White light powered antimicrobial nanoagents for triple photothermal, chemodynamic and photodynamic based sterilization

Antibacterial nanoagents have been increasingly developed due to their favorable biocompatibility, cost-effective raw materials, and alternative chemical or optical properties. Nevertheless, there is still a pressing need for antibacterial nanoagents that exhibit outstanding bacteria-binding capabilities and high antibacterial efficiency. In this study, we constructed a multifunctional cascade bioreactor (GCDCO) as a novel antibacterial agent. This involved incorporating carbon dots (CDs), cobalt sulfide quantum dots (CoSx QDs), and glucose oxidase (GOx) to enhance bacterial inhibition under sunlight irradiation. The GCDCO demonstrated highly efficient antibacterial capabilities attributed to its favorable photothermal properties, photodynamic activity, as well as the synergistic effects of hyperthermia, glucose-augmented chemodynamic action, and additional photodynamic activity. Within this cascade bioreactor, CDs played the role of a photosensitizer for photodynamic therapy (PDT), capable of generating ˙O2- even under solar light irradiation. The CoSx QDs not only functioned as a catalytic component to decompose hydrogen peroxide (H2O2) and generate hydroxyl radicals (˙OH), but they also served as heat generators to enhance the Fenton-like catalysis process. Furthermore, GOx was incorporated into this cascade bioreactor to internally supply H2O2 by consuming glucose for a Fenton-like reaction. As a result, GCDCO could generate a substantial amount of reactive oxygen species (ROS), leading to a significant synergistic effect that greatly induced bacterial death. Furthermore, the in vitro antibacterial experiment revealed that GCDCO displayed notably enhanced antibacterial activity against E. coli (99+ %) when combined with glucose under simulated sunlight, surpassing the efficacy of the individual components. This underscores its remarkable efficiency in combating bacterial growth. Taken together, our GCDCO demonstrates significant potential for use in the routine treatment of skin infections among diabetic patients.

[Impact of obesity on the incidence of postoperative pulmonary complications following laparoscopic colorectal surgery]

Objective: To evaluate the effects of obesity on the incidence of postoperative pulmonary complications (PPCs) following laparoscopic colorectal surgery. Methods: A total of 150 patients with pathological diagnosis of colorectal cancer who accepted laparoscopic colorectal excision from January to May 2023 were retrospectively recruited. All the patients scored 26 points or more in the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) model, making them all in intermediate to high risks of PPCs. Patients were divided into obesity group and non-obesity group depending on whether they were obese or not. Propensity score matching (1∶1) was performed to achieve the balance of clinicopathological characteristics with the matching factors of age, sex, respiratory complications and ARISCAT score. A total of 96 patients were eventually enrolled, with 48 patients in obesity group and 48 patients in non-obesity group. Besides, the patients were divided into 25°-30° Trendelenburg subgroup and ±10°-15° Trendelenburg subgroup according to surgical sites for further analysis. The incidence of PPCs, the intraoperative airway pressure and blood biomarker expression of lung injury, including soluble receptor for advanced glycation end products (sRAGE) and angiopoietin-2 (ANG2) at postoperative day (POD) 1 and POD3 between the two groups were compared. The relationship between obesity and incidence of PPCs within 30 postoperative days were analyzed with unifactorial Cox proportional hazard model. Results: The obesity group was comprised of 35 males and 13 females with a median age of 60 (49, 69) years, and the non-obesity group was comprised of 35 males and 13 females with a median age of 60 (52, 67) years. The incidence of PPCs was 50.0% (24/48) in the obesity group, which was higher than 20.8% (10/48) in the non-obesity group and the incidence of grade Ⅰ PPCs and microatelectasis were 31.3% (15/48) and 33.3% (16/48), higher than the 12.5% (6/48) and 12.5% (6/48) of the non-obesity group (all P<0.05). The peak airway pressure (Ppeak) and plateau airway pressure (Pplat) of patients in obesity group were 34.0(31.5, 36.5) and 30.0(27.0, 32.0) cmH2O(1 cmH2O=0.098 kPa), which were significantly higher than the 26.0 (24.0, 29.5) and 22.0 (21.0, 26.5) cmH2O of the non-obesity group (all P<0.001). The ANG2 level of the obesity group at POD3 was 11.9 (8.4, 16.5) μg/L, which was higher than 9.2 (6.0, 12.3) μg/L of the non-obesity group (P=0.045). In 25°-30°Trendelenburg subgroup, the incidence of PPCs in obese patients were significantly higher than that of non-obese patients [41.4% (12/29) vs 11.4% (4/35), P=0.005]. In ±10°-15°Trendelenburg subgroup, no significant difference was found in PPCs incidence between obese and non-obese patients [63.2% (12/19) vs 46.2% (6/13), P=0.215]. The unifactorial Cox proportional hazard model analysis showed that obesity was a risk factor of PPCs in 30 postoperative days (HR=3.015, 95%CI: 1.438-6.321, P=0.001). Conclusion: In patients undergoing laparoscopic colorectal surgery with intermediate to high risk of PPCs, obesity raises intraoperative airway pressure and aggravates intraoperative lung endothelial injury. Obesity is a risk factor of PPCs in 30 postoperative days.

Sunflower pollen-derived microcapsules adsorb light and bacteria for enhanced antimicrobial photothermal therapy

Bacterial infection is one of the most serious clinical complications, with life-threatening outcomes. Nature-inspired biomaterials offer appealing microscale and nanoscale architectures that are often hard to fabricate by traditional technologies. Inspired by the light-harvesting nature, we engineered sulfuric acid-treated sunflower sporopollenin exine-derived microcapsules (HSECs) to capture light and bacteria for antimicrobial photothermal therapy. Sulfuric acid-treated HSECs show a greatly enhanced photothermal performance and a strong bacteria-capturing ability against Gram-positive bacteria. This is attributed to the hierarchical micro/nanostructure and surface chemistry alteration of HSECs. To test the potential for clinical application, an in situ bacteria-capturing, near-infrared (NIR) light-triggered hydrogel made of HSECs and curdlan is applied in photothermal therapy for infected skin wounds. HSECs and curdlan suspension that spread on bacteria-infected skin wounds of mice first capture the local bacteria and then form hydrogels on the wound upon NIR light stimulation. The combination shows a superior antibacterial efficiency of 98.4% compared to NIR therapy alone and achieved a wound healing ratio of 89.4%. The current study suggests that the bacteria-capturing ability and photothermal properties make HSECs an excellent platform for the phototherapy of bacteria-infected diseases. Future work that can fully take advantage of the hierarchical micro/nanostructure of HSECs for multiple biomedical applications is highly promising and desirable.

[The effect of deep neuromuscular block combined with low pneumoperitoneum pressure on postoperative pain in patients undergoing laparoscopic radical colorectal surgery]

Objective: To investigate the effect of deep neuromuscular blockade (DNMB) combined with low pneumoperitoneum pressure anesthesia strategy on postoperative pain in patients undergoing laparoscopic colorectal surgery. Methods: This study was a randomized controlled trial. One hundred and twenty patients who underwent laparoscopic colorectal surgery at Cancer Hospital of Chinese Academy of Medical Sciences from December 1, 2022 to May 31, 2023 were selected and randomly divided into two groups by random number table method. Moderate neuromuscular blockade [train of four stimulations count (TOFC)=1-2] was maintained in patients of the control group (group C, n=60) and pneumoperitoneum pressure level was set at 15 mmHg(1 mmHg=0.133 kPa). DNMB [post-tonic stimulation count (PTC)=1-2] was maintained in patients of the DNMB combined with low pneumoperitoneum pressuregroup (group D, n=60) and pneumoperitoneum pressure level was set at 10 mmHg. The primary measurement was incidence of moderate to severe pain at 1 h after surgery. The secondary measurements the included incidence of moderate to severe pain at 1, 2, 3, 5 d and 3 months after surgery, the incidence of rescue analgesic drug use, the doses of sufentanil in analgesic pumps, surgical rating scale (SRS) score, the incidence of postoperative residual neuromuscular block, postoperative recovery [evaluated with length of post anesthesia care unit (PACU) stay, time of first exhaust and defecation after surgery and length of hospital stay] and postoperative inflammation conditions [evaluated with serum concentration of interleukin (IL)-1β and IL-6 at 1 d and 3 d after surgery]. Results: The incidence of moderate to severe pain in group D 1 h after surgery was 13.3% (8/60), lower than 30.0% (18/60) of group C (P<0.05). The incidence of rescue analgesia in group D at 1 h and 1 d after surgery were 13.3% (8/60) and 4.2% (5/120), respectively, lower than 30.0% (18/60) and 12.5% (15/120) of group C (both P<0.05). The IL-1β level in group D was (4.1±1.8)ng/L at 1 d after surgery, which was lower than (4.9±2.6) ng/L of group C (P=0.048). The IL-6 level in group D was (2.0±0.7)ng/L at 3 d after surgery, which was lower than (2.4±1.1) ng/L of group C (P=0.018). There was no significant difference in the doses of sufentanil in analgesic pumps, intraoperative SRS score, incidence of neuromuscular block residue, time spent in PACU, time of first exhaust and defecation after surgery, incidence of nausea and vomiting, and length of hospitalization between the two groups (all P>0.05). Conclusion: DNMB combined with low pneumoperitoneum pressure anesthesia strategy alleviates the early-stage pain in patients after laparoscopic colorectal surgery.

