vitamins and minerals can have a profound impact on sleep patterns, enhancing both the duration and quality of rest. The primary categories of sleep disorders include insomnia, sleep apnea (SA), narcolepsy, parasomnias, circadian rhythm disorders, and restless legs syndrome (RLS). The drugs used to treat sleep disorders are primarily habit-forming and have a history of withdrawal effects. This insufficiency in medication has prompted the hunt for newer, better options. Nutraceuticals are well-suited to the treatment of such illnesses. Its non-toxic, non-habit-forming properties, and practical efficiency have made it an outstanding choice. This review provides nutraceuticals used in sleep disorders. A comprehensive literature search was conducted utilizing several databases, including Google Scholar, Elsevier, Springer Nature, Wiley, PubMed, and EKB. Nutraceuticals are products that employ food or dietary components to treat or prevent disease. In the therapy of sleep disorders, nutraceuticals such as Artemisia annua, valerian, rosemary, jujube, Passionflower, lemon balm, ashwagandha, kava-kava, lavender, and chamomile have been shown to have remarkable benefits. These remedies exert their effects through multiple mechanisms, both directly by modulating neurotransmitter and hormonal pathways within sleep circuits, and indirectly by enhancing sleep quality through the alleviation of stress, inflammation, and oxidative stress. Clinical studies were piloted to validate the efficacy of natural sleep aids. Future research should focus on elucidating the precise mechanisms through which natural products influence sleep.

Dietary fennel (Foeniculum vulgare Mill) seeds supplementation affects yield, fatty acid composition and flavour profile of milk and cheese in grazing goats

Fennel (Foeniculum vulgare Mill) is an annual plant belonging to the family of Apiaceae, widely used in Mediterranean areas for its aromatic and medical properties, especially for carminative, digestive and galactagogue effects. In this trial, 20 multiparous goats homogeneous for body weight (BW: 50.0 ± 2 kg), parity (3rd) and milk yield (1940 ± 120 g/head/day), were randomly allocated into two groups (C: control; F: fennel) fed on a permanent pasture (9:00 am to 4:00 pm). In the pen both groups received 400 g of concentrate mixture (barley and corn meals) and group F diet was supplemented with 15 g/head/day of organic fennel seeds. From the beginning of May until September, milk yield was measured daily, and samples of milk and pasture were collected monthly and analysed, along with concentrate, for their chemical composition and fatty acid profile. Cheese samples were obtained at the beginning and at the end of the trial and analysed for chemical composition, fatty acid and VOCs profile. Milk yield was significantly higher in group F (1809.6 g vs 1418.3 g for group F and C respectively), whereas the solid content did not differ between groups. Milk fatty acid profile differed between groups, especially for the content of MUFA, PUFA, and SFA. Cheese production and composition also was different for yield, fatty acid profile and VOCs composition between the groups. Indeed, the cheese of group F had higher antioxidant capacity and 4 aromatic compounds which were completely absent in the cheese of group C. These results confirm the galactagogue activity of fennel seeds in dairy goats and suggest their potential role as feed additive in grazing system to enhance production in terms of yield and antioxidant activity.

Homologous-Targeting Porous Type I/II Nanophotosensitizers for Efficient Delivery of STING Agonists and Enhanced Photodynamic Cancer Immunotherapy

Immunotherapy as a transformative cancer treatment modality frequently struggles with the immunosuppressive tumor microenvironment, which hinders effective immune responses. In this report, we construct biomimetic tumor cell membrane-cloaked porous covalent organic framework (COF) nanophotosensitizers (CMSCOFs) to synergistically enhance photodynamic therapy (PDT) and stimulate interferon genes (STING)-mediated immunotherapy. CMSCOF is prepared from porphyrin and benzothiadiazole-based units and cloaked with 4T1 cancer cell membranes for homologous tumor targeting. The porous structure of COF enables efficient encapsulation of the non-nucleotide STING agonist SR717. Upon 660 nm light irradiation, CMSCOFs trigger both type I and II photodynamic effects by producing both superoxide (O2•-) and singlet oxygen (1O2). The tumor cell membrane-cloaked design improves the stability of the nanophotosensitizers and mimics the natural cancer cells for enhanced blood circulation, tumor accumulation, and homologous-targeting to tumors. Inside tumor tissues, this unique CMSCOF design leads to enhanced immunogenic cell death (ICD) of tumor cells upon exposure to light irradiation. Furthermore, the encapsulated STING agonist SR717 is released after cellular internalization to activate the STING pathway and elicit a potent antitumor immune response. This synergistic approach effectively reverses the immunosuppressive tumor microenvironment, enhances cytotoxic T cell infiltration, and suppresses both primary and metastatic tumors, demonstrating the potential of CMSCOF nanophotosensitizers as a promising platform for photodynamic cancer immunotherapy.

TIM-3 teams up with PD-1 in cancer immunotherapy: mechanisms and perspectives

Immunotherapy using immune checkpoint inhibitors (ICIs) has become a prominent strategy for cancer treatment over the past ten years. However, the efficacy of ICIs remains limited, with certain cancers exhibiting resistance to these therapeutic approaches. Consequently, several immune checkpoint proteins are presently being thoroughly screened and assessed in both preclinical and clinical studies. Among these candidates, T cell immunoglobulin and mucin-domain containing-3 (TIM-3) is considered a promising target. TIM-3 exhibits multiple immunosuppressive effects on various types of immune cells. Given its differential expression levels at distinct stages of T cell dysfunction in the tumor microenvironment (TME), TIM-3, along with programmed cell death protein 1 (PD-1), serves as indicators of T cell exhaustion. Moreover, it is crucial to carefully evaluate the impact of TIM-3 and PD-1 expression in cancer cells on the efficacy of immunotherapy. To increase the effectiveness of anti-TIM-3 and anti-PD-1 therapies, it is proposed to combine the inhibition of TIM-3, PD-1, and programmed death-ligand 1 (PD-L1). The efficacy of TIM-3 inhibition in conjunction with PD-1/PD-L1 inhibitors is being evaluated in a number of ongoing clinical trials for patients with various cancers. This study systematically investigates the fundamental biology of TIM-3 and PD-1, as well as the detailed mechanisms through which TIM-3 and PD-1/PD-L1 axis contribute to cancer immune evasion. Additionally, this article provides a thorough analysis of ongoing clinical trials evaluating the synergistic effects of combining PD-1/PD-L1 and TIM-3 inhibitors in anti-cancer treatment, along with an overview of the current status of TIM-3 and PD-1 antibodies.

SPP1 + macrophages cause exhaustion of tumor-specific T cells in liver metastases

Functional tumor-specific CD8+ T cells are essential for effective anti-tumor immune response and immune checkpoint inhibitor therapy. Here we show that, compared to other organ sites, primary, metastatic liver tumors in murine models contain a higher number of tumor-specific CD8+ T cells which are also dysfunctional. High-dimensional, multi-omic analysis of patient samples reveals a higher frequency of exhausted tumor-reactive CD8+ T cells and enriched interactions between these cells and SPP1+ macrophages in profibrotic, alpha-SMA rich regions specifically in the liver. Differential pseudotime trajectory inference analysis reveals that extrahepatic signaling promotes an intermediate cell (IC) population in the liver, characterized by co-expression of VISG4, CSF1R, CD163, TGF-βR, IL-6R, and SPP1. Analysis of premetastatic adenocarcinoma patient samples reveals enrichment of this population may predict liver metastasis. These findings suggest a mechanism by which extrahepatic tumors drive liver metastasis by promoting an IC population that inhibits tumor-reactive CD8+ T cell function.

Development of a high-performance sliding microneedle-lateral flow immunoassay strip device for ultra-rapid point-of-care diagnosis

Interstitial fluid (ISF) is a promising biofluid for non-invasive diagnostics, but its clinical application is limited by slow extraction rates and small sample volumes. To address these challenges, we developed the high-performance sliding microneedle-lateral flow immunoassay (HP-SML) device, an improved microneedle (MN)-based platform for rapid ISF extraction and on-site biomarker detection. The device incorporates extended MNs (1400 μm), a 3D-printed insertion case, and a lateral flow assay (LFA), enabling efficient ISF collection and immediate visual confirmation of test results. The HP-SML device demonstrated a 5-fold increase in ISF extraction speed compared to conventional SML devices, achieving 1.5 μL min-1 extraction rates with minimal tissue disruption and rapid skin recovery within 15 minutes. The device successfully detected C-reactive protein (CRP) at a clinically relevant limit of 104 ng mL-1, confirming its applicability for Hodgkin lymphoma (HL) prognosis monitoring. It also exhibited high specificity for CRP, with no cross-reactivity observed against other inflammatory biomarkers such as IL-6, TNF-α, MMP-9, and MMP-2. Furthermore, ISF-derived CRP levels strongly correlated with serum CRP concentrations, validating ISF as a viable alternative for HL management. Given its high efficiency, ease of use, and on-site detection capabilities, the HP-SML device presents a significant advancement in point-of-care diagnostics and continuous disease monitoring.

circRNA/TLR interaction: key players in immune regulation and autoimmune diseases

Circular RNAs are a class of non-coding RNAs with covalently closed loops. They have been revealed to regulate immune responses by affecting gene expression. Although initially considered splicing byproducts, new studies have indicated their role in transcriptional and post-transcriptional control, especially with TLRs. TLRs start inflammatory signaling and let the innate immune system recognize PAMPs. circRNAs interact context-dependently with TLR pathways to influence immune homeostasis and inflammation in either pathogenic or protective roles. In autoimmune diseases, dysregulated circRNA expression can aggravate immune responses and damage tissue. CircRNAs can interact with RNA-binding proteins, function as molecular sponges for miRNAs, and change inflammatory pathways like the NF-κB signaling cascade, influencing immune responses. They control adaptive immunity, function of antigen-presenting cells, and cytokine generation. The stability and presence of circRNAs in many body fluids make them therapeutic targets and biomarkers for inflammatory and autoimmune diseases. The several immune control roles of circRNA-TLR interactions are discussed in this review, as well as their consequences for immunologically mediated disease diagnosis and treatment.

