Sirtuin 5 alleviates excessive mitochondrial fission via desuccinylation of ATPase inhibitory factor 1 in sepsis-induced acute kidney injury

ABSTRACT

Sepsis-induced acute kidney injury (SAKI) poses a significant clinical challenge with high morbidity and mortality. Excessive mitochondrial fission has been identified as the central pathogenesis of sepsis-associated organ damage, which is also implicated in the early stages of SAKI. Sirtuin 5 (SIRT5) has emerged as a central regulator of cellular mitochondrial function; however, its role in the regulation of sepsis-induced excessive mitochondrial fission in kidney and the underlying mechanism remains unclear.In this study, SAKI was modeled in mice through cecal ligation and puncture (CLP), and in human renal tubular epithelial (HK-2) cells stimulated with lipopolysaccharide (LPS), to mimic the cell SAKI model. Our findings revealed that septic mice with a SIRT5 knockout (SIRT5 KO) exhibited shortened survival times and elevated levels of renal injury compared to wild-type (WT) mice, suggesting the significant involvement of SIRT5 in SAKI pathophysiology. Additionally, we observed that SIRT5 depletion led to increased renal mitochondrial fission, while the use of a mitochondrial fission inhibitor (Mdivi-1) reversed the detrimental effects caused by SIRT5 depletion, emphasizing the pivotal role of SIRT5 in preventing excessive mitochondrial fission. In vitro experiments demonstrated that the overexpression of SIRT5 effectively mitigated the adverse effects of LPS on HK-2 cells viability and mitochondrial fission. Conversely, downregulation of SIRT5 decreased HK-2 cells viability and exacerbated LPS-induced mitochondrial fission. Mechanistically, the protective function of SIRT5 may be in part, ascribed to its desuccinylating action on ATPase inhibitory factor 1 (ATPIF1).In conclusion, this study provides novel insights into the underlying mechanisms of SAKI, suggesting the possibility of identifying future drug targets in terms of improved mitochondrial dynamics by SIRT5.

Multiple Warthin Tumors With Epithelial-Myoepithelial Carcinoma of the Ipsilateral Parotid Gland: A Case Report

Multiple primary tumors of the parotid gland refer to the occurrence of 2 or more primary tumors in the ipsilateral or bilateral parotid gland metachronously or synchronously, which do not originate from postoperative recurrence or metastasis. Multiple primary tumors of the parotid gland, especially synchronous benign and malignant tumors, are extremely uncommon. A rare case of multiple Warthin tumors with epithelial-myoepithelial carcinoma of the ipsilateral parotid gland is reported as follows.

Genomic and epidemiological perspectives on the first local sporadic cases of Mpox in China

From June 7th to 11th, 2023, eight cases of Mpox were identified in Guangzhou, China. This is the first report of multiple local sporadic cases after the imported case in Chongqing, China. Epidemiological investigation revealed that these cases had no history of international travel and no connections with each other. Haplotype network and phylogenetic analyses indicated that the possible origin is likely from Japan, although the direct origin may remain uncertain due to limited genomic sequences and sampling bias in GISAID. The three Guangzhou sequences have accumulated several novel mutations, suggesting the local transmission of Mpox may have been ongoing for some time. Based on the daily cases during the early stage of Mpox outbreak in four other countries, the number of possible infected cases in Guangzhou is inferred to be more than 300, suggesting that swift and efficient control measures must be implemented to mitigate the risk of a potential epidemic.

Increasing Nonfossil Fuel Contributions to Atmospheric Nitrate in Urban China from Observation to Prediction

China's nitrogen oxide (NOx) emissions have undergone significant changes over the past few decades. However, nonfossil fuel NOx emissions are not yet well constrained in urban environments, resulting in a substantial underestimation of their importance relative to the known fossil fuel NOx emissions. We developed an approach using machine learning that is accurate enough to generate a long time series of the nitrogen isotopic composition (δ15N) of atmospheric nitrate using high-level accuracies of air pollutants and meteorology data. Air temperature was found to be the critical driver of the variation of nitrate δ15N at daily resolution based on this approach, while significant reductions of aerosol and its precursor emissions played a key role in the change of nitrate δ15N on the yearly scale. Predictions from this model found a significant decrease in nitrate δ15N in Chinese megacities (Beijing and Guangzhou as representative cities in the north and south, respectively) since 2013, implying an enhanced contribution of nonfossil fuel NOx emissions to nitrate aerosols (up to 22%-26% in 2021 from 18%-22% in 2013 quantified by an isotope mixing model), as confirmed by the Weather Research and Forecasting model coupled with online chemistry (WRF-Chem) simulation. Meanwhile, the declining contribution in coal combustion (34%-39% in 2013 to 31%-34% in 2021) and increasing contribution of natural gas combustion (11%-14% in 2013 to 14%-17% in 2021) demonstrated the transformation of China's energy structure from coal to natural gas. This approach provides missing records for exploring long-term variability in the nitrogen isotope system and may contribute to the study of the global reactive nitrogen biogeochemical cycle.

Outdoor Health Risk of Atmospheric Particulate Matter at Night in Xi'an, Northwestern China

The deterioration of air quality via anthropogenic activities during the night period has been deemed a serious concern among the scientific community. Thereby, we explored the outdoor particulate matter (PM) concentration and the contributions from various sources during the day and night in winter and spring 2021 in a megacity, northwestern China. The results revealed that the changes in chemical compositions of PM and sources (motor vehicles, industrial emissions, coal combustion) at night lead to substantial PM toxicity, oxidative potential (OP), and OP/PM per unit mass, indicating high oxidative toxicity and exposure risk at nighttime. Furthermore, higher environmentally persistent free radical (EPFR) concentration and its significant correlation with OP were observed, suggesting that EPFRs cause reactive oxygen species (ROS) formation. Moreover, the noncarcinogenic and carcinogenic risks were systematically explained and spatialized to children and adults, highlighting intensified hotspots to epidemiological researchers. This better understanding of day-night-based PM formation pathways and their hazardous impact will assist to guide measures to diminish the toxicity of PM and reduce the disease led by air pollution.

