Mechanistic insight into the impact of polystyrene microparticle on submerged plant during asexual propagules germination to seedling: Internalization in functional organs and alterations of physiological phenotypes

Asexual reproduction is one of the most important propagations in aquatic plants. However, there is a lack of information about the growth-limiting mechanisms induced by microplastics on the submerged plant during asexual propagule germination to seedling. Hence, we investigated the effects of two sizes (2 µm, 0.2 µm) and three concentrations (0.5 mg/L, 5 mg/L, and 50 mg/L) of polystyrene microplastics (PSMPs) on Potamogeton crispus turion germination and seedling growth. Both PSMPs sizes were found in P. crispus seedling tissues. Metabolic profile alterations were observed in leaves, particularly affecting secondary metabolic pathways and ATP-binding cassette transporters. Metal elements are indispensable cofactors for photosynthesis; however, alterations in the metabolic profile led to varying degrees of reduced concentrations in magnesium, iron, copper, and zinc within P. crispus. Therefore, the maximum quantum yield of photosystem II significantly decreased in all concentrations with 0.2 µm-PSMPs, and at 50 mg/L with 2 µm-PSMPs. These findings reveal that internalization of microplastics, nutrient absorption inhibition, and metabolic changes contribute to the negative impact on P. crispus seedlings.

Lateral lymph node metastasis in papillary thyroid cancer: Is there a difference between PTC and PTMC?

Papillary thyroid carcinoma (PTC) and papillary thyroid microcarcinoma (PTMC) are generally characterized as less invasive forms of thyroid cancer with favorable prognosis. However, once lateral cervical lymph node metastasis takes place, the prognosis may be significantly impacted. The purpose of this study was to evaluate whether there is a difference in the pattern of lateral lymph node metastasis between PTC and PTMC. A retrospective analysis was performed for PTC and PTMC patients that underwent central area dissection and unilateral lateral neck lymph node dissection (II-V area) between January 2020 and December 2021. Compared with PTMC group, the PTC group exhibited higher incidence of capsule invasion, extrathyroid invasion and lymphatic vessel invasion. Both the number and rate of central lymph nodes metastasis were elevated in the PTC group. While the number of lateral cervical lymph node metastasis was higher, the metastasis rate did not demonstrate significant difference. No significant differences were identified in the lymph node metastasis patterns between the 2 groups. The determination of the extent of lateral neck lymph node dissection solely based on the tumor size may be unreliable, as PTC and PTMC showed no difference in the number and pattern of lateral neck metastasis. Additional clinical data are warranted to reinforce this conclusion. For patients categorized as unilateral, bilateral, or contralateral cervical lymph node metastasis (including level I, II, III, IV, or V) or retropharyngeal lymph node metastasis who require unilateral lateral neck dissection, the size of the primary tumor may not need to be a central consideration when assessing and deciding the extent of lateral neck dissection.

Effects of no perforation margin trimming and EAC packing in cartilage underlay myringoplasty for chronic large perforations in children

OBJECTIVE

Trimming of perforation margins and external auditory canal (EAC) packing are basic procedures in underlay myringoplasty for repairing chronic perforations. The objective of this study was to compare the operation time, graft outcome, hearing improvement, and complications of endoscopic cartilage underlay myringoplasty with and without trimming of perforation margins and EAC packing in children.

STUDY DESIGN

Prospective, randomized study.

SETTING

Tertiary referral center.

MATERIAL AND METHODS

Pediatric patients older than 12 years with chronic perforations were randomly divided into two groups: myringoplasty with trimming of perforation margin and EAC packing (TPME) group or no trimming of perforation margin and EAC packing (NTPME) group. The operation time, graft success rate, hearing improvement, and complications were compared between the two groups.

RESULTS

Fifty-two patients were ultimately included in the study. The mean operation time was 31.4 ± 4.2 min in the TPME group and 23.6 ± 1.7 min in the NTPME group; the difference was significant (P < 0.01). The rate of aural fullness significantly differed between the TPME and NTPME groups (P = 0.000). All participants were followed up for 12 months; the graft success rate did not significantly differ between the groups (88.5% vs. 96.2%; P = 0.603). No patients developed adhesive otitis media. Between the preoperative and postoperative measurements, the mean air-bone gap improved by 10.2 ± 2.8 dB in the TPME group and 11.6 ± 0.7 dB in the NTPME group; this was significant (P < 0.001) in both groups.

CONCLUSIONS

Endoscopic cartilage underlay myringoplasty NTPME shorted the operation time and avoided aural fullness and EAC discomfort compared with the TPME technique; however, graft success and hearing improvement were comparable between the two techniques for repairing large perforations in children.

Comparison of two endoscopic perichondrium-cartilage graft underlay myringoplasty for large perforations: a randomized controlled trial

OBJECTIVE

The objective of this study was to compare the graft outcomes and complications of two endoscopic perichondrium-cartilage graft techniques for repairing large perforations.

STUDY DESIGN

Single center blinded randomized controlled trial.

MATERIALS AND METHODS

61 large perforations more than 50% of TM area were prospectively randomized to undergo the free perichondrium and free cartilage graft group (FPFC, n = 31) or perichondrium partial attachment the cartilage graft group (PPAC, n = 30). The primary outcome measures were the operation time; secondary outcome measures were the graft success rate and hearing gain at 12 months postoperatively and postoperative complications.

RESULTS

All patients completed follow-up of 12 months. The mean operation time was 38.2 ± 2.3 min in the FPFC group and 37.4 ± 5.6 min in the PPAC group (P = 0.658). At postoperative 3 months, the graft success rates were 96.7% in the FPFC group and 93.3% in the PPAC group (P = 0.976). At postoperative 12 months, the graft success rates were 96.7% in the FPFC group and 83.3% in the PPAC group (P = 0.182). However, the residual and re-perforation rate with no infection was 0.0% (0/31) in the FPFC group and 16.7% (5/30) in the PPAC group (P = 0.056). No significant between-group differences were observed pre- (P = 0.842) or post- (P = 0.759) operative air bone gap (ABG) values or mean ABG gain (P = 0.886). However, granular myringitis has been noted in 6.5% in the FPFC group and in 3.3% in the PPAC group.

CONCLUSIONS

This study suggested that 12-month graft success and hearing gain were comparable between the perichondrium free and partial attachment the cartilage graft techniques, nevertheless, partial attachment technique could increase residual and re-perforations.

Quantitative comparison of three thyroidectomy approaches in neck muscles, voice, and swallowing functions

OBJECTIVE

This study compares endoscopic thyroidectomy by gasless unilateral axillary approach (ETGUA) and sternocleidomastoid leading-edge approach (SLEA) with conventional open thyroidectomy (COT) in hemithyroidectomy. The main focus is on the protection of neck muscles (sternocleidomastoid, omohyoid, sternothyroid) and the postoperative function of voice and swallowing yielded through these common approaches.

METHODS

A total of 302 patients who underwent hemithyroidectomy were enrolled and divided into three groups: ETGUA (n = 101), SLEA (n = 100), and COT (n = 101). Ultrasound was used to measure the thickness of bilateral neck muscles, including the sternocleidomastoid, omohyoid, and sternothyroid. The changes in thickness on the surgical side compared to the non-surgical side. Analyzed factors included muscle thickness changes, Swallowing Impairment Score (SIS), Voice Handicap Index (VHI), Scar Cosmesis Assessment and Rating (SCAR), Neck Injury Index (NII), surgery duration, drainage volume, hospitalization, and number of lymph nodes.

RESULTS

The clinical characteristics among the three groups were consistent except for differences in sex, age, and BMI. Metrics such as sternocleidomastoid muscle, NII, hypocalcemia, postoperative PTH, transient hoarseness, and number of lymph nodes showed no significant differences among the three groups. However, significant differences were found in the duration of surgery, drainage volume, hospitalization period omohyoid muscle, Sternohyoid muscle, VHI, SIS, and SCAR (all p < 0.001).

CONCLUSION

In comparison to COT, ETGUA and SLEA demonstrate superiority in protecting neck muscles and preserving voice and swallowing function without compromising surgical safety or radicality.

Intravenous Alteplase Versus Best Medical Therapy for Patients With Minor Stroke: A Systematic Review and Meta-Analysis

BACKGROUND

The efficacy of thrombolysis (IVT) in minor stroke (National Institutes of Health Stroke Scale score, 0-5) remains inconclusive. The aim of this study is to compare the effectiveness and safety of IVT with best medical therapy (BMT) by means of a systematic review and meta-analysis of randomized controlled trials and observational studies.

METHODS

We searched the PubMed, Embase, Cochrane Library, and Web of Science databases to obtain articles related to IVT in minor stroke from inception until August 10, 2023. The primary outcome was an excellent functional outcome, defined as a modified Rankin Scale score of 0 or 1 at 90 days. The associations were calculated for the overall and preformulated subgroups by using the odds ratios (ORs). This study was registered with PROSPERO (CRD42023445856).