[Effect of a novel pH-responsive tertiary amine monomer dodecylmethylaminoethyl methacrylate modified resin adhesive on biofilm formation of Streptococcus mutans and Lactobacillus casei in vitro]

Objective: To explore the application prospect of a new pH-responsive tertiary amine monomer dodecylmethylaminoethyl methacrylate (DMAEM) modified resin adhesive (DMAEM@RA) in the prevention and treatment of secondary caries. Methods: Five percents DMAEM was added to the resin adhesive to synthesize DMAEM@RA for modifying. Streptococcus mutans (Sm) and Lactobacillus casei (Lc) biofilms were cultured on resin adhesive and DMAEM@RA, respectively. The culture systems were set up at pH=7.4, 6.0, 5.5, and 5.0. The antimicrobial activity of DMAEM@RA was evaluated by quantitative PCR. The effects of DMAEM@RA on biofilm thickness, bacterial amount, and extracellular polysaccharides were studied by scanning electron microscope (SEM) and extracellular polysaccharide staining. Real-time fluorescence quantitative PCR was used to study the effect of DMAEM@RA on the expression levels of cariogenic genes in Sm. Results: DMAEM@RA could significantly reduce the amount of Sm and Lc under acidic conditions, especially Lc. At pH=5.0, the logarithm value of co-cultured Sm bacteria [lg (CFU/ml)] in DMAEM@RA group (7.58±0.01) was significantly lower than that in control group (7.87±0.03) (t=14.32, P<0.001), and the logarithm value of Lc bacteria [lg (CFU/ml)] (7.29±0.04) was also significantly lower than that in control group (7.93±0.15) (t=6.93, P=0.002). SEM observed that the bacteria decreased and the cell fragments appeared in DMAEM@RA group. In addition, DMAEM@RA significantly reduced the biomass of extracellular polysaccharides in the dual-species biofilm under acidic conditions. At pH=5.0, the biomass of extracellular polysaccharides in DMAEM@RA group [(25.13±3.14) mm3/mm2] was significantly lower than that in the control group [(42.66±7.46) mm3/mm2] (t=3.75, P=0.020). DMAEM@RA could significantly up-regulate the expressions of gtfB and gtfC genes in Sm under acidic conditions. At pH=5.0, gtfB and gtfC genes were significantly up-regulated by (14.64± 0.44) times and (2.99±0.20) times, respectively (t=-42.74, P<0.001; t=-13.55, P<0.001). Conclusions: The DMAEM@RA has a good antibacterial effect under acidic conditions, demonstrating that it has a good potential to prevent the occurrence and development of secondary caries.

Mercury-Mediated Epitaxial Accumulation of Au Atoms for Stained Hydrogel-Improved On-Site Mercury Monitoring

Trivalent Au ions are easily reduced to be zerovalent atoms by coexisting reductant reagents, resulting in the subsequent accumulation of Au atoms and formation of plasmonic nanostructures. In the absence of stabilizers or presence of weak stabilizers, aggregative growth of Au nanoparticles (NPs) always occurs, and unregular multidimensional Au materials are consequently constructed. Herein, the addition of nanomole-level mercury ions can efficiently prevent the epitaxial accumulation of Au atoms, and separated Au NPs with mediated morphologies and superior plasmonic characteristics are obtained. Experimental results and theoretical simulation demonstrate the Hg-concentration-reliant formation of plasmonic nanostructures with their mediated sizes and shapes in the presence of weak reductants. Moreover, the sensitive plasmonic responses of reaction systems exhibit selectivity comparable to that of Hg species. As a concept of proof, polymeric carbon dots (CDs) were used as the initial reductant, and the reactions between trivalent Au and CDs were studies. Significantly, Hg atoms prevent the epitaxial accumulation of Au atoms, and plasmonic NPs with decreased sizes were in situ synthesized, corresponding to varied surface plasmonic resonance absorption performance of the CD-induced hybrids. Moreover, with the integration of sensing substrates of CD-doped hydrogels, superior response stabilities, analysis selectivity, and sensitivity of Hg2+ ions were achieved on the basis of the mercury-mediated in situ chemical reactions between trivalent Au ions and reductant CDs. Consequently, a high-performance sensing strategy with the use of Au NP-staining hydrogels (nanostaining hydrogels) was exhibited. In addition to Hg sensing, the nanostaining hydrogels facilitated by doping of emerging materials and advanced chem/biostrategies can be developed as high-performance on-site monitoring routes to various pollutant species.

An intelligent "chemical tongue" for high-order monitoring ATP-related physiological phosphates and ATP hydrolysis through diverse transduction principles

For discriminating diverse analytes and monitoring a specific chemical reaction, the emerging multi-channel "chemical nose/tongue" is challenging multi-material "chemical nose/tongue". The former contributes greatly to integrating different transduction principles from a single sensing material, avoiding the need for complex design, high cost, and tedious operation involved with the latter. Therefore, this high-order sensing puts a particular emphasis on the effects of encapsulation. Herein, the plasmonic gold nanoparticles (Au NPs) are encapsulated as a core into the fluorescent guanine monophosphate-Tb3+ infinite coordination polymer nanoparticles (GMP-Tb ICPs) to obtain a core-shell nanocomposite named Au NPs@GMP-Tb ICPs. Hence, a dual-channel "chemical tongue" based on Au NPs@GMP-Tb ICPs is present to realize high-order sensing of adenosine triphosphate (ATP)-related physiological phosphates and the monitoring of ATP hydrolysis. Considering the affinity of Tb3+ towards P-O bonds, four inorganic phosphates and three nucleotide phosphates with different phosphate group numbers and steric hindrance effect directly regulate two stimulus responses (fluorescence intensity and UV-vis absorbance) of Au NPs@GMP-Tb ICPs. Robust statistical methods, such as linear discriminant analysis and hierarchical cluster analysis, are used to recognize each phosphate by the developed sensor array either in the aqueous solution or in complex media such as serum, together with efficiently monitored ATP hydrolysis at different intervals. These findings and blind test clarify that the designed "chemical tongue" guarantees interference resistance and strengthens analytical capacity, together with offering valuable insight into "lab-on-a-nanoparticle" development for monitoring specific chemical reactions.

Tracking the Growth of Chiral Plasmonic Nanocrystals at Molybdenum Disulfide Heterostructural Interfaces

The way of accurately regulating the growth of chiral plasmonics is of great importance for exploring the chirality information and improving its potential values. Herein, cysteine enantiomers modulate the anisotropic and epitaxial growth of gold nanoplasmonics on seeds of exfoliated MoS₂ nanosheets. The heterostructural Au and MoS₂ hybrids induced by enantiomeric cysteine are presented with chiroptical characteristics, dendritic morphologies, and plasmonic performances. Moreover, the synthesis, condition optimization, formation mechanism, and plasmonic properties of Au and MoS₂ dendritic nanostructures are studied. The chirality characteristics are identified using the circular dichroism spectra and scanning electron microscopy. Time-resolved transmission electron microscopy and UV-vis spectra of the intermediate products captured are analyzed to confirm the formation mechanism of dendritic plasmonic nanostructures at heterostructural surfaces. The specific dendritic morphologies originate from the synergistic impacts of heterostructural MoS₂ interfaces and enantiomeric cysteine-induced anisotropic manipulation. Significantly, the developed synthesis strategy of chiral nanostructures at heterostructural interfaces is highly promising in promoting the understanding of the plasmonic function and crucial chirality bioinformation.

