Pressureless Welding of Temperature-Invariant Multifunctionality Body Based on Hydroxyl-Functionalized Boron Nitride Nanosheets and Bifunctional Monoethanolamine Cross-linker

Bulk hexagonal boron nitride (h-BN) ceramics with structural integrity, high-temperature resistance and low expansion rate are expected for multifunctional applications in extreme conditions. However, due to its sluggish self-diffusion and intrinsic inertness, it remains a great challenge to overcome high-energy barrier for h-BN powder sintering. Herein, a cross-linking and pressureless-welding strategy is reported to produce bulk boron nitride nanosheets (BNNSs) ceramics with well-crystalized and dense B-N covalent-welding frameworks. The essence of this synthesis strategy lies in the construction of >B─O─H2C─H2C─H2N:→B< bond bridge connection structure among hydroxyl functionalized BNNSs (BNNSs-OH) using bifunctional monoethanolamine (MEA) as cross-linker through esterification and intermolecular-coordination reactions. The prepared BNNSs-interlaced ceramics have densities not less than 1.2 g cm-3, and exhibit exceptional mechanical robustness and resiliency, excellent thermomechanical stability, ultra-low linear thermal expansion coefficient of 0.06 ppm °C-1, and high thermal diffusion coefficient of 4.76 mm2 s-1 at 25 °C and 3.72 mm2 s-1 at 450 °C. This research not only reduces the free energy barrier from h-BN particles to bulk ceramics through facile multi-step physicochemical reaction, but also stimulates further exploration of multifunctional applications for bulk h-BN ceramics over a wide temperature range.

[Comparison of the clinical efficacy of all-inside arthroscopic lateral ligament augmentation procedure and Broström procedure for the treatment of chronic lateral rotational ankle instability]

Objective: To compare the clinical efficacy of patients with chronic lateral rotational ankle instability(CLRAI) after all-inside arthroscopic lateral ligament augmentation procedure and Broström procedure. Methods: This is a retrospective cohort study. The clinical and imaging data of 106 CLRAI patients were collected at the Xuzhou Central Hospital from January 2021 to December 2022. The patients included 55 males and 51 females with an age of (32.6±8.2) years (range: 16 to 50 years). All patients were treated under all-inside arthroscopic, and were divided into Broström-Gould surgery group (n=54) and Broström surgery group (n=52) according to different ligament repair methods. At 3, 6, and 12 months after surgery, ankle inversion stress tests and anterior drawer tests were used to examine the stability of the ankle joint and observe gait. The American Orthopedic Foot and Ankle Society ankle hindfoot scale (AOFAS-AH) and Karlsson ankle function score (KAFS) were used to assess ankle function; Tegner score was used to assess the patient's level of exercise; the foot and ankle outcome score(FAOS)(including score of symptoms,pain,function, daily living,function, sports and recreational activities (sport); quality of life (QOL)) was used to assess the patient's daily activity ability. Comparisons of data were made using independent sample t test, repeated measures analysis of variance, LSD multiple comparison method, χ2 test or Mann-Whitney U test. Results: All operations were successfully accomplished. All incisions healed by first intention, without evidence of postoperative complications of implant rejection, ligation reaction, and nerve and vessel injury. All patients were followed up at 3, 6, and 12 months after surgery. Ankle varus stress test and anterior drawer test were negative. No evidence supporting lateral ankle instability was obtained. All patients eventually regained normal gait. No patients underwent revision surgery. Repeated measurement analysis of variance showed that AOFAS-AH, Tegner, KAFS and FAOS scores in the Brostrom-Gould group and the Brostrom group were significantly higher than those before surgery (P<0.01). The change trends of Tegner score and FAOS-sport score were significantly different between the two groups (F=18.839, P<0.01; F=8.169, P=0.005). Multiple comparisons revealed that at 3-, 6-and 12-month follow-up, the Tegner scores ((3 months: 3.7±0.5 vs. 3.3±0.5, t=-3.980, P<0.01; 6 months: 4.4±0.6 vs. 3.8±0.7, t=-4.792,P<0.01;12 months: 5.8±0.9 vs. 5.1±1.0, t=-3.889,P<0.01)), sport scores ((3 months: 82.5±3.7 vs. 79.3±3.8, LSD-t=-4.316, P<0.01; 6 months: 88.5±4.9 vs. 85.7±3.8, LSD-t=-3.312,P=0.001;12 months: 90.1±4.3 vs. 88.2±5.1, LSD-t=-2.112,P=0.037)) in the Broström-Gould surgery group were higher than those in the Broström surgery group, with statistical significances. Conclusions: Both Broström-Gould and Broström procedures under all-inside arthroscopic can make ankle stability and improve ankle function in the treatment of CLRAI. However, the former maybe shorten the time to return to exercise and achieve higher motor function.

[Strolling through the glorious years of Alveolar Surgery, bravely stepping onto the path of practice and innovation]

This article summarizes and organizes relevant publications in journals, along with a review of medical history, systematically summarizing the development process of dental alveolar surgery in China. The initial establishment phase (1935-1952) marked the starting point of Chinese Alveolar Surgery. Despite the impact of wars, it laid the foundation for subsequent research and practice. During the early development phase (1953-1966), the "Chinese Journal of Stomatology" was founded, which promoted the development of Alveolar Surgery. Research focused on tooth extraction methods and complications. Tooth Transplantation and Preprosthetic Surgery gradually began to take off. The stagnant phase (1967-1977) occurred due to the interruption of international exchanges, leading to an almost complete halt in the development of Alveolar Surgery. Entering the rapid catch-up phase (1978-1985), Alveolar Surgery scholars in China began striving to overcome the stagnation of the previous decade. While some progress was made, no significant innovative achievements emerged. In the scientific development phase (1986-2010), clinical research, basic experiments, and paper writing in modern Chinese Alveolar Surgery began to adhere to scientific standards with the rise of experimental medicine. The exploration and innovation stage (2011-2023) is the current development phase, during which Chinese Aveolar Surgery has reached its peak, making substantial progress in technology, clinical practices, and basic research, gradually reaching or even surpassing international advanced levels. Looking back at the development history in China, we can find the wisdom and hard work of the older generation of Alveolar Surgery scholars. However, contemporary challenges and issues, such as standardizing technology, promoting clinical practices, and talent cultivation, need to be addressed by present-day Alveolar Surgery professionals as they forge ahead.

The impact of pre-operative depression on pain outcomes after major surgery: a systematic review and meta-analysis

Symptoms of depression are common among patients before surgery. Depression may be associated with worse postoperative pain and other pain-related outcomes. This review aimed to characterise the impact of pre-operative depression on postoperative pain outcomes. We conducted a systematic review of observational studies that reported an association between pre-operative depression and pain outcomes after major surgery. Multilevel random effects meta-analyses were conducted to pool standardised mean differences and 95%CI for postoperative pain scores in patients with depression compared with those without depression, at different time intervals. A meta-analysis was performed for studies reporting change in pain scores from the pre-operative period to any time-point after surgery. Sixty studies (n = 501,962) were included in the overall review, of which 18 were eligible for meta-analysis. Pre-operative depression was associated with greater pain scores at < 72 h (standardised mean difference 0.97 (95%CI 0.37-1.56), p = 0.009, I2  = 41%; moderate certainty) and > 6 months (standardised mean difference 0.45 (95%CI 0.23-0.68), p < 0.001, I2  = 78%; low certainty) after surgery, but not at 3-6 months after surgery (standardised mean difference 0.54 (95%CI -0.06-1.15), p = 0.07, I2  = 83%; very low certainty). The change in pain scores from pre-operative baseline to 1-2 years after surgery was similar between patients with and without pre-operative depression (standardised mean difference 0.13 (95%CI -0.06-0.32), p = 0.15, I2  = 54%; very low certainty). Overall, pre-existing depression before surgery was associated with worse pain severity postoperatively. Our findings highlight the importance of incorporating psychological care into current postoperative pain management approaches in patients with depression.

