Impact of health investment on household income distribution: insights from China's longitudinal survey data

This paper investigates the impact of health investment on household income distribution, drawing from data spanning over 10 years from the China Nutrition and Health Survey. The study aims to contribute to the literature by examining the nuanced pathways through which health investment influences income distribution. Utilizing a rich dataset, rigorous empirical methods including quantile regression and cross-sectional data modeling are employed to explore the relationship between health investment and income distribution. The analysis reveals a robust positive association between health investment and both absolute and relative income levels across various demographic and occupational groups. Additionally, the study elucidates the pathways through which health investment influences income, including its effects on illness duration, employment opportunities, effective working time, and educational attainment. The findings demonstrate the dynamic nature of the relationship, indicating that as income levels rise, the impact of health investment on income becomes more pronounced. Moreover, the analysis highlights the role of health investment in facilitating upward income mobility, particularly for low-income households. Overall, these findings provide valuable insights for policymakers, suggesting that strategic health investment initiatives can contribute to achieving more equitable income distribution.

Dielectric barrier discharge cold plasma modifies the multiscale structure and functional properties of banana starch

Banana starch has attracted significant attention due to its abundant content of resistant starch. This study aims to compare the multiscale structure and functional properties of banana starch obtained from five cultivated varieties and investigate the impact of dielectric barrier discharge cold plasma (DBD) treatment on these starch characteristics. All five types of natural banana starch exhibited an elliptical and irregular shape, conforming to the CB crystal structure, with a bimodal distribution of branch chain lengths. The resistant starch content ranged from 88.9 % to 94.1 %. Variations in the amylose content, amylopectin branch chain length distribution, and structural characteristics resulted in differences in properties such as gelatinization behavior and sensitivity to DBD treatment. The DBD treatment inflicted surface damage on starch granules, reduced the amylose content, shortened the amylopectin branch chain length, and changed the relative crystallinity to varying degrees. The DBD treatment significantly increased starch solubility and light transmittance. Simultaneously, it resulted in a noteworthy decrease in peak viscosity and gelatinization enthalpy of starch paste. The in vitro digestibility test showed that 76.2 %-86.5 % of resistant starch was retained after DBD treatment. The DBD treatment renders banana starch with reduced viscosity, increased paste transparency, enhanced solubility, and broadens its potential application.

Lysozyme amyloid fibril-chitosan double network hydrogel: Preparation, characterization, and application on inhibition of Nε-(carboxyethyl)lysine

Nε-(carboxyethyl)lysine (CML), a typical advanced glycosylation end product produced during the processing of meat under high temperature, poses health risks. Active substances like polyphenols are known to inhibit the formation of harmful products during the processing of food. In this study, our objective was to prepare a double network hydrogel (DN) loaded with gallic acid using amyloid fibers and chitosan as a rigid and flexible network, respectively. The network as well as the interactions between the two networks were observed and analyzed. Chitosan concentration was the key factor regulating the structure and properties of the DN. At a chitosan concentration of 0.7%wt, the structure of DN became dense and its mechanical properties were improved, with the loading capacity and loading efficiency being increased by 143.79 % and 128.21 %, compared with those of amyloid fibril alone. Furthermore, the digestibility of gallic acid in simulated intestinal fluid was increased by 215.10 %. Moreover, adding DN to the beef patties effectively inhibited the formation of CML in a dose-response dependent manner. Addition of 3 wt% DN resulted in the inhibitory rate of CML in roast beef patties reaching a high 73.09 %. The quality and palatability of beef patties were improved. These findings suggest that DN shows great potential as an application that may be utilized to deliver active substances aimed at inhibiting CML in the meat processing industry.

Volatile aroma compounds of passion fruit seed Oils: HS-GC-IMS analysis and interpretation

The physicochemical properties, fatty acid composition and volatile aroma compounds of cold-pressed passion fruit seed oils were analyzed. The oils were rich in linoleic acid, oleic acid and volatile compounds. A total of 108 volatile compounds including 17 aldehydes, 23 alcohols, 21 esters, 19 ketones, 6 acids, 9 alkenes, 5 pyrazines and 8 others were identified using HS-GC-IMS. The significant differences of volatile compounds in the purple and yellow passion fruit seed oils were observed via the GalleryPlot graph and distinguished by principal component analysis. The results showed that acids, alcohols, esters and ketones were major aromatic compounds in purple passion fruit seed oils, which contribute to flavors such as flowery, fruity, creamy, yogurt. Whereas the contents of aldehydes, pyrazines, alkenes were higher in yellow passion fruit seed oils, which contributes to fatty and nutty odors. The findings filled in our understanding of volatilization characteristics in passion fruit seed oils.

Long-term prognostic value of thyroid hormones in left ventricular noncompaction

PURPOSE

Thyroid function is closely related to the prognosis of cardiovascular diseases. This study aimed to explore the predictive value of thyroid hormones for adverse cardiovascular outcomes in left ventricular noncompaction (LVNC).

METHODS

This longitudinal cohort study enrolled 388 consecutive LVNC patients with complete thyroid function profiles and comprehensive cardiovascular assessment. Potential predictors for adverse outcomes were thoroughly evaluated.

RESULTS

Over a median follow-up of 5.22 years, primary outcome (the combination of cardiovascular mortality and heart transplantation) occurred in 98 (25.3%) patients. For secondary outcomes, 75 (19.3%) patients died and 130 (33.5%) patients experienced major adverse cardiovascular events (MACE). Multivariable Cox analysis identified that free triiodothyronine (FT3) was independently associated with both primary (HR 0.455, 95%CI 0.313-0.664) and secondary (HR 0.547, 95%CI 0.349-0.858; HR 0.663, 95%CI 0.475-0.925) outcomes. Restricted cubic spline analysis illustrated that the risk for adverse outcomes increased significantly with the decline of serum FT3. The LVNC cohort was further stratified according to tertiles of FT3 levels. Individuals with lower FT3 levels in the tertile 1 group suffered from severe cardiac dysfunction and remodeling, resulting in higher incidence of mortality and MACE (Log-rank P < 0.001). Subgroup analysis revealed that lower concentration of FT3 was linked to worse prognosis, particularly for patients with left atrial diameter ≥ 40 mm or left ventricular ejection fraction ≤ 35%. Adding FT3 to the pre-existing risk score for MACE in LVNC improved its predictive performance.

CONCLUSION

Through the long-term investigation on a large LVNC cohort, we demonstrated that low FT3 level was an independent predictor for adverse cardiovascular outcomes.

Tong-Xie-Yao-Fang promotes dendritic cells maturation and retards tumor growth in colorectal cancer mice with chronic restraint stress

ETHNOPHARMACOLOGICAL RELEVANCE

Depression is one of the important risk factors that accelerate the progression of colorectal cancer (CRC). Tong-Xie-Yao-Fang (TXYF) is a widely used classical formula for treating psychiatric-related intestinal diseases in traditional Chinese medicine, that is composed of four different herbs: Atractylodes macrocephala Koidz. (Baizhu), Paeonia lactiflora Pall. (Baishaoyao), Citrus reticulata Blanco (Chenpi), Saposhnikovia divaricata (Turcz.) Schischk (Fangfeng). TXYF has over a hundred years of history and can significantly improve depression and reduce intestinal symptoms. However, the intervention effect and mechanism of TXYF on colorectal cancer accompanied by psychological stress are not still clear.

AIM OF STUDY

This study investigated the therapeutic effect of TXYF on CRC mice with chronic restraint stress (CRS) and to explore its mechanism.

MATERIALS AND METHODS

We constructed a mouse model of chronic stress by CRS and subcutaneous injection of CT26-Luc cells, and administered TXYF by gavage. We measured the body weight, tumor size, and tumor weight of each group of mice. The tumor growth was monitored dynamically of by vivo bioluminescence analysis. The depressive state of each group of mice were evaluated by tail suspension test, forced swimming test, and hormone level changes. We used flow cytometry to detect the ratio of CD4+ T cells, CD8+ T cells, Th1 cells, Th2 cells, and dendritic cells (DCs) phenotype (MHC II, CD80, and CD86) and chemotaxis ability (CXCR4 and CCR7) of in peripheral blood and tumor tissue. the levels of IL-12, IL-18, Th1 cytokines, and Th2 cytokines in the serum of each group of mice were determined by ELISA.

RESULTS

TXYF can improve the body weight of CRC mice with CRS, inhibit tumor volume and weight, alleviate depressive state, upregulate 5-HT levels, and inhibit HPA axis hormone secretion. The results of flow cytometry showed that TXYF can promote the maturation of DCs phenotype and function, enhance antigen presentation ability, increase the ratio of CD4+ T cells and CD4+/CD8+ T cells, and shift Th1/Th2 balance towards Th1 cells, thus increasing serum levels of IFN-γ, IL-18, IL-2, and IL-12, while decreasing serum levels of IL-4 and IL-10, and effectively triggering T cell-mediated immune response.