[Analysis of safety and efficacy of laparoscopic surgery for gallbladder carcinoma]

Objective: To examine the efficacy and safety of laparoscopic surgery for gallbladder carcinoma. Methods: The data of 197 gallbladder carcinoma patients admitted at Peking Union Medical College Hospital between January 2012 and September 2022 were analyzed retrospectively. There were 86 males and 111 females,with age of (64.4±9.8)years(range:35 to 89 years). Patients were divided into laparoscopic group(n=53) and open group(n=144) according to different surgical methods. The general information of the two groups were matched by propensity score matching,and the clinical data and prognosis were compared between the two groups. Categorical variables were analyzed using χ2 test or Fisher's exact test,as appropriate. Continuous variables with and without normal distribution were analyzed using t-test and Mann-Whitney U test,respectively. Kaplan-Meier curves with Log-rank test were used to analyze the cumulative survival rates. Results: Forty-eight pairs of patients were matched successfully. There was no difference in general information,cholecystolithiasis,partial hepatectomy,and tumor stage between two groups(all P>0.05). The laparoscopic group had shorter operation time(t=-3.987,P<0.01),less bleeding(Z=-4.862,P<0.01),shorter total(Z=-5.009,P<0.01) and postoperative(Z=-5.412,P<0.01) hospital stay. Seventeen patients had postoperative complications. According to the Clavien-Dindo system,there were 4,11,1,and 1 patient with grade Ⅰ,Ⅱ,Ⅲa,and Ⅲb,respectively. All complications were improved after active treatment. After a median follow-up of 24(36) months(range:3 to 130 months),56 patients(58.3%) survived without tumor,7 patients(7.3%) survived with tumor,and 33 patients(34.4%) died. According to the Kaplan-Meier curves,there was no significant difference between laparoscopic and open groups in disease free(χ2=0.399,P=0.528) and overall(χ2=0.672,P=0.412) survival rates. Conclusions: The laparoscopic surgery is safe and effective in selected patients with gallbladder carcinoma. It can reduce surgical trauma and enhance patient recovery without increasing complication. Its prognosis is similar to that of open surgery.

Chiral nanocrystals grown from MoS2 nanosheets enable photothermally modulated enantioselective release of antimicrobial drugs

The transfer of the concept of chirality from molecules to synthesized nanomaterials has attracted attention amongst multidisciplinary teams. Here we demonstrate heterogeneous nucleation and anisotropic accumulation of Au nanoparticles on multilayer MoS₂ planes to form chiroptically functional nanomaterials. Thiol amino acids with chiral conformations modulate asymmetric growth of gold nanoarchitectures on seeds of highly faceted Au/MoS₂ heterostructures. Consequently, dendritic plasmonic nanocrystals with partial chiral morphologies are synthesized. The chirality of dendritic nanocrystals inherited from cysteine molecules refers to the structural characteristics and includes specific recognition of enantiomeric molecules. With integration of the intrinsic photothermal properties and inherited enantioselective characteristics, dendritic Au/MoS₂ heterostructures exhibit chirality-dependent release of antimicrobial drugs from hydrogel substrates when activated by exogenous infrared irradiation. A three-in-one strategy involving synthesis of chiral dendritic heterostructures, enantioselective recognition, and controlled drug release system is presented, which improves nanomaterial synthetic technology and enhances our understanding of crucial chirality information.

[Double-edged sword of opioids in the treatment of cancer pain: hyperalgesia]

Hyperalgesia is an occult complication during the treatment of cancer pain, not only related to opioids, but also pertaining to the tumor itself and cancer therapeutic drugs. Yet it is often ignored by clinicians. Patients with cancer pain who were treated with opioids often have sensory abnormalities presented with reduced pain threshold and increased sensitivity to nociceptive stimuli. This phenomenon is clinically called opioid-induced hyperalgesia (OIH). However, due to the complexity of pathogenesis and the lack of clinical diagnostic criteria, the pain management of cancer patients is still facing great challenges. Therefore, this article focuses on the clinical diagnosis, pathogenesis, prevention and treatment of hyperalgesia related to cancer pain treatment, in order to provide a basis for optimal use of opioids in the future.

Defect-Rich Molybdenum Sulfide Quantum Dots for Amplified Photoluminescence and Photonics-Driven Reactive Oxygen Species Generation

Transition metal dichalcogenide (TMD) quantum dots (QDs) with defects have attracted interesting chemistry due to the contribution of vacancies to their unique optical, physical, catalytic, and electrical properties. Engineering defined defects into molybdenum sulfide (MoS₂ ) QDs is challenging. Herein, by applying a mild biomineralization-assisted bottom-up strategy, blue photoluminescent MoS₂ QDs (B-QDs) with a high density of defects are fabricated. The two-stage synthesis begins with a bottom-up synthesis of original MoS₂ QDs (O-QDs) through chemical reactions of Mo and sulfide ions, followed by alkaline etching that creates high sulfur-vacancy defects to eventually form B-QDs. Alkaline etching significantly increases the photoluminescence (PL) and photo-oxidation. An increase in defect density is shown to bring about increased active sites and decreased bandgap energy; which is further validated with density functional theory calculations. There is strengthened binding affinity between QDs and O₂ due to lower gap energy (∆E_ST ) between S₁ and T₁ , accompanied with improved intersystem crossing (ISC) efficiency. Lowered gap energy contributes to assist e^- -h⁺ pair formation and the strengthened binding affinity between QDs and ³ O₂ . Defect engineering unravels another dimension of material properties control and can bring fresh new applications to otherwise well characterized TMD nanomaterials.

[Application of enhanced recovery after surgery in perioperative management of patients with gallbladder carcinoma]

Objective: To investigate the efficacy and safety of enhanced recovery after surgery (ERAS) in perioperative management of patients with gallbladder carcinoma. Methods: The data of the patients with gallbladder carcinoma admitted at Peking Union Medical College Hospital between January 2017 and December 2021 were analyzed retrospectively. There were 69 males(42.1%) and 95 females(57.9%),with age of (64.0±10.3) years(range:37 to 89 years). Patients were divided into ERAS group(n=53) and normal group(n=111) according to whether they were treated with ERAS measures during the perioperative period.The basic characteristics of the two groups were matched by propensity score matching,and then the perioperative information was compared between the two groups. Categorical variables were presented as absolute numbers or frequencies. Differences between study groups were analyzed using χ² test, Fisher's exact test, t-test, or Mann-Whitney U test, as appropriate. Results: Each group had 45 patients after propensity score matching with well-balanced basic characteristics. There was no difference in basic characteristics, operation time,bleeding,complication,and hospitalization expenses between two groups(all P>0.05). Compared with the normal group,time of ambulation (M(IQR)) (1(1) day vs. 2(2) days;Z=-3.839,P<0.01),postoperative anal exhaust time (2(1) days vs. 3(1) days;Z=-3.013,P=0.003),feeding time(2(1) days vs. 2(1) days;Z=-3.647,P<0.01),postoperative (5(2) days vs. 7(4) days;Z=-3.984,P<0.01) and total(8(4) days vs. 13(6) days;Z=-3.605,P<0.01) hospitalization time were shorter in ERAS group. Postoperative complications occurred in 12 patients. According to the Clavien-Dindo classification,6,4,and 2 patients were classified as grade Ⅰ,Ⅱ,and Ⅲa,respectively. Conclusion: The ERAS measures is safe and effective for perioperative management of patients with gallbladder carcinoma, enhancing patient recovery and shortening hospitalization time without increasing complication or hospitalization cost.

Plasmonic Gold Nanoparticles Stain Hydrogels for the Portable and High-Throughput Monitoring of Mercury Ions

The hybrid of l-cysteine and agarose can reduce HAuCl₄ and support the rapid growth of plasmonic gold nanoparticles (Au NPs) in the hydrogel phase. The l-cysteine-doped agarose hydrogel (C-AGH) not only offers the substrate the capacity to reduce Au(III) ions but also stabilizes and precisely modulates the in situ grown Au NPs with high repeatability, easy operation, and anti-interference performance. Herein, before the incubation of HAuCl₄, the improved hydrogel is preincubated in the aqueous solution containing mercury ions, and the cysteine can specifically conjugate with mercury via the thiol groups. Subsequently, the responsive allochroic bands from dark blue to red can be identified in the solid hydrogel after the incubation of HAuCl₄, which is attributed to the formation of regulated Au-Hg nanoamalgams. As a proof-of-concept, toxic Hg²⁺ ions are exploited as targets for constructing novel sensing assays based on the improved C-AGH protocol. Based on naked-eye recognition, Hg²⁺ could be rapidly and simply measured. Additionally, the high-throughput and trace analysis with a low limit of detection (3.7 nM) is performed using a microplate reader. On the basis of the filtering technique and remodeling of hydrogels, C-AGH working as the filtering membrane can even achieve the integration of enrichment and measurement with enhanced sensitivity. Significantly, the strategy of using an allochroic hydrogel with the staining of Au NPs can promote the rapid and primary assessment of water quality in environmental analysis.