Sources and health risk assessment of water-soluble and water-insoluble metals in road and foliar dust in Xi'an, Northwest China

Road dust pollution is still an important environmental problem in the cities of northwest China. To better understand the risk exposure and sources of unhealthy metals in road dust and foliar dust, the dust samples were collected in Xi'an city, Northwest China. The sampling period was during December 2019 and 53 metals in the dust were analyzed using Inductive Coupled Plasma Emission Spectrometer (ICPA-RQ). Compared to road dust, most metals are found in relatively higher concentrations in foliar dust, especially water-soluble metals, with Mn being 3710 times more abundant in foliar dust. However, the regional characteristics of road dust are more pronounced, i.e., the concentrations of Co and Ni are six times higher in industrial manufacturing areas than in residential areas. The results of the non-negative matrix factorization and principal component analysis source analyses demonstrate this difference, the dust in Xi'an is mainly from transportation (63 %) and natural sources (35 %). From the emission characteristics of the traffic source dust, brake wear is the main cause of traffic source, accounting for 43 %. However, the metal sources in each principal component of foliar dust show a more mixed state, which is consistent with the results of regional characterization. The health risk evaluation shows that traffic sources are the main risk source and contribute 67 % to the total risk. Among them, Pb from tire wear is the main contribution to the total non-carcinogenic risk for children, which is close to the risk threshold. In addition, Cr and Mn are also worthy of attention. The above results all emphasize the contribution of traffic emissions, especially the non-tailpipe emission component, to dust emissions and health risks. Therefore, controlling vehicle wear and tear and exhaust emissions should be the main way to improve air quality, such as traffic control and improvement of vehicle component materials.

Pathogen Diagnosis Value of Nanopore Sequencing in Severe Hospital-Acquired Pneumonia Patients

Background

Next-generation sequencing of the metagenome (mNGS) is increasingly used in pathogen diagnosis for infectious diseases due to its short detection time. The time for Oxford Nanopore Technologies (ONT) sequencing-based etiology detection is further shortened compared with that of mNGS, but only a few studies have verified the time advantage and accuracy of ONT sequencing for etiology diagnosis. In 2022, a study confirmed that there was no significant difference in sensitivity and specificity between ONT and mNGS in suspected community-acquired pneumonia patients, which there was no clinical study verified in patients with SHAP.

Methods

From October 24 to November 20, 2022, 10 patients with severe hospital-acquired pneumonia (SHAP) in the Nanfang Hospital intensive care unit (ICU) were prospectively enrolled. Bronchoalveolar lavage fluid (BALF) was collected for ONT sequencing, mNGS, and traditional culture. The differences in pathogen detection time and diagnostic agreement among ONT sequencing, mNGS, traditional culture method, and clinical composite diagnosis were compared.

Results

Compared with mNGS and the traditional culture method, ONT sequencing had a significant advantage in pathogen detection time (9.6±0.7 h versus 24.7±2.7 h versus 132±58 h, P <0.05). The agreement rate between ONT sequencing and the clinical composite diagnosis was 73.3% (kappa value=0.737, P <0.05).

Conclusion

ONT sequencing has a potential advantage for rapidly identifying pathogens.

Pollution characteristics of environmental persistent free radicals (EPFRs) and their contribution to oxidation potential in road dust in a large city in northwest China

Environmental persistent free radicals (EPFRs) are new environmental health risk substances in the atmosphere, and their oxidative toxicity (OT) has not been strongly confirmed. In this study, the fugitive characteristics of EPFRs in road dust in a metropolitan city located in northwest China, and their potential oxidative toxicity were investigated. The results showed that the road dust contains Carbon-centered EPFRs with the mean mass concentration of (6.6 ± 5.0) × 10¹⁷ spins/g. EPFRs in road dust are degradable and have a half-life of 4.5 years. The water insoluble (WIS) components contribute 71% to the oxidative toxicity of road dust and show a rapid toxicity generation process, while the oxidative toxicity generation rate of water-soluble dust is more stable. Based on the positive matrix factorization (PMF) model, the contribution of EPFRs-dominated factors to Total-OT and WIS-OT is 17.3% and 33.3%, respectively. The PMF model results indicated that different types of EPFRs contributed differently to the oxidative toxicity of road dust and Carbon-centered EPFRs are more likely to participate in reactive oxygen species generation. Our results highlight that the EPFRs are an important contributor to the oxidative toxicity of atmospheric particulate matter, and their oxidative toxicity is dependent on the types of free radicals. It also provides an important insight into the influence of other potentially toxic substances on the oxidative toxicity of atmospheric PM.

Significant Promotion of Light Absorption Ability and Formation of Triplet Organics and Reactive Oxygen Species in Atmospheric HULIS by Fe(III) Ions

Metal ions are key components in atmosphere that potentially affect the optical properties and photochemical reactivity of atmospheric humic-like substances (HULIS), while this mechanism is still unclear. In this study, we demonstrated that atmospheric HULIS coupled with Fe³⁺, Cu²⁺, Zn²⁺, and Al³⁺ exhibited distinct optical properties and reactive intermediates from that of HULIS utilizing three-dimensional fluorescence spectroscopy and electron paramagnetic resonance spectroscopy. The HULIS components showed light absorption that increased by 56% for the HULIS-Fe³⁺ system, fluorescence blue shift, and fluorescence quenching, showing a certain dose-effect relationship. These are mainly attributed to the fact that the highly oxidative HULIS chromophores have a stronger complexing ability with Fe³⁺ ions than the other metal ions. In addition, triplet organics (promoting ratio: 53%) and reactive oxygen species (promoting ratio: 82.6%) in the HULIS-Fe³⁺ system showed obvious generation promotion. Therefore, the main assumption of the photochemical mechanisms of atmospheric HULIS in the HULIS-Fe³⁺ system is that Fe³⁺ ions can form ³HULIS*-Fe³⁺ complexation with photoexcited ³HULIS* and then transition to the ground state through energy transfer, electron transfer, or nonradiative transition, accompanied by the formation of singlet oxygen and hydroxyl radicals. Our results provide references for evaluating the radiative forcing and aging effect of metal ions on atmospheric aerosols.

Association between dexmedetomidine administration and outcomes in critically ill patients with sepsis-associated acute kidney injury

STUDY OBJECTIVE

To investigate the association between dexmedetomidine administration and outcomes in critically ill patients with sepsis-associated acute kidney injury (SA-AKI).

DESIGN

A single-center, retrospective, cohort study.

SETTING

Intensive care unit (ICU).

PATIENTS

A total of 2192 critically ill patients with SA-AKI were included in the analysis, which identified from the Medical Information Mart for Intensive Care (MIMIC-IV) database between 2008 and 2019.

INTERVENTIONS

Intravenous infusion of dexmedetomidine.

MEASUREMENTS

The primary outcome was recovery of renal function. In-hospital mortality, vasopressor requirements, length of ICU and hospital stay were considered secondary outcomes. The Cox proportional hazards, logistic regression, and linear regression models were used to assess the association between dexmedetomidine and outcomes. Propensity score matching (PSM) analysis was used to match patients receiving dexmedetomidine to those without treatment.