Pharmacological and therapeutic effects of natural products on liver regeneration-a comprehensive research

Liver regeneration (LR) refers to the physiological process by which hepatocytes undergo cellular proliferation to restore the structure and function of the liver following significant hepatocyte loss due to injury or partial hepatectomy (PH). While the liver possesses a remarkable regenerative capacity, this process is tightly regulated to ensure appropriate cessation once homeostasis is reestablished. Various strategies, including technological interventions and pharmacological agents, have been explored to enhance LR. Among these, natural products have emerged as promising candidates for promoting LR. For instance, quercetin, a natural compound, has been shown to enhance LR following PH by maintaining redox homeostasis and stimulating hepatocyte proliferation. However, natural products present certain limitations, such as poor solubility and low bioavailability, which may hinder their clinical application. Modifications in the formulation and mode of administration have demonstrated potential in overcoming these challenges and optimizing their pharmacological effects. Recent advancements in research have further highlighted the growing relevance of natural products, including traditional Chinese medicine (TCM), in the context of LR. Despite this progress, a comprehensive and systematic review of their roles, mechanisms, and therapeutic potential remains lacking. This review aims to bridge this gap by summarizing natural products with demonstrated potential to promote LR. Drawing on data from PubMed, Web of Science, and CNKI databases, it elucidates their pharmacological effects and regulatory mechanisms, providing a valuable reference for future research and clinical application in the field of LR.

From bone marrow mesenchymal stem cells to diseases: the crucial role of m6A methylation in orthopedics

Elucidating the molecular mechanisms underlying orthopedic diseases is crucial for guiding therapeutic strategies and developing innovative interventions. N6-methyladenosine (m6A)-an epitranscriptomic modification-has emerged as a key regulator of cellular fate and tissue homeostasis. Specifically, m6A plays a pivotal role in several RNA biological processes such as precursor RNA splicing, 3'-end processing, nuclear export, translation, and stability. Recent advancements indicate that m6A methylation regulates stem cell proliferation and osteogenic differentiation by modulating various signaling pathways. Extensive research has shown that abnormalities in m6A methylation contribute significantly to the onset and progression of various orthopedic diseases such as osteoporosis (OP), osteoarthritis (OA), rheumatoid arthritis (RA), and bone tumors. This review aims to summarize the key proteases involved in m6A methylation and their functions. The detailed mechanisms by which m6A methylation regulates osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) through direct and indirect ways are also discussed, with a focus on specific molecular pathways. Finally, this review analyzes the roles and mechanisms of m6A modification in the development and progression of multiple orthopedic diseases, offering a comprehensive understanding of the pathophysiology of these conditions and proposing new directions and molecular targets for innovative treatment strategies.

M2 Macrophages Mitigate Ocular Surface Inflammation and Promote Recovery in a Mouse Model of Dry Eye

PURPOSE

Dry eye disease (DED) is a chronic, progressive, multifactorial condition characterized by tear film instability and ocular surface damage. Ocular surface inflammation is one of the main mechanisms of DED. This study aims to investigate the therapeutic effects of anti-inflammatory M2 macrophages on ocular surface inflammation and their potential mechanisms in improving dry eye symptoms in a mouse model.

METHODS

Mouse macrophages (RAW264.7) were polarized into M2 macrophages by IL-4 under different osmolarities, and M2 macrophage conditioned medium (M2-CM) was collected. Flow cytometry and ELISA were applied to measure the cytokine expression of the M2 macrophages. Primary mouse corneal epithelial cells (CECs) were co-cultured with RAW264.7 and M2 macrophages using a Transwell system. The viability and migration of CECs were assessed using CCK-8 and scratch assays. Mouse DED was established by subcutaneous injection of scopolamine, and the therapeutic effects of M2-CM were evaluated by phenol red thread test, fluorescein staining, and tear film breakup time (BUT). PCR and immunofluorescence staining were applied to observe inflammatory factors and cells on the ocular surface.

RESULTS

M2 macrophages enhanced CEC viability, proliferation, and migration, but hyperosmolarity inhibited M2 macrophage polarization. In the DED model, M2-CM improved ocular surface conditions, reduced pro-inflammatory cytokine expression, and increased anti-inflammatory factors. Immunofluorescence revealed reduced pro-inflammatory cells (M1 macrophages, Th1, and Th17) and increased M2 macrophages in the ocular tissues after M2-CM treatment.

CONCLUSION

These results suggest that M2-CM ameliorates ocular surface inflammation and promotes recovery in DED, offering a potential therapeutic strategy for DED.

Organic acids from ice wine ameliorate fructose-induced disorders of glycolipid metabolism in C57BL/6J mice

Excessive intake of fructose has been widely reported to cause glycolipid metabolism disorders, and it is unclear whether long-term consumption of ice wine, a sweet wine with high sugar content, is beneficial for health. In this study, 6-week-old male C57BL/6J mice were divided into pure water, ice wine, fructose, fructose + succinic acid, fructose + malic acid and fructose + alcohol groups to study the effects and mechanisms of organic acids on glycolipid metabolism. The results indicated that long-term consumption of ice wine did not lead to disorders of glycolipid metabolism, and organic acids inhibited the negative effects of fructose and reduced hepatic fat synthesis by decreasing the mRNA expression of hepatic ACC1, SREBP-1c, and ChREBP-β, as well as controlling the protein expression of KHK-C. These findings provide a theoretical basis for the healthy consumption of ice wine, helping consumers enjoy wine more scientifically and promoting the high-quality development of the industry.

Comparison of 12- and 15-mm endoscopic papillary large balloon dilation combined with a limited endoscopic sphincterotomy for large bile duct stones: A propensity score-matched analysis

BACKGROUND AND STUDY AIMS

Endoscopic papillary large balloon dilation (EPLBD) combined with endoscopic sphincterotomy (EST) has been increasingly used to remove large common bile duct (CBD) stones. However, the clinical outcomes of stone extraction have rarely been investigated in regard to the size of the balloon. The aim of this study was to assess the short- and long-term outcomes of 12- and 15-mm EPLBD with a limited EST for large CBD stones.

PATIENTS AND METHODS

Patients without prior endoscopic retrograde cholangiopancreatography (ERCP) who received 12- or 15-mm EPLBD in combination with a limited EST for large CBD stones at our center between January 2013 and December 2020 were recruited. Matched pairs with 12- and 15-mm EPLBD were generated.

RESULTS

A total of 161 patients were included, with 50 patients successfully matched in each group. The total procedure time (36.8 min vs. 47.3 min, p = 0.003) and the tone removal time (30.5 min vs. 39.2 min, p = 0.008) were significantly lower in the matched 15-mm EPLBD group, while the initial and overall stone removal success rates were comparable between the two groups (p > 0.05). The matched 15-mm EPLBD group had a lower incidence of post-ERCP pancreatitis (PEP) compared to the matched 12-mm EPLBD group (2.0 % vs. 16.0 %, p = 0.031). The cumulative long-term biliary complications were not statistically different between the two groups (log-rank test p = 0.612).

CONCLUSION

15-mm EPLBD combined with a limited EST shortened the procedure time and reduced the incidence of PEP without increasing long-term biliary complications compared to 12-mm EPLBD combined with a limited EST.

The burden of colorectal cancer attributable to high body mass index in China: findings from 1990 to 2021 and prediction to 2035

BACKGROUND

Colorectal cancer (CRC) incidence and mortality are rising in China, with high body mass index (BMI) established as a significant risk factor. However, comprehensive evidence regarding the BMI-attributable CRC burden in the Chinese population remains limited.

