[α2-macroglobulin alleviates glucocorticoid-induced avascular necrosis of the femoral head in mice by promoting proliferation, migration and angiogenesis of vascular endothelial cells]

OBJECTIVE

To explore the mechanism underlying the protective effect of α2-macroglobulin (A2M) against glucocorticoid-induced femoral head necrosis.

METHODS

In a human umbilical vein endothelial cell (HUVEC) model with injuries induced by gradient concentrations of dexamethasone (DEX; 10-8-10-5 mol/L), the protective effects of A2M at 0.05 and 0.1 mg/mL were assessed by examining the changes in cell viability, migration, and capacity of angiogenesis using CCK-8 assay, Transwell and scratch healing assays and angiogenesis assay. The expressions of CD31 and VEGF-A proteins in the treated cells were detected using Western blotting. In BALB/c mouse models of avascular necrosis of the femoral head induced by intramuscular injections of methylprednisolone, the effects of intervention with A2M on femoral trabecular structure, histopathological characteristics, and CD31 expression were examined with Micro-CT, HE staining and immunohistochemical staining.

RESULTS

In cultured HUVECs, DEX treatment significantly reduced cell viability, migration and angiogenic ability in a concentration- and time-dependent manner (P<0.05), and these changes were obviously reversed by treatment with A2M in positive correlation with A2M concentration (P<0.05). DEX significantly reduced the expression of CD31 and VEGF-A proteins in HUVECs, while treatment with A2M restored CD31 and VEGF-A expressions in the cells (P<0.05). The mouse models of femoral head necrosis showed obvious trabecular damages in the femoral head, where a large number of empty lacunae and hypertrophic fat cells could be seen and CD31 expression was significantly decreased (P<0.05). A2M treatment of the mouse models significantly improved trabecular damages, maintained normal bone tissue structures, and increased CD31 expression in the femoral head (P<0.05).

CONCLUSION

A2M promotes proliferation, migration, and angiogenesis of DEX-treated HUVECs and alleviates methylprednisolone-induced femoral head necrosis by improving microcirculation damages and maintaining microcirculation stability in the femoral head.

Network Pharmacology and Molecular Docking Identify the Potential Mechanism and Therapeutic Role of Scutellaria baicalensis in Alzheimer's Disease

Aim

Scutellaria baicalensis, a traditional Chinese medicinal herb renowned for its anti-inflammatory, antioxidant, and anti-tumor properties, has shown promise in alleviating cognitive impairment associated with Alzheimer's disease. Nonetheless, the exact neuroprotective mechanism of Scutellaria baicalensis against Alzheimer's disease remains unclear. In this study, network pharmacology was employed to explore the possible mechanisms by which Scutellaria baicalensis protects against Alzheimer's disease.

Methods

The active compounds of Scutellaria baicalensis were retrieved from the TCMSP database, and their corresponding targets were identified. Alzheimer's disease-related targets were obtained through searches in the GeneCards and OMIM databases. Cytoscape 3.6.0 software was utilized to construct a regulatory network illustrating the "active ingredient-target" relationships. Subsequently, the target genes affected by Scutellaria baicalensis in the context of Alzheimer's disease were input into the String database to establish a PPI network. GO analysis and KEGG analysis were conducted using the DAVID database to predict the potential pathways associated with these key targets. Following this, the capacity of these active ingredients to bind to core targets was confirmed through molecular docking. In vitro experiments were then carried out for further validation.

Results

A total of 36 active ingredients from Scutellaria baicalensis were screened out, which corresponded to 365 targets. Molecular docking results demonstrated the robust binding abilities of Baicalein, Wogonin, and 5,2'-Dihydroxy-6,7,8-trimethoxyflavone to key target proteins (SRC, PIK3R1, and STAT3). In vitro experiments showed that the active components of Scutellaria baicalensis can inhibit STAT3 expression by downregulating the PIK3R1/SRC pathway in Neuro 2A cells.

Conclusion

In summary, these findings collectively suggest that Scutellaria baicalensis holds promise as a viable treatment option for Alzheimer's disease.

The incidence of surgical site infections in China

Surgical site infections (SSIs) are a common type of healthcare-associated infection. We performed a literature review to demonstrate the incidence of SSIs in mainland China based on studies since 2010. We included 231 eligible studies with ≥30 postoperative patients, comprising 14 providing overall SSI data regardless of surgical sites and 217 reporting SSIs for a specific site. We found that the overall SSI incidence was 2.91% (median; interquartile range: 1.05%, 4.57%) or 3.18% (pooled; 95% confidence interval: 1.85%, 4.51%) and the SSI incidence varied remarkably according to the surgical site between the lowest (median, 1.00%; pooled, 1.69%) in thyroid surgeries and the highest (median, 14.89%; pooled, 12.54%) in colorectal procedures. We uncovered that Enterobacterales and staphylococci were the most common types of micro-organisms associated with SSIs after various abdominal surgeries and cardiac or neurological procedures, respectively. We identified two, nine, and five studies addressing the impact of SSIs on mortality, the length of stay (LOS) in hospital, and additional healthcare-related economic burden, respectively, all of which demonstrated increased mortality, prolonged LOS, and elevated medical costs associated with SSIs among affected patients. Our findings illustrate that SSIs remain a relatively common, serious threat to patient safety in China, requiring more action. To tackle SSIs, we propose to establish a nationwide network for SSI surveillance using unified criteria with the aid of informatic techniques and to tailor and implement countermeasures based on local data and observation. We highlight that the impact of SSIs in China warrants further study.

Biochar's dual role in greenhouse gas emissions: Nitrogen fertilization dependency and mitigation potential

Biochar was popularly used for reducing greenhouse gas (GHG) emissions in vegetable production, but using biochar does not necessarily guarantee a reduction in GHG emissions. Herein, it's meaningful to elucidate the intricate interplay among biochar properties, soil characteristics, and GHG emissions in vegetable production to provide valuable insights for informed and effective mitigation strategies. Therefore, in current research, a meta-analysis of 43 publications was employed to address these issues. The boost-regression analysis results indicated that the performance of biochar in inhibiting N2O emissions was most affected by the N application rate both in high and low N application conditions. Besides, biochar had dual roles and showed well performance in reducing GHG emissions under low N input (≤300 kg N ha-1), while having the opposite effect during high N input (>300 kg N ha-1). Specifically, applying biochar under low N fertilization input could obviously reduce soil N2O emissions, CO2 emissions, and CH4 emissions by 18.7 %, 17.9 %, and 16.9 %, respectively. However, the biochar application under high N fertilization input significantly (P < 0.05) increased soil N2O emissions, CO2 emissions, and CH4 emissions by 39.7 %, 43.0 %, and 27.7 %, respectively. Except for the N application rate, the soil pH, SOC, biochar C/N ratio, biochar pH, and biochar pyrolysis temperature are also the key factors affecting the control of GHG emissions in biochar-amended soils. The findings of this study will contribute to deeper insights into the potential application of biochar in regulating GHG under consideration of N input, offering scientific evidence and guidance for sustainable agriculture management.

Uncovering the mechanisms of how corn steep liquor and microbial communities minimize cadmium translocation in Chinese cabbage

Corn steep liquor-assisted microbial remediation has been proposed as a promising strategy to remediate cadmium (Cd)-contaminated soil. In this study, we determined Bacillus subtilis (K2) with a high cadmium (Cd) accumulation ability and Cd resistance. However, studies on this strategy used in the Cd uptake of Chinese cabbage are lacking, and the effect of the combined incorporation of corn steep liquor and K2 on the functions and microbial interactions of soil microbiomes is unclear. Here, we study the Cd uptake and transportation in Chinese cabbage by the combination of K2 and corn steep liquor (K2 + C7) in a Cd-contaminated soil and corresponding microbial regulation mechanisms. Results showed that compared to inoculant K2 treatment alone, a reduction of Cd concentration in the shoots by 14.4% and the dry weight biomass of the shoots and the roots in Chinese cabbage increased by 21.6% and 30.8%, respectively, under K2 + C7 treatment. Meanwhile, hydrogen peroxide (H2O2) and malondialdehyde (MDA) levels were decreased by enhancing POD and SOD activity, thereby reversing Cd-induced oxidative damage. Importantly, inoculation of K2 would decrease the diversity of the microbial community while enhancing the abundance of dominant species. These findings provide a promising strategy for reducing the Cd accumulation in Chinese cabbage and recovering soil ecological functions.