[The long-term efficacy of metformin in megestrol acetate-based fertility-sparing treatment for patients with endometrial atypical hyperplasia and endometrioid endometrial cancer]

Objective: To assess the long-term efficacy of metformin in megestrol acetate (MA)-based fertility-sparing treatment for patients with endometrial atypical hyperplasia (EAH) and endometrioid endometrial cancer (EEC). Methods: The randomized controlled trail study was conducted from October 2013 to October 2017 in the Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. Patients with EAH or EEC were firstly stratified according to pathology, and randomized to receive MA (160 mg orally, daily) plus metformin (500 mg orally, three times a day) or MA (160 mg orally, daily). Baseline data between two groups of patients were compared. Estimates of time to complete remission (CR) and recurrence-free survival (RFS) were calculated using the Kaplan-Meier method. Cox proportional-hazards regression model was used to estimate hazard ratios (HR) of related factors for recurrence-free survival. Quantitative data were represented by M (Q1, Q3). Results: A total of 150 patients were included, and 76 patients were allocated to receive MA plus metformin with the age of 32.5 (28.0, 36.0), while 74 patients received MA alone with the age of 32.0 (28.0, 36.0). By the end of follow-up period, 96.7% (n=145) of patients achieved complete remission, with a median follow-up time of 57.7 (26.7, 70.5) months. The median CR time for the MA plus metformin group and the MA alone group were 6.3 (3.5, 8.3) months and 6.8 (4.0, 9.3) months, respectively (P=0.193), with 2-year cumulative CR rate of 98.6% and 98.5%, respectively (P=0.879). The median time of RFS was 28.1 (12.5, 57.3) months for the MA plus metformin group and 33.3 (14.1, 62.5) months for the MA alone group (P=0.213), with a cumulative RFS rate of 61.9% and 65.8%, respectively (P=0.560). In the subgroup of non-obese (body mass index<28 kg/m2) patients with EAH, the median RFS times were 25.7 (7.6, 60.3) months and 47.3 (17.5, 64.8) months for the MA plus metformin group and the MA alone group, respectively (P=0.033), with a cumulative RFS rate of 57.5% and 80.6%, respectively (P=0.029). According to Cox proportional hazards regression analysis, undergoing assisted reproductive treatment (HR=2.358, 95%CI: 1.069-5.204, P=0.034) was identified as an independent risk factor for recurrence-free survival after complete remission of endometrial lesions. Conclusion: The long-term follow-up outcome indicates that there is no significant difference in CR time and RFS time between MA plus metformin therapy and MA alone therapy for patients with EAH or EEC.

Condensation-assembly synthesis of three-dimensionally porous boron nitride for effective oil removal

A template-free pyrolysis route has been developed using condensation-assembly precursors made of trimethoxyboroxane (TMB) and melamine (M) to cater the requirements of an industrial real-world environment. The precursors contain abundant B-N bonds and exhibit a high level of interconnectivity, resulting in 3D-PBN with enhanced mechanical properties and the ability to be easily customized in terms of shape. Moreover, 3D-PBN demonstrates rapid adsorption kinetics and excellent reusability, efficiently removing up to 270% of its own weight of fuel within 30 s and being readily regenerated through simple calcination. Even after undergoing 50 cycles, the mechanical properties remain at a remarkable 80%, while the adsorption performance exceed 95%. Furthermore, a comprehensive analysis of thermal behavior from precursor to 3D-PBN has been conducted, leading to the proposal of a molecular-scale evolution process comprising four major steps. This understanding enables us to control the phase reaction and regulate the composition of the products, which is crucial for determining the characteristics of the final product.

[Fertility-preserving treatment outcomes in endometrial cancer and atypical hyperplasia patients with different molecular profiles]

Objective: To investigate the impact of molecular classification and key oncogenes on the oncologic outcomes in patients with endometrial carcinoma (EC) and atypical endometrial hyperplasia (AEH) receiving fertility-preserving treatment. Methods: Patients with EC and AEH undergoing progestin-based fertility-preserving treatment and receiving molecular classification as well as key oncogenes test at Obstetrics and Gynecology Hospital, Fudan University from January 2021 to March 2023 were reviewed. Hysteroscopic lesion resection and endometrial biopsy were performed before initiating hormone therapy and every 3 months during the treatment to evaluate the efficacy. The risk factors which had impact on the treatment outcomes in EC and AEH patients were further analyzed. Results: Of the 171 patients analyzed, the median age was 32 years, including 86 patients with EC and 85 patients with AEH. The distribution of molecular classification was as follows: 157 cases (91.8%) were classified as having no specific molecular profile (NSMP); 9 cases (5.3%), mismatch repair deficient (MMR-d); 3 cases (1.8%), POLE-mutated; 2 cases (1.2%), p53 abnormal. No difference was found in the cumulative 40-week complete response (CR) rate between the patients having NSMP or MMR-d (61.6% vs 60.0%; P=0.593), while the patients having MMR-d had increased risk than those having NSMP to have recurrence after CR (50.0% vs 14.4%; P=0.005). Multi-variant analysis showed PTEN gene multi-loci mutation (HR=0.413, 95%CI: 0.259-0.658; P<0.001) and PIK3CA gene mutation (HR=0.499, 95%CI: 0.310-0.804; P=0.004) were associated with a lower cumulative 40-week CR rate, and progestin-insensitivity (HR=3.825, 95%CI: 1.570-9.317; P=0.003) and MMR-d (HR=9.014, 95%CI: 1.734-46.873; P=0.009) were independent risk factors of recurrence in EC and AEH patients. Conclusions: No difference in cumulative 40-week CR rate is found in the patients having NSMP or MMR-d who received progestin-based fertility-preserving treatment, where the use of hysteroscopy during the treatment might be the reason, while those having MMR-d have a higher risk of recurrence after CR. Oncogene mutation of PTEN or PIK3CA gene might be associated with a lower response to progestin treatment. The molecular profiles help predict the fertility-preserving treatment outcomes in EC and AEH patients.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Boron Nitride Microspheres via Pyrolysis of Polymerized Precursors

Microspheric BN materials have high application potential because they have better fluidity and dispersion ability to endow hexagonal boron nitride (h-BN) ceramics and h-BN/polymer composites with highly desired performance. In this work, a novel synthetic route to the BN microspheres has been developed by means of a controllable pyrolysis of polymerized spherical precursors. The precursor formation mechanism is proposed to be the F-127-induced self-assembling polymerization of a boric acid-melamine-formaldehyde (MF) colloid. It is found that ammonia-annealing of an air-pyrolysis (700 °C) intermediate causes higher BN phase transformation within final BN microspheres with more uniform diameter distribution compared to those of direct ammonia-pyrolysis of spherical precursors at the same temperatures of 1100 and 1500 °C. After ammonia-annealing and ammonia-pyrolyzed treatment at 1100 and 1500 °C, the obtained BN microspheres have a low specific surface area (SSA) property, but replacing part of melamine with dicyandiamide could increase their SSAs to more than 1000 m²/g. We believe that this new microspherical BN preparation with more facile and controllable operation would be well suited for industrialization.

Highly Multifunctional Performances of Boron Nitride Nanosheets/Polydimethylsiloxane Composite Foams

Although this kind of hexagonal boron nitride (h-BN)-filled polydimethylsiloxane (PDMS) multifunctional composite foam has been greatly expected, its development is still relatively slow as a result of the limitation of synthetic challenge. In this work, a new foaming process of BNNSs-PDMS, alcohol, and water three-phase emulsion system is employed to synthesize a series of high-quality BNNSs/PDMS composite foams (BSFs) filled with highly functional and uniformly distributed BNNSs. As a result of well-bonded interfaces between the BNNSs and PDMS, enhanced multiple functions of BSFs appeared. The BSFs can show complete resilience at a compressive strain of 90% and only 3.99% irreversible deformation after 100,000 compressing-releasing hyperelastic cycles at a strain of 60%. On the basis of their outstanding shape-memory properties, the maximum voltage value of compression-driven piezo-triboelectric (CDPT) responses of the BSFs is up to ∼20 V. Depending on the remarkable super-elastic and CDPT performances, the BSFs can be used for sensitive sensing of temperature difference and electromechanical responses. Also, in the range of 12-40 GHz, the BSF materials display ultralow dielectric constants between 1.1 and 1.4 with proper dielectric loss tangent values of <0.3 and exhibit an enhanced and broadened sound adsorption capacity ranging from 500 to 6500 Hz. Although BSFs have high porosities of >65%, their thermal conductivities can still reach up to 0.407 ± 0.039 W m^-1 K^-1. Moreover, the BSF materials display favorable thermal stability, obviously reduced coefficient of thermal expansion, and good flame retardancy. All of these properties render the BSFs as a new category of excellent multifunctional material.