RESULTS

A total of 20 high-quality studies, comprised of 13 397 patients with acute minor ischemic stroke, were included. There were no significant differences observed in the modified Rankin Scale scores of 0 to 1 (OR, 1.10 [95% CI, 0.89-1.37]) and 0 to 2 (OR, 1.16 [95% CI, 0.95-1.43]), mortality rates (OR, 0.67 [95% CI, 0.39-1.15]), recurrent stroke (OR, 0.89 [95% CI, 0.57-1.38]), and recurrent ischemic stroke (OR, 1.09 [95% CI, 0.68-1.73]) between the IVT and BMT group. There were differences between the IVT group and the BMT group in terms of early neurological deterioration (OR, 1.81 [95% CI, 1.17-2.80]), symptomatic intracranial hemorrhage (OR, 7.48 [95% CI, 3.55-15.76]), and hemorrhagic transformation (OR, 4.73 [95% CI, 2.40-9.34]). Comparison of modified Rankin Scale score of 0 to 1 remained unchanged in subgroup patients with nondisabling deficits or compared with those using antiplatelets.

CONCLUSIONS

These findings indicate that IVT does not yield significant improvement in the functional prognosis of patients with acute minor ischemic stroke. Additionally, it is associated with an increased risk of symptomatic intracranial hemorrhage when compared with the BMT. Moreover, IVT may not have superiority over BMT in patients with nondisabling deficits or those using antiplatelets.

Predation risk-mediated indirect effects promote submerged plant growth: Implications for lake restoration

Biological manipulation, involving fish stockings, is commonly used to counteract the deterioration of submerged vegetation in eutrophic lakes. Nevertheless, the non-consumptive effects (NCEs) of stocked carnivorous fish are often overlooked. Using a controlled experimental system, we investigated the NCEs of a native carnivorous fish, snakehead (Channa argus), on two key biological factors, herbivore-dominated grass carp (Ctenopharyngodon idella) and disturbance-dominated loach (Misgurnus anguillicaudatus), influencing submerged plants growth. Additionally, we conducted a meta-analysis on predation risk and primary productivity. The results reveal that predation risk induces oxidative stress damage and affects grass carp growth. Non-significant changes in cortisol and glucose may be linked to predation risk prediction. Simultaneously, predation risk reduces fish feeding and disturbance behavior, relieving pressure on submerged plants to be grazed and disturbed, thereby supporting plant development. The presence of submerged plants, in turn, enhances loach activity and influences water body characteristics through negative feedback. Furthermore, the meta-analysis results indicate the facilitative effect of predation risk on primary producers. Our findings contribute to the understanding of biological manipulation theory. We demonstrate that the predation risk associated with introducing carnivorous fish can promote the growth of submerged plants through behaviorally mediated indirect effects. This highlights the potential utility of predation risk in lake restoration efforts.

Species-specific functional trait responses of canopy-forming and rosette-forming macrophytes to nitrogen loading: Implications for water-sediment interactions

Globally intensified lake eutrophication, attributed to excessive anthropogenic nitrogen loading, emerges as a significant driver of submerged vegetation degradation. Consequently, the impact of nitrogen on the decline of submerged macrophytes has received increasing attention. However, a functional trait-based approach to exploring the response of submerged macrophytes to nitrogen loading and its environmental feedback mechanism was unclear. Our study utilized two different growth forms of submerged macrophytes (canopy-forming Myriophyllum spicatum, and rosette-forming Vallisneria natans) to established "submerged macrophytes-water-sediment" microcosms. We assessed the influence of nitrogen loading, across four targeted total nitrogen concentrations (original control, 2, 5, 10 mg/L), on plant traits, water parameters, sediment properties, enzyme activities, and microbial characteristics. Our findings revealed that high nitrogen (10 mg/L) adversely impacted the relative growth rate of fresh biomass and total chlorophyll content in canopy-forming M. spicatum, while the chlorophyll a/b and free amino acid content increased. On the contrary, the growth and photosynthetic traits of resource-conservative V. natans were not affected by nitrogen loading. Functional traits (growth, photosynthetic, and stoichiometric) of M. spicatum but not V. natans exhibited significant correlations with environmental variables. Nitrogen loading significantly increased the concentration of nitrogen components in overlying water and pore water. The presence of submerged macrophytes significantly reduced the ammonia nitrogen and total nitrogen both in overlying water and pore water, and decreased total organic carbon in pore water. Nitrogen loading significantly inhibited sediment extracellular enzyme activities, but the planting of submerged macrophytes mitigated their negative effects. Furthermore, rhizosphere bacterial interactions were less compact compared to bare control, while eukaryotic communities exhibited increased complexity and connectivity. Path modeling indicated that submerged macrophytes mitigated the direct effects of nitrogen loading on overlying water and amplified the indirect effects on pore water, while also attenuating the direct negative effects of pore water on extracellular enzymes. The findings indicated that the restoration of submerged vegetation can mitigate eutrophication resulting from increased nitrogen loading through species-specific changes in functional traits and direct or indirect feedback mechanisms in the water-sediment system.

Outcomes of perichondrium graft covering the epithelium of the tympanic membrane for large-sized perforations: A 3-5-year follow-up study

OBJECTIVE

The objective of this study was to evaluate the graft outcomes and iatrogenic cholesteatomas for 3 years following cartilage-perichondrium over-underlay technique with perichondrial graft covering the epithelium for large-sized tympanic membrane (TM) perforations.

MATERIALS AND METHODS

This prospective case series enrolled patients with large-sized perforation who underwent endoscopic cartilage-perichondrium over-underlay technique. The graft success rate, hearing outcomes, and development of iatrogenic middle ear cholesteatomas and graft cholesteatomas were assessed at 3 years postoperatively.

RESULTS

This study included 62 ears of 62 patients. The mean follow-up duration was 47.3 ± 10.8 (38-64) months. Neovascularization was observed in the lateral perichondrium graft in 55 (88.7 %) patients, which inosculated into the TM remnant at 4-5 weeks. However, graft neovascularization was not observed in the four patients with excessive perichondrium graft that migrated into the external auditory canal and the three patients with middle ear infections. The graft failure rate was 6.5 % at 6 months, 11.3 % at 12 months, 6.5 % at 24 months, and the overall graft success rate was 91.8 % at the last follow-up. Granular myringitis developed in 11.3 % (7/62) of the patients. High-resolution computed tomography revealed well-pneumatized mastoids and middle ear at the final follow-up. However, graft cholesteatomas were observed in 3 (4.8 %) patients at 7-24 months postoperatively.

CONCLUSIONS

The cartilage-perichondrium over-underlay technique with perichondrial graft covering TM epithelium is safe and effective for the repair of large perforations, with good short- and long-term graft outcomes, minimal risk of graft cholesteatoma development, and no risk of iatrogenic middle ear cholesteatomas.

Additional cartilage reinforcement of the annulus in myringoplasty for subtotal perforation

OBJECTIVE

In this study, graft success, hearing outcome, and complications were compared following the repair of subtotal perforation using a cartilage reinforcement underlay technique (CRUT) versus the traditional cartilage underlay technique (TCUT).

STUDY DESIGN

Randomized controlled trial.

MATERIALS AND METHODS

Seventy-six patients with subtotal perforations were prospectively randomized to the CRUT (n = 38) or TCUT (n = 38) group. The graft success rate, hearing outcome, and complications were compared at 12 months.

RESULTS

The mean operation time was 32.9 ± 4.2 (range: 26-47) min in the CRUT group and 51.8 ± 6.3 (range: 48-73) min in the TCUT group (P < 0.001). At 12 months postoperatively, no residual perforation was seen in either group. The graft success rate was 94.7 % (36/38) in the CRUT group and 92.1 % (35/38) in the TCUT group; the difference was not significant (P = 0.643). The postoperative air bone gap (ABG) was significantly improved compared to the preoperative value in both groups, without significant between-group differences in either the preoperative (P = 0.741) or postoperative (P = 0.865) ABG or the mean ABG gain (P = 0.812). Additionally, there were no significant between-group differences in the preoperative (P = 0.887) or postoperative (P = 0.753) mean bone-conduction pure tone average. In the TCUT group, seven (18.4 %) patients developed temporary hypogeusia and two (5.3 %) had external auditory canal scarring. Graft cholesteatoma was not observed in either group.

CONCLUSION

In the treatment of subtotal perforations, lateral reinforcement of the annulus with additional cartilage is simpler than traditional cartilage underlay for achieving graft and hearing success. The technique also does not involve raising the tympanomeatal flap or removing perforation margins.

Similarities and differences in the physiological adaptation to water salinity between two life forms of aquatic plants in alpine and arid wetlands

Aquatic plants play a crucial role in freshwater ecosystems as primary producers, but their survival is threatened by salinization. Understanding the physiological responses of aquatic plants to increasing water salinity is important for predicting their adaptive strategies under future climate change scenarios. In this study, we measured 15 physiological traits of 49 aquatic plant species along a large environmental gradient in alpine and arid regions of western China to explore their physiological adaptations and compare the similarities and differences in adaptive strategies between emergent and submerged life forms. We found that water salinity and low temperature were key factors affecting aquatic plants in these regions. Aquatic plants adapted to saline habitats by accumulating proline and sulfur (S) concentrations, and to cold habitats by increasing ascorbate peroxidase activity. Plant trait network analysis revealed that S was the hub trait in emergent plants, while proline was the hub trait in submerged plants, indicating that emergent plants balanced osmoregulation and reactive oxygen metabolism through S-containing compounds, while submerged plants prioritized the regulation of osmotic balance through proline.