Amino acid application inhibits root-to-shoot cadmium translocation in Chinese cabbage by modulating pectin methyl-esterification

The exogenous application of amino acids (AAs) generally alleviates cadmium (Cd) toxicity in plants by altering their subcellular distribution. However, the physiological mechanisms underlying AA-mediated cell wall (CW) sequestration of Cd in Chinese cabbage remain unclear. Using two genotypes of Chinses cabbage, Jingcui 60 (Cd-tolerant) and 16-7 (Cd-sensitive), we characterized the root structure, subcellular distribution of Cd, CW component, and related gene expression under the Cd stress. Cysteine (Cys) supplementation led to a reduction in the Cd concentration in the shoots of Jingcui 60 and 16-7 by 65.09 % and 64.03 %, respectively. Addition of Cys alleviated leaf chlorosis in both cultivars by increasing Cd chelation in the root CW and reducing its distribution in the cytoplasm and organelles. We further demonstrated that Cys supplementation mediated the downregulation of PMEI1 expression and improving the activity of pectin methyl-esterase (PME) by 17.98 % and 25.52 % in both cultivars, respectively, compared to the Cd treatment, resulting in an approximate 12.00 %-14.70 % increase in Cd retention in pectin. In contrast, threonine (Thr) application did not significantly alter Cd distribution in the shoots of either cultivar. Taken together, our results suggest that Cys application reduces Cd root-to-shoot translocation by increasing Cd sequestration in the root CW through the downregulation of pectin methyl-esterification.

PIM3 regulates myocardial ischemia/reperfusion injury via ferroptosis

BACKGROUND

Myocardial ischemia/reperfusion (I/R) injury is closely related with cardiovascular diseases; however, the underlying pathogenic mechanisms remain not fully understood. This study sought to investigate the effect and mechanisms of PIM3 implicated in myocardial I/R injury using a rat model of myocardial I/R injury and a cell model of oxygen-glucose deprivation/reoxygenation (OGD/R) induction.

METHODS

The morphology changes were detected by HE staining while cell viability was accessed by the CCK-8 method. The characteristics of ferroptosis were evaluated by ROS production, MDA content, SOD level, iron content, TfR1, FTH1, and GPX4 expression.

RESULTS

Myocardial I/R operation increased myocardial tissue damage in rats, while OGD/R treatment reduced the viability of H9c2 cells. Both myocardial I/R operation and OGD/R stimulation increased ferroptosis, as demonstrated by elevated ROS, MDA, iron content, decreased SOD level, upregulation of TfR1, and downregulation of FTH1 and GPX4. Additionally, myocardial I/R modeling or OGD/R treatment enhanced the expression of PIM3. Silencing of PIM3 inhibited ferroptosis, which resulted in alleviated myocardial I/R-induced damage and improved H9c2 cell survival.

CONCLUSIONS

Our findings highlight a vital role of PIM3 in myocardial I/R injury, indicating that PIM3-targeting ferroptosis may be a promising target for the development of novel therapies of myocardial I/R injury-associated diseases.

Mechanistic insights into mitigating Cd stress in plants using typical organic waste fermentation solutions

Finding practical solutions for utilizing agricultural organic wastes has always been a challenge. To address this, our study investigated the effects and mechanisms of different exogenous organic waste fermentation solutions on alleviating Cd stress in plants using hydroponic experiments. Out of the seven fermentation solutions examined, pea fermentation liquid (T3), chicken manure (T5), molasses (T6), and chitosan oligosaccharide broth (T9) exhibited positive effects. They increased shoot fresh weight by 1.17%, 26.83%, 7.94%, and 15.59%, and root fresh weight by 50.00%, 12.21%, 81.19%, and 19.47%, respectively. Conversely, amino acid mother liquid (T7) and potassium polyaspartate liquid (T8) reduced shoot fresh weight by 34.21% and 24.74%, and root fresh weight by 27.06% and 7.10%, respectively. All organic waste liquids reduced Cd concentration in shoots and roots. Corn fermentation liquid (T4) reduced Cd in shoots from 87.91 to 19.20 mg/kg, while molasses (T6) reduced Cd in roots from 980.94 to 260.47 mg/kg. SEM-EDX results revealed that molasses (T6) effectively repaired Cd damage on root surfaces. In addition, several waste liquids mitigated microelement absorption disturbances. All waste liquids reduced MDA, corn fermentation liquid (T4), chicken manure (T5), molasses (T6), potassium polyaspartate liquid (T8), and chitosan oligosaccharide liquid (T9) significantly decreased H2O2 by 21.6-38.3%. Structural equation model (SEM) and correlation analysis highlighted the importance of root Mg, Cu, and Zn content and CAT activity in relieving Cd stress and promoting plant growth. Overall, molasses (T6) and chicken manure (T5) demonstrated the most beneficial combined effects, while amino acid mother liquid (T7) and chitosan oligosaccharide liquid (T9) should be exercised with caution due to their weaker effects.

Total iron binding capacity: an independent predictor of prognosis for pulmonary arterial hypertension in systemic lupus erythematosus

OBJECTIVE

To investigate the role of parameters of iron metabolism in systemic lupus erythematosus (SLE) patients with pulmonary arterial hypertension (PAH).

METHOD

This was a prospective observational study recruiting patients diagnosed with systemic lupus erythematosus-associated pulmonary arterial hypertension (SLE-PAH). Patients with other factors that might lead to PAH were excluded from the study. All patients were assessed for PAH every 1-3 months and were followed up for 6 months. The primary outcome was considered improved if the grade of risk stratification declined at the endpoint; otherwise, it was considered unimproved.

RESULTS

In total, 29 patients with SLE-PAH were included in this study. The mean of serum ferritin was higher than normal, and total iron binding capacity (TIBC) decreased in 48% of patients. Correlation analyses showed that serum iron (SI) was negatively correlated with World Health Organization functional class (WHO-FC) (r = -0.409, p = 0.028), and positively correlated with Six-Minute Walk Test distance (6MWD) (r = 0.427, p = 0.021) and tricuspid annular plane systolic excursion (TAPSE) (r = 0.388, p = 0.037). Primary outcomes improved in 12 patients at the endpoint, and univariate logistic regression analyses indicated that TIBC was associated with improved primary outcomes in patients with SLE-PAH (odds ratio 12.00, 95% confidence interval 1.90-75.72).

CONCLUSION

SI was negatively correlated with WHO-FC, and positively correlated with 6MWD and TAPSE. Furthermore, TIBC was associated with improved outcomes of patients with SLE-PAH, which could be an independent predictor of prognosis. Further research is needed to verify the findings.

Cleaner production of Chinese cabbage by intercropping from Cd contaminated soil: Effects of hyperaccumulator variety and planting strip width

The utilization of Cd-contaminated soil in vegetable crop production can lighten the food crisis and improve the soil environmental resilience. Intercropping is a reliable technology in safety production from contaminated soil. A field-scale experiment was carried out to unravel how plant species and pattern affect the growth and Cd uptake of Chinese cabbage from Cd contaminated land. Among all the intercropping systems designed in this study, one row of Chinese cabbage intercropping with one row of Solanum nigrum L. is the best planting mode (high yields (2.78 kg/m2) and low Cd accumulation (0.02 mg/kg) of Chinese cabbage). Combined with the in-depth joint analysis of diverse soil physicochemical features (soil nutrient characteristics and microbial community structure), biomass yield and quality, and soil microbiological properties, we elaborated that two measures (screening hyperaccumulation types and controlling planting strip width) were the major factors in determining the growth of the aboveground and underground parts of Chinese cabbage respectively, thus directly regulating the application effectiveness of intercropping technology. The intertwined mechanisms (interspecific and intraspecific relationship) of different intercropping systems are summarized, which include better utilization of space, light and other resources in the aboveground part, bioavailability of nutrient, drive of soil bacteria and alleviated soil Cd stress in the underground part, etc. Our research outputs indicate the effectiveness and feasibility of intercropping can be improved by optimizing the streamline configuration and plant mode, which provide theory of reference and practical evidence for warranting the food safety and agricultural soil remediation simultaneously.

Impacts of pregnancy and menopause on COVID-19 severity: a systematic review and meta-analysis of 4.6 million women

BACKGROUND

Corona Virus Disease 2019 (COVID-19) pandemic is still a public health emergency of international concern. However, whether pregnancy and menopause impact the severity of COVID-19 remain unclear.

AIM

This study is performed to investigate the truth.

DESIGN

Study appraisal and synthesis follows PRISMA guideline. Meta-analysis is performed in random-effects model.

