Efficient Photodegradation of Antibiotics by g-C3N4 and 3D flower-like Bi2WO6 Perovskite Structure: Insights into the Preparation, Evaluation, and Potential Mechanism

Antibiotics are emerging organic pollutants that have attracted huge attention owing to their abundant use and associated ecological threats. The aim of this study is to develop and use photocatalysts to degrade antibiotics, including tetracycline (TC), ciprofloxacin (CIP), and amoxicillin (AMOX). Therefore, a novel Z-scheme heterojunction composite of g-C3N4 (gCN) and 3D flower-like Bi2WO6 (BW) perovskite structure was designed and developed, namely Bi2WO6/g-C3N4 (BW/gCN), which can degrade low-concentration of antibiotics in aquatic environments under visible light. According to the Density Functional Theory (DFT) calculation and the characterization results of X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FITR), Scanning electron microscopy - energy spectroscopy (SEM-EDS) and X-ray photoelectron spectroscopy (XPS), this heterojunction was formed in the recombination process. Furthermore, the results of 15wt%-BW/gCN photocatalytic experiments showed that the photodegradation rates (Rp) of TC, CIP, and AMOX were 92.4%, 90.1% and 82.3%, respectively, with good stability in three-cycle photocatalytic experiments. Finally, the quenching experiment of free radicals showed that the holes (h+) and superoxide radicals (·O2-) play a more important role than the hydroxyl radicals (·OH) in photocatalysis. In addition, a possible antibiotic degradation pathway was hypothesized on the basis of High performance liquid chromatography (HPLC) analysis. In general, we have developed an effective catalyst for photocatalytic degradation of antibiotic pollutants and analyzed its photocatalytic degradation mechanism, which provides new ideas for follow-up research and expands its application in the field of antibiotic composite pollution prevention and control.

Molecular Engineering and Morphology Control of Covalent Organic Frameworks for Enhancing Activity of Metal-Enzyme Cascade Catalysis

Metal-enzyme integrated catalysts (MEICs) that combine metal and enzyme offer great potential for sustainable chemoenzymatic cascade catalysis. However, rational design and construction of optimal microenvironments and accessible active sites for metal and enzyme in individual nanostructures are necessary but still challenging. Herein, Pd nanoparticles (NPs) and Candida antarctica lipase B (CALB) are co-immobilized into the pores and surfaces of covalent organic frameworks (COFs) with tunable functional groups, affording Pd/COF-X/CALB (X = ONa, OH, OMe) MEICs. This strategy can regulate the microenvironment around Pd NPs and CALB, and their interactions with substrates. As a result, the activity of the COF-based MEICs in catalyzing dynamic kinetic resolution of primary amines is enhanced and followed COF-OMe > COF-OH > COF-ONa. The experimental and simulation results demonstrated that functional groups of COFs modulated the conformation of CALB, the electronic states of Pd NPs, and the affinity of the integrated catalysts to the substrate, which contributed to the improvement of the catalytic activity of MEICs. Further, the MEICs are prepared using COF with hollow structure as support material, which increased accessible active sites and mass transfer efficiency, thus improving catalytic performance. This work provides a blueprint for rational design and preparation of highly active MEICs.

Circularly Polarized Luminescence Induced by Hydrogen-Bonding Networks in a One-Dimensional Hybrid Manganese(II) Chloride

Chiral hybrid metal halides hold great potential as circularly polarized luminescence light sources. Herein, we have obtained two enantiomeric pairs of one-dimensional hybrid chiral manganese(II) chloride single crystals, R/S-(3-methyl piperidine)MnCl3 (R/S-1) and R/S-(3-hydroxy piperidine)MnCl3 (R/S-2), crystallizing in the non-centrosymmetric space group P212121. In comparison to R/S-1, R/S-2 single crystals not only show red emission with near-unity photoluminescence quantum yield (PLQY) and high resistance to thermal quenching but also exhibit circularly polarized luminescence with an asymmetry factor (glum) of 2.5×10-3, which can be attributed to the enhanced crystal rigidity resulting from the hydrogen bonding networks between R/S-(3-hydroxy piperidine) cations and [MnCl6]4- chains. The circularly polarized luminescence activities originate from the asymmetric [MnCl6]4- luminophores induced by N-H⋅⋅⋅Cl hydrogen bonding with R/S-(3-hydroxy piperidine). Moreover, these samples demonstrate great application potential in circularly polarized light-emitting diodes and X-ray scintillators. This work shows a highly efficient photoluminescent Mn-based halide and offers a strategy for designing multifunctional chiral metal halides.

[Development and validation of a persistent postural-perceptual dizziness screening questionnaire]

Objective: To develop a simple screening questionnaire for persistent postural-perceptual dizziness (PPPD) and evaluate its screening ability. Methods: A convenience sample of 296 individuals who met the inclusion criteria between November 2021 and January 2023 were prospectively selected for three rounds of screening at the Vertigo Specialty Clinic of the Department of Otorhinolaryngology-Head and Neck Surgery in the First Hospital of Shanxi Medical University. In conjunction with expert opinion and statistical analysis, the first and second rounds of screening were used to modify and finalize the questionnaire entries, and the third round of screening was used to evaluate the questionnaire's screening ability. Independent sample t-test was used for inter group comparison, reliability and validity indicators were employed to screen and evaluate questionnaire entries, and the receiver operating characteristic (ROC) curve was plotted to determine the optimal cut-off value and corresponding sensitivity and specificity. Results: The final PPPD screening questionnaire entries included 21 items. In evaluating the reliability of this questionnaire, the Cronbach's alpha coefficient was 0.831, the half folding coefficient was 0.742, the content validity was 0.86, and the Kaiser-Meyer-Olkin (KMO) value in the structural validity was 0.811. Additionally, there were six factors with characteristic root>1 and a cumulative contribution rate of 62.62%. The area under the ROC curve of the screening questionnaire was 0.935 (95%CI: 0.877-0.992), and the optimal cut-off value was 8.5, with a sensitivity of 85.0%, a specificity of 85.5%, and a Kappa value of 0.653. Conclusion: The PPPD simple screening questionnaire designed in this study has a high sensitivity and specificity, making it a useful tool for identifying PPPD patients.

Resin-Immobilized Palladium Acetate and Alcohol Dehydrogenase for Chemoenzymatic Enantioselective Synthesis of Chiral Diarylmethanols

The enantioselective synthesis of chiral diarylmethanols is highly desirable in synthetic chemistry and the pharmaceutical industry, but it remains challenging, especially in terms of green and sustainable production. Herein, a resin-immobilized palladium acetate catalyst was fabricated with high activity, stability, and reusability in Suzuki cross-coupling reaction of acyl halides with boronic acids, and the coimmobilization of alcohol dehydrogenase and glucose dehydrogenase on resin supports was also conducted for asymmetric bioreduction of diaryl ketones. Experimental results revealed that the physicochemical properties of the resins and the immobilization modes played important roles in affecting their catalytic performances. These two catalysts enabled the construction of a chemoenzymatic cascade for the enantioselective synthesis of a series of chiral diarylmethanols in high yields (83-90%) and enantioselectivities (87-98% ee). In addition, the asymmetric synthesis of the antihistaminic and anticholinergic drugs (S)-neobenodine and (S)-carbinoxamine was also achieved from the chiral diarylmethanol precursors, demonstrating the synthetic utility of the chemoenzymatic cascade.