Effects of intrathecally administered interferon α on chronic constriction injury model rats’ mechanical pain threshold and G protein expression in the spinal cord

INTRODUCTION

The aim of the study was to explore the analgesic mechanism of effects of intrathecally administered interferon a (IFN-a) on chronic constriction injury (CCI) model rats.

MATERIAL AND METHODS

24 rats were divided into 6 groups, with 4 rats in each group, including the negative control group (Group N, no operation or treatment), the sham operation group (Group S, only the left sciatic nerve of the rats was exposed without ligation, 0.9% NaCl was intrathecally administered), and four experimental groups (CCI model was established first and then different drugs were intrathecally administered respectively), including 0.9% NaCl (Group C), IFN-a (Group CI), morphine (Group CM), and IFN-a combined with morphine (Group CIM). The mRNA levels of G proteins in both the spinal cord and dorsal root ganglia (DRG), as well as the content of amino acid and chemokine (C-X-C motif) ligand 6 (CXCL-6) in the cerebrospinal fluid were measured and analysed in each group.

RESULTS

Intrathecal administration of IFN-a increased the mechanical pain threshold in CCI rats (33.32 ±1.36 vs. 21.08 ±1.59, p < 0.001), achieving the effect comparable to that of morphine (33.32 ±1.36 vs. 32.44 ±3.18, p > 0.05), increased the mRNA expression level of Gi protein (0.62 ±0.04 vs. 0.49 ±0.05, p = 0.006), and decreased the mRNA expression level of Gs protein in the spinal cord (1.80 ±0.16 vs. 2.06 ±0.15, p = 0.035) and DRG (2.11 ±0.10 vs. 2.79 ±0.13, p < 0.001). The intrathecal administration of both IFN-a and morphine can reduce the glutamate content in the cerebrospinal fluid (261.55 ±38.12 vs. 347.70 ±40.69, p = 0.012), but without any statistically significant difference in the content of CXCL-6 across all groups ( p > 0.05).

CONCLUSIONS

Intrathecal injection of IFN-a improved the mechanical pain threshold in CCI rats, so we inferred that intrathecal administration of IFN-a had analgesic effects on neuropathic pain, possibly related to the activation of G-proteincoupled µ receptors in the spinal cord and the inhibition of glutamate release.

Enhanced Performance of Li-S Batteries due to Synergistic Adsorption and Catalysis Activity within a Separation Coating Made of Hybridized BNNSs/N-Doping Porous Carbon Fibers

Lithium-sulfur (Li-S) batteries with high theoretical energy density are considered as the most promising devices for rechargeable energy-storage systems. However, their actual applications are rather limited by the shuttle effect of lithium polysulfides (LiPSs) and the sluggish redox kinetics. Here, the boron nitride nanosheets are homodispersedly embedded into N-doping porous carbon fibers (BNNSs/CHFs) by an electrospinning technique and a subsequent in situ pyrolysis process. The hybridized BNNSs/CHFs can be smartly designed as a multifunctional separation coating onto the commercial PP membrane to enhance the electrochemical performance of Li-S batteries. As a result, the Li-S batteries with extra BNNSs/CHF modification deliver a highly reversible discharge capacity of 830.4 mA h g^-1 at a current density of 1 C. Even under 4 C, the discharge specific capacity can reach up to 609.9 mA h g^-1 and maintain at 553.9 mA h g^-1 after 500 cycles, showing a low capacity decay of 0.01836% per cycle. It is considered that the excellent performance is attributed to the synergistic effect of adsorption and catalysis of the BNNSs/CHF coating used. First, this coating can efficiently reduce the charge transfer resistance and enhance Li-ion diffusion, due to increased catalytic activity from strong electronic interactions between BNNSs and N-doping CHFs. Second, the combination of polar BNNSs and abundant pore structures within the hybridized BNNSs/CHF networks can highly facilitate an adsorption for LiPSs. Here, we believed that this work would provide a promising strategy to increase the Li-S batteries' performance by introducing hybridized BNNSs/N-doping carbon networks, which could efficiently suppress the LiPSs' shuttle effect and improve the electrochemical kinetics of Li-S batteries.

[Long-term efficacy of low-dose rituximab treatment in patients with primary membranous nephropathy]

Objective: To explore the long-term efficacy of low-dose rituximab (RTX) treatment in patients with primary membranous nephropathy (PMN). Methods: Patients with biopsy-proven PMN who received low-dose RTX as initial or second-line regimen from August 2018 to May 2020 in the Department of Nephrology, Tianjin Medical University General Hospital were respectively enrolled. The clinical parameters of patients were urinary protein>3.5 g/24 h, serum albumin<30 g/L and estimated glomerular filtration rate (eGFR)>20 ml·min^-1·(1.73 m²)^-1. The treatment response of patients with PMN was observed during follow-up, and the remission rate of patients with urinary protein<8 g/24 h or ≥8 g/24 h, anti-PLA2R antibody<150 RU/ml or ≥150 RU/ml, eGFR≥ 60 ml·min^-1·(1.73 m²)^-1 or<60 ml·min^-1·(1.73 m²)^-1 were analyzed, respectively. Results: A total of 40 patients were enrolled, including 26 males and 14 females, aged (53±15) years. There were 14 patients received RTX as initial treatment and 26 patients as second-line therapy. The total median dose of RTX in the first course was 800 (425, 1 075) mg. The overall remission rate at the 1st, 3rd, 6th, 12th and 24th months were 12.5% (5/40), 17.5% (7/40), 47.5% (19/40), 57.5% (23/40), 60% (24/40), respectively. The median overall response time was 6.0 (3.0, 7.5) months. Two cases relapsed. Patients with remission (n=24) had a higher level of baseline eGFR [(93.9±28.0) vs (62.4±28.1) ml·min^-1·(1.73 m²)^-1, P=0.001), and a lower level of both urinary protein [5.9 (5.0, 6.5) vs 11.7 (8.6, 15.5) g/24 h, P<0.001] and anti-PLA2R antibody level [73 (29, 132) vs 453 (182, 950) RU/ml, P=0.004] than those without remission (n=16) 24 month after treatment. There was no statistically significant difference in the remission rate between initial and second-line treatment (P=0.101). Moreover, patients had a higher remission rate in urinary protein<8 g/24 h group (21/26 vs 3/14, P<0.001), anti-PLA2R antibody<150 RU/ml group (16/19 vs 5/16, P=0.002) and eGFR ≥ 60 ml·min^-1·(1.73 m²)^-1 group (22/29 vs 2/11, P=0.003). Conclusions: Low-dose RTX treatment in PMN is effective during long-term follow-up, and has a lower recurrence rate. The results also suggest that it is more suitable for patients with baseline urinary protein<8 g/24 h, anti-PLA2R antibody<150 RU/ml and eGFR≥ 60 ml·min^-1·(1.73 m²)^-1.