Chest imaging classification in Mycoplasma pneumoniae pneumonia is associated with its clinical features and outcomes

BACKGROUND

The imaging findings of Mycoplasma pneumoniae pneumonia (MPP) vary; however, few studies have focused on the relationship of imaging classification with clinical manifestations and outcomes.

OBJECTIVE

To prospectively investigate whether chest imaging classification in Mycoplasma pneumoniae pneumonia (MPP) is associated with its clinical features and outcomes.

METHODS

A total of 1,401 hospitalized children with MPP were enrolled from January 2019 to December 2021. Imaging findings were categorized as bronchopneumonia and consolidation/atelectasis according to X-ray, and bronchopneumonia, consolidation/atelectasis, bronchiolitis, and mosaic pattern according to computed tomography (CT). Clinical characteristics and outcomes of patients with different imaging classifications were prospectively analyzed based on electronic medical records.

RESULTS

Bronchopneumonia was the most common finding (59.6%), while consolidation/atelectasis was the most severe group. Clinical manifestations and laboratory indicators for the consolidation/atelectasis group included serious abnormalities. Further, outcomes of the patients were worse, including having longer total durations of fever and hospitalization, greater hospitalization expenses, and a higher likelihood of developing refractory MPP, necrotizing pneumonia, and bronchiolitis obliterans (BO) in this group. The incidence of bronchiolitis, a disease characterized by a high prevalence of fever, moist rales, and an atopic constitution, tended to increase after the coronavirus disease pandemic and predisposed patients to BO. A mosaic pattern occurred in allergic and young individuals, with wheezing as the main manifestation, with patients having relatively mild symptoms and good outcomes.

CONCLUSION

Different imaging classifications have different clinical features and clinical outcomes; thus, formulating an imaging-based classification system is of great clinical value.

Comparison of temporalis fascia and cartilage graft over-under myringoplasty for repairing large perforations

OBJECTIVE

The objective of this study was to compare the operation time, graft success, audiometric outcomes and complications of over-under technique using a temporalis fascia (TMF) and cartilage grafts for the repair of large perforations.

STUDY DESIGN

Randomized controlled trial.

MATERIALS AND METHODS

80 large perforations >2 quadrants of eardrum were prospectively randomized to undergo TMF over-under technique group (TFON, n = 40) or cartilage-perichondrium over-under technique group (CPON, n = 40). The graft success rate, audiometric outcomes, and complications were compared among two groups at 12 months.

RESULTS

The mean operation time was 56.8 ± 4.2 (range:52-71) min in the TFON group and 37.9 ± 2.8 (range: 31-47) min in the CPON group (P < 0.001). The lost follow-up rate was 3 (7.5 %) patients in the TFON group and 2 (5.0 %) patient in the CPON group (P = 0.644). Finally, 37 patients in the TFON group and 38 patients in the CPON group were included in this study. The graft infection rate was 2 (5.4 %) patients in the TFON group and 2 (5.3 %) patient in the CPON group (P = 0.626), all the graft infection resulted in the residual perforation. The remaining residual perforation was 2 (5.4 %) patients in the TFON group and 1 (2.6 %) patient in the CPON group; the re-perforation was 3 (8.1 %) patients in the TFON group and 0 (0.0 %) patient in the CPON group. The graft success rate was 81.1 % (30/37) patients in the TFON group and 92.1 % (35/38) patient in the CPON group. The mean preoperative and 12-month postoperative ABGs were significantly different in any group (P < 0.01). However, there were no significant difference among two groups regardless of pre-or post-ABGs or ABG closure. No lateralization of the graft or blunting was noted in any group. Four (10.8 %)patients developed atelectasis and one (2.7 %) developed the EAC scarring in the TFON group. Graft cholesteatomas was found in 2 (5.4 %) patients in the TFON group and in 5 (13.2 %) patients in the CPON group (P = 0.449). Three (8.1 %) patients had temporary hypogeusia in the TFON group.

CONCLUSION

Although temporalis fascia graft over-under technique obtained similar graft success rates and hearing outcomes for large chronic perforations to the cartilage-perichondrium over-under technique, temporalis fascia graft technique prolonged the operation time and increased the re-perforation and graft atelectasis. Nevertheless, the graft cholesteatomas were comparable among two techniques.

Role of topical antibiotic ointment in the lateral graft following underlay myringoplasty: a prospective randomised study

OBJECTIVE

The objective of this study was to compare the graft outcome and postoperative infection of with and without the use of antibiotic ointment following myringoplasty for the treatment of chronic perforations.

STUDY DESIGN

Randomized controlled trial.

MATERIAL AND METHODS

135 chronic perforations were prospectively randomized to use of antibiotic ointment group (UAO, n = 68) or no use of antibiotic ointment group (NAO, n = 67) following myringoplasty. The graft outcomes and postoperative infection were compared among two groups at 6 months.

RESULTS

At postoperative 6 months, the graft infection rate was 4.4% in the UAO group and 10.4% in the NAO group, the difference was not significant (P = 0.312).The graft success rates were 92.6% in the UAO group and 91.0% in the NAO group, the difference was not significant (P = 0.979). In the UAO group, 3 patients with purulence ear discharge resulted in a residual perforation although they received ofloxacin ear drops and intravenous antibiotic therapy treatment. In the NAO group, 6 patients with purulence ear discharge resulted in a residual perforation, only one, with mild purulence discharge was successfully treated and closed. In addition, no significant between-group differences were observed pre- (P = 0.746) or post- (P = 0.521) operative air bone gap (ABG) values or mean ABG gain (P = 0.745). However, granular myringitis with minimal moistness but without infection has been noted in 3 (4.4%) patients in the UAO group and in 5 (7.5%) in the NAO group, the difference was not significant (P = 0.699).

CONCLUSIONS

Use and non-use of antibiotic ointments for lateral packing of graft are both comparable methods following myringoplasty for postoperative infection and graft outcomes.

Shifting enzyme activity and microbial composition in sediment coregulate the structure of an aquatic plant community under polyethylene microplastic exposure

It has been shown that microplastics (MPs) interfere with critical biological processes (including development, growth and fitness); however, there is no information about the impact of MPs on plant productivity and community structure in freshwater ecosystems. Here, we investigated the effects of two sizes (MIC: 20-300 μm, MAC: 2-3 mm) and three concentrations (0.03 %, 0.3 %, and 0.6 %) of low-density polyethylene MPs on submerged plant communities. The results showed that plant responses to MPs were species specific, which can affect plant community structure. For canopy-forming species (Hydrilla verticillata), total biomass increased by 4 %-46 % and relative abundance increased by 23 %-34 % under MP exposure, while rosette-forming species (Vallisneria natans) decreased by 44 %-67 % in total biomass and relative abundance decreased by 54 %-71 %. Myriophyllum spicatum growth was largely unaffected by MPs. Community diversity was negatively correlated with MAC treatments, and the community root to shoot ratio decreased by 40 %, while community productivity increased by 41 % at a 0.6 % MAC concentration. Although MPs did not change the microbial community composition, alpha diversity was reduced at the 0.6 % concentration. It is worth noting that 0.6 % is a higher concentration than most field sediment investigations. During the experiment, the activity of functional enzymes related to carbon and nitrogen increased under most MP treatments. Structural equation modelling showed that MIC changed the community structure mainly by driving sediment enzyme activity, while MAC changed the community structure mainly by driving plant growth. The results implied that MPs may affect sediment enzymatic activities, microbial alpha diversity and aquatic plant growth, potentially altering the diversity and stability of aquatic ecosystems.

Association of serum uric acid with all-cause and cardiovascular mortality in obstructive sleep apnea

The study investigated the association between Serum Uric Acid (SUA) levels and all-cause as well as cardiovascular mortality in patients with Obstructive Sleep Apnea (OSA). This prospective cohort study enrolled participants with OSA from four cycles of the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2008, and 2015-2018. A weighted Cox proportional hazards model was used to assess adjusted hazard ratios (aHRs) and their corresponding 95% confidence intervals (CI) for all-cause and cardiovascular mortality. Additionally, multivariable logistic regression and restricted cubic splines (RCS) models were employed to examine nonlinear relationships between SUA and all-cause and cardiovascular mortality. Among the 5,584 OSA participants included in the study, covering the four NHANES cycles and with a median follow-up of 4.333 years, a total of 537 deaths were observed, including 108 deaths attributed to cardiovascular disease. Comparing the fourth quartile (Q4) of uric acid levels, both the fifth quartile (Q5) (aHRs = 1.51, 95% CI [1.08, 2.12]) and the second quartile (Q2) (aHRs = 1.53, 95% CI [1.04, 2.25]) of uric acid levels were independently associated with an increased risk of all-cause mortality. Furthermore, comparing the fourth quartile (Q4) of uric acid levels, the second quartile (Q2) (aHRs = 2.40, 95% CI [1.08, 5.35]) of uric acid levels were independently associated with an increased risk of cardiovascular mortality. The RCS model demonstrated a U-shaped pattern in the association between SUA and all-cause mortality in OSA, with an inflection point observed at 5.83 mg/dl. The findings of this study suggest a U-shaped association between serum SUA levels and all-cause mortality and nonlinearity association between serum SUA levels and all-cause mortality. Further studies are warranted to determine the causal relationship between SUA levels and all-cause and cardiovascular mortality.