FGF4 protects the liver from immune-mediated injury by activating CaMKKβ-PINK1 signal pathway to inhibit hepatocellular apoptosis

Immune-mediated liver injury (ILI) is a condition where an aberrant immune response due to various triggers causes the destruction of hepatocytes. Fibroblast growth factor 4 (FGF4) was recently identified as a hepatoprotective cytokine; however, its role in ILI remains unclear. In patients with autoimmune hepatitis (type of ILI) and mouse models of concanavalin A (ConA)- or S-100-induced ILI, we observed a biphasic pattern in hepatic FGF4 expression, characterized by an initial increase followed by a return to basal levels. Hepatic FGF4 deficiency activated the mitochondria-associated intrinsic apoptotic pathway, aggravating hepatocellular apoptosis. This led to intrahepatic immune hyper-reactivity, inflammation accentuation, and subsequent liver injury in both ILI models. Conversely, administration of recombinant FGF4 reduced hepatocellular apoptosis and rectified immune imbalance, thereby mitigating liver damage. The beneficial effects of FGF4 were mediated by hepatocellular FGF receptor 4, which activated the Ca2+/calmodulin-dependent protein kinasekinase 2 (CaMKKβ) and its downstream phosphatase and tensin homologue-induced putative kinase 1 (PINK1)-dependent B-cell lymphoma 2-like protein 1-isoform L (Bcl-XL) signalling axis in the mitochondria. Hence, FGF4 serves as an early response factor and plays a protective role against ILI, suggesting a therapeutic potential of FGF4 and its analogue for treating clinical immune disorder-related liver injuries.

Synergistic effect of photoelectrochemical aptasensor based on staggered gap ZnO/BiFeO3 heterojunction coupled with cDNA-CdS sensitizer enabling ultrasensitive assay of kanamycin

Using staggered-gap ZnO/BiFeO3 heterojunction as photoactive materials and cDNA-CdS as the sensitizer for sensitive Kanamycin (KAN) detection, we have created a unique signal-off biosensing platform. The ZnO/BiFeO3 heterojunction provides active sites for aptamer loading and enhances photocurrent responsiveness. Rapid interfacial charge transfer and the separation efficiency of photo-generated carriers are enhanced by sensitization of the ternary heterojunction ZnO/BiFeO3/CdS. Signal-amplified quenching occurs when sensitizers are replaced with sterically hindered KAN. Because of the aptamer's greater affinity for KAN, the replacement of CdS causes a decrease in photocurrent response. Additionally, the weakly conductive aptamer-KAN complex causes steric hindrance, which exacerbates the photoelectrochemical signal-damping effect even more. The photoelectrochemical aptasensor exhibits excellent selectivity and stability, detecting KAN within the range of 0.00005825-0.233 μg/mL with a detection limit of 0.0466 ng/mL (S/N = 3). This work demonstrates the potential of perovskite oxides and their heterostructures for advanced photoelectrochemical biosensing applications.

Activated hedgehog gene pattern correlates with dismal clinical outcome and tumor microenvironment heterogeneity in hepatocellular carcinoma

Background

Activation of the Hedgehog signaling pathway is linked to the initiation and development of human hepatocellular carcinoma (HCC). However, its impact on clinical outcomes and the HCC microenvironment remains unclear.

Methods

We performed comprehensive analyses of Hedgehog pathway genes in a large cohort of HCC patients. Specifically, we utilized univariate Cox regression analysis to identify Hedgehog genes linked to overall survival, and the LASSO algorithm was used to construct a Hedgehog-related gene pattern. We subsequently examined the correlation between the Hedgehog pattern and the HCC microenvironment employing the CIBERSORT and ssGSEA algorithms. Furthermore, Tumor Immune Dysfunction and Exclusion (TIDE) algorithm and the anti-PD-L1 treatment dataset (IMvigor210) are used to evaluate the clinical response of the Hedgehog pattern in predicting immune checkpoint inhibitors.

Results

We found that the Hedgehog activation score (HHAS), a prognostic score based on 11 Hedgehog genes, was significantly associated with HCC patient survival. Patients exhibiting high HHAS experienced markedly reduced survival rates compared to those with low HHAS, and HHAS emerged as an independent prognostic factor for HCC. Functional enrichment analysis unveiled the association of the HHAS phenotype with functions related to the immune system, and further investigation demonstrated that HCC patients exhibiting low HHAS displayed elevated levels of anti-tumor immune activation in CD8+ T cells, while high HHAS were linked to immune escape phenotypes and increased infiltration of immune suppressive cells. In addition, in the Immune Checkpoint Inhibitor (ICI) cohort of IMvigor210, patients with higher HHAS had worse ICI treatment outcomes and shortened survival time, indicating that the HHAS is a useful indicator for predicting patient response to immunotherapy.

Conclusions

In summary, our study offers valuable insights for advancing research on Hedgehog and its impact on tumor immunity, which provides an opportunity to optimize prognosis and immune therapy for HCC.

Pathophysiological aspects of transferrin-A potential nano-based drug delivery signaling molecule in therapeutic target for varied diseases

Transferrin (Tf), widely known for its role as an iron-binding protein, exemplifies multitasking in biological processes. The role of Tf in iron metabolism involves both the uptake of iron from Tf by various cells, as well as the endocytosis mediated by the complex of Tf and the transferrin receptor (TfR). The direct conjugation of the therapeutic compound and immunotoxin studies using Tf peptide or anti-Tf receptor antibodies as targeting moieties aims to prolong drug circulation time and augment efficient cellular drug uptake, diminish systemic toxicity, traverse the blood-brain barrier, restrict systemic exposure, overcome multidrug resistance, and enhance therapeutic efficacy with disease specificity. This review primarily discusses the various biological actions of Tf, as well as the development of Tf-targeted nano-based drug delivery systems. The goal is to establish the use of Tf as a disease-targeting component, accentuating the potential therapeutic applications of this protein.

[Randomized controlled study on the application effect of a new type of intravenous radiofrequency closed therapy system made in China and an imported system]

Objective: To compare the application effect of domestic and imported intravenous radiofrequency closure system in the treatment of primary varicose veins of lower extremities. Methods: This single-center prospective, non-inferiority randomized controlled trial was performed in the Department of Vascular Surgery, the Fourth Affiliated Hospital, Zhejiang University School of Medicine from January 2021 to January 2022. Patients with primary varicose veins of lower extremities who met the ataxation criteria were randomly assigned to the experimental group(domestic novel venous radiofrequency closure system) or the control group(imported venous radiofrequency closure system) in a ratio of 1∶1. The two groups of subjects were compared in terms of target vein closure rate, technical success rate, system operation performance, incidence of adverse events and incidence of serious adverse events(SAE) within 6 months after surgery. Quantitative data were compared by Mann-Whitney U test, and categorical data were compared by χ2 test and non-inferiority test. Results: A total of 80 subjects were included in the trial (41 in the experimental group and 39 in the control group), including 27 males and 53 females, aged (M(IQR)) 55(23) years (range:40 to 78 years). There were 48 cases of left lower limb and 32 cases of right lower limb. The technical success rate and system control performance between the groups were 100%.The incidence of adverse events (58.5% (24/41) vs. 61.5% (24/39), χ2=0.075, P=0.784), and the incidence of SAE (7.3% (3/41) vs. 5.1% (2/39), χ2=0.163, P=0.686) within 6 months after surgery in experimental group and control group had no statistical significance. There was one device-related adverse event in each of the two groups. In the experimental group, one patient developed endovenous heat-induced thrombosis after surgery and recovered after taking rivaroxaban tablets. One patient in the control group had pain in the upper right thigh for more than 1 day after operation, which was cured after using analgesic cream. No device-related SAE occurred. The venous closure rate of the experimental group was 100% (38/38) at 6 months after surgery, and that of the control group was 97.4% (37/38). The difference between the two groups was 2.63% (95%CI:-3.19 to 8.45, Z=4.865, P<0.01), and the 95%CI lower limit of the difference in target venous closure rate between two groups was greater than the non-inferiority threshold of -10.00%. Conclusion: The early application effect of the new domestic intravenous radiofrequency closure system in patients with primary varicose veins of lower extremities is in line with expectations, it is not inferior to the imported system.

