Novel alternative tools for metastatic pheochromocytomas/paragangliomas prediction

OBJECTIVE

The existing prediction models for metastasis in pheochromocytomas/paragangliomas (PPGLs) showed high heterogeneity in different centers. Therefore, this study aimed to establish new prediction models integrating multiple variables based on different algorithms.

DESIGN AND METHODS

Data of patients with PPGLs undergoing surgical resection at the Peking Union Medical College Hospital from 2007 to 2022 were collected retrospectively. Patients were randomly divided into the training and testing sets in a ratio of 7:3. Subsequently, decision trees, random forest, and logistic models were constructed for metastasis prediction with the training set and Cox models for metastasis-free survival (MFS) prediction with the total population. Additionally, Ki-67 index and tumor size were transformed into categorical variables for adjusting models. The testing set was used to assess the discrimination and calibration of models and the optimal models were visualized as nomograms. Clinical characteristics and MFS were compared between patients with and without risk factors.

RESULTS

A total of 198 patients with 59 cases of metastasis were included and classified into the training set (n = 138) and testing set (n = 60). Among all models, the logistic regression model showed the best discrimination for metastasis prediction with an AUC of 0.891 (95% CI, 0.793-0.990), integrating SDHB germline mutations [OR: 96.72 (95% CI, 16.61-940.79)], S-100 (-) [OR: 11.22 (95% CI, 3.04-58.51)], ATRX (-) [OR: 8.42 (95% CI, 2.73-29.24)] and Ki-67 ≥ 3% [OR: 7.98 (95% CI, 2.27-32.24)] evaluated through immunohistochemistry (IHC), and tumor size ≥ 5 cm [OR: 4.59 (95% CI, 1.34-19.13)]. The multivariate Cox model including the above risk factors also showed a high C-index of 0.860 (95% CI, 0.810-0.911) in predicting MFS after surgery. Furthermore, patients with the above risk factors showed a significantly poorer MFS (P ≤ 0.001).

CONCLUSIONS

Models established in this study provided alternative and reliable tools for clinicians to predict PPGLs patients' metastasis and MFS. More importantly, this study revealed for the first time that IHC of ATRX could act as an independent predictor of metastasis in PPGLs.

Prenatal to preimplantation genetic diagnosis of a novel compound heterozygous mutation in HSPA9 associated with Even-Plus syndrome

BACKGROUND

Heat shock protein family A member 9 (HSPA9) prevents unfolded and dysfunctional protein accumulation, with genetic variants known to be pathogenic. Here, we determined the genetic cause of Even-Plus syndrome (OMIM: 616854) in a Chinese family.

METHODS

We collected samples from two affected and two normal individuals. Whole-exome sequencing was performed to identify their genetic profiles. Potential variants were validated using Sanger sequencing. Assisted reproduction with mutation-free embryos successfully blocked the transmission of mutations.

RESULTS

We identified novel inherited pathogenic complex heterozygous variations in the HSPA9 gene in the two affected fetuses. Three-dimensional spatial simulation of the HSPA9 protein after prediction of the mutated RNA splicing pattern abolished part of the substrate-binding domain of the protein. According to ACMG guidelines, c. 1822-1G>A and c. 1411-3T>G were classified as pathogenic and likely pathogenic, respectively. Mutation-free embryos were selected for transplantation and reconfirmed to possess no mutations. A healthy daughter was successfully born into the family.

CONCLUSIONS

This study is the first to report complex heterozygous variations in the HSPA9 gene that influence alternative splicing in early pregnancy. Our findings expand on the mutational spectrum leading to Even-Plus syndrome and provide a basis for genetic counseling and future embryonic studies.

The Impact of Testosterone on Alzheimer's Disease Are Mediated by Lipid Metabolism and Obesity: A Mendelian Randomization Study

BACKGROUND

To investigate the causal relationship between testosterone (BT) levels and Alzheimer's disease (AD) risk and to quantify the role of obesity and lipid metabolism as potential mediators.

METHODS

We used a two-sample, two-step MR to determine:1) the causal effect of BT levels on AD; 2) the causal effect of two lipid metabolites, obesity and LDLc on AD; and 3) the mediating effects of these metabolites. Pooled data for BT levels and lipid metabolism were obtained from the UK Biobank. AD data were obtained from the Alzheimer's Disease Project International Genomics Consortium, FinnGen Consortium, and UK Biobank study. Effect estimates from external genome-wide association study (GWAS) pooled statistics were obtained using inverse variance-weighted (IVW) MR analysis.

RESULTS

Higher levels of BT were associated with a reduced risk of AD (odds ratio [OR] 0.9992, 95% CI 0.9985-0.9998, P = 0.019), and there was a negative correlation with LDLc (OR 0.9208, 95% CI 0.8569-0.9895, P = 0.024) and obesity class 2 (OC2) (OR 0.7445, 95% CI 0.5873-0.9437, P = 0.014). Conversely, there was a positive correlation between LDLc (OR 1.0014, 95% CI 1.0000-1.0029, P = 0.043) and OC2 (OR 1.0005, 95% CI 1.0001-1.0009, P = 0.003) and AD. Mediation analysis showed that the indirect effect of BT levels on AD was achieved through LDLc and OC2, which accounted for 17% and 17% of the total effect, respectively.

CONCLUSION

Our study identified a causal role of BT levels in LDLc and OC2. BT levels may affect AD through LDLc and OC2 metabolic processes.

Mendelian Randomization Analysis Reveals Causal Factors behind Alzheimer's Disease Risk: Evidence, Opportunities, and Challenges

Alzheimer's disease and its comorbidities pose a heavy disease burden globally, and its treatment remains a major challenge. Identifying the protective and risk factors for Alzheimer's disease, as well as its possible underlying molecular processes, can facilitate the development of interventions that can slow its progression. Observational studies and randomized controlled trials have provided some evidence regarding potential risk factors for Alzheimer's disease; however, the results of these studies vary. Mendelian randomization is a novel epidemiological methodology primarily used to infer causal relationships between exposures and outcomes. Many Mendelian randomization studies have identified potential causal relationships between Alzheimer's disease and certain diseases, lifestyle habits, and biological exposures, thus providing valuable data for further mechanistic studies and the development and implementation of clinical prevention strategies. However, the results and data from Mendelian randomization studies must be interpreted based on comprehensive evidence. Moreover, the existing Mendelian randomization studies on the epidemiology of Alzheimer's disease have some limitations that are worth exploring. Therefore, the aim of this review was to summarize the available evidence on the potential protective and risk factors for Alzheimer's disease by assessing published Mendelian randomization studies on Alzheimer's disease, and to provide new perspectives on the etiology of Alzheimer's disease.