Mercury ion-engineering Au plasmonics on MoS2 layers for absorption-shifted optical sensors

Semiconducting MoS₂ layers offer the electrons, reducing conjugated Au(I) to Au atoms, and sebsequently serve as desirable substrates for supporting the interfacial growths of gold nanostructures. Au-covering MoS₂ heterostructures perform morphology-varied optical characteristics, and the surface engineering of MoS₂ involved by Hg²⁺ ions results in the differential growths of nanostructures and morphological diversities. Naked-eye colorimetric responses to mercury ions, with a low limit of detection of 1.27 nM, are achieved based on the in situ grown heterostructures.

[Safety and efficacy of transcatheter tricuspid valve replacement with LuX-Valve in patients with severe tricuspid regurgitation]

Objectives: To evaluate the safety and efficacy of LuX-Valve on the treatment of severe tricuspid regurgitation (TR). Methods: This is a prospective observational study. From September 2018 to March 2019, 12 patients with severe TR, who were not suitable for surgery, received LuX-Valve implantation in Changhai Hospital. LuX-Valve was implanted under general anesthesia and the guidance of transesophageal echocardiography and X-ray fluoroscopy. Access to the tricuspid valve was achieved via a minimally invasive thoracotomy and transatrial approach. Main endpoints were surgery success and device success. Surgery success was defined as successful implanting the device and withdrawing the delivery system, positioning the valve correctly and stably without severe or life-threatening adverse events. Device success was defined as satisfied valve function (TR severity reduction ≥ 2 grades, tricuspid gradient ≤ 6 mmHg (1 mmHg=0.133 kPa)), absence of malposition, valve failure and reintervention, major adverse events including device related mortality, embolization, conduction system disturbances and new onset shunt across ventricular septum at day 30 post implantation. Results: A total of 12 patients with severe to torrential TR were included in this study. The age was (68.5±6.9) years and 7 were female. All patients had typical right heart failure symptoms. Procedural success was achieved in all cases, there was no intraprocedural mortality or transfer to open surgery. TR significantly improved after LuX-Valve implantation (none/trivial in 8 patients, mild in 3 patients and moderate in 1 patient). The average device time was (9.2±4.2) minutes. Intensive care unit duration was 3.0 (2.0, 4.8) days. One patient died at postoperative day 18 due to non-surgery and device reasons. Transthoracic echocardiography at 30 days after operation showed that TR was significantly reduced (none/trivial in 8 patients, mild in 2 patients and moderate in 1 patient) and device success was achieved in 11 cases. All survived patients experienced a significant improvement in life quality with significantly improvement in New York Heart Association (NYHA) classification (Ⅰ and Ⅱ: 6/11 post operation vs. 0/11 before operation, P=0.012) and there were no device related complications in this patient cohort. Conclusions: LuX-Valve implantation is feasible, safe and effective for the treatment of patients with severe TR.

[Progress in gastric cancer with positive peritoneal cytology]

Gastric cancer with positive peritoneal cytology is a hotspot in the study of gastric cancer, and its prognosis is poor. Intraperitoneal free cancer cells may be associated with cancer cells migration, invasion and metastasis. Tumor T stage, peritoneal metastasis, lymph node metastasis, low histological differentiation, linitis plastica, adenocarcinoma of esophagogastric junction, and operation are the clinicopathological risk factors of gastric cancer with positive peritoneal cytology. Currently, the acquisition of free cancer cells is mainly through diagnostic laparoscopy combined with peritoneal lavage, and cytopathological examination is gold standard for diagnosis. Its treatment strategies are not in consensus, including preoperative chemotherapy combined with radical resection, postoperative chemotherapy and peritoneal local treatment, which can prolong the survival of patients. At present, postoperative chemotherapy is often used in China, and the best treatment strategies remain to be further studied.

[A new strategy for non-invasive diagnosis of liver diseases: DSA-FACE technology based-glycomics method]

Chronic liver disease has gradually become a serious health problem worldwide. Liver biopsy is the current gold standard to assess liver lesions; however, it is an invasive procedure that may cause severe complications. Therefore, there is an urgent need for an economical and rapid non-invasive detection method that can be used in clinic for diagnosis. In the past decade, protein glycosylation has become a research hotspot, and the concept of changes in serum proteoglycans structure has gradually been accepted by many researchers as an indication of liver injury. At the same time, N-linked glycans via DNA sequencing equipment-Fluorophore Assisted Carbohydrate Electrophoresis (DSA-FACE) has also brought high sensitivity and specificity diagnostic models (GlycoHepatoTest) for various chronic liver diseases, which is a new strategy for non-invasive diagnosis of liver diseases.

Aggregation-induced responses (AIR) of 2D-derived layered nanostructures enable emerging colorimetric and fluorescence sensors

Layered nanostructures (LNs), including two-dimensional nanosheets, nanoflakes, and planar nanodots, show large surface-to-volume ratios, unique optical properties, and desired interfacial activities. LNs are highly promising as alternative probes and platforms due to numerous merits, e.g. signal amplification, improved recognition ability, and anti-interference capacity, for emerging sensing applications. Significantly, when stimuli-responsive aggregation occurs, the modified LNs show engineered morphologies, attractive optical absorption and fluorescence characteristics, which are remarkably programmable. On the basis of the altered aggregation behaviours of LNs, as well as their modulated physical and chemical characteristics, a series of novel sensing assays exhibiting enhanced sensitivity, simple operation, multiple functions, and improved anti-interference capacity are reported, contributing to both point-of-care testing and high-throughput measurements. Herein, the aggregation-induced response sensing strategies of LNs are comprehensively summarized with the classification of materials and variation of aggregated routes aiming at understanding dimension-dependent features, expanding nanoscale biosensor applications, and addressing key issues in disease diagnosis and environmental analysis.

Multifunctional Binding Strategy on Nonconjugated Polymer Nanoparticles for Ratiometric Detection and Effective Removal of Mercury Ions

Developing a multifunctional platform for the selective detection and effective removal of toxic ions is a major challenge when addressing heavy metal contamination in environmental science. Herein, novel nonconjugated polymer nanoparticles (PNPs) called mercaptosuccinic acid-thiosemicarbazide PNPs (MT-PNPs) with appealing fluorescence and stability are synthesized via facile one-step hydrothermal treatment for attractive sensing and simultaneous removal of mercury(II). Interestingly, aggregation-induced fluorescence switch-off and scattering enhancement are found upon the addition of Hg²⁺, rendering MT-PNPs as a ratiometric sensor for selective and accurate Hg²⁺ monitoring. A wide linear range (0.1-1471 μM) and a low detection limit (95 nM) are obtained. This dual-signal opposite responses triggered by Hg²⁺ originate from the formation of MT-PNP-Hg²⁺ congeries via the multisite binding between S,N,O-containing groups of MT-PNPs and mercury. Meanwhile, target-induced aggregation renders an effective Hg²⁺ separation from contaminative aqueous media by MT-PNPs, which exhibits a satisfactory absorption efficiency of 90.42% within 50 min. Upon the simple Na₂S treatment, the MT-PNPs can be regenerated and reused. This work thus delivers an applicable method for the ratiometric detection and effective removal of mercury with the novel nonconjugated PNPs, offering potential in tackling the problem of heavy metal ion pollution for environmental monitoring and remediation.

[Analysis of key genes and signal pathways of human papilloma virus-related head and neck squamous cell carcinoma]

Objective: To explore differentially expressed genes (DEG) and pathways between human papilloma virus (HPV) positive and negative head and neck squamous cell carcinoma (HNSCC) and to search gene targets for diagnosis and treatment of HPV-related HNSCC. Methods: HPV-related HNSCC expression profile chips of GSE3292 (including 8 HPV-positive and 28 HPV-negative HNSCC tissues, of which 15 collected from oral cavity cancer, 9 from oropharyngeal cancer, 9 from laryngeal cancer and 3 from hypopharyngeal cancer) were selected from Gene Expression Omnibus (GEO) database of National Center for Biotechnology Information and DEG were screened out using Gene-Cloud of Biotechnology Informs (GCBI). Gene ontology and pathway enrichment analysis were performed using DAVID and protein-to-protein interaction (PPI) network was constructed by STRING. Hub genes were identified by Cytoscape and then performed pathway enrichment analysis. Finally, expression differences of hub genes in the cancer genome atlas (TCGA) database were checked using UALCAN. Results: Five hundred and seventy-three DEG were screened out from more than 25 000 genes detected in the chips including 539 up-regulated genes and 34 down regulated ones. Twenty-seven hub genes including cyclin-dependent kinases 1(CDK1), proliferating cell nuclear antigen (PCNA), minichromosome maintenance proteins (MCM) family (MCM2, MCM3, MCM6 and MCM7), replication factor C subunit 4 (RFC4) and kinesin family member 11 (KIF11) were identified after two rounds of Cytoscape screening. Gene ontology and pathway analysis showed that DEG were mainly distributed in chromosome, nucleoplasm, nuclear lumen and membrane-enclosed lumen and participated in biological processes such as DNA replication, DNA metabolism, cell cycle and cell division, and also 6 major signaling pathways centered on p53 signaling pathway （P<0.01）. All hub genes were expressed differently between HPV-positive and negative HNSCC in TCGA database（P<0.01）. Conclusions: Hub genes including CDK1, PCNA, MCM family (MCM2, MCM3, MCM6 and MCM7) act as an important part on HPV-induced HNSCC and the p53 pathway is the key of this process and plays different regulatory roles between two subtypes of HNSCC. CDK1, MCM7 and RFC4 are expected to be potential treatment targets for HPV-positive HNSCC while MCM2, MCM3, PCNA and KIF11 may be employed as biomarkers for diagnosis and prognosis.