MAIN RESULTS

After PSM, 719 matched patient pairs were derived from patients who received dexmedetomidine and those who did not. The administration of dexmedetomidine was associated with a higher rate of renal recovery [61.8% vs. 55.8%, hazard ratio (HR) 1.35; P = 0.01], reduced in-hospital mortality [28.3% vs. 41.3%, HR 0.56; P < 0.001], and prolonged intensive care unit (ICU) stay [15.8d vs 12.6d, HR 2.34; P < 0.001] and hospital stay [23.7d vs 19.7d, HR 4.47; P < 0.001]. No significant difference was found in vasopressor requirements in patients with SA-AKI. Nevertheless, results illustrated that dose receiving between 0.30 and 1.00 μg/kg/h and duration using under 48 h of dexmedetomidine was associated with improvements in renal function recovery in SA-AKI patients.

CONCLUSION

Dexmedetomidine administration was associated with improvements in renal function recovery and in-hospital survival in critically ill patients with SA-AKI. The results need to be verified in further randomized controlled trials.

[Changes of the World Health Organization 2022 classification (5th edition) of salivary glands tumors]

Pathological diagnosis of salivary gland tumors is one of the most challenging areas in all head and neck surgical pathology. The classification of salivary gland tumors was updated in the 5th edition of the World Health Organization Classification of Head and Neck Tumours, most of which were based on their molecular pathological characteristerics. This new classification features a description of several new entitiesamong benign and malignant neoplasms, salivary gland tumors with updated naming or diagnostic criteria, and lesions deleted from this section, etc.This present review focuses on the updates and changes in the new classification of salivary gland tumors, and provides some reference for head and neck surgeons and pathologists.

Early pulmonary artery catheterization is not associated with survival benefits in critically ill patients with cardiac disease: An analysis of the MIMIC-IV database

BACKGROUND

Many studies demonstrated no improved survival in patients with pulmonary artery catheter placement. However, no consistent conclusions have been drawn regarding the impact of pulmonary artery catheter in critically ill patients with heart disease. This study aimed to investigate the association of early pulmonary artery catheter use with 28-day mortality in that population.

METHODS

The Multiparameter Intelligent Monitoring in Intensive Care IV (MIMIC-IV) database, a single-center critical care database, was employed to investigate this issue. This study enrolled a total of 11,887 critically ill patients with cardiac disease with or without pulmonary artery catheter insertion. The primary outcome was 28-day mortality. The multivariate regression was modeled to examine the association between pulmonary artery catheter and outcomes. Additionally, we examined the effect modification by cardiac surgeries. Propensity score matching was conducted to validate our findings.

RESULTS

No improvement in 28-day mortality was observed among the pulmonary artery catheter group compared to the non-pulmonary artery catheter group (odds ratio 95% confidence interval: 1.18 [1.00-1.38], P = .049). When stratified by cardiac surgeries, the results were consistent. The patients in the pulmonary artery catheter group had fewer ventilation-free days and vasopressor-free days than those in the nonpulmonary artery catheter group after surgery stratification. In the surgical patients, pulmonary artery catheter insertion was not associated with the occurrence of acute kidney injury, and it was associated with a higher daily fluid input (mean difference 95% confidence interval: 0.13 [0.05-0.20], P = .001). In nonsurgical patients, the pulmonary artery catheter group had a higher risk of acute kidney injury occurrence (odds ratio 95% confidence interval: 1.94 [1.32-2.84], P = .001).

CONCLUSION

Early pulmonary artery catheter placement is not associated with survival benefits in critically ill patients with cardiac diseases, either in surgical or nonsurgical patients.

Development and regeneration of periodontal supporting tissues

Periodontal tissues, including gingiva, cementum, periodontal ligament, and alveolar bone, play important roles in oral health. Under physiological conditions, periodontal tissues surround and support the teeth, maintaining the stability of the teeth and distributing the chewing forces. However, under pathological conditions, with the actions of various pathogenic factors, the periodontal tissues gradually undergo some irreversible changes, that is, gingival recession, periodontal ligament rupture, periodontal pocket formation, alveolar bone resorption, eventually leading to the loosening and even loss of the teeth. Currently, the regenerations of the periodontal tissues are still challenging. Therefore, it is necessary to study the development of the periodontal tissues, the principles and processes of which can be used to develop new strategies for the regeneration of periodontal tissues. This review summarizes the development of periodontal tissues and current strategies for periodontal healing and regeneration.

Ongoing Positive Selection Drives the Evolution of SARS-CoV-2 Genomes

SARS-CoV-2 is a new RNA virus affecting humans and spreads extensively through world populations since its first outbreak in December, 2019. Whether the transmissibility and pathogenicity of SARS-CoV-2 in humans after zoonotic transfer are actively evolving, and driven by adaptation to the new host and environments is still under debate. Understanding the evolutionary mechanism underlying epidemiological and pathological characteristics of COVID-19 is essential for predicting the epidemic trend, and providing guidance for disease control and treatments. Interrogating novel strategies for identifying natural selection using within-species polymorphisms and 3,674,076 SARS-CoV-2 genome sequences of 169 countries as of December 30, 2021, we demonstrate with population genetic evidence that during the course of SARS-CoV-2 pandemic in humans, 1) SARS-CoV-2 genomes are overall conserved under purifying selection, especially for the 14 genes related to viral RNA replication, transcription, and assembly; 2) ongoing positive selection is actively driving the evolution of 6 genes (e.g., S, ORF3a, and N) that play critical roles in molecular processes involving pathogen-host interactions, including viral invasion into and egress from host cells, and viral inhibition and evasion of host immune response, possibly leading to high transmissibility and mild symptom in SARS-CoV-2 evolution. According to an established haplotype phylogenetic relationship of 138 viral clusters, a spatial and temporal landscape of 556 critical mutations is constructed based on their divergence among viral haplotype clusters or repeatedly increase in frequency within at least 2 clusters, of which multiple mutations potentially conferring alterations in viral transmissibility, pathogenicity, and virulence of SARS-CoV-2 are highlighted, warranting attentions.

Inhibitor of Growth 4 (ING4) Plays a Tumor-Repressing Role in Oral Squamous Cell Carcinoma via Nuclear Factor kappa-B (NF-kB)/DNA Methyltransferase 1 (DNMT1) Axis-Mediated Regulation of Aldehyde Dehydrogenase 1A2 (ALDH1A2)

BACKGROUND

Inhibitor of growth 4 (ING4) level was reported to be decreased in head and neck squamous cell carcinoma (HNSC) tissue, however, it is unknown whether and how ING4 participates in regulating the development of oral squamous cell carcinoma (OSCC).

OBJECTIVE

To investigate the role and mechanism of ING4 in OSCC.

METHODS

ING4 was forced up-or down-regulated in two OSCC cell lines, and its effects on the malignant behavior of OSCC cells were investigated in vitro. The ubiquitination level of NF-kB p65 in ING4 upregulated cells was measured by co-immunoprecipitation. Moreover, the effects of ING4 on the methylation level of ALDH1A2 were evaluated by methylation-specific polymerase chain reaction (MSP) assay. The role of ING4 in OSCC growth in vivo was observed in nude mice.