Causal association between aspirin use and risk of endometrioid carcinoma: a Mendelian randomization study

OBJECTIVE

The aim of the study was to investigate the causal relationship between aspirin use and the risk of endometrial endometrioid cancer (EEC) using two-sample Mendelian randomization (TSMR) and multivariable Mendelian randomization (MVMR) study.

MATERIALS AND METHODS

A TSMR analysis was conducted to estimate the potential causal relationship between aspirin use and the risk of EEC using genome-wide data from Genome-wide association study (GWAS). The causal association between aspirin use and EEC was further analyzed by MVMR analysis after adjusting for various factors such as obesity, hypertension, diabetes, and infertility. The single nucleotide polymorphism (SNP) data associated with aspirin use and EEC was obtained from the GWAS catalog database.

RESULTS

A total of six SNPs were included as instrumental variables in TSMR, which showed that taking aspirin reduced the risk of EEC [OR = 0.02, 95% CI = 0-0.28, p = 0.005, inverse variance weighted (IVW) method]. Besides, the results of the weighted median (WME) method, weighted mode, and simple mode were consistent with the results shown by the IVW method. After further using the MVMR method, the causal association of aspirin use and prevention of EEC onset remained significant after adjusting for the effects of obesity, hypertension, and diabetes (OR = 0.076, 95% CI = 0.007-0.793, p = 0.031). Sensitivity analyses, including heterogeneity, horizontal multiplicity, and leave-one-out tests, showed the reliability of the instrumental variables, proving that the results were reliable and not significantly biased.

CONCLUSIONS

Taking aspirin can reduce the risk of EEC morbidity, and it is expected to be of great significance for the early prevention and treatment of endometrial cancer by exploring the biological mechanism of aspirin on endometrioid cancer at a deeper level.

Mechanistic Implications of Low CO Coverage on Cu in the Electrochemical CO and CO2 Reduction Reactions

Electrochemical CO or CO2 reduction reactions (CO(2)RR), powered by renewable energy, represent one of the promising strategies for upgrading CO2 to valuable products. To design efficient and selective catalysts for the CO(2)RR, a comprehensive mechanistic understanding is necessary, including a comprehensive understanding of the reaction network and the identity of kinetically relevant steps. Surface-adsorbed CO (COad) is the most commonly reported reaction intermediate in the CO(2)RR, and its surface coverage (θCO) and binding energy are proposed to be key to the catalytic performance. Recent experimental evidence sugguests that θCO on Cu electrode at electrochemical conditions is quite low (∼0.05 monolayer), while relatively high θCO is often assumed in literature mechanistic discussion. This Perspective briefly summarizes existing efforts in determining θCO on Cu surfaces, analyzes mechanistic impacts of low θCO on the reaction pathway and catalytic performance, and discusses potential fruitful future directions in advancing our understanding of the Cu-catalyzed CO(2)RR.

CO Binding Energy is an Incomplete Descriptor of Cu-Based Catalysts for the Electrochemical CO2 Reduction Reaction

CO binding energy has been employed as a descriptor in the catalyst design for the electrochemical CO2 reduction reactions (CO2 RR). The reliability of the descriptor has yet been experimentally verified due to the lack of suitable methods to determine CO binding energies. In this work, we determined the standard CO adsorption enthalpies (Δ H C O ∘ ${\Delta {H}_{CO}^{^\circ{}}}$ ) of undoped and doped oxide-derived Cu (OD-Cu) samples, and for the first time established the correlation ofΔ H C O ∘ ${\Delta {H}_{CO}^{^\circ{}}}$ with the Faradaic efficiencies (FE) for C2+ products. A clear volcano shaped dependence of the FE for C2+ products onΔ H C O ∘ ${\Delta {H}_{CO}^{^\circ{}}}$ is observed on OD-Cu catalysts prepared with the same hydrothermal durations, however, the trend becomes less clear when all catalysts investigated are taken into account. The relative abundance of Cu sites active for the CO2 -to-CO conversion and the further reduction of CO is identified as another key descriptor.

[Protective effect of recombinant Schistosoma japonicum cystatin against acute kidney injury associated with acute liver failure in mice]

OBJECTIVE

To evaluate the protective effect of recombinant Schistosoma japonicum cystatin (rSj-Cys) against acute kidney injury induced by acute liver failure and unravel the underlying mechanism, so as to provide insights into the clinical therapy of acute kidney injury.

METHODS

Twenty-four male C57BL/6J mice at ages of 6 to 8 weeks were randomly divided into the normal control group, rSj-Cys control group, lipopolysaccharide (LPS)/D-galactosamine (D-GaIN) model group and LPS/D-GaIN + rSj-Cys treatment group, of 6 mice each group. Mice in the LPS/D-GaIN group and LPS/D-GaIN + rSj-Cys group were intraperitoneally injected with LPS (10 μg/kg) and D-GaIN (700 mg/kg), and mice in the LPS/D-GaIN + rSj-Cys group were additionally administered with rSj-Cys (1.25 mg/kg) by intraperitoneal injection 30 min post-modeling, while mice in the rSj-Cys group were intraperitoneally injected with rSj-Cys (1.25 mg/kg), and mice in the normal control group were injected with the normal volume of PBS. All mice were sacrificed 6 h post-modeling, and mouse serum and kidney samples were collected. Serum creatinine (Cr) and urea nitrogen (BUN) levels were measured, and the pathological changes of mouse kidney specimens were examined using hematoxylin-eosin (HE) staining. Serum tumor necrosis factor (TNF)-α and interleukin (IL)-6 levels were detected using enzyme-linked immunosorbent assay (ELISA), and the expression of inflammatory factors and pyroptosis-related proteins was quantified in mouse kidney specimens using immunohistochemistry. In addition, the expression of pyroptosis-related proteins and nuclear factor-kappa B (NF-κB) signaling pathway-associated proteins was determined in mouse kidney specimens using Western blotting assay.