[Transcriptomic analysis of tuberculosis peptide-based vaccine MP3RT in humanized mice]

Objective: To identify the differentially expressed genes (DEGs) induced by tuberculosis peptide-based vaccine MP3RT in a humanized mouse model using transcriptomics technology. Methods: This study was conducted from August 2019 to February 2022. We used edgeR software to screen DEGs with a fold change greater than or equal to 1.5 and a P value less than 0.05 as screening conditions. Gene ontology (GO), Kyoto encyclopedia of genes and genomes (KEGG), and protein interaction network analyses were performed on the screened DEGs. Then, these DEGs were verified by RT-qPCR and statistically analyzed by GraphPad Prism 8 software. Results: A total of 367 DEGs (214 up-regulated and 153 down-regulated) were identified by transcriptomics. Bioinformatics analysis showed that the GO enrichment of the DEGs mentioned above significantly focused on cell metabolism, growth, apoptosis, inflammation, and other terms. In contrast, the KEGG enrichment significantly focused on inflammatory pathways such as the MAPK signaling pathway. Protein interaction network analysis showed that protein Abl1 had the highest aggregation, the highest aggregation coefficient, and the best connectivity. RT-qPCR results showed that gene expressions of cpne4 (t=2.48, P=0.048 0), h2-q10 (t=2.95, P=0.025 6), mef2c (t=2.87, P=0.028 4), cr2 (t=3.23, P=0.178), ablim1 (t=2.91, P=0.033 5), dll1 (t=2.70, P=0.027 3) and ms4a2 (t=3.03, P=0.019 2) genes in the MP3RT group were significantly up-regulated than those in the PBS group, while gene expressions of cd163l1 (t=2.56, P=0.043 0), il1r1 (t=2.91, P=0.022 7) and cd34 (t=2.42, P=0.046 2) genes in the MP3RT group were significantly down-regulated than those in the PBS group. Conclusions: The MP3RT vaccine induced 367 DEGs in humanized mice, which were associated with metabolic and immune responses. Furthermore, we found that p38 MAPK and JNK/MAPK signaling pathways played an important role in the molecular mechanism of the MP3RT vaccine.

[Clinical phenotype and genotype of Gaucher disease in 14 children]

Objective: To analyze the clinical and genetical characteristics of children with Gaucher disease and to explore the relationship between genotype and phenotype. Methods: In this retrospective study, the clinical data of 14 children with Gaucher disease diagnosed in Children's Hospital of Nanjing Medical University from August 2016 to October 2021 were analyzed. Their general conditions, clinical manifestations, laboratory tests and gene variations were collected, followed by the analysis of the clinical phenotypes and genotypes. Results: Among 14 children diagnosed with Gaucher disease, 9 were males and 5 were females, with the age of diagnosis ranging from 0.7 to 15.8 years. There were 10 patients with type 1 Gaucher disease, 2 patients with type 2, and 2 patients with type 3. The most common clinical manifestations were splenomegaly, thrombocytopenia (14 cases), hepatomegaly (8 cases) and anemia (8 cases). There were 6 patients with growth retardation, and 5 patients lag in height compared with their peers. Bone abnormalities were revealed by magnetic resonance imaging in 7 type 1 Gaucher disease patients, but only 1 patient experienced bone pain. Patients with type 2 and type 3 Gaucher disease also presented with convulsions, nystagmus and hearing loss. Gaucher cells were found in bone marrow smears in 12 patients. The glucocerebrosidase gene variations identified in 13 patients were heterozygous and in 1 type 1 patient was homozygous of L483P. L483P variation accounted for 33%(10/30) of the variation alleles, followed by V414L, D448H and R159W. The variation alleles were L483P and L422R, F252I and L483P in 2 children with severe neurological manifestations of Gaucher disease. A novel variation c.22A>G was detected. Conclusions: Splenomegaly and thrombocytopenia are the main clinical presentations of Gaucher disease in children and bone lesions revealed by radiologic imaging appear prior to the occurrence of bone diseases, type 2 and type 3 Gaucher disease also present growth retardation and neurological manifestation. The most frequent variant allele is L483P, which are detected in all 3 subtypes of Gaucher disease. The L422R, F252I gene variants correlated with the neuronopathic phenotype.

SARS-CoV-2 Variant Spike and accessory gene mutations alter pathogenesis.. [PMID: 35677080 PMCID: PMC9176647 DOI: 10.1101/2022.05.31.494211]

The ongoing COVID-19 pandemic is a major public health crisis. Despite the development and deployment of vaccines against SARS-CoV-2, the pandemic persists. The continued spread of the virus is largely driven by the emergence of viral variants, which can evade the current vaccines through mutations in the Spike protein. Although these differences in Spike are important in terms of transmission and vaccine responses, these variants possess mutations in the other parts of their genome which may affect pathogenesis. Of particular interest to us are the mutations present in the accessory genes, which have been shown to contribute to pathogenesis in the host through innate immune signaling, among other effects on host machinery. To examine the effects of accessory protein mutations and other non-spike mutations on SARS-CoV-2 pathogenesis, we synthesized viruses where the WA1 Spike is replaced by each variant spike genes in a SARS-CoV-2/WA-1 infectious clone. We then characterized the in vitro and in vivo replication of these viruses and compared them to the full variant viruses. Our work has revealed that non-spike mutations in variants can contribute to replication of SARS-CoV-2 and pathogenesis in the host and can lead to attenuating phenotypes in circulating variants of concern. This work suggests that while Spike mutations may enhance receptor binding and entry into cells, mutations in accessory proteins may lead to less clinical disease, extended time toward knowing an infection exists in a person and thus increased time for transmission to occur.

[Factor analysis of effective platelet-producing ability of fetal liver-derived cells]

Objective: To study the different factors affecting platelet production post transplantation of hematopoietic stem cells (HSCs) isolated from different sources in order to explore novel options for treating platelet depletion following HSCs transplantation. Methods: HSCs and their downstream derivatives including myeloid and lymphoid cells (i.e., collective of mononuclear cells (MNCs)), were isolated from E14.5 fetal liver (FL) and bone marrow (BM) of 8-week-old mice by Ficoll separation technique. These cells were subsequently transplanted into the tibia bone marrow cavity of recipient mice post lethal myeloablative treatment in order to construct the FL-MNCs and BM-MNCs transplantation mouse model. Routine blood indices were examined in these recipient mice. The chimeric rate of donor cells in recipient peripheral blood cells were determined by flow cytometry. Different groups of cells involved in platelet reconstruction were analyzed. CD41⁺megakaryocytes were sorted from fetal liver or bone marrow using magnetic beads, which were then induced to differentiate into platelets in an in vitro assay. Quantitative RT-PCR was used to detect the expression of platelet-related genes in CD41⁺megakaryocytes from the two sources. Results: Both the FL-MNCs and the BM-MNCs transplantation groups resumed normal hematopoiesis at the 4th week after transplantation, and the blood cells of the recipient mice were largely replaced by the donor cells. Compared with the mice transplanted with BM-MNCs, the platelet level of mice transplanted with FL-MNCs recovered faster and were maintained at a higher level. At week 4, the PLT level of the FL-MNCs group was (1.45±0.37)×10¹²/L, and of the BM-MNCs group was (1.22±0.24)×10¹²/L, P<0.05. The FL-MNCs contain a higher proportion of hematopoietic stem cells (Lin^-Sca-1⁺c-Kit⁺)(7.60%±1.40%) compared to the BM-MNCs (1.10%±0.46%), P<0.01; the proportion of the megakaryocyte progenitor cells (Lin^-Sca-1^-c-Kit⁺CD41⁺CD150⁺) and mature megakaryocyte cells (CD41⁺CD42b⁺), also differ significantly between the FL-MNCs (3.05%±0.22%, 1.60%±0.06%, respectively) and the BM-MNCs (0.15%±0.02%, 0.87%±0.11%, respectively) groups, both P<0.01. In vitro functional studies showed that FL-MNCs-CD41⁺megakaryocytes could produce proplatelet-like cells more quickly after induction, with proplatelet-like cells formation on day 3 and significant platelet-like particle formation on day 5, in contrast to bone marrow-derived BM-MNCs-CD41⁺megakaryocytes that failed to form proplatelet-like cell on day 5. In addition, FL-MNCs-CD41⁺cells expressed higher levels of platelet-related genes, Mpl (3.25-fold), Fog1 (3-fold), and Gata1 (1.5-fold) (P<0.05). Conclusion: Compared with the BM-MNCs group, the FL-MNCs transplantation group appears to have a more efficient platelet implantation effect in the HSCs transplantation recipient in vivo, as well as a higher platelet differentiation rate in vitro. This might be related to a higher proportion of megakaryocytes and higher expression levels of genes such as Mpl, Fog1, and Gata1 that could be important for platelet formation in FL-MNCs-CD41⁺cells. Further exploration of the specific functions of these genes and the characteristics of the different proportions of the donor cells will provide valuable clues for the future treatment of platelets reconstitution after HSCs transplantation clinically.