A simple photoelectrochemical aptasensor based on MoS2/rGO for aflatoxin B1 detection in grain crops

Designing a simple and sensitive photoelectrochemical (PEC) sensor is crucial to addressing the limitations of routine analytical methods. The sensitivity of the PEC sensor, however, relies on the photoelectric material used. In this manuscript, composites of MoS2/rGO (MG) with a large area and layered structure are prepared by simple steps. This material exhibits sensitivity to visible light and demonstrates outstanding photoelectric conversion performance. The constructed PEC aptasensor using this material to detect aflatoxin B1 (AFB1) shows significantly higher sensitivity and stability compared to similar sensors. This may be attributed to the presence of surface defects in MoS2, which provide more active sites for photocatalysis. Additionally, graphene oxide (GO) is reduced to rGO by thiourea and forms a heterojunction with MoS2, enhancing charge carrier separation and interfacial electron transfer. Our research has revealed that the photocurrent intensity of the aptamer electrode decreases with an increase in AFB1 concentration, resulting in a "signal-off" PEC aptasensor. The detection limit of this aptasensor is 2.18 pg mL-1, with a linear range of 0.001 to 100 ng mL-1. This result will also provide a reference for the study of other mycotoxins in food.

Human Parathyroid Hormone (1-34) accelerates skin wound healing through inducing cell migration via up-regulating the expression of Rac1

Delayed wound healing is a public issue that imposes a significant burden on both society and the patients themselves. To date, although numerous methods have been developed to accelerate the speed of wound closure, the therapeutic effects are partially limited due to the complex procedures, high costs, potential side effects, and ethical concerns. While some studies have reported that the in-vivo application of Human Parathyroid Hormone (1-34) (hPTH(1-34)) promotes the wound-healing process, the definitive role and underlying mechanisms through which it regulates the behavior of fibroblasts and keratinocytes remains unclear. Herein, hPTH(1-34)'s role in cell migration is evaluated with a series of in-vitro and in-vivo studies, whereby hPTH(1-34)'s underlying mechanism in activating the two types of cells was detected. The in-vitro study revealed that hPTH(1-34) enhanced the migration of both fibroblasts and HaCaT cells. Ras-associated C3 botulinum toxin subunit 1 (Rac1), a classical member of the Rho family, was upregulated in hPTH(1-34)-treated fibroblasts and HaCaT cells. Further study by silencing the expression of Rac1 with siRNA reversed the hPTH(1-34)-enhanced cell migration, thus confirming that Rac1 was involved in hPTH(1-34)-induced cell behavior. In-vivo study on rat wound models confirmed the effects of hPTH(1-34) on fibroblasts and keratinocytes, with increased collagen deposition, fibroblasts accumulation, and Rac1 expression in the hPTH(1-34)-treated wounds. In summary, the present study demonstrated that hPTH(1-34) accelerated wound healing through enhancing the migration of cells through the up-regulation of Rac1 expression.

Heteroatom Structural Engineering of Conjugated Porous Polymers Enhances Photocatalytic Nicotinamide Cofactor Regeneration

Photocatalysis is an eco-friendly method to regenerate nicotinamide (NADH) cofactors, which is essential for biotransformation over oxidoreductases. Organic polymers exhibit high stability, biocompatibility and functional designability as photocatalysts, but still suffering from rapid charge recombination. Herewith the heteroatom structural engineering of donor-π-acceptor (D-π-A) conjugated porous polymers were conducted to promote charge transfer and photocatalytic NADH regeneration. The electron delocalization of polymer photocatalysts can be readily tuned by changing the electron density of the donor unit, leading to faster charge separation and better photocatalytic performance. The optimum sulfur-doped polymer exhibits the highest NADH regeneration yield of 47.4 % in 30 min and 94.1 % in 4 h, which can drive the biocatalytic C=C bond reduction of 2-cyclohexen-1-one by ene-reductase, giving the corresponding cyclohexanone yield of 96.7 % in 10 h. Moreover, the oxygen-doped polymer, from biomass derived 2,5-diformylfuran, exhibits comparable photocatalytic activity to the sulfur-doped CPP, suggesting the potential of furan as alternative donor unit to thiophene.

Ligand-Induced In Situ Epitaxial Growth of PbI2 Nanosheets/MAPbI3 Heterojunction Realizes High-Performance HTM-Free Carbon-Based MAPbI3 Solar Cells

Hole-transporting layer-free carbon-based perovskite solar cells (HTL-free C-PSCs) hold great promise for photovoltaic applications due to their low cost and outstanding stability. However, the low power conversion efficiency (PCE) of HTL-free C-PSCs mainly results from grain boundaries (GBs). Here, epitaxial growth is proposed to rationally design a hybrid nanostructure of PbI2 nanosheets/perovskite with the desired photovoltaic properties. A post-treatment technique using tri(2,2,2-trifluoromethyl) phosphate (TFEP) to induce in situ epitaxial growth of PbI2 nanosheets at the GBs of perovskite films realizes high-performance HTL-free C-PSCs. The structure model and high-resolution transmission electron microscope unravel the epitaxial growth mechanism. The epitaxial growth of oriented PbI2 nanosheets generates the PbI2 /perovskite heterojunction, which not only passivates defects but forms type-I band alignment, avoiding carrier loss. Additionally, Fourier-transform infrared spectroscopy, 31 P NMR, and 1 H NMR spectra reveal the passivation effect and hydrogen bonding interaction between TFEP and perovskite. As a result, the VOC is remarkably boosted from 1.04 to 1.10 V, leading to a substantial gain in PCE from 14.97% to 17.78%. In addition, the unencapsulated PSC maintains the initial PCE of 80.1% for 1440 h under air ambient of 40% RH. The work offers a fresh perspective on the rational design of high-performance HTL-free C-PSCs.

From Ancient Blue Pigment to Unconventional NIR Phosphor: A Thermal-Stable Near-Infrared I/II Broadband Emission from Ca1-xSrxCuSi4O10 Solid Solution

Phosphors used in NIR spectroscopy require broadband emission, high external quantum yield, good ability, as well as a tunable spectral range to meet the detection criteria. Two-dimensional copper silicates MCuSi4O10 (M = Ca, Sr, Ba) play an important part in ancient art and technology as synthetic blue pigments. In the recent years, these compounds were reported to show a broad near-infrared emission when excited in the visible region. Inspired by the tunable structure of MCuSi4O10, a series of broadband phosphors Ca1-xSrxCuSi4O10 were designed for realizing continuously tunable NIR emission by a modulated Cu2+ crystal field environment. The emission maximum exhibits a red shift from 915 to 950 nm and the integral intensity enhances as the Sr2+ content varies in the range of 0-0.50, which is led by the lattice expansion and the following weakened crystal field splitting on tetrahedral-coordinated Cu2+. Compared to CaCuSi4O10, the optimized sample Ca0.5Sr0.5CuSi4O10 shows enhanced NIR emission by about 2.0-fold. It exhibits quite a high external quantum efficiency covering the NIR-I and -II regions (λmax = 950 nm, fwhm = 135 nm, EQE = 26.3%) with a strong absorption efficiency (74.7%) and a long excited-state lifetime (134 μs). These solid-solution phosphors (x = 0.0-0.5) show excellent thermal stability and maintain over 50% of the RT intensity at 200 °C. The optimized phosphor was encapsulated with red-light chips to fabricate NIR pc-LED and put into night-vision application. These good properties make these Cu2+-activated NIR phosphors appealing for multiple applications such as nondestructive testing, night version, lasers, and luminescent solar concentrators.

Novel solution and solid-state emissive long-wavelength carbon dots for water sensing and white LED applications

Carbon dots (CDs) are among the most popular nanomaterials due to their remarkable fluorescent and electronic properties, as well as their good biocompatibility and low cytotoxicity. Currently, CDs with aggregation-induced emission (AIE) are relatively rare and have become a significant research hotspot. This is because most conventional CDs suffer from severe quenching in a solid state. Herein, novel CDs with both solution and solid-state emissions were obtained using a facile one-step hydrothermal synthesis. Specifically, the CDs exhibit yellow solvent-dependent fluorescence in solution state (λem = 580 nm) and red AIE emission in solid state (λem = 640 nm). CDs powder is utilized as a red phosphor for light-emitting diode (LED). The resulting fabricated white LEDs (WLEDs) demonstrate good performance metrics, including a Color Rendering Index (CRI) of 89.5, Correlated Color Temperature (CCT) of 3876 K, and commission Internationale d'Éclairage (CIE) coordinates of (0.350, 0.331). Furthermore, the solvent-dependent phenomenon observed in AIE-CDs can be exploited to apply their solution as a highly sensitive fluorescence sensor for quantitatively detecting amounts of water in various organic solvents. The method offers both high accuracy and sensitivity, with R2 values varying from 0.853 to 0.994 and a low detection limit ranging from 0.296 to 3.23 % across a wide linear range. This inherent versatility makes the CDs suitable for a wide range of applications, including sensing and LED devices.