RESULTS

HE staining showed no remarkable abnormality in the mouse kidney structure in the normal control group and the rSj-Cys control group, and renal tubular injury was found in LPS/D-GaIN group, while the renal tubular injury was alleviated in LPS/D-GaIN+rSj-Cys treatment group. There were significant differences in serum levels of Cr (F = 46.33, P < 0.001), BUN (F = 128.60, P < 0.001), TNF-α (F = 102.00, P < 0.001) and IL-6 (F = 202.10, P < 0.001) among the four groups, and lower serum Cr [(85.35 ± 32.05) μmol/L], BUN [(11.90 ± 2.76) mmol/L], TNF-α [(158.27 ± 15.83) pg/mL] and IL-6 levels [(56.72 ± 4.37) pg/mL] were detected in the in LPS/D-GaIN + rSj-Cys group than in the LPS/D-GaIN group (all P values < 0.01). Immunohistochemical staining detected significant differences in TNF-α (F = 24.16, P < 0.001) and IL-10 (F = 15.07, P < 0.01) expression among the four groups, and lower TNF-α [(106.50 ± 16.57)%] and higher IL-10 expression [(91.83 ± 5.23)%] was detected in the LPS/D-GaIN + rSj-Cys group than in the LPS/D-GaIN group (both P values < 0.01). Western blotting and immunohistochemistry detected significant differences in the protein expression of pyroptosis-related proteins NOD-like receptor thermal protein domain associated protein 3 (NLRP3) (F = 24.57 and 30.72, both P values < 0.001), IL-1β (F = 19.24 and 22.59, both P values < 0.001) and IL-18 (F = 16.60 and 19.30, both P values < 0.001) in kidney samples among the four groups, and lower NLRP3, IL-1β and IL-18 expression was quantified in the LPS/D-GaIN + rSj-Cys treatment group than in the LPS/D-GaIN group (P values < 0.05). In addition, there were significant differences in the protein expression of NF-κB signaling pathway-associated proteins p-NF-κB p-P65/NF-κB p65 (F = 71.88, P < 0.001), Toll-like receptor (TLR)-4 (F = 45.49, P < 0.001) and p-IκB/IκB (F = 60.87, P < 0.001) in mouse kidney samples among the four groups, and lower expression of three NF-κB signaling pathway-associated proteins was determined in the LPS/D-GaIN + rSj-Cys treatment group than in the LPS/D-GaIN group (all P values < 0.01).

CONCLUSIONS

rSj-Cys may present a protective effect against acute kidney injury caused by acute liver failure through inhibiting inflammation and pyroptosis and downregulating the NF-κB signaling pathway.

NLRP3 participates in the differentiation and apoptosis of PMA‑treated leukemia cells

Acute myeloid leukemia (AML) is a clonal malignant proliferative disease. In recent years, with the use of all‑trans retinoic acid to induce cancer cell differentiation in acute promyelocytic leukemia, and its advantages of high efficacy and low toxic side effects, tumor differentiation therapy has become a research hotspot; however, the mechanisms underlying its role remain to be fully established. Nod‑like receptor family pyridine domain containing 3 (NLRP3) is the most extensively studied and well‑characterized inflammasome, is involved in a variety of inflammation‑related diseases, including cancer, and is a very attractive potential target for the study of novel therapeutic agents. Activation of the NLRP3 inflammasome is a double‑edged sword in tumor therapy, with evidence of protective anti‑tumor and pro‑tumor effects in different types of cancer. Whether the NLRP3 inflammasome promotes disease progression or exerts a protective anti‑tumor effect in hematological malignancies remains contested. In the present study, the protective anti‑tumor effects of NLRP3 on leukemia cells during their differentiation and maturation were investigated. It was found that the upregulation of NLRP3 expression induced using Phorbol 12‑Myristate 13‑Acetate played a role in promoting the differentiation and maturation of leukemia cells into monocytes/macrophages, and it was directly involved in the apoptosis of leukemia cells and the differentiation and maturation of CD11b⁺ cells. These results provide novel theoretical evidence for exploring the mechanism of differentiation therapy in leukemia and improves our understanding of the role of NLRP3 in hematologic tumors.

Improving the solubility of pseudo-hydrophobic Alzheimer's Disease medicinal chemicals through co-crystal formulation

Natural products are ligands and potential inhibitors of Alzheimer's disease (AD) tau. Dihydromyricetin (DHM) is a CNS active natural product. Despite having signature polyphenolic character, DHM is ostensibly hydrophobic owing to intermolecular hydrogen bonds that shield hydrophilic phenols. Our research shows DHM becomes ionized at near-neutral pH allowing formulation of salts with transformed solubility. The MicroED co-crystal structure with trolamine reveals DHM salts as metastable solids with unlocked hydrogen bonding and a thermodynamic bent to solubilize in water. All salt formulations show better inhibitory activity against AD tau than the non-salt form, with efficacies correlating to enhanced solubilities. These results underscore the role of structural chemistry in guiding selection of solubilizing agents for chemical formulation. We propose DHM salts are appropriate formulations for research as dietary supplements to promote healthy aging by combating protein misfolding. Additionally, DHM is a suitable lead for medicinal chemistry and possible development of CNS pharmaceuticals.