CONCLUSIONS

This study shows that TXYF inhibits the growth of tumors in CRC mice with CRS by stimulating immune response. The mechanism may be inhibiting the HPA axis and promoting DCs maturation, thus activating T cells and enhancing anti-tumor immune response, ultimately preventing the progression of CRC.

The Preparation and Properties of Ti(Nb)-Si-C Coating on the Pre-Oxidized Ferritic Stainless Steel for Solid Oxide Fuel Cell Interconnect

Cr2O3 scale growth and volatilization are the main cause of the performance degradation of solid oxide fuel cells (SOFCs) with an Fe-based ferritic stainless steel (FSS) interconnect. In this work, an amorphous Ti(Nb)-Si-C coating is prepared on the pre-oxidized SUS430 with D.C. magnetron sputtering as the protective coating. The amorphous Ti(Nb)-Si-C coated alloy exhibits significantly enhanced oxidation resistance, and the oxidation kinetics obey the parabolic law with a low parabolic rate of 9.36 × 10-15 g2·cm-4·s-1. A dual-layer oxide scale is formed composed of an inner layer rich in Cr2O3 and an outer layer rich in rutile TiO2 and amorphous SiO2. MnCr2O4 appears at the interface between the inner and outer oxide layers. Meanwhile, the amorphous Ti(Nb)-Si-C coating also effectively blocks the outward diffusion of Cr. In addition, the coated steel presents good electrical properties with an area-specific resistance (ASR) of 13.57 mΩ·cm2 at 800 °C after oxidation at 800 °C in air for 500 h.

Helicobacter pylori infection in humans and phytotherapy, probiotics, and emerging therapeutic interventions: a review

The global prevalence of Helicobacter pylori (H. pylori) infection remains high, indicating a persistent presence of this pathogenic bacterium capable of infecting humans. This review summarizes the population demographics, transmission routes, as well as conventional and novel therapeutic approaches for H. pylori infection. The prevalence of H. pylori infection exceeds 30% in numerous countries worldwide and can be transmitted through interpersonal and zoonotic routes. Cytotoxin-related gene A (CagA) and vacuolar cytotoxin A (VacA) are the main virulence factors of H. pylori, contributing to its steep global infection rate. Preventative measures should be taken from people's living habits and dietary factors to reduce H. pylori infection. Phytotherapy, probiotics therapies and some emerging therapies have emerged as alternative treatments for H. pylori infection, addressing the issue of elevated antibiotic resistance rates. Plant extracts primarily target urease activity and adhesion activity to treat H. pylori, while probiotics prevent H. pylori infection through both immune and non-immune pathways. In the future, the primary research focus will be on combining multiple treatment methods to effectively eradicate H. pylori infection.

[Current prevalence and control strategies of visceral leishmaniasis in Sichuan Province: A review]

Visceral leishmaniasis is a parasitic disease transmitted by Phlebotomus chinensis that poses a great threat to human health. Historically, visceral leishmaniasis was predominantly prevalent in northwestern regions of Sichuan Province. Following the founding of the People's Republic of China, large-scale integrated interventions had been implemented in visceral leishmaniasis-endemic areas of Sichuan Province, including identification and treatment of visceral leishmaniasis patients, elimination of infected dogs, Ph. chinensis control and health education. This review summarizes the prevalence of visceral leishmaniasis, discusses the control strategy of visceral leishmaniasis and analyzes the challenges of elimination of visceral leishmaniasis based on the One Health concept in Sichuan Province, so as to provide insights into elimination of visceral leishmaniasis in the province.

Global trends in coronary artery disease and artificial intelligence relevant studies: a bibliometric analysis

OBJECTIVE

Coronary artery disease (CAD) is a major global cause of death, greatly affecting life expectancy and quality of life for populations. With the advent of artificial intelligence (AI), there is new hope for accurately managing CAD. While recent studies have shown remarkable progress in AI and CAD research, there is a gap in comprehensive bibliometric analysis in this field. Therefore, this study aims to provide a thorough analysis of trends and hotspots in AI and CAD-related research utilizing bibliometrics.

MATERIALS AND METHODS

Publications on AI and CAD relevant research from 2009 to 2023 were searched through the WoS core database (WoSCC). CiteSpace, VOSviewer and Excel 365 were used to conduct the bibliometric analysis.

RESULTS

The bibliometric analysis included 1,248 publications, indicating a steady increase in AI and CAD-related publications annually. The United States of America (USA), China, and Germany were identified as the most influential countries in this field. Research institutions such as Cedars Sinai Med Ctr, Med Univ South Carolina, Harvard Med Sch and Capital Med Univ were the main contributors to research production. FRONT CARDIOVASC MED is the top-ranked journal, while J AM COLL CARDIOL emerged as the most cited journal. Schoepf, U. Joseph, Slomka, Piotr J., Berman, Daniel S. and Dey, Damini were the most prolific authors, while U. Rajendra Acharya was the most frequently co-cited author. Research related to the AI calculation of coronary flow reserve fraction and coronary artery calcification, based on coronary CT to identify CAD and cardiovascular risk, was a key research topic in this field. The potential link between cardiovascular risk stratification and radiomics is currently at the forefront of the field.

CONCLUSIONS

This study is the first to use a bibliometric approach to visualize and analyze AI and CAD-related research. The findings provide insights into recent research trends and hotspots in the field and can serve as a reference for scholars to identify critical issues in this field.

Human papillomavirus prevalence and genotype distribution in Liaocheng men between 2016 and 2022

Human papillomavirus (HPV) infection can lead to HPV-related cancer in men, including the anus, penile, and oropharyngeal cancers and precancerous lesions. This study retrospectively investigated HPV prevalence and genotype distribution in Liaocheng men between 2016 and 2022. The total HPV positive rate was 64.87% (2388/3681, 95% confidence interval [CI]: 63.32%-66.40%), where high risk (HR)-HPV and low risk (LR)-HPV accounted for 42.49% (1564/3681, 95% CI: 40.90%-44.09%) and 69.71% (2566/3681, 95% CI: 68.20%-71.17%), respectively. The mixed HPV infection rate of two and more genotypes was 35.72%. The infection rate of HR-HPV increased with the number of positive cases annually from 2016 (16.91%) to 2022 (46.59%). The most common HR-HPV genotypes were HPV16 (11.60%), HPV52 (6.95%), and HPV59 (6.28%), whereas the least common HR-HPV was HPV26. The most common LR-HPV genotypes were HPV6 (56.99%), HPV11 (23.79%), and HPV43 (6.37%). The 9 v HPV vaccine preventable for LR-HPV and HR-HPV accounted for 80.78% and 30.40%, respectively, in this study. Most HPV-positive patients aged 1-86 were in the 30-39 age group. This study confirmed that HPV prevalence in Liaocheng men was common and diverse. HPV16, HPV52, and HPV59 are widely distributed in Liaocheng men, and the male HR-HPV infection rate remained high in this region. Regarding public health and cancer prevention, it is recommended and effective to include the HPV vaccination in the national vaccination program for men.

κ-Carrageenan inhibits the formation of advanced glycation end products in cakes: Inhibition mechanism, cake characteristics, and sensory evaluation

Inhibiting the formation of advanced glycation end products (AGEs) in the heat-processed food can reduce health risks related to diabetic complications. However, additives used for this purpose may also affect the sensory characteristics of food products. In this study, the effects of six hydrocolloids on the formation of AGEs were evaluated in the lysine-glucose model, with κ-carrageenan exhibited the highest inhibitory activity. Mechanistic investigations indicated that κ-carrageenan conjugated with the key intermediates of AGEs, namely glyoxal (GO) and methylglyoxal (MGO). Subsequently, the inhibitory effect of κ-carrageenan on AGEs formation in cakes was verified. The data showed that κ-carrageenan in cakes significantly inhibited the formation of fluorescent and non-fluorescent AGEs. In addition, analysis of cake characteristics and sensory evaluation showed that cakes with 1% (w/w) κ-carrageenan had the highest quality and overall acceptance. Overall, κ-carrageenan is an effective inhibitor of AGEs formation in heat-processed food.

miRNAs from Inflamed Gingiva Link Gene Signaling to Increased MET Expression

Several array-based microRNA (miRNA) expression studies independently showed increased expression of miRNAs hsa-miR-130a-3p, -142-3p, -144-3p, -144-5p, -223-3p, -17-5p, and -30e-5p in gingiva affected by periodontal inflammation. We aimed to determine direct target genes and signaling pathways regulated by these miRNAs to identify processes relevant to gingival inflammatory responses and tissue homeostasis. We transfected miRNA mimics (mirVana) for each of the 7 miRNAs separately into human primary gingival fibroblasts cultured from 3 different donors. Following RNA sequencing, differential gene expression and second-generation gene set enrichment analyses were performed. miRNA inhibition and upregulation was validated at the transcript and protein levels using quantitative reverse transcriptase polymerase chain reaction, Western blotting, and reporter gene assays. All 7 miRNAs significantly increased expression of the gene MET proto-oncogene, receptor tyrosine kinase (MET). Expression of known periodontitis risk genes CPEB1, ABCA1, and ATP6V1C1 was significantly repressed by hsa-miR-130a-3p, -144-3p, and -144-5p, respectively. The genes WASL, ENPP5, ARL6IP1, and IDH1 showed the most significant and strongest downregulation after hsa-miR-142-3p, -17-5p, -223-3p, and -30e-5p transfection, respectively. The most significantly regulated gene set of each miRNA related to cell cycle (hsa-miRNA-144-3p and -5p [Padj = 4 × 10-40 and Padj = 4 × 10-6], -miR-17-5p [Padj = 9.5 × 10-23], -miR-30e-5p [Padj = 8.2 × 10-18], -miR-130a-3p [Padj = 5 × 10-15]), integrin cell surface interaction (-miR-223-3p [Padj = 2.4 × 10-7]), and interferon signaling (-miR-142-3p [Padj = 5 × 10-11]). At the end of acute inflammation, gingival miRNAs bring together complex regulatory networks that lead to increased expression of the gene MET. This underscores the importance of mesenchymal cell migration and invasion during gingival tissue remodeling and proliferation in restoring periodontal tissue homeostasis after active inflammation. MET, a receptor of the mitogenic hepatocyte growth factor fibroblast secreted, is a core gene of this process.