RESULTS

Our results showed that the expression of ING4 in OSCC cell lines was lower than that in normal oral keratinocyte cells. In vitro, ING4 overexpression inhibited the proliferation, migration, and invasion of OSCC cell lines and ING4 silencing exhibited opposite results. We also demonstrated that ING4 overexpression promoted the ubiquitination and degradation of P65 and reduced DNA methyltransferase 1 (DNMT1) expression, and Aldehyde dehydrogenase 1A2 (ALDH1A2) methylation. Moreover, overexpression of p65 rescued the suppression of malignant behavior, induced by ING4 overexpression. In addition, ING4 negatively regulated the growth of OSCC xenograft tumors in vivo.

CONCLUSION

Our data evidenced that ING4 played a tumor-repressing role in OSCC in vivo and in vitro via NF-κB/DNMT1/ALDH1A2 axis.

Improvement of inorganic aerosol component in PM2.5 by constraining aqueous-phase formation of sulfate in cloud with satellite retrievals: WRF-Chem simulations

High concentrations of PM_2.5 in China have caused severe visibility degradation and health problems. However, it is still challenging to accurately predict PM_2.5 and its chemical components in numerical models. In this study, we compared the inorganic aerosol components of PM_2.5 (sulfate, nitrate, and ammonium (SNA)) simulated by the Weather Research and Forecasting model fully coupled with chemistry (WRF-Chem) model with in-situ data in a heavy haze-fog event during November 2018 in Nanjing, China. Comparisons show that the model underestimates sulfate concentrations by 81% and fails to reproduce the significant increase of sulfate from early morning to noon, which corresponds to the timing of fog dissipation that suggests the model underestimates the aqueous-phase formation of sulfate in clouds. In addition, the model overestimates both nitrate and ammonium concentrations by 184% and 57%, respectively. These overestimates contribute to the simulated SNA being 77.2% higher than observed. However, cloud water content is also underestimated which is a pathway for important aqueous-phase reactions. Therefore, we constrained the simulated cloud water content based on the Moderate Resolution Imaging Spectroradiometer (MODIS) Liquid Water Path observations. Results show that the simulation with MODIS-corrected cloud water content increases the sulfate by a factor of 3, decreases the Normalized Mean Bias (NMB) by 53.5%, and reproduces its diurnal cycle with the peak concentration occurring at noon. The improved sulfate simulation also improves the simulation of nitrate, which decreases the simulated nitrate bias by 134%. Although the simulated ammonium is still higher than the observations, corrected cloud water content leads to a decrease of the modelled bias in SNA from 77.2% to 14.1%. The strong sensitivity of simulated SNA concentration to the cloud water content provides an explanation for the simulated SNA bias. Hence, uncertainties in cloud water content can contribute to model biases in simulating SNA which are less frequently explored from a process-level perspective and can be reduced by constraining the model with satellite observations.

Effects of ex vivo Extracorporeal Membrane Oxygenation Circuits on Sequestration of Antimicrobial Agents

Objectives: Our ex vivo study was designed to determine the sequestration of teicoplanin, tigecycline, micafungin, meropenem, polymyxin B, caspofungin, cefoperazone sulbactam, and voriconazole in extracorporeal membrane oxygenation (ECMO) circuits.

Methods: Simulated closed-loop ECMO circuits were prepared using 2 types of blood-primed ECMO. After the circulation was stabilized, the study drugs were injected into the circuit. Blood samples were collected at 2, 5, 15, 30 min, 1, 3, 6, 12, and 24 h after injection. Drug concentrations were measured by high-performance liquid chromatography-tandem mass spectrometry. Control groups were stored at 4°C after 3, 6, 12, and 24 h immersing in a water bath at 37°C to observe spontaneous drug degradation.

Results: Twenty-six samples were analyzed. The average drug recoveries from the ECMO circuits and control groups at 24 h relative to baseline were 67 and 89% for teicoplanin, 100 and 145% for tigecycline, 67 and 99% for micafungin, 45 and 75% for meropenem, 62 and 60% for polymyxin B, 83 and 85% for caspofungin, 79 and 98% for cefoperazone, 75 and 87% for sulbactam, and 60 and 101% for voriconazole, respectively. Simple linear regression showed no significant correlation between lipophilicity (r² = 0.008, P = 0.225) or the protein binding rate (r² = 0.168, P = 0.479) of drugs and the extent of drug loss in the ECMO circuits.

Conclusions: In the two ECMO circuits, meropenem and voriconazole were significantly lost, cefoperazone was slightly lost, while tigecycline and caspofungin were not lost. Drugs with high lipophilicity were lost more in the Maquet circuit than in the Sorin circuit. This study needs more in vivo studies with larger samples for further confirmation, and it suggests that therapeutic drug concentration monitoring should be strongly considered during ECMO.

Molecular mechanisms of ferroptosis and their role in inflammation

Ferroptosis is a type of non-apoptotic cell death, which demonstrates a definite iron-dependent expression pattern and is associated with lipid peroxidation. Glutathione peroxidase 4 (GPX4) is a key regulator of ferroptosis. Ferroptosis is involved in the development and progression of various diseases, such as cancer, tissue ischemia-reperfusion injury, neurological diseases, and respiratory diseases. It has been established previously that ferroptotic cells trigger the innate immune system by releasing inflammation-linked damage-related molecules, and immune cells stimulate the inflammatory response by recognizing the operational mechanism of ferroptosis. Some anti-inflammatory drugs have been shown to inhibit ferroptosis in certain cell models. Conversely, some ferroptosis inhibitors also exert anti-inflammatory effects in certain diseases. The present review evaluated the relationship between ferroptosis and inflammation, as well as the underlying internal mechanism, and provided valuable insights into developing novel treatment strategies for inflammatory diseases and cancer.

Exploring dust heterogeneous chemistry over China: Insights from field observation and GEOS-Chem simulation

Dust heterogeneous chemistry plays an important role in tropospheric chemistry, but its parameterization in numerical models is often quite simplified, which hampers accurate prediction of particulate matter and its chemical component. In this study, we investigate the evolution of dust heterogeneous chemical process and its potential impacts on gaseous and aerosol components during a dust pollution episode from March 27 to April 2, 2015 over North China. Based on field measurements, the significant role of relative humidity (RH) in dust heterogeneous chemistry is found and a RH-dependent parameterization for uptake coefficients of HNO₃ and SO₂ is incorporated in GEOS-Chem to reproduce the dust heterogeneous chemical process. During the study period, observed dust sulfate (DSO4) and dust nitrate (DNIT) exhibit maximum concentrations of 9.1 and 22.8 μg m^-3 respectively, accompanied by high RH and gaseous precursor concentrations. DSO4 concentrations are positively related to RH. The observed dust sulfate oxidation ratio (DSOR) is elevated evidently with increased RH, especially when RH is higher than ~40%, implying that enhanced RH could promote heterogeneous oxidation of SO₂ to DSO4. Model simulation shows that when incorporating the RH-dependent parameterization, DNIT and DSO4 are generally well captured and the model performance of total sulfate oxidation ratio (TSOR) and total nitrate oxidation ratio (TNOR) are improved. High contribution of DNIT and DSO4 are found to be located over the regions close to source areas (>60%) and downwind regions (>40%), respectively. Sensitivity results show that SO₂ and HNO₃ reduce by 2-24 μg m^-3 and 1-18 μg m^-3 when considering dust heterogeneous impacts, thus leading to reduction in non-dust sulfate and non-dust nitrate concentrations. As a result, simulated NH₃ increases and ammonium reduces by more than 20%. Our study indicates that the contribution of heterogeneous reactions to sulfate formation is 20-30% over North China.