Correlating the Experimentally Determined CO Adsorption Enthalpy with the Electrochemical CO Reduction Performance on Cu Surfaces

CO binding energy has been widely employed as a descriptor for effective catalysts in the electrochemical CO₂ and CO reduction reactions (CO₍₂₎ RR), however, it has yet to be determined experimentally at electrochemical interfaces due to the lack of suitable techniques. In this work, we developed a method to determine the standard adsorption enthalpy of CO on Cu surfaces with quantitative surface enhanced infrared absorption spectroscopy. On dendritic Cu at -0.75 V vs. SHE, the standard adsorption enthalpy, entropy and Gibbs free energy were determined to 1.5±0.5 kJ mol^-1 , ≈37.9±13.4 J/(mol K), and ≈-9.8±4.0 kJ mol^-1 , respectively. Comparison of the standard adsorption enthalpy of oxide-derived Cu and dendritic Cu, as well as their CORR activities, suggests the presence of stronger binding sites on OD Cu, which could favor multicarbon products. The method developed in this work will help establish the correlation between the CO binding energy and the CO₍₂₎ RR activity.

Metal-Organic Frameworks-Based Optical Nanosensors for Analytical and Bioanalytical Applications

Metal-organic frameworks (MOFs)-based optical nanoprobes for luminescence and surface-enhanced Raman spectroscopy (SERS) applications have been receiving tremendous attention. Every element in the MOF structure, including the metal nodes, the organic linkers, and the guest molecules, can be used as a source to build single/multi-emission signals for the intended analytical purposes. For SERS applications, the MOF can not only be used directly as a SERS substrate, but can also improve the stability and reproducibility of the metal-based substrates. Additionally, the porosity and large specific surface area give MOF a sieving effect and target molecule enrichment ability, both of which are helpful for improving detection selectivity and sensitivity. This mini-review summarizes the advances of MOF-based optical detection methods, including luminescence and SERS, and also provides perspectives on future efforts.

Correlating CO Coverage and CO Electroreduction on Cu via High-Pressure in Situ Spectroscopic and Reactivity Investigations

The absolute coverage of CO has been a missing piece in the mechanistic puzzle of the CO reduction reaction (CORR) on Cu. For the first time, we revealed the upper bound of the CO coverage under electrocatalytic conditions to be 0.05 monolayer at atmospheric pressure and the saturation CO coverage to be ∼0.25 monolayer by conducting surface enhanced infrared spectroscopy at CO pressures up to 60 barg in a custom-designed spectroelectrochemical cell. CORR activities on Cu were also determined in the same pressure range. Calculated reaction orders of C₂₊ products with respect to adsorbed CO are substantially less than unity, clearly indicating that the coupling of adsorbed CO is not the rate-determining step leading to multicarbon products. The increase in CO coverage can reduce the C affinity on the Cu surface and favor the selectivity towards oxygenates, especially acetate, over ethylene. Uncommon products, including ethane, glycolaldehyde, and ethylene glycol, were detected in appreciable amounts, likely due to a new C-C coupling mechanism taking place at elevated CO pressures.

The gene LpBCP increased NaHCO3 resistance by enhancing lignin or ROS scavenging in the Nicotiana benthamiana

Lilium pumilum is an excellent wildflower germplasm resource with high resistance to salinity stress. The gene LpBCP plays an important role in salinity tolerance of L. pumilum. Studying the molecular mechanism of salinity resistance in L. pumilum will provide insights into multiple aspects, including breeding better varieties, environmental protection, improving soil conditions, etc. Conventional methods were used to determine different physiological indicators of Nicotiana benthamiana after NaHCO₃ treatment, i.e. chlorophyll content, soluble phenol content and lignin content. RT-qPCR was carried out to find expression of LpBCP in different organs and under abiotic stresses. DAB was used to detect H₂ O₂ in leaves in situ. A yeast two-hybrid system was used to screen for LpBCP interacting proteins. LpBCP was cloned from bulbs of L. pumilum. The highest expression of LpBCP was in roots and bulbs of transgenic plants. LpBCP-overexpressed plants showed less wilting, compared to WT plants. LpBCP transgenic plants have higher chlorophyll, soluble phenol and lignin content, and lower relative conductivity under 500 mM NaHCO₃ stress. In addition, H₂ O₂ scavenging in transgenic plants was much improved, indicating increased resistance to NaHCO₃ stress. Thirteen LpBCP-interacting proteins were screened using the yeast two-hybrid method and five were associated with salt stress. Based on our findings, LPBCP could be a key gene that can be used to improve L. pumilum salt tolerance.

Understanding the complementarities of surface-enhanced infrared and Raman spectroscopies in CO adsorption and electrochemical reduction

In situ/operando surface enhanced infrared and Raman spectroscopies are widely employed in electrocatalysis research to extract mechanistic information and establish structure-activity relations. However, these two spectroscopic techniques are more frequently employed in isolation than in combination, owing to the assumption that they provide largely overlapping information regarding reaction intermediates. Here we show that surface enhanced infrared and Raman spectroscopies tend to probe different subpopulations of adsorbates on weakly adsorbing surfaces while providing similar information on strongly binding surfaces by conducting both techniques on the same electrode surfaces, i.e., platinum, palladium, gold and oxide-derived copper, in tandem. Complementary density functional theory computations confirm that the infrared and Raman intensities do not necessarily track each other when carbon monoxide is adsorbed on different sites, given the lack of scaling between the derivatives of the dipole moment and the polarizability. Through a comparison of adsorbed carbon monoxide and water adsorption energies, we suggest that differences in the infrared vs. Raman responses amongst metal surfaces could stem from the competitive adsorption of water on weak binding metals. We further determined that only copper sites capable of adsorbing carbon monoxide in an atop configuration visible to the surface enhanced infrared spectroscopy are active in the electrochemical carbon monoxide reduction reaction.

Infrared and Raman spectroscopies are often assumed to provide similar insights into heterogeneous reaction mechanisms. This study shows that these techniques provide similar data when CO is strongly bound to a surface, yet distinct subpopulations of CO are probed when binding is weaker.