Asymmetric α-benzylation of cyclic ketones enabled by concurrent chemical aldol condensation and biocatalytic reduction

Chemoenzymatic cascade catalysis has emerged as a revolutionary tool for streamlining traditional retrosynthetic disconnections, creating new possibilities for the asymmetric synthesis of valuable chiral compounds. Here we construct a one-pot concurrent chemoenzymatic cascade by integrating organobismuth-catalyzed aldol condensation with ene-reductase (ER)-catalyzed enantioselective reduction, enabling the formal asymmetric α-benzylation of cyclic ketones. To achieve this, we develop a pair of enantiocomplementary ERs capable of reducing α-arylidene cyclic ketones, lactams, and lactones. Our engineered mutants exhibit significantly higher activity, up to 37-fold, and broader substrate specificity compared to the parent enzyme. The key to success is due to the well-tuned hydride attack distance/angle and, more importantly, to the synergistic proton-delivery triade of Tyr28-Tyr69-Tyr169. Molecular docking and density functional theory (DFT) studies provide important insights into the bioreduction mechanisms. Furthermore, we demonstrate the synthetic utility of the best mutants in the asymmetric synthesis of several key chiral synthons.

Targeting GABARAPL1/HIF-2a axis to induce tumor cell apoptosis in nasopharyngeal carcinoma

Objectives

The primary gene mutations associated with nasopharyngeal carcinoma (NPC) are located within the phosphoinositide 3-kinase-mammalian target of rapamycin signaling pathways, which have inhibitory effects on autophagy. Compounds that target autophagy could potentially be used to treat NPC. However, autophagy-related molecular targets in NPC remain to be elucidated. We aimed to examine levels of autophagy-related genes, including autophagy-related 4B cysteine peptidase (ATG4B) and gamma-aminobutyric acid (GABA) type A receptor-associated protein-like 1 (GABARAPL1), in NPC cells and explored their potential role as novel targets for the treatment of NPC.

Materials and Methods

The mRNA and protein expression of autophagy-related genes were detected in several NPC cells. Levels of GABARAPL1 were modified by either overexpression or knockdown, followed by examining downstream targets using RT-qPCR and western blotting. The role of GABARAPL1 in NPC proliferation and apoptosis was examined by flow cytometry. Furthermore, the role of GABARAPL1 was assessed in vivo using a nude mouse xenograft tumor model. The underlying mechanism by which GABARAPL1 regulated nasopharyngeal tumor growth was investigated.

Results

Autophagy-related 4B cysteine peptidase (ATG4B), GABARAPL1, and Unc-51-like kinase 1 (ULK1) were significantly down-regulated in multiple NPC cell lines. Overexpression of GABARAPL1 up-regulated the expression of autophagy-related proteins, decreased the level of hypoxia-inducible factor (HIF)-2α, and induced apoptosis in NPC cells. Importantly, overexpression of GABARAPL1 slowed tumor growth. Western blotting showed that autophagy was activated, and HIF-2α was down-regulated in tumor tissues.

Conclusion

HIF-2α, as a substrate for autophagic degradation, may play an interesting role during NPC progression.

Eu-Based Porphyrin MOF Enables High-Performance Carbon-Based Perovskite Solar Cells

The low power conversion efficiency (PCE) of hole transport materials (HTM) - free carbon-based perovskite solar cells (C-PSCs) poses a challenge. Here, a novel 2D Eu-TCPP MOF (TCPP; [tetrakis (4-carboxyphenyl) porphyrin]) sandwiched between the perovskite layer and the carbon electrode is used to realize an effective and stable HTM-free C-PSCs. Relying on the synergistic effect of both the metal-free TCPP ligand with a unique absorption spectrum and hydrophobicity and the EuO4 (OH)2 chain in the Eu-TCPP MOF, defects are remarkably suppressed and light-harvesting capability is significantly boosted. Energy band alignment is achieved after Eu-TCPP MOF treatment, promoting hole collection. Förster resonance energy transfer results in improved light utilization and protects the perovskite from decomposition. As a result, the HTM-free C-PSCs with Eu-TCPP MOF reach a champion PCE of 18.13%. In addition, the unencapsulated device demonstrates outstanding thermal stability and UV resistance and keeps 80.6% of its initial PCE after 5500 h in a high-humidity environment (65%-85% RH).

[Antimicrobials discovery against Staphylococcus aureus by high throughput screening of drug library]

To develop antimicrobials against Staphylococcus aureus by high throughput screening of drug library. The type of this study is experimental research. The clinical isolates of S. aureus were collected from the sputum samples of respiratory inpatient department of the Third Xiangya Hospital of Central South University. The anti-planktonic cells growth inhibition activity of FDA-approved drugs library (including 1 573 molecules) was assessed by building a planktonic cells screening platform; The biofilm inhibitory effect of the FDA-approved drugs was detected by building a biofilm screening platform combined with crystal violet staining; Minimal inhibitory concentrations of the selected hits were determined by broth microdilution assay. Finally, the cytotoxicity of the selected hits was detected by CCK-8 assay. The results showed that 218 hits were exhibited effective growth inhibitory effects against S. aureus by setting the concentrations of the molecules in the FDA-approved library to 100 μmol/L. These selected molecules are mainly anti-infective drugs, accounting for 118 hits; Followed by anti-cancer drugs, anti-inflammatory/-immune drugs, neurological drugs, cardiovascular drugs, endocrine drugs, and metabolic disease drugs, which accounts for 40, 19, 12, 9, 8, and 3 hits; Other unclassified drugs accounts for 9 hits. The top 10 hits exhibiting anti-planktonic cells activity against S. aureus were mainly including antitumor drugs, followed by neurological drugs and unclassified drugs like vitamin K3 with the inhibition rate of 99.65%-100%. Similarly, the top 10 hits showing biofilm inhibitory effects against S. aureus were also mainly including antitumor drugs, followed by neurological drugs and anti-inflammatory/-immune drugs with the inhibition rate of 50.22%-92.95%. The minimal inhibitory concentration (MIC) of the 51 hits by second round screening was determined by micro-dilution assay, which mainly include the antitumor drugs, cardiovascular drugs, endocrine drugs, anti-inflammatory/-immune drugs, metabolic disease drugs, neurological drugs and other unclassified drugs accounted for 22, 5, 3, 9, 2, 5 and 5 hits, respectively, with the MICs of 1.56-50 μmol/L, 6.25-25 μmol/L, 6.25-25 μmol/L, 0.2-50 μmol/L, 25-50 μmol/L, 1.56-50 μmol/L and 0.1-12.5 μmol/L, respectively. In conclusion, the minimum inhibitory concentrations of small molecules screened through high-throughput assay are at the level of micromolar with strong drug development potential and high modifiability. The high effective anti-planktonic cells and anti-biofilm activity by these molecules are expected to provide new ideas for the development of new antimicrobials against S. aureus.