OBJECTIVE

This study aims to analyze the trend of CRC burden attributable to high BMI (BMI ≥ 25 kg/m2) in China from 1990 to 2021 and to predict its development from 2022 to 2035, in order to provide a scientific foundation for the formulation of public health policies.

METHODS

We analyzed data from the Global Burden of Disease Study 2021 (GBD 2021) to assess the BMI-attributable CRC burden in China from 1990 to 2021. Temporal trends were analyzed using Joinpoint regression models. Future projections through 2035 were generated using Bayesian age-period-cohort (BAPC) modeling. The Das Gupta method was used to explore the contribution of population growth, aging, and epidemiologic factors to these burden changes.

RESULTS

From 1990 to 2021, China's BMI-attributable CRC burden increased substantially, with ASMR and ASDR rising at annual rates of 2.393% (95% CI 2.306-2.481) and 2.305% (95% CI 2.188-2.422), respectively. The mortality and disability-adjusted life years (DALYs) rate both increased with age. Males showed higher burden rates in most age groups. Projections indicate continued increases in ASMR (2.43% annually) and ASDR (2.44% annually) through 2035. Epidemiological factors were the primary drivers, contributing 99.73% to mortality changes and 44.81% to DALYs changes.

CONCLUSIONS

The BMI-attributable CRC burden in China shows a concerning upward trajectory that is predicted to continue, with epidemiologic factors playing a major role. Urgent public health interventions targeting obesity prevention, lifestyle modification, and expanded CRC screening are needed to mitigate this growing burden.

Role and Significance of MicroRNAs in the Relationship Between Obesity and Cancer

MicroRNAs (miRNAs) are small, noncoding RNAs that are essential for regulating gene expression at the posttranscriptional stage. Recent research shows that miRNAs are crucial in the development of two major global health issues: obesity and cancer, two significant health issues worldwide. This study examines the complex mechanisms by which miRNAs govern vital biological processes, including adipogenesis, cancer, and metabolic dysregulation. We highlight the dual function of miRNAs as oncogenes and tumor suppressors in obesity-related malignancies and investigate their potential as prognostic and diagnostic markers. To demonstrate their varied roles, specific examples of vital miRNAs are underscored, such as miR-21, which promotes adipogenesis and is overexpressed in various cancers, and miR-34a, a tumor suppressor involved in cell cycle arrest and apoptosis. In addition, we examined the recent developments in miRNA-based therapies, which include miRNA inhibitors, mimics, and novel delivery vehicles and have the potential for treating obesity-related malignancies. This review aims to clarify, within the framework of miRNA biology, the therapeutic potential of miRNAs in addressing the interrelation between obesity and cancer.

IFN-γ could induce ferroptosis in keloid fibroblasts by inhibiting the expression of serpine2

Keloids are common pathological scars resulting from previous trauma or inflammation. Interferon-gamma (IFN-γ) has shown significant therapeutic effects when used alone or in combination with other agents. While IFN-γ has been found to regulate ferroptosis in tumor cells, its ability to regulate ferroptosis in keloid fibroblasts (KFs) is unclear. Here, we have demonstrated a direct causal relationship between IFN-γ levels and ferroptosis in KFs. To explore the intrinsic mechanism, we performed genome-wide RNA and proteomics sequencing and found that serpine2 was the most significantly downregulated gene in KFs after exogenous overexpression of IFN-γ. Serpine2, which belongs to a family of serine protease inhibitors, has been shown to play an important role in fibrotic diseases. Therefore, we hypothesized that serpine2 is a downstream gene in the regulation of ferroptosis in KFs by IFN-γ. Our results showed that serpine2 overexpression promotes collagen synthesis, which in turn promotes the proliferation, migration, and invasive functions of KFs. We further demonstrated that serpine2 overexpression promoted system Xc- transporter expression, cystine uptake, and glutathione synthesis, enhanced GPX4 activity; and inhibited reactive oxygen species generation. This resulted in a reduction in intracellular lipid peroxidation and the levels of its metabolite malondialdehyde, as well as inhibited ferroptosis in KFs. IFN-γ reversed these effects of serpine2 overexpression. These results were largely confirmed in in vivo keloid models too. These findings imply that IFN-γ not only directly induces ferroptosis in KFs but also enhances their sensitivity to ferroptosis by inhibiting the synthesis of SLC7A11 and SLC3A2 through downregulation of serpine2. In summary, we suggest that the serpine2-system Xc- axis is a promising therapeutic target for the treatment of keloids.

The dual effect of interferon-γ in acute myeloid leukemia: A narrative review

Acute myeloid leukemia (AML) is a hematological malignancy representing a very rapid, uncontrolled growth of myeloid precursors in the BM and peripheral circulation. Studies on AML have highlighted the crucial role of IFN-γ therapy in immune surveillance, both promotive and inhibitory effects on leukemic cells, and regulation of the tumor microenvironment. However, there is a need for a comprehensive understanding of the dual effects of IFN-γ in AML. Thus, this review aimed to assess the dual effects of IFN-γ in AML. Literature searches were conducted in Pub Med, Google Scholar, and direct Google Search. The data was presented in tables and figures, with findings summarized through a narrative synthesis. Depending on the circumstances and stage of the disease IFN-γ shows two different activities in AML patients. First, IFN-γ enhances NK cells and CD8+T lymphocyte functions, which collectively evoke antileukemic immunity. Another promising effect of IFN-γ includes the differentiation of myeloid cells, thereby possibly reducing the severity of leukemia. However, prolonged exposure to IFN-γ can activate Treg cells and inhibitory immunological checkpoints, which can help leukemia evade immune surveillance and encounter an immunosuppressive environment. Our review highlights IFN-γ's critical role in the complex interplay between the immune system and AML pathogenesis. Its dual role in both inhibiting and promoting leukemic processes has been highlighted. However, future pre-clinical and clinical studies should focus on the specific mechanisms by which IFN-γ impacts AML progression and treatment outcomes, with the goal of achieving curative results for patients.

Role of noncoding RNA and protein interaction in pancreatic cancer

ABSTRACT

Noncoding RNAs (ncRNAs) are a class of RNA molecules with little or no protein-coding potential. Emerging evidence indicates that ncRNAs are frequently dysregulated and play pivotal roles in the pathogenesis of pancreatic cancer. Their aberrant expression can arise from chromosomal abnormalities, dysregulated transcriptional control, and epigenetic modifications. ncRNAs function as protein scaffolds or molecular decoys to modulate interactions between proteins and other biomolecules, thereby regulating gene expression and contributing to pancreatic cancer progression. In this review, we summarize the mechanisms underlying ncRNA dysregulation in pancreatic cancer, emphasize the biological significance of ncRNA-protein interactions, and highlight their clinical relevance. A deeper understanding of ncRNA-protein interactions is essential to elucidate molecular mechanisms and advance translational research in pancreatic cancer.

Novel dihydrochalcone from Fissistigma latifolium targets STAT3 and survivin to overcome multidrug resistance cancers in vitro and in vivo

BACKGROUND

Multidrug resistance (MDR) remains a significant challenge in cancer chemotherapy, with no FDA-approved drugs currently available for its treatment. Natural chalcones, known for their diverse bioactivities, have emerged as potential therapeutic candidates.

PURPOSE

This study aimed to investigate the potential of 4,6-dimethoxy-2,5-quinodihydrochalcone (DODHC), a compound derived from Fissistigma latifolium, in overcoming MDR in cancer and to elucidate its underlying molecular mechanisms.

METHODS

The reversal effects of DODHC on MDR were evaluated using cytotoxicity assays. The molecular mechanisms were explored through apoptosis- and cell cycle-related assays, STAT3 ELISA, western blotting, docking simulations, and a zebrafish model. The impact of DODHC on P-glycoprotein (P-gp) activity was assessed using the Calcein-AM uptake assay.

RESULTS

DODHC promoted apoptosis in MDR cancer cells by suppressing survivin expression and activating the extrinsic apoptotic pathway. It also induced G2/M phase cell cycle arrest by downregulating cell division control protein 2 (CDC2) and cyclin B1 (CCNB1), thereby inhibiting cell proliferation. Additionally, DODHC reduced both total and phosphorylated STAT3 levels in MDR cancer cells without affecting P-gp activity. In vivo, DODHC significantly inhibited tumor growth in MDR cancer models, both as a monotherapy and in combination with paclitaxel.

CONCLUSION

This study highlights DODHC as a dual inhibitor of STAT3 and survivin, demonstrating its potential as a promising candidate for the treatment of MDR cancers.

Accuracy and Safety Assessment of Subaxial Cervical Pedicle Screw Instrumentation: A Systematic Review

BACKGROUND CONTEXT

Given increasing use of both cervical pedicle screw (CPS) fixation in the subaxial cervical spine (C3-C7) and emerging navigation technologies, a quantitative profile of safety and accuracy remains wanting. Compared with lateral mass instrumentation of this region, CPS fixation shows superior biomechanical properties but poses higher risk of complications because of the narrow cervical pedicle width and proximity to neurovascular structures.