METHODS

PubMed, Embase, Cochrane database, Central, CINAHL, ClinicalTrials.gov, WHO COVID-19 database and WHO-ICTRP are searched until 28 March 2023.

RESULTS

In total, 57 studies (4 640 275 COVID-19 women) were analyzed. Pregnant women were at a lower risk of severe COVID-19, intensive care unit (ICU) admission and disease mortality compared to those nonpregnant women with comparable comorbidities. In contrast, pregnant women with more prepregnancy comorbidities were at a higher risk of severe COVID-19, ICU admission and invasive mechanical ventilation (IMV). In addition, pregnant women with pregnancy complications had a significantly increased risk of severe COVID-19 and ICU admission. Menopause increased COVID-19 severity, IMV requirement and disease mortality. Hormone replacement therapy inhibited COVID-19 severity in postmenopausal women. Premenopausal and postmenopausal women had a lower chance of severe illness than age-matched men. The impact of pregnancy on COVID-19 severity was significant in Americans and Caucasians, whereas the effect of menopause on COVID-19 severity was only significant in Chinese.

CONCLUSIONS

Pregnancy and menopause are protective and risk factors for severe COVID-19, respectively. The protective role of pregnancy on COVID-19 is minimal and could be counteracted or masked by prepregnancy or pregnancy comorbidities. The administration of estrogen and progesterone may prevent severe COVID-19.

Impact of PRaG Therapy on Immune Microenvironment of Bilateral Subcutaneous Tumor Model of Colon Cancer

PURPOSE/OBJECTIVE(S)

Immune microenvironment is closely related to the efficacy of PD-1 inhibitors. The immune microenvironment contains a variety of immune cells, including effector T cells (cytotoxic CD8+T cells and effector CD4+T cells), dendritic cells (DC), and Myeloid-derived suppressor cells (MDSCs). The antitumor effects of PRaG therapy have been confirmed in bilateral subcutaneous transplantation tumor model of colon cancer. But the impact of PRaG therapy on immune microenvironment of such model is unclear. Therefore, the study continued to reveal the changes of immune microenvironment in mice.

MATERIALS/METHODS

80 male Balb/c mice aged 6-8 weeks were divided into five groups: control group, PD-1 inhibitor group, radiation group, radiation + PD-1 inhibitor group, and radiation + PD-1 inhibitor +GM-CSF (PRaG therapy) group. Bilateral subcutaneous tumor model of colon cancer in mice was constructed. 3×105 CT26.WT cells were inoculated subcutaneously in the right thigh root, and then the left thigh root 3 days later. Right subcutaneous tumor was selected for radiotherapy of 8 Gy×3. GM-CSF (100ng, i.p.) was given on the 1st day and PD-1 inhibitor (0.25mg/kg, i.p.) was given on the 2nd day after radiotherapy with one cycle every 3 days. On day 15, the spleen, left inguinal lymph node and left subcutaneous tumor of mice were collected. The proportion of immune cells was detected by flow cytometry.

RESULTS

Compared with other groups, PRaG therapy decreased the proportion of cDC1 in left inguinal lymph node, increased the proportion of cDC2 in left subcutaneous tumor and left inguinal lymph node. Moreover, PRaG therapy increased the proportion of CD8+ effector memory T cells and CD226+CD8+T cells in left inguinal lymph nodes. Finally, PRaG therapy increased the proportion of CD4+, CD8+ central memory T cells and CD69+CD8+T cells and reduced the proportion of M-MDSCs in spleen.

CONCLUSION

PRaG therapy can improve the immune microenvironment of spleen, unirradiated tumors and inguinal draining lymph nodes of bilateral subcutaneous tumor model of colon cancer in mice.

A Generalized Deep Learning Method for Synthetic CT Generation

PURPOSE/OBJECTIVE(S)

The application of deep learning to generate synthetic CT (sCT) has been widely studied in radiotherapy. Existing methods generally involve data from two different image modalities, such as CBCT-CT or MRI-CT, the quality of sCT is adversely affected by source image quality. We propose a unique method of synthesizing MRI and CBCT into sCT based on single-modal CT for training, and call it SmGAN.

MATERIALS/METHODS

We used planning CT of a group of 35 head and neck cases to as training data. We then applied two different spatial transformations to the planning CT image to produce the transformed CT1 and CT2. And We used a random style enhancement technique (Shuffle Remap) to modify the image distribution of CT1 which we termed CT1+E. CT1+E was used to simulate the patient's "image of the day" while CT2 to simulate the "planning image". After feeding both CT1+E and CT2 into the generator, we obtained the sCT predicted by the generator. The generator was trained using the Mean Absolute Error (MAE) loss between sCT and CT1. In the actual clinical process, we use the patient's CBCT or MRI instead of CT1+E and the patient's planning CT instead of CT2 as the input of the generator. After processing, we get an sCT that can maintain the spatial position of the image taken on the day, while presenting features similar to the planning CT. The evaluation data we have includes 10 pairs of MRI-Def_CT and 10 pairs of CBCT-Def_CT Head and Neck patients. Def_CT is obtained from the planning CT based on the spatial position deformation of MRI and CBCT. To evaluate the accuracy of sCT based on MRI and CBCT with Def CT, we use a range of metrics, including Hounsfield Unit (HU) difference, peak signal-to-noise ratio (PSNR), structural similarity (SSIM) and gamma pass rate. All results will be benchmarks against the advanced method RegGAN for comparison.

RESULTS

Compared to RegGAN, the results of SmGAN were significantly better. The mean absolute errors within the body were (44.7±216.2 HU vs. 36.7±131.4 HU) and (64.9±123.7 HU vs. 58.2±152.8 HU) for the CBCT-SCT and MRI-SCT, respectively (Table 1). In addition, experimental results show that SmGAN also outperforms RegGAN in dose calculation accuracy. For example, under the 10% threshold, SmGAN's gamma pass rate of 1mm and 1% is 0.926±0.02, compared with gamma rate of 0.896±0.02 for RegGAN.

CONCLUSION

We proposed a generalized deep learning model for synthetic CT generation, based on CBCT or MRI images. The proposed algorithm achieved high accuracy of dosimetric metrics, as well as excellent IMRT QA verification results. Compared to other existing synthetic CT generation methods, the proposed SmGAN required a single-modal image for training, which is considered as a major breakthrough in the industry, and is expected to have wide spread of clinical applications.

Mitigation of Dosimetric Uncertainty in MRI-Based Proton Planning Using Spot-Scanning Proton Arc (SPArc) Technique

PURPOSE/OBJECTIVE(S)

MRI-based synthetic CT (SCT) images created using generative adversarial network (GAN) have been demonstrated to be feasible for intensity-modulated proton therapy (IMPT) planning. However, dose calculation accuracy can be uncertain in some regions within/near the target of head and neck patients due to the local CT number estimation error or sharp dose fall-off. This study investigated the feasibility of using the SPArc technique to mitigate such dosimetric uncertainty.

MATERIALS/METHODS

A GAN using a 3D U-net as the generator and a 6-layer 3D convolutional neural network as the discriminator was trained with T1-weighted MR-CT image pairs from 162 nasopharyngeal carcinoma patients (14 for validation). The generator was used to generate SCT images from MR images for 7 test patients. For each test patient, the CT image was used to create a SPArc plan and an IMPT plan with the same clinical objectives. The SPArc plans (control point frequency sampling, arc trajectory, etc.) were optimized using a previously developed iterative approach. The dose distributions of both SPArc plans and IMPT plans were re-calculated on the SCT images and compared to the one calculated on the CT images. The dosimetric uncertainty was quantified using the gamma index.

RESULTS

The 2%/2mm and 3%/3mm passing rates for SPArc plans were (96.9¡À2.7) % and (98.6¡À1.5) %, while the passing rates for IMPT plans were (94.0¡À3.9) % and (96.4+2.9) %. A significant reduction in dosimetric uncertainty was identified for SPArc plans (p ¡Ü0.021). Table 1 shows the passing rates for the 7 test individuals.

CONCLUSION

SPArc can mitigate the uncertainty of dose calculation in MRI-based proton planning. Further research needs to validate these findings on a larger patient cohort. The study paves the road map for using MRI for SPArc planning.

Multidetector CT-derived tricuspid annulus measurements predict tricuspid regurgitation reduction after transcatheter aortic valve replacement

AIM

To use multidetector row computed tomography (MDCT)-derived tricuspid annulus (TA) measurements to identify predictors for tricuspid regurgitation (TR) reduction after transcatheter aortic valve replacement (TAVR), and to investigate the impact of TR change on prognosis.

