Molecular Engineering of Electrosprayed Hydrogel Microspheres to Achieve Synergistic Anti-Tumor Chemo-Immunotherapy with ACEA Cargo

Molecular engineering of drug delivering platforms to provide collaborative biological effects with loaded drugs is of great medical significance. Herein, cannabinoid receptor 1 (CB1)- and reactive oxygen species (ROS)-targeting electrosprayed microspheres (MSs) are fabricated by loading with the CB1 agonist arachidonoyl 2'-chloroethylamide (ACEA) and producing ROS in a photoresponsive manner. The synergistic anti-tumor effects of ACEA and ROS released from the MSs are assessed. ACEA inhibits epidermal growth factor receptor signaling and altered tumor microenvironment (TME) by activating CB1 to induce tumor cell death. The MSs are composed of glycidyl methacrylate-conjugated xanthan gum (XGMA) and Fe3+, which form dual molecular networks based on a Fe3+-(COO-)3 network and a C═C addition reaction network. Interestingly, the Fe3+-(COO-)3 network can be disassembled instantly under the conditions of lactate sodium and ultraviolet exposure, and the disassembly is accompanied by massive ROS production, which directly injures tumor cells. Meanwhile, the transition of dual networks to a single network boosts the ACEA release. Together, the activities of the ACEA and MSs promote immunogenic tumor cell death and create a tumor-suppressive TME by increasing M1-like tumor-associated macrophages and CD8+ T cells. In summation, this study demonstrates strong prospects of improving anti-tumor effects of drug delivering platforms through molecular design.

A 2D carbon nitride-based electrochemical aptasensor with reverse amplification for highly sensitive detection of okadaic acid in shellfish

Okadaic acid (OA) is one of the main virulence factors of diarrheal shellfish toxins (DSP). It is of great significance to detect OA with an accurate, specific and cost-effective technique in the fields of seafood safety and water quality control. In this work, an electrochemical aptasensor with reverse amplification was developed for the sensitive detection of OA. A two-dimensional graphite-phase nanomaterial (carbon nitride) modified with an anti-OA aptamer and thionine (Th) was immobilized onto the surface of the electrochemical electrode as the sensitive element to capture target OA molecules. ssDNA-modified carbon nitride was used as the reverse amplification element by hybridizing with non-OA linked aptamers. The preparation of the electrochemical aptasensor was well characterized by Scanning Electron Microscopy (SEM), zeta potential detection, UV-Vis absorption, Brunner-Emmet-Teller (BET) measurements, and electrochemical measurements. The quantitative assessment of OA was achieved by differential pulse voltammetry (DPV). Experimental results indicated that this aptasensor showed a concentration-dependent response to OA with a good detection performance including in terms of selectivity, repeatability, reproducibility, and stability. It exhibited 100-fold selectivity between OA and other toxins including dinophysistoxins (DTX), pectenotoxins (PTX), and yessotoxins (YTX). In addition, it showed a much wider quantification range, which is 10-13 M-10-10 M (0.080-80.50 pg mL-1). The detection limit was as low as 10-13 M (0.080 pg mL-1). The aptasensor also successfully achieved significant practicality on real shellfish samples contaminated by OA. All these results demonstrated that the reverse amplification strategy for marine toxin detection may provide a label-free and rapid detection approach for portable applications in the fields of environmental monitoring and food security.

Efficacy of e-health interventions for smoking cessation management in smokers: a systematic review and meta-analysis

Background

Smoking is one of the major risk factors for shortened lifespan and disability, while smoking cessation is currently the only guaranteed method to reduce the harm caused by smoking. E-health is a field that utilizes information and communication technology to support the health status of its users. The emergence of this digital health approach has provided a new way of smoking cessation support for smokers seeking help, and an increasing number of researchers are attempting to use e-health for a wide range of effective smoking cessation interventions. We conducted a systematic review and meta-analysis of studies that used e-health as a smoking cessation support tool.

Methods

This systematic review and meta-analysis searched the PubMed, Embase, and Cochrane Library databases until December 2022. The included studies were randomized controlled trials (RCTs) comparing the use of e-health interventions and traditional offline smoking cessation care interventions. The primary outcome of the studies was the point smoking cessation rate (7-day and 30-day), and the secondary outcome was sustained smoking cessation rates. Studies were excluded if there was no clear e-health intervention described or if standard-compliant cessation outcomes were not clearly reported. Fixed-effects meta-analysis and meta-regression analyses were performed on the included study data to evaluate the effectiveness of the interventions. The meta-analysis outcome was the risk ratio (RR) and a 95% confidence interval. The study was registered with PROSPERO, CRD42023388667.

Findings

We collectively screened 2408 articles, and ultimately included 39 articles with a total of 17,351 eligible participants, of which 44 studies were included in the meta-analysis. The meta-analysis revealed that compared to traditional smoking cessation interventions, e-health interventions can increase point quit rates (RR 1.86, 95% CI 1.69-2.04) as well as sustained quit rates in the long-term (RR 1.79, 95% CI 1.60-2.00) among smokers. Subgroup analysis showed that text and telephone interventions in e-health significantly improved short-term quit rates for up to 7 days (RR 2.10, 95% CI 1.77-2.48). Website and app interventions also had a positive impact on improving short-term quit rates for up to 7 days (RR 1.74, 95% CI 1.56-1.94). The heterogeneity of the study results was low, demonstrating the significant smoking cessation advantages of e-health interventions.

Interpretation

We have found that personalized e-health interventions can effectively help smokers quit smoking. The diverse remote intervention methods of e-health can provide more convenient options for further customization. Additionally, further follow-up research is needed to evaluate the sustained effectiveness of interventions on smokers' continuous abstinence over a longer period (greater than one year). In the future, e-health can further optimize smoking cessation strategies.

Funding

No funding.

High fatigue resistance in a titanium alloy via near-void-free 3D printing

The advantage of 3D printing-that is, additive manufacturing (AM) of structural materials-has been severely compromised by their disappointing fatigue properties1,2. Commonly, poor fatigue properties appear to result from the presence of microvoids induced by current printing process procedures3,4. Accordingly, the question that we pose is whether the elimination of such microvoids can provide a feasible solution for marked enhancement of the fatigue resistance of void-free AM (Net-AM) alloys. Here we successfully rebuild an approximate void-free AM microstructure in Ti-6Al-4V titanium alloy by development of a Net-AM processing technique through an understanding of the asynchronism of phase transformation and grain growth. We identify the fatigue resistance of such AM microstructures and show that they lead to a high fatigue limit of around 1 GPa, exceeding the fatigue resistance of all AM and forged titanium alloys as well as that of other metallic materials. We confirm the high fatigue resistance of Net-AM microstructures and the potential advantages of AM processing in the production of structural components with maximum fatigue strength, which is beneficial for further application of AM technologies in engineering fields.

Field-induced Bose-Einstein condensation in zigzag spin chain KGaCu(PO4)2

Single crystals of GaKCu(PO4)2were synthesized using the hydrothermal method, and subsequent measurements of specific heat, magnetic susceptibility, and high-field magnetization were performed. A broad peak is observed in the magnetic susceptibility and specific heat curves, with the maximum values appearing at about 11.5 K and 5.29 K, respectively. The highest maximum peak value of susceptibility is observed when the magnetic field is applied along thec-axis, followed by thea-axis,b-axis, and polycrystalline samples. These indicate that the system exhibits one-dimensional magnetism and the magnetic easy axis is thecaxis. The magnetization at 2 K reveals the occurrence of a field-induced Bose-Einstein condensation (BEC) phase within the magnetic field range of approximately 8-12 T. High-field magnetization up to 40 T indicates that the compound reaches magnetization saturation as the field exceedsHs= 12 T. Through systematic measurements, a field-temperature (H-T) phase diagram was constructed, and dome-like phase boundaries were observed. The findings suggest that GaKCu(PO4)2is a spin gap system and a promising candidate for studying BEC of magnons due to its phase transition boundary occurring at low magnetic fields.

[Clinical effect of modified vertical rectus abdominis myocutaneous flap in repairing skin and soft tissue defects after abdominoperineal resection for rectal cancer]

Objective: To investigate the clinical effect of the modified vertical rectus abdominis myocutaneous flap in repairing the skin and soft tissue defect after abdominoperineal resection for rectal cancer. Methods: This study was a retrospective observational study. From June 2019 to July 2022, five male patients with low rectal cancer who were conformed to the inclusion criteria were admitted to the Department of Basic Surgery of Xiangya Hospital of Central South University, with ages ranging from 65 to 70 years and the sizes of the perianal skin ulcers ranging from 5 cm×4 cm to 11 cm×9 cm, and all of them underwent abdominoperineal resection. The secondary skin and soft tissue defects in the perineum with an area of 8 cm×6 cm-14 cm×12 cm (with the depth of pelvic floor dead space being 10-15 cm) were repaired intraoperatively with transplantation of modified vertical rectus abdominis myocutaneous flaps with the skin area being 9 cm×7 cm-16 cm×12 cm, the volume of the muscle being 18 cm×10 cm×5 cm-20 cm×12 cm×5 cm, and the vessel pedicle being 18-20 cm in length. During the operation, most of the anterior sheath of the rectus abdominis muscle was retained, the flap was transferred to the recipient area through the abdominal cavity, the remaining anterior sheaths of the rectus abdominis muscle on both sides of the donor area were repeatedly folded and sutured, the free edge of the transverse fascia of the abdomen was sutured with the anterior sheath of the rectus abdominis muscle, and the donor area skin was directly sutured. After the operation, the survival of the transplanted myocutaneous flap was observed. The occurrence of complications in the perineal recipient area was recorded within 2 weeks after the operation. The recovery of the perineal recipient area and the abdominal donor area was observed during follow-up, and the occurrence of complications in the donor area of the abdomen as well as the recurrence of tumors and metastasis were recorded. Results: All transplanted myocutaneous flaps in 5 patients survived after surgery. One patient had dehiscence of the incision in the perineal recipient area 2 days after surgery, which healed after 7 d with intermittent dressing changes and routine vacuum sealing drainage treatment. In the other 4 patients, no complications such as incisional rupture, incisional infection, or fat liquefaction occurred in the perineal recipient area within 2 weeks after surgery. Follow-up for 6-12 months after discharge showed that the skin of the perineal recipient area had good color, texture, and elasticity, and was not bloated in appearance; linear scars were left in the perineal recipient area and the abdominal donor area without obvious scar hyperplasia or hyperpigmentation; no complications such as incisional rupture, incisional infection, intestinal adhesion, intestinal obstruction, or weakening of the abdominal wall strength occurred in the abdominal donor area, and the abdominal appearance was good with no localized bulge or formation of abdominal hernia; there was no local recurrence of tumor or metastasis in any patient. Conclusions: The surgical approach of using the modified vertical rectus abdominis myocutaneous flap to repair the skin and soft tissue defects after abdominoperineal resection for rectal cancer is relatively simple in operation, can achieve good postoperative appearances of the donor and recipient areas with few complications, and is worthy of clinical promotion.