YEATS domain-containing 2 (YEATS2), targeted by microRNA miR-378a-5p, regulates growth and metastasis in head and neck squamous cell carcinoma

Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide with poor prognosis and the development of HNSCC is a complex process. Some research have found that YEATS domain-containing 2 (YEATS2) is highly expressed in non-small cell lung cancer and pancreatic cancer, whereas its function in HNSCC is left to be studied. The primary aim was to investigate the role of YEATS2 in proliferation, apoptosis, invasion and migration in HNSCC cells and explore the possible mechanisms. We found YEATS2 expression was elevated in HNSCC clinical samples. Our work also indicated YEATS2 knockdown inhibited cell proliferation, induced apoptosis, and diminished the migration and invasion capability in HNSCC cell lines, including Detroit562 and FaDu cells. Besides, these inhibiting effects of YEATS2 knockdown could be crippled by microRNA-378a-5p (miR-378a-5p) inhibitor. In conclusion, our data suggested that YEATS2 expression was regulated by miR-378a-5p and YEATS2 knockdown inhibited proliferation and metastasis while induced apoptosis in HNSCC cells.

A Prediction Model for Assessing Prognosis in Critically Ill Patients with Sepsis-associated Acute Kidney Injury

BACKGROUND

Sepsis-associated acute kidney injury (SA-AKI) is a common problem in critically ill patients and is associated with high morbidity and mortality. Early prediction of the survival of hospitalized patients with SA-AKI is necessary, but a reliable and valid prediction model is still lacking.

METHODS

We conducted a retrospective cohort analysis based on a training cohort of 2,066 patients enrolled from the Multiparameter Intelligent Monitoring in Intensive Care Database III (MIMIC III) and a validation cohort of 102 patients treated at Nanfang Hospital of Southern Medical University. Least absolute shrinkage and selection operator (LASSO) regression and multivariate Cox regression analysis were used to identify predictors for survival. Areas under the ROC curves (AUC), the concordance index (C-index), and calibration curves were used to evaluate the efficiency of the prediction model (SAKI) in both cohorts.

RESULTS

The overall mortality of SA-AKI was approximately 18%. Age, admission type, liver disease, metastatic cancer, lactate, BUN/SCr, admission creatinine, positive culture, and AKI stage were independently associated with survival and combined in the SAKI model. The C-index in the training and validation cohorts was 0.73 and 0.72. The AUC in the training cohort was 0.77, 0.72, and 0.70 for the 7-day, 14-day, and 28-day probability of in-hospital survival, respectively, while in the external validation cohort, it was 0.83, 0.73, and 0.67. SAPSII and SOFA scores showed poorer performance. Calibration curves demonstrated a good consistency.

CONCLUSIONS

Our SAKI model has predictive value for in-hospital mortality of SA-AKI in critically ill patients and outperforms generic scores.

NCAPG, mediated by miR-378a-3p, regulates cell proliferation, cell cycle progression, and apoptosis of oral squamous cell carcinoma through the GSK-3β/β-catenin signaling

Exploring the molecular mechanism of oral squamous cell carcinoma (OSCC) pathogenesis is of great significance for its improvement and therapy. Non-structural maintenance of chromatin condensin Ⅰ complex subunit G (NCAPG) is responsible for chromatin condensation and is associated with the progression of many malignant tumors. This study was aimed to investigate the role of NCAPG on OSCC pathogenesis. NCAPG mRNA expression data in OSCC tissues were obtained from the Gene Expression Omnibus (GEO) database and NCAPG protein expression in OSCC cell lines was determined by western blotting analysis. The results demonstrated that NCAPG expression in OSCC tissues and cells was higher than that of normal control. Following the short interfering RNA (siRNA) knockdown of NCAPG in two OSCC cell lines, we observed that NCAPG depletion notably inhibited OSCC proliferation and cell cycle progression, as well as promoted apoptosis in vitro. Besides, silencing of NCAPG specifically inhibited the GSK-3β/β-catenin signaling. Furthermore, we demonstrated that NCAPG was a downstream target of miR-378a-3p. NCAPG silencing counteracted the effect of the miR-378a-3p inhibitor on cell proliferation/cycle induction. Collectively, these findings suggest that NCAPG is crucial in OSCC progression and development, and may serve as a potential therapeutic target for OSCC.

Serum levels of inhibitory costimulatory molecules and correlations with levels of innate immune cytokines in patients with pulmonary tuberculosis

Objective

To analyze serum levels of inhibitory costimulatory molecules and their correlations with innate immune cytokine levels in patients with pulmonary tuberculosis (PTB).

Methods

Data for 280 PTB patients and 280 healthy individuals were collected. Serum levels of immune molecules were measured using ELISA. Univariate, multivariate, subgroup, matrix correlation, and receiver operating characteristic curve analyses were performed.

Results

Host, environment, lifestyle, clinical features, and medical history all influenced PTB. Serum levels of soluble programmed death ligand 1 (sPD-L1), soluble T-cell immunoglobulin- and mucin-domain–containing molecule 3 (sTim-3), soluble galectin-9 (sGal-9), interleukin (IL)-4, and IL-33 were significantly higher in patients with PTB, while levels of IL-12, IL-23, IL-18, and interferon (IFN)-γ were significantly lower. Serum levels of sTim-3 were higher in alcohol users. Levels of sTim-3 were negatively correlated with those of IL-12. Levels of IL-12, IL-23, and IL-18 were positively correlated with those of IFN-γ, while levels of IL-12 were negatively correlated with those of IL-4. The areas under the curve of sPD-L1, sTim-3, sGal-9, IL-12, IL-23, IL-18, IFN-γ, IL-4, and IL-33 for identifying PTB were all >0.77.

Conclusions

Inhibitory costimulatory molecules may be targets for controlling PTB. Immune molecules may be helpful for diagnosis of PTB.