PURPOSE

This systematic review quantifies the accuracy and safety of all types of subaxial CPS insertion, with or without navigation or template-based methods, to weigh the strengths and limitations of each technique.

STUDY DESIGN

Systematic review according to PRISMA guidelines.

PATIENT SAMPLE

Patients who underwent CPS instrumentation since its introduction.

OUTCOME MEASURES

Primary and secondary outcomes in our review included pedicle screw breach in the subaxial cervical spine determined on intra- or postoperative imaging, and screw-related operative complications, respectively.

METHODS

Following the PRISMA guidelines, our literature search of PubMed, Cochrane, and Scopus databases identified 3,312 clinical studies (1980-2024) using subaxial CPS that assessed for screw accuracy. After full-text analysis, data extracted included number of CPS, level of placement, number of patients, indications, insertion techniques, accuracy assessment method, classification of accuracy, breach rate, complication rate, and study origin.

RESULTS

The 73 studies included in final analysis from Asia (80%), Europe (12%) and North America (8%) yielded 14,118 CPS in 3,342 patients (1999-2024). Accuracy rates were 85.3% for 10,108 CPS placed with non-navigated techniques (free-hand and fluoroscopy), 82.7% for 3,067 with navigation techniques, and 96.3% for 943 CPS placed using 3D templates. Complication rates were 1.1%, 2.1%, and zero, respectively.

CONCLUSION

Our comprehensive review of more than 14,000 subaxial CPSs inserted found rates of high 84% overall accuracy and low 1.2% perioperative complications (i.e., attributed to a misplaced screw). With biomechanical advantages superior to lateral mass screws, our quantitative findings support consideration for CPS instrumentation in select patients by experienced surgeons.

Bacteriophage-based gene delivery: a novel approach for targeted breast cancer therapy

Bacteriophage-based gene delivery systems are emerging as a promising alternative to traditional viral and non-viral vectors for targeted gene therapy in breast cancer. Their unique structural adaptability, low immunogenicity, and cost-effective production make them ideal candidates for precision medicine applications. Unlike conventional gene delivery platforms, bioengineered bacteriophages can be functionalized with tumor-specific ligands, modified for PEGylation to enhance circulation stability, and integrated with CRISPR/Cas9 gene-editing systems for precise genomic modifications. Additionally, bacteriophage vectors can be utilized in combination therapy, amplifying the effectiveness of chemotherapy and immunotherapy in breast cancer treatment. This mini-review discusses the bioengineering strategies used to enhance bacteriophage-based gene delivery, including surface modifications for tumor targeting, ligand-receptor binding for cellular uptake, and controlled genetic cargo release. We further examine in vitro and in vivo studies that demonstrate the potential of bacteriophage vectors in tumor suppression, gene expression efficiency, and immunomodulation. Furthermore, we explore the challenges and future directions of integrating bacteriophage-mediated gene therapy into clinical applications, addressing key issues such as systemic circulation half-life, off-target effects, and immune system interactions.

Plasma proteomics identify novel biomarkers and dynamic patterns of biological aging

INTRODUCTION

Plasma proteomics examines levels of thousands of proteins and has the potential to identify clinical biomarkers for healthy aging.

OBJECTIVES

This large proteomics study aims to identify clinical biomarkers for healthy aging and further explore potential mechanisms involved in aging.

METHODS

This study analyzed data from 51,904 UK Biobank participants to explore the association between 2,923 plasma proteins and nine aging-related phenotypes, including PhenoAge, KDM-Biological Age, healthspan, parental lifespan, frailty, and longevity. Protein levels were measured using proteomics, and associations were assessed with a significance threshold of P < 1.90E-06. We utilized the DE-SWAN method to detect and measure the nonlinear alterations in plasma proteome during the process of biological aging. Mendelian randomization was applied to assess causal relationships, and a PheWAS explored the broader health impacts of these proteins.

RESULTS

We identified 227 proteins significantly associated with aging (P < 1.90E-06), with the pathway of inflammation and regeneration being notably implicated. Our findings revealed fluctuating patterns in the plasma proteome during biological aging in middle-aged adults, pinpointing specific peaks of biological age-related changes at 41, 60, and 67 years, alongside distinct age-related protein change patterns across various organs. Furthermore, mendelian randomization further supported the causal association between plasma levels of CXCL13, DPY30, FURIN, IGFBP4, SHISA5, and aging, underscoring the significance of these drug targets. These five proteins have broad-ranging effects. The PheWAS analysis of proteins associated with aging highlighted their crucial roles in vital biological processes, particularly in overall mortality, health maintenance, and cardiovascular health. Moreover, proteins can serve as mediators in healthy lifestyle and aging processes.

CONCLUSION

These significant discoveries underscore the importance of monitoring and intervening in the aging process at critical periods, alongside identifying potential biomarkers and therapeutic targets for age-related disorders within the plasma proteomic landscape, thus offering valuable insights into healthy aging.

Dietary inflammatory index and the risk of esophageal cancer: a systematic review and meta-analysis

BACKGROUND AND AIM

It is well-recognized that inflammation is an adaptive pathophysiological response in many types of cancer. Research on nutrition's critical role in inflammation, a risk factor for all forms of cancer, is growing. The dietary inflammatory index (DII) was created lately to assess if a diet is pro- or anti-inflammatory in terms of inflammation. Indeed, several studies have demonstrated the correlation between DII and the risk of several cancer types. This meta-analysis set out to look into the relationship between DII and the different forms of esophageal cancer.

METHOD

PubMed, Cochrane library, Embase, Scopus, and Web of Science databases were searched up to May 2024 to retrieve relevant articles. RAYYAN intelligent tool for systematic reviews was incorporated for the screening of studies. Original articles written in English Studies that investigated the inflammatory index of diet in individuals who developed esophageal cancer were included in this study.STATA v18 software was used to conduct the meta-analysis. Egger's test for publication bias assessment was implemented. Newcastle Ottawa scale was used to evaluate the qualities of the included studies. A plot digitizer was used to extract digital data.

RESULT

A total of 13 studies were included in the systematic review, with 6 studies contributing to the meta-analysis, comprising 10,150 participants. The participants were categorized into high and low DII groups, with the low DII group (n = 3,403) serving as the reference. The meta-analysis demonstrated a significant association between high DII and increased risk of esophageal cancer. Specifically, individuals in the high DII group were 29% more likely to develop esophageal cancer, with a pooled odds ratio (OR) of 1.29 (95% Confidence Interval [CI]: 1.16-1.43), as calculated using a random-effects model. Moderate heterogeneity was observed (I2 > 50%). Egger's test indicated evidence of publication bias (p < 0.05). Subgroup and sensitivity analyses confirmed the robustness of this association across populations and study designs.

CONCLUSION

our study concludes that a higher level of DII is associated with a higher risk of esophageal cancer development. This study suggests that modifying inflammatory properties of dietary patterns can reduce the risk of incidence of esophageal cancer.

Microneedle-aided nanotherapeutics delivery and nanosensor intervention in advanced tissue regeneration

Microneedles (MNs) have been extensively used as transdermal therapeutics delivery devices since 1998 due to their capacity to penetrate physiological barriers with minimal invasiveness. Recent advances demonstrate the potential of MNs in improving diverse tissue regeneration when integrated with nanometer-sized therapeutics or sensors. This synergistic strategy can enhance drug delivery efficiency and therapeutic outcomes, and enable precise and personalized therapies through real-time monitoring of the repair process. In this review, we discuss how optimized MNs (through adjustments in geometry, material properties, and modular structure), when combined with dimension- and composition-specific nanomaterials, enhance tissue regeneration efficiency. Moreover, integrating stimuli-responsive nanotherapeutics or nanosensors into MNs for spatiotemporal-controlled and targeted drug release, physiotherapy effects, and intelligent monitoring is systematically outlined. Furthermore, we summarize therapeutic applications of nanotherapeutics-MN platforms in various soft and hard tissues, including skin, hair follicles (HF), cornea, joint, tendons, sciatic nerves, spinal cord, periodontium, oral mucosa, myocardium, endometrium, bone and intervertebral discs (IVD). Notably, recent attempts using nanosensor-MN platforms as smart wearable devices for monitoring damaged tissues via interstitial fluid (ISF) extraction and biomarker sensing are analyzed. This review potentially provides tissue regeneration practitioners/researchers with a cross-disciplinary perspective and inspiration.

Pathogenesis and Systemic Treatment of Hepatocellular Carcinoma: Current Status and Prospects

Hepatocellular carcinoma (HCC) remains one of the major threats to human health worldwide. The emergence of systemic therapeutic options has greatly improved the prognosis of patients with HCC, particularly those with advanced stages of the disease. In this review, we discussed the pathogenesis of HCC, genetic alterations associated with the development of HCC, and alterations in the tumor immune microenvironment. Then, important indicators and emerging technologies related to the diagnosis of HCC are summarized. Also, we reviewed the major advances in treatments for HCC, offering insights into future prospects for next-generation managements.