Achieving Ultra-Wideband NIR-II Emission in Cr3+-Doped Li(Sc,In)(Si,Ge)O4 Phosphors Based on Host Composition Engineering

Realizing ultra-wideband and tunable near-infrared (NIR) emission remains a great challenge in NIR phosphor development. The luminescence of most reported NIR phosphors exhibits a peak wavelength shorter than 1000 nm and the corresponding FWHM is <200 nm. Here, a series of Cr3+-activated Li(Sc,In)(Si,Ge)O4 phosphors with ultra-wideband and tunable NIR-II emission are successfully developed based on the host composition engineering strategy. Significant spectral engineering in the NIR-II region is achieved with a peak wavelength changing from 1110 to 1253 nm. The olivine host structure could provide Cr3+ activator a highly distorted octahedral site with very weak crystal field strength, which results in NIR-II ultra-wideband emission with FWHM > 300 nm. A detailed discussion on the relationship between structural variation, crystal field splitting, and NIR luminescence has been applied. As far as we know, it is the first report about Cr3+ NIR luminescence engineering in such a long wavelength and wide range. The application of these NIR-II phosphors is demonstrated in intensity-based luminescent thermometry with a relative sensitivity of >2.0% K-1 in the physiological temperature range.

Sharp-Line Near-Infrared Emission from Tetrahedron-Occupied Ni2+ in Ca2GeO4

As far as we are concerned, the phenomenon of Ni2+ luminescence in tetrahedral coordination has not been reported. For the first time, a new NIR phosphor Ca2GeO4:Ni2+ is developed in this work. It is found that the NIR emission from this phosphor is a sharp peak attributed to the unusual Ni2+-occupied GeO4 site in the lattice, instead of the conventional broadband luminescence of Ni2+ in the octahedrally coordinated site. Crystal-field analysis has been applied, and the parameters Dq, B, and Δ are calculated to reveal the relationship between the emission profile and the crystal field strength. The optimal Ni2+ doping concentration is found to be 1%. Ca2GeO4:Ni2+ provides an efficient sharp-line (fwhm = 16 nm) emission centered at 1164 nm which originates from the 1T2 → 3T1 transition with an internal quantum efficiency of 23.1% and a decay lifetime of about 300 μs. This work could provide some new insights to explore novel NIR luminescent materials based on transition-metal elements.

Tetracoordinate Fe3+ Activated Li2ZnAO4 (A = Si, Ge) Near-Infrared Luminescent Phosphors

Fe3+-doped near-infrared (NIR) phosphors have received a lot of interest because they are nontoxic, inexpensive, and ecologically benign. In this work, Fe3+-activated Li2ZnAO4 (A = Si, Ge) phosphors were synthesized by solid-phase reactions, in which Fe3+ entered the Zn2+ tetrahedral site. When excited by 300 nm UV light, broad NIR emission bands at 750 nm (Li2ZnSiO4: Fe3+) and 777 nm (Li2ZnGeO4: Fe3+) were observed, with internal quantum efficiencies (IQE) of 62.70% (Li2ZnSiO4: Fe3+) and 30.57% (Li2ZnGeO4: Fe3+). The thermal stability was increased from 35.43 to 49.79% at 373 K via cationic regulation. The combination of activation energy, electron-phonon coupling, and Debye temperature explained the improved thermal stability of Li2ZnGeO4: Fe3+ phosphor. Besides, the as-synthesized phosphor demonstrated sensitive and selective Cu2+ ion detection.

Prognostic prediction of thrombolytic therapy with rt-PA in acute ischemic stroke patients using an artificial intelligence model

OBJECTIVE

Through the comparison of different prediction models, we hope to find a promising statistical method to evaluate the prognosis of patients with acute ischemic stroke (AIS) after thrombolytic therapy.

METHODS

Data of 518 patients who received thrombolytic therapy were retrospectively collected in this study. Among them, 362 patients met the eligibility criteria, so their data such as age, sex, smoking history, previous medical history, clinical and laboratory indicators were analyzed. According to the 3 month follow-up results, 266 patients were included in a good prognosis group (modified Rankin Scale (mRS) score ≤2) and 96 in a poor prognosis group (3≤mRS≤6). All variables with P<0.05 in univariant and multivariant analyses were assigned in logistic regression model and artificial neural network (ANN) model to predict neurological prognosis, and the performance of the two models were compared.

RESULTS

Age, NIHSS scores, the serum concentration of immediate glucose, APTT and MBP at admission were found to be the predictive factors through ANN and logistic regression analysis. The binary logistic regression model revealed that the percentage correction, the precision, recall and F1 score of the regression model were 79%, 69.23%, 37.50% and 48.65%, respectively. While those of ANN were 79.98%, 69.70%, 37.25%, and 49.66%, correspondingly.

CONCLUSIONS

ANN model is as effective as a logistic regression model in predicting the prognosis of AIS after thrombolytic therapy with rt-PA. Moreover, ANN is slightly superior to logistic regression in accuracy, precision and F1 score.

Metal Halide Perovskite Nanocrystals for Near-Infrared Circularly Polarized Luminescence with High Photoluminescence Quantum Yield via Chiral Ligand Exchange

Using ligand exchange on FAPbI₃ perovskite nanocrystals (PNCs) surface with chiral tridentate l-cysteine (l-cys) ligand, we successfully prepared chiral FAPbI₃ PNCs that show circularly polarized luminescence (CPL) (dissymmetry factor; g_lum = 2.1 × 10^-3) in the near-infrared (NIR) region from 700 to 850 nm and a photoluminescence quantum yield (PLQY) of 81%. The chiral characteristics of FAPbI₃ PNCs are ascribed to induction by chiral l/d-cys, and the high PLQY is attributed to the passivation of the PNCs defects with l-cys. Also, effective passivation of defects on the surface of FAPbI₃ PNCs by l-cys results in excellent stability toward atmospheric water and oxygen. The conductivity of the l-cys treated FAPbI₃ NC films is improved, which is attributed to the partial substitution of l-cys for the insulating long oleyl ligand. The CPL of the l-cys ligand treated FAPbI₃ PNCs film retains a g_lum of -2.7 × 10^-4. This study demonstrates a facile yet effective approach to generating chiral PNCs with CPL for NIR photonics applications.

Bismuth, esomeprazole, metronidazole, and minocycline or tetracycline as a first-line regimen for Helicobacter pylori eradication: A randomized controlled trial

BACKGROUND

Given the general unavailability, common adverse effects, and complicated administration of tetracycline, the clinical application of classic bismuth quadruple therapy (BQT) is greatly limited. Whether minocycline can replace tetracycline for Helicobacter pylori ( H . pylori ) eradication is unknown. We aimed to compare the eradication rate, safety, and compliance between minocycline- and tetracycline-containing BQT as first-line regimens.

METHODS

This randomized controlled trial was conducted on 434 naïve patients with H . pylori infection. The participants were randomly assigned to 14-day minocycline-containing BQT group (bismuth potassium citrate 110 mg q.i.d., esomeprazole 20 mg b.i.d., metronidazole 400 mg q.i.d., and minocycline 100 mg b.i.d.) and tetracycline-containing BQT group (bismuth potassium citrate/esomeprazole/metronidazole with doses same as above and tetracycline 500 mg q.i.d.). Safety and compliance were assessed within 3 days after eradication. Urea breath test was performed at 4-8 weeks after eradication to evaluate outcome. We used a noninferiority test to compare the eradication rates of the two groups. The intergroup differences were evaluated using Pearson chi-squared or Fisher's exact test for categorical variables and Student's t -test for continuous variables.

RESULTS

As for the eradication rates of minocycline- and tetracycline-containing BQT, the results of both intention-to-treat (ITT) and per-protocol (PP) analyses showed that the difference rate of lower limit of 95% confidence interval (CI) was >-10.0% (ITT analysis: 181/217 [83.4%] vs . 180/217 [82.9%], with a rate difference of 0.5% [-6.9% to 7.9%]; PP analysis: 177/193 [91.7%] vs . 176/191 [92.1%], with a rate difference of -0.4% [-5.6% to 6.4%]). Except for dizziness more common (35/215 [16.3%] vs . 13/214 [6.1%], P = 0.001) in minocycline-containing therapy groups, the incidences of adverse events (75/215 [34.9%] vs . 88/214 [41.1%]) and compliance (195/215 [90.7%] vs . 192/214 [89.7%]) were similar between the two groups.

