Associations of ambient ozone exposure and CD4+ T cell levels with mortality among people living with HIV: An eight-year longitudinal study

There has been a consistent upward trend in ground-level ozone (O3) concentration in China. People living with HIV (PLWH) may be more vulnerable to the health impacts of O3 exposure due to their immunosuppressed state. This study aims to investigate the association between ambient O3 exposure and mortality among PLWH, as well as the potential exacerbating effects of a decreased CD4+ T cell level. Daily maximum 8-hour O3 concentrations were assigned to 7270 PLWH at a county level in Guangxi, China. Every 10-unit increase in ambient O3 concentration was associated with a significant rise in all-cause mortality ranging from 7.3 % to 28.7 % and a significant rise in AIDS-related mortality ranging from 8.4 % to 14.5 %. When PLWH had a higher CD4+ count (≥350 cells/μL), elevated O3 concentration was associated with increased blood CD4+ count at lag0 [percent change with 95 % confidence interval, 0.20(0.00, 0.40)], lag1 [0.26(0.06, 0.47)], and lag2 [0.23(0.03, 0.44)]; however, an opposite association was observed when CD4+ count was <350 cells/μL for half-year average [-2.45(-4.71, -0.14)] and yearly average [-3.42(-5.51, -1.29)] of O3 exposure. The association of O3 exposure with all-cause and AIDS-related mortality was more prominent among those with higher CD4+ count. Exploratory analysis revealed possible associations between O3 exposure and respiratory infections and clinical symptoms. These findings suggest potential synergistic effects between a compromised immune status and elevated O3 exposure levels on mortality risk among PLWH. Ambient O3 exposure should be considered as an emerging mortality risk factor for PLWH in the era of antiretroviral therapy, requiring further attention from researchers and healthcare professionals.

Hesperidin Protects Against High-Fat Diet-Induced Lipotoxicity in Rats by Inhibiting Pyroptosis

It is currently thought that excess fatty acid-induced lipotoxicity in hepatocytes is a critical initiator in the development of nonalcoholic fatty liver disease (NAFLD). Lipotoxicity can induce hepatocyte death; thus, reducing lipotoxicity is one of the most effective therapeutic methods to combat NAFLD. Abundant evidence has shown that hesperidin (HSP), a type of flavanone mainly found in citrus fruits, is able to ameliorate NAFLD, but the molecular mechanisms are unclear. We previously reported that pyroptosis contributed to NAFLD development and that inhibiting pyroptosis contributed to blunting the progression of NAFLD in rat models. Therefore, we questioned whether HSP could contribute to ameliorating NAFLD by modulating pyroptosis. In this study, a high-fat diet (HFD) induced dyslipidemia and hepatic lipotoxicity in rats, and HSP supplementation ameliorated dyslipidemia and insulin resistance. In addition, the HFD also caused pyroptosis in the liver and pancreas, while HSP supplementation ameliorated pyroptosis. In vitro, we found that HSP ameliorated palmitic acid-induced lipotoxicity and pyroptosis in HepG2 and INS-1E cells. In conclusion, we showed for the first time that HSP has a protective effect against liver and pancreas damage in terms of pyroptosis and provides a novel mechanism for the protective effects of HSP on NAFLD.

Shen-Ling-Bai-Zhu-San alleviates the imbalance of intestinal homeostasis in dextran sodium sulfate-induced colitis mice by regulating gut microbiota and inhibiting the NLRP3 inflammasome activation

ETHNOPHARMACOLOGICAL RELEVANCE

Shen-Ling-Bai-Zhu-San (SLBZS) is a classic formula for strengthening the spleen and dispelling dampness, which has shown excellent efficacy in inflammatory bowel disease (IBD) in traditional Chinese medicine clinical studies. However, its exact pharmacological mechanism needs to be further elucidated.

AIM OF THE STUDY

This study aims to investigate the restorative effect and mechanism of SLBZS on disturbed intestinal homeostasis in DSS-induced colitis mice.

MATERIALS AND METHODS

A colitis model was induced by 3% dextran sulfate sodium (DSS) for seven days, and SLBZS was administered by gavage. The influence of SLBZS on DSS-induced clinical symptoms and disease activity index (DAI) was monitored and analyzed. Alcian blue and fluorescein isothiocyanate-conjugated wheat germ agglutinin (FITC-WGA) staining were used to assess intestinal mucus changes. The expression of intestinal barrier function indexes and immune-associated indexes were determined by H&E staining, real-time quantitative PCR (RT-qPCR), and Western blot. And gut microbiota changes were detected by 16S rDNA sequencing technology. The antibiotic experiment was used to explore the role of gut microbiota in SLBZS treatment.

RESULTS

The results showed that SLBZS significantly improved the physiological indexes including body weight, DAI score, and colon length of colitis mice. We focused on the effects of SLBZS on intestinal homeostasis in colitis mice. First, SLBZS could enhance the secretion of intestinal mucin and the expression levels of tight junctions and adhesive junctions. Second, SLBZS inhibited the expression level of inflammatory factors and reduced the protein expression level of NLRP3 inflammasome. Third, 16S rDNA sequencing analysis revealed that SLBZS repaired the dysfunctional gut microbiota of colitis mice, such as enhancing the abundance of short-chain fatty acid-producing bacteria including Faecalibaculum, Colidextribacter, and Coprococcus. Further, by gut microbiota-depleted mice, we found that SLBZS could not exert an anti-colitis effect when gut microbiota was absent.

CONCLUSIONS

SLBZS restored intestinal environmental homeostasis by enhancing intestinal barrier function, inhibiting NLRP3 inflammasome, and restoring disturbed gut microbiota. And SLBZS could not ameliorate colitis mice with depleted gut microbiota. Our finding provided a theoretical basis for the clinical application of SLBZS in IBD.

The PCM scaffold enables RNA localization to centrosomes

As microtubule-organizing centers, centrosomes direct assembly of the bipolar mitotic spindle required for chromosome segregation and genome stability. Centrosome activity requires the dynamic assembly of pericentriolar material (PCM), the composition and organization of which changes throughout the cell cycle. Recent studies highlight the conserved localization of several mRNAs encoded from centrosome-associated genes enriched at centrosomes, including Pericentrin-like protein (Plp) mRNA. However, relatively little is known about how RNAs localize to centrosomes and influence centrosome function. Here, we examine mechanisms underlying the subcellular localization of Plp mRNA. We find that Plp mRNA localization is puromycin-sensitive, and the Plp coding sequence is both necessary and sufficient for RNA localization, consistent with a co-translational transport mechanism. We identify regions within the Plp coding sequence that regulate Plp mRNA localization. Finally, we show that protein-protein interactions critical for elaboration of the PCM scaffold permit RNA localization to centrosomes. Taken together, these findings inform the mechanistic basis of Plp mRNA localization and lend insight into the oscillatory enrichment of RNA at centrosomes.