Efficient separation of impurities Fe/Al/Ca and recovery of Zn from electroplating sludge using glucose as reductant

Electroplating sludge (ES), a hazardous waste containing heavy metals and Fe/Al/Ca impurities, is conventionally disposed of in landfills. In this study, a pilot-scale vessel with an effective capacity of 20 L was applied to recycle Zn from real ES. The sludge contained 6.3 wt% Fe, 6.9 wt% Al, 2.6 wt% Si, 6.1 wt% Ca, and 17.6 wt% Zn and was treated using a four-step method. First, ES was dissolved in nitric acid after washing in a water bath at 75 °C for 3 h to produce an acidic solution with Fe, Al, Ca, and Zn concentrations of 4527.2, 3116.1, 3357.7, and 21,275 mg/L, respectively. Second, the acidic solution was added with glucose at an Mglucose/Mnitrate ratio of 0.08 and hydrothermally treated at 160 °C for 4 h. During this step, nearly 100 % Fe and 100 % Al were simultaneously removed as a mixture containing 53.1 wt% Fe2O3 and 45.7 wt% Al2O3. This process was repeated five times, during which the Fe/Al removal and Ca/Zn loss rates remained unchanged. Third, the residual solution was adjusted with sulfuric acid, and over 99 % Ca was removed as gypsum. The residual Fe, Al, Ca, and Zn concentrations were 0.44, 0.88, 52.59, and 31,177.1 mg/L, respectively. Finally, Zn in the solution was precipitated as ZnO with a concentration of 94.3 %. Economic calculations showed that each 1 t of ES processed created revenue of about $122. This is the first study of high-value metal resource recovery using real electroplating sludge at the pilot scale. This work highlights the pilot-scale application of resource utilization of real ES and provides new insights into the recycling of heavy metals from hazardous waste.

Energetic Electron Precipitation Driven by Electromagnetic Ion Cyclotron Waves from ELFIN's Low Altitude Perspective

We review comprehensive observations of electromagnetic ion cyclotron (EMIC) wave-driven energetic electron precipitation using data collected by the energetic electron detector on the Electron Losses and Fields InvestigatioN (ELFIN) mission, two polar-orbiting low-altitude spinning CubeSats, measuring 50-5000 keV electrons with good pitch-angle and energy resolution. EMIC wave-driven precipitation exhibits a distinct signature in energy-spectrograms of the precipitating-to-trapped flux ratio: peaks at >0.5 MeV which are abrupt (bursty) (lasting ∼17 s, or Δ L ∼ 0.56 ) with significant substructure (occasionally down to sub-second timescale). We attribute the bursty nature of the precipitation to the spatial extent and structuredness of the wave field at the equator. Multiple ELFIN passes over the same MLT sector allow us to study the spatial and temporal evolution of the EMIC wave - electron interaction region. Case studies employing conjugate ground-based or equatorial observations of the EMIC waves reveal that the energy of moderate and strong precipitation at ELFIN approximately agrees with theoretical expectations for cyclotron resonant interactions in a cold plasma. Using multiple years of ELFIN data uniformly distributed in local time, we assemble a statistical database of ∼50 events of strong EMIC wave-driven precipitation. Most reside at L ∼ 5 - 7 at dusk, while a smaller subset exists at L ∼ 8 - 12 at post-midnight. The energies of the peak-precipitation ratio and of the half-peak precipitation ratio (our proxy for the minimum resonance energy) exhibit an L -shell dependence in good agreement with theoretical estimates based on prior statistical observations of EMIC wave power spectra. The precipitation ratio's spectral shape for the most intense events has an exponential falloff away from the peak (i.e., on either side of ∼ 1.45 MeV). It too agrees well with quasi-linear diffusion theory based on prior statistics of wave spectra. It should be noted though that this diffusive treatment likely includes effects from nonlinear resonant interactions (especially at high energies) and nonresonant effects from sharp wave packet edges (at low energies). Sub-MeV electron precipitation observed concurrently with strong EMIC wave-driven >1 MeV precipitation has a spectral shape that is consistent with efficient pitch-angle scattering down to ∼ 200-300 keV by much less intense higher frequency EMIC waves at dusk (where such waves are most frequent). At ∼100 keV, whistler-mode chorus may be implicated in concurrent precipitation. These results confirm the critical role of EMIC waves in driving relativistic electron losses. Nonlinear effects may abound and require further investigation.

Effective recovery of Ti as anatase nanoparticles from waste red mud via a coupled leaching and boiling route

Red mud (RM) a solid waste generated by the bauxite smelting industry, is a rich source of metal resources, especially Ti, and its recycling can bring significant environmental and economic benefits. In this study, precious metal Ti was efficiently recovered from red mud using a coupled acid leaching and boiling route for the effective separation of low-value metals. The red mud which contained mainly 10.69% Si, 12.1% Al, 15.2% Ca, 10.99% Fe, and 4.37% Ti, was recovered in five steps. First, a nitric acid solution was used to leach the metals in multiple stages, resulting in an acidic leach solution with high concentrations of Fe, Al, Ti, and Ca ions 2.7 g/L, 4.7 g/L, 5.43 g/L, and 1.8 g/L, respectively. Then, a small amount of sucrose was added as a catalyst to recover Ti from the leach solution under hydrothermal conditions, resulting in the targeted recovery of 98.6% of Ti in the form of high-purity anatase while Fe, Al, and Ca remained in the solution. Next, the Fe in solution was separated as hematite products at a temperature of 110°C and a reaction time of 4 h. Similarly, the Al in the solution was separated and precipitated as boehmite by heating it at 260°C for a reaction time of 20 h. Finally, the remaining Ca in solution was recovered by simple pH regulation. Economic accounting assessment showed that the method yields $101.06 for 1 t of red mud treated, excluding labor costs. This study provides a novel approach to recover precious metals from metal wastes through the whole process resource recovery of solid waste red mud.

High-field magnetization and electronic spin resonance study in the twisted honeycomb latticeα-Mn2V2O7

We report the single-crystal growth of Mn₂V₂O₇and the results of magnetic susceptibility, high-field magnetization up to 55 T and high-frequency electric spin resonance (ESR) measurements for its low-temperatureαphase. Two antiferromagnetic (AFM) ordering at 17.5 K and 3 K and obvious magnetic anisotropy are observed inα-Mn₂V₂O₇upon cooling. In pulsed high magnetic fields, the compound reaches the saturation magnetic moment of ∼10.5μ_Bfor each molecular formula at around 45 T after two undergoing AFM phase transitions atH_c1≈ 16 T,H_c2≈ 34.5 T forH//[11-0] andH_sf1= 2.5 T,H_sf2= 7 T forH//[001]. In these two directions, two and seven resonance modes are detected by ESR spectroscopy, respectively. Theω₁andω₂modes ofH//[11-0] can be well described by two-sublattice AFM resonance mode with two zero-field gaps at 94.51 GHz and 169.28 GHz, indicating a hard-axis feature. The seven modes forH//[001] are partially separated by the critical fields ofH_sf1andH_sf2, displaying the two signs of spin-flop transition. The fittings ofω_c1andω_c2modes yield zero-field gaps at 69.50 GHz and 84.73 GHz forH//[001], confirming the axis-type anisotropy. The saturated moment and gyromagnetic ratio indicate the Mn²⁺ion inα-Mn₂V₂O₇is in a high spin state with orbital moment completely quenched. A quasi-one-dimensional magnetism with a zig-zag-chain spin configuration is suggested inα-Mn₂V₂O₇, due to the special neighbor interactions caused by a distorted network structure with honeycomb layer.

Utilizing network pharmacological analysis to investigate the key targets and mechanisms of kaempferol against oxaliplatin-induced neurotoxicity

This study investigated the pharmacological mechanism of kaempferol in the treatment of oxaliplatin-induced neuropathic pain by network pharmacological method and cells experiment. The kaempferol and disease target genes were obtained from several databases, including TCMSP, SwissTargetPrediction, GeneCards, and CTD. Then, the common target genes of drugs and diseases were obtained using Venny online tools. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional analyses were carried out to obtain the enriched molecular pathways associated with the kaempferol and disease. Finally, we constructed a neuropathic pain cell experiment to confirm the findings. 138 intersection targets were identified between targets of kaempferol and oxaliplatin-induced neurotoxicity. Enrichment analyses revealed that the IL-17 signaling pathway was associated with the therapeutic effects of kaempferol. Kaempferol down-regulated the mRNA expression levels of TNF-α, IL-6, and CCL2 in oxaliplatin-treated astrocytes. Our findings showed that kaempferol alleviated oxaliplatin-induced neurotoxicity via regulation of inflammation-related genes.