Mechanical Thrombectomy in Anticoagulated Patients With Acute Ischemic Stroke: A Meta-Analysis

BACKGROUND

According to a previous studies, mechanical thrombectomy(MT) is safe for anticoagulated patients. However, the safety and prognosis of direct oral anticoagulants (DOACs) and vitamin K antagonists (VKA) have not been compared with those of MT.This meta-analysis aimed at determining the efficacy of DOACs or VKA for patients after MT.

REVIEW SUMMARY

We searched PubMed, Embase, Web of Science databases, and Cochrane from their inception to Aug 2022. Revman 5.3 served for the meta-analysis. The meta-analysis included 12 studies that covered 3571 patients, finding that after MT treatment, DOACs significantly decreased the symptomatic intracerebral hemorrhage [odd ratio (OR)=0.49, 95% CI 0.30-0.80, P=0.004] and mortality (OR=0.63, 95% CI 0.48-0.83, P=0.001) compared with VKA. Meanwhile, no obvious differences were found between DOACs and VKA after MT treatment in terms of in any hemorrhagic transformation (OR=1.07, 95% CI 0.84-1.37, P=0.59), good functional outcome (OR=1.06, 95% CI 0.88-1.27, P=0.53), and successful arterial recanalization (OR=1.24, 95% CI 1.00-1.53, P=0.05).

CONCLUSIONS

This meta-analysis demonstrates that the application of DOACs in MT treatment for anticoagulated patients with acute ischemic stroke is safer than that in the VKA group. However, further studies are necessary to confirm these results.

Comparison of perichondrium-cartilage double and single underlay myringoplasty for subtotal perforations: a randomized controlled trial

OBJECTIVE

The objective of this study was to compare graft outcome, operation time and surgical complications of the double and single perichondrium-cartilage underlay techniques for repairing subtotal tympanic membrane (TM) perforations.

MATERIALS AND METHODS

Patients with unilateral subtotal perforations undergoing myringoplasty were prospectively randomized to undergo DPCN or SPCN. The operation time, graft success rate, audiometric outcomes, and complications were compared between these groups.

RESULTS

In total, 53 patients with unilateral subtotal perforations were included (DPCN group, 27; SPCN group, 26).All patients completed 6 months of follow-up. The mean operation time was 41.2 ± 1.8 min in the DPCN group and 37.2 ± 5.4 min in the SPCN group, the difference was not significant (p = 0.613).The graft success rates were 96.3% (26/27) in the DPCN group and 73.1% (19/26) in the SPCN group, the difference was significant (p = 0.048). During the period of follow-up, residual perforation was found at postoperative in one (3.7%) in the DPCN group, while cartilage graft slipped (graft lateralization) in 2 (7.7%) and residual perforation in 5 (19.2%) were found in the SPCN group, the difference of residual perforation was not significant among two group (p = 0.177).In addition, no significant between-group differences were observed pre- (p = 0.741) or post- (p = 0.687) operative ABG values or mean ABG gain (p = 0.659) (Table 2).The functional success rates (postoperative ABG ≤ 20 dB) were 85.2% (23/27) in the DPCN group and 73.1% (19/26) in the SPCN group (p = 0.454).

CONCLUSION

Although similar functional result and operation time can be obtained with double perichondrium-cartilage underlay technique compared to the single perichondrium-cartilage underlay technique for endoscopic closure of subtotal perforations, double unerlay technique offers better anatomical result with minimum complications.

Level II lateral neck dissection for papillary thyroid carcinoma: A retrospective cohort study

BACKGROUND

For N1b papillary thyroid carcinoma (PTC) patients, lateral neck dissection encompassing levels Ⅱ-Ⅴ is generally recommended. However, routine level Ⅱ dissection is controversial given the low incidence of metastasis, and potential complications such as increased shoulder syndrome.

METHODS

Retrospective analysis of consecutive patients with papillary thyroid carcinoma who underwent lateral neck dissection at a single institution from January 2019 to April 2021 was performed. Clinicopathological features such as age, gender, tumor location, tumor size, TgAb and TPOAb levels, capsular invasion, multifocality and lymph node metastases were examined to evaluate the occurrence of metastatic Level Ⅱ lymph nodes.

RESULTS

Overall and occult level Ⅱ metastases were observed in 51.83% and 34.84% of cN1b PTC patients. Multivariant analysis showed that primary tumor, location of primary tumor and positive level Ⅴ can serve as independent risk factors of metastasis in level Ⅱ. For cN1b PTC patients not suspected of level Ⅱ lymph nodes preoperatively, independent risk factors for predicting occult level Ⅱ metastases may include the location of primary tumor, positive level Ⅲ and positive level Ⅴ.

CONCLUSION

A significant number of patients with PTC and lateral neck disease experienced Level Ⅱ metastasis, with the location of primary tumor and multilevel lymph node involvement being the independent risk factors. If the tumor is less than 1 cm and located at lower 2/3 lobe, there is minimal possibility of level Ⅱ lymph node metastasis.

Comparison of Endoscopic Modified and Typical Myringoplasty: A Randomized Controlled Trial

OBJECTIVE

Here, we aimed to compare the operation time, postoperative pain score, graft healing, graft success rate, cholesteatoma incidence, audiometric outcomes, and complications between endoscopic modified myringoplasty (EMM) and endoscopic typical myringoplasty (ETM).

METHODS

Patients with unilateral chronic tympanic membrane (TM) perforations undergoing myringoplasty were prospectively randomized to undergo EMM (n = 44) or ETM (n = 45). The operation time, postoperative pain score, graft healing, graft success rate, cholesteatoma incidence, audiometric outcomes, and complications were compared between these groups.

RESULTS

In total, 89 patients with unilateral chronic perforations were included (EMM group, 44; ETM group, 45). There were significant differences between the EMM and ETM groups in mean pain scores on the day after surgery (1.32 ± 0.56 vs. 2.58 ± 1.16, p < 0.001) and in the mean operation time (18.18 ± 2.43 vs. 51.53 ± 8.28 min, p < 0.001). There were no significant differences in graft success rates (93.18% vs. 88.89%, p = 0.735), pre- or postoperative air conduction pure-tone averages or air bone gaps (ABGs), or changes in ABGs between the groups. However, the difference in graft healing was significant at postoperative week 2 (33/44 vs. 24/45, p = 0.033) but was nonsignificant at postoperative week 4 and month 6. Computed tomography revealed the middle ear and mastoid to be well pneumatized at 12 months in all patients.

CONCLUSION

While 12-month graft and audiometric outcomes were comparable between EMM and ETM techniques, patients who underwent EMM had less postoperative pain, shorter operative times, faster healing, and a lower incidence of complications.

LEVEL OF EVIDENCE

1 Laryngoscope, 133:2779-2785, 2023.

A comparison of radiofrequency Coblation and cold steel excision in the treatment of idiopathic vocal process granulomas

OBJECTIVE

To compare the effectiveness of radiofrequency Coblation assisted excision and cold steel excision in the treatment of idiopathic vocal process granulomas.

METHODS

A retrospective study was performed of patients with idiopathic vocal process granulomas who underwent radiofrequency Coblation excision or cold steel excision between January 2013 and January 2020. The recurrence rate was compared among the two groups at six months post-operatively.

RESULTS

Of the 47 patients with vocal process granulomas, 28 were in the cold steel excision (control) group and 19 were in the Coblation-assisted group. The recurrence rate in the control group was significantly higher than that in the Coblation-assisted group (60.7 per cent vs 5.3 per cent; p < 0.001). In addition, the voice recovery of the Coblation-assisted group was significantly better than that of the control group; vocal quality recovered one month after surgery in the Coblation-assisted group.

CONCLUSION

Radiofrequency Coblation should be considered the optimal method when approaching idiopathic vocal process granulomas surgically.

Automated diagnosis and management of follicular thyroid nodules based on the devised small-dataset interpretable foreground optimization network deep learning: a multicenter diagnostic study

BACKGROUND

Currently, follicular thyroid carcinoma (FTC) has a relatively low incidence with a lack of effective preoperative diagnostic means. To reduce the need for invasive diagnostic procedures and to address information deficiencies inherent in a small dataset, we utilized interpretable foreground optimization network deep learning to develop a reliable preoperative FTC detection system.