Nobiletin Ameliorates Hepatic Lipid Deposition, Oxidative Stress, and Inflammation by Mechanisms That Involve the Nrf2/NF-κB Axis in Nonalcoholic Fatty Liver Disease

Nobiletin (NOB), a flavonoid with significant antioxidant potential, holds promise for treating nonalcoholic fatty liver disease (NAFLD). In this work, we aim to assess the effects and investigate the molecular mechanisms of NOB on NAFLD. After using a methionine choline-deficient diet to induce C57BL/6J mice, as well as oleic acid to induce HepG2 and L02 cells, we administered NOB as an intervention. The results indicated that the NOB significantly ameliorated lipid deposition, oxidative stress, and inflammation in NAFLD in both models. Its mechanism may involve the Nrf2, SREBP-1c, and NF-κB signaling pathways. Furthermore, Nrf2 is not only a direct target for NOB to improve oxidative damage but also indirectly involved in lipid-lowering and anti-inflammatory processes in NAFLD. By inhibiting Nrf2, we found that the regulatory role of Nrf2 in lipid metabolism is not related to SREBP-1c but is closely associated with NF-κB in terms of inflammation. Our results suggest that Nrf2 is one of the most critical targets for NOB against NAFLD in multiple aspects.

International performance of acupuncture for shoulder pain over more than four decades: a bibliometric study

PURPOSE

This bibliometric study aims to reveal the current situation, cooperative teams, and future development trends of acupuncture for shoulder pain (SP).

MATERIALS AND METHODS

The data source is the Web of Science Core Collection. The software programs used in this study are VOSviewer, Pajek, CiteSpace, Scimago Graphica, and Microsoft Excel. Co-occurrence analysis, descriptive statistical analysis, and burst keywords analysis are applied to analyze paper authors, institutions, countries or regions, keywords, and citations.

RESULTS

This study included 350 papers. In the first 30 years since 1976, the number of papers published was very limited. Since 2004, it has shown rapid growth momentum. High-yield countries and institutions were China (92) and Kyung Hee University (18), respectively. In terms of the cooperative relationship, the USA (centrality 0.34) and Beijing University of Chinese Medicine (centrality 0.15) play central roles in the team. The author Macpherson H ranked first with 10 published papers. Evidence Based Complementary and Alternative Medicine (27) has published the most papers. The keywords are grouped into five clusters. The most recent burst keywords include stroke, electroacupuncture, diagnosis, disability, stimulation, mechanism, bee venom acupuncture, and systematic review.

CONCLUSION

In general, the research and international cooperation of acupuncture for SP will continue to emerge. Most of the current studies believe that acupuncture for SP is effective, and more studies will appear to verify its effectiveness. More well-designed trials will be introduced. More classification and detailed treatment methods for SP will be introduced to this research field.

Correlation of serum levels of HIF-1α, SMAD3, and HDAC3 with the disease severity in stroke patients

OBJECTIVE

Explore serum levels of hypoxia-inducible factor-1α (HIF-1α), signal transduction molecule 3 (SMAD3), and histone deacetylase (HDAC) and their correlation with the severity of the condition of stroke patients.

PATIENTS AND METHODS

Clinical records of 93 stroke patients and 93 healthy individuals were retrospectively analyzed. Serum levels of HIF-1α, SMAD3, and HDAC3 in patients with different disease degrees and lesion areas were compared between the two groups. Correlation between serum levels of HIF-1α, SMAD3, and HDAC3 and the severity and lesion area of the observation group were analyzed.

RESULTS

Serum levels of HIF-1α, SMAD3, and HDAC3 in the observation group were higher than those in the control group (p<0.05). Serum levels of HIF-1α, SMAD3, and HDAC3 in patients with moderate and severe disease were significantly higher than those in patients with mild disease and were the highest in patients with severe disease (p<0.05). Serum levels of HIF-1α, SMAD3, and HDAC3 in patients with moderate and large areas of cerebral infarction were significantly higher than those in patients with small areas of cerebral infarction and the highest in patients with large areas of cerebral infarction (p<0.05). Spearman correlation analysis showed that serum levels of HIF-1α, SMAD3, and HDAC3 significantly positively correlated with the severity of stroke and lesion area (p<0.05).

CONCLUSIONS

Serum levels of HIF-1α, SMAD3, and HDAC3 in stroke patients are highly expressed, and the increase positively correlates with the severity of the disease and the area of the lesion.

Cardiac telerehabilitation under 5G internet of things monitoring: a randomized pilot study

Owing to issues such as time and cost, patients often show poor acceptance of and adherence to center-based cardiac rehabilitation (CBCR), which impacts the effectiveness of rehabilitation. Therefore, there is growing interest in home-based cardiac rehabilitation and cardiac telerehabilitation (CTR), which entail less time and cost than CBCR. This study aimed to compare the changes in physiological and psychological indicators, compliance, and satisfaction after CTR and CBCR. In this single-blind, randomized, controlled trial, the intervention group received CTR via the 5G Internet of Things platform, while the control group received CBCR. Data from 50 patients (age 66.28 ± 4.01 years) with acute myocardial infarction who underwent percutaneous coronary intervention were analyzed. After an intervention period of three months, the maximal oxygen uptake and metabolic equivalent of task were 5.53 ± 0.12 and 19.32 ± 0.17, respectively, in the intervention group, and 4.15 ± 0.13 and 16.52 ± 0.18, respectively, in the control group. After three months of intervention, there were significant differences between the two groups in all observed indicators (p < 0.05), except for low-density lipoprotein and the incidence of major adverse cardiovascular events (p > 0.05). The use of a 5G Internet of Things platform cardiac rehabilitation model effectively improved outcomes in patients with acute myocardial infarction who underwent percutaneous coronary intervention. Trials registry: The study protocol was registered at Chinese Clinical Trials Registry (ChiCTR), first trial registration 07/08/2023, identification number ChiCTR2300074435.

Knowledge mapping of immunotherapy for thyroid cancer from 1980 to 2022: A review

With the gradual development of immunotherapy for thyroid cancer, relevant research has increased. To better understand the current situation, development trend, evolution process, and research hotspots of this field, we conducted this comprehensive bibliometrics visual analysis. We retrieved papers published from 1980 to 2022 from Web of Science Core Collection on January 31, 2023. CiteSpace, Pajek, VOSviewer, R-Bibliometrix, and Scimago Graphics are the tools to perform the analysis. Analysis methods mainly include co-occurrence analysis and cluster analysis. Analysis objects are countries or regions, institutions, authors, journals, and keywords, etc. In terms of publication number, the recent decade has witnessed rapid growth. USA was the most prolific country and has the most influence in the cooperation team. Sweden took the lead in focus on this research field and lasted for 21 years. Garden State Cancer Center was released most papers (28). INSERM played a major role in institutional cooperation. Goldenberg DM published the most papers (48), with H-Index 25 and G-Index 43. Journal of Nuclear Medicine has the greatest papers published (41). The average impactor factor of the top 10 journals is 7.2058. The top keywords with high burst strength are: radioimmunotherapy (14.85), monoclonal antibody (13.78), non hodgkins lymphoma (12.54). The research field of immunotherapy for thyroid cancer will be further developed. This study provides a valuable reference for future research in the field.