CAFs-derived small extracellular vesicles circN4BP2L2 promotes proliferation and metastasis of colorectal cancer via miR-664b-3p/HMGB3 pathway

Our previous research has demonstrated that colorectal cancer (CRC) progression was promoted by circN4BP2L2. This study aimed to further explore the mechanism of circN4BP2L2 in the development of CRC from the perspective of small extracellular vesicles (sEVs). Cancer-associated fibroblasts cell (CAFs) and normal fibroblasts cell (NFs) were isolated from CRC tissues and adjacent tissues, respectively. The ultra-centrifugation was used for extraction of their related sEVs. Cell proliferation and apoptosis were analyzed using CCK-8 and flow cytometry, respectively. Transwell assay was conducted to measure cell migration. The tube formation ability was assessed by tube formation assay. The target relationships between circN4BP2L2 and miR-664b-3p, and miR-664b-3p and HMGB3 were validated by dual-luciferase reporter detection. The effect of CAFs-derived sEV (CAFs-sEVs) circN4BP2L2 on CRC was further studied in nude mice. CAFs-exo promoted cell proliferation, migration, tube formation ability, and inhibited apoptosis of CRC cells. CAFs-sEV circN4BP2L2 knockdown reversed the above results. CircN4BP2L2 directly targeted miR-664b-3p, and HMGB3 was targeted by miR-664b-3p. Moreover, subcutaneous tumorigenesis and liver metastasis of nude mice with CRC were repressed by CAFs-sEV circN4BP2L2 knockdown. CAFs-sEV circN4BP2L2 knockdown restrained CRC cell proliferation and migration by regulating miR-664b-3p/HMGB3 pathway.

Effectiveness of eHealth Self-management Interventions in Patients With Heart Failure: Systematic Review and Meta-analysis

Background

Heart failure (HF) is a common clinical syndrome associated with substantial morbidity, a heavy economic burden, and high risk of readmission. eHealth self-management interventions may be an effective way to improve HF clinical outcomes.

Objective

The aim of this study was to systematically review the evidence for the effectiveness of eHealth self-management in patients with HF.

Methods

This study included only randomized controlled trials (RCTs) that compared the effects of eHealth interventions with usual care in adult patients with HF using searches of the EMBASE, PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), and CINAHL databases from January 1, 2011, to July 12, 2022. The Cochrane Risk of Bias tool (RoB 2) was used to assess the risk of bias for each study. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria were used to rate the certainty of the evidence for each outcome of interest. Meta-analyses were performed using Review Manager (RevMan v.5.4) and R (v.4.1.0 x64) software.

Results

In total, 24 RCTs with 9634 participants met the inclusion criteria. Compared with the usual-care group, eHealth self-management interventions could significantly reduce all-cause mortality (odds ratio [OR] 0.83, 95% CI 0.71-0.98, P=.03; GRADE: low quality) and cardiovascular mortality (OR 0.74, 95% CI 0.59-0.92, P=.008; GRADE: moderate quality), as well as all-cause readmissions (OR 0.82, 95% CI 0.73-0.93, P=.002; GRADE: low quality) and HF-related readmissions (OR 0.77, 95% CI 0.66-0.90, P<.001; GRADE: moderate quality). The meta-analyses also showed that eHealth interventions could increase patients’ knowledge of HF and improve their quality of life, but there were no statistically significant effects. However, eHealth interventions could significantly increase medication adherence (OR 1.82, 95% CI 1.42-2.34, P<.001; GRADE: low quality) and improve self-care behaviors (standardized mean difference –1.34, 95% CI –2.46 to –0.22, P=.02; GRADE: very low quality). A subgroup analysis of primary outcomes regarding the enrolled population setting found that eHealth interventions were more effective in patients with HF after discharge compared with those in the ambulatory clinic setting.

Conclusions

eHealth self-management interventions could benefit the health of patients with HF in various ways. However, the clinical effects of eHealth interventions in patients with HF are affected by multiple aspects, and more high-quality studies are needed to demonstrate effectiveness.

Mechanism of Oxidization of Graphite to Graphene Oxide by the Hummers Method

The mechanism of oxidizing reaction in the preparation of graphene oxide (GO) by a chemical oxidation method remains unclear. The main oxidant of graphite oxide has not been determined. Here, we show a new mechanism in which Mn₂O₇, the main oxidant, is heated to decompose oxygen atoms and react with graphite. The whole preparation process constitutes of four distinct independent steps, different from the three steps of literature registration, and each step has its own chemical oxidation reaction. In the first step, concentrated sulfuric acid and nitric acid are intercalated between graphite layers in the form of a molecular thermal motion to produce HNO₃-H₂SO₄-GIC. In the second step, Mn₂O₇ is intercalated between graphite layers in the molecular convection-diffusion to Mn₂O₇-H₂SO₄-GIC. In the third step, Mn₂O₇ is decomposed by heat. Oxygen atoms are generated to oxidize the defects in the graphite layer to PGO. This discovery is the latest and most important. In the fourth step, PGO is purified with deionized water, hydrogen peroxide, and hydrochloric acid to GO. Optical microscopy, ultraviolet-visible spectroscopy, Fourier transform infrared spectroscopy, X-ray diffraction spectrometry, and scanning electron microscopy analytical evidence was used for confirming Mn₂O₇ as the main oxidant and the structure of GO. This work provides a more plausible explanation for the mechanism of oxidizing reaction in the preparation of GO by a chemical oxidation method.

CAFs-secreted exosomal cricN4BP2L2 promoted colorectal cancer stemness and chemoresistance by interacting with EIF4A3

Cancer-associated fibroblasts secreted exosomes (CAFs-exo) are important for tumor carcinogenesis and chemoresistance, but its underlying mechanism in colorectal cancer (CRC) has not yet been clarified. In this study, we investigated the regulatory mechanism of CAFs-exo cricN4BP2L2 on the proliferation, apoptosis, stemness and chemoresistance of LoVo cells. We found that CAFs-exo promoted the oxaliplatin resistance and stemness of LoVo cells, while inhibited the LoVo cell apoptosis. Moreover, knockdown of cricN4BP2L2 in CAFs-exo inhibited the oxaliplatin resistance and stemness characteristics of LoVo cells. Mechanistically, cricN4BP2L2 regulated PI3K/AKT/mTOR axis by binding to EIF4A3. Rescue experiments proved that CAFs-derived exosomal cricN4BP2L2 promoted CRC cells stemness and oxaliplatin resistance by upregulating EIF4A3. Moreover, in vivo experiments showed that depletion of cricN4BP2L2 suppressed CRC tumorigenesis growth. In conclusion, CAFs-exo cricN4BP2L2 promoted the CRC cells stemness and oxaliplatin resistance through EIF4A3/PI3K/AKT/mTOR pathway.

Cannabinoid Receptor-1 suppresses M2 macrophage polarization in colorectal cancer by downregulating EGFR

Cannabinoid receptors, CB1 and CB2, have been implicated as emerging targets for cancer therapy. Herein, we investigated the potential regulation mechanism of CB1 and its implications in colorectal cancer. CB1 and EGFR expression were examined in colorectal cancer cell lines. The effects of CB1 agonist ACEA and its antagonist AM251 on the proliferation, migration and invasion of colorectal cancer cells and the expression of M1 and M2 macrophage markers were examined. EGFR overexpression was performed with plasmids containing EGFR gene. Tumor xenografts were constructed to explore the effects of CB1 activation on tumorigenesis. We showed that CB1 was downregulated while EGFR was upregulated in colorectal cancer cells. The activation of CB1 suppressed the proliferation, migration and invasion of colorectal cancer cells and the differentiation of M2 macrophages, while CB1 inhibition had opposite effects. Moreover, the alterations in tumorigenesis and M2 macrophage activation induced by CB1 activation were counteracted by EGFR overexpression. Besides, CB1 silencing promoted tumor cell proliferation and M2 polarization which was counteracted by EGFR knockdown. In vivo, CB1 activation also repressed tumorigenesis and M2 macrophage activation. The present study demonstrated that CB1 activation suppressed M2 macrophage through EGFR downregulation in colorectal cancers. These findings first unveiled the potential avenue of CB1 as a targeted therapy for colorectal cancer.

The molecular basis of spinocerebellar ataxia type 48 caused by a de novo mutation in the ubiquitin ligase CHIP

The spinocerebellar ataxias (SCAs) are a class of incurable diseases characterized by degeneration of the cerebellum that results in movement disorder. Recently, a new heritable form of SCA, spinocerebellar ataxia type 48 (SCA48), was attributed to dominant mutations in STIP1 homology and U box-containing 1 (STUB1); however, little is known about how these mutations cause SCA48. STUB1 encodes for the protein C terminus of Hsc70 interacting protein (CHIP), an E3 ubiquitin ligase. CHIP is known to regulate proteostasis by recruiting chaperones via a N-terminal tetratricopeptide repeat domain and recruiting E2 ubiquitin-conjugating enzymes via a C-terminal U-box domain. These interactions allow CHIP to mediate the ubiquitination of chaperone-bound, misfolded proteins to promote their degradation via the proteasome. Here we have identified a novel, de novo mutation in STUB1 in a patient with SCA48 encoding for an A52G point mutation in the tetratricopeptide repeat domain of CHIP. Utilizing an array of biophysical, biochemical, and cellular assays, we demonstrate that the CHIPA52G point mutant retains E3-ligase activity but has decreased affinity for chaperones. We further show that this mutant decreases cellular fitness in response to certain cellular stressors and induces neurodegeneration in a transgenic Caenorhabditis elegans model of SCA48. Together, our data identify the A52G mutant as a cause of SCA48 and provide molecular insight into how mutations in STUB1 cause SCA48.