Design of a Novel Multi-Epitope Vaccine Against Echinococcus granulosus in Immunoinformatics

All the time, echinococcosis is a global zoonotic disease which seriously endangers public health all over the world. In order to speed up the development process of anti-Echinococcus granulosus vaccine, at the same time, it can also save economic cost. In this study, immunoinformatics tools and molecular docking methods were used to predict and screen the antigen epitopes of Echinococcus granulosus, to design a multi-epitope vaccine containing B- and T-cell epitopes. The multi-epitope vaccine could activate B lymphocytes to produce specific antibodies theoretically, which could protect the human body against Echinococcus granulosus infection. It also could activate T lymphocytes and clear the infected parasites in the body. In this study, four CD8+ T-cell epitopes, three CD4+ T-cell epitopes and four B-cell epitopes of Protein EgTeg were identified by immunoinformatics methods. Meanwhile, three CD8+ T-cell epitopes, two CD4+ T-cell epitopes and four B-cell epitopes of Protein EgFABP1 were identified. We constructed the multi-epitope vaccine using linker proteins. The study based on the traditional methods of antigen epitope prediction, further optimized the prediction results combined with molecular docking technology and improved the precision and accuracy of the results. Finally, in vivo and in vitro experiments had verified that the vaccine designed in this study had good antigenicity and immunogenicity.

A Multi-Epitope Chitosan Nanoparticles Vaccine of Canine Against Echinococcus granulosus

Cystic Echinococcosis (CE) is caused by Echinococcus granulosus (Eg), which endangers the health of the intermediate host. Therefore, effective canid vaccines against Eg infection are urgently needed to reduce the incidence of this disease. In the present work, the aim was to predict epitopes in four vaccine candidate antigens (VCAs) in Eg as a basis to design a multi-epitope canine-directed vaccine. This vaccine is based on chitosan nanoparticles (CS-NPs) and is directed against Eg infection in the definitive host. The canine-directed vaccine was designed based on Eg antigens EgM9, Eg_10196, EgA31 and EgG1Y162. Several tools in online servers were used to predict VCAs information, which was combined with B cell, CTL and Th epitopes. Considering that acquiring experimental information in canids is difficult, and that it may be possible to perform future experiments in mice, we predicted both canine and murine T cell epitopes. The multi-epitope vaccine was synthetically prepared by ionic crosslinking method, and CS-NPs was used as adjuvant. The mice were immunized by oral gavage and laser scanning confocal microscopy was used to localize the fluorescein- labeled multi-epitope peptide in the intestinal tract. The final multi-epitope vaccine was construct consist of Co1 targeting peptide, four B-cell epitopes, four canine-directed CTL epitopes and four murine-directed Th epitopes. It has been proven experimentally by this research that multi-epitope antigen concentration merged with microfold cells was high in the CS-NPs vaccine group. The present bioinformatics study is a first step towards the construction of a canine-specific multiepitope vaccine against Eg with twelve predicted epitopes. CS-NPs is a potential adjuvant with relatively safe penetration enhancement delivery and a potent immunostimulant.

Impacts of Soil NOx Emission on O3 Air Quality in Rural California

Nitrogen oxides (NO_x) are a key precursor in O₃ formation. Although stringent anthropogenic NO_x emission controls have been implemented since the early 2000s in the United States, several rural regions of California still suffer from O₃ pollution. Previous findings suggest that soils are a dominant source of NO_x emissions in California; however, a statewide assessment of the impacts of soil NO_x emission (SNO_x) on air quality is still lacking. Here we quantified the contribution of SNO_x to the NO_x budget and the effects of SNO_x on surface O₃ in California during summer by using WRF-Chem with an updated SNO_x scheme, the Berkeley Dalhousie Iowa Soil NO Parameterization (BDISNP). The model with BDISNP shows a better agreement with TROPOMI NO₂ columns, giving confidence in the SNO_x estimates. We estimate that 40.1% of the state's total NO_x emissions in July 2018 are from soils, and SNO_x could exceed anthropogenic sources over croplands, which accounts for 50.7% of NO_x emissions. Such considerable amounts of SNO_x enhance the monthly mean NO₂ columns by 34.7% (53.3%) and surface NO₂ concentrations by 176.5% (114.0%), leading to an additional 23.0% (23.2%) of surface O₃ concentration in California (cropland). Our results highlight the cobenefits of limiting SNO_x to help improve air quality and human health in rural California.

Early combination of albumin with crystalloids administration might be beneficial for the survival of septic patients: a retrospective analysis from MIMIC-IV database

Background

Fluid therapy is a cornerstone in the treatment of sepsis. Recently, the guidelines have recommended the combined administration that using crystalloids plus albumin for septic patients, but the optimal timing for albumin combined is still unclear. The objective of this study was to investigate the association of timing of albumin combined with 28-day mortality in patients with sepsis.

Methods

We involved septic patients from the Medical Information Mart for Intensive Care (MIMIC)-IV database, and these patients were categorized into crystalloids group (crystalloids alone) and early combination group (crystalloids combined albumin at 0–24 h). The primary outcome was 28-day mortality. We used propensity score matching (PSM) to adjust confounding and restricted mean survival time (RMST) analysis was conducted to quantify the beneficial effect on survival due to the combination group.

Results

We categorized 6597 and 920 patients in the “crystalloids alone” and “early combination”, respectively. After PSM, compared to the crystalloids group, the combination group was associated with the increased survival among 28-day (increased survival: 3.39 days, 95% CI 2.53–4.25; P < 0.001) after ICU admission. Patients who received albumin combination at the first 24-h was associated with prolonged LOS in ICU (10.72 days vs. 8.24 days; P < 0.001) but lower risk of 28-day mortality (12.5% vs 16.4%, P = 0.003) than those received crystalloids alone.

Conclusion

In septic patients, receiving albumin combined within the first 24-h after crystalloids administration was associated with an increment of survival in 28 days.

Hypertension in Patients Hospitalized with COVID-19 in Wuhan, China

It is unclear whether patients with hypertension are more likely to be infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) than the general population and whether there is a difference in the severity of coronavirus disease (COVID-19) pneumonia in patients who have taken ACEI/ARB drugs compared with those who have not.This observational study included data from all patients with clinically confirmed COVID-19 admitted to Hankou Hospital, Wuhan, China, between January 5 and March 8, 2020. Data were extracted from clinical and laboratory records. Follow-up was cut off on March 8, 2020.A total of 274 patients, 75 with hypertension and 199 without hypertension, were included in the analysis. Compared with patients without hypertension, patients with hypertension were older and were more likely to have preexisting comorbidities, including chronic renal insufficiency, cardiovascular disease, diabetes mellitus, and cerebrovascular disease. Moreover, patients with hypertension tended to have higher positive rate for SARS-CoV-2 PCR detection. Multivariate logistic regression analysis showed that age (P = 0.005) and gender (P = 0.019) were independent risk factors associated with the severity of pneumonia in patients on admission, whereas ACEI/ARB treatment (P = 0.184) was not.Patients with COVID-19 with hypertension were significantly older and were more likely to have underlying comorbidities, including chronic renal insufficiency, cardiovascular disease, diabetes mellitus, and cerebrovascular disease. ACEI/ARB drugs did not influence the severity of pneumonia in patients with SARS-CoV-2. In future studies, a larger sample size and multi-center clinical data would be needed to support these conclusions.