MATERIALS AND METHODS

A retrospective, single-centre study was conducted on consecutive patients who underwent TAVR with concomitant baseline mild or more severe TR from April 2012 to April 2022. TA parameters were measured using MDCT.

RESULTS

The study comprised 266 patients (mean age 74.2 ± 7.6 years, 147 men) and 45.1% had more than one grade of TR reduction at follow-up. Independent predictors of TR reduction at follow-up were distance between TA centroid and antero-septal commissure (odd ratio [OR] 0.776; 95% confidence interval [CI]: 0.672-0.896, p=0.001), baseline TR of moderate or worse (OR 4.599; 95% CI: 2.193-9.648, p<0.001), systolic pulmonary artery pressure (OR 1.018; 95% CI: 1.002-1.035, p=0.027), age (OR 0.955; 95% CI: 0.920-0.993, p=0.019), and pre-existing atrial fibrillation (OR 0.209; 95% CI: 0.101-0.433, p<0.001). Patients without TR reduction had higher rates of rehospitalisation (hazard ratio [HR] 0.642; 95% CI: 0.413-0.998, p=0.049).

CONCLUSIONS

The MDCT-derived TA parameter was predictive of TR reduction after TAVR. Persistent TR after TAVR was associated with higher rates of rehospitalisation.

Impact of PRaG Therapy on Peripheral Immune Cells of Subcutaneous Tumor Peritoneal Metastasis Model of Colon Cancer

PURPOSE/OBJECTIVE(S)

Immune cells in peripheral blood may be closely related to the efficacy of immune checkpoint inhibitors. T cells originally present in tumors may have limited antitumor effects, and T cells that respond to immune checkpoint inhibitors may be derived from peripheral blood. Therefore, in this study, subcutaneous tumor peritoneal metastasis model of colon cancer was constructed to reveal the changes of T cells and their subsets (CD4+T cells, CD8+T cells, CD226+T cells), MDSCs and their subsets (G-MDSCs, M-MDSCs) in peripheral blood of mice after PRaG therapy.

MATERIALS/METHODS

A total of 90 male Balb/c mice aged 6-8 weeks were divided into five groups: control group, PD-1 inhibitor group, radiation group, radiation + PD-1 inhibitor group, and radiation + PD-1 inhibitor +GM-CSF (PRaG therapy) group. The subcutaneous tumor peritoneal metastasis model of colon cancer was constructed. 3×105 CT26.WT cells was inoculated subcutaneously at the right thigh root, and 5 days later, 1×105 CT26.WT cells was inoculated on the left side at the junction of the anterior superior iliac spine and the midabdominal line. The subcutaneous tumor was selected for radiotherapy of 8 Gy×3. GM-CSF (100ng, i.p.) was given on the 1st day and PD-1 inhibitor (0.25mg/kg, i.p.) was given on the 2nd day after radiotherapy with one cycle every 3 days. On day 22, the peripheral blood of mice was collected. The proportion of immune cells was detected by flow cytometry.

RESULTS

Compared with other groups, PRaG therapy decreased the proportion of CD4+T cells and increased the proportion of CD8+T cells. Moreover, PRaG therapy increased the proportion of CD226+CD4+T cells and CD226+CD8+T cells. Finally, PRaG therapy increased the proportion of M-MDSCs and decreased the proportion of G-MDSCs.

CONCLUSION

PRaG therapy can improve the immune microenvironment of peripheral blood of subcutaneous tumor peritoneal metastasis model of colon cancer in mice.

Radiation-Induced Nasopharyngeal Necrosis in Locally-Recurrent Nasopharyngeal Carcinoma Patients after Re-Radiotherapy

PURPOSE/OBJECTIVE(S)

Re-radiotherapy (re-RT) is the main treatment for locally recurrent nasopharyngeal carcinoma (lrNPC) patients, and commonly led to radiation-induced nasopharyngeal (NP) necrosis, which was lethal but rare study has focused on it. The aim of this study was to evaluate the cause and impact of radiation-induced NP necrosis in lrNPC patients who received re-RT.

MATERIALS/METHODS

Totally 252 lrNPC patients who received re-RT between January 2013 and December 2020 were retrospectively collected. The inclusion criteria were as follows: (1) no NP necrosis before re-RT; (2) complete medical records, including treatment, clinical and dosimetric information; (3) conventional fractionated radiotherapy. All patients received intensity-modulated radiotherapy ± chemotherapy. Radiation-induced NP necrosis was diagnosed by magnetic resonance imaging and/or electronic nasopharyngoscopy. Dosimetric factors of the planning target volume of primary tumor (PTVp) were extracted from the dose-volume histogram (DVH), which was rescaled to an equivalent dose of 2 Gy per fraction (EQD 2 Gy) using a linear quadratic model. Logistic regression was used to identify the independent prognostic factors for generating the nomogram.

RESULTS

With a median follow-up of 44.63 months (inter-quartile range [IQR], 27.70 - 69.20 months), 47.6% of patients (120/252) occurred radiation-induced NP necrosis, which mostly happened within 1 year post re-RT (median [IQR], 5.83 [3.37 - 11.57] months). The 3-year overall survival was 83.0% vs 39.7% (P<0.001) in lrNPC patients with or without radiation-induced NP necrosis. Except for the fractionated dose, other dosimetric factors of PTVp were not significantly different between two groups, including D98 (dose to 98% of PTVp), D50, D2 and homogeneity index (Table 1). Furthermore, multivariate analysis showed that continuous variable age (HR [95% CI]: 1.04 [1.02 - 1.07], P = 0.003) and tumor volume (HR [95% CI]: 1.02 [1.01 - 1.03], P<0.001), and fractionated dose > 2.22 Gy (HR [95% CI]: 2.36 [1.32 - 4.21], P = 0.004) were independent factors in predicting radiation-induced NP necrosis, which yielded a C-index of 0.742 (95% CI, 0.682 - 0.803) for OS in the nomogram.

CONCLUSION

The incidence of radiation-induced NP necrosis was high in lrNPC patients who received re-RT. Patients with older age, larger tumor volume or receiving fractionated dose over 2.22 Gy were more easily to suffer NP necrosis, which need to explore novel treatment strategies to improve patients' survivals.

[Preliminary experience of transcatheter pulmonary valve replacement using domestic balloon-expandable valve]

Objectives: To evaluate the feasibility and preliminary clinical results of transcatheter pulmonary valve replacement (TPVR) with the domestically-produced balloon-expandable Prizvalve system. Methods: This is a prospective single-center observational study. Patients with postoperative right ventricular outflow tract (RVOT) dysfunction, who were admitted to West China Hospital of Sichuan University from September 2021 to March 2023 and deemed anatomically suitable for TPVR with balloon-expandable valve, were included. Clinical, imaging, procedural and follow-up data were analyzed. The immediate procedural results were evaluated by clinical implant success rate, which is defined as successful valve implantation with echocardiography-assessed pulmonary regurgitation Collapse

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MESH Headings

• Male
• Humans
• Pulmonary Valve/surgery
• Heart Valve Prosthesis/adverse effects
• Heart Valve Prosthesis Implantation
• Constriction, Pathologic/complications
• Constriction, Pathologic/surgery
• Prospective Studies
• Ventricular Outflow Obstruction/etiology
• Ventricular Outflow Obstruction/surgery
• Treatment Outcome
• Cardiac Catheterization/methods
• Transcatheter Aortic Valve Replacement

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Grants

• 2022ZDZX0030 Sichuan Science and Technology Program

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Affiliation(s)

Z G Zhao Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China
R T Li Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China
X Wei Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China
Y Peng Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China
J F Wei Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China
S He Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China
Q Li Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China
X Li Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
Y J Li Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China
X Li Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China
X Zhou Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
M X Zheng Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China
G Chen Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, China
Q An Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
M Chen Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China
Y Feng Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China

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In-plane reorientation induced single laser pulse magnetization reversal

Single Pulse All Optical Switching represents the ability to reverse the magnetization of a nanostructure using a femtosecond single laser pulse without any applied field. Since the first switching experiments carried out on GdFeCo ferrimagnets, this phenomena has been only recently extended to a few other materials, MnRuGa alloys and Tb/Co multilayers with a very specific range of thickness and composition. Here, we demonstrate that single pulse switching can be obtained for a large range of rare earth-transition metal multilayers, making this phenomenon much more general. Surprisingly, the threshold fluence for switching is observed to be independent of the laser pulse duration. Moreover, at high laser intensities, concentric ring domain structures are induced. These striking features contrast to those observed in Gd based materials pointing towards a different reversal mechanism. Concomitant with the demonstration of an in-plane magnetization reorientation, a precessional reversal mechanism explains all the observed features.