A Fluorescence Biosensor for Tyrosinase Activity Analysis Based on Silicon-Doped Carbon Quantum Dots

Tyrosinase (TYR) plays a pivotal role in the biosynthesis of melanin, and its activity level holds critical implications for vitiligo, melanoma cancer, and food nutritional value. The sensitive determination of TYR activity is of great significance for both fundamental research and clinical investigations. In this work, we successfully synthesized silicon-doped carbon quantum dots (Si-CQDs) through a one-pot hydrothermal method with trans-aconitic acid as carbon source and N-[3-(trimethoxysilyl)propyl]ethylenediamine as the dopant, exhibiting remarkable fluorescence quantum yield (QY) and photostability. Correspondingly, Si-CQDs were used as a probe to construct a sensitive, rapid, and user-friendly fluorescence method for TYR detection. The method relied on the oxidation of isoprenaline (ISO) by TYR, where Si-CQDs were employed as a highly efficient probe. The testing mechanism was the internal filtering effect (IFE) observed between Si-CQDs and the oxidative system of ISO and TYR. Under the optimized conditions, the fluorescence strategy exhibited a detection range of 0.05-2.0 U/mL for TYR with a limit of detection (LOD) of 0.041 U/mL. Furthermore, we successfully demonstrated the accurate determination of TYR levels in human serum, showcasing the promising potential of this method in various practical scenarios.

Study on Job Burnout of Staff with Different Qualifications in Disinfection Supply Center of Public Hospitals

Objective

To investigate the job burnout situation in different seniority staff in a public hospital disinfection supply center.

Methods

The hospital Disinfection supply center staff in 4 grade 3 A public hospitals received a questionnaire From January 1st to 7th, 2023 including Maslach Burnout Inventory-General Survey, MBI-GS, and other programs. 158 subjects were included in this study. They were divided into three groups according to working years: A short seniority group of 68 cases (≤5 years), middle seniority: 49 cases (5 ~15 years), and long seniority: 41 cases (≥15 years). The correlation between seniority and job burnout was explored by comparing the job burnout scores of three groups. MBI-GS is divided into three parts: the sense of achievement, work attitude, and emotional failure. The full score of achievement is 36 (reverse scored). Higher scores indicate lower achievement from work and severe burnout. Besides, the gender rate, educational background, and job title, as well as the scores in achievability, job attitude, emotional exhaustion, and job burnout were compared among the three groups.

Results

By comparing with the short seniority group, the proportion of men in the long seniority group (41.4%) and the middle seniority group (44.8%) were higher. Compared with the long seniority group (39%), the highly educated rate of the short seniority group (92.6%) and middle seniority group (77.5%) was higher. Compared with the long seniority group (63.5%), the proportion of low job titles including primary nurse and no job title in the short seniority group (95.6%) and middle seniority group (77.6%) were higher. The achievability of the short seniority group (19.4 ± 4.2) was significantly lower than those of the middle (11.4 ± 3.6) and long seniority group (9.4 ± 4.0). Compared with the short (10.2 ± 2.3) and long subgroups group (13.5 ± 3.1), the job attitude of the middle seniority group (9.7 ± 3.3) was poorer. Compared with the short (9.7 ± 3.3) and long seniority group (12.3 ± 4.2), the emotional control ability and thus emotional exhaustion of the middle seniority group (14.2 ± 3.8) was poorer. In contrast with the long-seniority group, job burnout situations in the short and middle-seniority groups were more serious.

Conclusion

There was a significant difference in the job burnout of different seniority staff in public hospital disinfection supply centers, with lower achievability for short seniority, emotional exhaustion, and poorer job attitude for middle seniority staff.

Evaluation of outcomes after conservative mandibular surgery in patients with oral squamous cell carcinoma

This study aimed to assess preoperative radiological and clinical examinations for identifying bone status and to evaluate survival outcomes in patients undergoing marginal mandibulectomy for the primary treatment of oral squamous cell carcinoma. The medical records, enhanced computed tomography (CT) scans, and pathological specimens of these patients were reviewed. Disease-free (DFS), local recurrence-free (LRFS), and osteoradionecrosis-free (ORNFS) survival were analysed. The study included 104 patients. The preoperative CT and clinical examinations achieved a sensitivity of 45.8% and specificity of 100% for judging bone condition. LRFS was 79.6% and DFS was 68.8%. Pathological bone invasion in significantly affected DFS (P = 0.597), while DFS was significantly higher for those with a lower clinical tumour stage (1/2 vs 3/4; P = 0.005) and postoperative radiotherapy (P = 0.011). Among 39 patients receiving postoperative radiotherapy, ORNFS was 75.2%. Postoperative chemotherapy significantly decreased ORNFS (P = 0.009). Tumour subsite (P = 0.003) and the resection site (P = 0.035) significantly affected the remaining bone height. The results indicate that CT and clinical examinations cannot precisely identify superficial bone damage, but work well in selecting patients for marginal resection. Adhering to current indications, this resection approach can guarantee safe bone margins in terms of survival outcomes.

Study on Green Nanofluid Profile Control and Displacement of Oil in a Low Permeability Reservoir

Low permeability reservoirs are characterized by low permeability, small pore throat, strong heterogeneity, and poor injection-production ability. High shale content of the reservoir, strong pressure sensitivity, micropore undersaturation, and significant water-lock effect in water injection development lead to increased fluid seepage resistance. There is an urgent need to adopt physical and chemical methods to supplement energy and improve infiltration efficiency, thereby forming effective methods for increasing the production and efficiency. Aiming at the characteristics of ultralow permeability reservoirs, in this paper, a green and environmental friendly biobased profile control and displacement agent (Bio Nano30) has been developed using noncovalent supramolecular interaction. Physical simulation experiments illustrate the profile control and displacement mechanism of Bio-Nano30. Laboratory experiments and field applications show that good results have been achieved in oil well plugging removal, water well pressure reduction and injection increase, and well group profile control and oil displacement. This research has good application prospects in low permeability heterogeneous reservoirs.

Analysis of factors affecting crash under risk scenarios based on driver homogenous clustering

Research on road safety has focused on analyzing the factors that affect crashes. However, previous studies have often neglected differences in crash causation among heterogeneous clusters of drivers. In particular, the differences in the combined effect mechanisms of the factors in the risk scenarios have not been completely explained. Therefore, this study used the K-means algorithm to perform multidimensional feature homogeneous clustering for drivers involved in crashes and near-crashes. Structural equation modeling involving mediating effects was introduced to explore the direct and indirect effects of each influencing factor on vehicle crashes under risk scenarios and compare the differences in crash causation among different driver clusters. The results indicate that the drivers who experienced the risk scenarios can be classified into two homogeneous driver clusters. Significant differences exist in the demographic characteristics, intrinsic driving characteristics, and crash rates between them. In the risk scenario, traffic factors, distraction state, crash avoidance reaction, and maneuver judgment directly affect the crash outcomes of the two cluster drivers. Demographic characteristics and environmental factors have fewer direct influence on the crash outcomes of two-cluster drivers, but produce more complex mediating effects. Analysis of the differences in the influence of factors between clusters indicates that the fundamental cause of crashes for cluster 1 drivers includes poor driving skills. In contrast, cluster 2 drivers' crashes were more influenced by traffic conditions and their safety awareness. The analysis method of this study can be used to develop more targeted road safety policies to reduce the occurrence of vehicle crashes.