C-C Coupling Is Unlikely to Be the Rate-Determining Step in the Formation of C2+ Products in the Copper-Catalyzed Electrochemical Reduction of CO

The identity of the rate-determining step (RDS) in the electrochemical CO reduction reaction (CORR) on Cu catalysts remains unresolved because: 1) the presence of mass transport limitation of CO; and 2) the absence of quantitative correlation between CO partial pressure (p_CO ) and surface CO coverage. In this work, we determined CO adsorption isotherms on Cu in a broad pH range of 7.2-12.9. Together with electrokinetic data, we demonstrate that the reaction orders of adsorbed CO at p_CO <0.4 and >0.6 atm are 1^st and 0^th , respectively, for multi-carbon (C₂₊ ) products on three Cu catalysts. These results indicate that the C-C coupling is unlikely to be the RDS in the formation of C₂₊ products in the CORR. We propose that the hydrogenation of CO with adsorbed water is the RDS, and the site competition between CO and water leads to the observed transition of the CO reaction order.

Preoperative Conization May Have a Positive Impact on Survival in Early-Stage Cervical Cancer: A Propensity-Matched Study

INTRODUCTION

A recent prospective randomized study demonstrated that minimally invasive surgery (MIS) was inferior to open surgery in disease survival in early-stage cervical cancer. Our aim was to investigate whether there were survival benefits of preoperative conization prior to MIS for early-stage cervical cancer.

METHODS

We retrospectively analyzed patients who eventually underwent definitive MIS with stage IA2 to IB1 (no >2 cm) squamous cell carcinoma, adenocarcinoma, and adenosquamous carcinoma. Preoperatively, the patients were separated into 2 groups: one managed with conization and the other undergoing biopsy without conization. Propensity scoring weight and matching were used to reduce the influence of possible allocation biases. The Cox regression model was used for univariate and multivariate analyses of disease recurrence and survival.

RESULTS

227 patients were contained in this study (99 patients in the conization group and 128 patients in the nonconization group). The 5-year DFS of the conization group was statistically better than that of the nonconization group (98.4% vs. 91.8%, p = 0.011). By univariate analysis, conization (HR = 0.11, 95% CI = 0.01-0.87, p = 0.03) and histologic cell type (p = 0.01) were considered as risk factors for recurrence. Multivariate analysis further confirmed conization (HR = 0.04, 95% CI = 0.01-0.51, p = 0.01) and histologic cell type (p < 0.01) correlated with DFS. After propensity score matching (1:1), 84 patients were included in the conization and nonconization groups, respectively, with 5-year DFS still higher in the conization group (98.3% vs. 92.9%, p = 0.037). The results after univariate and multivariate analyses were consistent with those prior to propensity score matching.

CONCLUSION

Preoperative conization in conjunction with MIS seemed to be a safe and feasible approach, with results that may have implications for the reduction of recurrence. Histologic cell type also impacted survival. Therefore, more future prospective studies are warranted.

Application of Da Vinci robotic surgery system in cervical cancer: A single institution experience of 557 cases

OBJECTIVE

Conflicting data have been published regarding the oncologic appropriateness of minimally invasive surgery (MIS) in the treatment of cervical cancer. The purpose of the present study was to investigate whether our experience in the treatment of early cervical cancer using a robotic surgical approach was safe and oncologically effective.

METHODS

The data of 557 patients with cervical cancer treated by robotic surgery were retrospectively collected, including the perioperative and survival outcomes. Tumor stage was based on the International Federation of Gynecology and Obstetrics (FIGO 2009). The disease-free survival (DFS) and overall survival (OS) were calculated by the Kaplan-Meier method.

RESULTS

Of the 557 patients, 196 (35.2%) patients were stage IA1 to IB1, and 304 (54.6%) patients were stage IB2 to I1A2. Also included were 57 (10.2%) patients with either recurrent or persistent disease following concurrent chemoradiotherapy. Two patients (0.4%) experienced severe intraoperative complications and 11 patients (2.0%) developed postoperative complications. A stratified analysis of survival was conducted in 91 patients who met a follow-up time of 3-year or more. The median follow-up time was 49 (range, 6-57) months. Both the 3-year DFS and OS of early-stage (stage IA1 to IB1) cervical cancer were 97.6%. For patients with locally advanced (stage IB2 to IIA2) disease, DFS and OS were 88.1% and 90.5%, respectively. The patients with recurrent or persistent disease had DFS and OS of 62.5%.

CONCLUSION

Our study results demonstrated that the robotic surgical approach could achieve satisfying therapeutic outcomes in patients with early-stage cervical cancer, with a low complication rate. For advanced cervical cancer patients with recurrent or persistent disease following concurrent chemoradiotherapy, robotic surgery undertaken as supplementary therapy may improve prognosis. However, there remains a need for additional prospective data reporting long-term survival of cervical cancer patients treated with a robotic surgical approach.

[Fucoxanthin induces prostate cancer PC-3 cell apoptosis by causing mitochondria dysfunction and oxidative stress]

OBJECTIVE

To investigate the apoptosis- inducing effect of fucoxanthin in human prostate cancer PC-3 cells and the underlying mechanism.

OBJECTIVE

The viability and apoptosis of PC-3 cells treated with fucoxanthin were analyzed using commercial kits, and the mitochondrial membrane potential, mitochondrial morphology and mitochondrial superoxide were detected using fluorescence probe staining. The contents of ATP, H₂O₂, malondialdehyde (MDA), superoxide and the total antioxidant capacity of PC-3 cells were determined. The protein expressions of Bcl-2, Bax and cytochrome c were detected with Western blotting, and the activity of caspase-9 and caspase- 3/7 was detected using corresponding kits.

OBJECTIVE

Fucoxanthin significantly inhibited the viability of PC-3 cells in a time- and dose-dependent manner, and dose-dependently induced apoptosis of the cells (P < 0.05). Fucoxanthin-treated PC-3 cells showed significantly decreased mitochondrial membrane potential, mitochondrial fragmentation and increased superoxide level in the mitochondria (P < 0.05), and these effects of fucoxanthin were dose- dependent. Fucoxanthin dose-dependently decreased ATP level and the total antioxidant capacity of PC-3 cells, increased the contents of H₂O₂, MDA and superoxide (all P < 0.05), enhanced the protein expressions of Bax and cytochrome c in the cytoplasm, and lowered the protein expressions of Bcl-2 and cytochromes in the mitochondria (P < 0.05).