Metal oxide modified biochars for fertile soil management: Effects on soil phosphorus transformation, enzyme activity, microbe community, and plant growth

Metal oxide modified biochars are increasingly being used for intensive agricultural soil remediation, but there has been limited research on their effects on soil phosphorus transformation, soil enzyme activity, microbe community and plant growth. Two highly-performance metal oxides biochars (FeAl-biochar and MgAl-biochar) were investigated for their effects on soil phosphorus availability, fractions, enzyme activity, microbe community and plant growth in two typical intensive fertile agricultural soils. Adding raw biochar to acidic soil increased NH4Cl-P content, while metal oxide biochar reduced NH4Cl-P content by binding to phosphorus. Original biochar slightly reduced Al-P content in lateritic red soil, while metal oxide biochar increased it. LBC and FBC significantly reduced Ca2-P and Ca8-P properties while improving Al-P and Fe-P, respectively. Inorganic phosphorus-solubilizing bacteria increased in abundance with biochar amendment in both soil types, and biochar addition affected soil pH and phosphorus fractions, leading to changes in bacterial growth and community structure. Biochar's microporous structure allowed it to adsorb phosphorus and aluminum ions, making them more available for plants and reducing leaching. In calcareous soils, biochar additions may dominantly increase the Ca (hydro)oxides bounded P or soluble P instead of Fe-P or Al-P through biotic pathways, favoring plant growth. The recommendations for using metal oxides biochar for fertile soil management include using LBC biochar for optimal performance in both P leaching reduction and plant growth promotion, with the mechanisms differing depending on soil type. This research highlights the potential of metal oxide modified biochars for improving soil fertility and reducing phosphorus leaching, with specific recommendations for their use in different soil types.

Safe Production Strategies for Soil-Covered Cultivation of Morel in Heavy Metal-Contaminated Soils

Morel is a popular edible mushroom with considerable medicinal and economic value which has garnered global popularity. However, the increasing heavy metal (HM) pollution in the soil presents a significant challenge to morels cultivation. Given the susceptibility of morels to HM accumulation, the quality and output of morels are at risk, posing a serious food safety concern that hinders the development of the morel industry. Nonetheless, research on the mechanism of HM enrichment and mitigation strategies in morel remains scarce. The morel, being cultivated in soil, shows a positive correlation between HM content in its fruiting body and the HM content in the soil. Therefore, soil remediation emerges as the most practical and effective approach to tackle HM pollution. Compared to physical and chemical remediation, bioremediation is a low-cost and eco-friendly approach that poses minimal threats to soil composition and structure. HMs easily enriched during morels cultivation were examined, including Cd, Cu, Hg, and Pb, and we assessed soil passivation technology, microbial remediation, strain screening and cultivation, and agronomic measures as potential approaches for HM pollution prevention. The current review underscores the importance of establishing a comprehensive system for preventing HM pollution in morels.

[Construction of a dual fluorescent reporter system for tracing horizontal transfer of mcr-1-carrying plasmid]

The green fluorescent reporter gene was inserted into the gene interval of polymyxin resistant mcr-1-carrying plasmid (pSH13G841) by homologous recombination of suicide plasmid. At the same time, E. coli J53 with red fluorescent reporter gene was constructed. Using the ability of spontaneous conjugation of drug resistant plasmid (pSH13G841), pSH13G841-GFP plasmid was transferred into J53 RFP bacteria to construct a double fluorescent labeled donor bacterium. The two light-emitting systems could stably and spontaneously express fluorescence without mutual interference. The dual fluorescence report system constructed can be used for visual tracing horizontal transfer of mcr-1-carrying plasmid, the subsequent model can study the colonization, transfer and prognosis of drug-resistant bacteria/drug-resistant genes mcr-1 by using mouse in vivo imaging technology.

[Feasibility and safety of transseptal transcatheter mitral valve replacement for severe mitral regurgitation]

A prospective, single-center, single-arm, and open-design study was performed to evaluate the feasibility and safety of transseptal transcatheter mitral valve replacement in the treatment of severe mitral regurgitation. Patients with symptomatic moderate-severe or severe mitral regurgitation at high-surgical risk and anatomically appropriate for the HighLife transseptal mitral valve replacement (TSMVR) system in West China Hospital, Sichuan University from December 2021 to August 2022 were enrolled. Four patients (1 male and 3 females) with severe mitral regurgitation were included, with a median age of 68.5 (64.0-77.0) years and a median Society of Thoracic Surgeons (STS) score of 8.1% (6.4%-8.9%). Technical success was achieved in all the patients. There was no residual mitral regurgitation, paravalvular leakage, or left ventricular outflow tract obstruction. Three major cardiovascular and cerebrovascular adverse events occurred within 30 days after the procedure, including ventricular tachycardia, iatrogenic atrial septal defect closure, and heart failure readmission. The current study preliminarily demonstrates that transcatheter mitral valve replacement using the HighLife system via the transseptal approach for severe mitral regurgitation is feasible and relatively safe.

Modifying engineered nanomaterials to produce next generation agents for environmental remediation

The application of pristine nanomaterials (PNMs) for environment remediation remains challenging due to inherently high potential for aggregation, low stability, sub-optimum efficiency, and non-uniformity in size and toxicity. Conversely, modified nanomaterials (MNMs) approaches have shown significant potential to enhance the technical and economic efficiency of conventional nanoscale remediation strategies by decreasing aggregation of nanomaterials by imparting electrostatic, electrosteric or steric repulsion between particles. Furthermore, the solubility enhancing agents in MNMs have been shown to increase metal bioavailability and accelerate the breakdown of pollutants. As such, it is imperative to modify nanomaterials for unlocking their full potential and expanding their range of applications. However, there is no comprehensive review in the literature that evaluates the efficacy and environmental impact of MNMs against PNMs in the environment. This critical review identifies major barriers preventing the widescale application of nano-enabled remediation and discusses strategies to increase the stability and activity of nanomaterials at reaction sites. The higher reactivity and versatility of MNMs, along with novel properties and functionalities, enable effective removal of a range of chemical pollutants from complex environmental matrices. Additionally, MNMs show significant improvement in mobility, reactivity, and controlled and targeted release of active ingredients for in situ remediation. However, the uncertainties associated with the adverse effects of some modification agents of MNMs are not well-understood, and require further in-depth investigations. Overall, our findings show that MNMs are potentially more efficient, cost-effective, and resilient for remediation of soil and sediment, water, and air pollution than PNMs. The possible action mechanisms of MNMs have been demonstrated for different environmental compartments. Conclusively, this work provides a path forward for developing effective nano-enabled remediation technologies with MNMs, which are widely applicable to a range of environmental contamination scenarios.

[Corneal melt after intracorneal ring segment implantations: a case report]

A 50-year-old female patient presented to the Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, with complaints of right eye pain, tearing, and difficulty opening the eye for over a month after intrastromal corneal ring segment (ICRS) implantation 18 years prior in both eyes. Slit lamp examination revealed corneal stromal melting around the ICRS at the 3 to 4 o'clock position of the right eye, with fluorescein staining. Optical coherence tomography showed epithelial and superficial stromal layer defects in the area of the lesion. The patient was diagnosed with corneal melting after ICRS implantation in the right eye. Under general anesthesia, the corneal stromal ring was removed, and deep lamellar keratoplasty was performed. The patient had no discomfort and the corneal graft remained transparent after the surgery.

[Prevalence of parasitic infections in human stool samples from a hospital in Chenzhou City of Hunan Province]

OBJECTIVE

To investigate the prevalence of parasitic infections in human stool samples from a hospital in Chenzhou City, Hunan Province, so as to provide insights into the management of intestinal parasitic diseases.

METHODS

Stool samples were collected from patients admitted to a hospital in Chenzhou City from September 2020 to March 2021, subjected to physiological saline smearing and microscopy for detection of intestinal parasites. The prevalence of parasitic infections and the species of parasites were descriptively analyzed.