Layered MoS2 defect-driven in situ synthesis of plasmonic gold nanocrystals visualizes the planar size and interfacial diversity

Current defect theories significantly guide broad research progress, whereas the recognition of defect status remains challenging. Herein, MoS2 defect type, density and exposed state are visually identified with a reagent indicator of HAuCl4. Mo-terminated defects spontaneously reduce [AuCl4]- anions and oxidized Mo species are dissociated. Consequently, MoS2 edges guide the epitaxial branch of Au nanocrystals (NCs), followed by sequential growths at their planar defects. The size-evolution processes of LaMer growth and planar packages of the aggregative growth of Au/MoS2 nanoseeds result in the occupation of Au atomic layers on heterostructures. Consequently, shell-core hybrids are presented with localized surface plasmon resonance characteristics. The mechanism is systematically explored via the discriminated performance of plasmonic characteristics of Au nanostructures on semiconducting MoS2 substrates. With plasmonic identification, defect-associated size and interfacial diversities of MoS2 are visually information-rich. Tunable morphologies and synergistic optical characteristics of plasmonic semiconductor heterostructures inspire many more applications through the edge and planar defects intrinsic in layered MoS2.

Assembling Defined DNA Nanostructure with Nitrogen-Enriched Carbon Dots for Theranostic Cancer Applications

DNA nanostructures as scaffolds for drug delivery, biosensing, and bioimaging are hindered by its vulnerability in physiological settings, less favorable of incorporating arbitrary guest molecules and other desirable functionalities. Noncanonical self-assembly of DNA nanostructures with small molecules in an alternative system is an attractive strategy to expand their applications in multidisciplinary fields and is rarely explored. This work reports a nitrogen-enriched carbon dots (NCDs)-mediated DNA nanostructure self-assembly strategy. Given the excellent photoluminescence and photodynamic properties of NCDs, the obtained DNA/NCDs nanocomplex holds great potential for bioimaging and anticancer therapy. NCDs can mediate DNA nanoprism (NP^NCD ) self-assembly isothermally at a large temperature and pH range in a magnesium-free manner. To explore the suitability of NP^NCD in potential biomedical applications, the cytotoxicity and cellular uptake efficiency of NP^NCD are evaluated. NP^NCD with KRAS siRNA (NP^NCD K) is further conjugated for KRAS-mutated nonsmall cell lung cancer therapy. The NP^NCD K shows excellent gene knockdown efficiency and anticancer effect in vitro. The current study suggests that conjugating NCDs with programmable DNA nanostructures is a powerful strategy to endow DNA nanostructures with new functionalities, and NP^NCD may be a potential theranostic platform with further fine-tuned properties of CDs such as near-red fluorescence or photothermal activities.

Bioconversion of Hg0 into HA-Hg for simultaneous removal of Hg0 and NO in a denitrifying membrane biofilm reactor

Bacterial mercury oxidation coupled to denitrification offers great potential for simultaneous removal of elemental mercury (Hg⁰) and nitric oxide (NO) in a denitrifying membrane biofilm reactor (MBfR). Four potentially contributory mechanisms tested separately, namely, membrane gas separation, medium absorption, biosorption and biotransformation, which contributed 4.9%/7.2%, 8.1%/8.9%, 38.8%/9.5% and 48.2%/84.9% of overall Hg⁰/NO removal in MBfR. Herein, Hg⁰ bio-oxidation, oxidative Hg⁰ biosorption and denitrification played leading roles in simultaneous removal of Hg⁰ and NO. Living microbes performed simultaneous Hg⁰ bio-oxidation and denitrification, in which Hg⁰ as electron donor was biologically oxidized to oxidized mercury (Hg²⁺), while NO as the terminal electron acceptor was denitrified to N₂. The Hg²⁺ further complexed with humic acids in extracellular polymeric substances via functional groups (-SH, -OH, -NH^- and -COO^-) and formed humic acids bound mercury (HA-Hg). Non-living microbial matrix performed oxidative Hg⁰ biosorption, in which Hg⁰ may be physically adsorbed by cellular matrix, then non-metabolically oxidized to Hg²⁺ via oxidative complexation with -SH in humic acids and finally cleavage of S-H bond and surface charge transfer led to formation of HA-Hg. Therefore, bioconversion of Hg⁰ to HA-Hg by Hg⁰ bio-oxidation and oxidative Hg⁰ biosorption coupled with NO denitrification to N₂ dynamically cooperated to accomplish simultaneous removal of Hg⁰ and NO in MBfR.

Photocatalytic membrane combined with biodegradation for toluene oxidation

Photocatalytic membrane coupled to biodegradation offers potential for degrading volatile organic compounds (VOCs) in photocatalytic membrane biofilm reactor. An intimately coupled photocatalysis and biodegradation reactor was operated in continuous operation for 500 days to treat simulated waste gas containing toluene. Toluene removal efficiency obtained 99%, with the elimination capacity of 550 g m^-3·h^-1. Membrane photocatalysis coupled to biodegradation was created to improve toluene removal from 11 to 20%. The dominant genera were Lysinibacillus, Hydrogenophaga, Pseudomonas at 30 d, Rudaea, Dongia, Litorilinea at 230 d xyl, Tod, Tcb, Bed, Tmo, Tbu, Tou, Dmp, Cat were functional genes of toluene metabolism, as shown by16S rDNA and metagenomic sequencing. Photocatalysis destroyed part of the toluene into biodegradable intermediates that were immediately mineralized by microorganisms in biofilm, some toluene was directly degraded by toluene degrading bacterial community into carbon dioxide and water. The novel hybrid photocatalytic membrane biofilm reactor is a cost-effective and robust alternative to VOCs treatment.

Toxicity of Two-Dimensional Layered Materials and Their Heterostructures

Two-dimensional layered materials (2D LMs) are taking the scientific world by storm. Graphene epitomizes 2D LMs with many interesting properties and corresponding applications. Following the footsteps of graphene, many other types of 2D LMs such as transition metal dichalcogenides, black phosphorus, and graphitic-phase C₃N₄ nanosheets are emerging to be equally interesting as graphene and its derivatives. Some of these applications such as nanomedicine do have a high probability of human exposure. This review focuses on the biological and toxicity effects of 2D LMs and their associated mechanisms linking their chemistries to their biological end points. This review aims to help researchers to predict and mitigate any toxic effects. With understanding, redesign of newer and safer 2D LMs becomes possible.

[Paying attention to the diagnosis and treatment of IgG4-related sclerosing cholangitis]

IgG4-related sclerosing cholangitis (IgG4-SC) is characterized by biliary strictures and obstructive jaundice.Elevated levels of serum IgG4 and a multifocal IgG4-rich lymphoplasmacytic infiltration of affected organs are also the characteristics of IgG4-SC. Prednisone is recommended in the initial treatment of IgG4-SC. The differential diagnosis between IgG4-SC and cholangiocarcinoma is not easy. Comprehensively collection of medical history, paying attention to other organs involvement, and getting the pathologic diagnosis are important for diagnosis of this disease. In order to prevent misdiagnosis we should learn more about IgG4-SC. On the other hand, if we can not differentiate IgG4-SC and cholangiocarcinoma, operation may be recommended.