CircRNAs in the tumor microenvironment: new frontiers in cancer progression and therapy

The tumor microenvironment (TME), a dynamic ecosystem which including immune cells, cancer-associated fibroblasts (CAFs), endothelial cells, pericytes and acellular components, is orchestrating cancer progression through crosstalk between malignant cells and stromal components and increasingly recognized as a therapeutic frontier. Within this intricate network, circular RNAs (circRNAs) have emerged as pivotal regulators due to their unique covalently closed structures, which confer exceptional stability and multifunctional capabilities. This regulation is mediated through multiple mechanisms, such as acting as microRNA (miRNA) sponges, interacting with proteins, and, in certain instances, encoding functional peptides. The interaction between circRNAs and the TME not only affects cancer growth and metastasis but also influences immune evasion and therapeutic resistance. Elucidating the mechanisms by which circRNAs orchestrate these interactions is essential for identifying novel diagnostic biomarkers and developing effective therapeutic strategies. Such insights are expected to bridge gaps in current cancer biology, offering promising avenues for precision oncology and ultimately improving clinical outcomes for cancer patients.

Prevalence of MAFLD in the U.S. based on NHANES 2009-2018: differences in demographic characteristics, physical indices and lifestyle conditions

BACKGROUND

The incidence of metabolic dysfunction-associated fatty liver disease (MAFLD) is high among U.S. adults, but studies on its occurrence in different ethnic and age groups are limited. The aim of the present study was to assess MAFLD occurrence among the U.S. adults by considering demographic characteristics, physical indices, and lifestyle conditions.

METHODS

This study utilized the National Health and Nutrition Examination Survey (NHANES) data 2009-2018 from 23,546 participants aged ≥ 20 years. Variables such as age, sex, race, body mass index (BMI), waist circumference (WC), blood pressure, sedentary behavior, sleep, and depression were analyzed.

RESULTS

Among 9933 participants, 3562 had MAFLD (34.1%), with notably higher percentages of Mexican-Americans (54.1%) and lower percentages of blacks (20.5%). The incidence of MAFLD was significantly greater (P < 0.001) in males (39%) than in females (29.2%), which was particularly evident within the 36-40 years age group. The MAFLD incidence exhibited an age-dependent pattern, initially increasing and subsequently declining (except for whites). Compared to white MAFLD patients, black MAFLD patients exhibited greater BMI, WC, systolic blood pressure (SBP), and diastolic blood pressure (DBP) values, whereas values for these measures were lower among Mexican-American patients. Logistic regression analysis adjusting for age and sex revealed that depression was more common among MAFLD patients (P < 0.001), except for severe depression (P > 0.05). Notably, the MAFLD incidence was not significantly associated with sedentary behavior or sleep duration.

CONCLUSIONS

The MAFLD incidence varies across different racial, age, and sex groups, and targeted interventions are essential for reducing the burden of MAFLD. However, further research is necessary to explore the correlations among MAFLD incidence, sleep patterns, and an inactive lifestyle.

[18F]flutemetamol uptake in the colon of a memory clinic population and its association with brain amyloidosis and the gut microbiota profile: an exploratory study

PURPOSE

Some Alzheimer's disease (AD) patients report gastro-intestinal symptoms and present alterations in the gut microbiota (GM) composition. Elevated colonic amyloid immunoreactivity has been shown in patients and animal models. We evaluated the colonic uptake of the amyloid positron emission tomography (PET) imaging agent [18F]flutemetamol (FMM) in a memory clinic population and investigated its association with brain amyloidosis and GM composition.

METHODS

Forty-five participants underwent (i) abdominal and cerebral FMM PET, acquired at 40 (early phase) and 120 min (late phase) after tracer injection, (ii) abdominal computed tomography, and (iii) cerebral T1-weighted MRI. Colonic standardized uptake value ratio (SUVr) was determined through manual tracing and automatic segmentation (TotalSegmentator), using the aortic blood signal as a reference region. Fecal GM composition was assessed using 16 S rRNA sequencing. Amyloid positive (A+) and negative (A-) participants, based on cortical FMM quantification (PetSurfer), were compared in terms of SUVr and GM features.

RESULTS

Increased colonic early SUVr was reported in A+ than A- (manual, p =.008; automated, p =.035). Altered GM composition was found in A + as shown by lower Pielou's evenness (p =.023), lower abundance of Eubacterium hallii group, and higher abundance of several genera. High UC5-1-2E3 abundance positively correlated with high colonic early SUVr (whole group: manual, p =.012, automated, p =.082; A+: manual, p =.074; automated, p =.016).

CONCLUSION

This exploratory study showed that subjects with cerebral amyloidosis have greater colonic FMM uptake than subjects with normal cerebral amyloid load, correlating with altered GM composition. Further analysis is needed to determine if these changes denote amyloid-related changes or other phenomena.

Plant genotype-specific modulation of Clonostachys rosea-mediated biocontrol of septoria tritici blotch disease in wheat

BACKGROUND

Beneficial microorganisms can act as biological control agents (BCAs) directly by targeting pathogens or indirectly by enhancing the plant's defense mechanisms against pathogens. However, efficiencies with which plants benefit from BCAs vary, potentially because of genetic variation in plants for plant-BCA compatibility. The aim of this study was to explore the genetic variation in winter wheat for modulation of Clonostachys rosea-mediated biocontrol of septoria tritici blotch disease caused by the fungal pathogen Zymoseptoria tritici.

RESULTS

In total, 202 winter wheat genotypes, including landraces and old cultivars grown from 1900 onwards in the Scandinavian countries, were tested under greenhouse-controlled conditions. Foliar spray applications of the pathogen and the fungal BCA in two treatments, i.e., Z. tritici (Zt) alone and Z. tritici along with C. rosea (ZtCr) were used to assess the disease progress over time. The absence and presence of C. rosea in Zt and ZtCr, respectively, allowed the dissection of variation for plant disease resistance and biocontrol efficacy. The study showed significant (P < 0.05) phenotypic variation among plant genotypes for disease progression in both Zt and ZtCr treatments. Moreover, the application of C. rosea resulted in a significant (P < 0.05) reduction in disease progression for seven genotypes and increased disease progression for eleven genotypes, indicating a plant genotype-dependent effect on the interaction between wheat, C. rosea and Z. tritici. For the phenotypic variation in disease progress and biocontrol efficacy, a genome-wide association study using a 20K single-nucleotide polymorphism (SNP) marker array was also performed. In total, five distinct SNP markers associated with disease resistance and four SNP markers associated with C. rosea biocontrol efficacy were identified.

CONCLUSIONS

This work serves as a foundation to further characterize the genetic basis of plant-BCA interactions when inoculated with Z. tritici, facilitating opportunities for simultaneous breeding for disease resistance and biocontrol efficacy.

Accuracy of Low-Dose Chest CT-Based Artificial Intelligence Models in Osteoporosis Detection: A Systematic Review and Meta-analysis

The purpose of this study is to systematically review and evaluate the accuracy of low-dose chest CT-based artificial intelligence in osteoporosis screening. A systematic literature search for relevant studies up to 13th December 2024 was performed in the PubMed, Scopus, Web of Science, and Cochrane Library databases. This meta-analysis was conducted in accordance with the PRISMA-DTA statement. Modified QUADAS-2 was used to assess the methodological quality of the studies. Quantification bias metrics were extracted to evaluate the performance of the AI models for vertebrae segmentation and labeling based on low-dose chest CT images. Pooled sensitivity, specificity, and area under the curve (AUC) were calculated. To assess publication bias, Egger test and funnel plot were conducted. Meta-regression and subgroup analysis were performed to explore potential heterogeneity. Eight studies suitable for the analysis were included. The pooled Dice similarity coefficient (DSC) for automatic vertebrae segmentation was 0.92 (95% CI 0.88-0.97). For the diagnosis of abnormal (osteoporosis + osteopenia) or osteoporosis participants, respectively, pooled sensitivities were 0.90 (95% CI 0.88-0.91) and 0.86(95% CI 0.82-0.89); pooled specificities were 0.90 (95% CI 0.88-0.91) and 0.93 (95% CI 0.92-0.94); and summary receiver operating characteristic (SROC) curves were 0.9653 and 0.9676. Meta-regression and subgroup analyses identified potential sources of heterogeneity, including result source (external dataset vs. internal dataset), ROI annotations (one radiologist vs. two radiologists), model developed with or without radiomics, and VBs segmentation output (included lumbar spine vs. only thoracic spine) (P < 0.05). The low-dose chest CT-based AI model shown promise information for identifying patients with osteoporosis or osteopenia who need further evaluation. Further prospective multi-center, multi-dataset studies are still required to assess the complementary role of the AI model in osteoporosis and osteopenia diagnosis through low-dose chest CT images.