Effects of Mindfulness-Based Tai Chi Chuan on Physical Performance and Cognitive Function among Cognitive Frailty Older Adults: A Six-Month Follow-Up of a Randomized Controlled Trial

OBJECTIVE

To assess the effectiveness of a mindfulness-based Tai Chi Chuan on physical performance and cognitive function among cognitive frailty older adults.

DESIGN

A single-blind,three-arm randomized controlled trial.

SETTING

Three communities in Daqing, China.

PARTICIPANTS

The study sample comprised 93 men and women aged 65 years or older who were able to walk more than 10 m without helping tools, scored 0.5 on Clinical Dementia Rating (CDR) and absence of concurrent dementia, identified pre-frailty (scored 1-2 on Fried Frailty Criteria) and frailty older adults (scored 3-5 on Fried Frailty Criteria).

INTERVENTION

Subjects were randomly allocated to three groups: Group1, which received mindfulness intervention (formal and informal mindfulness practices); Group 2, which received Tai-Chi Chuan intervention; Group 3, which received MTCC intervention.

MEASUREMENTS

The primary outcomes was cognitive frailty rate(measured by Fried Frailty Criteria and Clinical Dementia Rating-CDR) , the secondary outcome were cognitive function (measured by Min-Mental State Examination-MMES) and physical level (measured by Short physical performance battery- SPPB, Timed up and Go test-TUG and the 30-second Chair test). They were all assessed at Time 1-baseline, Time 2-after the end of 6-month intervention and the follow up (Time 3-half year after the end of 6-month intervention).

RESULTS

The baseline characteristics did not differ among the groups.Improvements in the cognitive function (MMES), physical performance (SPPB, TUG, 30-second Chair test) were significantly difference between time-group interaction (p<.05). The rate of CF was significantly different among groups at 6-month follow-up period (χ2=6.37, p<.05). A lower prevalence of frailty and better cognitive function and physical performance were found in the Group 3 compared with other two groups at the follow-up period (p<.05).

CONCLUSIONS

MTCC seems to be effectively reverse CF, improving the cognitive and physical function among older adults, suggesting that MTCC is a preferably intervention option in community older adults with cognitive frailty.

[Recommendations of diagnosis and treatment of Takayasu's arteritis in China]

Takayasu's arteritis (TAK) mainly involves the aorta and its major branches, which is characterized as a chronic, progressive and inflammatory disease. China belongs to one of the regions with a high prevalence of TAK referring to its global distribution. However, it is insufficient for the spread and update of standardized diagnosis and treatment of TAK. Based on the evidence and guidelines from China and other countries, Chinese Rheumatology Association developed the standardized diagnosis and treatment of TAK in China. The purpose is to standardize the methods for diagnosis of TAK, assessment of disease activity and disease severity, strategies of internal treatment and timing of surgical intervention, and further leading to protect the function of important organs and improve the disease prognosis.

Engineering O-O Species in Boron Nitrous Nanotubes Increases Olefins for Propane Oxidative Dehydrogenation

Boron nitride (BN) has been widely studied as an efficient catalyst for oxidative propane dehydrogenation (OPDH). Oxygen-containing boron species (e.g., BO·, B(OH)_xO_3-x) are generally considered as the active centers in BN for OPDH. Here, we show an effective progressive substitution strategy toward the development of boron-oxygen-nitrogen nanotubes (BONNTs) enriched with O-O species as a highly active, selective, and stable catalyst for OPDH. At 525 °C, an olefin yield of 48.6% is achieved over BONNTs with a propane conversion of 64.4%, 2.8 times that of boron nitrogen nanotubes (BNNTs). Even after reaction for 150 h (475 °C), BONNTs exhibit good olefin yield. Both the B(OH)_xO_3-x and O-O species that coexist in the BONNT catalyst are demonstrated as active centers, which differs from the B(OH)_xO_3-x one in BNNTs. Based on catalytic results, propane and oxygen alternate treatment experiments, and theoretical calculations, the O-O center is more favorable for producing both propylene (C₃₌) and ethylene (C₂₌), which experiences a dehydration pathway and two possible reaction paths with a lower energy barrier to yield olefins, while B(OH)_xO_3-x is mainly responsible for producing few C₃₌.

The acoustical absorption by air-saturated aerogel powders

The acoustical behavior of air-saturated aerogel powders in the audible frequency range is not well understood. It is not clear, for example, which physical processes control the acoustic absorption and/or attenuation in a very light, loose granular mix in which the grain diameter is on the order of a micron. The originality of this work is the use of a Biot-type poro-elastic model to fit accurately the measured absorption coefficients of two aerogel powders with particle diameters in the range 1-40 μm. It is shown that these materials behave like a viscoelastic layer and their absorption coefficient depends strongly on the root mean square sound pressure in the incident wave. Furthermore, it was found that the loss factor controlling the energy dissipation due to the vibration of the elastic frame is a key model parameter. The value of this parameter decreased progressively with the frequency and sound pressure. In contrast, other fitted parameters in the Biot-type poro-elastic model, e.g., the stiffness of the elastic frame and pore size, were found to be relatively independent of the frequency and amplitude of the incident wave. It is shown that these materials absorb acoustic waves very efficiently around the frequencies of the frame resonance.

The influence of CYP2R1 polymorphisms and gene-obesity interaction with hypertension risk in a Chinese rural population

BACKGROUND AND AIMS

Several studies have reported that variants in CYP2R1 have been linked with an increased risk of hypertension. However, the interaction between CYP2R1 variants and environmental factors on the susceptibility of hypertension remained unclear. Therefore, this study evaluated the influence of CYP2R1 polymorphisms on hypertension susceptibility, and explored the interaction effect of CYP2R1 variations and obesity on the disease.

METHODS AND RESULTS

We included 766 incident hypertension cases matched with non-hypertension controls in a 1:1 ratio by sex, age (within 3 years). Two loci in CYP2R1 gene (rs10766197 and rs12794714) were genotyped by TaqMan probe assays. The concentration of 25-hydroxyvitamin-D was determined by human enzyme-linked immunosorbent assay (ELISA) kits. The associations of CYP2R1 polymorphisms and risks of vitamin D deficiency (VDD) were analyzed by logistic regression. Multifactor dimensionality reduction (MDR) was used to analyze the gene-environment interaction. Multiple logistic regression was used to examine the effect of CYP2R1 gene variations, and the interaction between CYP2R1 variation and obesity on hypertension susceptibility. The results showed that rs10766197 (GG vs. AA) and rs12794714 (GG vs. AA) polymorphisms were both associated with an increased risk of VDD (OR = 1.49, 95% confidence interval (CI) = 1.08-2.05 and OR = 1.63, 95% CI = 1.19-2.25, respectively), after adjustment for potential risk factors. We also found that rs12794714 polymorphism was significantly associated with elevated risk of hypertension under the dominant model (OR = 1.26, 95% CI = 1.01-1.56). In addition, the interactions between rs12794714 with both general obesity (OR = 3.93, 95% CI = 2.72-5.68) and central obesity (OR = 3.22, 95% CI = 2.29-4.52) have significant effects on hypertension susceptibility.

CONCLUSIONS

The study provided further evidence that CYP2R1 variation was associated with a higher risk of hypertension in Chinese rural population. The interaction between CYP2R1 rs12794714 and obesity may increase the risk of hypertension.

Design and development of multilayer cotton masks via machine learning

With the ongoing COVID-19 pandemic, reusable high-performance cloth masks are recommended for the public to minimize virus spread and alleviate the demand for disposable surgical masks. However, the approach to design a high-performance cotton mask is still unclear. In this study, we aimed to find out the relationship between fabric properties and mask performance via experimental design and machine learning. Our work is the first reported work of employing machine learning to develop protective face masks. Here, we analyzed the characteristics of Egyptian cotton (EC) fabrics with different thread counts and measured the efficacy of triple-layered masks with different layer combinations and stacking orders. The filtration efficiencies of the triple-layered masks were related to the cotton properties and the layer combination. Stacking EC fabrics in the order of thread count 100-300-100 provides the best particle filtration efficiency (45.4%) and bacterial filtration efficiency (98.1%). Furthermore, these key performance metrics were correctly predicted using machine-learning models based on the physical characteristics of the constituent EC layers using Lasso and XGBoost machine-learning models. Our work showed that the machine learning-based prediction approach can be generalized to other material design problems to improve the efficiency of product development.