Simultaneous mercury oxidation and NO reduction in a membrane biofilm reactor

This work demonstrates bacterial oxidation of mercury (Hg⁰) coupled to nitric oxide (NO) reduction in a denitrifying membrane biofilm reactor (MBfR). In 93 days' operation, Hg⁰ and NO removal efficiency attained 90.7% and 74.1%, respectively. Thauera, Pseudomonas, Paracoccus and Pannonibacter played dual roles as Hg⁰ oxidizers and denitrifiers simultaneously. Denitrifying bacteria and the potential mercury resistant bacteria dominated the bacterial community. Denitrification-related genes (norB, norC, norD, norE, norQ and norV) and enzymatic Hg⁰ oxidation-related genes (katG, katE) were responsible for bacterial oxidation of Hg⁰ and NO reduction, as shown by metagenomic sequencing. XPS, HPLC-ICP-MS and SEM-EDS indicated the formation of a stable mercuric species (Hg²⁺) reasulting from Hg⁰ oxidation in the biofilm. Bacterial oxidation of Hg⁰ was coupled to NO reduction in which Hg⁰ served as the initial electron donor while NO served as the terminal electron acceptor and thereby redox between Hg⁰ and NO was formed. MBfR was capable of both Hg⁰ bio-oxidation and denitrifying NO reduction. This research opens up new possibilities for application of MBfR to simultaneous flue gas demercuration and denitration.

Biosorption of lead(II) from aqueous solution by lactic acid bacteria

The biosorption of Pb(II) from aqueous solutions by lactic acid bacterium, Lactobacillus brevis, was studied. The effects of initial pH, contact time, initial Pb(II) concentration, bacterial concentration, rotation speed and temperature of biosorption of Pb(II) from aqueous solutions were investigated. The optimal condition for Pb²⁺ ions adsorption was observed at pH 6, with the rotational speed of 120 rpm.min^-1, bacterial concentration of 3 g.L^-1, temperature of 40 °C and contact time of 12 h. The correlation regression coefficients showed that the biosorption process can be well fitted with the Redlich-Peterson, Langmuir, Freundlich and Temkin isotherm models. The equilibrium adsorption capacity reached 53.632 mg.g^-1. Binding energy value was 0.264 kJ/mol, which indicated that the adsorption process seemed to involve chemisorption and physisorption. Kinetics of adsorption was found to fit well with the pseudo-second-order and Elovich kinetic equations. Thermodynamic parameters revealed the feasibility, spontaneity and endothermic nature of adsorption.

Layered Aggregation with Steric Effect: Morphology-Homogeneous Semiconductor MoS2 as an Alternative 2D Probe for Visual Immunoassay

Liquid-phase exfoliation routes unavoidably generate 2D nanostructures with inhomogeneous morphologies. Herein, thickness-dependent sorting of exfoliated nanostructures is achieved via a treatment of differential-zone centrifugation in the surfactant aqueous phase. With this approach, homogeneous MoS₂ nanosheets are obtained, and due to the intrinsic semiconducting characteristics, those 2D nanosheets are endowed with desired optical properties, rivaling classic gold nanoparticles in sensing applications. Furthermore, MoS₂ nanosheets with high uniformity and chemical inertness are coupled with proteins, exhibiting high performance in stability and anti-interferences for bioanalysis. As a consequence of aggregation-induced steric effect, distinguishing running shifts of antibody-anchored conjugates in gel electrophoresis are visually responsive to those specific antigens. This assay enables the easy and fast monitoring of tumor biomarkers just according to "naked-eye" identification of band location in electrophoresis results, which are presented by an alternative visual probe of 2D MoS₂ -protein conjugates. The developed visual immunoassay with the synergistic effect of gel electrophoresis techniques and 2D semiconductors pushes significant progress in "home-made" tests for disease early diagnosis.

[Analysis of the related factors of attention deficit/hyperactivity disorder and allergic rhinitis in children]

Objective:To investigate the association between symptom of attention deficit/hyperactivity disorder (ADHD) and allergic rhinitis (AR) in children with AR at different sexes and different ages. Method:A total of 439 AR children aged 6 to 12 years were enrolled in this study. Basic information (age, gender, medical history, family history and comorbidities) of children with AR was collected. Results of prick tests on children skin were recorded. (TNSS) and Chinese version of the SNAP-Ⅳ scale, children under the guidance of independent completion of children's quality of life of children with nasal conjunctivitis scale (PRQLQ). According to the results of SNAP-Ⅳ, children were divided into AR with ADHD group ［attention deficit and hyperactivity symptom score (IHS) >1.25］ and AR without ADHD group (IHS≤1.25). The differences between the two groups of children were analyzed using group t-test and χ² test, and the relationship between each parameter and IHS >1.25 was analyzed by binary logistic regression. Result:Using SPSS 22.0 software, among all the included AR children, IHS >1.25 children accounted for 26.4%, IHS >1.25 group AR symptom scores were significantly higher than HIS ≤1.25 groups. Univariate analysis showed that children with age, gender, duration of AR symptoms, skin index and PRQLQ subscales had a correlation with IHS >1.25. After controlling for age and gender, duration of AR symptoms and skin index correlated with IHS >1.25 The estimated OR values are 1.807 (95%CI: 1.350-2.419) and 1.912 (95%CI: 1.320-2.772), respectively. The estimated OR values of PRQLQ subscale and IHS >1.25 were 1.657 (nasal symptom score), 1.324 (eye symptom score), 2.48 (non-eye-nasal symptom score), 1.418 (Behavior problem score) and 2.045 (activity and sleep score). The correlation between IHS>1.25 and the skin index and PRQLQ subscales was mainly found in males with stratification of age and gender, and the association between duration of AR symptoms and HIS >1.25 was statistically significant among all groups reflected. Conclusion:The association between attention deficits and hyperactivity symptoms in AR children was correlated with the severity of AR symptoms, duration, and skin index, and this association was more pronounced in males. In children with AR and ADHD, early management of AR symptoms may improve their ADHD symptoms.

Nanodots of transition metal (Mo and W) disulfides grown on NiNi Prussian blue analogue nanoplates for efficient hydrogen production

Zero-dimensional MoS₂ and WS₂ nanodots are prepared with the assistance of a template of NiNi PBA nanoplates via a facile hydrothermal method.

Emerging 0D Transition-Metal Dichalcogenides for Sensors, Biomedicine, and Clean Energy

Following research on two-dimensional (2D) transition metal dichalcogenides (TMDs), zero-dimensional (0D) TMDs nanostructures have also garnered some attention due to their unique properties; exploitable for new applications. The 0D TMDs nanostructures stand distinct from their larger 2D TMDs cousins in terms of their general structure and properties. 0D TMDs possess higher bandgaps, ultra-small sizes, high surface-to-volume ratios with more active edge sites per unit mass. So far, reported 0D TMDs can be mainly classified as quantum dots, nanodots, nanoparticles, and small nanoflakes. All exhibited diverse applications in various fields due to their unique and excellent properties. Of significance, through exploiting inherent characteristics of 0D TMDs materials, enhanced catalytic, biomedical, and photoluminescence applications can be realized through this exciting sub-class of TMDs. Herein, we comprehensively review the properties and synthesis methods of 0D TMDs nanostructures and focus on their potential applications in sensor, biomedicine, and energy fields. This article aims to educate potential adopters of these excitingly new nanomaterials as well as to inspire and promote the development of more impactful applications. Especially in this rapidly evolving field, this review may be a good resource of critical insights and in-depth comparisons between the 0D and 2D TMDs.

[The outcome of trial of labor after cesarean section]

Objective: To explore the outcome of trial of labor after cesarean section(TOLAC). Methods: Totally 614 TOLAC were conducted in the First Affiliated Hospital of Kunming Medical University from July 2013 to June 2016. Among them, 586 cases of singleton pregnancy with one prior cesarean section(gestational age≥28 weeks)were studied retrospectively. The maternal and neonatal outcomes among the vaginal birth after cesarean(VBAC)group(481 cases), failed TOLAC group(105 cases)and the elective repeat cesarean section(ERCS)group(1 145 cases)were compared. Multiple logistic regression was used to determine the risk factors of admission to neonatal intensive care unit(NICU). Results: (1)The TOLAC rate was 29.62%(614/2 073)from July 2013 to June 2016, and the VBAC rate was 82.6%(507/614). The cesarean section rate was reduced by VBAC by 3.147%(507/16 112).(2)The comparison of adverse maternal outcomes: in the VBAC group, the postpartum hemorrhage volume was(431±299)ml, the rate of postpartum fever was 6.4%(31/481), the birth weight of the neonates was(3 085± 561)g, and the rate of large for gestational age was 2.9%(14/481). All were significantly lower than those in the failed TOLAC group and the ERCS group(P<0.05). There was no significant difference in other adverse maternal outcomes[the uterine rupture rate(0.2% ,1/481), the bladder injury rate(0), the proportion of postpartum hemorrhage volume≥1 500 ml(1.0%, 5/481), the blood transfusion rate(3.7%, 18/481)]and adverse perinatal outcomes[the rate of neonatal 5-minute Apgar score<7(0.4%, 21/481), the rate of umbilical arterial pH<7.0(0.6% , 3/481), the rate of the NICU admission and the perinatal mortality rate(12.3%, 59/481)]among the 3 groups(P>0.05). Multiple logistic regression showed no association between VBAC and admission to the NICU(OR=0.84, 95%CI: 0.58-1.21). The isolated risk factors for admission to the NICU were preterm birth(OR=16.71, 95% CI: 11.44-24.40), hypertensive disorder complicating pregnamcy(OR=3.89, 95% CI: 2.39-6.35), meconium stained amniotic fluid(OR=2.48, 95% CI: 1.62-3.80), small for gestational age(OR=2.00, 95% CI: 1.19-3.36)and diabetes mellitus(OR=1.69, 95% CI: 1.14-2.50). Conclusions: VBAC reduces cesarean section rate, with good outcomes in both mother and neonate. It is a safe and feasible way of labor in women with only one cesarean section history.