The effect of Baduanjin exercise training on balance and fall risk in elderly individuals: A randomized controlled trial

BACKGROUND

While studies have reported the potential effectiveness of Baduanjin exercises and physical activity recommendations in addressing balance disorders and the increased fall risk commonly observed in elderly individuals, it remains unclear which approach yields superior outcomes. This study aimed to compare the effects of Baduanjin exercise training and physical activity recommendations on balance and fall risk in elderly individuals.

METHODS

Sixty elderly individuals were included the study. The participants were randomly divided into experimental (n = 30) and control group (n = 30). A Baduanjin exercise training was given to experimental group and physical activity recommendation was given to control group. Both groups performed the exercises training or physical activity recommendation 5 days a week for 8 weeks. The Berg balance scale and the timed up and go test were used to assess balance and fall risk, respectively. All assessments were repeated before and after the 8-week program for both groups.

RESULTS

There was a significant increase both in the Berg balance scale and the timed up and go test in both groups (P < .05), but the increases in the experimental group were greater than in the control group (P < .05).

CONCLUSION

The results of this study suggest that both Baduanjin exercise training and general physical activity recommendations are effective in enhancing balance and mitigating fall risk among elderly individuals. Nevertheless, Baduanjin exercise training exhibited greater efficacy in achieving these outcomes compared to physical activity recommendations.

Heterogeneous Responses to High-Dose Testosterone in Castration-Resistant Prostate Cancer Tumors with Mixed Rb-Proficient and Rb-Deficient Cells

Androgen deprivation therapy remains a cornerstone in managing prostate cancer. However, its recurrence often leads to the more aggressive castration-resistant prostate cancer (CRPC). Although second-line androgen receptor signaling inhibition treatments such as enzalutamide and abiraterone are available, their effectiveness against CRPC is only transient. High-dose testosterone (Hi-T) has recently emerged as a promising treatment for CRPC, primarily through the suppression of E2F and MYC signaling. However, the roles of Rb family proteins in influencing this therapeutic response remain debated. In this study, we utilized a CRPC patient-derived xenograft model that includes both Rb pathway-proficient and -deficient cell populations based on the positive or negative expression of RB family genes. Single-cell RNA sequencing analysis revealed that Rb-proficient cells displayed a robust response to Hi-T, whereas Rb-deficient cells exhibited significant resistance. Notably, our analysis indicated increased enrichment of the hypoxia signature in the Rb-deficient cell population. Further studies in RB1-silenced CRPC cell lines showed that treatment with a hypoxia-inducible factor-1α inhibitor can restore the sensitivity of Rb-deficient cells to high-dose dihydrotestosterone treatment. In conclusion, our research provides new molecular insights into CRPC tumor cell responses to Hi-T and proposes a new strategy to resensitize Rb-deficient CRPC cells to Hi-T treatment.

Antipseudomonal cephalosporins versus piperacillin/tazobactam or carbapenems for the definitive antibiotic treatment of Pseudomonas aeruginosa bacteraemia: new kids on the ICU block?

BACKGROUND

Pseudomonas aeruginosa bloodstream infections (Pa-BSIs) are still a major cause of mortality in ICUs, posing many treatment uncertainties.

METHODS

This multicentre, retrospective study analysed data from 14 Italian hospitals, including all consecutive adults developing Pa-BSI in ICU during 2021-22 and treated with antibiotics for at least 48 h. The primary aim was to identify predictors of 30 day mortality using Cox regression. Results were adjusted with inverse probability of treatment weighting (IPTW) and for immortal time bias.

RESULTS

Overall, 170 patients were included. High-risk BSI (source: lung, intra-abdominal, CNS) occurred in 118 (69%) patients, and 54 (32%) had septic shock. In 37 (22%), 73 (43%), 12 (7%) and 48 (28%) the definitive backbone therapy was piperacillin/tazobactam, carbapenems, colistin or new antipseudomonal cephalosporins (ceftolozane/tazobactam, n = 20; ceftazidime/avibactam, n = 22; cefiderocol, n = 6), respectively. Moreover, 58 (34%) received a second drug as combination therapy. The incidence of 30 day all-cause mortality was 27.6% (47 patients). By Cox regression, Charlson comorbidity index, neutropenia, septic shock and high-risk BSI were independent predictors of 30 day mortality, while previous colonization by P. aeruginosa, use of antipseudomonal cephalosporins as definitive treatment, and combination therapy were shown to be protective. However, after IPTW adjustment, only the protective effect of antipseudomonal cephalosporins was confirmed (adjusted HR = 0.27, 95% CI = 0.10-0.69), but not for combination therapy. Hence, the treatment effect was calculated: antipseudomonal cephalosporins significantly reduced mortality risk [-17% (95% CI = -4% to -30%)], while combination therapy was beneficial only in the case of septic shock [-66% (95% CI = -44% to -88%].

CONCLUSIONS

In ICU, antipseudomonal cephalosporins may be the preferred target therapy for the treatment of Pa-BSI; in addition, initial combination therapy may be protective in the case of septic shock.

Unplanned extubation prevention in the neuroscience ICU at a High Reliability Organization

BACKGROUND

Intubated neuroscience ICU patients are at risk for unplanned extubation (premature removal of the endotracheal tube by the patient or during patient care). The incidence of unplanned extubation is an indicator of the quality of ICU care. Unplanned extubation is a risk factor for pneumonia, increased ventilator days, the need for tracheostomy and increased ICU and hospital length-of-stay. After serial unplanned extubations, we introduced a multidisciplinary unit-based practice standard to reduce unplanned extubations as part of a quality improvement initiative in the neuroscience ICU in a large academic medical center at a High Reliability Organization in May 2021. The unit-based practice standard to guide care of intubated neuroscience ICU patients focused on communication, timely escalation of concerns, use of sedation/analgesia targeting RASS ≤ -1, soft wrist restraints (unless specified exclusion criteria met) and continuous observation for patients at high risk of agitation/restlessness. We sought to determine the impact of this initiative on the incidence of unplanned extubations.

METHOD

Unplanned extubations were identified via retrospective audit of prospective incident reports from our Patient Safety Incident registry pre-initiative (June 2020-May 2021) and prospective audit of incident reports post-initiative (July 2021-March 2024). Chart review facilitated collection of data on patient age, sex, diagnosis, intubation day, RASS goal, sedation/analgesia, restraints, constant observation, shift, and reintubation. The total number of intubated patients and ventilator days during these timeframes was identified retrospectively via an electronic medical record report of all patients on ventilators in the neuroscience ICU.

RESULTS

During the pre-initiative audit period, there were 214 intubated patients (968 ventilator days). The audit identified 9 unplanned extubations (0.93/100 ventilator days; 8 males, median age 63-years-old (IQR 47-67)). There were 4 patients who were not ordered for sedation/analgesia or had a RASS goal of 0 and no patients were in nonviolent soft wrist restraints. During the post-initiative audit period, there were 576 intubated patients (2,730 ventilator days). The audit identified 6 unplanned extubations (0.22/100 ventilator days; 6 males, median age 53-years-old (IQR 27-78)). All 6 patients had a RASS goal ≤ -1 and were in nonviolent soft wrist restraints.

CONCLUSION

This quality improvement initiative effectively reduced the incidence of unplanned extubations in our neuroscience ICU.

Bioinformatics combined with network pharmacology and experimental validation to identify key biomarkers of hepatocellular carcinoma and corresponding compounds in Radix Astragali and Pueraria Mirifica

The occurrence and death rates of primary hepatocellular carcinoma (HCC) are increasing, and there remains a shortage of effective oral medications with minimal side effects. We aim to identify potential biomarkers and compounds from Radix Astragali (RA) and Pueraria Mirifica (PM) to treat liver cancer and improve prognosis. Differentially expressed genes (DEGs) associated with HCC were identified by bioinformatics analysis of three datasets, GSE112791, GSE101685, and GSE45114. Using public databases to predict the bioactive components and possible targets of RA and PM. Target crossover from Gene Expression Omnibus (GEO) and public databases were used to identify potential biomarkers for HCC. Subsequently, validation and prognostic value analyses were performed using the Gene Expression Profile Interaction Analysis (GEPIA) platform. The Cytoscape software created a network of "compound targets" to pinpoint compounds linked to the biomarkers. Molecular docking techniques were utilized to validate the connection between these compounds and the identified biomarkers. Ultimately, the HepG2 liver cancer cell line was chosen to assess the inhibitory effect of Hederagenin (HDG) and to confirm the expression of ADH1B through Western blot analysis. In this study, four key biomarkers (NR1I2, ADH1B, NQO1, GHR) were identified. Molecular docking showed that these four core targets could form stable conformations with the corresponding compounds. As the drug concentration decreases, the inhibitory effect on HepG2 diminishes, and the survival rate of HepG2 cells significantly declines following the administration of 100 µmol/L HDG. Compared to the control, the expression of ADH1B protein is significantly increased in HepG2 cells treated with 100 µmol/L HDG. The study identified four key biomarkers (ADH1B, GHR, NQO1, NR1I2) that have prognostic ability for HCC. This study provides biomarkers and potential targeted monomeric medicines for treating HCC.