Inhibition of LAMP3 mediates the protective effect of vitamin D against hypoxia/reoxygenation in trophoblast cells

Inadequate invasion and excessive apoptosis of trophoblast cells are associated with the development of preeclampsia. Vitamin D deficiency in pregnant women may lead to an increased risk of preeclampsia. However, the underlying mechanisms by which vitamin D is effective in preventing preeclampsia are not fully understood. The objectives of this study were to investigate the role of lysosome-associated membrane glycoprotein 3 (LAMP3) in the pathogenesis of preeclampsia and to evaluate whether vitamin D supplementation would protect against the development of preeclampsia by regulating LAMP3 expression. Firstly, the mRNA and protein levels of LAMP3 were significantly upregulated in the placentas of preeclampsia patients compared to normal placentas, especially in trophoblast cells (a key component of the human placenta). In the hypoxia/reoxygenation (H/R)-exposed HTR-8/Svneo trophoblast cells, LAMP3 expression was also upregulated. H/R exposure repressed cell viability and invasion and increased apoptosis of trophoblast cells. siRNA-mediated knockdown of LAMP3 increased cell viability and invasion and suppressed apoptosis of H/R-exposed trophoblast cells. We further found that 1,25(OH)2D3 (the hormonally active form of vitamin D) treatment reduced LAMP3 expression in H/R exposed trophoblast cells. In addition, 1,25(OH)2D3 treatment promoted cell viability and invasion and inhibited apoptosis of H/R-exposed trophoblast cells. Notably, overexpression of LAMP3 abrogated the protective effect of 1,25(OH)2D3 on H/R-exposed trophoblast cells. Collectively, we demonstrated trophoblast cytoprotection by vitamin D, a process mediated via LAMP3.

[Progress in clinical research on potential therapeutic drugs for acute-on-chronic liver failure]

Acute-on-chronic liver failure (ACLF), has a high mortality rate and a poor prognosis. Currently, the only effective treatment for ACLF is liver transplantation. However, the number of patients who can successfully undergo liver transplantation is limited due to the rapid progression of ACLF, the occurrence of serious complications, and a dearth of liver donors. The available drug treatment indication expansion and pathogenesis exploration are expected to delay the progression of ACLF, reduce complications, and provide patients with opportunities for liver transplantation by improving portal vein pressure, inhibiting excessive inflammatory response, correcting energy metabolism disorders, reducing oxidative stress, resisting hepatic cell apoptosis, and promoting liver regeneration.

Pathway Mutations are Associated with Clinical Outcomes in Localized Pancreatic Cancer Treated with Neoadjuvant Chemoradiation Followed by Surgery

PURPOSE/OBJECTIVE(S)

The purpose of this study was to determine if mutations in biological pathways are associated with clinical outcomes in patients with localized pancreatic cancer who undergo neoadjuvant chemoradiation followed by surgical resection.

MATERIALS/METHODS

Patients treated with neoadjuvant chemoradiation followed by oncologic resection from 2015-2019 who also underwent next generation sequencing (NGS) of the primary tumor were included in this retrospective analysis. NGS was done using either Foundation One (n = 20), in-house Solid Tumor Panel (n = 121), or Tempus XT (n = 1). Genes were included in pathway analysis if at least one patient harbored a mutation in the gene. Pathways were defined from the Molecular Signatures Database Hallmark, KEGG, and Reactome gene sets. A pathway was deemed mutated if at least one gene within the pathway was mutated. Univariable Cox regression was performed to determine the association between pathway mutation status and overall survival (OS) as well as progression-free survival (PFS).

RESULTS

In total, 142 patients met criteria for study inclusion. For pathway analysis, 329 genes met inclusion criteria. Patients were typically treated with neoadjuvant chemotherapy (either 5-fluorouracil-based or gemcitabine-based) followed by radiation. Patients received SBRT (n = 104, most commonly 33 Gy in 5 fractions) or conventionally fractionated radiation (n = 38, most commonly 50.4 Gy in 28 fractions). For clinical variables, worse OS was significantly associated with T stage (p = 0.036), N stage (p = 0.044), and lymphovascular invasion (LVI, p = 0.011); worse PFS was significantly associated with T stage (p = 0.0008), N stage (p = 0.022), LVI (p = 0.026), and conventional RT (p = 0.007). Mutations in major pathways were associated with worse OS, notably hedgehog signaling (p = 0.001), chromatin modifying enzymes (p = 0.002), WNT/beta-catenin signaling (p = 0.005), mismatch repair (0.006), E2F targets (p = 0.008), FLT signaling (p = 0.012), VEGF signaling (0.025), innate immune system (p = 0.026), and NOTCH signaling (p = 0.029). Pathway mutations associated with worse PFS included mismatch repair (p = 0.007) and hedgehog signaling (p = 0.013).

CONCLUSION

For pancreatic cancer patients that undergo neoadjuvant chemoradiation followed by oncologic resection of the primary tumor, mutations in key biological pathways are associated with OS and PFS. Characterizing the importance of common pathway mutations may become increasingly valuable to help categorize less commonly mutated genes assayed by NGS.

Characterization of DNA Damage Response-Associated Somatic Mutations in Borderline Resectable and Locally Advanced Pancreatic Cancer

PURPOSE/OBJECTIVE(S)

The role of radiation for pancreatic cancer remains controversial, with recent studies showing conflicting results, highlighting the need to develop biomarkers of radiation response. Despite its potential utility in predicting radiosensitivity, the landscape of somatic mutations in borderline resectable pancreatic cancer (BRPC) and locally advanced pancreatic cancer (LAPC), as related to DNA damage response (DDR), has not been well characterized. This study aimed to characterize the frequency of such mutations in a cohort of patients with BRPC/LAPC treated with neoadjuvant chemotherapy and stereotactic body radiotherapy (SBRT).

MATERIALS/METHODS

Mutational data was collected from patients with BRPC/LAPC treated at a single institution with neoadjuvant chemotherapy and SBRT, followed by surgical resection from 2016-2021. Chemotherapy consisted of modified FOLFIRINOX or gemcitabine/nab-paclitaxel, and patients were treated with SBRT in 33 Gy in 5 fractions. Genomic data was obtained from either endoscopic biopsy or surgical specimens, and next-generation sequencing was performed either in-house with a Solid Tumor Panel or with FoundationOne CDx. Specific emphasis was placed on the characterization of double-strand DNA break (DSB) repair genes, as this is the type of tumor cell damage traditionally induced by radiation therapy. Genes associated with the two main pathways of DSB repair, non-homologous end joining (NHEJ) and homologous repair (HR), were analyzed. Specific HR pathway mutations assessed were BLM, BRCA1/2, MRE11, NBN, PALB2, RAD50, RAD51B-D, and RAD54L, while PRKDC mutations were assessed for the NHEJ pathway. Mutations in ATM, an important initiator of DDR pathways, were also analyzed. Additionally, the frequency of mutations in TP53, CDKN2A and SMAD4 in patients with concomitant KRAS mutations was assessed.

RESULTS

Eighty-five patients were included in the study. Five (5.9%) patients had mutations in the NHEJ pathway of the PRKDC gene. Twenty (23.5%) patients had mutations in the HR pathway, including BRCA2 (10/85; 11.8%), PALB2 (5/85; 5.9%), BRCA1 (3/85; 3.5%), and RAD50 (1/85; 1.2%). Six (7.1%) patients had mutations in ATM. No patients were found to have mutations in BLM, RAD51B-D, RAD54L, or NBN. Amongst patients with KRAS mutations (72/85), concomitant mutations were observed in TP53 (47/85; 55.3%), CDKN2A (16/85; 18.8%), and SMAD4 (9/85; 10.6%).

CONCLUSION

Herein, we characterized the frequency of somatic mutations associated with DSB repair genes in patients with BRPC/LAPC. Data analysis on outcomes related to radiation response in patients with mutations in DDR pathways is ongoing, but will likely also benefit from multi-institutional efforts to increase the power to answer this question.

Molecular Mechanisms of Intratumoral Nerve Recruitment and Perineural Invasion Elucidated with Spatial Transcriptomics and CRISPR Activation

PURPOSE/OBJECTIVE(S)

Perineural invasion (PNI) is an aggressive manifestation of tumor-nerve interactions associated with postoperative recurrence, metastasis, pain, and decreased survival. Hence, PNI is included in the staging criteria of several malignancies and often an indication for treatment intensification using adjuvant radiotherapy. However, the diverse molecular mechanisms underlying tumor-nerve crosstalk remain largely unknown-hindering the development of new therapies targeting this key pathological process. Moreover, prior studies were limited by a lack of cell-type information, spatial context, and/or a fragmented focus on a small number of pathways.

MATERIALS/METHODS

Using pancreatic ductal adenocarcinoma (PDAC) as an exemplar given the exceptionally high frequency of PNI in this malignancy, we performed the first comprehensive, cell-type specific, and spatially resolved whole-transcriptome analysis of human PDAC to identify molecular mediators of tumor-nerve crosstalk and PNI. We constructed 12 custom tissue microarrays (TMAs) derived from matched malignant regions with and without tumor-nerve proximity (n = 288 cores). We performed whole-transcriptome digital spatial profiling (DSP) to independently determine mRNA abundance from the malignant, fibroblast, and nerve compartments through optical sectioning.