OBJECTIVE

Fucoxanthin induces apoptosis of PC-3 cells by triggering mitochondrial dysfunction to cause oxidative stress and by activating mitochondria-mediated apoptotic signaling pathways, suggesting its potential in prostate cancer treatment.

Survival outcomes of minimally invasive surgery for early-stage cervical cancer: A single-center, one surgeon, retrospective study

OBJECTIVE

Recent studies have shown that minimally invasive surgery (MIS) is associated with a higher recurrence rate in patients with early-stage cervical cancer. In this study, we aim to report the survival outcomes of patients with early-stage cervical cancer who received MIS, performed in a single center by the same surgeon.

METHODS

Eligible participants included patients with early-stage cervical cancer in stage IA1 with lymphovascular space invasion (LVSI+), IA2, and IB1. The surgeries were carried out by a single surgeon and survival outcomes of the 137 patients were evaluated retrospectively.

RESULTS

The median follow-up time for the 137 patients was 53 (25-94) months, with the five-year disease-free survival (DFS) rate of 96.4% and the five-year overall survival (OS) rate of 96.8%. Among them, six (4.38%) patients relapsed and four (2.92%) of whom died. The five-year DFS rate was significantly higher in patients with tumor≤2 cm in size than in those with tumor >2 cm (P = 0.013), however, with no significant difference in the five-year OS rate (P = 0.219).

CONCLUSION

According to the existing literature and the results of this study, for MIS, the proficiency levels of a surgeon may be associated with survival outcomes of cancer patients. Tumor size may also be an important factor affecting survival outcomes of cervical cancer patients.

Electrokinetic and in situ spectroscopic investigations of CO electrochemical reduction on copper

Rigorous electrokinetic results are key to understanding the reaction mechanisms in the electrochemical CO reduction reaction (CORR), however, most reported results are compromised by the CO mass transport limitation. In this work, we determined mass transport-free CORR kinetics by employing a gas-diffusion type electrode and identified dependence of catalyst surface speciation on the electrolyte pH using in-situ surface enhanced vibrational spectroscopies. Based on the measured Tafel slopes and reaction orders, we demonstrate that the formation rates of C₂₊ products are most likely limited by the dimerization of CO adsorbate. CH₄ production is limited by the CO hydrogenation step via a proton coupled electron transfer and a chemical hydrogenation step of CO by adsorbed hydrogen atom in weakly (7 < pH < 11) and strongly (pH > 11) alkaline electrolytes, respectively. Further, CH₄ and C₂₊ products are likely formed on distinct types of active sites.

Electrokinetic results are key to understanding the mechanisms in electrochemical CO reduction reaction. Here, the authors determine mass transport free kinetics using a gas-diffusion electrode and identified dependence of copper surface speciation on the electrolyte pH using in situ surface enhanced spectroscopies.

Analysis of pelvic floor electrical physiological parameters in nulliparous women with stress urinary incontinence

Background

To investigate the changes in pelvic floor electrical physiological parameters in nulliparous women with stress urinary incontinence (SUI).

Methods

A retrospective survey was conducted on 922 women aged 20–40 years who received health examinations at the First Affiliated Hospital of Nanjing Medical University between July 2017 and December 2019. The women were split into two groups: those who had SUI (n=87) and those that did not (n=835). Questionnaires and pelvic floor electrical physiological indexes were collected.

Results

The mean age of the group of women with SUI was 29.77 years, while the mean age of the group of women with no SUI was 24.49 years. The body mass indexes (BMI) of the women with SUI were significantly higher than those of the women with no SUI. Importantly, the normal rates of type I and II fibers in the women with SUI were obviously lower than those in the women with no SUI. Moreover, the vaginal dynamic pressure in the women with SUI was significantly lower than in the women with no SUI. The study also found that the incidence of SUI in nulliparous women was higher in those aged 30–40 and that both low-weight and obese women had an increased risk of SUI. Type I and type II muscle fibers were more abnormal in the women with SUI than in those with no SUI. In multivariate logistic regression, the ages, BMIs, and type I fiber indexes of nulliparous women were related to SUI.

Conclusions

Nulliparous women have a higher rate of SUI. Compared to women with no SUI, the possible potential risk factors are age (>30 years), higher BMI, and abnormal type I muscle fiber of the pelvic floor.

Integrating Narcissus-derived galanthamine production into traditional upland farming systems

Alzheimer's disease (AD) is a disorder associated with progressive degeneration of memory and cognitive function. Galantamine is a licenced treatment for AD but supplies of the plant alkaloid that it is produced from, galanthamine, are limited. This three-year system study tested the potential to combine Narcissus-derived galanthamine production with grassland-based ruminant production. Replicate plots of permanent pasture were prepared with and without bulbs of Narcissus pseudonarcissus sown as lines into the sward. Two different fertiliser regimes were imposed. The above-ground green biomass of N. pseudonarcissus was harvested in early spring and the galanthamine yield determined. In the second harvest year a split-plot design was implemented with lines of N. pseudonarcissus cut annually and biennially. All plots were subsequently grazed by ewes and lambs and animal performance recorded. Incorporation of N. pseudonarcissus into grazed permanent pasture had no detrimental effects on the health or performance of the sheep which subsequently grazed the pasture. There was no consistency to the effects of fertiliser rates on galanthamine yields. There was no difference in overall galanthamine yield if N. pseudonarcissus was cut biennially (1.64 vs. 1.75 kg galanthamine/ha for annual combined vs biennial cuts respectively; s.e.d = 0.117 kg galanthamine/ha; ns). This study verified the feasibility of a dual cropping approach to producing plant-derived galanthamine.

Determining intrinsic stark tuning rates of adsorbed CO on copper surfaces

This work reports a general and effective strategy of determining the intrinsic Stark tuning rate by removing the impact of the dynamical coupling of adsorbed CO on the Cu surface with surface enhanced infrared absorption spectroscopy (SEIRAS).