Mesenchymal Stem Cells Inhibit Epithelial-to-Mesenchymal Transition by Modulating the IRE1α Branch of the Endoplasmic Reticulum Stress Response

Background

Idiopathic pulmonary fibrosis (IPF) is the most common idiopathic interstitial lung disease, and it carries a poor prognosis due to a lack of efficient diagnosis methods and treatments. Epithelial-mesenchymal transition (EMT) plays a key role in IPF pathogenesis. Endoplasmic reticulum (ER) stress contributes to fibrosis via EMT-mediated pathways. Mesenchymal stem cell (MSC) transplantation is a promising treatment strategy for pulmonary fibrosis and ameliorates lung fibrosis in animal models via paracrine effects. However, the specific mechanisms underlying the effect of transplanted MSCs are not known. We previously reported that MSCs attenuate endothelial injury by modulating ER stress and endothelial-to-mesenchymal transition. The present study investigated whether modulation of ER stress- and EMT-related pathways plays essential roles in MSC-mediated alleviation of IPF.

Methods and Results

We constructed a A549 cell model of transforming growth factor-β1 (TGF-β1)-induced fibrosis. TGF-β1 was used to induce EMT in A549 cells, and MSC coculture decreased EMT, as indicated by increased E-cadherin levels and decreased vimentin levels. ER stress participated in TGF-β1-induced EMT in A549 cells, and MSCs inhibited the expression of XBP-1s, XBP-1u, and BiP, which was upregulated by TGF-β1. Inhibition of ER stress contributed to MSC-mediated amelioration of EMT in A549 cells, and modulation of the IRE1α-XBP1 branch of the ER stress pathway may have played an important role in this effect. MSC transplantation alleviated bleomycin (BLM)-induced pulmonary fibrosis in mice. MSC treatment decreased the expression of ER stress- and EMT-related genes and proteins, and the most obvious effect of MSC treatment was inhibition of the IRE1α/XBP1 pathway.

Conclusions

The present study demonstrated that MSCs decrease EMT by modulating ER stress and that blockade of the IRE1α-XBP1 pathway may play a critical role in this effect. The current study provides novel insight for the application of MSCs for IPF treatment and elucidates the mechanism underlying the preventive effects of MSCs against pulmonary fibrosis.

Androgens in endometrial carcinoma: the killer or helper?

PURPOSE

The aim of this review is to discuss the role of androgens in the progression of endometrial carcinoma (EC) with particular focus on the different kinds of androgenic hormones, androgen receptor (AR) and intracrine androgen metabolism.

METHODS

A comprehensive literature search within PubMed was performed. Selected publications related to androgens and EC were reviewed.

RESULTS

There are different kinds of androgenic hormones, and different kinds of androgens may have different effects. Elevated androgens (especially testosterone) have been associated with an increased EC risk in postmenopausal women. 5α-reductases (5α-Reds) and 17β-hydroxysteroid dehydrogenase type 2 (17βHSD2) pathway may inhibit the progression of EC mediated by dihydrotestosterone (DHT), but aromatases stimulate further progression of EC. The most of studies accessing the prognostic value of AR have found that AR expression may be a favorable prognostic indicator.

CONCLUSION

Androgens may have both oncogenic and tumor suppressive roles. Androgen-specific biases in metabolism and the expression of AR may contribute to the different prognosis of patients with EC.

Uniaxial cyclic stretch enhances osteogenic differentiation of OPLL-derived primary cells via YAP-Wnt/β-catenin axis

The pathogenesis of posterior longitudinal ligament ossification (OPLL) remains inadequately understood. Mechanical stimulation is one of the important pathogenic factors in OPLL. As one of the mechanical stimulation transduction signals, the yes-associated protein (YAP) interacts with the Wnt/β-catenin signalling pathway, which plays an important role in osteogenic differentiation. This study aimed to demonstrate the role of YAP-Wnt/β-catenin axis in cell differentiation induced by mechanical stress. Primary cells extracted from posterior longitudinal ligament tissues from OPLL or non-OPLL patients were subjected to sinusoidal uniaxial cyclic stretch (5 %, 0.5 Hz, 3 d). The expression of runt-related transcription factor 2, collagen I, osterix, osteocalcin and alkaline phosphatase were compared between the static and the experimental groups. In addition, the cytoskeleton was detected using phalloidin staining while YAP phosphorylation states and nuclear location were identified using immunofluorescence. The results showed that mechanical stretching loading increased the expression of osteogenic genes and proteins in the OPLL group, while it had no significant effect on the control group. When OPLL cells were stretched, YAP exhibited an obvious nuclear translocation and the Wnt/β-catenin pathway was activated. Knocking down YAP or β-catenin could weaken the impact upon osteogenic differentiation induced by mechanical stimulation. YAP-mediated mechanical stimulation promoted osteogenic differentiation of OPLL cells through Wnt/β-catenin pathway and this progress was independent of the Hippo pathway.

Family outcome disparities between sexual minority and heterosexual families: a systematic review and meta-analysis

BACKGROUND

The number of children in sexual minority parent families has increased. This systematic review aims to synthesise the evidence of disparities in family outcomes between sexual minority and heterosexual families and to identify specific social risk factors of poor family outcomes.

METHODS

We systematically searched PubMed, the Web of Science, Embase, the Cochrane Library and APA PsycNet for original studies that compared family outcomes between sexual minority and heterosexual families. Two reviewers independently selected studies and assessed the risk of bias of included studies. Narrative synthesis and meta-analysis were conducted to synthesise evidence.

RESULTS

Thirty-four articles were included. The narrative synthesis results revealed several significant findings for children's gender role behaviour and gender identity/sexual orientation outcomes. Overall, 16 of 34 studies were included in the meta-analyses. The quantitative synthesis results suggested that sexual minority families may perform better in children's psychological adjustment and parent-child relationship than heterosexual families (standardised mean difference (SMD) -0.13, 95% CI -0.20 to -0.05; SMD 0.13, 95% CI 0.06 to 0.20), but not couple relationship satisfaction (SMD 0.26, 95% CI -0.13 to 0.64), parental mental health (SMD 0.00, 95% CI -0.16 to 0.16), parenting stress (SMD 0.01, 95% CI -0.20 to 0.22) or family functioning (SMD 0.18, 95% CI -0.11 to 0.46).

CONCLUSION

Most of the family outcomes are similar between sexual minority and heterosexual families, and sexual minority families have even better outcomes in some domains. Relevant social risk factors of poor family outcomes included stigma and discrimination, poor social support and marital status, etc. The next step is to integrate multiple aspects of support and multilevel interventions to reduce the adverse effects on family outcomes with a long-term goal of influencing policy and law making for better services to individuals, families, communities and schools.

Knowledge Mapping of International Research on Acupuncture for Chronic Pain: A Bibliometric Analysis

INTRODUCTION

With the wide acceptance of acupuncture, many papers and guidelines recommend that acupuncture is effective for chronic pain (CP). In this study, we applied bibliometric methods to analyze the current research situation of acupuncture intervention in CP, to gain insight into the current situation and future development trend of this field.