RESULTS

We mapped malignant subtypes we previously identified onto the spatial data and found strong (p<0.0001) positive nerve associations with the mesenchymal, basaloid, and neural-like progenitor subtypes and a negative nerve association with the classical subtype. Numerous genes expressed by malignant cells were enriched (e.g., MMP2, PLXND1, NRP1) or depleted (e.g., SEMA3B) in association with radial distance from nerves, including recapitulation of prior literature. To functionally explore these candidate mediators of tumor-nerve crosstalk, we derived genetically-engineered murine organoids (KrasLSL-G12D/+; Trp53FL/FL; Rosa26-dCas9-VPR) and transduced them with guide RNAs to overexpress subtype-specific transcription factors or candidate genes from the spatial analysis. We quantified (1) cancer cell invasion through extracellular matrix using cultured dorsal root ganglia (DRG) sensory neurons as the chemoattractant, and (2) the role of cancer-intrinsic signaling on nerve recruitment/outgrowth by applying conditioned media or exogenous proteins to cultured DRG sensory neurons and tracking their growth with live imaging.

CONCLUSION

Our results suggest that the mechanisms enabling cancer cells to recruit nerves into the tumor microenvironment are distinct from those facilitating perineural invasion. This study has transformed our understanding of how cancer cells and the peripheral nervous system collaborate to promote tumor growth, survival, and dissemination, and is now guiding prioritization of therapeutic strategies that synergize with adjuvant radiotherapy in the burgeoning field of cancer neuroscience.

First Measurement of the Nuclear-Recoil Ionization Yield in Silicon at 100 eV

We measured the nuclear-recoil ionization yield in silicon with a cryogenic phonon-sensitive gram-scale detector. Neutrons from a monoenergetic beam scatter off of the silicon nuclei at angles corresponding to energy depositions from 4 keV down to 100 eV, the lowest energy probed so far. The results show no sign of an ionization production threshold above 100 eV. These results call for further investigation of the ionization yield theory and a comprehensive determination of the detector response function at energies below the keV scale.

Comparative Analysis of Key Odorants and Aroma Characteristics in Hot-Pressed Yellow Horn (Xanthoceras sorbifolia bunge) Seed Oil Via Gas Chromatography-Ion Mobility Spectrometry and Gas Chromatography-Olfactory-Mass Spectrometry

Volatile compounds (VOCs) present in the oil extracted from yellow horn seeds were first analyzed using GC-IMS and GC-O-MS at varying roasting temperatures. A total of 97 VOCs were detected using GC-IMS, while 77 were tentatively identified using GC-O-MS. Moreover, both methods allowed the identification of 24 VOCs, of which the type of aldehydes is the most abundant. Combining the results of GC-IMS, GC-O-MS, OAVs, and VIP, it was concluded that hexanal, 2,5-dimethylpyrazine, heptanal, 2-pentylfuran, 1-hexanol, and 1-octen-3-ol were the key aroma compounds. The PLS-DA and OPLS-DA models have demonstrated the ability to discriminate between different oil roasting temperatures with high accuracy. The roasting temperature of 160 °C was found to yield the highest content of main aroma substances, indicating its optimality for yellow horn seed oil production. These findings will prove beneficial for optimizing industrial production and enhancing oil aroma control.

Early adjunctive diagnostic value of contrast-enhanced ultrasound-related quantitative parameter and its relationship with micro-perfusion of nontraumatic necrosis of femoral head

OBJECTIVE

The aim of this study is to explore the early diagnostic value of contrast-enhanced ultrasound (CEUS)-related quantitative parameter and its relationship with the micro-perfusion of nontraumatic necrosis of the femoral head.

PATIENTS AND METHODS

According to the random and double-blind method, the patients with non-traumatic femoral head necrosis diagnosed and treated in our hospital from July 2019 to January 2022 were selected as the subjects (the research group). According to the staging of the International Society of Bone Circulation for Femoral Head Necrosis, 89 patients with stage Ⅱ and Ⅲ A were included (39 patients with stage Ⅱ and 50 patients with stage Ⅲ A). 25 patients who conducted physical examination in our hospital during the same time were taken as the control group. Quantitative parameters of CEUS were analyzed. The content of serum vascular endothelial growth factor (VEGF) and bone morphogenetic protein-2 (BMP-2) were evaluated. The relationship among the quantitative parameters of CEUS, the expression of VEGF and BMP-2 in serum and the patient's condition, and the value for assisting the early diagnosis of nontraumatic femoral head necrosis were analyzed.

RESULTS

The body mass, body mass index (BMI), blood lipid, and cholesterol levels were much higher in the research group than in the control group (p < 0.05). The research group had a markedly higher slope of ascending branch (AS), strength enhancement index (EI), and VEGF and obviously lower decay slope (DS), mean transit time (MTT), and time to peak (TTP) than the control group (p < 0.05). In the research group, compared to stage Ⅱ, the levels of AS, EI, and VEGF in stage Ⅲ A patients were memorably higher, and the levels of DS, MTT, TTP and BMP-2 were dramatically lower (p < 0.05). Pearson's correlation test showed that AS, EI, and VEGF were positively correlated with the patients' condition, while DS, MTT, TTP and BMP-2 were negatively correlated with the patients' condition (p < 0.05). The receiver operating characteristic (ROC) curve analysis showed that the diagnostic area under the curve (AUC) of quantitative parameters of CEUS was 0.961, with sensitivity and specificity of 88.0% and 97.4%, respectively. The AUC of the combined detection of VEGF and BMP-2 was 0.945 with sensitivity and specificity of 82.3% and 87.5%, respectively, and the combined detection had a high diagnostic value (p < 0.05).

CONCLUSIONS

The quantitative parameters of CEUS were of great value in the early diagnosis of nontraumatic necrosis of the femoral head with microvascular perfusion and the patients' condition, and provided a reference for the clinical treatment of non-traumatic necrosis of the femoral head. These parameters were expected to be useful indicators for judging the efficacy before and after treatment.

Breast cancer diagnosis and prognosis using a high b-value non-Gaussian continuous-time random-walk model

AIM

To compare the diagnostic performance of mono-exponential model-derived apparent diffusion coefficient (ADC), continuous-time random-walk (CTRW) model-derived D_m, α, β and their combinations in discriminating malignancy of breast lesions, and investigate the association between model-derived parameters and prognosis-related immunohistochemical indices.

MATERIALS AND METHODS

A total of 85 patients with breast lesions (51 malignant, 34 benign) were analysed in this retrospective study. Clinical characteristics include oestrogen receptor (ER), progesterone receptor (PR), human epidermal receptor 2 (HER2), and Ki-67. The ADC was fitted using a mono-exponential model (b-values = 0, 800 s/mm²), while D_m, α, and β were fitted using a CTRW model. Independent Student's t-test and the Mann-Whitney U-test were used for the comparison of parameters. Discrimination performance was accomplished by receiver operating characteristic (ROC) analysis, and Spearman's correlation analysis was used to explore the association between immunohistochemical indices and diffusion parameters, the statistical significance level was p<0.05.

RESULTS

D_m and ADC demonstrated similar performance in differentiating malignant and benign lesions (AUC = 0.928 versus 0.930), while the combination of D_m, α, and β could improve the AUC to 0.969. The combined parameter generated by ADC, D_m, α, and β was effective in identifying the ER+/ER- and PR+/PR- patients. Temporal heterogeneity parameter α correlated significantly with the expression of PR.

CONCLUSION

Diffusion parameters derived from the CTRW model could effectively discriminate the malignancy of breast lesions. Meanwhile, the hormone receptor expression could be distinguished by combined diffusion parameters, and have the potential to reflect the prognosis.

[Evaluation of the clinical efficacy of minimally invasive endoscopic surgery in the treatment of isolated non-syndromic sagittal synostosis in infants]

The current study aimed to evaluate the early efficacy in infants with isolated non-syndromic sagittal synostosis who underwent minimally invasive endoscopic-assisted surgery. The clinical data of infants with isolated non-syndromic sagittal synostosis who were admitted to the Department of Neurosurgery of the Children's Hospital of Nanjing Medical University and underwent endoscopic-assisted surgery from October 2018 to December 2021 were retrospectively analyzed. All the infants underwent minimally invasive endoscopic-assisted surgery, and were treated with supine sleeping position after surgery. Computer-aided reconstruction technique was used to reconstruct and measure the thin-slice CT scan images of the head before and 3 months after surgery, and the differences in cranial index (CI), cranial cavity volume and angle drawn between the cranial vertex, nasion, and opisthocranion (VNO angle) of preoperative and postoperative groups were analyzed. A total of 103 infants were included in the final analysis, including 85 males and 18 females. The age at surgery was (2.1±0.8) months, and the weight was (6.1±0.9) kg. The postoperative CI was (84±6)%, which increased obviously compared with the pre-operation [(70±5)%] (P<0.001). The cranial volume of post-operation was (947±130) cm³, which was larger than that of the pre-operation [(748±104) cm³] (P<0.001). The VNO angle after surgery was (45±4)°, which showed a significant reduction compared with the pre-operation [(55±4)°] (P<0.001). The correction of head shape was satisfactory. For the treatment of sagittal synostosis in infants, minimally invasive endoscopic-assisted surgery is safe and effective, and in the case of switching from an auxiliary helmet to a supine position, the postoperative correction efficacy of head shape is better.