Bridging the Gap in the Mechanistic Understanding of Electrocatalysis via In Situ Characterizations

Electrocatalysis offers a promising strategy to take advantage of the increasingly available and affordable renewable energy for the sustainable production of fuels and chemicals. Attaining this promise requires a molecular level insight of the electrical interface that can be used to tailor the selectivity of electrocatalysts. Addressing this selectivity challenge remains one of the most important areas in modern electrocatalytic research. In this Perspective, we focus on the use of in situ techniques to bridge the gap in the fundamental understanding of electrocatalytic processes. We begin with a brief discussion of traditional electrochemical techniques, ex situ measurements and in silico analysis. Subsequently, we discuss the utility and limitations of in situ methodologies, with a focus on vibrational spectroscopies. We then end by looking ahead toward promising new areas for the application of in situ techniques and improvements to current methods.

[Application of autologous platelet-rich plasma separation in cardiac valve replacement: a random clinical trial]

Objective: To examine the blood protective effect of autologous platelet-rich plasma separation for cardiac valve replacement under cardiopulmonary bypass. Methods: Sixty patients who underwent cardiac valve replacement under cardiopulmonary bypass from August 2018 to May 2019 in Shanghai Chest Hospital, Shanghai Jiao Tong University were randomly divided into control and treatment groups(each 30 cases). There were 33 males and 27 females, aged (52.0±8.4) years (range: 35 to 65 years). Autologous platelet separation was performed in the treatment group after anaesthesia administration and was completed before systemic heparinisation. Platelet separation was not performed in the control group. The thromboelastogram, blood routine, blood coagulation, perioperative fluid infusion, allogeneic blood transfusion, postoperative pleural fluid volume and postoperative fibrinogen were recorded before the operation, and 1 hour and 24 hours post operation. The two groups' data was compared by t test, Kruskal-Wallis test, Mann-Whitney U test or χ(2) test. Repeated measurement analysis of variance was used to compare platelet and coagulation indexes at different times. Results: The perioperative red blood cell transfusion of 0, 1~2, 3~4,>4 units with 6, 11, 1, 12 cases in treatment group and 14, 8, 6, 2 cases in control group (Z=-2.516, P=0.012). The postoperative fibrinogen of 0, 1, 2 units with 19, 2, 9 cases in treat group and 26, 2, 2 cases in control group (Z=-2.190, P=0.029). There was no significant difference in the cost of blood transfusion between the two groups during admission ((1 732±1 275) yuan vs. (1 176±941) yuan; t=-1.570, P=0.125). Conclusion: The use of autologous platelet-rich plasma separation can reduce the amount of allogeneic blood transfusion during valvular surgery under cardiopulmonary bypass.

Understanding the electric and nonelectric field components of the cation effect on the electrochemical CO reduction reaction

Electrolyte cations affect the activity of surface-mediated electrocatalytic reactions; however, understanding the modes of interaction between cations and reaction intermediates remains lacking. We show that larger alkali metal cations (excluding the thickness of the hydration shell) promote the electrochemical CO reduction reaction on polycrystalline Cu surfaces in alkaline electrolytes. Combined reactivity and in situ surface-enhanced spectroscopic investigations show that changes to the interfacial electric field strength cannot solely explain the reactivity trend with cation size, suggesting the presence of a nonelectric field strength component in the cation effect. Spectroscopic investigations with cation chelating agents and organic molecules show that the electric and nonelectric field components of the cation effect could be affected by both cation identity and composition of the electrochemical interface. The interdependent nature of interfacial species indicates that the cation effect should be considered an integral part of the broader effect of composition and structure of the electrochemical interface on electrode-mediated reactions.

The mediating role of perceived stress on the relationship between perceived social support and self-care ability among Chinese enterostomy patients

PURPOSE

Enterostomy patients were exposed to various stressors, and self-care ability played an important role in their daily lives. This study aimed to examine the relationship between perceived social support and self-care ability among Chinese enterostomy patients and to explore whether perceived stress mediated this relationship.

METHODS

A sample of 410 enterostomy patients aged 59.68 ± 12.95 years old were recruited in the study. Participants completed a set of questionnaires including demographics, perceived stress scale, perceived social support scale, and ostomy self-care ability scale.

RESULTS

A total of 392 valid questionnaires were finally used in the data analyses among 410 questionnaires; the effective response rate was 95.6%. Results demonstrated that the scores of perceived social support were positively correlated with scores of self-care ability scores and negatively with perceived stress scores. And the effect of perceived social support on self-care ability was partially mediated by perceived stress (51.53%).

CONCLUSIONS

This study explained the mediating model that connects perceived social support with self-care ability through perceived stress, which enhances our understanding about the mediating role of perceived stress. Thus, when focusing on the self-care ability of enterostomy patients, perceived stress was as important as perceived social support.

Propranolol regulates ERK1/2 signaling pathway and promotes chronic wound healing in diabetic rats

OBJECTIVE

This study aimed to investigate if propranolol could regulate ERK1/2 signaling pathway and promote chronic wound healing in diabetic rats.

MATERIALS AND METHODS

Twenty-two rats were used to establish a diabetic chronic wound animal model. They were randomly separated into two groups: the propranolol group and the control group. The propranolol group was treated with propranolol ointment and the control group was treated with propranolol matrix cream to cover the wound surface. The expression of the p-ERK1/2 protein was detected by the Western Blot. RT-qPCR was used to detect the expression of VEGF. The concentrations of IL-6 and TNF-α were detected by ELISA.

RESULTS

The body weight of rats was significantly reduced after type 2 diabetes mellitus modeling. The healing rate of rats in the control group was significantly lower than that in the propranolol group (p<0.05). There was a significant increase in the expression of the p-ERK1/2 protein in the wound tissue of the propranolol group compared with that in the control group, except for the 11th day (p<0.05). The relative expression of Vascular Endothelial Growth Factor (VEGF) in the propranolol group was significantly higher than that in the control group on the 2nd day (p<0.05), while the relative expression of VEGF in the propranolol group was significantly increased on the 11th day after modeling (p<0.05). On the 20th day, the expressions of IL-6 and TNF-α in the propranolol group were significantly higher than those in the control group, and there were significant differences (p<0.05). It was found that the IL-6 and TNF-α expressions in the propranolol group reached the peak on the 11th day and then gradually decreased (p<0.05).