Substance P modulates BMSCs migration for tissue repair through NK-1R/CXCR4/p-Akt signal activation

BACKGROUND

The migration of bone marrow-derived mesenchymal stem cells (BMSCs) to the wound site played an important role in tissue repair. Substance P (SP) has been studied and reported to be involved in tissue repair by promoting the growth of endothelial cells and the migration of BMSCs. However, the complicated process and the molecular mechanisms were not fully understood. Thus, we aimed to investigate the effect of SP-induced BMSCs migration on tissue repair and its possible mechanism.

METHODS AND RESULTS

Western blot and q-PCR assay revealed that SP could induce the BMSCs migration through overexpression of CXCR4 and upregulation of Akt phosphorylation. And the upregulation was related to the activation of neurokinin-1 receptor (NK-1R). Besides, we found that the increased phosphorylation Akt caused by SP could be canceled by the inhibition of CXCR4 both in vitro and in vivo. Furthermore, a skin-injury animal model was established and used to observe the tissue repair process. Results showed that SP could accelerate wound closure, gain more granulation tissue accumulation, and more collagen deposition through the promotion of angiogenesis and induction of the BMSCs migration to the wound site. And these effects could be impaired by inhibition of CXCR4 and p-Akt.

CONCLUSIONS

Our results suggested that SP promoted tissue repair through BMSCs migration via upregulation of CXCR4 and p-Akt. The expression of CXCR4 and p-Akt were regulated by NK-1R activation. These findings add more evidence in understanding the mechanisms of SP-induced BMSCs migration and highlight the potential for clinical implementation of SP in tissue repair.

Stepwise extraction of Fe, Al, Ca, and Zn: A green route to recycle raw electroplating sludge

Electroplating sludge is a hazardous waste produced in large quantities in the electroplating industry during production. It is rich in heavy metal resources and can be recovered as value-added heavy metal products. To recover Zn in electroplating sludge, Fe/Al/Ca impurities were effectively removed as hematite, boehmite, and calcium sulfate, respectively, via a facile hydrothermal method with reduction of nitric acid by addition of glucose. After the sludge was dissolved in nitric acid, the generated solution contained 6.1 g/L of Zn, 2.2 g/L of Fe, 2.5 g/L of Al, and 2.9 g/L of Ca. First, approximately 100% Fe was extracted as hematite nanoparticles containing 94.6 wt% Fe₂O₃ after the solution was treated at 190 °C for 6 h. Second, when the temperature was elevated to 270 °C, nearly 99% Al was isolated as boehmite particles containing 95.2 wt% Al₂O₃. Third, more than 98% Ca was removed as anhydrite, which contained 95.9 wt% CaSO₄, by adding sulfuric acid. During the steps, the total loss of Zn was less than 3%, and 5.75 g/L of residual Zn was recovered as zincite containing 92.2 wt% ZnO by adjusting the pH to 8. The dissolved Fe, Al, and Ca impurities were successfully removed as purified hematite, boehmite, and anhydrite, respectively, through the stepwise separation method by adjusting reaction temperatures and pH. The high content of Zn in the electroplating sludge was finally purified as zincite.

Case Report. Cryoglobulin Hyaline-thrombi Associated Acute Jejunitis in A Patient with Type 2 Cryoglobulinemic Glomerulonephritis

Introduction/Objective

Only one prior case report indicates that mixed positive cryoglobulin in serum can be associated with intestinal vasculitis (Annals of Internal Medicine, 1974).

Methods/Case Report

We report a 63-year old man with history of positive serum cryoglobulin and hepatitis-C 4 years ago and membranoproliferative pattern of glomerulonephritis with possible cryoglobulin type of deposits by electron microscopy on renal biopsy. After treatment, his hepatitis C became negative. But he was recently found to have monoclonal IgM-kappa and positive cryoglobulin in his serum, and the concurrent renal biopsy showed membranoproliferative pattern of glomerulopathy with many hyaline-thrombi (eosinophilic vascular occlusions with no lamination, inflammatory cells or nuclear debris) in the glomerular capillary loops (Figure, left panel). Both immunofluorescent and electron microscopy confirmed a mixed IgG polyclonal and IgM monoclonal type 2 cryglobulinemic glomerulonephritis. The patient also developed abdominal pain and underwent intestinal endoscopy with biopsy. His jejunal biopsy revealed neutrophil infiltration into glands and surface epithelium, with superficial sloughed epithelial cells, consistent with acute jejunitis with features of ischemic etiology. In addition, hyaline-thrombi were identified in the submucosal vessels with surrounding vasculitis (Figure, right panel); the central part of thrombi was morphologically similar to that found in glomerular capillary loops. Therefore, we conclude that cryoglobulin associated hyaline-thrombi were the most likely etiology to cause the acute ischemic jejunitis in this patient.

Results (if a Case Study enter NA)

NA

Conclusion

NA

GATA3 Is a Useful Immunohistochemical Marker to Differentiate Variants of Renal Tubular Lesions from Different Segments of Renal Tubules

Introduction/Objective

GATA3 is found in glomerular mesangial cells, and the distal tubules & collecting ducts in metanephros and eventual kidneys, but not associated with the proximal tubules and loops of Henle. We hypothesize that GATA3 can be used as a marker to identify the origin of tubular differentiation in most renal tumors.

Methods/Case Report

Ten negative controls and 43 renal mass lesions (RCC, papillary, clear cell papillary, and chromophobe carcinomas, oncocytoma, and polycystic kidney disease). GATA3 nuclear stain was graded as negative (absent stain), equivocal and positive (&lt; 5 and &gt; 5% cells, respectively). Details of their GATA3 nuclear expression was analyzed for identifying their tubular segmental origins.

Results (if a Case Study enter NA)

In 10 normal renal parenchyma, GATA3 was positive in mesangial cells, distal tubules, and collecting ducts, but was negative in the proximal tubules and loop of Henle. The cystic lining of glomerulocystic renal disease was stained negatively for GATA3 (proximal tubular origin), whereas pediatric and adult variants of polycystic kidney diseases was positive for GATA3 staining (distal tubular origin). 1/10 ten clear cell RCC and papillary RCC showed focal positive GATA3 stain. GATA3 showed weakly positive staining in some oncocytomas (4/11) and some chromophobe RCC (4/11), indicating that they might be derived from the junctional segment between the loop of Henle and the distal tubules. By contrast, all clear cell papillary RCC (distal tubule origin) were diffusely positive.

Conclusion

Our results indicate that GATA3 is a useful immunohistochemical marker to determine the developmental origin in the specific renal tubular segment for the majority of renal mass lesions. Thus, it may be useful for routine differential diagnosis of these lesions.

Increased Activated Plasma Cells in Inflammatory Bowel Disease When Compared to Ischemic Acute Colitis

Introduction/Objective

Inflammatory bowel disease (IBD) and acute ischemic colitis can both be involved by active colitis. IBD is characterized by crypt architectural distortion, basal lymphoplasmacytosis, and occasional granulomatous changes. However, diagnosis of IBDs is still largely by exclusion of other types of active colitis with similar changes. We previously demonstrated that glucose regulated protein 94 (grp94) is mainly expressed by activated plasma cells. We postulate that increased numbers of grp94-positive plasma cells may support diagnosis of IBDs. Here, we compared IBD and active ischemic colitis for grp94 expression in mucosal plasma cells of colectomy specimens

Methods/Case Report

Tissue sections from colectomy specimens with active IBD (n = 8) and ischemic colitis (n = 7) were examined for grp94 expression by immunohistochemistry (monoclonal antibody clone 9G10 at dilution of 1:200, Enzo Life Science, Inc Farmindale, NY). The staining intensity and highest number of grp94 in plasma cells per high power field was counted and recorded for each case, and combined scores were calculated as # of plasma cells multiplied by staining intensity (ranging from 0 to 3+). Unpaired student T tests were used to compare these indices between the two groups for statistical significance (p value &lt; 0.05 was considered significantly different)

Results (if a Case Study enter NA)

Plasma cells in lamina propria identified by grp94 staining showed higher intensity in IBD than ischemic groups. The number of plasma cells and combined scores were also significantly higher in the IBC group than that of ischemic group

Conclusion

Our data indicates that active plasma cells are much more numerous in IBD than ischemic colitis, supporting the notion that active plasma cells are involved in the development of this disease process. Morphologically, active colitis with increased number of plasma cells appears to be another index favoring the diagnosis of IBD.

Utilization of 2D Barcode Technology to Create Surgical Pathology Reports

Introduction/Objective

After professional transcription service is eliminated, pathologists inevitably undertake the task of diagnostic data entry into pathology repot by adapting a variety of methods such as speech recognition, manual typing, and pre-texted command. Errors and inefficiency in reporting remain common problems, especially for information with unusual syntax such as genotype or nucleotide sequences. To overcome these shortcomings, we introduce here a novel application of a well-established technology as a complementary method, namely 2- dimensional (2D) barcode symbology.