RESULTS

The overall prevalence of intestinal parasitic infections was 1.61% in the 10 728 stool samples, and there were 3 samples with mixed infections of two parasite species. A total of seven parasite species were identified, including Blastocystis hominis (162 cases, 1.55%), Giardia lamblia (5 cases, 0.05%), Dientamoeba fragilis (5 cases, 0.05%), Endolimax nana (one case, 0.01%), Iodamoeba bütschlii (one case, 0.01%), Strongyloides stercoralis (one case, 0.01%) and Trichomonas hominis (one case, 0.01%). The prevalence of intestinal parasitic infection was significantly higher among women than in men (2.14% vs. 1.25%; χ² = 13.01, P < 0.01), and a high prevalence rate was seen among patients at ages of 20 to 30 years (2.99%) and 80 years and older (2.86%); however, no age-specific prevalence of intestinal parasitic infection was detected (χ² = 12.45, P > 0.05).

CONCLUSIONS

The overall prevalence of intestinal parasitic infection was low among patients admitted to a hospital in Chenzhou City, and gender-specific prevalence was found. Food-borne and opportunistic parasites were predominant intestinal parasites, including B. hominis, G. lamblia and D. fragilis.

[Analysis on missed diagnosis or misdiagnosis of anomalous origin of left coronary artery from pulmonary artery by echocardiography from one single medical center]

Objectives: To analyze the reasons of missed diagnosis or misdiagnosis on anomalous origin of left coronary artery from pulmonary artery (ALCAPA) by echocardiography. Methods: This is a retrospective study. Patients with ALCAPA who underwent surgical treatment in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from August 2008 to December 2021 were included. According to the results of preoperative echocardiography and surgical diagnosis, the patients were divided into confirmed group or missed diagnosis/misdiagnosis group. The results of preoperative echocardiography were collected, and the specific echocardiographic signs were analyzed. According to the experience of the doctors, the echocardiographic signs were divided into four types, namely clear displayed, vague/doubtful displayed, no display and no notice, and the display rate of each sign was calculated (display rate=number of clearly displayed cases/total number of cases×100%). By referring the surgical data, we analyzed and recorded the pathological anatomy and pathophysiological characteristics of the patients, and the rate of missed diagnosis/misdiagnosis of echocardiography in patients with different characteristics was compared. Results: A total of 21 patients were enrolled, including 11 males, aged 1.8 (0.8, 12.3) years (range 1 month to 47 years). Except for one patient with anomalous origin of left anterior descending artery, the others were all originated from the main left coronary artery (LCA). There were 13 cases of ALCAPA in infant and children, and 8 cases of adult ALCAPA. There were 15 cases in the confirmed group (diagnostic accuracy was 71.4% (15/21)), and 6 cases in the missed diagnosis/misdiagnosis group (three cases were misdiagnosed as primary endocardial fibroelastosis, two cases were misdiagnosed as coronary-pulmonary artery fistula; and one case was missed diagnosis). The working years of the physicians in the confirmed group were longer than those in the missed diagnosis/misdiagnosed group ((12.8±5.6) years vs. (8.3±4.7) years, P=0.045). In infants with ALCAPA, the detection rate of LCA-pulmonary shunt (8/10 vs. 0, P=0.035) and coronary collateral circulation (7/10 vs. 0, P=0.042) in confirmed group was higher than that in missed diagnosis/misdiagnosed group. In adult ALCAPA patients, the detection rate of LCA-pulmonary artery shunt was higher in confirmed group than that in missed diagnosis/misdiagnosed group (4/5 vs. 0, P=0.021). The missed diagnosis/misdiagnosis rate of adult type was higher than that of infant type (3/8 vs. 3/13, P=0.410). The rate of missed diagnosis/misdiagnosis was higher in patients with abnormal origin of branches than that of abnormal origin of main trunk (1/1 vs. 5/21, P=0.028). The rate of missed diagnosis/misdiagnosis in patients with LCA running between the main and pulmonary arteries was higher than that distant from the main pulmonary artery septum (4/7 vs. 2/14, P=0.064). The rate of missed diagnosis/misdiagnosis in patients with severe pulmonary hypertension was higher than that in patients without severe pulmonary hypertension (2/3 vs. 4/18, P=0.184). The reasons with an echocardiography missed diagnosis/misdiagnosis rate of≥50% included that (1) the proximal segment of LCA ran between the main and pulmonary arteries; (2) abnormal opening of LCA at the right posterior part of the pulmonary artery; (3) abnormal origin of LCA branches; (4) complicated with severe pulmonary hypertension. Conclusions: Echocardiography physicians' knowledge of ALCAPA and diagnostic vigilance are critical to the accuracy of diagnosis. Attention should be paid to the pediatric cases with no obvious precipitating factors of left ventricular enlargement, regardless of whether the left ventricular function is normal or not, the origin of coronary artery should be routinely explored.

[Different forms of free radial collateral artery perforator flaps for reconstruction after removal of oral tumors]

Objective: To investigate the efficacies of different forms of free radial collateral artery perforator flaps in repairing the defects after oral tumor surgeries. Methods: From May 2016 to March 2021, 28 patients (22 males, 6 females, aged 35-62 years) with oral tumors admitted by Hunan Cancer Hospital received the reconstructive surgeries with the free radial collateral artery perforator flaps after removal of oral tumors, including 24 cases of tongue cancer (11 cases of tongue marginal cancer, 9 cases of tongue belly cancer and 4 cases of tongue cancer involved in the floor of the mouth) and 4 cases of buccal and oral cancer. Four forms of radial collateral artery perforator flaps were used: single perforator flaps for 6 cases, double perforators flaps for 7 cases, flaps without perforator visualization for 10 cases and chimeric perforator myocutaneous flaps for 5 cases. The recipient vessels were the superior thyroid artery and superior thyroid vein, and if second concomitant vein available, it was anastomosed with internal jugular vein in end-to-side fashion. SPSS 20.0 statistical software was used to analyze the data. Results: The mean length of flaps was (9.7±0.4) cm, mean width (4.4±0.3) cm and mean thickness (1.1±0.4) cm. The mean length of the vascular pedicles was (7.1±0.6)cm (6.0-8.0 cm), the mean diameter of the radial accessory arteries was (1.1±0.3)mm (0.8-1.3 mm). Eleven cases(39.3%) had respectively one accompanying vein and 17 cases(60.7%) had respectively two accompanying veins, with the mean diameter of (1.1±0.3) mm (0.8-1.3 mm). All the 28 flaps survived, the donor and recipient wounds healed in one stage, the appearances of the flaps were satisfactory, only linear scars remained in the donor sites, and the upper arm functions were not significantly affected. Follow up for 12-43 months showed that the flaps were soft with partially mucosalization, the reconstructed tongue and buccal cavity were in good shape, and the swallowing and language functions were satisfactory. The swallowing and language functions were retained to the greatest extent in 3 cases with near total tongue resection, although the functions were still significantly affected. There was no local recurrence of the tumor during follow-up. One case had regional lymph node metastasis, and further lymph node dissection and comprehensive treatment were performed, with satisfactory outcomes. Conclusions: The vascular pedicle of the radial collateral artery perforator flap has a constant anatomy, which can be prepared in different forms to improve the safety of the operation and minimize the donor site damage. It is an ideal choice for the repair of small and medium-sized defects after oral tumor surgery.

[Research advances of stem cell-based tissue engineering repair materials in promoting the healing of chronic refractory wounds on the body surface]

Repairing chronic refractory wounds on the body surface is a complex medical problem involving all stages of wound healing. In recent years, stem cells (SCs) and tissue engineering (TE) have brought hope for repairing chronic refractory wounds. SCs have excellent regenerative and paracrine effects; various TE strategies have the potential to repair chronic refractory wounds on the body surface and also improve the delivery efficiency of SCs. This article reviews the pathological characteristics of chronic refractory wounds, SCs used to repair chronic refractory wounds, and SC-based TE wound repair strategies.

Correlation between capsule endoscopy classification and CT lymphangiography of primary intestinal lymphangiectasia

AIM

To investigate the correlation between capsule endoscopy (CE) classification of primary intestinal lymphangiectasia (PIL) and computed tomography (CT) lymphangiography (CTL).

MATERIALS AND METHODS

A total of 52 patients with diagnosed PIL were enrolled. All patients were examined using CTL and small intestinal CE before surgery. CE assessments included the morphology, scope, colour, and size of lesions. CTL assessments included intestinal wall, lymphatic vessel dilatation, lymph fluid reflux, and lymphatic fistula. Patients were divided into three groups according to type diagnosed by CE, and the CTL characteristics were analysed among the groups.

RESULTS

CE showed 15 patients with type I, 27 with II, and 10 with type III. Intestinal wall thickening was observed in 15 type I, 21 type II, and seven type III. Pericardial effusion was observed in only three type I patients; the difference among types was statistically significant (p=0.02). Abnormal contrast agent distribution in the intestinal wall and mesentery was observed in 15 type II patients, and the difference was significantly greater than that of types I and III (p=0.02). Abnormal contrast agent distribution in the abdominal cavity was observed in 12 type II, and the difference was statistically significant (p=0.03).