[Acute kidney injury in patients hospitalized with COVID-19 in Wuhan, China: a single-center retrospective observational study]

OBJECTIVE

To assess the predictors and outcomes of acute kidney injury (AKI) among patients with coronavirus disease 2019 (COVID-19).

OBJECTIVE

This retrospective observational study was conducted among patients with a confirmed diagnosis of COVID-19 admitted to Hankou Hospital between January, 5 and March 8, 2020. We evaluated the association of AKI with the demographic and biochemical parameters and clinical outcomes of the patients using univariate regression analysis.

OBJECTIVE

Atotal of 287 COVID-19 patients, including 55 with AKI and 232 without AKI, were included in the analysis. Compared with the patients without AKI, the patients with AKI were older, predominantly male, and were more likely to have hypoxia and pre-existing hypertension and cerebrovascular diseases. The patients with AKI also had higher levels of white blood cells, D-dimer, aspartate aminotransferase, total bilirubin, creatine kinase, lactate dehydrogenase, procalcitonin, C-reactive protein, a higher prevalence of hyperkalemia, lower lymphocyte counts, and higher chest computed tomographic scores. The incidence of stage 1 AKI was 14.3% and that of stage 2 or 3 AKI was 4.9%. The patients with AKI had much higher mortality rate than those without AKI.

OBJECTIVE

AKI is an important complication of COVID-19. An older age, a male gender, multiple pre- existing comorbidities, lymphopenia, increased infection indicators, elevated D-dimer, and impaired heart and liver functions are all potential risk factors ofAKI. COVID- 19 patients with AKI that progresses into stages 2 or 3 AKI have a high mortality rate. Prevention of AKI and monitoring kidney function is critical in the care of COVID-19 patients.

Distribution and susceptibility of ERCC1/XPF gene polymorphisms in Han and Uygur women with breast cancer in Xinjiang, China

This study aimed to explore the roles of ERCC1/XPF gene polymorphisms in the occurrence of breast cancer in the Uygur and Han ethnic groups in Xinjiang, China. Single nucleotide polymorphisms (SNPs) were detected by TaqMan real‐time PCR. The rs11615 G>A and rs2276466 C>G variant frequencies were higher in Uygur patients with breast cancer than in Han patients, while the frequency of rs2298881 C>A was higher in Han patients. We found that rs2298881 C>A (CA vs. CC: OR = 0.35, 95% CI = 0.20‐0.60; AA vs. CC: OR = 0.13, 95% CI = 0.04‐0.34; CA + AA vs. CC: OR = 0.33, 95% CI = 0.18‐0.51; AA vs. CA + CC: OR = 0.24, 95% CI = 0.08‐0.62; CA vs. AA + CC: OR = 0.49, 95% CI = 0.29‐0.82) was associated with a reduced breast cancer risk and rs3212986 C>A (AA vs. CC: OR = 4.80, 95% CI = 1.79‐15.29,; CA+AA vs. CC: OR = 1.71, 95% CI = 1.06‐2.77; AA vs. CA+CC: OR = 4.12, 95% CI =1.58‐12.89) and rs11615 G > A (AA vs. GG: OR = 3.49, 95% CI =1.54‐8.55; GA + AA vs. GG: OR = 1.98, 95% CI = 1.21‐3.27; AA vs. GA+GG: OR = 2.87, 95% CI = 1.30‐6.85) were associated with an elevated breast cancer risk among Uygur individuals. In addition, Uygur patients with breast cancer with 2‐3 combined risk genotypes of ERCC1 had a higher risk than patients with 0‐1 risk genotypes (OR = 2.91; 95% CI = 1.54‐5.71, p = 0.001). However, we failed to detect a statistically significant association between ERCC1/XPF polymorphisms and breast cancer risk in five genetic models among Han individuals. Our results showed that ERCC1/XPF gene polymorphisms predispose Uygur individuals to breast cancer; this finding should be verified by further large‐scale analyses.

[Clinical characteristics and outcomes of adult critically ill patients with COVID-19 in Honghu, Hubei Province]

OBJECTIVE

To explore the clinical characteristics and outcomes of adult critically ill patients with COVID-19 and identify the risk factors correlated with in-hospital deaths.

METHODS

This study was conducted among 20 confirmed adult cases of COVID-19 in the Intensive Care Unit (ICU) of Honghu People's Hospital in Jingzhou City, Hubei Province. According to the final outcome, the patients were divided into survivor group and death group with 10 patients each. The demographic data, clinical manifestations and signs, laboratory findings, treatment measures and clinical outcomes were obtained from electronic medical records to compare the clinical characteristics and outcomes between the two groups. Univariate logistic analysis was used to analyze the risk factors associated with in-hospital death.

RESULTS

The mean age of patients with confirmed COVID-19 was 70 ± 12 years, and 40% of them were male. The patients were admitted to ICU 11 ± 9 days after symptom onset. The most common symptoms on admission were cough (19 cases), fatigue or myalgia (18 cases), fever (17 cases) and dyspnea (16 cases). Eleven (55%) of the patients had underlying diseases, among which hypertension was the most common (11 cases), followed by cardiovascular disease (4 cases) and diabetes (3 cases). Six (30%) of the patients received invasive mechanical ventilation and continued renal replacement therapy but eventually died. Acute cardiac injury was the most common complication (19 cases). Half of the patients died between the 2nd and 19th day after ICU admission. Compared with dead patients, the surviving patients had a lower average body weight (61.70±2.36 vs 68.60±7.15 kg, P=0.01) and a higher Glasgow Coma Index (14.69 ± 0.70 vs 12.70 ± 2.45, P=0.03), and were less likely to develop shock (2 vs 10, P=0.001) or acute respiratory distress syndrome (2 vs 10, P=0.001).

CONCLUSIONS

Critically ill patients with COVID-19 are generally older. A higher body weight and a lower lymphocyte count are potentially associated with a greater likeliness of fatality in ICU patients with COVID-19.