T1 and T2 measurements of the neonatal brain at 7 T

PURPOSE

To determine the expected range of NMR relaxation times (T1 and T2) in the neonatal brain at 7 T.

METHODS

Data were acquired in a total of 40 examinations on infants in natural sleep. The cohort included 34 unique subjects with postmenstrual age range between 33 and 52 weeks and contained a mix of healthy individuals and those with clinical concerns. Single-slice T1 and T2 mapping protocols were used to provide measurements in white matter, cortex, cerebellum, and deep gray matter. Automatic image segmentation of a separate T2-weighted brain volume was used to define regions of interest for analysis.

RESULTS

Linear regression was used to estimate relaxation times at term equivalent age (40 weeks postmenstrual age).T 1 40 wk $$ {T}_1^{40 wk} $$ with 95% confidence intervals was measured to be 2933 [2893, 2972] ms in white matter; 2653 [2604, 2701] ms in cerebellum; and 2486 [2439, 2532] ms in basal ganglia.T 2 40 wk $$ {T}_2^{40 wk} $$ was estimated as 119 [116, 121] ms in white matter, 99 [96, 102] ms in cerebellum, and 90 [89, 92] ms in basal ganglia. Most tissue-relaxation times showed a significant negative correlation with postmenstrual age, with the strongest correlation seen in cerebellum.

CONCLUSIONS

We describe neonatal brain tissue and age-specific T1 and T2 relaxation values at 7 T. The presented values differ substantially from both adult values at 7 T and neonate values measured at lower field strengths, and will be essential for pulse-sequence optimization for neonatal studies.

Economic Evaluation of Penpulimab Plus Paclitaxel and Carboplatin Combination Therapy as First-Line Treatment for Locally Advanced or Metastatic Squamous Non-small Cell Lung Cancer in China

INTRODUCTION

Penpulimab is a PD-1 monoclonal antibody recommended for treating squamous non-small cell lung cancer (sqNSCLC) in combination with paclitaxel and carboplatin. This study aimed to assess the cost-effectiveness of penpulimab combined with paclitaxel and carboplatin against paclitaxel plus carboplatin as first-line treatment for locally advanced or metastatic sqNSCLC in China.

METHODS

A three-state partitioned survival model was constructed using the efficacy outcomes obtained by digitizing the AK105-302 trial and was extrapolated to the lifetime horizon. Data on direct medical costs and utilities was gathered from the literature and commercial databases from the perspective of the Chinese healthcare system. Outcomes included quality-adjusted life years (QALYs), life years (LYs), and the incremental cost-effectiveness ratio (ICER). Sensitivity analysis and scenario analysis were performed to test the model robustness.

RESULTS

The incremental efficacy of penpulimab plus paclitaxel and carboplatin was 0.821 QALYs and 1.176 LYs with an incremental cost of $20,335 compared with paclitaxel plus carboplatin combination therapy. The ICER was $24,778 per QALY, falling below the threshold of three times the per capita gross domestic product of China, a commonly applied benchmark. The results of the one-way sensitivity analysis demonstrated that the ICER values were primarily influenced by the utility of progression-free state and cost of penpulimab. Probabilistic sensitivity analysis showed that penpulimab plus paclitaxel and carboplatin was cost-effective for 98.3% of the cases. Scenario analysis yielded results similar to those of the base-case analysis.

CONCLUSIONS

Our analysis suggests that penpulimab plus paclitaxel and carboplatin combination therapy is cost-effective for patients with locally advanced or metastatic sqNSCLC in China.

Integrating a multi-omics strategy framework to screen potential targets in cognitive impairment-related epilepsy

Epilepsy is a prevalent neurological disorder that affects over 70 million individuals worldwide and is often associated with cognitive impairments. Despite the widespread impact of epilepsy and cognitive impairments, the genetic basis and causal relationships underlying these conditions remain uncertain, prompting us to conduct a comprehensive investigation into the molecular mechanisms involved. In this study, we utilized statistical data from the third National Health and Nutrition Examination Survey (NHANES III) to evaluate correlation and large-scale pan-phenotype genome-wide association study (GWAS) data to establish genetic correlation and causality. Leveraging multi-omics datasets, we performed a comprehensive post-analysis that included variant prioritization, gene analysis, tissue and cell type enrichment, and pathway annotation. An integrated strategy-multi-trait analysis of GWAS (MTAG), transcriptome-wide association study (TWAS), summary-data-based Mendelian Randomization (SMR), and protein quantitative trait locus (pQTL)-MR-was performed to investigate the shared genetic architecture. Based on multiple orthogonal lines of evidence, we thereby identified 40 single nucleotide polymorphisms (SNPs) and 85 genes common to both conditions. Additionally, we optimized candidate genes such as GNAQ, FADS1, and PTK2 by single-cell expression analysis and molecular pathway mechanisms, thereby highlighting potential shared genetic pathways. These findings elucidate the genetic interplay and co-occurring mechanisms between epilepsy and cognitive impairments, providing crucial insights for future research and therapeutic strategies.

What is the most effective antibiotic monotherapy for severe Pseudomonas aeruginosa infection? A systematic review and meta-analysis of randomized controlled trials

BACKGROUND AND OBJECTIVES

Severe infections caused by Pseudomonas aeruginosa are associated with significant morbidity and mortality, particularly in hospitalized and immunocompromised patients. Determining the optimal definitive monotherapy for these infections is critical. The main objective was to compile the evidence of subgroups of patients with Pseudomonas aeruginosa infection from randomized control trials (RCTs) evaluating different definite antipseudomonal monotherapies for severe P. aeruginosa infection.

METHODS

Systematic review and meta-analysis of RCTs that assessed monotherapy with an antipseudomonal drug versus another antipseudomonal for definite treatment, and reported on the subgroup of patients with P. aeruginosa infection. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, LILACS and the reference lists of included trials. Eligibility criteria included RCTs enrolling hospitalized adults (≥18 years) with microbiologically confirmed severe P. aeruginosa infections. Studies were excluded if they included >20% of patients receiving combination therapy or if patients had resistant P. aeruginosa strains at recruitment. Antipseudomonal drugs evaluated included cephalosporins, carbapenems, penicillins, quinolones and aztreonam. The primary outcome was 30-day mortality. Risk of bias was assessed using the Cochrane tool. Results were pooled using fixed-effects and random-effects models as appropriate. Relative risk (RR) and 95% CIs were calculated. Sensitivity analyses and subgroup analyses were performed when data were available.

RESULTS

A total of 76 RCTs and 1681 patients with pseudomonal infection were included. Due to the low number of studies which reported our outcomes of interest, all subgroup analyses were underpowered. No difference in all-cause mortality was found for any direct antibiotic comparison. Higher clinical failure rates of carbapenems versus piperacillin-tazobactam were observed for pneumonia in two RCTs (RR, 2.55; 95% CI, 1.29-5.03; I2 = 0%, n = 2), and higher microbiological failure rates with carbapenems versus other comparators (RR, 1.24; 95% CI, 1.02-1.51; I2 = 0%, n = 23). Patients treated with imipenem were more likely to develop resistance to the study drug versus comparators (RR, 2.33; 95% CI, 1.61-3.38; I2 = 0%, n = 7).

CONCLUSIONS

In this systematic review and meta-analysis of definite antipseudomonal monotherapy for P. aeruginosa infection, we found no evidence of clinical benefit differences among direct antibiotic comparisons, but all subgroup analyses were underpowered to detect significant differences.

SHP2-mediated ROS activation induces chondrocyte paraptosis in osteoarthritis and is attenuated by low-intensity pulsed ultrasound

Background

Paraptosis is a novel form of programmed cell death, generally caused by disrupted proteostasis or alterations of redox homeostasis. However, its impact and underlying mechanisms on the pathology of osteoarthritis (OA) are still unclear. This study aimed to investigate the role and regulatory mechanism of SHP2 in chondrocyte paraptosis and the effects influenced by low-intensity pulsed ultrasound (LIPUS).

Methods

SHP2, a MAPK upstream intermediary, has been identified as one of the critical targets of IL-1β-induced paraptosis in the GEO and GeneCard databases. The expression of SHP2 in chondrocytes was regulated by either siRNA knockdown or plasmid overexpression. Additionally, adeno-associated viruses were injected into the knee joints of rats to explore whether SHP2 plays a role in the development of OA. The impact of LIPUS on paraptosis and OA was examined in IL-1β-induced chondrocytes and a post-traumatic OA model, with SHP2 regulation assessed at both cellular and animal levels.