A promising approach for simultaneous removal of ammonia and multiple heavy metals from landfill leachate by carbonate precipitating bacterium

The effective and cheap remediation of ammonia (NH⁺₄) and multiple heavy metals from landfill leachate is currently a grand challenge. In this study, Paracoccus denitrificans AC-3, a bacterial strain capable of heterotrophic nitrification aerobic denitrification (HNAD) and carbonate precipitation, exhibited good tolerance to a variety of heavy metals and could remove 99.70% of NH⁺₄, 99.89% of zinc (Zn²⁺), 97.42% of cadmium (Cd²⁺) and 46.19% of nickel (Ni²⁺) simultaneously after 24 h of incubation. The conversion pathway of NH⁺₄ by strain AC-3 was dominated by assimilation (84.68%), followed by HNAD (14.93%), and the increase in environmental pH was mainly dependent on assimilation rather than HNAD. Calcium (Ca²⁺) primarily played four roles in heavy metal mineralization: (ⅰ) improving bacterial tolerance to heavy metals; (ⅱ) ensuring the HNAD capacity of strain AC-3; (ⅲ) co-precipitating with heavy metals; and (ⅳ) precipitating into calcite to adsorb heavy metals. The heavy metals removal mechanisms were mainly calcite adsorption and formation of carbonate and hydroxide precipitation for Zn²⁺, co-precipitation for Cd²⁺, and adsorption for Ni²⁺. The Zn²⁺, Cd²⁺, and Ni²⁺ precipitates displayed unique morphologies. This research provided a promising biological resource for the simultaneous remediation of NH⁺₄ and heavy metals from landfill leachate.

Baicalin alleviates silica-induced lung inflammation and fibrosis by inhibiting TLR4/NF-?B pathway in rats

Silicosis is an occupational lung disease caused by inhaling silica dust. The disease is characterized by early lung inflammation and late irreversible pulmonary fibrosis. Here we report the effect of Baicalin, a main flavonoid compound from the roots of Chinese herbal medicine Huang Qin on silicosis in a rat model. Results showed Baicalin (50 or 100 mg/kg/day) can mitigate the silica-induced lung inflammation and reduce the harm of alveolar structure and the blue region of collagen fibers in rat lung at 28 days after administration. At the same time, Baicalin also diminished the level of interleukin-1beta (IL-1beta, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta1 (TGF-beta1) in lung tissues. The protein expression of collagen I (Col-1), alpha-smooth muscle actin (alpha-SMA) and vimentin were down-regulated while E-cadherin (E-cad) was increased in Baicalin-treated rats. In addition, the Toll Like Receptor 4 (TLR4)/ nuclear factor kappaB (NF-kappaB) pathway was enabled at 28 days after silica infusion, and the treatment of Baicalin diminished the expression of TLR4 and NF-?B in the lungs of rat with silicosis. These results suggested that Baicalin inhibited the pulmonary inflammatory and fibrosis in a rat model of silicosis, which could be attributed to inhibition of the TLR4/NF-kappaB pathway.

Baicalin alleviates silica-induced lung inflammation and fibrosis by inhibiting TLR4/NF-?B pathway in rats

Silicosis is an occupational lung disease caused by inhaling silica dust. The disease is characterized by early lung inflammation and late irreversible pulmonary fibrosis. Here we report the effect of Baicalin, a main flavonoid compound from the roots of Chinese herbal medicine Huang Qin on silicosis in a rat model. Results showed Baicalin (50 or 100 mg/kg/day) can mitigate the silica-induced lung inflammation and reduce the harm of alveolar structure and the blue region of collagen fibers in rat lung at 28 days after administration. At the same time, Baicalin also diminished the level of interleukin-1beta (IL-1beta, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta1 (TGF-beta1) in lung tissues. The protein expression of collagen I (Col-1), alpha-smooth muscle actin (alpha-SMA) and vimentin were down-regulated while E-cadherin (E-cad) was increased in Baicalin-treated rats. In addition, the Toll Like Receptor 4 (TLR4)/ nuclear factor kappaB (NF-kappaB) pathway was enabled at 28 days after silica infusion, and the treatment of Baicalin diminished the expression of TLR4 and NF-?B in the lungs of rat with silicosis. These results suggested that Baicalin inhibited the pulmonary inflammatory and fibrosis in a rat model of silicosis, which could be attributed to inhibition of the TLR4/NF-kappaB pathway.

[Bioinformatics analysis in metagenomic next-generation sequencing of pathogenic microorganisms: current status and challenges]

The clinical application of metagenomic next-generation sequencing (mNGS) in the diagnosis of unknown pathogenic infections and critical infections has become increasingly valuable. Due to the huge volume of mNGS data and the complexity of clinical diagnosis and treatment, mNGS has difficulties in data analysis and interpretation in practical application. Therefore, in the process of clinical practice, it is crucial to grasp the key points of bioinformatics analysis and establish a standardized bioinformatics analysis process, which is an important step in the transformation of mNGS from laboratory to clinic. At present, bioinformatics analysis of mNGS has made great progress, but with the high requirements of clinical standardization of bioinformatics analysis and the development of computer technology, bioinformatics analysis of mNGS is also facing new challenges. This article mainly elaborates on quality control, and identification and visualization of pathogenic bacteria.

Use of free flaps with supermicrosurgery for oncological reconstruction of the maxillofacial region

Supermicrosurgery involves the dissection and anastomosis of vessels<0.8 mm in diameter with minimal donor site morbidity. This study evaluated the feasibility and outcomes of free flaps using supermicrosurgery to repair oncological defects in the maxillofacial region. Forty-two patients were treated with supermicrosurgery to repair oncological defects in the maxillofacial region between December 2015 and February 2021. The supermicrosurgery technique was used for different types of free flap, including 24 superficial circumflex iliac artery perforator flaps, seven anterolateral thigh flaps, three peroneal artery perforator flaps, five medial femoral condyle osteo-adipofascial flaps, and three profunda artery perforator flaps. An artery-to-artery approach was used in 38 patients; venous grafts for anastomosis were used in four patients to resolve an arterial discrepancy. Forty-one flaps (97.6%) survived. Thirty-six patients (85.7%) healed without any complications; three flaps required revision surgery including one lost, one demonstrated wound dehiscence, and two demonstrated wound infection. Supermicrosurgery is a useful complement to conventional microsurgery in head and neck reconstruction.

Case Report: Identification of a rare nonsense mutation in the POC1A gene by NGS in a diabetes mellitus patient

Objective: This study aimed to investigate the clinical and molecular biology of a patient with a type of diabetes mellitus caused by a mutation in the POC1A (OMIM number: 614783) gene and explore its pathogenesis and related characteristics.

Methods: The patient was interviewed about his medical history and subjected to relevant examinations. Blood DNA samples were collected from the patient and his family members (parents) for trio whole-exome sequencing. Whole-exome sequencing was performed using the IDT xGen Exome Research Panel v1.0 whole-exome capture chip and sequenced using an Illumina NovaSeq 6,000 series sequencer (PE150); the sequencing coverage of the target sequence was not less than 99%. After systematic analysis and screening of the cloud platform for accurate diagnosis of genetic diseases, which integrated molecular biology annotation, biology, genetics, and clinical feature analysis, combined with a pathogenic mutation database, normal human genome database, and clinical feature database of 4,000 known genetic diseases, hundreds of thousands of gene variants were graded using the gene data analysis algorithm, a three-element grading system, and the American Society of Medical Genetics gene variant grading system. After polymerase chain reaction testing, the target sequence was verified by Sanger sequencing using an ABI3730 sequencer, and the verification result was obtained using sequence analysis software.

Results: The patient had a peculiar face, a thin body, and a body mass index of 16.0 kg/m2. His fasting connecting peptide was 10.2 ug/L, his fasting insulin was 44 mIU/L, his fasting blood glucose was 10.5 mmol/L, and his glycosylated haemoglobin was 12.5%. After hospitalisation, the patient was given 0.75 g/d metformin tablets and 15 mg/d pioglitazone dispersible tablets, and his fasting blood glucose reduced to 9.2 mmol/L. After 48 U/L insulin treatment, the patient’s fasting blood glucose was reduced to 8.5 mmol/L. Genetic screening revealed that there was a pathogenic variant at the POC1A gene locus and a cytosine-to-thymine mutation at the G81 locus, turning the Arg to a termination codon and shortening the POC1A protein from 359 amino acids (aa) to 80 aa. No mutation was detected in the patient’s parents’ POC1A gene loci.