Methods/Case Report

Commonly used diagnostic wordings of pathology reports including specimen type, surgical procedure, diagnosis, and test results are collated and organized by organ (specimen type) and by their frequency of usage/occurrence. Next, 2D data matrix barcodes are created for these diagnostic wordings using a on-line tool (www.free-barcode-generator.net/datamatrix/). The 2D barcodes along with their text are displayed on the computer screen (or printed out as a booklet). A 2D barcode scanner (Symbol LS2208, Motorola) was used to retrieve the text information from the barcodes and transfer into the pathology report. To assess the efficacy of this barcode method, we evaluated the time of data entry into reports for 117 routine cases using an on-line stopwatch and compared with those by other data entry methods.

Results (if a Case Study enter NA)

Unlike manual typing or speech recognition, the barcode method did not introduce typographic or phonosemantic errors since the method simply transferred pre-texted and proof-read text content to report. It was also faster than manual typing or speech recognition, and its speed was comparable to that of the pre-text method integrated in LIS but did not require human memorization of innumerable text commands to retrieve desired diagnosis wordings.

Conclusion

Our preliminary results demonstrated that the diagnostic data entry time was reduced from 28.5% by other methods to 22.1% by the barcode method although due to the small sample size, statistical analysis was not conclusive.

The Effect of Emotional Labor on Presenteeism of Chinese Nurses in Tertiary-Level Hospitals: The Mediating Role of Job Burnout

Background: Employees who are physically present but work insufficiently because of illness are deemed as having presenteeism. In the health care setting, the issue has taken on greater importance because of the impairment of the physical and mental health of nurses and the nursing safety of the patients. According to the Job Demand-Resource Model, burnout may link emotional labor with presenteeism. Thus, this study analyzed the role of burnout as a mediating factor between the three types of emotional labor strategies and presenteeism among nurses in tertiary-level hospitals. Methods: A cross-sectional study of 1,038 nurses from six Chinese hospitals was conducted. The questionnaires, including the 14-item emotional labor strategies scale, 22-item Maslach Burnout Inventory scale, 6-item Stanford Presenteeism Scale, and items about demographic characteristics and work-related factors, were used to collect data. A multivariable linear regression was used to predict work-related factors and investigate the correlation of emotional labor, burnout, and presenteeism. The structural equation model was implemented to test the mediating effects of job burnout. Results: The results of the study showed that the average presenteeism score of the participants was 14.18 (4.33), which is higher than in Spanish, Portuguese, and Brazilian nurses. Presenteeism was explained by 22.8% of the variance in the final model in multivariable linear regression (P < 0.01). Presenteeism was found to be positively correlated with surface acting, emotionally expressed demands, deep acting, emotional exhaustion, depersonalization, and low personal accomplishment (P < 0.01). Notably, presenteeism was negatively correlated with deep acting (P < 0.01). In addition, burnout partially mediated the correlation between emotionally expressed demands, deep acting, and presenteeism with a mediatory effect of 24 and 63.31% of the total effect. Burnout completely mediated the association between surface acting and presenteeism, a mediating effect of 86.44% of the total effect. Conclusions: The results of this study suggested that different emotional labor strategies affect presenteeism, either directly or indirectly. Nursing managers should intervene to reduce presenteeism by improving the ability of the nurses to manage emotions, thereby alleviating burnout.

ERK/Drp1-dependent mitochondrial fission contributes to HMGB1-induced autophagy in pulmonary arterial hypertension

OBJECTIVES

High-mobility group box-1 (HMGB1) and aberrant mitochondrial fission mediated by excessive activation of GTPase dynamin-related protein 1 (Drp1) have been found to be elevated in patients with pulmonary arterial hypertension (PAH) and critically implicated in PAH pathogenesis. However, it remains unknown whether Drp1-mediated mitochondrial fission and which downstream targets of mitochondrial fission mediate HMGB1-induced pulmonary arterial smooth muscle cells (PASMCs) proliferation and migration leading to vascular remodelling in PAH. This study aims to address these issues.

METHODS

Primary cultured PASMCs were obtained from male Sprague-Dawley (SD) rats. We detected RNA levels by qRT-PCR, protein levels by Western blotting, cell proliferation by Cell Counting Kit-8 (CCK-8) and EdU incorporation assays, migration by wound healing and transwell assays. SD rats were injected with monocrotaline (MCT) to establish PAH. Hemodynamic parameters were measured by closed-chest right heart catheterization.

RESULTS

HMGB1 increased Drp1 phosphorylation and Drp1-dependent mitochondrial fragmentation through extracellular signal-regulated kinases 1/2 (ERK1/2) signalling activation, and subsequently triggered autophagy activation, which further led to bone morphogenetic protein receptor 2 (BMPR2) lysosomal degradation and inhibitor of DNA binding 1 (Id1) downregulation, and eventually promoted PASMCs proliferation/migration. Inhibition of ERK1/2 cascade, knockdown of Drp1 or suppression of autophagy restored HMGB1-induced reductions of BMPR2 and Id1, and diminished HMGB1-induced PASMCs proliferation/migration. In addition, pharmacological inhibition of HMGB1 by glycyrrhizin, suppression of mitochondrial fission by Mdivi-1 or blockage of autophagy by chloroquine prevented PAH development in MCT-induced rats PAH model.

CONCLUSIONS

HMGB1 promotes PASMCs proliferation/migration and pulmonary vascular remodelling by activating ERK1/2/Drp1/Autophagy/BMPR2/Id1 axis, suggesting that this cascade might be a potential novel target for management of PAH.

Resource Recycling of Mn-Rich Sludge: Effective Separation of Impure Fe/Al and Recovery of High-Purity Hausmannite

Groundwater treatment sludge is a Fe/Mn-rich waste generated in mass production in a groundwater treatment plant for potable water production. The conventional disposal of sludge, such as direct discharge into river/lake, sea, and landfill, is not environmentally sustainable. Herein, a novel method was proposed to effectively separate Fe/Al and recover Mn via a combined hydrochloric acid leaching and hydrothermal route. The sludge contained 14.6% Fe, 6.3% Mn, and 11.5% Al and was first dissolved in 5 M HCl to prepare a leaching solution. Second, the leaching solution was hydrothermally treated, in which 97.1% Fe and 94.8% Al were precipitated as hematite and boehmite and more than 98% Mn was kept. Increasing the reaction temperature to 270 °C was beneficial for Fe/Al removal. With the consumption of abundant H+, the reaction of added glucose and nitrate accelerated as the temperature increased. An optimal pH was utilized for Fe/Al hydrolysis and crystallization, leading to extensive removal of Fe/Al. Third, the residual solution was adjusted to pH 8.3 with NaOH, and approximately, 99.2% Mn was removed as hausmannite with a Mn content of 63.6%. This method exhibited efficient separation of impure Fe/Al from Mn-rich groundwater treatment plant iron mud, and the recycled high-purity hausmannite was a marketable active pharmaceutical ingredient.

Prognostic and clinicopathological role of long noncoding RNA NORAD in various cancers: a meta-analysis

Aim: Long noncoding RNA (lncRNA) noncoding RNA activated by DNA damage (NORAD) is widely investigated in different tumors. Our meta-analysis intends to assess the prognostic and clinicopathological value of NORAD in cancers. Materials & methods: We searched PubMed, Web of Science, Embase and Chinese National Knowledge Infrastructure from inception to 1 August 2020. Results: The results showed that higher expression of NORAD had a significant association with worse overall survival. Additionally, correlations were detected between elevated level of NORAD and poor differentiation degree, positive lymph node metastasis and large tumor size in cancer patients. Conclusion: LncRNA NORAD can serve as a novel and promising biomarker for prognosis and clinicopathological characteristics in different cancers.

A facile calcination conversion of groundwater treatment sludge (GTS) as magnetic adsorbent for oxytetracycline adsorption

In this paper, groundwater treatment sludge (GTS) was recycled as a magnetic adsorbent via a facile calcination process without adding any reductant. The prepared magnetic adsorbents (MAs) were characterized by scanning electron microscopy (SEM), X-ray diffractometer (XRD) and X-ray photoelectron spectroscopy (XPS), vibrating sample magnenometer (VSM) and Mössbauer spectroscopy. The results showed that GTS comprised 33.2% Fe, 1.4% Al and 6.2% Si, and exhibited a weak saturation magnetization of 0.0008 emu/g. Without NaOH, the GTS calcinated at 700 and 500 °C were well magnetized with Ms of 20.1 and 7.1 emu/g, separately, but exhibited a low Ms of 0.43 emu/g at 300 °C. By adding NaOH powder, the Ms of GTS apparently increased to 4.9 emu/g after calcination at 300 °C, and further to 8.5 emu/g at 500 °C. In GTS, about 96.1% Fe was involved in ferrihydrite form. The Ms of calcinated GTS was accompanied with the phase transformation of ferrihydrite to maghemite. Si/Al oxides in GTS coordinated on the surface sites of ferrihydrite and inhibited the conjunction and phase transformation of adjacent ferrihydrite particles, but were effectively desorbed as in the presence of NaOH. Na500, preparing by calcinating GTS at 500 °C with NaOH, showed an optimal total surface sites (Hs) of 0.65 mmol/g. Oxytetracycline (OTC) was used as a target for studying the adsorption characteristics of synthetic magnetic adsorbents and a high adsorption capacity of oxytetracycline of 862.1 mg/g in comparison with the other calcinated GTS, and the adsorption data was consistent with the Langmuir model. By adding 6 g/L Na-500, approximately 100% of oxytetracycline and tetracycline and nearly 40% total organic carbon were removed from real pharmaceutical wastewater. With the method, GTS can be converted in mass production to magnetic adsorbent that exhibits effective application in pharmaceutical wastewater treatment.