MATERIAL AND METHODS

Science Citation Index Expanded was searched for publications related to acupuncture for CP between 1900 and 2022. VOSviewer, CiteSpace and Thomson Data Analyzer were used to analyze the annual publication, authors and cited authors and their countries (regions) and institutions, journals and cited journals, cited references, co-occurrence keywords, burst keywords, and the relevant centrality.

RESULTS

A total of 1968 papers were retrieved, the annual publications have shown a rapid growth trend in the recent 20 years. The USA (708) and the Kyung Hee University (31) were the most productive country and institution, respectively, while the USA (0.37) and University of Maryland (0.13) had the highest centrality. MacPherson, Hugh published the most papers in this field (29), and Vickers, A J were the most influential author (289 times cited). Journal of Alternative and Complementary Medicine was the most productive journal (92), whereas PAIN was the most influential one (4743 times cited). Breivik, H's (2006) paper had the most citation count (3025), while Furlan's (2005) paper had the highest centrality (0.23). The research focuses in this field mainly include pain, electroacupuncture, Low back pain, Systematic review, Randomized controlled trial etc. Researchers are currently paying more attention to the psychological problems caused by CP.

CONCLUSION

The research of acupuncture for CP will be further expanded. International cooperation of this research field needs to be further strengthened. More high-quality designed trials need to be conducted.

Ultralight type I transvaginal mesh: an alternative for recurrent severe posterior vaginal prolapse

OBJECTIVE

This study aimed to analyze the medium-term outcomes of ultralight type I mesh for postmenopausal women with recurrent severe posterior vaginal prolapse (PVP).

METHODS

All participants underwent transvaginal ultralight type I mesh repair between April 2016 and April 2021 and were followed until May 2022. Pelvic Organ Prolapse Quantification System (POP-Q) staging, mesh-related complications, Patient Global Impression of Improvement (PGI-I) scale and quality of life questionnaire responses were evaluated. The primary outcome was composite surgical success rate at the last follow-up, composite success being defined as no vaginal bulge symptoms, no POP-Q point at or beyond the hymen and no re-treatment for POP. Secondary outcomes included anatomic outcomes (POP-Q score), symptomatic relief and complications.

RESULTS

The median follow-up was 37.3 months. At the last follow-up, the composite success rate was 75%, and POP-Q scores for the vault and posterior wall and quality of life questionnaire scores were significantly improved (p < 0.01). The subjective satisfaction (PGI-I ≤ 2) rate was 83.3%. There were no mesh-related complications.

CONCLUSIONS

Ultralight mesh can achieve good clinical outcomes and substantially improve the quality of life of patients with severe recurrent PVP in the medium term, and may thus be a viable alternative for treating this condition.

Usability of dual HIV/syphilis self-testing among men who have sex with men in China: study protocol for a three-arm randomised controlled trial

INTRODUCTION

HIV self-testing (HIVST) provides a key measure for the early detection of HIV infection in men who have sex with men (MSM). However, dual HIV/syphilis self-testing in the MSM population has not been studied. We describe a randomised controlled trial to evaluate the effect of dual HIV/syphilis self-testing on the testing frequency among MSM in China.

METHODS AND ANALYSIS

This randomised controlled trial will be implemented in Guangxi, China. 330 MSM, including 255 frequent testers and 75 less frequent testers, will be recruited and randomly assigned in a 1:1:1 ratio into one of three arms: a site-based testing arm, a single HIVST arm and a dual HIV/syphilis self-testing arm. Participants in the single HIVST arm and dual HIV/syphilis self-testing arm will receive two free finger-prick-based HIVST or HIV/syphilis self-testing kits at enrolment. The data will be collected at five separate times: baseline, 3 months, 6 months, 9 months and 12 months. The primary outcome is the mean frequency of HIV testing used by MSM after intervention comparing each group during the study period. The secondary outcome includes changes in sex behaviours (eg, number of male sex partners and the proportion of consistent condom use) and the mean number of HIV tests used by the social network members over the study period.

ETHICS AND DISSEMINATION

The study protocol was reviewed and approved by the Medical Ethics Committee of Guangxi Medical University, China (20210173). The study results will be disseminated through conferences and academic journals.

TRIAL REGISTRATION NUMBER

ChiCTR2100050898.

Carbene and photocatalyst-catalyzed decarboxylative radical coupling of carboxylic acids and acyl imidazoles to form ketones

The carbene and photocatalyst co-catalyzed radical coupling of acyl electrophile and a radical precursor is emerging as attractive method for ketone synthesis. However, previous reports mainly limited to prefunctionalized radical precursors and two-component coupling. Herein, an N-heterocyclic carbene and photocatalyst catalyzed decarboxylative radical coupling of carboxylic acids and acyl imidazoles is disclosed, in which the carboxylic acids are directly used as radical precursors. The acyl imidazoles could also be generated in situ by reaction of a carboxylic acid with CDI thus furnishing a formally decarboxylative coupling of two carboxylic acids. In addition, the reaction is successfully extended to three-component coupling by using alkene as a third coupling partner via a radical relay process. The mild conditions, operational simplicity, and use of carboxylic acids as the reacting partners make our method a powerful strategy for construction of complex ketones from readily available starting materials, and late-stage modification of natural products and medicines.

The combination of carbene- and photocatalysis has enabled unorthodox routes to ketone syntheses, but usually requires engineered or activated substrates. Herein the authors present a carbene- and photocatalytic decarboxylative radical coupling of carboxylic acids and acyl imidazoles, in which the carboxylic acids are directly used as radical precursors.

Highly efficient generation of narrowband terahertz radiation driven by a two-spectral-line laser in PPLN

We demonstrate record ∼0.9% efficiencies for optical conversion to narrowband (<1% relative bandwidth) terahertz (THz) radiation by strongly cascaded difference frequency generation. These results are achieved using a novel, to the best of our knowledge, laser source, customized for high efficiencies, with two narrow spectral lines of variable separation and pulse duration (≥250 ps). THz radiation generation in 5% MgO-doped periodically poled lithium niobate (PPLN) crystals of varying poling period was explored at cryogenic and room temperature operation as well as with different crystal lengths. This work addresses an increasing demand for high-field THz radiation pulses which has, up to now, been largely limited by low optical-to-THz radiation conversion efficiencies.

Effect of COVID-19 Infection on HeartCare, Data from the SHORE Multicenter Registry

Purpose

Transplant patients represent a cohort in which COVID-19 (C19) may stimulate an unpredictable clinical course. The aim of this study was to evaluate the impact of C19 infection on AlloMap gene expression profiling (AM) and AlloSure donor derived cell free DNA (AS) results in patients post heart transplant.

Methods

The Surveillance Using HeartCare Outcomes Registry (SHORE) is a multicenter study for post heart transplant patients followed with AM/AS for 5 years. Patients enrolled were analyzed based on C19 . AM/AS were evaluated before, at the time and following infection. Both individual trends and the differences between the median AS and AS levels were studied. Nonparametric tests were used to assess categorical and longitudinal variables.