Directing Assembly and Disassembly of 2D MoS2 Nanosheets with DNA for Drug Delivery

Layer-by-layer (LbL) self-assembled stacked Testudo-like MoS₂ superstructures carrying cancer drugs are formed from nanosheets controllably assembled with sequence-based DNA oligonucleotides. These superstructures can disassemble autonomously in response to cancer cells' heightened ATP metabolism. First, we functionalize MoS₂ nanosheets (MoS₂-NS) nanostructures with DNA oligonucleotides having thiol-terminated groups (DNA/MoS₂-NS) via strong binding to sulfur atom defect vacancies on MoS₂ surfaces. The driving force to assemble into a higher-order DNA/MoS₂-NS superstructure is guided by a linker aptamer that induced interlayer assembly. In the presence of target ATP molecules, these multilayer superstructures disassembled as a consequence of stronger binding of ATP molecules with the linking aptamers. This design plays a dual role of protection and delivery by LbL stacked MoS₂-NS similar in concept to a Greek Testudo. These superstructures present a protective armor-like shell of MoS₂-NS, which still remains responsive to small and infiltrating ATP molecules diffusing through the protective MoS₂-NS, contributing to an enhanced stimuli-responsive drug release system for targeted chemotherapy.

Efficacy and safety of fosaprepitant in the prevention of nausea and vomiting following highly emetogenic chemotherapy in Chinese people: A randomized, double-blind, phase III study

The prevention of chemotherapy‐induced nausea and vomiting was one of the most challenging supportive care issues in oncology, especially to highly emetogenic chemotherapy (HEC). A total of 645 patients were randomized into fosaprepitant group (fosaprepitant/placebo 150 mg d1 in combination with granisetron and dexamethasone) or aprepitant group (aprepitant/placebo 125 mg d1; 80 mg d2‐d3 plus granisetron and dexamethasone).The primary endpoint was the percentage of patients who had a complete response (CR) over the entire treatment course (0–120 hr, overall phase [OP]). It was assessed by using a non‐inferiority model, with a non‐inferiority margin of 10%. The difference of the CR rate was compared between two groups with chi‐square analysis. Six hundred and twenty‐six patients were included in the per protocol analysis. The percentage of patients with a CR in the fosaprepitant group was not inferior to that in the aprepitant group (90.85% versus 94.17%, p = .1302) during OP. Whether the cisplatin‐based chemotherapy or not, the CR rate of the fosaprepitant group was not inferior to that of the aprepitant group. Both regimens were well tolerated. The most common adverse event was constipation. Fosaprepitant provided effective and well‐tolerated control of nausea and vomiting associated with HEC in Chinese patients.

Bio-friendly Maillard reaction fluorescent products from glutathione and ascorbic acid for the rapid and label-free detection of Fe3+in living cells

Non-cytotoxic Maillard reaction fluorescent products were used as an imaging probe for Fe³⁺detection in living cells.

Exogenous Catalase and Pyruvate Dehydrogenase Improve Survival and Regeneration and Affect Oxidative Stress in Cryopreserved Dendrobium nobile Protocorm-like Bodies

BACKGROUND

Reactive oxygen species (ROS)-induced oxidative damage is responsible for viability loss in plant tissues following cryopreservation. Antioxidants may improve viability by preventing or repairing the injury.

OBJECTIVE

This work aimed at studying the effect of catalase (CAT) and pyruvate dehydrogenase (PDH), which are involved in ROS metabolism and are differentially expressed during pollen cryopreservation, for cryopreservation of Dendrobium nobile Lindl. 'Hamana Lake Dream' protocorm-like bodies (PLBs).

MATERIALS AND METHODS

Different concentrations of exogenous CAT or PDH were added at the loading, PVS2 treatment, unloading steps during vitrification-cryopreservation of PLBs. Their survival and regeneration were evaluated and correlated with physiological oxidative indexes.

RESULTS

PLB survival increased significantly when CAT and PDH were added separately to the unloading solution at a suitable concentration. CAT at 400 U·ml^-1 increased PLB survival and regeneration by 33.5 and 14.6 percent respectively. It had no impact on the production of superoxide anion radical (·O2-) and on superoxide dismutase (SOD) activity, but it reduced the hydrogen peroxide (H₂O₂) and malondialdehyde (MDA) contents and enhanced ascorbic acid (AsA) and endogenous CAT levels compared to PLBs cryopreserved using the standard vitrification protocol (CK1). PDH at 0.1 U·ml^-1 significantly improved PLB survival (by 2.5 percent), but it had no marked effect on regeneration compared to the CK1 group. It induced the same variations in ·O2-, AsA and endogenous CAT levels that were observed following CAT addition. However, PDH did not affect the H₂O₂ and MDA content but significantly increased SOD activity.

CONCLUSION

These results indicate that the addition of 400 U·ml^-1 CAT and 0.1 U·ml^-1 PDH at the unloading step increased survival of cryopreserved PLBs and that this improvement was associated with scavenging of H₂O₂ and the repair of oxidative damage. Exogenous CAT also significantly improved PLB regeneration after cryopreservation, while PDH had no obvious effect. The effect of exogenous CAT on PLB survival and regeneration was stronger than that of PDH, which may be due to the increased SOD activity by PDH addition.

[Effect of mitochondrial apoptosis on pulmonary fibrosis in rats with severe scald injury]

OBJECTIVE

To explore the role of mitochondrial apoptosis on pulmonary fibrosis in rats with severe scald injury.

METHODS

According to the random digital table, a total number of 32 Wistar rats were divided into 4 groups: sham burn (group A), burn group (group B), 12-week post burn recovery group (group C), and 12-week post burn recovery plus a second burn injury group (group D). In group A and group B, lung tissues were harvested on post burn day 4. After received first burn injury 12 weeks, the group C and group D received separately a second sham burn injury and burn injury. Lung tissues were harvested on post burn day 4 after the second burn injury. All tissues were examined for cells apoptosis by Terminal-deoxynucleoitidyl Transferase Mediated Nick End Labeling (TUNEL). Pulmonary fibrosis was assessed by Masson trichrome staining and Sirius red staining. The protein expression levels of cleaved Caspase-3, Bax and Bcl-2 were assessed by Western blot.

RESULTS

Both Masson trichrome staining and Sirius red staining showed obvious pulmonary fibrosis in group C and group D. The apoptosis rates of group B, C and D were significantly higher than that in group A ((15.50±3.30)%, (7.88±3.10)%, (15.88±3.23)% vs (2.10±1.07)%, all P<0.05). Compared to group A, cleaved Caspase-3 levels were significantly higher in group B, C and D ((0.59±0.11), (0.33±0.08), (0.73±0.13) vs (0.16±0.05), all P<0.05). The ratio of Bax/Bcl-2 in group B, C and D also increased significantly ((2.08±0.30), (0.83±0.09), (1.54±0.12) vs (0.64±0.05), all P<0.05).

CONCLUSION

Severe burn injury can induce pulmonary fibrosis and mitochondrial apoptosis may play an important role in the development of pulmonary fibrosis.

[Comparative proteomics study on lung tissue in early stage of burn-blast combined injury in rats]

OBJECTIVE

To explore changes in the proteomics of lung tissue in early stage of burn-blast combined injury in rats.