In vitro and in vivo human gastric cancer inhibition by Trifolirhizin is facilitated via autophagy, mitochondrial mediated programmed cell death, G2/M phase cell cycle arrest and inhibition of m-TOR/PI3K/AKT signalling pathway

Retraction of: 'In vitro and in vivo human gastric cancer inhibition by Trifolirhizin is facilitated via autophagy, mitochondrial mediated programmed cell death, G2/M phase cell cycle arrest and inhibition of m-TOR/PI3K/AKT signalling pathway', by Ke Zhang, Weidong Liu*, Zhan Qu, Qin Liu, Jie Chen, Ran Tao, Youming Deng, Yu Zhang JBUON 2019;24(3):1100-1105; PMID:31424667. Following the publication of the above article, readers drew to our attention that part of the data was unreliable. The authors were requested to provide the raw data to prove the originality, but were unable to do so. After an investigation, the Editors of JBUON decided to retract this article. We thank the readers for bringing this matter to our attention. We apologize for any inconvenience it may cause.

Hippocampal insulin resistance and the Sirtuin 1 signaling pathway in diabetes-induced cognitive dysfunction

In the peripheral nervous system, the activation of Sirtuin 1 can improve insulin resistance; however, the role played by Sirtuin 1 in the central nervous system remains unknown. In this study, rat models of diabetes mellitus were generated by a single injection of streptozotocin. At 8 weeks after streptozotocin injection, the Morris water maze test and western blot assays confirmed that the diabetic model rats had learning and memory deficits, insulin resistance, and Sirtuin 1 expression could be detected in the hippocampus. Insulin and the insulin receptor inhibitor S961 were intranasally administered to investigate the regulatory effects of insulin signaling on Sirtuin 1. The results showed that insulin administration improved the impaired cognitive function of diabetic model rats and increased the expression levels of phosphorylated insulin receptor, phosphorylated insulin receptor substrate 1, and Sirtuin 1 in the hippocampus. Conversely, S961 administration resulted in more severe cognitive dysfunction and reduced the expression levels of phosphorylated insulin receptor, phosphorylated insulin receptor substrate 1, and Sirtuin 1. The Sirtuin 1 activator SRT2104 and the inhibitor Sirtinol were injected into the lateral ventricle, which revealed that the activation of Sirtuin 1 increased the expression levels of target of rapamycin complex 1, phosphorylated cAMP-response element-binding protein, and brain-derived neurotrophic factor. Hippocampal dendritic length and spine density also increased in response to Sirtuin 1 activation. In contrast, Sirtinol decreased the expression levels of target of rapamycin complex 1, phosphorylated cAMP-response element-binding protein, and brain-derived neurotrophic factor and damaged the dendritic structure. These findings suggest that the Sirtuin 1 signaling pathway plays an important role in the development of insulin resistance-related cognitive deficits in diabetic rats. This study was approved by the Animal Ethics Welfare Committee of the First Affiliated Hospital of Hunan University of Chinese Medicine (approval No. ZYFY201811207) in November 2018.

Urinary microRNAs miR-15b and miR-30a as novel noninvasive biomarkers for gentamicin-induced acute kidney injury

MicroRNAs serve as potential biomarkers in various pathological models, and are stable and detectable in biofluids. We investigated the urinary microRNA expression profile in a gentamicin-induced acute kidney injury canine model using RNA sequencing. A total of 234 differentially expressed microRNAs were screened after 12 consecutive days of gentamicin administration (P < 0.05). Six candidate microRNAs (miR-15b, -15b-3p, -16, -30a, -30a-3p, and -30c-2-3p) were selected according to a set criterion, and validated by real-time quantitative PCR. The diagnostic values of these six candidate microRNAs were better than the traditional serum biomarkers (all P < 0.05). Further, using receiver operating characteristic curve analysis, we found that miR-15b and -15b-3p were superior to urinary kidney injury molecule-1 (both P < 0.05). Moreover, miR-15b and -30a levels in the urine samples significantly correlated with their respective levels in the kidney tissue samples (r=0.512 and 0.505, respectively, both P < 0.05). Our data concluded that miR-15b and -30a may be promising biomarkers for renal toxicity.

Niacin Metal-Organic Framework-Laden Self-Healing Hydrogel for Wound Healing

Bacterial infection is one of the most significant impediments to wound healing. To treat wounds, non-biological and non-pharmacological interventions have gained increasing importance as they are easily translatable into clinical products. In this study, we developed a niacin metal-organic frameworks (NOFs)-laden hybrid hydrogel with self-healing ability for better wound healing. The copper based-NOFs (Cu-NOFs) and zinc based-NOFs (Zn-NOFs) were constructed and encapsulated into the self-healing hydrogels, which could prevent NOFs from directly interacting with protein-containing solutions (e. g., tissue fluid). The hydrogel was prepared by using four-armed benzaldehyde-terminated polyethylene glycol (BAPEG) and carboxymethyl chitosan (CMC). Our results showed that the hydrogel gained self-healing ability through reversible Schiff base reaction. In addition, after loading NOFs, the hybrid hydrogel exerted significant effects on antibacterial and antioxidant activities. The in vivo studies demonstrated that the hybrid hydrogel could alleviate inflammation and enhance the formation of granulation tissue, collagen and vascular tissue, thereby promoting wound closure in rats with E. coli -infected wounds. Overall, this study highlights the tremendous potential for the clinical implementation of NOFs-laden hydrogel with good self-healing, antibacterial and antioxidant properties in wound healing.

Management of cN0 papillary thyroid microcarcinoma patients according to risk-scoring model for central lymph node metastasis and predictors of recurrence

BACKGROUND

The role of routine prophylactic central neck dissection (pCND) in clinically lymph node-negative (cN0) papillary thyroid microcarcinoma (PTMC) patients remains controversial. This retrospective study aimed to identify the clinical and pathologic factors of central lymph node metastasis (CLNM) and recurrence in PTMC patients.

METHODS

A total of 371 cN0 PTMC patients from two hospitals were retrospectively analyzed. All patients underwent thyroidectomy plus pCND between January 2010 and January 2018. Clinicopathological features were collected, univariate and multivariate analyses were performed to determine the risk factors of CLNM. A scoring model was constructed on the basis of the results of independent risk factors of CLNM. The Cox proportional hazards model was used to analyze the risk factors of recurrence.

RESULTS

CLNM occurred in 123 (33.2%) patients. Multivariate analysis showed male, tumor size > 0.75 cm, multifocality, extrathyroidal extension (ETE) and tumor in the middle/lower pole were independent risk predictors of CLNM (P < 0.05). A seven-point risk-scoring model was established to predict the stratified CLNM in cN0 PTMC patients. Multivariate Cox regression model showed ETE, vascular invasion and CLNM were independent risk predictors of recurrence (P < 0.05).

CONCLUSION

Our study suggested that routine pCND should be performed for cN0 PTMC patients with score ≥ 3 according to the risk-scoring model. Moreover, patients with risk factors of recurrence should consider more complete treatment and more frequent follow-up.

Multivariate analysis of factors for failed continuous bladder irrigation in hemorrhagic cystitis patients after hematopoietic stem cell transplantation

Background

Continuous bladder irrigation (CBI) and proper adjustment of saline irrigation speed are important to avoid CBI failure in hemorrhagic cystitis (HC) patients after allogeneic hematopoietic stem cell transplantation (HSCT). Nevertheless, too fast irrigation speed could take away the patient's much heat, contribute to blood coagulopathy, and increase the nursing workload. Evaluation of risk for CBI failure remains an unmet clinical need.

Methods

The general information, clinical characteristics, and consultation records of HC patients in 1380 patients with hematopoietic stem cell transplantation in our center from 2017 to 2019 were analyzed retrospectively. The receiver operating characteristic (ROC) curve was used to calculate the cutoff point of the continuous variable, and multivariate logistic regression was used to analyze the risk factors affecting CBI failure in HC patients.

Results

The incidence of HC after HSCT was 23%. A total of 227 patients with HC above grade 2 were included. Univariate analysis showed that CRP, age, platelet counts, onset time after transplantation, albumin, and hemoglobin were associated with CBI failure in the short-term (P < 0.05). ROC curve and multivariate logistic regression analysis showed that CRP > 8.89 ng/ml (RR = 7.828, 95% CI 2.885–21.244), age < 14.5 years (RR = 9.940, 95% CI 3.219–30.697), and onset time of HC > 37d after transplantation (RR = 7.021, 95% CI 2.204–22.364), were independent risk factors for failure of CBI (P < 0.05).

Conclusions

The study identified CRP > 8.89 ng/ml, age < 14.5 years, and onset time of HC after HSCT > 37d are independent factors for failure of CBI, which could be combined to allow stratification of HC after HSCT patients into low-, intermediate- and high-risk subgroups of CBI failure.