Results

21 patients developed C19 infection; 16 (76%) were males, median age 50 years. There was no significant difference in AM or AS in stable patients (no rejection, CAV, graft dysfunction, dnDSA) compared to the first AM/AS profile in the C19+ patients, Figure 1. Event rates in C19+ patients are described in Table 1. 12 C19+ patients had 28 biopsies, 2 of which were within 30 days of C19. 1 patient had ACR 2R and another AMR 1; all other biopsies were <ACR 2R/AMR1. Additionally, 5 patients developed dnDSA and 7 patients developed subsequent CMV viremia, a median of 67 and 158 days after C19 diagnosis, respectively. No CAV, graft dysfunction, or deaths were reported in this small group of C19+ patients.

Conclusion

The presence of C19 infection is not associated with a significant increase in AS or AM scores, suggesting AS and AM are not confounded by C19 and can be used safely as non-invasive surveillance in this population.

Non-magnetic ion site disorder effects on the quantum magnetism of a spin-1/2 equilateral triangular lattice antiferromagnet

With the motivation to study how non-magnetic ion site disorder affects the quantum magnetism of Ba₃CoSb₂O₉, a spin-1/2 equilateral triangular lattice antiferromagnet, we performed DC and AC susceptibility, specific heat, elastic and inelastic neutron scattering measurements on single crystalline samples of Ba_2.87Sr_0.13CoSb₂O₉with Sr doping on non-magnetic Ba²⁺ion sites. The results show that Ba_2.87Sr_0.13CoSb₂O₉exhibits (i) a two-step magnetic transition at 2.7 K and 3.3 K, respectively; (ii) a possible canted 120 degree spin structure at zero field with reduced ordered moment as 1.24μ_B/Co; (iii) a series of spin state transitions for bothH∥ab-plane andH∥c-axis. ForH∥ab-plane, the magnetization plateau feature related to the up-up-down phase is significantly suppressed; (iv) an inelastic neutron scattering spectrum with only one gapped mode at zero field, which splits to one gapless and one gapped mode at 9 T. All these features are distinctly different from those observed for the parent compound Ba₃CoSb₂O₉, which demonstrates that the non-magnetic ion site disorder (the Sr doping) plays a complex role on the magnetic properties beyond the conventionally expected randomization of the exchange interactions. We propose the additional effects including the enhancement of quantum spin fluctuations and introduction of a possible spatial anisotropy through the local structural distortions.

[Study on parameters of robot-assisted ultrasonic drilling on bovine vertebral body]

Objective: To investigate the effect of ultrasonic parameter settings on maximum temperatures in the drilling site and penetration time and determine the most suitable parameters for efficient and safe robot-based ultrasonic bone drilling in spinal surgery. Methods: Five adult bovine thoracic and lumbar vertebrae specimens (T10-L6) were cut into 10 mm thick slices. A total of 50 slices were obtained. Among them, 30 and 20 slices were used for cancellous bone experiments and cortical bone experiments, respectively. In the cancellous bone experiment, the slices were randomly divided into three groups, corresponding to different feed rates of 0.8 mm/s, 1.6 mm/s, and 2.4 mm/s, respectively, with 10 slices in each group. The cancellous part of each slice was drilled 9 times with different output powers from 20% (48 W) to 100% (120 W). In the cortical bone experiment, the slices were randomly assigned into two groups, corresponding to a different feed rate (0.8 mm/s and 1.6 mm/s). Drilling was performed on the cortical part of each slice 4 times with different output power, which increased from 70% (84W) to 100% (120 W). All experiments were conducted at room temperature of 25 ℃. Maximum temperature and penetration time were recorded. The maximum grinding temperature and penetration time of cancellous bone and cortical bone under different output power and feed rate were compared. Results: At the same feed rate, the maximum temperature of the cancellous bone decreased as output power increased. There were statistically significant differences in the maximum temperature between the output powers of 120 W and 24 W under different feed rates(61.2 ℃±9.4 ℃ vs 70.9 ℃±5.7 ℃, 59.2 ℃±7.1 ℃ vs 69.5 ℃±10.7 ℃, 55.5 ℃±5.5 ℃ vs 69.2 ℃±9.3 ℃, all P<0.05). At the premise of the same output power, there was no significant difference in the maximum temperature among different feed rates (all P>0.05). At the feed rate of 0.8 mm/s, the maximum temperature of cortical bone decreased as the output power increased. The maximum temperature at the output power of 120 W was significantly lower than that of 84 W (P=0.048). However, at the feed rate of 1.6 mm/s, the maximum temperature could not be significantly lowered by the increase in output power (P>0.05). Under the same output power, the maximum temperature at the feed rate of 1.6 mm/s were all significantly lower than those of 0.8 mm/s (all P<0.05). The penetration time of cancellous bone did not decrease significantly with the increase in the output power (all P>0.05) while it decreased significantly as the feed rate increased (all P<0.05). Regarding cortical bone at the feed rate of 0.8 mm/s, the increase in output power could not shorten the penetration time (P>0.05); at the feed rate of 1.6 mm/s, the penetration time at the output power of 120 W was significantly shorter than that of 96 W (P=0.008). With the same output power, the penetration time at the feed rate of 1.6 mm/s were significantly shorter than those at 0.8 mm/s (all P<0.05). There was no statistical difference in the penetration failure rate among different feed rates with the same output power (all P>0.05). The penetration failure rate was 0 when the output power of cancellous bone was 48 W and above and the output power of cortical bone were 108 W and 120 W. Conclusions: The maximum temperature of vertebral cancellous bone and the cortical bone is primarily influenced by the output power and the feed rate, respectively; the penetration time of cancellous bone and the cortical bone is affected by the feed rate and both of feed rate and output power, respectively. The most suitable parameters are output power of 120 W and feed rate of 2.4 mm/s for cancellous bone and output power of 120 W and feed rate of 1.6 mm/s for cortical bone.

BMSC-Derived ApoEVs Promote Craniofacial Bone Repair via ROS/JNK Signaling

Bone defect caused by trauma, neoplasia, congenital defects, or periodontal disease is a major cause of disability and physical limitation. The transplantation of bone marrow mesenchymal stem cells (BMSCs) promotes bone repair and regeneration. However, it has been shown that most BMSCs die within a short period after transplantation. During apoptosis, BMSCs generate a large number of apoptotic cell-derived extracellular vesicles (ApoEVs). This study aims to understand the potential role of ApoEVs in craniofacial bone defect repair and regeneration. First, we confirmed that BMSCs undergo apoptosis within 2 d after transplantation into the defect of the cranium. Abundant ApoEVs were generated from apoptotic BMSCs. Uptake of ApoEVs efficiently promoted the proliferation, migration, and osteogenic differentiation of recipient BMSCs in vitro. ApoEVs from cells in the middle stage of apoptosis were the most efficient to enhance the regenerative capacity of BMSCs. Moreover, a critical size bone defect model in rats was used to evaluate the osteogenic property of ApoEVs in vivo. Local transplantation of ApoEVs promoted bone regeneration in the calvarial defect. Mechanistically, ApoEVs promoted new bone formation by increasing intracellular reactive oxygen species to activate JNK signaling. This study reveals a previously unknown role of the dying transplanted BMSCs in promoting the viability of endogenous BMSCs and repairing the calvarial defects. Since it could avoid several adverse effects and limits of BMSC cytotherapy, treatment of ApoEVs might be a promising strategy in craniofacial bone repair and regeneration.