METHODS

In this study, a deep learning model (FThyNet) was established using preoperative ultrasound images. Data on patients in the training and internal validation cohort ( n =432) were obtained from Ruijin Hospital, China. Data on patients in the external validation cohort ( n =71) were obtained from four other clinical centers. We evaluated the predictive performance of FThyNet and its ability to generalize across multiple external centers and compared the results yielded with assessments from physicians directly predicting FTC outcomes. In addition, the influence of texture information around the nodule edge on the prediction results was evaluated.

RESULTS

FThyNet had a consistently high accuracy in predicting FTC with an area under the receiver operating characteristic curve (AUC) of 89.0% [95% CI 87.0-90.9]. Particularly, the AUC for grossly invasive FTC reached 90.3%, which was significantly higher than that of the radiologists (56.1% [95% CI 51.8-60.3]). The parametric visualization study found that those nodules with blurred edges and relatively distorted surrounding textures were more likely to have FTC. Furthermore, edge texture information played an important role in FTC prediction with an AUC of 68.3% [95% CI 61.5-75.5], and highly invasive malignancies had the highest texture complexity.

CONCLUSION

FThyNet could effectively predict FTC, provide explanations consistent with pathological knowledge, and improve clinical understanding of the disease.

Autophagic blockade potentiates anlotinib-mediated ferroptosis in anaplastic thyroid cancer

Anlotinib-mediated angiogenic remodeling was delineated in various tumors. Meanwhile, we previously showed that anlotinib inhibited tumor angiogenesis in anaplastic thyroid cancer (ATC). However, the potential role of anlotinib on cell lethality in ATC remains an enigma. Herein, we found that anlotinib inhibited the viability, proliferation, and migration of KHM-5M, C643, and 8505C cells in a dose-dependently manner. Under anlotinib treatment, PANoptosis (pyroptosis, apoptosis, and necroptosis) markers were not changed; however, ferroptosis targets (transferrin, HO-1, FTH1, FTL, and GPX4) were significantly downregulated. ROS levels also increased in a concentration-dependent manner after anlotinib treatment in KHM-5M, C643, and 8505C cells. In addition, protective autophagy was activated in response to anlotinib, and autophagic blockade potentiated anlotinib-mediated ferroptosis and antitumor effects in vitro and in vivo. Our new discovery identified autophagy-ferroptosis signaling pathway which provides mechanistic insight into anlotinib-mediated cell death, and synergistic combination therapy may help develop new ATC treatment strategies.

Shape Transformation via Etching and Regrowth: A Systematic Study of Pd Nanocrystals with Different Shapes and Twin Structures

This article describes a systematic study of the oxidative etching and regrowth behaviors of Pd nanocrystals, including single-crystal cubes bounded by {100} facets, single-crystal octahedra and tetrahedra enclosed by {111} facets; and multiple-twinned icosahedra covered by {111} facets and twin boundaries. During etching, Pd atoms are preferentially oxidized and removed from the corners regardless of the type of nanocrystal, and the resultant Pd2+ ions are then reduced back to elemental Pd. For cubes and icosahedra, the newly formed Pd atoms are deposited on the {100} facets and twin boundaries, respectively, due to their relatively higher energies. For octahedra and tetrahedra, the Pd atoms self-nucleate in the solution phase, followed by their growth into small particles. We can control the regrowth rate relative to etching rate by varying the concentration of HCl in the reaction solution. As the concentration of HCl is increased, 18-nm Pd cubes are transformed into octahedra of 23, 18, and 13 nm, respectively, in edge length. Due to the absence of regrowth, however, Pd octahedra are transformed into truncated octahedra, cuboctahedra, and spheres with decreasing sizes whereas Pd tetrahedra evolve into truncated tetrahedra and spheres. In contrast, Pd icosahedra with twin boundaries on the surface are converted to asymmetric icosahedra, flower-like icosahedra, and spheres. This work not only advances the understanding of etching and growth behaviors of metal nanocrystals with various shapes and twin structures but also offers an alternative method for controlling their shape and size.

A novel catalyst derived from Co-ZIFs to grow N-doped carbon nanotubes for all-solid-state supercapacitors with high performance

Carbon nanotubes (CNTs) have been widely used as electrode materials for electrochemical energy storage devices (e.g., supercapacitors) due to their excellent chemical and physical properties. However, conventional approaches (e.g., electron-beam vapor deposition and atomic layer deposition) to fabricate catalysts for the growth of CNTs are complex and demand high energy consumption. Herein, we report a facile method to synthesize catalysts derived from cobalt-containing zeolitic imidazolate frameworks (Co-ZIFs), which is exploited to in situ construct the three-dimensional (3D) CNT hybrid materials for all-solid-state supercapacitors. In brief, Co-ZIFs with a controllable structure is first grown on the inner porous surface of carbon foams pyrolyzed from commercial melamine foams, followed by thermal annealing and chemical vapor deposition to grow CNTs, achieving 3D free-standing CNT-based hybrids. The well-distributed Co-ZIFs in the carbon foam enable the grown CNTs with uniform structures and morphologies. Using the fabricated CNT-based hybrid as electrodes, the assembled all-solid-state supercapacitors show a high specific capacitance of 19.4 mF cm-2 at a current density of 0.5 mA cm-2, which could be further optimized to as high as 871.8 mF cm-2 by incorporating the pseudocapacitive material of manganese dioxide in CNT-based hybrids. This study provides a facile solution approach to fabricate the catalyst for the growth of a CNT inner porous substrate; the resultant 3D free-standing hybrids could be used as efficient electrodes for high-performance energy storage devices beyond supercapacitors.

Ultrafast self-assembly of supramolecular hydrogels toward novel flame-retardant separator for safe lithium ion battery

Traditional polyolefin separators for lithium-ion batteries (LIBs) often experience limited thermal stability and intrinsic flammability, resulting in great safety risks during their usage. Therefore, it is highly important to develop novel flame-retardant separators for safe LIBs with high performance. In this work, we report a flame-retardant separator derived from boron nitride (BN) aerogel with a high BET surface area of 1127.3 m² g^-1. The aerogel was pyrolyzed from a melamine-boric acid (MBA) supramolecular hydrogel, which was self-assembled at an ultrafast speed. The in-situ evolution details of the nucleation-growth process of the supramolecules could be observed in real-time using a polarizing microscope under ambient conditions. The BN aerogel was further composited with bacterial cellulose (BC) to form a BN/BC composite aerogel with excellent flame-retardant performance, electrolyte-wetting ability and high mechanical property. By using the BN/BC composite aerogel as the separator, the developed LIBs exhibited high specific discharge capacity of 146.5 mAh g^-1 and excellent cyclic performance, maintaining 500 cycles with a capacity degradation of only 0.012% per cycle. The high-performance flame-retardant BN/BC composite aerogel represents a promising candidate for separators not only in LIBs but also in other flexible electronics.

High voltage and healing flexible zinc ion battery based on ionogel electrolyte

Flexible and multifunctional zinc ion batteries (ZIBs) play an important role in flexible or wearable electronics. Polymer gels with outstanding mechanical stretchability and high ionic conductivity are very promising to be used as electrolytes for the solid-state ZIBs. Herein, a novel ionogel of poly(N,N'-dimethylacrylamide)/zinc trifluoromethanesulfonate (PDMAAm/Zn(CF₃SO₃)₂) is designed and synthesized by UV-initiated polymerization of monomer DMAAm in ionic liquid solvent 1-butyl-3-methylimidazolium trifluoromethanesulfonate ([Bmim][TfO]). The prepared PDMAAm/Zn(CF₃SO₃)₂ ionogels possess high mechanical performance (893.7% tensile strain and 151.0 kPa tensile strength), moderate ionic conductivity (0.96 mS cm^-1) and superior healable performance. The as-prepared ZIBs based on PDMAAm/Zn(CF₃SO₃)₂ ionogel electrolyte assembled by carbon nanotubes (CNTs)/polyaniline as cathode and CNTs/Zn as anode not only exhibit excellent electrochemical properties (up to 2.5 V), flexible and cyclic performance, but also possess good healability for five broken/healed cycles with slight 12.5% performance decay. More significantly, the broken/healed ZIBs exhibit superior flexibility and cyclic stability. This ionogel electrolyte can be extended the flexible energy storage devices for use in other multifunctional portable and wearable energy related devices.