CONCLUSION

The eradication efficacy of minocycline-containing BQT was noninferior to tetracycline-containing BQT as first-line regimen for H . pylori eradication with similar safety and compliance.

TRIAL REGISTRATION

ClinicalTrials.gov, ChiCTR 1900023646.

New regimens as first-line eradication therapy for Helicobacter pylori infection in patients allergic to penicillin: A randomized controlled trial

BACKGROUND

Helicobacter pylori eradication in penicillin-allergic patients is challenging. The effective regimen is lacking in areas with high antibiotic resistance and tetracycline unavailable. Minocycline, cefuroxime, and full-dose metronidazole are promising drugs.

AIMS

To compare the eradication rate, safety, and compliance among three new bismuth quadruple therapies for first-line H. pylori eradication in penicillin-allergic patients.

METHODS

This randomized trial was conducted on 450 naive patients with H. pylori infection and penicillin allergy. The 14-day minocycline-metronidazole-containing (minocycline 100 mg twice daily and metronidazole 400 mg four times/day), minocycline-cefuroxime-containing (minocycline 100 mg twice daily and cefuroxime 500 mg twice daily), and cefuroxime-metronidazole-containing (cefuroxime 500 mg twice daily and metronidazole 400 mg four times/day) bismuth quadruple therapies were randomly assigned to the participants. Safety and compliance were assessed within 3 days after eradication. Urea breath test was performed 4-8 weeks after eradication to evaluate outcome.

RESULTS

The differences of eradication rates in either intention-to-treat (84.0%, 82.7%, and 23 82.0%, p = .896) or per-protocol (91.7%, 90.9%, and 88.2%, p = .599) analysis among minocycline-metronidazole, minocycline-cefuroxime, and cefuroxime-metronidazole-containing bismuth quadruple therapies were statistically insignificant. The incidence of adverse events (35.1%, 22.6%, and 28.9%) and compliance (90.5%, 91.8%, and 91.9%) were similar. Taste distortion, nausea, and anorexia were more common in metronidazole-containing regimens, and dizziness was more common in minocycline-containing regimens. The allergy was rare (~3%).

CONCLUSIONS

The efficacies of three bismuth quadruple therapies containing minocycline, cefuroxime, and full-dose metronidazole (pairwise) for first-line H. pylori eradication in penicillin-allergic patients were similarly satisfactory with relatively good safety and compliance. The study was registered in the Chinese Clinical Trials Registration (ChiCTR1900023702).

Ultra-Broadband Near-Infrared Phosphors Realized by the Heterovalent Substitution Strategy

Near-infrared (NIR) phosphor-converted light-emitting diodes with broadband emission have received considerable interest. However, there remains a challenge in the construction of ultra-broadband NIR phosphors, hindering their further application. In this work, a heterovalent substitution strategy is proposed to construct a novel ultra-broadband NIR-emitting LaTiTaO₆:Cr³⁺ phosphor with a full width at half maximum of ∼300 nm. Crystal structure, time-resolved emission spectroscopy, and electron paramagnetic resonance analyses confirm that only one crystallographic site of Cr³⁺ with separated ions exists. Electron and phonon coupling (EPC) evaluated by the Huang-Rhys factor (S) reveals that the heterovalent substitution strategy contributes to strong EPC with S = 9.185, resulting in ultra-broadband emission. Interestingly, a remarkable blue shift of emission from 1050 to 922 nm with increasing temperature is observed. Moreover, the application of LaTiTaO₆:Cr³⁺ phosphor is demonstrated in the qualitative analysis of ethanol/water mixtures. The work will enrich the toolbox for designing broadband NIR-emitting materials.

rFGF4 alleviates lipopolysaccharide-induced acute lung injury by inhibiting the TLR4/NF-κB signaling pathway

Acute lung injury (ALI) is a serious and common clinical disease. Despite significant progress in ALI treatment, the morbidity and mortality rates remain high. However, no effective drug has been discovered for ALI. FGF4, a member of the FGF family, plays an important role in the regulation of various physiological and pathological processes. Therefore, in the present study, we aimed to study the protective effects of FGF4 against LPS-induced lung injury in vivo and in vitro. We found that rFGF4 treatment improved the lung W/D weight ratio, the survival rate, immune cell infiltration and protein concentrations in mice with LPS-induced ALI. Histological analysis revealed that rFGF4 significantly attenuated lung tissue injury and cell apoptosis. Furthermore, rFGF4 inhibited the activation of the TLR4/NF-κB signaling pathway and the production of pro-inflammatory mediators in LPS-injured lung tissues, murine alveolar macrophages (MH-S) and murine pulmonary epithelial (MLE-12) cells. The results of cell experiments further verified that rFGF4 inhibited the production of inflammatory mediators in MH-S cells and MLE-12 cells by regulating the TLR4/NF-κB signaling pathway. These results revealed that rFGF4 protected lung tissues and inhibited inflammatory mediators in mice with LPS-induced ALI by inhibiting the TLR4/NF-κB signaling pathway in MH-S and MLE-12 cells.

Individualized diagnosis and eradication therapy for Helicobacter pylori infection based on gene detection of clarithromycin resistance in stool specimens: A systematic review and meta-analysis

BACKGROUND

Empiric therapy for Helicobacter pylori infection results in significantly increased antibiotic resistance and decreased eradication efficacy. The genotypic testing of clarithromycin resistance from stool specimens is a promising method for individualized diagnosis and treatment. This study aimed to determine the status of research and application on this method through a systematic review and meta-analysis.

METHODS

PubMed, Embase, MEDLINE, and WAN FANG database were searched for relevant literature. The quality of included diagnostic articles was evaluated using the quality Assessment of Diagnostic Accuracy Studies-2 tool. A bivariate random-effect model was conducted to calculate the diagnostic accuracy of genotypic testing of clarithromycin resistance.

RESULTS

A total of 16 diagnostic-related were included and analyzed after exclusions. The pooled sensitivity and specificity of diagnostic meta-analysis were 0.93 (95% confidence interval [CI]: 0.90-0.96) and 0.98 (95% CI: 0.93-1.00), respectively. The area under the curve (AUC) of the summary receiver operating characteristic was 0.97 (95% CI: 0.95-0.98). The genotypic testing in stool samples had heterogeneous sensitivity (Q = 37.82, p < .01, I²  = 37.82) and specificity (Q = 60.34, p < .01, I²  = 93.72) in detecting clarithromycin resistance. Purification method, stool sample weight, real-time PCR, and antimicrobial susceptibility testing as reference accounted for the heterogeneity of pooled sensitivity, while patient age, purification method, stool sample weight, and real-time PCR for the heterogeneity of pooled specificity.

CONCLUSION

The genotypic testing of clarithromycin resistance from stool specimens is an accurate, convenient, noninvasive, and rapid detection technology, providing a definitive diagnosis of clarithromycin resistance and guiding the rational antibiotic selection.

Broadband-excited and green-red tunable emission in Eu2+-sensitized Ca8MnTb(PO4)7 phosphors induced by structural-confined cascade energy transfer

Novel green-red color-tunable Ca₈(Mg,Mn)Tb(PO₄)₇:Eu²⁺ phosphors have been synthesized via the traditional solid-state method. Since Tb³⁺/Mn²⁺ ions are the parent ions in the lattice, the structural confinement occurs when the sensitizer Eu²⁺ is introduced into the Ca₈(Mg,Mn)Tb(PO₄)₇:Eu²⁺ structure. The distance from Eu²⁺ to Tb³⁺/Mn²⁺ is confined in the 5 Å range, which induces a highly efficient energy transfer process. At Eu²⁺ 350 nm excitation, Ca₈MgTb(PO₄)₇:Eu²⁺ shows dominant Tb³⁺ green emission with almost-vanished Eu²⁺ emission. Red emission is clearly observed as Mn²⁺ ions doping into Ca₈MgTb(PO₄)₇:Eu²⁺, and color-tuning from green to red is realized by varying the Mn²⁺ contents. Eu²⁺-Tb³⁺-Mn²⁺ cascade energy transfer process is in effect due to short Eu²⁺-Tb³⁺/Mn²⁺ and Tb³⁺-Mn²⁺ distances, which is verified by PL and decay variations. Meanwhile, the Ca₈(Mg,Mn)Tb(PO₄)₇:Eu²⁺ phosphor indicates good thermal stability and maintained the 45% emission level at 150 °C, which demonstrates their potential applications in white light LEDs.