CONCLUSIONS

The results indicated that propranolol can accelerate the healing of diabetic wounds by regulating the expression of VEGF by phosphorylation of ERK1/2 protein, thus promoting chronic wound healing in diabetes.

Oxygen induced promotion of electrochemical reduction of CO2 via co-electrolysis

Harnessing renewable electricity to drive the electrochemical reduction of CO₂ is being intensely studied for sustainable fuel production and as a means for energy storage. Copper is the only monometallic electrocatalyst capable of converting CO₂ to value-added products, e.g., hydrocarbons and oxygenates, but suffers from poor selectivity and mediocre activity. Multiple oxidative treatments have shown improvements in the performance of copper catalysts. However, the fundamental underpinning for such enhancement remains controversial. Here, we combine reactivity, in-situ surface-enhanced Raman spectroscopy, and computational investigations to demonstrate that the presence of surface hydroxyl species by co-electrolysis of CO₂ with low concentrations of O₂ can dramatically enhance the activity of copper catalyzed CO₂ electroreduction. Our results indicate that co-electrolysis of CO₂ with an oxidant is a promising strategy to introduce catalytically active species in electrocatalysis.

Influence of roflumilast on sepsis mice through the JAK/STAT signaling pathway

OBJECTIVE

The aim of this study was to explore the influence of roflumilast on sepsis mice through the Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway.

MATERIALS AND METHODS

A total of 36 Sprague-Dawley mice were randomly divided into normal group (n=12), model group (n=12) and roflumilast group (n=12). Mice in the normal group were fed normally. However, mice in the model group and roflumilast group were intraperitoneally injected with endotoxin to establish the sepsis mouse model. Furthermore, mice in the model group and roflumilast group were intraperitoneally injected with 0.9% sodium chloride and roflumilast once a day, respectively. After 7 d of intervention, mice were sampled. Lung tissue morphology was observed via hematoxylin-eosin (HE) staining, and the pathological score was given. The protein expression levels of JAK and STAT-3 were detected via Western blotting. The expression levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected via enzyme-linked immunosorbent assay (ELISA). Meanwhile, the mRNA expression levels of JAK, STAT-3, IL-6 and TNF-α were detected via quantitative Polymerase Chain Reaction (qPCR). The number of inflammatory cells in the lavage fluid was counted by a biochemical detector.

RESULTS

The survival rate of mice in the roflumilast group was significantly higher than that of the model group (p<0.05). The results of HE staining revealed that lung tissue morphology in roflumilast group was significantly improved when compared with the model group. Meanwhile, the pathological score in the roflumilast group was significantly lower than that of the model group (p<0.05). Western blotting showed that the protein expression levels of JAK and STAT-3 in the roflumilast group were markedly lower than those of the model group (p<0.05). According to the results of ELISA, the expression levels of IL-6 and TNF-α in the roflumilast group were remarkably lower than the model group (p<0.05). Further qPCR results manifested that the mRNA expression levels of JAK, STAT-3, IL-6 and TNF-α in the roflumilast group were significantly lower than those of the model group (p<0.05). Moreover, the number of neutrophils, monocytes and lymphocytes in the roflumilast group was significantly smaller than the model group.

CONCLUSIONS

Roflumilast can improve lung tissue morphology of sepsis mice by inhibiting the JAK/STAT signaling pathway.

The Protective Effect of Pre-Moxibustion on Reproductive Hormones Profile of Rats with Tripterygium Glycosides-Induced Ovarian Damage

BACKGROUND

Acupuncture and moxibustion have been proven to be conducive to improving the ovarian reserve. However, the mechanism of pre-moxibustion on Tripterygium glycosides (TG)-induced ovarian damage has not been previously reported.

METHOD

Female rats were randomly divided into 5 groups: control, model (75 mg/kg TG, 14 days), preventive moxibustion 1 (PM1, receiving moxibustion for 4 weeks before TG administration), preventive moxibustion 2 (PM2, receiving moxibustion for 2 weeks before TG administration and another 2 weeks during TG administration), and preventive moxibustion 3 (PM3, receiving 4 weeks of moxibustion during TG administration). The estrous cycle of the animal was recorded after TG administration. Rats were sacrificed 14 days after TG administration. The reproductive hormones profiles in serum, ovary, and hypothalamic tissues were analyzed.

RESULT

Pre-moxibustion could revert abnormal estrous cycles, relieve follicle damage, and improve abnormal secretion of reproductive hormones resulting from ovarian damage. However, both PM2 and PM3 were more effective than PM1. In addition, PM2 disclosed more advantages in regulating reproductive hormones abnormalities, while PM3 performed better in follicular development.

CONCLUSION

In combination, the findings of this study suggest that pre-moxibustion is effective in protecting the ovary from damage in TG-induced ovarian damage rats. But different time points correspond to different modulation targets and mechanisms.

Speciation of Cu Surfaces During the Electrochemical CO Reduction Reaction

Cu-catalyzed selective electrocatalytic upgrading of carbon dioxide/monoxide to valuable multicarbon oxygenates and hydrocarbons is an attractive strategy for combating climate change. Despite recent research on Cu-based catalysts for the CO₂ and CO reduction reactions, surface speciation of the various types of Cu surfaces under reaction conditions remains a topic of discussion. Herein, in situ surface-enhanced Raman spectroscopy (SERS) is employed to investigate the speciation of four commonly used Cu surfaces, i.e., Cu foil, Cu micro/nanoparticles, electrochemically deposited Cu film, and oxide-derived Cu, at potentials relevant to the CO reduction reaction in an alkaline electrolyte. Multiple oxide and hydroxide species exist on all Cu surfaces at negative potentials, however, the speciation on the Cu foil is distinct from that on micro/nanostructured Cu. The surface speciation is demonstrated to correlate with the initial degree of oxidation of the Cu surface prior to the exposure to negative potentials. Combining reactivity and spectroscopic results on these four types of Cu surfaces, we conclude that the oxygen containing surface species identified by Raman spectroscopy are unlikely to be active in facilitating the formation of C₂₊ oxygenates in the CO reduction reaction.