Conclusion: The patient’s diabetes was caused by a POC1A gene mutation at the G81 locus, which is rarely reported in the clinic. The specific manifestations of this mutation need to be further investigated.

Polysaccharides from banana (Musa spp.) blossoms: Isolation, identification and anti-glycation effects

Musa spp. (banana) is consumed globally as a healthy fruit and improves the immune system. Banana blossoms are a by-product of banana harvesting rich in active substances such as polysaccharides and phenolic compounds; however, these blossoms are typically discarded as waste. In this report, a polysaccharide, MSBP11, was extracted, purified and identified from banana blossoms. MSBP11 is a neutral homogeneous polysaccharide with a molecular mass of ∼214.43 kDa and composed of arabinose and galactose at a ratio of 0.303:0.697. MSBP11 exhibited potent antioxidant and anti-glycation activities in a dose-dependent manner and can be used as a potential natural antioxidant and inhibitor of advanced glycosylation end products (AGEs). In addition, banana blossoms have been shown to decrease the levels of AGEs in chocolate brownies, which might possibly be developed as functional foods for diabetic patients. This study provides a scientific basis to further research the potential application of banana blossoms in functional foods.

Synergy of surface adsorption and intracellular accumulation for removal of uranium with Stenotrophomonas sp: Performance and mechanisms

Uranium is well-known to have serious adverse effects on the ecological environment and human health. Bioremediation stands out among many remediation methods owing to its being economically feasible and environmentally friendly. This study reported a great promising strategy for eliminating uranium by Stenotrophomonas sp. CICC 23833 in the aquatic environment. The bacterium demonstrated excellent uranium adsorption capacity (q_max = 392.9 mg/g) because of the synergistic effect of surface adsorption and intracellular accumulation. Further analysis revealed that hydroxyl, carboxyl, phosphate groups and proteins of microorganisms were essential in uranium adsorption. Intracellular accumulation was closely related to cellular activity, and the efficiency of uranium processing by the permeabilized bacterial cells was significantly improved. In response to uranium stress, the bacterium was found to release multiple ions in conjunction with uranium adsorption, which facilitates the maintenance of bacterial life activities and the conversion of uranyl to precipitates. These above results indicated that Stenotrophomonas sp. Had great potential application value for the remediation of uranium.

CD11c+ microglia promote white matter repair after ischemic stroke

Ischemic stroke leads to white matter damage and neurological deficits. However, the characteristics of white matter injury and repair after stroke are unclear. Additionally, the precise molecular communications between microglia and white matter repair during the stroke rehabilitation phase remain elusive. In this current study, MRI DTI scan and immunofluorescence staining were performed to trace white matter and microglia in the mouse transient middle cerebral artery occlusion (tMCAO) stroke model. We found that the most serious white matter damage was on Day 7 after the ischemic stroke, then it recovered gradually from Day 7 to Day 30. Parallel to white matter recovery, we observed that microglia centered around the damaged myelin sheath and swallowed myelin debris in the ischemic areas. Then, microglia of the ischemic hemisphere were sorted by flow cytometry for RNA sequencing and subpopulation analysis. We found that CD11c+ microglia increased from Day 7 to Day 30, demonstrating high phagocytotic capabilities, myelin-supportive genes, and lipid metabolism associated genes. CD11c+ microglia population was partly depleted by the stereotactic injecting of rAAV2/6M-taCasp3 (rAAV2/6M-CMV-DIO-taCasp3-TEVp) into CD11c-cre mice. Selective depletion of CD11c+ microglia disrupted white matter repair, oligodendrocyte maturation, and functional recovery after stroke by Rotarod test, Adhesive Removal test, and Morris Water Maze test. These findings suggest that spontaneous white matter repair occurs after ischemic stroke, while CD11c+ microglia play critical roles in this white matter restorative progress.

[Whole view of the immune microenvironment of biliary tract cancer]

Biliary tract cancer is a group of malignancies which originate from biliary epithelium, and adenocarcinoma is the main pathological type. Although surgical resection is the only radical treatment strategy, most biliary tract cancer patients are diagnosed at locally advanced stage or with distant metastasis. Biliary tract cancer is highly resistant to the conventional chemoradiotherapy and the emerging immunotherapy including immune checkpoint inhibitors, owing to the suppressive immune microenvironment. In a whole view, this paper discussed the anti-tumor and tumor-promoting immune responses of the various immune cells and stromal cells in the immune microenvironment of biliary tract cancer, as well as their correlation with prognosis. The understanding of the whole view of immune microenvironment in biliary tract cancer patients could further inform the design of clinical trials of immunotherapy or combination therapy.

Identification of novel characteristic biomarkers and immune infiltration profile for the anaplastic thyroid cancer via machine learning algorithms

PURPOSE

Anaplastic thyroid cancer (ATC) is a rare and lethal malignant cancer. In recent years, the application of molecular-driven targeted therapy and immunotherapy has markedly improved the prognosis of ATC. This study aimed to identify characteristic genes for ATC diagnosis and revealed the role of ATC characteristic genes in drug sensitivity and immune cell infiltration.

METHODS

We downloaded ATC RNA-sequencing data from the GEO database. Following the combination and normalization of the dataset, we first divided the combined datasets into the training cohort and the validation cohort. We identified differentially expressed genes (DEGs) in ATC by differential expression analysis in the training cohort. We used two machine learning algorithms, least absolute shrinkage and selection operator (LASSO) and support vector machine-recursive feature elimination (SVM-RFE) to identify ATC characteristic genes. The CIBERSORT algorithm was performed to calculate the abundance of various immune cells in ATC. Finally, we validated the expression of ATC characteristic genes by quantitative RT-PCR (RT-qPCR) in ATC cell lines and immunohistochemistry (IHC).

RESULTS

A total of 425 DEGs were identified in the training cohort, including 240 upregulated genes and 185 downregulated genes. Four ATC characteristic genes (ADM, PXDN, MMP1, and TFF3) were identified, and their diagnostic value was validated in the validation cohort (AUC in ROC analysis > 0.75). We established a practical gene expression-based nomogram to accurately predict the probability of ATC. We also found that ATC characteristic biomarkers are associated with the tumor immune microenvironment and drug sensitivity.

CONCLUSION

ADM, PXDN, MMP1, and TFF3 might serve as potential ATC diagnostic biomarkers and may be helpful for ATC molecular targeted therapy and immunotherapy.

Novel and recurrent genetic variants of VHL, SDHB, and RET genes in Chinese pheochromocytoma and paraganglioma patients

Background: Pheochromocytoma and paraganglioma (PPGL) are rare neuroendocrine tumors arising from chromaffin cells in the adrenal medulla and extra-adrenal ganglia, respectively. The study was aimed to investigate the clinical and genetic characteristics of 22 individuals from six families. Methods: The medical records of six PPGL probands who presented to our hospital between 2016 and 2021 were retrospectively studied. DNA isolated from the probands was analyzed using whole exome sequencing. The identified genetic variants were confirmed by Sanger sequencing and undergone bioinformatic analysis. Results: Six different genetic variants in the six probands were identified, respectively, of which three were novel. A novel von Hippel-Lindau (VHL) variant, c.602T>C (p.L201P), in exon 3 was found. Two novel genetic variants in SDHB (succinate dehydrogenases subunit B), c.423 + 1 G>T and c.662A>G (p.D221G), were identified. Two recurrent genetic variants of VHL, c.C284G (p.P95R) and c.558_560AGAdel (p.186Edel), and one in RET (ret proto-oncogene), c.1901G>A (p.C634Y), were also found. The ClinVar accession number for the present variants are SCV002028348, and SCV002028352 to SCV002028361. Conclusion: Genetic variants in VHL, SDHB and RET were identified in Chinese PPGL patients, which contributed to the knowledge of the genetic etiology and clinical outcome of these tumors.

Blocking CXC Motif Chemokine Ligand 2 Ameliorates Diabetic Peripheral Neuropathy via Inhibiting Apoptosis and NLRP3 Inflammasome Activation

Evidence suggests that CXC motif chemokines are involved in neuronal injury and inflammatory processes. Bioinformatics analysis by using data from the Gene Expression Omnibus (GEO) database was performed and identified CXC motif chemokine ligands (CXCLs) as associated with diabetic peripheral neuropathy (DPN). The present study focused on CXC motif chemokine ligand 2 (CXCL2), and the role and potential mechanisms of CXCL2 in DPN were investigated. The DPN rat model was generated by streptozotocin (STZ) injection in vivo, and high-glucose (HG)-stimulated Schwann cell RSC96 was considered a cell model of DPN in vitro. Neuropathic symptoms of DPN were explored by neurological tests and histological examinations. DPN rats showed a decreased level of motor nerve conduction velocity (MNCV) along with typical histological changes. CXCL2 expression was significantly increased in STZ-induced DPN rat sciatic nerve and HG-induced RSC96 cells. Functionally, CXCL2 knockdown inhibited cell apoptosis and inflammation activation under diabetic conditions in vitro and in vivo. CXCL2 knockdown increased cell viability in HG-treated RSC96 cells and reduced apoptosis concerning the decreased expression of cleaved Caspase 3/9. In addition, CXCL2 knockdown protected against NOD-like receptor protein 3 (NLRP3) inflammasome activation and reduced levels of pro-inflammatory cytokines, interleukin (IL)-1β and IL-18. The repressive effects of CXCL2 knockdown on inflammasome activation under HG conditions were significantly abolished by treatment of the NLRP3 activator nigericin. In conclusion, these results indicated that CXCL2 knockdown exhibited amelioration of hyperglycemia-induced DPN by inhibiting cell apoptosis and NLRP3 inflammasome activation, suggesting that targeting CXCL2 might be a potential strategy for DPN treatment.