Carbene-catalyzed atroposelective synthesis of axially chiral styrenes

Axially chiral styrenes bearing a chiral axis between a sterically non-congested acyclic alkene and an aryl ring are difficult to prepare due to low rotational barrier of the axis. Disclosed here is an N-heterocyclic carbene (NHC) catalytic asymmetric solution to this problem. Our reaction involves ynals, sulfinic acids, and phenols as the substrates with an NHC as the catalyst. Key steps involve selective 1,4-addition of sulfinic anion to acetylenic acylazolium intermediate and sequential E-selective protonation to set up the chiral axis. Our reaction affords axially chiral styrenes bearing a chiral axis as the product with up to > 99:1 e.r., > 20:1 E/Z selectivity, and excellent yields. The sulfone and carboxylic ester moieties in our styrene products are common moieties in bioactive molecules and asymmetric catalysis.

Dietary Fiber and All-Cause and Cardiovascular Mortality in Older Adults with Hypertension: A Cohort Study Of NHANES

OBJECTIVES

Several studies have documented that dietary fiber was inversely associated with a variety of diseases, but the association of dietary fiber with the prognosis of older adults with hypertension is unknown. The aim was to assess the association of dietary fiber with all-cause and cardiovascular mortality in older adults with hypertension.

METHODS

This study enrolled 4906 participants (51.6% were female) aged 65 years or older with hypertension in the National Health and Nutrition Examination Survey (NHANES) 2003-2014 and ascertained mortality through December 31, 2015. Dietary fiber intake data were assessed by using a 24-h recall survey. Participants were grouped by dietary fiber intake quartiles: Q1(fiber < 10.20, g/day), Q2 (10.20 ≤ fiber < 14.45, g/day), Q3 (14.45 ≤ fiber < 19.85, g/day), and Q4 (19.85 ≤ fiber, g/day). Multivariate Cox proportional hazard models were used to evaluate the associations of dietary fiber intake with all-cause and cardiovascular mortality. Kaplan-Meier survival curves and restricted cubic spline models were applied to reveal the relationship between dietary fiber intake and mortality.

RESULTS

Over the median follow-up duration of 70 months (interquartile range: 38-100 months), 1369 participants were determined as all-cause mortality (27.9%) and 270 participants were identified as cardiovascular mortality (5.5%). In the fully adjusted model, the higher dietary fiber intake group was associated with relatively lower all-cause (Q4 vs Q1: 0.68 (0.58, 0.80); P for trend <0.001) and cardiovascular mortality (Q4 vs Q1: 0.64 (0.45, 0.92); P for trend =0.010). The non-linear relationship was not observed between dietary fiber intake and all-cause or cardiovascular mortality.

CONCLUSIONS

Higher dietary fiber intake was significantly associated with decreased all-cause and cardiovascular mortality in older adults with hypertension. Increasing dietary fiber intake may improve the prognosis of older adults with hypertension.

Curcumin protects human umbilical vein endothelial cells against high oxidized low density lipoprotein-induced lipotoxicity and modulates autophagy

Objectives

Endothelial dysfunction is a precursor of cardiovascular disease, and protecting endothelial cells from damage is a treatment strategy for atherosclerosis (AS). Curcumin, a natural polyphenolic compound, has been shown to protect endothelial cells from dysfunction. In the present study, we investigated whether curcumin could ameliorate high oxidized low-density lipoprotein (ox-LDL)-induced endothelial lipotoxicity by inducing autophagy in human umbilical vein endothelial cells (HUVECs).

Materials and Methods

HUVECs were treated with 50 μM high ox-LDL alone or in combination with 5 μM curcumin for 24 hr. Cell viability and function were assessed by the cell counting kit-8 (CCK-8) assay, tube formation assay and cell migration experiments. Oil red O staining was used to detect lipid droplet accumulation in HUVECs. The change in reactive oxygen species (ROS) levels in HUVECs was measured with the probe DCFH-DA. Quantitative real-time PCR (qPCR) and Western blotting were used to evaluate the mRNA and protein levels of several inflammatory and autophagy-related factors.

Results

Cell viability was restored, tube formation and migration ability were increased, and lipid accumulation, oxidative stress and inflammatory responses were decreased in the curcumin-treated group compared with the high ox-LDL group. Furthermore, high ox-LDL inhibited HUVEC autophagy, and this effect was reversed by curcumin. Moreover, curcumin regulated the expression of several key proteins involved in the AMPK/mTOR/p70S6K signaling pathway.

Conclusion

Our findings suggest that curcumin is able to reduce endothelial lipotoxicity and modulate autophagy and that the AMPK/mTOR/p70S6K pathway might play a key role in these effects.

Carbene-catalyzed enantioselective annulation of dinucleophilic hydrazones and bromoenals for access to aryl-dihydropyridazinones and related drugs

4,5-Dihydropyridazinones bearing an aryl substituent at the C6-position are important motifs in drug molecules. Herein, we developed an efficient protocol to access aryl-dihydropyridazinone molecules via carbene-catalyzed asymmetric annulation between dinucleophilic arylidene hydrazones and bromoenals. Key steps in this reaction include polarity-inversion of aryl aldehyde-derived hydrazones followed by chemo-selective reaction with enal-derived α,β-unsaturated acyl azolium intermediates. The aryl-dihydropyridazinone products accessed by our protocol can be readily transformed into drugs and bioactive molecules.

Polarity inversion of arylidene hydrazones to react with bromoenals via carbene organic catalysis is disclosed. The reaction enantioselectively affords 6-aryl-4,5-dihydropyridazinones and related drugs with proven commercial applications.

Publication trends and hotspots in enhanced recovery after surgery: 20-year bibliometric analysis

We evaluated enhanced recovery after surgery (ERAS) research and used bibliometric analysis to quantitatively and qualitatively predict research hotspots through extracting relevant publications from the core collection of the Web of Science database.

Identification of Type H Vessels in Mice Mandibular Condyle

Type H vessel is a specific vessel subtype that is strongly positive for CD31 and endomucin (CD31^hiEmcn^hi). It has already been identified that it can tightly regulate the coupling of angiogenesis and osteogenesis in the long bone of mice and human beings. The long bone is formed through endochondral ossification, which is the same type of process happening in mandibular condyle. Although the ossification of long bone and mandibular condyle has the same developmental process, the existence of type H vessels in the mouse condyle remains unclear. To address this, we identified that abundant type H vessels existed in the subchondral bone of the mouse condylar head and endosteum of the mouse condylar neck. Meanwhile, immunofluorescence imaging of the condyles in different ages of male C57BL/6J mice demonstrated that type H vessels decreased while aging. Furthermore, we validated a positive correlation between type H vessels and Osterix⁺ osteoprogenitors in the condyle induced by mandibular advancement. Mechanistically, we confirmed that deferoxamine mesylate, which promoted the proliferation of type H endothelial cells by activating hypoxia-inducible factor 1α (HIF-1α) signaling pathways, largely prevented the osteopenia in the condyle induced by botulinum toxin type A. Collectively, these results demonstrate that in the mouse condyle, type H vessels in areas of high function positively correlate with bone formation. In addition, we show a novel influence of HIF-1α signaling on osteogenesis via an increase in type H vessels. In conclusion, promoting angiogenesis of type H vessels is a promising strategy for the therapeutic improvement of osteogenesis in mandibular condyle.