[The exposure of antibiotics on the eradication of bismuth quadruple therapy in H.pylori infection]

Objective: To analyze the impact of previous exposure to macrolide, quinolones and nitroimidazole antibiotics on eradication rate of bismuth quadruple therapy (BQT) in newly diagnosed patients with Helicobacter pylori(H. pylori). Methods: A total of 469 patients with H. pylori initially treated at the Third Hospital of Peking University from September 2017 to August 2020 were retrospectively recruited. The therapeutic regimens were BQT containing clarithromycin/levofloxacin/metronidazole recommended by Chinese guidelines. Clinical data were collected, including general demographic data, exposure history of antibiotics, CYP2C16 metabolic pattern, endoscopic diagnosis, bacterial density, H.pylori resistance, eradication results, etc. Univariate analysis, Chi-square test, Fisher exact probability test, Kruskal-Wallis H test and Logistic regression model were used as statistical methods. Results: Among different eradication therapies, univariate and multivariate analyses suggested that previous exposure to macrolides (OR=3.37,95%CI 1.04-10.98, P<0.05) was relevant to the decreased eradication rate of BQT containing clarithromycin. This may be due to increased resistance to clarithromycin (OR=6.12,95%CI 3.99-9.40, P<0.01).The previous exposure to quinolones (OR=3.65, 95%CI 1.27-10.49, P<0.05) was relevant to the decreased eradication rate of BQT containing levofloxacin, which was probably explained by the increased resistance to levofloxacin (OR=2.50, 95%CI 1.69-3.71, P<0.01). But the previous history of nitroimidazole did not impact the efficacy of BQT containing metronidazole. Conclusions: In patients newly diagnosed with H.pylori infection, the previous exposure to macrolide or quinolones antibiotics is related to lower eradiation rates of H. pylori. Although the exposure to nitroimidazole also indicates drug resistance to metronidazole, the clinical efficacy of BQT with metronidazole 400 mg four times a day is not affected.

[Activation of mir-30a-wnt/β-catenin signaling pathway upregulates cathepsin K expression to promote cementogenic differentiation of periodontal ligament stem cells]

OBJECTIVE

To explore the role of cathepsin K (CTSK) regulated by mir-30a-wnt/β-catenin signaling pathway in cementogenic differentiation of periodontal ligament stem cells (PDLSCs).

METHODS

Human PDLSCs isolated by limiting dilution culture were induced by enamel matrix protein derivative (EMD) for differentiation into cementoblast-like cells. MicroRNA chip technique was employed to screen the differentially expressed microRNAs in the cells during induced differentiation. The effect of inhibiting miR-30a on CTSK expression in the induced cells was examined using RT-PCR and Western blotting. Ceramic scaffolds coated with PDLSCs treated with EMD and transfected with the miR-30a inhibitor or a lentiviral vector for CTSK overexpression were prepared and implanted subcutaneously in nude mice, and 8 weeks later the cellular expressions of cementoblast markers CAP and CEMP-1 were detected with immunohistochemistry to verify whether CTSK participate in cementogenic differentiation of PDLSCs. The role of wnt signaling pathway in miR-30a-mediated regulation of CTSK expression was explored by examining CTSK protein expressions after blocking wnt signaling in PDLSCs.

RESULTS

In PDLSCs with EMD-induced differentiation into cementoblast-like cells, multiple microRNAs exhibited differential expressions; and among them, miR-30a was specifically and significantly up-regulated (P < 0.05). Up-regulation of miR-30a obviously increased the expression of CTSK (P < 0.05) and promoted PDLSCs to form cementum-like tissues with high expressions of CAP and CEMP-1. The regulatory effect of miR-30a on CTSK expression was obviously attenuated after inhibiting wnt/β-catenin signaling pathway.

CONCLUSION

EMD induces cementogenic differentiation of PDLSCs possibly by up-regulating the expression of miR-30a, which further activates the wnt/β-catenin signaling pathway to enhance the expression of CTSK.

Restoration of the intravertebral stability in Kümmell's disease following the treatment of severe postmenopausal osteoporosis by 1-34PTH-a retrospective study

Following the 1-34PTH application for conservative treatment of Kümmell's disease, the intravertebral cleft was filled or bridged by the osseous tissue; the radiological evidence of further collapsing was absent. Pain and the neurological disorder were relieved; bone turnover markers, BMD as well as the health-related quality of life were improved.

INTRODUCTION

Kümmell's disease (KD) patients with severe osteoporosis were applied by the 1-34PTH; the fracture union and the increased bone mineral density (BMD) following this treatment were retrospectively reviewed.

METHODS

Twenty-one postmenopausal osteoporosis (PMOP) patients with KD received at least 6 months of 1-34PTH treatment. The medical records, including clinical evaluation symptoms, radiological evaluation for bone union and the stability of intravertebral vacuum cleft (IVC), BMD, and laboratory examination for osteoporosis recovery and health-related quality of life (HRQOL), were reviewed.

RESULTS

From baseline to month 12, visual analog scale decreased from 8.24 ± 0.54 to 1.71 ± 0.56 (P < 0.001) and the modified Japanese Orthopedic Association scores increased from 6.86 ± 1.77 to 10.43 ± 1.29 (P < 0.001). Sagittal CT demonstrated that the IVC was filled or bridged by the osseous tissue in all patients. Within the vertebra, the IVC area (IVCA) decreased from 4.50 ± 2.50 to 0 mm² (P = 0.001) and the mineralized bone area (MBA) increased from 170.91 ± 102.23 to 259.56 ± 98.60 mm² (P < 0.001). The area ratio of IVC to vertebra decreased from 0.97 ± 0.46 to 0% (P < 0.001), and the area ratio of mineral bone to vertebra was increased from 32.85 ± 14.51 to 54.97 ± 14.01% (P < 0.001). The kyphosis angle increment was 3.43 ± 1.80°, and the loss rate of anterior border height was 11.14 ± 4.82%. No differences were found in posterior border height and spinal canal diameter. The PINP, β-CTx, BMD, and Short Form-36 Health Survey scores markedly increased.

CONCLUSIONS

In KD patients with severe PMOP, 1-34PTH treatment could alleviate the clinical evaluation symptoms, facilitate the recovery of the intravertebral stability, ameliorate the BMD, and improve the HRQoL.

[Relationship between nutrients intake during pregnancy and the glycemic control effect in pregnant women with gestational diabetes mellitus]

OBJECTIVE

To explore the relationship between nutrients intake during pregnancy and the glycemic control effect in pregnant women with gestational diabetes mellitus (GDM).

METHODS

Pregnant women for 25-35 gestational weeks who underwent prenatal examination and completed GDM diagnostic test in two third-class hospitals in Beijing from October 2015 to October 2017 were recruited to participate in the cohort study, and were investigated at enrollment, 2 weeks after enrollment, and delivery. The cross-sectional survey data 2 weeks after enrollment was used for this study. Among them, dietary survey used the 24 h dietary records to collect the food intake of the subjects for the past day, and the intake of energy, macronutrients and micronutrients, was calculated according to the Chinese Food Composition Table. Using the data of fasting blood glucose (FBG) collected by clinical information system and referring to the Chinese Guidelines for the Diagnosis and Treatment of Pregnancy Diabetes (2014), the GDM patients with FBG ≤5.3 mmol/L were divided into the well-control group, those with FBG >5.3 mmol/L were divided into poorly-control group, and pregnant women with normal glucose tolerance were consi-dered as the normal group. Binary Logistic regression was used to analyze the association between the nutrients intake and glycemic control effect in pregnant women with GDM.