CONCLUSION

The CE PIL classification reflects the extent and scope of intestinal mucosa lesions; CTL more systematically demonstrates abnormal lymphatic vessels or reflux, and its manifestations of PIL are related to the CE classification. The combination of CTL with CE is useful for accurately evaluating PIL, and provides guidance for preoperative assessment and treatment management of PIL patients.

Effects of Critical Operation and Cleaning Parameters on Performances and Economic Benefits of Biogas Slurry Concentration by Forward Osmosis Membrane

Forward osmosis membrane technology (FO) shows potential application prospects in biogas slurry concentration, which is conducive to promoting the sustainable development of biogas projects. However, at present, the key influencing factors of membrane concentration using FO are not well understood. Therefore, this study analyzed the influence of draw solution concentration, pH, temperature and cross-flow velocity on the concentration efficiency of FO membrane, and optimized the operation parameters of FO membrane. The results showed that the concentration effect of the NaCl draw solution at pH 5 or 9 was better than that at pH 7. The order of factor influencing the water flux was as follows: draw liquid concentration > cross-flow velocity > operating temperature. The optimal combination obtained by orthogonal analysis was under 45 °C, with a cross-flow velocity of 1 L/min and the use of 1.5 mol/L NaCl as draw solution. The results of the membrane cleaning implied that the recovery rate of the fouled membrane after acid-base cleaning is significantly higher (88%) than other cleaning solutions. This research offers a scientific reference for applying positive osmosis technology to re-utilize biogas slurry resources.

The role and molecular mechanism of gut microbiota in Graves' orbitopathy

PURPOSE

Graves' orbitopathy (GO) is an autoimmune orbital disorder. Gut microbiota dysfunction plays a vital role in autoimmune diseases, including Graves' disease (GD) and GO. In the present study, we aimed to investigate the change of gut microbiota in GD/GO using mouse model.

METHODS

The murine model of GD/GO was established by the challenge of adenovirus expressing thyroid-stimulating hormone (TSH) receptor (TSHR) (Ad-TSHR). The histological changes of orbital and thyroid tissues were analyzed by hematoxylin and eosin (H&E), Masson staining, and immunohistochemistry (IHC) staining. The fecal samples were collected for 16S rRNA gene sequencing and bioinformatics analysis.

RESULTS

The GD/GO model was established successfully, as manifested as the broadened eyelid, exophthalmia and conjunctive redness, severe inflammatory infiltration among thyroid glands and between extraocular muscle space, hypertrophic extraocular muscles, elevated thyroxine (T4) and decreased TSH, and positive CD34, CD40, collagen I, and α-SMA staining. A total of 222 operational taxonomic units (OUTs) were overlapped between mice in the Ad-NC and Ad-TSHR groups. The microbial composition of the samples in the two groups was mainly Bacteroidia and Clostridia, and the Ad-NC group had a significantly lower content of Bacteroidia and higher content of Clostridia. KEGG orthology analysis results revealed differences in dehydrogenase, aspartic acid, bile acid, chalcone synthase, acetyltransferase, glutamylcyclotransferase, glycogenin, and 1-phosphatidylinositol-4-phosphate 5-kinase between two groups; enzyme commission (EC) analysis results revealed differences in several dehydrogenase, oxidase, thioxy/reductase between two groups; MetaCyc pathways analysis results revealed differences in isoleucine degradation, oxidation of C1 compounds, tricarboxylic acid (TCA) cycle IV, taurine degradation, and biosynthesis of paromamine, heme, colonic acid building blocks, butanediol, lysine/threonine/methionine, and histidine/purine/pyrimidine between two groups.

CONCLUSION

This study induced a mouse model of GD/GO by Ad-TSHR challenge, and gut microbiota characteristics were identified in the GD/GO mice. The Bacteroidia and Clostridia abundance was changed in the GD/GO mice. These findings may lay a solid experimental foundation for developing personalized treatment regimens for GD patients according to the individual gut microbiota. Given the potential impact of regional differences on intestinal microbiota, this study in China may provide a reference for the global overview of the gut-thyroid axis hypothesis.

[Analysis of the characteristics of retracted scientific papers in the field of global liver diseases published by Chinese scholars]

Objective: To analyze the characteristics of scientific papers in the field of global liver diseases published by Chinese scholars that were retracted for diverse reasons from the Retraction Watch database, so as to provide a reference to publishing-related papers. Methods: The Retraction Watch database was retrieved for retracted papers in the field of global liver disease published by Chinese scholars from March 1, 2008 to January 28, 2021. The regional distribution, source journals, reasons for retraction, publication and retraction times, and others were analyzed. Results: A total of 101 retracted papers that were distributed across 21 provinces/cities were retrieved. Zhejiang area (n = 17) had the most retracted papers, followed by Shanghai (n = 14), and Beijing (n = 11). The vast majority were research papers (n = 95). The journal PLoS One had the highest number of retracted papers. In terms of time distribution, 2019 (n = 36) had the most retracted papers. 23 papers, accounting for 8.3% of all retractions, were retracted owing to journal or publisher concerns. Liver cancer (34%), liver transplantation (16%), hepatitis (14%), and others were the main areas of retracted papers. Conclusion: Chinese scholars have a large number of retracted articles in the field of global liver diseases. A journal or publisher chooses to retract a manuscript after investigating and discovering more flawed problems, which, however, require further support, revision, and supervision from the editorial and academic circles.

Recent progresses, challenges, and opportunities of carbon-based materials applied in heavy metal polluted soil remediation

The application of carbon-based materials (CBMs) for heavy metal polluted soil remediation has gained growing interest due to their versatile properties and excellent remediation performance. Although the progresses on applications of CBMs in removing heavy metal from aqueous solution and their corresponding mechanisms were well known, comprehensive review on applications of CBMs in heavy metal polluted soil remediation were less identified. Therefore, this review provided insights into advanced progresses on utilization of typical CBMs including biochar, activated carbon, graphene, graphene oxide, carbon nanotubes, and carbon black for heavy metal polluted soil remediation. The mechanisms of CBM remediation of heavy metals in soil were summarized, mainly including physical adsorption, precipitation, complexation, electrostatic interaction, and cationic-π coordination. The key factors affecting the remediation effect include soil pH, organic matter, minerals, microorganisms, coexisting ions, moisture, and material size. Disadvantages of CBMs were also included, such as: potential health risks, high cost, and difficulty in achieving co-passivation of anions and cations. This work will contribute to our understanding of current research advances, challenges, and opportunities for CBMs remediation of heavy metal-contaminated soils.

Comparison of automated breast volume scanning with conventional ultrasonography, mammography, and MRI to assess residual breast cancer after neoadjuvant therapy by molecular type

AIM

To compare the accuracy of hand-held ultrasonography (US), mammography (MG), magnetic resonance imaging (MRI), and automated breast volume scanning (ABVS) in defining residual breast cancer tumour size after neoadjuvant therapy (NAT).

MATERIALS AND METHODS

Patients diagnosed breast cancer and who received NAT at the Breast Center, Peking University People's Hospital, were enrolled prospectively. Imaging was performed after the last cycle of NAT. The residual tumour size, intraclass correlation coefficients (ICCs), and receiver operating characteristic (ROC) to predict pathological complete response (pCR) were analysed.

RESULTS

A total of 156 patients with 159 tumours were analysed. ABVS had a moderate correlation with histopathology residual tumour size (ICC = 0.666), and showed high agreement among triple-positive tumours (ICC = 0.797). With 5 mm as the threshold, the coincidence rate reached 64.7% between ABVS and pathological size, which was significantly higher than that between US, MG, MRI, and pathological size (50%, 45.1%, 41.4%; p=0.009, p=0.001, p<0.001, respectively). For ROC analysis, ABVS demonstrated a higher area under the ROC curve, but with no statistical difference, except for MG (0.855, 0.816, 0.819, and 0.788, respectively; p=0.183 for US, p=0.044 for MG, and p=0.397 for MRI, with ABVS as the reference).

CONCLUSIONS

The longest tumour diameter on ABVS had a moderate correlation with pathological residual invasive tumour size. ABVS was shown to have good ability to predict pCR and would appear to be a potential useful tool for the assessment after NAT for breast cancer.