Hope as a Process in Understanding Positive Mood and Suicide Protection

Background: According to the broaden-and-build model of positive mood, positive emotions are believed to broaden cognition resources and build psychological resiliency, to help incur positive psychological outcomes. Aim: We examined hope as a potential mediator of the association between positive mood and suicide protection (viz., life satisfaction and reasons for living) in adults. We hypothesized that positive mood would be associated with greater suicide protection through broadening hope agency and building hope pathways. Method: A sample of 320 college students completed measures of positive emotions, hope, and suicide protection. Results: Results from bootstrapped mediation testing indicated that hope agency, but not hope pathways, partially or fully mediated the relationship between positive mood and suicide protection. Limitations: It is not clear whether these findings are generalizable to a more diverse adult population. Also, it is not possible to rule out alternative causal models involving positive emotions and suicide protection. Conclusion: These findings provide some promising preliminary evidence for how positive emotions might help build hope agency to foster greater suicide protection in adults.

Oral Organoids: Progress and Challenges

Oral organoids are complex 3-dimensional structures that develop from stem cells or organ-specific progenitors through a process of self-organization and re-create architectures and functionalities similar to in vivo organs and tissues in the oral and maxillofacial region. Recently, striking advancements have been made in the construction and application of oral organoids of the tooth, salivary gland, and tongue. Dental epithelial and mesenchymal cells isolated from tooth germs or derived from pluripotent stem cells could generate tooth germ-like organoids by self-organization in a specific culture system. Tooth organoids can also be constructed based on tissue engineering principles by seeding stem cells on a scaffold with the bioregulatory functions of odontogenic differentiation. Two main approaches have been used to construct salivary gland organoids: 1) incubation of salivary gland-derived stem/progenitor cells in a 3-dimensional culture system to form the structure of the gland through mimicking regenerative processes and 2) inducing of pluripotent stem cells to generate embryonic salivary glands by replicating the development process. Taste bud organoids can be generated by embedding isolated circumvallate papilla tissue in Matrigel with a mixture of growth factors, while lingual epithelial organoids have been constructed using lingual stem cells in a suitable culture system containing specific signaling molecules. These oral organoids usually maintain the main functions and characteristic structures of the corresponding organ to a certain extent. Furthermore, using cells isolated from patients, oral organoids could replicate specific diseases such as maxillofacial tumors and tooth dysplasia. Until now, oral organoids have been applied in the study of mechanisms of tooth development, pathology and regeneration of the salivary gland, and precision therapeutics for tongue cancer. These findings strongly demonstrate that the organoid technique is a novel paradigm for the study of the development, pathology, and regeneration of oral and maxillofacial tissue.

Enantioselective modification of sulfonamides and sulfonamide-containing drugs via carbene organic catalysis

Enantioselective modification of sulfonamides and sulfonamide-containing drugs via carbene organic catalysis is disclosed. The cation−π interaction was computationally found to play a pivotal role in modulating the reaction enantioselectivity.

Exophytic condyloma: are they as benign as we think?

AIM

As the understanding of anal dysplasia continues to develop, controversy remains regarding treatment of these lesions. The purpose of this study was to evaluate lesion type (flat vs exophytic) and the association between morphology and dysplasia.

METHODS

This was a single-centre retrospective analysis of a prospectively collected pathological database of patients > 17 years old who underwent operative excision/biopsies for presumed anal condyloma or dysplasia from 2009 to 2018. The analysis includes comparisons between patient factors, phenotype and grade of dysplasia.

RESULTS

Sixty-nine patients had 423 lesions. The mean age of the study population was 48.2 years. 62.3% were men and 46.4% of patients were black. 47.8% of patients were human immunodeficiency virus (HIV) positive and 39.1% were men who have sex with men (MSM). There were 176 (41.6%) flat lesions and 234 (55.3%) exophytic lesions. Exophytic lesions were 2.5-fold more likely to be associated with a higher grade of dysplasia than flat lesions (OR 2.63, 95% CI 1.09-6.32). Neither lesion type nor dysplasia severity was associated with human papillomavirus, lesion location or patient characteristics, including race, MSM or HIV status.

DISCUSSION

Exophytic lesions were more than twice as likely to have advanced dysplasia compared with flat lesions. A clearer understanding of the association between gross lesion appearance and dysplasia will allow more appropriate counselling of patients and the development of better screening and treatment guidelines for anal condylomata and dysplasia.

The Evaluation and Prediction of Laminoplasty Surgery Outcome in Patients with Degenerative Cervical Myelopathy Using Diffusion Tensor MRI

BACKGROUND AND PURPOSE

DTI has been proved valuable for the diagnosis of degenerative cervical myelopathy, whereas its capacity for predicting the outcome of surgery is still under debate. Here we conduct a prospective cohort study to analyze the capacity of DTI for evaluating and predicting laminoplasty surgery outcome for degenerative cervical myelopathy.

MATERIALS AND METHODS

We recruited 55 patients with degenerative cervical myelopathy who underwent DTI before surgery and at 3- and 6-month follow-up stages, and 20 healthy subjects. For clinical assessment, the modified Japanese Orthopedic Association scale was recorded for each patient at different stages. DTI metrics were compared between patients before surgery and healthy subjects. Spearman correlation and receiver operating characteristic were used to analyze the evaluation and prediction capacity of DTI for the modified Japanese Orthopedic Association scale, respectively. We analyzed different vertebral levels: maximal compression level, average of all compression levels, and C2 level.

RESULTS

DTI metrics were significantly different between patients before surgery and healthy subjects. Before surgery, DTI for the maximal compression level or DTI for the average of all compression levels had no significant correlation with the modified Japanese Orthopedic Association scale. For all stages, DTI at the C2 level was correlated with the modified Japanese Orthopedic Association scale. DTI metrics at the C2 level before surgery were significantly correlated with the postoperative modified Japanese Orthopedic Association scale recovery rate. Receiver operating characteristic analysis demonstrated that fractional anisotropy at C2 was capable of predicting the postoperative modified Japanese Orthopedic Association scale recovery rate (P = .04).

CONCLUSIONS

The DTI metrics before laminoplasty surgery, especially fractional anisotropy at the C2 level, have the potential for evaluating and predicting the degenerative cervical myelopathy surgery outcome.

Association between preconception paternal smoking and birth defects in offspring: evidence from the database of the National Free Preconception Health Examination Project in China

OBJECTIVE

To clarify whether preconception paternal smoking has any adverse effects on the offspring.

DESIGN

Prospective, population-based study.