METHODS

According to a random digital table, a total number of 18 Sprague Dawley (SD) rats were divided into burn-blast combined injury group (n=9) and blast injury group (n=9). Lung protein samples were collected at 6 h post injury. 2-DE was performed to separate proteins. After silver staining, the protein of differential expression were analyzed by PQ Quest and then identified by matrix-assisted laser desorption/ionization time of fight mass spectrometry (MALDI-TOF-MS). The features of the changes of proteomics of rat lung after burn-blast combined injury were studied by biological spectrometry, protein bank and reference article analysis technique. At same time, pathologic changes of the lung were monitored after injury.

RESULTS

After removing death drain during the experiment, each group contained 8 rats and the results were analyzed statistically. Well focused and distinct 2-DE maps with good reproducibility were obtained, means of 736±47 and 782±30 protein spots were detected from the blast injury group and burn-blast combined injury group and the matching rates were 91%. From the two groups, 14 differential protein spots expressions were analyzed by MALDI-TOF-MS, of which 10 proteins were up-regulated and 4 proteins were down-regulated in burn-blast combined injury group. 12 different expression proteins were identified in the lung through 2-DE, mass spectrometry and protein date base, including heat shock 27 protein 1, heat shock 70 protein 1, carbonic anhydrase 2, cytochrome c oxidase, ATP synthase subunit alpha, Ca(2+) -transporting ATPase et al, which took part in stress reaction, metabolism, immune response and cytoskeleton.

CONCLUSIONS

Burn-blast combined injury could induce dramatically changes of proteomics in lung tissue at early stage. The mechanism probably involves several proteins associated with oxidative stress, energy metabolism, immune response and cytoskeleton.

Hydroxycamptothecin shows antitumor efficacy on HeLa cells via autophagy activation mediated apoptosis in cervical cancer

OBJECTIVES

To investigate the effect and the mechanism of anti-tumor agent hydroxycamptothecin (HCPT) on HeLa cells in cervical cancer.

MATERIALS AND METHODS

Autophagy and apoptosis were detected by western blotting and the transfection of GFP-LC3 shRNA as well as Hoechst staining.

RESULTS

The authors found that the expression of the regulators of Beclin-1, p62, and microtubule-associated protein 1 light chain 3 (LC3) upregulated and then triggered the occurrence of cell autophagy. On the other hand, HCPT could induce to the formation of autophagy and resulted in cell apoptosis after autophagy.

CONCLUSION

HCPT can alter cell autophagy and then trigger cell apoptosis to achieve antitumor effects.

In vitro wear testing of a contemporary design of reverse shoulder prosthesis

Reverse shoulder arthroplasty is an increasingly common surgical intervention. However there are concerns and known limitations in relation to such joint replacement, while novel designs of reverse shoulder prostheses continue to appear on the market. Many claim to offer improvements over older designs but such assertions are difficult to validate when there is no consensus as to how such implants should be tested in vitro or even if such testing is necessary. In order to permit appropriate in vitro testing of reverse shoulder prostheses a unique, multi-station test rig was designed which was capable of applying motion in three axes to test prostheses. The shoulder simulator can apply up to 110° of motion in the flexion-extension and abduction-adduction axes and up to 90° in the internal-external rotation axis. Dynamic loading of up to 1500 N can be provided. The simulator is computer controlled so that the motions and loading associated with particular activities of daily living can be applied. A 4.5 million cycle wear test of commercially available reverse shoulder prostheses was undertaken using a 'mug to mouth' activity of daily living. Gravimetric analysis was used to characterise wear. After 4.5 million cycles of 'mug to mouth', the average wear rate of the test components was 14.3mm(3)/million cycles. Polyethylene test components showed a reduction in roughness and the median wear particle diameter was 167 nm. A three axis shoulder simulator has been designed and used to successfully test multiple samples of a commercially available reverse shoulder prosthesis.

Early third trimester maternal response to glucose challenge and pregnancy outcome in Chinese women-relationship between upper distribution level and recommended diagnostic criteria

BACKGROUND/OBJECTIVES

The objective of this study was to examine the relationship between upper distribution levels of glucose values in the 75-g oral glucose tolerance test (OGTT) and recommended diagnostic criteria for gestational diabetes mellitus (GDM) and adverse pregnancy outcomes.

SUBJECTS/METHODS

The distribution of the OGTT 2-h values of 13,501 pregnant women, which were below the World Health Organization (WHO) threshold for overt diabetes mellitus (DM), and managed in one teaching hospital in China, was reviewed and related to maternal characteristics and pregnancy outcomes.

RESULTS

For the entire group, the 90th and 95th percentile values of the OGTT 2-h glucose level, respectively, were close to the diagnostic cutoff values of the WHO and International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. For adverse maternal outcomes, glucose level above the 90th percentile value was associated with increased hypertensive disorders, whereas no difference was seen with cutoff using the 95th percentile value. For perinatal outcomes, the 90th percentile was associated with increased neonatal intensive care unit admission and hypoglycemia, whereas the 95th percentile showed in addition association with phototherapy for jaundice and 5th-minute Apgar score <7. Although no differences in the incidence of adverse pregnancy outcomes were found using the different cutoffs, the >95th percentile cutoff value would have missed out 33.3-56.7% of the cases of adverse outcomes that would otherwise have been attributed to GDM.

CONCLUSIONS

Further studies are warranted to clarify which diagnostic criterion is most appropriate universally to identify adverse pregnancy outcomes attributed to GDM, and which could be mitigated with treatment specific for GDM.

A fluorescence detection of D-penicillamine based on Cu(2+)-induced fluorescence quenching system of protein-stabilized gold nanoclusters

In this contribution, a luminescent gold nanoclusters which were synthesized by bovine serum albumin as novel fluorescent probes were successfully utilized for the determination of D-penicillamine for the first time. Cupric ion was employed to quench the strong fluorescence of the gold nanoclusters, whereas the addition of D-penicillamine caused obvious restoration of fluorescence intensity of the Cu(2+)-gold nanoclusters system. Under optimum conditions, the increment in fluorescence intensity of Cu(2+)-gold nanoclusters system caused by D-penicillamine was linearly proportional to the concentration of D-penicillamine in the range of 2.0×10(-5)-2.39×10(-4) M. The detection limit for D-penicillamine was 5.4×10(-6) M. With the off-on fluorescence signal at 650 nm approaching the near-infrared region, the present sensor for D-penicillamine detection had high sensitivity and low spectral interference. Furthermore, the novel gold nanoclusters-based fluorescent sensor has been applied to the determination of D-penicillamine in real biological samples with satisfactory results.

Electrochemically induced Fenton reaction of few-layer MoS2 nanosheets: preparation of luminescent quantum dots via a transition of nanoporous morphology

Electrochemically induced Fenton (electro-Fenton) reaction was used for efficient and controllable preparation of hydroxyl radicals, leading to the generation of luminescent quantum dots through etching of as-exfoliated MoS2 nanosheets. Morphologic changes of MoS2 nanosheets during the electro-Fenton reaction were monitored using transmission electron microscopy, showing that etching of MoS2 nanosheets induced by hydroxyl radicals resulted in rapid homogeneous fracturing of the sheets into small dots via a transition of nanoporous morphology. The as-generated dots with vertical dimensional thickness of ca. 0.7 nm and plane size of ca. 5 nm were demonstrated to be MoS2 quantum dots (MoS2-QDs), and their photoluminescence properties were explored based on quantum confinement, edge effect, and intrinsic characteristics. Moreover, the degree of etching and the concomitant porosity of MoS2 nanosheets could be conveniently tuned via the electro-Fenton reaction time, resulting in a new morphology of nanoporous MoS2 nanosheets, with potential new applications in various significant areas.

p21-activated kinase 4 regulation of endometrial cancer cell migration and invasion involves the ERK1/2 pathway mediated MMP-2 secretion

Endometrial cancer (EC) is one of the most common malignancy of the female genital tract. Patients with metastatic disease have a poor prognosis. So far, however, the underlying molecular mechanisms of EC metastasis are largely unknown. P21-activated kinase 4 (Pak4) is important in cell motility and oncogenesis. Here we investigated a role of Pak4 in EC cell migration and invasion. Pak4 overexpression was observed in multiple human EC cell lines. In clinical samples, expression of total and phosphorylated Pak4 (Pak4 and p-Pak4, respectively) increased significantly with progression of EC from normal tissue to lymph node metastasis; both were positively correlated with depth of myometrial and vascular space invasion, lymph nodes metastasis, and poor histological differentiation. In two human EC cell lines, Pak4 overexpression promoted cell migration and invasion in vitro. Short hairpin RNA (shRNA)-mediated stable knockdown of Pak4 inhibited the metastatic potential of EC in an ERK1/2-MMP-2-dependent manner. These results suggest that Pak4 is an important regulator of EC cell migration and invasion. Therefore, Pak4 may be a promising target for the treatment of metastatic EC.