Immobilization of Enzymes on Cyclodextrin-Anchored Dehiscent Mesoporous TiO2 for Efficient Photoenzymatic Hydroxylation

A three-in-one heterogeneous catalyst (UPO@dTiO₂-CD) was fabricated by grafting cyclodextrins (CDs) on the dehiscent TiO₂ (dTiO₂) surface and subsequently immobilizing unspecific peroxygenase (rAaeUPO), which exhibited double enhanced electron/mass transfer in photo-enzymatic enantioselective hydroxylation of the C-H bond. The tunable anatase/rutile phase ratio and dehiscent mesoporous architectures of dTiO₂ and the electron donor feature and hydrophobic inner cavity of the CDs are independently responsible for accelerating both electron and mass transfer. The coordination of the photocatalytic and enzymatic steps was achieved by structural and compositional regulation. The optimized UPO@dTiO₂-CD not only displayed high catalytic efficiency (turnover number and turnover frequency of rAaeUPO up to >65,000 and 91 min^-1, respectively) but also exhibited high stability and reusability.

Tailored triple plus bismuth therapy based on previous antibiotic medication history for first-line Helicobacter pylori eradication: A randomized trial

INTRODUCTION

There are no randomized controlled trials that demonstrate the role of tailored therapy based on past medication history in improving efficacy of H. pylori eradication compared to empiric therapies. The objective of this study was to determine whether tailored triple plus bismuth therapy (TBT) can achieve higher eradication rates based on previous antibiotic history than empiric TBTs.

METHODS

800 treatment-naïve patients were randomly assigned to four groups receiving clarithromycin-, levofloxacin- or metronidazole-containing empiric TBT and tailored TBT (clarithromycin and levofloxacin chosen based on previous macrolides and quinolones medication history). Correlation analyses were performed between past medication history and resistance or eradication rate.

RESULTS

The eradication rates of tailored TBT were significantly higher than clarithromycin-, levofloxacin- and metronidazole-containing empiric TBT in both intention-to-treat (89.5%, 80.8%, 81.5% and 81.5%) and per-protocol (95.1%, 86.7%, 86.5% and 87.8%) analyses (P<0.05). In patients with previous macrolides, quinolones or nitroimidazoles medication history, the resistance rates of corresponding clarithromycin, levofloxacin or metronidazole were significantly higher than patients without past medication history, and the eradication rates of corresponding clarithromycin- or levofloxacin-containing empiric TBT were significantly lower.

CONCLUSION

Tailored TBT based on previous antibiotic history can achieve higher eradication rates than empiric TBT for first-line H. pylori eradication.

2022 Chinese national clinical practice guideline on Helicobacter pylori eradication treatment

BACKGROUND

Helicobacter pylori ( H. pylori ) infection is an infectious disease with a prevalence rate of up to 50% worldwide. It can cause indigestion, gastritis, peptic ulcer, and gastric cancer. H. pylori eradication treatment can effectively control disease progression and reduce the risk of the above conditions. However, the escalating trend of antibiotic resistance presents a global challenge for H. pylori eradication. We aim to provide guidance on pharmacological treatment of H. pylori infection.

METHODS

This clinical practice guideline is developed following the World Health Organization's recommended process, adopting Grading of Recommendations Assessment, Development and Evaluation in assessing evidence quality, and utilizing Evidence to Decision framework to formulate clinical recommendations, minimizing bias and increasing transparency of the clinical practice guideline development process. We used the Reporting Items for practice Guidelines in HealThcare (RIGHT) statement and The Appraisal of Guidelines for Research and Evaluation II (AGREE II) as reporting and conduct guides to ensure the guideline's completeness and transparency.

RESULTS

Though decreasing in developed countries, the prevalence of H. pylori remains high in developing countries, causing a major public health burden. This clinical practice guideline contains 12 recommendations concerning pharmacological treatment for H. pylori eradication. Among them, it is worth highlighting that bismuth preparations are inexpensive, safe, and effective, consequently making bismuth quadruple therapy a preferred choice for initial and rescue treatment. In empirical treatment, high-dose dual therapy is equally effective compared with bismuth quadruple therapy.

CONCLUSIONS

The 12 recommendations in this clinical practice guideline are formed with consideration for stakeholders' values and preferences, resource use, feasibility, and acceptability. Recommendations are generalizable to resource limited settings with similar antibiotic resistance pattern as China, and lower middle-income countries facing comparable sociological and technical challenges.

REGISTRATION

Guidelines International Network (GIN) website, https://guidelines.ebmportal.com/node/69996 .

Improved Energy Transfer in Mn-Doped Cs3Cu2I5 Microcrystals Induced by Localized Lattice Distortion

With nontoxicity and high emission efficiency, luminescent copper(I)-based halides have attracted much attention as alternatives for lead-based perovskites in photoelectric domains. However, extending the emission wavelength by doping with Mn²⁺ in a facile way is still a challenge. In this work, Mn²⁺-doped Cs₃Cu₂I₅ microcrystals were synthesized by a mild solution method, and double emission bands from self-trapped excitons (STEs) and Mn²⁺ peaking at 445 and 560 nm, respectively, were observed. More importantly, further introduction of alkali metal ions (Rb⁺, K⁺, Na⁺) considerably promoted the luminescence performance of the Cs₃Cu₂I₅-Mn microcrystals. The STE → Mn²⁺ energy transfer efficiency of the typical sample doped with Na⁺ increased from ∼0 to 21.30%, and the photoluminescence quantum yield (PLQY) increased from 47.32% to 62.06%. The detailed structural and optical characterizations combined with DFT calculations proved that the doping with alkali metal ions causes lattice distortion and enhances the coupling between [MnI₄] and [CuI₄] tetrahedra, thus promoting the energy transfer efficiency and the PLQY.

Epigenetic modification facilitates proline synthase PYCR1 aberrant expression in gastric cancer

BACKGROUND & AIMS

Pyrroline-5-carboxylate reductase 1 (PYCR1) upregulation contributes to the progression of gastric cancer (GC) and indicates poor survival. However, PYCR1 expression profile in GC subtypes and the mechanism behind its upregulation are not well-studied.

METHODS

PYCR1 expression profiles in GC subtypes and different stages of gastric carcinogenesis were assessed in different GC cohorts. Genetic alterations and epigenetic modulation in PYCR1 regulation were further investigated using bioinformatics analysis and in vitro experiments.

RESULTS

PYCR1 expression was significantly higher in intestinal-type GC and associated molecular subtypes in TCGA and ACRG GC cohorts. During the cascade of intestinal-type GC, PYCR1 was continuously increased from normal gastric tissues through to atrophic gastritis, to intraepithelial neoplasia, and to GC. Copy number alterations in PYCR1 were associated with PYCR1 transcript expression. One CpG island was observed in PYCR1 promoter region, and the hypomethylation occurred at this region could contribute to PYCR1 transcriptional activation in GC. Besides, H3K27ac combination was found in PYCR1 promoter, and acetyltransferase p300 induced H3K27ac could promote PYCR1 expression in GC.

CONCLUSIONS

PYCR1 expression varies across GC subtypes, with intestinal-type GC and associated molecular subtypes having the highest expression. Hypomethylation at CpG sites and p300-induced H3K27ac modification within PYCR1 promoter could contribute to maintaining PYCR1 overexpression in GC. These results provide us with a new insight into epigenetic modulation in mitochondrial proline metabolism.