RESULTS

A total of 227 pregnant women were enrolled, including 104 GDM patients and 123 normal pregnancy women. Among them, 76 subjects in the well-control group (73.1%, 76/104) and 28 subjects in the poorly-control group (26.9%, 28/104). Compared with the well-control group and the normal group, the protein intake and its energy ratio of the poorly-control group were significantly higher, while carbohydrate energy ratio was significantly lower. In terms of micronutrients, there was no significant difference between the well-control group and the poorly-control group. After adjusting for age, gestational age and physical activity level, with the well-control group as the control group, binary Logistic regression model showed that higher protein energy ratio was positively correlated with poorly glycemic control effect in pregnant women with GDM (OR=6.12, 95%CI: 1.44-25.98), while higher carbohydrate energy ratio was negatively correlated with poorly glycemic control (OR=0.54, 95%CI: 0.32-0.91).

CONCLUSION

Reduced protein intake and increased carbohydrate intake were associated with better glycemic control in pregnant women with GDM. It is suggested that GDM patients should adjust their dietary pattern further to achieve good glycemic control effect.

Transcriptome analysis reveals the effect of high-grain pelleted and non-pelleted diets on ruminal epithelium of Hu-lamb

High-grain non-pelleted (HG) and high-grain pelleted (HP) diets are becoming prevalent for ruminant feeding in intensive farms. However, rare information is about their effect on sheep and the comparison between these two kinds of diets. The current study investigated how HG and HP diets affected the transcriptome profiles of rumen epithelium in Hu-lamb. Fifteen male Hu-lambs were assigned randomly to three groups (n = 5 for each group). Lambs in the control (CON), HG, and HP groups were fed with low-grain non-pelleted diet (30% grain), HG diet (70% grain), and HP diet (70% grain), respectively, for 42 days. All these lambs were slaughtered to collect ruminal epithelium samples for transcriptome analysis. Results showed both HG and HP diets obviously changed the transcriptome profiles, and 192, 319, and three differentially expressed genes (DEGs) were identified for CON_HG, CON_HP, and HG_HP comparisons, respectively. Clusters of orthologous group functional classification of CON_HG and CON_HP DEG datasets both showed the enrichments of DEGs in pathways involved in protein biogenesis and modification as well as energy production and conversion. Kyoto encyclopedia of genes and genomes pathway analysis of CON_HG and CON_HP DEG datasets both displayed the enrichments of DEGs in ribosome and oxidative phosphorylation. Almost all these DEGs involved in translation and ribosomal structure and biogenesis as well as oxidative phosphorylation were downregulated in the HG and HP groups compared to the CON group. Furthermore, CON_HP comparison demonstrated more DEGs related to these two pathways than CON_HG comparison. In conclusion, both HG and HP diets inhibited energy production and conversion as well as protein synthesis and modification in ruminal epithelium. HP diet showed lower growth benefits, induced severer rumen acidosis, and more seriously inhibited energy production and protein synthesis as compared to HG diet.

Absent Cortical Venous Filling Is Associated with Aggravated Brain Edema in Acute Ischemic Stroke

BACKGROUND AND PURPOSE

Predicting malignant cerebral edema can help identify patients who may benefit from appropriate evidence-based interventions. We investigated whether absent cortical venous filling is associated with more pronounced early brain edema, which leads to malignant cerebral edema.

MATERIALS AND METHODS

Patients with acute ischemic stroke caused by large-vessel occlusion in the MCA territory who presented between July 2017 and September 2019 to our hospital were included. Collateral filling was rated using the modified Tan scale on CTA, and good collaterals were defined as a score of 2-3. The Cortical Vein Opacification Score (COVES) was calculated, and absent cortical venous filling was defined as a score of 0. Early brain edema was determined using net water uptake on baseline CT images. Malignant cerebral edema was defined as a midline shift of ≥5 mm on follow-up imaging or a massive cerebral swelling leading to decompressive hemicraniectomy or death. Multivariate linear and logistic regression models were performed to analyze data.

RESULTS

A total of 163 patients were included. Net water uptake was significantly higher in patients with absent than in those with favorable cortical venous filling (8.1% versus 4.2%; P < .001). In the multivariable regression analysis, absent cortical venous filling (β = 2.04; 95% CI, 0.75-3.32; P = .002) was significantly and independently associated with higher net water uptake. Absent cortical venous filling (OR, 14.68; 95% CI, 4.03-53.45; P < .001) and higher net water uptake (OR, 1.29; 95% CI, 1.05-1.58; P = .016) were significantly associated with increased likelihood of malignant cerebral edema.

CONCLUSIONS

Patients with absent cortical venous filling were associated with an increased early brain edema and a higher risk of malignant cerebral edema. These patients may be targeted for optimized adjuvant antiedematous treatment.

[A dose-response meta-analysis on the relationship between daily tea intake and cardiovascular mortality based on the GRADE system]

Objective: To explore the relationship between daily tea intake and cardiovascular disease (CVD) mortality. Methods: PubMed, EMbase, The Cochrane, Chinese Biomedical Literature Database, CNKI, and Wanfang Database were searched to collect research on tea intake and CVD mortality. The search period was from the establishment of the database to June 2020. Two researchers independently screened and extracted literature. The risk of bias was evaluated in the included studies, a dose-response meta-analysis was conducted, sensitivity analysis and publication bias analysis of the research results, and quality evaluation of the included literature and GRADE classification of the evidence body were performed. Results: A total of 21 cohort or case-control studies were included, including 1 304 978 subjects. Among them, 38 222 deaths from CVD were reported. The quality scores of the included studies were all ≥ 6 points. The dose-response meta-analysis showed that for every additional cup of tea intake per day, the mortality rate of CVD decreased by about 3% (95%CI 0.95-0.98, P<0.05), and there was a non-linear dose-response relationship (P<0.05). Compared with people who do not drink tea, people who drink 1 to 8 cups of tea a day have 8% lower CVD mortality (RR=0.92, 95%CI 0.89-0.95), 13% (RR=0.87, 95 %CI 0.84-0.91), 15% (RR=0.85, 95%CI 0.82-0.89), 15% (RR=0.85, 95%CI 0.81-0.89), 16% (RR=0.84, 95%CI 0.80-0.89), 16% (RR=0.84, 95%CI 0.81-0.88), 16% (RR=0.84, 95%CI 0.81-0.87), 16% (RR=0.84, 95%CI 0.80-0.88), respectively. The results of traditional meta-analysis showed that compared with people who do not drink tea, people who drink more than 1 cup of tea a day are associated with 14% lower CVD mortality rate (RR=0.86, 95%CI 0.81-0.91, I²=73.2%, P<0.05). The results of subgroup analysis showed that compared with the corresponding people who did not drink tea, men who drank more than 1 cup of tea a day reduced the CVD mortality rate by 24%, women by 14%, European and American populations by 12%, and Asian populations by 15%. The population who consumed green tea decreased CVD mortality by 15%, and the population of non-smokers decreased CVD mortality by 20% (all P<0.05). The population who consumed black tea decreased CVD mortality by 8%, and the smoking population who consumed black tea decreased CVD mortality by 3%, and the difference was not statistically significant (all P>0.05). The results of the bias analysis showed that Begg=0.42 and Egger=0.62, indicating that the distribution on both sides of the funnel chart is symmetrical, suggesting that there is no publication bias. The results of sensitivity analysis showed that the effect size of the outcome index did not change significantly after excluding any article, indicating that the results are robust and credible. The GRADE evaluation showed that the evidence grades of the outcome indicators were all low grade. Conclusions: Daily tea consumption is related to reduced CVD mortality. It is therefore recommended to drink an appropriate amount of tea daily.