Responses of soil phosphorus cycling and bioavailability to plant invasion in river-lake ecotones

The invasion of exotic plants in the river-lake ecotone has seriously affected the nutrient cycling processes in wetland soil. The South American species Alternanthera philoxeroides (Mart.) Griseb. is rapidly invading the river-lake ecotone in subtropical China, and has become the dominant species in the river-lake ecotone. However, there have been few studies on the effects of A. philoxeroides invasion on soil phosphorus (P) cycling and bioavailability in this ecotone. Here, we measured the bioavailable P fractions, physicochemical properties and nutrient content in the surface soils of the native plant (Zizania latifolia (Griseb.) Turcz and Nelumbo nucifera Gaertn.) communities and the adjacent invasive A. philoxeroides communities in three river-lake ecotones with different nutrient substrates in the subtropical Dongting Lake basin over a 3-year period to reveal the effects of A. philoxeroides invasion on the morphology and concentrations of soil bioavailable P. The principal coordinate analysis results showed that the A. philoxeroides invasion significantly altered the bioavailable P concentrations in the soil of native plant communities in the different river-lake ecotones, and this effect was not disturbed by the heterogeneity of the soil matrix. However, the effects of invasion into different native plant communities on the fractions of soil bioavailable P were different. Compared with native Z. latifolia and N. nucifera communities, A. philoxeroides invasion increased the concentration of inorganic P by 39.5% and 3.7%, respectively, and the concentration of organic P decreased by 32.7% and 31.9%, respectively. In addition, the invasion promoted P cycling and accumulation in the river-lake ecotone, which resulted in average decreases in the soil N:P and C:P ratios of 7.9% and 12.5%, respectively. These results highlight the impact of exotic plant invasions on nutrient cycling in wetland ecosystems in the river-lake ecotone, and this process may be detrimental to the late recovery of native plants.

A novel bilayer heterogeneous poly(ionic liquid) electrolyte for high-performance flexible supercapacitors with ultraslow self-discharge

Flexible supercapacitors with high power density and long cyclic stability represent a promising candidate to be used as power supplies for portable electronics, but often suffer from the disadvantages of a limited working voltage and rapid self-discharge (spontaneous drop of open-circuit voltage). Here, we design a bilayer heterogeneous poly(ionic liquid) electrolyte (BHPE) consisting of a polycation complex and a polyanion complex with different zeta potentials to suppress the self-discharge of flexible symmetric supercapacitors. The resultant BHPE-based supercapacitors using active carbon/carbon nanotube composite electrodes exhibit a high working potential of 3.0 V and an energy density of 33 W h kg^-1, which are comparable with those of devices obtained by using a homogeneous poly(ionic liquid) electrolyte (HPE). More significantly, the developed BHPE-based supercapacitor charged under forward bias exhibits a self-discharge time of 23.2 h, which is at least twice that of the device charged under reverse bias and is also much superior to those of HPE-based supercapacitors. The BHPE-based supercapacitors also possess excellent mechanical flexibility and stability, due to the stabilized interface contact between two layers of poly(ionic liquid)s.

Correlation between blood pressure variability and deep cerebral microbleeds in patients with acute ischemic stroke

INTRODUCTION

To observe the 24-h ambulatory blood pressure characteristics of patients with acute ischemic stroke and explore the correlation between blood pressure variability and strictly deep cerebral microbleeds (CMBs).

MATERIAL AND METHODS

A convenient sampling method was used to enrol 131 patients with acute ischemic stroke in the Department of Neurology between April 2021 and May 2022. Hospitalised patients with acute ischemic stroke were assessed retrospectively; their ambulatory blood pressure was monitored continuously for 24 h, and the relevant parameters were recorded. Magnetic susceptibility-weighted imaging was used to divide the CMBs into a strictly deep CMB group ( n = 24) and a non-CMB group ( n = 107) according to the location of the CMBs. A logistic regression analysis was performed to determine the independent correlation between the 24-h ambulatory blood pressure parameters and strictly deep CMBs. The receiver operating characteristic (ROC) was further used to analyse the predictive value of the ambulatory blood pressure parameters for strictly deep CMBs in patients with acute ischemic stroke.

RESULTS

The results showed that the night systolic blood pressure standard deviation and the night diastolic blood pressure standard deviation (NDBP-SD) in the strictly deep CMB group were higher than those in the non-CMB group ( p < 0.05). The multiple logistic regression analysis indicated that the NDBP-SD (odds ratio [OR] = 1.205, 95% confidence interval [CI]: 1.011-1.436, p = 0.038) was an independent risk factor for strictly deep CMBs in patients. The ROC curve analysis revealed that the area under the curve value of the NDBP-SD was 0.682, and the intercept was 7.81. When NDBP-SD is ≥ 7.81, the occurrence of strictly deep CMBs is closely related (OR = 3.872, 95% CI: 1.347-11.125, p = 0.012).

CONCLUSIONS

The NDBP-SD is an independent risk factor for strictly deep CMBs in patients with acute ischemic stroke. When NDBP-SD is > 7.81, it may promote the production of strictly deep CMBs.

Computed Tomography for Detecting Patent Foramen Ovale: A Meta-Analysis

OBJECTIVE

Patent foramen ovale (PFO) has been regarded as a potential source of cryptogenic stroke, which was conventionally detected by transesophageal echocardiography. Cardiac computed tomography (CCT) is a promising, noninvasive test for detection of PFO. We sought to conduct a meta-analysis to evaluate the diagnostic performance of CCT in detecting PFO.

METHODS

PubMed, ISI Web of Knowledge, Embase, Cochrane Library, and Wanfang from inception to June 2020 were searched for relevant studies comparing CCT and transesophageal echocardiography as the reference standard in detecting PFO. A bivariate model was used to pool sensitivity and specificity and to construct summary receiver operating characteristic (SROC) curves.

RESULTS

A total of seven studies with 483 patients were included in this meta-analysis. For the diagnosis of PFO, CCT had a mean sensitivity and specificity of 0.70 [95% CI:0.58, 0.79] and 0.97 [95% CI: 0.95, 0.99]. The SROC analysis showed an area under the curve of 0.97.

CONCLUSION

CCT shows good diagnostic accuracy in detecting PFO with relatively high sensitivity and specificity. CCT could be considered a noninvasive alternative to transesophageal echocardiography for detecting PFO.

Discovery of steroidal alkaloid glycosides from the bulbs of Fritillaria unibracteata with anti-inflammatory activities using an in vivo zebrafish model

Nine undescribed steroidal alkaloid glycosides, unibrasolanosides A-F, unibraverazosides A-B, and unibratomatoside A, were isolated from the bulbs of Fritillaria unibracteata P. K. Hsiao & K. C. Hsia (Liliaceae). Their structures were elucidated by HRESIMS and 1D and 2D NMR data analyses as well as chemical methods and single-crystal X-ray diffraction analyses. Further investigation revealed that eight steroidal alkaloid glycosides displayed moderate anti-inflammatory activity in vivo in a CuSO4-induced transgenic zebrafish model.

Comparison Between Coblation and Microflap Resection of Leukoplakia of the Vocal Fold

OBJECTIVES

The objective of this study was to compare the recurrence rate and voice improvement of vocal fold leukoplakia (VFL) between microflap resection alone or radiofrequency (RF) Coblation alone.

METHODS

Patients with VFL intraoperatively treated via microflap resection alone or Coblation alone were enrolled. The recurrence rate, voice assessment, and Videostroboscopic images were compared between the two groups.

RESULTS

The recurrence rate at postoperative 12 months was 37.7% (26/69) in the microflap resection group and 7.7% (4/52) in the Coblation group; the difference was significant (P < 0.05). The preoperative and postoperative subjective detection data from the two groups showed significant differences, but the Coblation group recovered better compared to the microflap resection group. No Coblation-related complications were found, including postoperative granulation tissue hyperplasia or anterior commissure adhesion.

CONCLUSIONS

In patients with vocal cord leukoplakia, RF Coblation had a lower recurrence rate and better voice improvement compared with microflap resection.

Response of spatio-temporal changes in sediment phosphorus fractions to vegetation restoration in the degraded river-lake ecotone

Phosphorus (P) is an essential element in the ecosystem and the cause of the eutrophication of rivers and lakes. The river-lake ecotone is the ecological buffer zone between rivers and lakes, which can transfer energy and material between terrestrial and aquatic ecosystems. Vegetation restoration of degraded river-lake ecotone can improve the interception capacity of P pollution. However, the effects of different vegetation restoration types on sediment P cycling and its mechanism remain unclear. Therefore, we seasonally measured the P fractions and physicochemical properties of sediments from different restored vegetation (three native species and one invasive species). The results found that vegetation restoration significantly increased the sediment total P and bioavailable P content, which increased the sediment tolerance to P pollution in river-lake ecotone. In addition, the total P content in sediments was highest in summer and autumn, but lower in spring and winter. The total P and bioavailable P contents in surface sediments were the highest. They decreased with increasing depth, suggesting that sediment P assimilation by vegetation restoration and the resulting litter leads to redistribution of P in different seasons and sediment depths. Microbial biomass-P (MBP), total nitrogen (TN), and sediment organic matter (SOM) are the main factors affecting the change of sediment phosphorus fractions. All four plants' maximum biomass and P storage appeared in the autumn. Although the biomass and P storage of the invasive species Alternanthera philoxeroides were lower, the higher bioavailable P content and MBP values of the surface sediments indicated the utilization efficiency of sediment resources. These results suggest that vegetation restoration affects the distribution and circulation of P in river and lake ecosystems, which further enhances the ecological function of the river-lake ecotone and prevents the eutrophication and erosion of water and sediment in the river-lake ecotone.