Asymmetric Hydrogenation of C = C Bonds in a SpinChem Reactor by Immobilized Old Yellow Enzyme and Glucose Dehydrogenase

The application of immobilized enzymes in pharmaceutical and bulk chemical production has been shown to be economically viable. We demonstrate the exceptional performance of a method that immobilizes the old yellow enzyme YqjM and glucose dehydrogenase (GDH) on resin for the asymmetric hydrogenation (AH) of C = C bonds in a SpinChem reactor. When immobilized YqjM and GDH are reused 10 times, the conversion of 2-methylcyclopentenone could reach 78%. Which is because the rotor of the SpinChem reactor effectively reduces catalyst damage caused by shear force in the reaction system. When the substrate concentration is 175 mM, an 87% conversion of 2-methylcyclopentenone is obtained. The method is also observed to perform well for the AH of C = C bonds in other unsaturated carbonyl compounds with the SpinChem reactor. Thus, this method has great potential for application in the enzymatic production of chiral compounds.

Diagnosis and treatment of Helicobacter pylori infection by physicians in China: A nationwide cross-sectional study

BACKGROUND

To investigate the current state of knowledge and practice of Helicobacter pylori (H. pylori) infection management in China.

MATERIALS AND METHODS

This nationwide, multicenter, cross-sectional questionnaire survey was conducted between March and April 2021 with respect to the diagnosis and treatment of H. pylori infection in 31 provinces, encompassing over 1000 hospitals in mainland China. General physician information, diagnostic and detection status, eradication treatment, reexamination and follow-up after treatment, and basic knowledge of physicians were collected and compared with the Fifth Chinese National Consensus Report on Management of H. pylori infection and the 2016 Maastricht V/Florence guidelines. The subgroup analysis was also performed.

RESULTS

Of the 6873 questionnaire respondents, 48.8% were males, and 51.2% were females. Approximately, 26.5% of respondents indicated that their hospitals had dedicated clinics for managing H. pylori infection. Moreover, 88.0% of respondents prescribed a bismuth-containing quadruple regimen as the initial eradication treatment, and 92.7% deemed the gastric acid suppression critical. Furthermore, 91.0% of respondents routinely recommended a reexamination 1-2 months after eradication therapy, and 95.1% advised patients to stop PPI treatment at least 2 weeks before reexamination. The detail of following (the choice of target population/methods; the choice/availability of drugs/regimens, indications for eradication, factors influencing eradication efficacy/improvement methods and factors influencing adherence, management options/factors influencing relapse; the timing and methods, awareness of reinfection rates/prevention measures, and the approach to continuing education, awareness of guidelines, and acceptance of current core concepts of management) was also described. Subgroup analysis further revealed that significant differences were existed in being gastroenterologist or not, different education level, professional title, years of working, and provincial administrative regions.

CONCLUSIONS

Chinese physicians' skills and knowledge about the diagnosis and treatment of H. pylori infection could be improved. More works on education are needed in future.

Long-Term Outcome of Gastric Mild-Moderate Dysplasia: A Real-World Clinical Experience

BACKGROUND & AIMS

The natural course of gastric mild-moderate dysplasia in a country with high incidence of gastric cancer (GC) is relatively unknown. We aimed to determine the long-term cumulative incidence of and risk factors for advanced neoplasia in patients with gastric dysplasia.

METHODS

This was a single-center observational study including all consecutive patients diagnosed with gastric mild-moderate dysplasia between 2000 and 2017. Follow-up data were collected until December 2019. We determined the cumulative incidence of advanced neoplasia and identified risk factors with Cox regression.

RESULTS

A total of 3489 consecutive participants were followed for a median of 4.19 years from initial mild-moderate dysplasia diagnosis. The median surveillance interval between index endoscopy and next follow-up endoscopy was 1.08 years, and more than half of patients had at least 3 surveillance gastroscopies. During the study period, the majority of participants did not show disease progression, either with dysplasia not detected (51.4%) or with persistent dysplasia (46.1%). There were 88 (2.9%) patients (5.13 per 1000 patient-years) who progressed to advanced neoplasia within a median of 4.3 years. The annual incidence of advanced neoplasia and GC were 0.43% and 0.26%, respectively, within 5 years of mild-moderate dysplasia diagnosis. Increasing age, male sex, moderate dysplasia, dysplasia detected in fundus or cardia at index endoscopy, and persistent Helicobacter pylori infection during follow-up were independent risk factors for developing advanced neoplasia.

CONCLUSIONS

Even in a country with high incidence of GC, the majority of patients with gastric mild-moderate dysplasia did not experience disease progression in the long term. Intensified surveillance during the first 5 years after mild-moderate dysplasia detection is suggested.

The necessity and appropriate range of the diagnostic "gray zone" of 13C-urea breath test

BACKGROUND

The ¹³C-urea breath test (¹³C-UBT) is preferred for non-invasive detection of Helicobacter pylori (H. pylori); however, its accuracy drops when results fall between 2‰ and 6‰ (called the gray zone). This study aimed to evaluate the accuracy of ¹³C-UBT (cut-off point 4‰) between 2‰ and 6‰, find a more appropriate gray zone, and identify the factors influencing ¹³C-UBT.

METHODS

Patients with ¹³C-UBT results 2‰-6‰, over an eight-year period, were studied. H. pylori infection was diagnosed if patients were positive for either Warthin-Starry staining or quantitative real-time polymerase chain reaction (real-time PCR), and excluded if both were negative. Accuracy of ¹³C-UBT under different cut-off points was calculated, and the factors affecting ¹³C-UBT were analyzed.

RESULTS

A total of 208 patients were included, of whom 129 were H. pylori-positive. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of ¹³C-UBT were 71.32%, 83.54%, 64.08%, and 87.62%, respectively. When the cut-off point was changed to 2.15‰, the NPV of ¹³C-UBT reached a maximum (76.47%); when the cut-off point was changed to 4.95‰, PPV reached its maximum (93.22%). Therefore, the original gray zone (2‰-6‰) was adjusted to 2‰-4.95‰. Gastric antral intestinal metaplasia (OR = 3.055, 95% CI: 1.003-9.309) was an independent risk factor for false-negative ¹³C-UBT.

CONCLUSIONS

Accuracy of ¹³C-UBT over 2‰-6‰ was poor, and the gray zone was changed to 2‰-4.95‰. ¹³C-UBT results over 2‰-4.95‰ should be interpreted with caution during mass screening of H. pylori, especially for patients with gastric antral intestinal metaplasia.

[Perifosine inhibits biofilm formation of Pseudomonas aeruginosa by interacting with PqsE protein]

To explore the biofilm inhibitory efficacy of perifosine against Pseudomonas aeruginosa (P. aeruginos) and its mechanisms. Twenty-fourwell plate was used to form biofilms at the bottom and crystal violet staining was used to determine the biofilm inhibitory effects of perifosine against P. aeruginosa, the wells without perifosine was set as control group. Glass tubes combined with crystal violet staining was used to detect the gas-liqud interface related bioiflm inhibitory effects of perifosine, the wells without perifosine was set as control group. Time-growth curved was used to detect the effects of perifosine on the bacteial planktonic cells growth of P. aeruginosa, the wells without perifosine was set as control group. The interaction model between perifosine and PqsE was assessed by molecular docking assay. The inhibitory effects of perifosine on the catalytic activity of PqsE was determined by detection the production of thiols, the wells without perifosine was set as control group. Binding affinity between perifosine and PqsE was detected by plasma surface resonance. The biofims at the bottom of the microplates and air-liquid interface were effectively inhibited by perifosine at the concentration of 4-8 μg/ml. There was no influence of perifosine on the cells growth of P. aeruginosa. The resuts of molecular docking assay indicates that perifosine could interacted with PqsE with the docking score of -10.67 kcal/mol. Perifosine could inhibit the catalytic activity of PqsE in a dose-dependent manner. The binding affinity between perifosine and PqsE was comfirmed by plasma surface resonance with KD of 6.65×10^-5mol/L. Perifosine could inhibited the biofilm formation of P. aeruginosa by interacting with PqsE.