Highly Multifunctional and Thermoconductive Performances of Densely Filled Boron Nitride Nanosheets/Epoxy Resin Bulk Composites

In the development of hexagonal boron nitride (h-BN)-based polymeric composites with high thermal conductivity, it is always challenging to achieve a dense filling of h-BN fillers to form a desired high-density thermal transfer network. Here, a series of boron nitride nanosheets (BNNSs)/epoxy resin (EP) bulk composites filled with ultrahigh BNNSs content (65-95 wt %) is successfully constructed through a well-designed mechanical-balling prereaction combined with a general pressure molding method. By means of this method, the highly filled BNNSs fillers are uniformly dispersed and strongly bonded with EP within the composites. As a result, the densely BNNSs-filled composites can exhibit multiple performances. They have excellent mechanical properties, and their maximum compression strength is 30-97 MPa. For a BNNSs/EP composite with filling ultrahigh BNNSs fraction up to 90 wt %, its highly in-plane thermal conductivities (TC) are 6.7 ± 0.1 W m^-1 K^-1 (at 25 °C) to 8.7 ± 0.2 W m^-1 K^-1 (200 °C), respectively. In addition, the minimum coefficient of thermal expansion of BNNSs/EP composites is 4.5 ± 1.3 ppm/°C (only ∼4% of that of the neat EP), while their dielectric constants are basically located between 3-4 along with their dielectric loss tangent values exceptionally <0.3 in the ultrahigh frequency range of 12-40 GHz. Additionally, these BNNSs/EP composites exhibit remarkable cycle stability in heat transfer during heating and cooling processes because of their structural robustness. Thus, this type of densely BNNSs-filled BNNSs/EP composite would have great potential for further practical thermal management fields.

Short and long-term impact of four sets of actions on acute ischemic stroke management in Rhône County, a population based before-and-after prospective study

Background

Optimizing access to recanalization therapies in acute ischemic stroke patients is crucial. Our aim was to measure the short and long term effectiveness, at the acute phase and 1 year after stroke, of four sets of actions implemented in the Rhône County.

Methods

The four multilevel actions were 1) increase in stroke units bed capacity and development of endovascular therapy; 2) improvement in knowledge and skills of healthcare providers involved in acute stroke management using a bottom-up approach; 3) development and implementation of new organizations (transportation routes, pre-notification, coordination by the emergency call center physician dispatcher); and 4) launch of regional public awareness campaigns in addition to national campaigns. A before-and-after study was conducted with two identical population-based cohort studies in 2006–7 and 2015–16 in all adult ischemic stroke patients admitted to any emergency department or stroke unit of the Rhône County. The primary outcome criterion was in-hospital management times, and the main secondary outcome criteria were access to reperfusion therapy (either intravenous thrombolysis or endovascular treatment) and pre-hospital management times in the short term, and 12-month prognosis measured by the modified Rankin Scale (mRS) in the long term.

Results

Between 2015–16 and 2006–7 periods ischemic stroke patients increased from 696 to 717, access to reperfusion therapy increased from 9 to 23% (p < 0.0001), calls to emergency call-center from 40 to 68% (p < 0.0001), first admission in stroke unit from 8 to 30% (p < 0.0001), and MRI within 24 h from 18 to 42% (p < 0.0001). Onset-to-reperfusion time significantly decreased from 3h16mn [2 h54-4 h05] to 2h35mn [2 h05-3 h19] (p < 0.0001), mainly related to a decrease in delay from admission to imaging. A significant decrease of disability was observed, as patients with mild disability (mRS [0–2]) at 12 months increased from 48 to 61% (p < 0.0001). Pre-hospital times, however, did not change significantly.

Conclusions

We observed significant improvement in access to reperfusion therapy, mainly through a strong decrease of in-hospital management times, and in 12-month disability after the implementation of four sets of actions between 2006 and 2016 in the Rhône County. Reducing pre-hospital times remains a challenge.

Interfacial modification of Co(OH)2/Co3O4 nanosheet heterostructure arrays for the efficient oxygen evolution reaction

The development of efficient, stable and low-cost oxygen evolution reaction (OER) catalysts in anodes is essential for the production of hydrogen resources by electrolyzing water.

Genome-wide association studies for growth-related traits in a crossbreed pig population

Growth-related traits are important economic traits in the pig industry that directly influence pork production efficiency. To detect quantitative trait loci and candidate genes affecting growth traits, genome-wide association studies were performed for backfat thickness (BF) and loin muscle depth (LMD) in 370 Chuying-black pigs using Illumina PorcineSNP50 BeadChip array. We totally identified 14 BF-associated SNPs, which included 11 genome-wide SNPs (P < 1.39E-06) and 3 chromosome-wide suggestive SNPs (P < 2.79E-05) and for LMD, 9 SNPs surpassed the genome-wide significant threshold (P < 1.39E-06). These SNPs explained 30.33 and 27.51% phenotypic variance for BF and LMD respectively. Furthermore, 14 and 9 genes nearest to the significant SNPs were selected to be candidate genes, including MAGED1, GPHN, CCSER1, and GUCY2D for BF and PARM1, COL18A1, HSF5, and SCML2 genes for LMD. One significant SNP, which explained 6.07% of phenotypic variance for BF, mapped to a pleiotropic quantitative trait locus with a 494-kb interval. Together, the SNPs and candidate genes identified in this study will advance our understanding of the complex genetic architecture of BF and LMD traits, and they will also provide important clues for future implementation of a genomic selection program in Chuying-black pigs.

[Effect of tissue inhibitor of metalloproteinase-1 and 2 siRNA on the expression of smad2/3/4 protein in hepatic stellate cells]

Objective: To study the effect of tissue inhibitor of metalloproteinases (TIMP)-1 siRNA and TIMP-2 siRNA on the expression of smad2/3/4 protein in CCl4-induced liver fibrosis rat hepatic stellate cells (HSC). Methods: Rat's liver tissues with liver fibrosis after treatment with pre-built TIMP-1siRNA and TIMP-2 siRNA were used as the research subjects. Immunohistochemistry, Western blotting and real-time PCR were used to detect the protein and corresponding mRNA expression levels on smad2/3/4. TUNEL and α-smooth muscle actin (α-SMA) positive cells were quantified by double-labeled immunofluorescence. Analysis of variance (ANOVA) was used to compare the means between multiple groups, and the SNK test was used for the pairwise comparison of means. Results: The results of immunohistochemistry showed that the protein expressions of smad2, smad3, and smad4 in the TIMP-1 siRNA group and TIMP-2 siRNA group were significantly reduced than those of the model and the negative control group (P < 0.05). In addition, Western blotting results had also shown the same trend. The protein expression of smad2, smad3, and smad4 in the TIMP-1siRNA group and TIMP-2siRNA group were significantly reduced than those of the model and the negative control group (P < 0.01). The mRNA expression of smad2, smad3, and smad4 in TIMP-1siRNA group and TIMP-2siRNA group was significantly reduced than those of the model and negative control group (P < 0.05). Immunofluorescence showed that the apoptosis of activated HSC in the TIMP-1 siRNA group(0.014 3 ± 0.002 4) and TIMP-2 siRNA group(0.010 7 ± 0.004 4) was increased than those of the model(0) and the negative control group (0.002 4 ± 0.002 4, P < 0.05). Conclusion: TIMP-1 siRNA and TIMP-2 siRNA promote the apoptosis of activated HSCs. In addition, it also has a significant inhibitory effect on the expression of smad protein.

[In vitro evaluation of the antibacterial activity of nemonoxacin against Mycobacterium tuberculosis, Mycobacterium intracellulare and Mycobacterium abscessus]

Objective: To test the in vitro antibacterial activity of nemonoxacin against clinically isolates of Mycobacterium tuberculosis complex(MTBC), Mycobacterium intracellulare(MI) and Mycobacterium abscessus(MA). Methods: Totally 128, 80 and 50 isolates of MTBC, M.intracellulare and M.abscessus were tested, respectively. The minimum inhibitory concentrations (MICs) of nemonoxacin and levofloxacin against the strains of the three most frequently isolated mycobacterium species were measured by double dilution method with micro-well plate. Results: The MICs of 104(81.2%) strains of MTBC isolates against levofloxacin were ≤ 1 μg/ml. Whereas 112 (87.5%) strains of MTBC isolates had MICs against nemonoxacin than>1 μg/ml, furthermore, the MICs of 88(68.8%)strains of MTBC isolates against nemonoxacin were≥4 μg/ml. The median MIC of M. intracellulare isolates against levofloxacin and nenofloxacin were 16 and 32 μg/ml, separately, while were 16 μg/ml and 8 μg/ml for M. abscessus, respectively. The ratios of nemonoxacin MIC/levofloxacin MIC of M. abscessus were between 0.125-1.000. Conclusions: Nemonoxacin presented weaker inhibitory activity than levofloxacin against M. tuberculosis, whereas it had better activity than levofloxacin against M. abscessus.