Community structure and function of epiphytic bacteria attached to three submerged macrophytes

In aquatic ecosystems, large amounts of epiphytic bacteria living on the leaf surfaces of submerged macrophytes play important roles in affecting plant growth and biogeochemical cycling. The restoration of different submerged macrophytes has been considered an effective measure to improve eutrophic lakes. However, the community ecology of epiphytic bacteria is far from well understood for different submerged macrophytes. In this study, we used quantitative PCR, 16S rRNA gene high-throughput sequencing and functional prediction analysis to explore the structure and function of epiphytic bacteria in an aquatic ecosystem recovered by three submerged macrophytes (Hydrilla verticillata, Vallisneria natans and Potamogeton maackianus) during two growth periods. The results showed that the community compositions and functions of epiphytic bacterial communities on the submerged macrophyte hosts were different from those of the planktonic bacterial communities in the surrounding water. The alpha diversity of the epiphytic bacterial community was significantly higher in October than in July, and the community compositions and functions differed significantly in July and October. Among the three submerged macrophytes, the structures and functions of the epiphytic bacterial community exhibited obvious differences, and some specific taxa were enriched on the biofilms of the three plants. The alpha diversity and the abundance of functions related to nitrogen and phosphorus transformation were higher in the epiphytic bacteria of P. maackianus. In summary, these results provide clues for understanding the distribution and formation mechanisms of epiphytic bacteria on submerged macrophyte leaves and their roles in freshwater ecosystems.

The spatiotemporal characteristics of water quality and phytoplankton community in a shallow eutrophic lake: Implications for submerged vegetation restoration

One of the most serious consequences of eutrophication in shallow lakes is deterioration of water quality, proliferation of phytoplankton and disappearance of submerged macrophytes. After removing herbivorous and plankti-benthivorous fish, submerged macrophyte restoration was utilized at the entire lake (82.7 km²) to combat eutrophication and improve water quality in the shallow subtropical aquaculture of Lake Datong. We conducted two years of monitoring, from March 2018 to February 2020. During the first year of restoration, 80% of the area of Lake Datong (approximately 60 km²) was successfully recovered by submerged vegetation, and the water quality was improved. For example, the phosphorous (P) content (including total P (TP), dissolved reactive P (DRP) and total dissolved P (TDP)) and turbidity decreased, and the Secchi depth (SD) increased. However, the submerged vegetation disappeared from autumn 2019 in the intermittent recovery area (MN), while the continuous recovery area (DX) continued to recover with an abundance of submerged vegetation. During the second year, the water quality continued to improve significantly in the DX area, with high biomass and coverage of submerged vegetation. In the MN area, although turbidity and ammonia nitrogen (NH₄⁺-N) increased significantly and SD decreased significantly, the P content (TP, TDP, and DRP) still continued to decrease. The restoration of submerged macrophytes could significantly decrease the density of phytoplankton. Over time, there was a regime shift in Lake Datong. The structural equation model (SEM) results illustrated that the water level and submerged plant coverage were the primary drivers that triggered changes in the state of the lake ecosystem. Our results highlight the potential of restoring submerged vegetation to control water eutrophication at the whole-lake scale. However, the water level in spring was the primary driver that triggered changes in the state of the lake ecosystem. Water level management should be emphasized during the early stages of recovery of submerged plants.

The recurrent factors of idiopathic vocal process granulomas after cold steel excision

OBJECTIVE

To identify the factors predicting postoperative recurrence after cold steel excision for the market trader with idiopathic vocal process granulomas (VPGs).

MATERIAL AND METHODS

The market traders with idiopathic VPGs who do not respond to medical treatment were treated by cold steel excision. The factors considered likely to affect the recurrence were evaluated by univariate and multivariate logistic regression.

RESULTS

The total of 80 idiopathic VPGs underwent the cold steel excision. All postoperative 6 months, the complete remission rate was 37.5% (30 VPGs) and 50 recurrences developed (62.5%). The recurrence rate was not significantly associated with sex (P = 0.119), side (P = 0.468), VPG size (P = 0.726), LPR (P = 0.293), diabetes mellitus (P = 0.5611), cerebrovascular disease (P = 0.129), or chronic pulmonary disease (P = 0.190). Multivariate logistic regression showed that only vocalization frequency (P = 0.006) and smoking and alcohol consumption (P = 0.001) were independent predictors of recurrence. There was no significant correlation between age and recurrence (P = 0.59). However, recurrence was more common in those aged 51-60 years than those aged ≥61 years (P = 0.019). Of the recurrent 49 VPGs treated conservatively via behavioural modification and oral deanxit, the granulomas disappeared spontaneously in 38 (77.6%) within 6-10 months and in 11 (22.4%) within 2-3 years.

CONCLUSIONS

The market traders with VPG would be a high recurrence rate after cold steel excision, the frequency of voice use and smoking and alcohol consumption were significant independent predictors of recurrence. Antidepressant medications and behavioural modification could effectively improve the outcome of VPG.

A prospective, randomized, single‐blind study comparing coblation and monopolar extracapsular tonsillectomy

Objective

The aim of this study was to compare intraoperative blood loss, postoperative pain, post‐tonsillectomy hemorrhage (PTH), and medical costs associated with extracapsular tonsillectomy between coblation and monopolar electrocautery in children.

Materials and methods

This study included 293 patients aged 6–15 years planned to undergo extracapsular tonsillectomy. Data on estimated blood loss, postoperative pain score, operation time, PTH, and the cost of disposable equipment were collected.

Results

Coblation extracapsular tonsillectomy was associated with significantly lower mean pain scores than monopolar technique on postoperative days 1 (p <.001) and 2 (p = 0.02). However, the pain score was similar between the groups at all other time points. The monopolar group had a significantly shorter operation time compared to the coblation group (11.09 ± 7.53 vs. 17.12 ± 4.29 min, p <.001). Intraoperative estimated blood loss was not significantly different between the groups (p = .43).The cost of extracapsular tonsillectomy was significantly lower in the monopolar compared to the coblation group (US$ 28.18 vs. US$ 430.48, p <.001). PTH occurred in 17 patients (5.80%) and required a second surgery. Secondary PTH occurred in 6.16% (9/146) and 0.68% (1/147) of patients in the coblation and monopolar groups, respectively (p <.001). The PTH was significantly higher in the tonsillitis compared to in the tonsillar hypertrophy (12.37% vs. 2.55%, p = .002), However, the difference of PTH was not significant among mean pain scores subgroups. Of the 17 patients with PTH, the lower pole, middle portion, and upper pole were involved in 15 (88.24%), 2 (11.76%), and 0 cases, respectively.

Conclusions

Coblation and novel monopolar electrocautery extracapsular tonsillectomy are associated with similar postoperative pain scores except on postoperative days 1 and 2. However, monopolar technique offers significant advantages over coblation method with less operative time, decreased secondary PTH, and cost.

Level of Evidence: NA.

Natural wood-derived free-standing films as efficient and stable separators for high-performance lithium ion batteries

A sustainable and low-cost separator is highly required for electrochemical energy storage systems. Herein, a type of modified natural wood film with excellent mechanical properties, ion conductivity and thermal stability is fabricated for high-performance lithium ion batteries. Using the modified natural wood film as a separator, the fabricated symmetric cell exhibits a more stable and lower plating/stripping voltage for Li than that of the cell with a commercialized polypropylene (PP) separator. The LiFePO₄/Li half-cell with the modified wood film separator shows a small polarization voltage and high discharge capacity because of the multi-level nanostructure and abundant functional groups of the modified wood films. The results suggest that the modified wood films are a promising candidate for use as separators in lithium ion batteries. As desired, the LiFePO₄/Li half-cells with the modified wood film separator deliver much higher discharge capacities and more stable Coulomb efficiency over two hundred charge/discharge cycles than the cell based on the PP separator. The present work systematically investigate the feasibility of abundant and cheap natural wood-derived materials for use as efficient separators instead of synthetic polymers for high-performance lithium ion batteries with long cycle life.

HR1405-01, a Safe intravenous NSAID with superior anti-inflammatory and analgesic activities in preclinical trials

Combinational utilization of intravenous non-steroidal anti-inflammatory drugs (NSAIDs) with opium analgesic is an effective alternative modality for pain control after surgery. This regimen is known for reducing the risk of addiction induced by opium analgesic. However, current intravenous NSAIDs have solubility problems, limiting their clinical applications. Although loxoprofen exhibits strong anti-inflammatory and analgesic activities with relatively low ulcerogenicity, its relatively low bioavailability makes it not an ideal drug candidate for intravenous injection. We selected the bioactive metabolite (6) of loxoprofen as a candidate and developed a new intravenous NSAID, HR1405-01. This metabolite exhibited significantly stronger anti-inflammatory and analgesic activities than parecoxib sodium injection or ibuprofen injection. The excellent potency and solubility of HR1405-01 allowed the avoidance of utilization of cosolvent in the formulation, resulting in fewer side effects and a better safety profile. Therefore, HR1405-01 might be a promising candidate for the development of a new intravenous NSAID.