Short- and long-term outcomes of laparoscopic versus open pelvic exenteration for locally advanced rectal cancer: a single-center propensity score matching analysis

BACKGROUND

Research on short-term outcomes and long-term oncological results of laparoscopic pelvic exenteration (LPE) for locally advanced rectal cancer (LARC) is still limited. The purpose of this study was to compare the outcomes of LPE and open pelvic exenteration (OPE).

METHODS

Between January 2010 and December 2019, consecutive LARC patients who underwent radical pelvic exenteration at Peking University First Hospital were enrolled. Groups were matched at a 1:1 ratio using propensity score matching. The primary endpoints were 3 year overall survival (OS) and disease-free survival (DFS). The secondary endpoints were postoperative short-term outcomes.

RESULTS

There were 144 patients (68 males and 76 females, median age 58.5 [range 27.0-86.0] years). After matching, patients were stratified into LPE (n = 48) and OPE (n = 48) groups (LPE: 24 males and 24 females, median age 57.0 [range 27.0-81.0] years; OPE: 26 males and 22 females, median age 58.0[range 36.0-80.0] years). There were no significant differences on baseline data between the two groups. Compared with the OPE group, the LPE group had a significantly lower estimated blood loss (200 vs 500 ml, p = 0.003), less overall postoperative complications (12/48 vs 25/48, p = 0.006), less surgical site infection (8/48 vs 20/48, p = 0.007), shorter length of stay (12 vs. 15 days, p = 0.005), but similar operative time (344 vs. 360 min, p = 0.493). The pathological R0 resection rate (98.0% vs. 93.7%, p = 0.610), 3 year local recurrence (18.4% vs. 23.5, p = 0.140), 3 year OS (74.6% vs. 65.5%, p = 0.290) and 3-year DFS (60.0% vs. 50.3%, p = 0.208) were similar between the two groups. Shorter distance from anal verge (HR = 0.92, p = 0.042), (y) pT4b (HR = 2.45, p = 0.023), (y)pN1-2 (HR = 2.42, p = 0.004) and positive CRM (HR = 6.23, p = 0.004) were independent prognostic risks for 3 year DFS.

CONCLUSIONS

LPE can be performed safely and has certain short-term advantages over OPE, most notably less blood loss and surgical site infection. However, LPE does not improve long-term oncological outcomes.

Noninvasive Assessment of Liver Fibrosis and Inflammation in Chronic Hepatitis B: A Dual-task Convolutional Neural Network (DtCNN) Model Based on Ultrasound Shear Wave Elastography

BACKGROUND AND AIMS

Liver stiffness (LS) measured by shear wave elastography (SWE) is often influenced by hepatic inflammation. The aim was to develop a dual-task convolutional neural network (DtCNN) model for the simultaneous staging of liver fibrosis and inflammation activity using 2D-SWE.

METHODS

A total of 532 patients with chronic hepatitis B (CHB) were included to develop and validate the DtCNN model. An additional 180 consecutive patients between December 2019 and April 2021 were prospectively included for further validation. All patients underwent 2D-SWE examination and serum biomarker assessment. A DtCNN model containing two pathways for the staging of fibrosis and inflammation was used to improve the classification of significant fibrosis (≥F2), advanced fibrosis (≥F3) as well as cirrhosis (F4).

RESULTS

Both fibrosis and inflammation affected LS measurements by 2D-SWE. The proposed DtCNN performed the best among all the classification models for fibrosis stage [significant fibrosis AUC=0.89 (95% CI: 0.87-0.92), advanced fibrosis AUC=0.87 (95% CI: 0.84-0.90), liver cirrhosis AUC=0.85 (95% CI: 0.81-0.89)]. The DtCNN-based prediction of inflammation activity achieved AUCs of 0.82 (95% CI: 0.78-0.86) for grade ≥A1, 0.88 (95% CI: 0.85-0.90) grade ≥A2 and 0.78 (95% CI: 0.75-0.81) for grade ≥A3, which were significantly higher than the AUCs of the single-task groups. Similar findings were observed in the prospective study.

CONCLUSIONS

The proposed DtCNN improved diagnostic performance compared with existing fibrosis staging models by including inflammation in the model, which supports its potential clinical application.

Extraction of Pectin from Passion Fruit Peel: Composition, Structural Characterization and Emulsion Stability

Extraction methods directly affect pectin extraction yield and physicochemical and structural characteristics. The effects of acid extraction (AE), ultrasonic-assisted acid extraction (UA), steam explosion pretreatment combined with acid extraction (SEA) and ultrasonic-assisted SEA (USEA) on the yield, structure, and properties of passion fruit pectin were studied. The pectin yield of UA was 6.5%, equivalent to that of AE at 60 min (5.3%), but the emulsion stability of UA pectin was poor. The pectin obtained by USEA improved emulsion stability. Compared with UA, it had higher protein content (0.62%), rhamnogalacturonan I (18.44%) and lower molecular weight (0.72 × 10⁵ Da). In addition, SEA and USEA had high pectin extraction yields (9.9% and 10.7%) and the pectin obtained from them had lower degrees of esterification (59.3% and 68.5%), but poor thermal stability. The results showed that ultrasonic-assisted steam explosion pretreatment combined with acid extraction is a high-efficiency and high-yield method. This method obtains pectin with good emulsifying stability from passion fruit peel.

Physicochemical, Structural, and Digestive Properties of Banana Starch Modified by Ultrasound and Resveratrol Treatments

Ultrasonic treatment combined with resveratrol modification was used to improve banana starch's solubility, thermal stability, and digestion resistance. The solubility and freeze-thaw stability of the modified starch complex significantly increased. The oil-absorption capacity increased by 20.52%, and the gelatinization temperatures increased from 64.10-73.92 °C to 70.77-75.83 °C. The storage modulus (G') and loss modulus (G″) increased after ultrasound and resveratrol treatment, and the proportion of viscosity was increased after composition with resveratrol. Additionally, the in vitro digestibility decreased from 44.12% to 40.25%. The modified complexes had release-control ability for resveratrol. X-ray diffraction (XRD) and Fourier transform infrared (FT-IR) spectroscopy demonstrated that complex structures became more compact and organized, whereas crystalline patterns were unchanged. Scanning electron microscopy (SEM) showed that the resveratrol modification caused physical change on the granular surface by creating pores and fissures. The findings can help develop antioxidant functional foods using banana starch.

Recent RhIG Administration Does Not Interfere with the Rosette Test

Introduction/Objective

Administration of Rh immune globulin (RhIG) is indicated mid-gestation (28 weeks) and after delivery to prevent Rh D sensitization in Rh D negative women. Women with sporadic prenatal care may not receive the first dose at 28 weeks, and may end up receiving their first dose closer to delivery. The rosette test (RT) is a rapid screen for fetomaternal hemorrhage (FMH) that uses an IgM anti-D antibody to detect fetal Rh D positive red blood cells (RBC) in maternal circulation. It is not currently known if or how recent administration of RhIG prior to performance of a RT may interfere with RBC agglutination and test results.

Methods/Case Report

To approximate mixing of fetal Rh D positive RBC with maternal Rh D negative RBC during FMH, 2% volume of Rh D positive RBC from fetal cord and adult donor samples were spiked into Rh D negative RBC. These mixtures were then incubated with a physiologic concentration of RhIG to occupy all Rh D antigen sites on the Rh D positive cells prior to performing the RT.

Results (if a Case Study enter NA)

Addition of Rh D positive RBC and RhIG to Rh D negative RBC did not affect rosette formation. Rh D negative cells had 0 rosettes/LPF. Rh D negative cells spiked with 2% Rh D positive adult donor and fetal cord RBC by volume produced an average of 9.8 rosettes/LPF (SD: 2.8) and 11.2 (SD: 3.3), respectively. Addition of a physiologic concentration of RhIG to the spiked Rh D positive adult donor and fetal cord RBC produced an average of 13.0 rosettes/LPF (SD: 2.5) and 11.2 rosettes/LPF (SD: 2.6), respectively.

Conclusion

Incubation of Rh D positive RBCs with physiologic concentration of RhIG does not affect the rosette test. Clinicians and laboratorians should be reassured that the rosette test continues to be an accurate way to quantitate FMH after recent RhIG administration.