Dust radiative forcing and its impact on surface energy budget over West Africa

Dust is the dominant aerosol type over West Africa (WA), and therefore accurate simulation of dust impact is critical for better prediction of weather and climate change. The dust radiative forcing (DRF) is estimated using two sets of experiments in this study: one without and the other with dust aerosol and its feedbacks with the Weather Research and Forecasting with Chemistry model (WRF-Chem). Results show that DRF presents a net warming effect at the top-of-atmosphere (TOA) and in the atmosphere (ATM), and cooling at the surface (SFC). The net DRF over WA is estimated to be 9 W/m2 at the TOA, 23 W/m2 in the ATM, and - 13 W/m2 at the SFC. Furthermore, dust-induced a reduction of sensible heat up to 24 W/m2 and SFC temperature up to 2 °C cooling over WA, an increase of latent heat up to 12 W/m2 over Sahara, a decrease up to 24 W/m2 over the vegetated surfaces and an increase in the surface energy balance up to 12 W/m2 over WA. The presence of dust significantly influences the surface energy budget over WA, suggesting that dust effects should be considered in more climate studies to improve the accuracy of climate predictions.

Bioinformatics analysis of candidate proteins Omp2b, P39 and BLS for Brucella multivalent epitope vaccines

This study focuses on analyzing the physicochemical properties, structural characteristics and dominant epitopes of Brucella outer membrane protein 2b (Omp2b), periplasmic binding protein (P39) and Brucella lumazine synthase (BLS) proteins by bioinformatics methods, and to provide a theoretical basis for constructing multi-epitope vaccines. The amino acid sequences of three kinds of proteins were obtained from the UniProt database. The highest frequency alleles in northern China were obtained from the AlleleFrequencies database. Analysis of the physicochemical properties of the proteins by ProtParam online software. Analysis of the secondary structure of the proteins were predicted by SOMPA online software. Using SWISS-MODEL online software constructed and analyzed the tertiary structure of the proteins. Using ABCpred, BepiPred, BCPred and SVMTrip online software analyzed linear B cell epitopes of proteins, The T cell dominant epitope of the protein was analyzed using SYFPEITHI, RANKPEP and IEDB online software. Omp2b was identified three linear B cell dominant epitopes, five CD8⁺ T cell dominant epitopes, and three CD4⁺ T cell dominant epitopes. P39 was identified three linear B cell dominant epitopes, two CD8⁺ T cell dominant epitopes, and two CD4⁺ T cell dominant epitopes. BLS was identified one linear B cell dominant epitope, one CD8⁺ T cell dominant epitope, and two CD4⁺ T cell dominant epitopes. The results indicated that epitope prediction of three Brucella vaccine candidate proteins can provide a theoretical basis for the construction of an ideal multivalent epitope vaccine against Brucella.

Melatonin and its analogues for the prevention of postoperative delirium: A systematic review and meta-analysis

It remains unclear whether melatonin and its analogues prevent postoperative delirium (POD). Therefore, we conducted a systematic review and meta-analysis to evaluate the effect of melatonin and its analogues on POD prevention. PubMed, Cochrane Library, Web of Science, Embase and CINAHL databases were searched. Primary outcome was the incidence of POD. Six randomized controlled trials, 2 cohort studies and 1 case-control study were included in this meta-analysis. Results showed that melatonin and its analogue ramelteon decreased the incidence of POD in the entire adult surgical population (odds ratio [OR] = 0.45, 95% confidence interval [CI] 0.24-0.84, P = .01). When administered at a higher dose (5 mg), melatonin was effective in reducing the POD incidence (OR = 0.32, 95% CI 0.20-0.52, P < .00001). Melatonin administered less than 5 elimination half-lives before the surgery significantly reduced the POD incidence (OR = 0.31, 95% CI 0.19-0.49, P < .00001). Current literature supports the effectiveness of melatonin and its analogue ramelteon in POD prevention. However, the present study was limited by the significant heterogeneity of the included studies. More studies are needed to ascertain the preventive effect of melatonin and its analogues on the incidence of delirium after cardiac and noncardiac surgeries.

Spatial and seasonal characteristics of particulate matter and gaseous pollution in China: Implications for control policy

By employing the air pollution data including particular matter (PM) and gaseous pollutants (SO₂, NO₂, CO, and O₃) measured over 130 cities in China from April 2014 to March 2015, the spatial and seasonal variations of air pollution are analyzed. The 9 representative regions including Beijing, Tianjin, and Hebei (BTH), Yangze River Delta (YRD), central China (CC), Sichuan Basin (SB), northeast China (NEC), northwest China (NWC), Pearl River Delta (PRD), Yungui Plateau (YP), and Tibet, are chose to quantify the conditions of PM and gaseous pollution. According to the magnitudes of PM_2.5 from high to low, the regions are listed in sequence as BTH, CC, SB, YRD, NEC, NWC, PRD, YP, and Tibet. The spatial patters of gaseous pollutants except O₃ are generally consistent with PM's. The CO maximum is found in BTH and NWC while the O₃ maximum in YRD, PRD, and Tibet. The seasonal cycles of SO₂ and NO₂ are quite similar to that of PM, but the SO₂ is overall higher than NO₂ in winter over the northern China while the opposite is true over the southern China. The O₃ concentrations are generally low in winter, but high in spring and summer due to active photochemical reaction when temperature is high. The percentage of haze days (daily PM_2.5 exceeds NAAQS Grade II, i.e. 75  μg m^-3) to the entire year is 45, 32 and 29%, respectively over BTH, CC, and SB, three most PM pollution regions during the study period. Although the most severe haze region occurs in BTH (139 days) from annual mean, the most severe winter in SB (54 days) owing to its basin landform and high air pollutant emissions. In contrary to PM pollution, gaseous pollution in China are overall quite trivial.

An update on acupuncture point injection

This overview reports the global research advances in acupuncture point injection in the last 5 years. Acupuncture point injection can be applied to a wide range of curable diseases, predominantly those involving pain, but it has poor clinical evidence. Progress has been attained in the mechanism research on acupuncture point injection, but further studies remain necessary. With the reported adverse effects of acupuncture point injection, the need to standardize its clinical procedure has become urgent.

Improved tolerance of maize (Zea mays L.) to heavy metals by colonization of a dark septate endophyte (DSE) Exophiala pisciphila

Dark septate endophytes (DSE) are ubiquitous and abundant in stressful environments including heavy metal (HM) stress. However, our knowledge about the roles of DSE in improving HM tolerance of their host plants is poor. In this study, maize (Zea mays L.) was inoculated with a HM tolerant DSE strain Exophiala pisciphila H93 in lead (Pb), zinc (Zn), and cadmium (Cd) contaminated soils. E. pisciphila H93 successfully colonized and formed typical DSE structures in the inoculated maize roots. Colonization of E. pisciphila H93 alleviated the deleterious effects of excessive HM supplements and promoted the growth of maize (roots and shoots) under HM stress conditions, though it significantly decreased the biomass of inoculated maize under no HM stress. Further analysis showed that the colonization of E. pisciphila H93 improved the tolerance of maize to HM by restricting the translocation of HM ions from roots to shoots. This study demonstrated that under higher HM stress, such a mutual symbiosis between E. pisciphila and its host (maize) may be an efficient strategy to survive in the stressful environments.