Snail communities increase submerged macrophyte growth by grazing epiphytic algae and phytoplankton in a mesocosm experiment

The relationships between producers (e.g., macrophytes, phytoplankton and epiphytic algae) and snails play an important role in maintaining the function and stability of shallow ecosystems. Complex relationships exist among macrophytes, epiphytic algae, phytoplankton, and snails. We studied the effects of snail communities (consisting of Radix swinhoei, Hippeutis cantori, Bellamya aeruginosa, and Parafossarulus striatulus) on the biomass of phytoplankton and epiphytic algae as well as on the growth of three species of submerged macrophytes (Hydrilla verticillata, Vallisneria natans, and one exotic submerged plant, Elodea nuttallii) in a 90-day outdoor mesocosm experiment conducted on the shore of subtropical Lake Liangzihu, China. A structural equation model showed that the snail communities affected the submerged macrophytes by grazing phytoplankton and epiphytic algae (reduction in phytoplankton Chl-a and epiphytic algal abundance), enhancing the biomass of submerged macrophytes. Highly branched macrophytes with high surfaces and morphologies and many microhabitats supported the most snails and epiphytic algae (the biomass of the snail communities and epiphytic algae on H. verticillata was greater than that on V. natans), and snails preferred to feed on native plants. Competition drove the snails to change their grazing preferences to achieve coexistence.

Comparison of endoscopic over-underlay technique with and without packing for repairing chronic perforation

OBJECTIVE

This study was performed to compare the efficacy of the endoscopic modified cartilage over-underlay technique with and without packing for repairing chronic tympanic membrane (TM) perforations.

METHODS

A total of 70 cases of chronic TM perforation were randomly allocated to endoscopic modified cartilage over-underlay myringoplasty groups with (n = 35) and without (n = 35) packing. The graft success rate and hearing outcomes were compared between the two groups. In addition, neovascularization scores were subjectively obtained.

RESULTS

At 12 months postoperatively, the difference in graft success rate between the packing and no-packing groups was not significant (94.3% vs. 100.0%, P = 0.473). In addition, there were no significant differences between the two groups in the pre- or postoperative air-bone gap (ABG) (15.18 ± 2.73 vs. 15.07 ± 4.02, P = 0.623 and 8.63 ± 3.03 vs. 8.52 ± 4.50, P = 0.591) or mean ABG gain (6.56 ± 3.23 vs. 6.54 ± 2.83, P = 0.751). However, the average operating times were 43.6 ± 7.1 and 32.7 ± 2.1 min in the packing and no-packing groups, respectively (P < 0.001).

CONCLUSIONS

Surgical and hearing outcomes were comparable between patients with chronic TM perforation treated using the endoscopic modified over-underlay technique with and without packing. However, without packing, the procedure was less invasive and had a shorter operating time.

Flexible and Stretchable Enzymatic Biofuel Cell with High Performance Enabled by Textile Electrodes and Polymer Hydrogel Electrolyte

Biofuel cells with good biocompatibility are promising to be used as the power source for flexible and wearable bioelectronics. We here report a type of highly flexible and stretchable biofuel cells, which are enabled by textile electrodes of graphene/carbon nanotubes (G/CNTs) composite and polymer hydrogel electrolyte. The CNT array covalently grown from a graphene layer not only can be served as a conducting substrate to immobilize enzyme molecules but also can provide efficient charge transport channels between the enzyme and graphene electrode. As a result, the developed biofuel cells deliver a high open-circuit voltage of 0.65 V and output power density of 64.2 μW cm^-2, which are much higher than previously reported results. Benefiting from the unique textile structure of electrodes and the polymer hydrogel electrolyte, the biofuel cells exhibit high retention of power density after 400 bending cycles and even stretched to a high strain of 60%.

An integrated biomimetic array chip for establishment of collagen-based 3D primary human hepatocyte model for prediction of clinical drug-induced liver injury

Drug-induced liver injury (DILI) is a leading cause of therapy failure in the clinic and also contributes much to acute liver failure cases. Investigations of predictive sensitivity in animal models have limitations due to interspecies differences. Previously reported in vitro models of liver injury based on primary human hepatocytes (PHHs) cannot meet the requirements of high physiological fidelity, low cost, simple operation, and high throughput with improved sensitivity. Herein, we developed an integrated biomimetic array chip (iBAC) for establishing extracellular matrix (ECM)-based models. A collagen-based 3D PHH model was constructed on the iBAC as a case for the prediction of clinical DILI at throughput. The iBAC has a three-layer structure with a core component of 3D implanting holes. At an initial cell seeding numbers of 5000-10,000, the collagen-based 3D PHH model was optimized with improved and stabilized liver functionality, including cell viability, albumin, and urea production. Moreover, basal activities of most metabolic enzymes on the iBAC were maintained for at least 12 days. Next, a small-scale hepatotoxicity screening indicated that the 3D PHH model on the iBAC was more sensitive for predicting hepatotoxicity than the 2D PHH model on the plate. Finally, a large-scale screening of liver toxicity using 122 clinical drugs further demonstrated that the collagen-based 3D PHH model on the iBAC had superior predictive sensitivity compared to all previously reported in vitro models. These results indicated the importance of 3D collagen for liver physiological functionality and hepatotoxicity prediction. We anticipant it being a promising tool for risk assessment of drug-induced hepatotoxicity with a widespread acceptance in drug industry.

Regulating the Self-Discharge of Flexible All-Solid-State Supercapacitors by a Heterogeneous Polymer Electrolyte

Supercapacitors with high power density and an ultralong cyclic lifetime have been intensively investigated. However, the crucial challenge of their rapid self-discharge process is often neglected in most cases. A heterogeneous interface formed between two layers of polymer electrolytes is designed, in which a polyanion and a polycation are added into a common matrix of polymer electrolyte, respectively. By using the heterogeneous polymer electrolyte (HPE) as the separator simultaneously, the resultant supercapacitors exhibit comparable electrochemical performance to that of devices based on traditional polymer electrolytes. The HPE-based supercapacitors using both electric double-layer capacitive and pseudocapacitive electrodes show at least one time longer self-discharge time than that of devices based on homogenous polymer electrolyte, especially for the electrode in an electrolyte containing polyanion served as a positive pole during the charging process. Because of the same polymer matrix used, the heterojunction structure of the HPE exhibits excellent stability without obvious phase separation during thousands of charge/discharge and repeated bending cycles. This novel strategy by interface engineering of electrolyte to suppress the self-discharge behavior of supercapacitors is very meaningful to promote their practical applications.

Enhancement of the Antibacterial Properties of Kefir by Adding Lactobacillus fermentum grx08

ABSTRACT

Kefir is an acidic-alcoholic fermented milk that can provide probiotic benefits, such as intestinal microecological balance regulation, antibacterial activity, and anti-inflammatory activity. In this study, Lactobacillus fermentum grx08 isolated from longevous people was used to further improve the health properties of kefir. L. fermentum grx08 and kefir grains obtained from Xinjiang, People's Republic of China, were mixed at ratios of 1:1, 5:1, and 25:1 as starters. The six gram-positive and gram-negative foodborne pathogens were able to grow in the supernatant of kefir but not in the supernatant of kefir with L. fermentum grx08. With increasing amounts of inoculated L. fermentum grx08, the antibacterial activity of the mixed fermented kefir gradually increased. The contents of lactic acid, fumaric acid, and malic acid in the mixed fermented milk were significantly increased by adding L. fermentum grx08 (P < 0.05), while the content of acetic acid decreased with the increase of L. fermentum grx08 and the content of citric acid was unaffected. This study suggests that the addition of L. fermentum grx08 shortened the fermentation time, improved the acidity, and retained the quality of fermented milk. Moreover, the antibacterial properties of kefir is enhanced by increasing the production of certain acids.

HIGHLIGHTS

The Biodiversity–Biomass Relationship of Aquatic Macrophytes Is Regulated by Water Depth: A Case Study of a Shallow Mesotrophic Lake in China

The relationship between biodiversity and productivity (or biomass production) (BPR) has been a popular topic in macroecology and debated for decades. However, this relationship is poorly understood in macrophyte communities, and the mechanism of the BPR pattern of the aquatic macrophyte community is not clear. We investigated 78 aquatic macrophyte communities in a shallow mesotrophic freshwater lake in the middle and lower reaches of the Yangtze River in China. We analyzed the relationship between biodiversity (species richness, diversity, and evenness indices) and community biomass, and the effects of water environments and interspecific interactions on biodiversity–biomass patterns. Unimodal patterns between community biomass and diversity indices instead of evenness indices are shown, and these indicate the importance of both the number and abundance of species when studying biodiversity–biomass patterns under mesotrophic conditions. These patterns were moderated by species identity biologically and water depth environmentally. However, water depth determined the distribution and growth of species with different life-forms as well as species identities through environmental filtering. These results demonstrate that water depth regulates the biodiversity–biomass pattern of the aquatic macrophyte community as a result of its effect on species identity and species distribution. Our study may provide useful information for conservation and restoration of macrophyte vegetation in shallow lakes through matching water depth and species or life-form combinations properly to reach high ecosystem functions and services.