[Anatomical classification of adductor magnus perforator flap and its application in head and neck reconstruction]

Objective: To investigate the anatomical classification of adductor magnus perforator flap and its application in head and neck reconstruction. Methods: From January 2017 to January 2020, Hunan Cancer Hospital treated 27 cases of oral tumor patients (15 cases of tongue cancer, 9 cases of gingival cancer and 3 cases of buccal cancer), including 24 males and 3 females, aged 31-56 years old. The course of disease was 1-12 months. Secondary soft tissue defects with the sizes of 5.0 cm × 3.5 cm to 11.0 cm × 8.0 cm were left after radical resection of the tumors, and were repaired with free adductor magnus perforator flaps. The flaps based on the origing locations of perforator vessels were divided into three categories: ① intramuscular perforator: vessel originated between the gracilis muscle and the adductor magnus or passed through a few adductor magnus muscles; ② adductor magnus middle layer perforator: vessel run between the deep and superficial layers of adductor magnus; ③ adductor magnus deep layer perforator: vessel run between the deep layer of adductor magnus and the semimembranous muscle. Descriptive analysis was used in this research. Results: Perforator vessels of adductor magnus were found in all cases, with a total of 62 perforator branches of adductor magnus. The anatomical classification of the perforator vessels was as follows: 12 branches for class ①, 31 branches for class ② and 19 branches for class ③. The vascular pedicles of the free adductor major perforator flaps included type ① for 3 cases, type ② for 16 cases and type ③ for 8 cases. All 27 flaps survived and the donor sites were closed directly. In 18 cases, the perforator arteries and the venae comitan were respectively anastomosed with the superior thyroid arteries and veins. In 9 cases, the pedicle arteries and the venae comitan were respectively anastomosed with the facial arteries and veins. Follow up for 12-40 months showed that the appearances of the flaps and the swallowing and language functions of patients were satisfactory, apart from linear scars were left in the donor sites with no significant affect on the functions of thigh. Local recurrence occurred in 3 cases and radical surgeries were performed again followed by repairs with pedicled pectoralis major myocutaneous flaps. Cervical lymph node metastasis occurred in 2 cases and cervical lymph node dissection was performed again. Conclusions: The adductor magnus perforator flap has soft texture, constant perforator vessel anatomy, flexible donor location and harvesting forms, and less damage to the donor site. It is an ideal choice for postoperative reconstruction in head and neck tumors.

Robot-Assisted Percutaneous Balloon Compression in Elderly Patients with Trigeminal Neuralgia

Objective

To investigate the clinical effects of percutaneous balloon compression (PBC) for trigeminal neuralgia in elderly patients with the assistance of a neurosurgical navigation and positioning planning system (referred to hereafter as the robot).

Methods

We performed a retrospective analysis of 11 patients with trigeminal neuralgia. Preoperative TOF MRA, T2WI-SPACE, and thin-slice CT scans were performed, and the volume of Meckel's Cave was calculated by multi-modal image fusion on a workstation. Surgical planning involved two paths. Path A was the actual puncture path, the target point was the anterior inner quadrant of the inner opening of the foramen ovale; Path B represented a virtual path for measurement, and was used to plan the depth of balloon placement. The foramen ovale puncture for path A was completed under the guidance of a robotic arm adapter, while path B was completed under lateral X-ray fluoroscopy with a DSA machine. The balloon was placed at a predetermined depth, and filled to a "pear" shape to complete the operation. Preliminary follow-up results were obtained by considering VAS score and BNI classification.

Results

The foramen ovale was successfully punctured in all 11 patients and entered Meckel's Cave, the balloon was then filled to create a "pear shape". Immediate complete healing was achieved in 10 patients and delayed healing was achieved in one patient by the 5th postoperative day. No serious complications were identified that were related to surgery, and over a follow-up time of 1-12 months, there was no recurrence of pain, and a BNI numbness grade of 2-3 points. The appropriate ratio of the balloon inflated volume to the preoperative Meckel's Cave volume was approximately 1.7.

Conclusion

Preliminary clinical application and short-term follow-up showed that robot-assisted PBC surgery is a safe and effective surgical method for elderly patients with trigeminal neuralgia.

Supplying amendments alleviates aluminum toxicity and regulates cadmium accumulation by spinach in strongly acidic soils

Al toxicity and Cd pollution are key limiting factors for agricultural production in the acidic soils in China. The application of amendments is an effective and promising measure for remediating strongly acidic Cd-contaminated soils. However, the information on applying amendments for alleviating Al toxicity and regulating plant Cd accumulation is still rare. Here, oyster shell (OS), red mud (RM), hydroxyapatite (HAP), and biochar (BC) at 30 g kg^-1 were investigated for alleviating Al toxicity and decreasing Cd accumulation in spinach plants. The results showed that four amendments significantly increased soil pH, and reduced soil exchangeable Al³⁺ and DTPA-Cd, promoted spinach growth (P < 0.05). Al(OH)₃⁰ and Al-HA were the main forms of active Al in soil. The BC and OS were more effective to alleviate Al toxicity but significantly (P < 0.05) increased Cd accumulation in spinach. RM and HAP effectively reduced the uptake of Cd by spinach plants as well as alleviated Al toxicity (P < 0.05). Bivariate correlation analysis and the partial least squares path modeling analysis indicated that soil exchangeable Al³⁺ was the main limiting factor for biomass production. Our study demonstrated that HAP could significantly alleviate Al toxicity, promote spinach growth, and decrease Cd accumulation in strongly acidic Cd-contaminated soils. Besides, OS and BC effectively alleviated soil Al toxicity leading to promoting the growth of spinach. Compared with CK, RM treatment significantly reduced soil Cd bioavailability (61.2%) and decreased Cd concentration and uptake of spinach plants by 90.0% and 50.7%. These results indicated that RM could be used as an efficient amendment in Cd contaminated.

Interception of fertile soil phosphorus leaching with immobilization materials: Recent progresses, opportunities and challenges

The non-point source pollution induced by phosphorus (P) leaching from fertile soils is accelerating the eutrophication phenomena in aqueous ecosystems. Herein, to alleviate and intercept the P leaching from the fertile soils, diverse P immobilization materials (PIM) which can transform labile P into stable P via a range of physicochemical and biological interactions have been adopted and received increasing research interest. However, the remediation mechanisms of different PIMs were complex and vary with soil properties and PIM application methods. In this review, the P fraction and mobility characteristics of different fertile soils were first introduced. Then, three kinds of PIM including inorganic materials (e.g., clay minerals and red mud), organic materials (e.g., polyacrylamide), and composites (e.g., modified biochar) applied in soil P leaching interception were concluded. The key factors (i.e., soil pH, soil texture, organic matter content and variable soil moisture) influencing PIM performance and potential PIMs used for reducing soil P leaching were also introduced. Current review can favor for proposing more suitable and insightful strategies to regulate the fertile soil P and achieve the dual goals of improving the crop land quality and yield, and preventing agricultural non-point source pollution.

Identifying biotic and abiotic processes of reversing biochar-induced soil phosphorus leaching through biochar modification with MgAl layered (hydr)oxides

Biochar (BC) as a increasing widely adopted soil amendments showed potential threat to soil P leaching, but the relevant mechanisms were not clear enough and relevant strategy should be proposed to address the P leaching induced by BC application. In this study, effects of ordinary corn straw BC, and a fabricated Mg/Al-LDHs modified biochar (LBC) on soil P availability, adsorption, fraction and mobility were compared and investigated by conducting the column and incubation experiments at biochar to soil rate of 1 %, 2 % and 4 % (w/w). Chemical sequential extraction methods and various solid-state method (i.e., three-dimensional excitation emission matrix (EEM), x-ray diffraction (XRD), scanning electron micrograph (SEM) and P K-edge X-ray absorption near edge structure (XANES)) were utilized to give deep insights into the P mobilization and immobilization mechanisms by respectively applying the BC and LBC. Results of incubation experiments showed that applying the LBC reduced the labile P with significant CaP transformation to Al-retained P, while ordinary BC promoted the Fe/Al-P transformation to labile dibasic calcium phosphate and monobasic calcium phosphate evidenced by the EEM analysis, in-situ XANES investigation and chemical sequential extraction methods. Results of phosphatase and microbial analyses indicated that the decreased labile P after 30 days' incubation and the mitigated P leaching in LBC treatment were dominantly ascribed to abiotic processes of inorganic P transformation and (de)sorption. This research gave deep insights into abiotic and biotic processes of ordinary biochar promoting soil P leaching, and important implications for applying engineered biochar in reducing P leaching and improving soil productivity.