[Analysis of the hard and soft tissue following immediate and early implant placement in the anterior area of maxilla]

Objective: To compare the difference of soft and hard tissue changes between immediate implant and early implant placement in maxillary anterior region, so as to provide the basis for the selection of implant timing and surgical method for patients in clinical maxillary anterior dental esthetic zone. Methods: From January 2016 to January 2019, 89 patients [48 males and 41 females, aged (38.0±13.3) years] with dentition defect and single tooth implant restoration in the Department of Oral Implantology, Dalian Stomatological Hospital were retrospectively collected. The patients were divided into three groups according to different implant timing and operation methods: immediate implant flapless group (26 cases), immediate implant flap group (30 cases) and early implant group (33 cases, early implant 4-8 weeks after tooth extraction). The operation time, intraoperative and postoperative complications were compared among the three groups. Cone-beam CT was taken before operation, immediately after operation and 6 months after operation. The bone plate thickness immediately after implantation, bone plate thickness at 6 months after operation and absorption amount of bone plate thickness at labial side (immediately after operation minus 6 months after operation) were measured, and the absorption rate of labial bone plate was calculated. Three dimensional quantitative analysis was performed on the lip bone increment, residual bone volume (6 months after operation minus preoperative), and bone volume absorption rate of the three groups immediately after operation by using GuideMia, PlastyCAD and Geomagic engineering software. The pink and white esthetic indexes of the three groups were evaluated at 9 months and 15 months after implant placement. The implant stability quotient (ISQ) value was measured at 6 months after implantation, and the patients' satisfaction with the whole treatment process was investigated at 6 months after implantation. Results: The operation time of immediate implant flapless group was the shortest, the median (lower quartile, upper quartile) was 36.5 (33.3, 38.5) min. At 9 months after operation, PES was relatively high [8.5 (8.0, 9.0)], and the final patient satisfaction was 8.0 (7.3, 8.8), and the difference was statistically significant compared with the other two groups (P<0.05). There was no significant difference in the incidence of intraoperative and postoperative complications among the groups (P>0.05). At 6 months after operation, the thickness of labial bone plate in early group was 3.09 (3.00, 3.25) mm, which was greater than that in the immediate non flap group [1.90 (1.72, 2.33) mm] and that in the immediate implant flap group [2.39 (2.05, 3.06) mm], and the difference was statistically significant (P<0.05). The absorption of labial bone thickness in immediate implant flapless group [0.61 (0.35, 0.98) mm] was significantly lower than that in the immediate implant flap group [1.13 (0.97, 1.53) mm] and that in the early implant group [1.23 (1.07, 1.37) mm] (P<0.05). After 6 months, the residual bone volume of immediate flapless group was 38.7 (31.2, 54.6) mm³ and was significantly different from that in early implant group [109.1 (85.6, 263.1) mm³] (P<0.05), and there was no significant difference in the residual bone volume between immediate implant flapless group and immediate implant flap group (P>0.05). Conclusions: Immediate implant can reduce the treatment time with equal esthetic outcome of implant supported restoration of anterior teeth, and patients prefer it more. The bone volume of lip side was not significantly increased after immediate flap operation, and the bone absorption was less after immediate flap operation. Early implant placement can better maintain the three-dimensional bone mass, and the three groups can obtain good clinical results in the short term, but the long-term effect needs further follow-up study.

Effective recycling of Cu from electroplating wastewater effluent via the combined Fenton oxidation and hydrometallurgy route

Heavy metals, which commonly occur in complex forms, are difficult to remove in alkali electroplating wastewater effluent, and their resource recycling is rarely reported. Here, a Cu-bearing alkali wastewater effluent was effectively treated through Fenton oxidation, and the generated Fenton sludge was recycled into highly pure tenorite and hematite particles. The effluent contained 1.51 mg/L Cu and was subjected to Fenton oxidation, pH adjustment and coagulation. Amongst the three methods, Fenton oxidation showed superior efficiency to Cu removal, and the residual Cu in the effluent was 0.06 mg/L, thereby meeting the discharge standard for electroplating wastewater. However, Cu removal achieved less than 20% after pH adjustment and coagulation. Cu-bearing sludge, which was generated through the Fenton process, was dissolved in a mixture of hydrochloric and nitric acids. The dissolved solution contained 1.92 g/L Cu and 73.6 g/L Fe impurity. Impure Fe (67.4%) was removed as hematite aggregates after the solution was directly treated via a hydrometallurgy route, whilst 99.2% Cu was kept. When 0.5 mL of methanol was introduced to the hydrometallurgy system, nearly 100% Fe was removed as hematite nanoparticles with 94.8% purity, whilst more than 98% Cu was kept. The residual Cu was 1.88 g/L and precipitated as a tenorite block with a CuO content of 91.1% by adjusting the treated solution to pH 9. This study presented an environment-friendly method for enriching Cu from electroplating wastewater effluent without generating any waste.

Applications of Micro-Indentation Technology to Estimate Fracture Toughness of Shale

The fracture toughness of shale is a basic parameter that can provide effective theoretical support for wellbore stability and hydraulic fracturing of a shale reservoir. Due to the composition and microstructure, there are many problems in evaluating the mechanical properties of shale in a macroscopic test. In this paper, the composition and pore distribution of shale were studied by X-ray diffraction and nuclear magnetic resonance. Scanning electron microscopy was used to characterize the pore structure. The setting of experimental parameters and the selection of the indenter were discussed. Micro-indentation technique was proposed and applied to fracture toughness analysis of shale. The results show that Berkovich indenter is more suitable for shale indentation test than Vickers indenter. Fracture toughness of shale indentation is obviously affected by surface roughness and indentation position. Fracture toughness of shale decreases slightly with the increase of the indentation load. The energy analysis result presents that the effect of cracking on the ratio of total/unloading work is minimal when there is no significant stripping on the shale surface. Compared with the experimental method, energy methods can obtain all the analysis parameters from a single indentation test. The results of comparative analysis with macroscopic experiments display that micro-indentation test can effectively predict the macroscopic fracture toughness of shale.

[Risk factors of permanent stoma in rectal cancer patients undergoing transabdominal anterior resection with temporary stoma]

Objective: To investigate the risk factors of turning temporary stoma into permanent stoma in rectal cancer patients undergoing transabdominal anterior resection with temporary stoma. Methods: A case-control study was carried out. Data of rectal cancer patients who underwent transabdominal anterior resection with temporary stoma and completed follow-up in Department of General Surgery of Xiangya Hospital of Central South University from June 2008 to June 2018 were collected and analyzed. In this study, temporary stoma included defunctioning stoma (ostomy was made during operation) and salvage stoma (ostomy was made within one month after operation due to anastomotic leakage or severe complications). Cases of multiple intestinal tumors were excluded. A total of 308 rectal cancer patients were enrolled in the study, including 198 males and 110 females with a median age of 56 (48-65) years. Ninety-four patients received intraperitoneal chemotherapy during operation. Among 308 patients, upper rectal cancer was observed in 64 cases, middle rectal cancer in 89 cases and low rectal cancer in 155 cases. Twenty patients underwent transverse colostomy and 288 underwent ileostomy. Phone call following-up was conducted from August to September 2019 to investigate whether stoma was reversed, causes of reversal failure, and tumor relapsed or not in detail. Permanent stoma was defined as that the stoma was still not reversed by the latest follow-up. The univariate analysis was performed with chi-square test or Fisher's exact test, and variables with P value < 0.10 were included in the non-conditional logistic regression model for multivariate analysis. Results: The median follow-up time was 54.3 (32.4-73.8) months. During follow-up, 8 cases had local recurrence and 37 cases had distant metastasis. Among the 308 patients with temporary ostomy, 247 (80.2%) patients had stomas reversed and the median interval time was 4.5 (3.5-6.1) months. The median interval time in 65 patients with salvage stoma was significantly longer that in 182 patients with defunctioning stoma [5.5 (4.3-7.5) vs. 4.2 (3.4-5.5) months; Z=-4.387, P<0.001]. The temporary ostomy was confirmed to become permanent stoma in 61 patients (19.8%), including 45 cases of defunctioning stoma and 16 cases of salvage stoma. Univariate analysis showed that preoperative anemia, intraperitoneal chemotherapy during operation, middle rectal cancer, transverse colostomy, pathological stage, postoperative local recurrence and distant metastasis were associated with permanent stoma (all P<0.10). Multivariate analysis revealed that the intraperitoneal chemotherapy during operation (OR=1.961, 95% CI: 1.029-3.738, P=0.041), middle rectal cancer (OR=2.401, 95% CI: 1.195-4.826, P=0.014), transverse colostomy (OR=3.433, 95% CI: 1.234-9.553, P=0.018), and distant metastasis (OR=8.282, 95% CI:3.820-17.954, P<0.001) were independent risk factors of permanent stoma. Conclusions: There is high risk of turning temporary stoma into permanent stoma among rectal cancer patients undergoing transabdominal anterior resection who receive intraperitoneal chemotherapy during operation, present as the middle rectal cancer, undergo transverse colostomy or develop distant metastasis. Surgeons need to evaluate and balance the risks and benefits thoroughly, and then inform the patients in order to avoid potential conflicts.

Effective recycling of Co and Sr from Co/Sr-bearing wastewater via an integrated Fe coagulation and hematite precipitation approach

Flocculant overdose has been considered an inefficient technique for precipitating heavy metals from wastewater at low levels due to the high yield of hazardous waste sludge that should be treated properly before it can be disposed of safely in landfills. This problem was effectively solved in this study via a novel method that recycles sludge separately into high-purity hematite and heavy metal-bearing products. The wastewater, which contained 10.3 mg/L of Co and 4.8 mg/L of Sr, was coagulated by adding ferric salt to generate Co/Sr-bearing sludge. The sludge was dissolved in HNO₃, followed by hydrothermal treatment with the addition of organic matter (e.g. methanol or isopropanol). Without the addition of organic matter, only 56.5% of total Fe was removed as irregular hematite particles, whilst Co/Sr remained unchanged in the acid. Over 99.5% of total Fe was eliminated as hematite nanoparticles with 97.7% Fe₂O₃ content, but more than 98% Co/Sr remained in the acid when methanol with a molar ratio (M_methanol/M_Fe) of 5 was added. Nearly 100% Co was precipitated by adjusting the pH of the acid to 8 to generate Co hydroxide with 83.9% purity. Meanwhile, the residual Sr was further precipitated by adding Na₂CO₃ to generate SrCO₃ with 96.8% purity. Isopropanol achieved total Fe removal similar to that of methanol. The optimal molar ratio (M_Isopropanol/M_Fe) was 1, which corresponded to the removal of 98.7% total Fe. Methanol and isopropanol can react with NO₃^- in acid to reduce NO₂^- concentration and improve acid pH, promoting hydrolysis followed by the crystallisation of ferric Fe with hematite as the final product. This paper is the first report on an environment-friendly method for enriching Co/Sr without generating any waste.