SETTING

Preconception registry data from the National Free Preconception Health Examination Project.

POPULATION OR SAMPLE

Couples planning pregnancy, with complete information on preconception paternal smoking behaviour and pregnancy outcomes.

METHODS

The effect of questionnaire-based paternal smoking behaviour during preconception and pregnancy was assessed via logistic regression. Additionally, we performed a 1:1 case-control (birth defects versus normal pregnancy) analysis, matched for maternal province, folic acid supplementation and paternal alcohol consumption.

MAIN OUTCOME MEASURES

Risk of birth defects in offspring.

RESULTS

In total, 566 439 couples with complete information on preconception paternal smoking behaviour and pregnancy outcomes were enrolled. The preconception paternal smoking rate was 28.7% (162 482) overall: 8.7% (49 303) stopped smoking, 13.3% (75 517) decreased their smoking, and 6.6% (37 662) continued smoking during early pregnancy. The risk of birth defects was higher in the continued-smoking (P < .000, odds ratio [OR] 1.87, 95% CI 1.36-2.56) and decreased-smoking groups (P = .007, OR 1.41, 95% CI 1.10-1.82). In the case-control analysis, infants whose fathers stopped (P = .003, OR 0.32, 95% CI 0.15-0.67) or decreased smoking (P = .000, OR 0.25, 95% CI 0.13-0.49) were at lower risk of congenital heart diseases, limb abnormalities, digestive tract anomalies and neural tube defects than those whose fathers continued smoking.

CONCLUSION

Preconception paternal smoking may be associated with congenital heart diseases, limb abnormalities and neural tube defects in the offspring. Changes in smoking behaviour may reduce this risk.

TWEETABLE ABSTRACT

This study suggests that preconception paternal smoking is associated with birth defects in offspring. Changes in smoking behaviour may reduce this risk.

[Exploration and prospect of 5G application in telemedicine]

The combination of network and medical field gave birth to telemedicine.The implementation of telemedicine can improve the uneven distribution of regional medical resources, reduce the working pressure of medical staff, shorten the distance between medical staff and patients and medical staff, and improve the timeliness of monitoring, diagnosis and treatment.The continuous development of telemedicine relies on the continuous innovation of network communication technology, the latest 5(th) generation wireless systems (5G) is bringing significant changes to mobile communication and other related industries by virtue of its advantages of high data rate and low latency. This paper reviews the development of telemedicine, introduces the characteristics of 5G technology, combines the research results of 5G technology applied in the medical field at home and abroad, and prospects the development of this field in the future.

Association of Dysplastic Coronoid Process with Long-Face Morphology

Vertical malocclusion is a developmental condition, resulting from complex interactions among multiple etiological factors during the growth period. As a tricky dentofacial deformity clinically, long-face (LF) morphology is characterized by excessive vertical facial growth with severe disarrangement of jaws and teeth. Since the improvement of LF patients on facial profile and occlusion is often difficult and lacks long-term stability, it becomes important to unravel the etiology of LF pattern formation for early prevention and treatment. In the current studies, we identified a transgenic mouse model that exhibited a dysplastic coronoid process and LF morphology. Although the mutant mice exhibited jaw structures and occlusion comparable to controls at birth, they all acquired typical LF morphology with anterior open bite during postnatal growth, resembling clinical features of the selected skeletal class III patients. Since the coronoid process provides an insertion site for the temporalis attachment, we examined the initial development and differentiation of the temporalis and found identical results in both control and mutant mice before E17.5 when the temporal muscle makes attachment to the coronoid process. However, thereafter, we observed altered orientation and reduced size of the cross-sectional area of the temporalis in mutant mice, which persisted to the weaning stage. Biomechanical analysis and simulation modeling further support the idea that altered morphology of the coronoid process may impair the efficiency of the vertical temporalis contraction and appears to correlate with LF formation. Consistently, we present evidence that a dysplastic mandibular coronoid process was also seen in some human patients with skeletal III LF morphology. Taken together, the results presented in this study establish an association of the craniofacial bony structures with vertical patterning, which will have implications in earlier prediction for clinical precaution and intervention.

Microcatheter shaping using three-dimensional printed models for intracranial aneurysm coiling

Background and purpose

Microcatheterization is an important, but also difficult, technique used for the embolization of intracranial aneurysms. The purpose of this study was to investigate the application of three-dimensional (3D) printing technology in microcatheter shaping.

Methods

Nine cases of internal carotid artery posterior communicating artery aneurysm diagnosed by CT angiography were selected, and 3D printing technology was used to build a 3D model including the aneurysm and the parent artery. The hollow and translucent model had certain flexibility; it was immersed in water and the microcatheter was introduced into the water to the target position in the aneurysm, followed by heating the water temperature to 50°C. After soaking for 5 min, the microcatheter was taken out and the shaping was completed. After sterilization, the shaped microcatheter was used for arterial aneurysm embolization and evaluation was conducted.

Results

Nine cases of microcatheter shaping were satisfactory and shaping the needle was not necessary; no rebound was observed. The microcatheter was placed in an ideal position, and the stent-assisted method was used in three cases of wide-neck aneurysm. There were no complications related to surgery.

Conclusion

A new microcatheter shaping method using 3D printing technology makes intracranial artery aneurysm embolization more stable and efficient.

Smad7 Regulates Dental Epithelial Proliferation during Tooth Development

Tooth morphogenesis involves dynamic changes in shape and size as it proceeds through the bud, cap, and bell stages. This process requires exact regulation of cell proliferation and differentiation. Smad7, a general antagonist against transforming growth factor-β (TGF-β) signaling, is necessary for maintaining homeostasis and proper functionality in many organs. While TGF-β signaling is widely involved in tooth morphogenesis, the precise role of Smad7 in tooth development remains unknown. In this study, we showed that Smad7 is expressed in the developing mouse molars with a high level in the dental epithelium but a moderate to weak level in the dental mesenchyme. Smad7 deficiency led to a profound decrease in tooth size primarily due to a severely compromised cell proliferation capability in the dental epithelium. Consistent with the tooth shrinkage phenotype, RNA sequencing (RNA-seq) analysis revealed that Smad7 ablation downregulated genes referred to epithelial cell proliferation and cell cycle G1/S phase transition, whereas the upregulated genes were involved in responding to TGF-β signaling and cell cycle arrest. Among these genes, the expression of Cdkn1a (encoding p21), a negative cell proliferation regulator, was remarkably elevated in parallel with the diminution of Ccnd1 encoding the crucial cell cycle regulator cyclin D1 in the dental epithelium. Meanwhile, the expression level of p-Smad2/3 was ectopically elevated in the developing tooth germ of Smad7 null mice, indicating the hyperactivation of the canonical TGF-β signaling. These effects were reversed by addition of TGF-β signaling inhibitor in cell cultures of Smad7^-/- molar tooth germs, with rescued expression of cyclin D1 and cell proliferation rate. In sum, our studies demonstrate that Smad7 functions primarily as a positive regulator of cell proliferation via inhibition of the canonical TGF-β signaling during dental epithelium development and highlight a crucial role for Smad7 in regulating tooth size.