Results

An increase in cellular reactive oxygen species (ROS) caused by IL-1β halts the growth of chondrocytes and induces paraptosis in the chondrocytes. IL-1β-induced paraptosis, manifested as endoplasmic reticulum (ER)-derived vacuolization, was mediated by ROS-mediated ER stress and MAPK activation. SHP2 facilitates ROS production, thereby exacerbating the chondrocytes paraptosis. SHP2 knockdown and ROS inhibition effectively reduced this process and significantly mitigated inflammation and cartilage degeneration. Furthermore, we discovered that LIPUS delayed OA progression by inhibiting the activation of the MAPK pathway, ER stress, and ER-derived vacuoles in chondrocytes, all of which play critical roles in paraptosis, through the downregulation of SHP2 expression. Results on animals showed that LIPUS inhibited cartilage degeneration and alleviated OA progression.

Conclusion

SHP2 exacerbates IL-1β-induced oxidative stress and the subsequent paraptosis in chondrocytes, promoting OA progression. LIPUS mitigates paraptosis by modulating SHP2, which in turn slows OA progression.

The translational potential of this article

This study indicates that a novel SHP2-mediated cell death mechanism, paraptosis, plays a role in post-traumatic OA progression. LIPUS helps maintain cartilage-subchondral bone unit integrity by targeting SHP2 inhibition. SHP2 emerges as a potential therapeutic target, while LIPUS provides a promising non-invasive approach for treating trauma-related OA.

The imbalance of follicular helper T cells and follicular regulatory T cells is involved in renal injury in active lupus nephritis

OBJECTIVE

This study is to research the role of follicular helper T (TFH) cells and follicular regulatory T (TFR) cells in the progression of lupus nephritis (LN).

METHODS

A total of 33 active LN patients, 30 stable LN patients, and 30 healthy controls (HC) were included in this study. The frequencies of TFH, TFR, T cell Ig and ITIM domain (TIGIT) + TFR, and CD226 + TFR cells in peripheral blood were measured using flow cytometry. The distribution and proportion of TFH and TFR cells in renal tissue were assessed using a multiplex immunohistochemical.

RESULTS

Active LN had a significantly lower TFR and TFR/TFH ratio in peripheral blood than HC and stable LN. TIGIT + TFR was lower in active LN, while CD226 + TFR was higher. In LN, TFR and TFR/TFH ratio showed a negative correlation with creatinine (CREA), but a positive correlation with endogenous creatinine clearance (Ccr). TFH and TFR mainly infiltrated the renal interstitium or surrounding renal tubules and participated in the formation of ectopic lymphoid-like structures in active LN. In active LN, TFH cells in renal tissue were higher than in control renal tissue. The tissue TFH showed a positive correlation with the activity index, CREA, but a negative correlation with Ccr. The tissue TFR/TFH ratio showed a negative correlation with the activity index, CREA, but a positive correlation with Ccr.

CONCLUSION

In active LN, the proportions of TFR cells in peripheral blood are reduced and function is impaired. In active LN, TFH and TFR imbalances have been observed and are associated with renal injury.

Heparin-binding protein levels as an emerging key biomarker for accurate diagnosis of bacterial meningitis: A promising yet preliminary evaluation

This systematic review aims to consolidate evidence on the potential of heparin-binding protein (HBP) as an emerging and promising biomarker for diagnosing bacterial meningitis (BM). We conducted a comprehensive search across PubMed, the Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI) databases, with no restrictions on publication date or language. Sixteen studies, encompassing a total of 2,032 participants, were included in the analysis. The results consistently demonstrated that HBP expression levels in both cerebrospinal fluid (CSF) and blood are markedly elevated in cases of BM compared to patients with non-central nervous system (CNS) infections or other types of meningitis, such as viral meningitis. The pooled sensitivity estimate for HBP measured in CSF was 0.94 [95% confidence interval (CI), 0.88-0.97], and the specificity was 0.96 [95%CI, 0.90-0.98]. The diagnostic odds ratio (DOR) was calculated as 327 [95%CI, 96-1,110]. According to Fagan's nomogram, an initial probability of 20% for a positive test result increased to 85% following a positive HBP test, while a negative test reduced the probability to just 2%. The diagnostic performance of CSF HBP surpassed that of procalcitonin in detecting BM. Furthermore, in cases where symptoms of CNS infection are present, HBP levels in blood also demonstrate notable diagnostic accuracy. These findings suggest that HBP holds significant potential as a biomarker for BM. However, further large-scale studies are required to establish optimal HBP thresholds for improved clinical applicability.

Dexmedetomidine mitigation of renal ischaemia-reperfusion injury: comprehensive insights from cellular mechanisms to clinical application

Renal ischaemia-reperfusion injury (IRI) is a critical cause of acute kidney injury (AKI) after major surgery, leading to elevated morbidity, mortality, and long-term renal dysfunction. Despite advances in perioperative care, the occurrence of IRI remains high. The renoprotective properties of dexmedetomidine (DEX), a selective α2-adrenergic receptor agonist, have been demonstrated, reducing oxidative stress, inflammation, apoptosis, ferroptosis, cellular senescence, and renal fibrosis while enhancing mitochondrial function and autophagy. From cellular studies to clinical applications, DEX has been effective in mitigating renal IRI, enhancing postoperative renal outcomes, and lowering the incidence of AKI in various surgical settings. This review comprehensively discusses and summarises the renoprotective effects and the underlying mechanisms of DEX, with a focus on its application across various surgical and clinical scenarios. In conclusion, DEX effectively mitigates renal IRI, as evidenced by robust in vitro, in vivo, and clinical studies. It significantly reduces kidney damage and improves surgical outcomes. However, its efficacy is less pronounced in kidney transplantation, suggesting that its renoprotective effects vary depending on the clinical context.

Glutamate stress in the caudal nucleus tractus solitarii (nTS): Impact on respiratory function and synaptic signaling in an Alzheimer's disease model

Respiratory dysfunction is a prevalent comorbidity in Alzheimer's disease (AD), yet its underlying mechanisms are poorly understood. Using the Streptozotocin (STZ) -induced rat model of AD, which replicates respiratory dysfunction and brain pathologies observed in human AD, we analyzed how these impairments relate to central neurological integration within the peripheral chemoreflex. Our focus was on glutamatergic signaling at the synapse between peripheral chemoafferents and second-order neurons in the nucleus tractus solitarii (nTS), a critical brainstem center for respiratory control. Activating the peripheral chemoreflex with potassium cyanide (KCN) increased respiratory frequency. Response magnitudes to repeated KCN injections typically decreased over time, which was exacerbated in the STZ-AD group. Similarly, repeated glutamate nanoinjections into the caudal/commissural nTS caused a pronounced reduction of respiratory frequency responses in STZ-AD. Electrophysiological analysis of nTS neurons within the peripheral chemoreflex revealed increased network activity, enhanced excitatory postsynaptic currents evoked by solitary tract stimulation (TS-EPSCs), and elevated asynchronous glutamate release following high-frequency stimulation (aEPSCs). These data were consistent with molecular evidence for astrogliosis (elevated GFAP expression), reduced astrocytic glutamate uptake (decreased EAAT2 expression), and presynaptic calcium dysregulation (increased TRPV1 expression). Additionally, presynaptic metabotropic glutamate receptors (mGluR3) were downregulated, while postsynaptic ionotropic receptor expression remained unchanged. With high-frequency solitary tract stimulation, STZ-AD rats had greater frequency-dependent TS-EPSC depression than controls, mirroring the diminished respiratory responses to KCN and glutamate nanoinjections. Our findings connect neurophysiological and molecular changes at the first nTS synapse of the peripheral chemoreflex with impaired respiratory responses to hypoxia in the STZ-AD model.

Identification and functional regulation of two alternative splicing isoforms of the Uhrf2 gene in Miichthysmiiuy

Alternative splicing can produce a variety of splicing isoforms to increase protein diversity, participate in the regulation of gene expression and the occurrence and development of diseases, and thus play an important role in innate immunity. Ubiquitin like with PHD and ring finger domains 2 (Uhrf2) protein is associated with cell proliferation, inflammation, tumors, and cancer, and is currently the focus of medical immunology research, but there is little research on alternative splicing of the Uhrf2 gene. In this study, we identified two different splicing isoforms of Uhrf2 in Miichthys miiuy through Sanger sequencing, dual-luciferase reporter gene assay, qRT-PCR, subcellular localization experiments, and named them Uhrf2-α and Uhrf2-β. Subcellular localization experiments found that Uhrf2-α was mainly located in the nucleus, while Uhrf2-β was mainly located in the cytoplasm. Although their localization was different, both could significantly inhibit the activation of IRF3 and NF-κB signaling pathways, and effectively inhibit the levels of inflammatory cytokines. These results indicate that Uhrf2-α and Uhrf2-β play important negative regulatory roles in innate immune responses in fish.