The ELFIN Mission

The Electron Loss and Fields Investigation with a Spatio-Temporal Ambiguity-Resolving option (ELFIN-STAR, or heretoforth simply: ELFIN) mission comprises two identical 3-Unit (3U) CubeSats on a polar (∼93^∘ inclination), nearly circular, low-Earth (∼450 km altitude) orbit. Launched on September 15, 2018, ELFIN is expected to have a >2.5 year lifetime. Its primary science objective is to resolve the mechanism of storm-time relativistic electron precipitation, for which electromagnetic ion cyclotron (EMIC) waves are a prime candidate. From its ionospheric vantage point, ELFIN uses its unique pitch-angle-resolving capability to determine whether measured relativistic electron pitch-angle and energy spectra within the loss cone bear the characteristic signatures of scattering by EMIC waves or whether such scattering may be due to other processes. Pairing identical ELFIN satellites with slowly-variable along-track separation allows disambiguation of spatial and temporal evolution of the precipitation over minutes-to-tens-of-minutes timescales, faster than the orbit period of a single low-altitude satellite (T_orbit ∼ 90 min). Each satellite carries an energetic particle detector for electrons (EPDE) that measures 50 keV to 5 MeV electrons with Δ E/E < 40% and a fluxgate magnetometer (FGM) on a ∼72 cm boom that measures magnetic field waves (e.g., EMIC waves) in the range from DC to 5 Hz Nyquist (nominally) with <0.3 nT/sqrt(Hz) noise at 1 Hz. The spinning satellites (T_spin ∼ 3 s) are equipped with magnetorquers (air coils) that permit spin-up or -down and reorientation maneuvers. Using those, the spin axis is placed normal to the orbit plane (nominally), allowing full pitch-angle resolution twice per spin. An energetic particle detector for ions (EPDI) measures 250 keV - 5 MeV ions, addressing secondary science. Funded initially by CalSpace and the University Nanosat Program, ELFIN was selected for flight with joint support from NSF and NASA between 2014 and 2018 and launched by the ELaNa XVIII program on a Delta II rocket (with IceSatII as the primary). Mission operations are currently funded by NASA. Working under experienced UCLA mentors, with advice from The Aerospace Corporation and NASA personnel, more than 250 undergraduates have matured the ELFIN implementation strategy; developed the instruments, satellite, and ground systems and operate the two satellites. ELFIN's already high potential for cutting-edge science return is compounded by concurrent equatorial Heliophysics missions (THEMIS, Arase, Van Allen Probes, MMS) and ground stations. ELFIN's integrated data analysis approach, rapid dissemination strategies via the SPace Environment Data Analysis System (SPEDAS), and data coordination with the Heliophysics/Geospace System Observatory (H/GSO) optimize science yield, enabling the widest community benefits. Several storm-time events have already been captured and are presented herein to demonstrate ELFIN's data analysis methods and potential. These form the basis of on-going studies to resolve the primary mission science objective. Broad energy precipitation events, precipitation bands, and microbursts, clearly seen both at dawn and dusk, extend from tens of keV to >1 MeV. This broad energy range of precipitation indicates that multiple waves are providing scattering concurrently. Many observed events show significant backscattered fluxes, which in the past were hard to resolve by equatorial spacecraft or non-pitch-angle-resolving ionospheric missions. These observations suggest that the ionosphere plays a significant role in modifying magnetospheric electron fluxes and wave-particle interactions. Routine data captures starting in February 2020 and lasting for at least another year, approximately the remainder of the mission lifetime, are expected to provide a very rich dataset to address questions even beyond the primary mission science objective.

Recycling of High-Purity Strontianite and Hematite from Strontium-Bearing Sludge

Sr-bearing sludge is a hazardous waste that is commonly generated by nuclear power plants and mineral refining operations. In this work, Sr-bearing sludge was simulated and then cleanly recycled into high-purity strontianite with hematite nanoparticles as a byproduct via a novel hematite precipitation route. The sludge contained 26.1% Fe, 3.5% Sr, and Si impurities. After dissolution in 1.2 M nitric acid, the sludge was treated hydrothermally with the addition of glycol to precipitate Fe effectively. Without the addition of glycol, only 52% Fe was hydrothermally precipitated in the form of hematite aggregates. With the addition of glycol at the optimal M glycol/M nitrate molar ratio of 0.4, nearly 100% Fe was removed in the form of hematite nanoparticles with an average diameter of 50 nm, whereas over 98% of Sr was retained in the leachate. The generated hematite was highly purified with an Fe2O3 content of 95.23%. Sr was present at a high concentration of 3.9 g/L in the treated leachate and further precipitated in the form of strontianite with a purity of 96.8% through Na2CO3 addition. Tertiary butanol (TeB) exhibited a similar Fe removal rate as glycol even though its optimal M TeB/M nitrate molar ratio was 0.1, which was approximately one-fourth the optimal M glycol/M nitrate molar ratio. Fe removal involved spontaneous Fe3+ hydrolysis under hydrothermal conditions and was promoted by increasing the pH of the redox reaction between nitrate and glycol and/or TeB. The method reported here successfully enabled the resource recycling of Sr-bearing sludge to generate high-purity strontianite and hematite products without producing any secondary waste.

Upcycling of groundwater treatment sludge to magnetic Fe/Mn-bearing nanorod for chromate adsorption from wastewater treatment

Groundwater treatment sludge is a Fe/Mn-bearing waste that is mass produced in groundwater treatment plant. In this study, sludge was converted to a magnetic adsorbent (MA) by adding ascorbate. The sludge was weakly magnetised in the amorphous form with Fe and Mn contents of 28.8% and 8.1%, respectively. After hydrothermal treatment, Fe/Mn oxides in the sludge was recrystallised to siderite and rhodochrosite, with jacobsite as the intermediate in the presence of ascorbate. With an increment in ascorbate dosage, the obtained magnetic adsorbent had a significant increase in chromate adsorption but a decrease in magnetisation. When the M_ascorbate/M_Fe molar ratio was 10, the produced MA-10 was a dumbbell-shaped nanorod with a length of 2–5 μm and a diameter of 0.5–1 μm. This MA-10 showed 183.2 mg/g of chromate adsorption capacity and 2.81 emu/g of magnetisation. The mechanism of chromate adsorption was surface coprecipitation of the generated Cr³⁺ and Fe³⁺/Mn⁴⁺ from redox reaction between chromate and siderite/rhodochrosite on MA-10, separately. This study demonstrated an efficient recycling route of waste sludge from groundwater treatment to produce MA for treating chromate-bearing wastewater.

Structure parameter optimization and bearing limit analysis of the expansion unit of three-roller tube expander

The critical technical issues for the structure design of three-roller tube expander were first studied and analysed in this paper. Then, the major design parameters of the expansion unit structure and the bearing limit of 12¼″ three-roller tube expander were optimized and investigated by finite-element numerical simulation method. Results from study show that the required expansion force increases when the taper angle of the roller outer surface gets larger, taking the axial expansion force as the quantitative indicators. It is suggested that the roller tape angle of the expansion unit should be in the range of 9-12° considering the proper length of the roller and the non-self-locking tube expansion process. The required expansion force of the bellows first decreases and then increases when the gauge length of the expansion unit becomes longer. The optimal value of the gauge length is 50 mm considering the proper length of the roller. And according to the numerical simulation results, the designed three-roller tube expander meets the strength requirements. The results of this study are of great significance to the expend bellows drilling technology.

Total tumor diameter: the neglected value in papillary thyroid microcarcinoma

BACKGROUND

Tumor multifocality is not uncommon in papillary thyroid carcinoma (PTC), especially in micro-PTC. However, assessing the size of the largest tumor may underestimate effect of additional foci. We aimed to investigate the effect of total tumor diameter (TTD) on clinicopathological features of micro-PTC.

METHODS

Data from 442 patients who underwent thyroidectomy with cervical lymph node dissection for PTC were retrospectively analyzed. Patients were classified into subgroups according to multifocality and TTD. The relationships of clinicopathological features among these groups were analyzed.

RESULTS

Multifocality was observed in 119 patients (26.9%). TTD > 1 cm and presence of extrathyroidal extension (ETE) were significantly higher in multifocal tumors compared to unifocal tumor (P < 0.001, P = 0.016, respectively). When comparing multifocal micro-PTC with TTD > 1 cm to those with unifocal micro-PTC or multifocal micro-PTC with TTD ≤ 1 cm, the proportions of cases with ETE, central lymph node metastasis (CLNM), and lateral lymph node metastasis (LLNM) were significantly higher (all P < 0.05). There was no significant difference in terms of these parameters between multifocal micro-PTC with TTD > 1 cm and macro-PTC or multifocal macro-PTC. The risk of CLNM was 2.056 (P = 0.044) times higher in multifocal micro-PTC with TTD > 1 cm than in unifocal micro-PTC.

CONCLUSION

For multifocal micro-PTC, TTD can better assess the aggressiveness of the tumor. Multifocal micro-PTC with TTD > 1 cm was more aggressive than unifocal micro-PTC or multifocal micro-PTC with TTD ≤ 1 cm.

[Analysis of misdiagnosis causes of suprasellar arachnoid cysts]

Objective: To investigate the causes of misdiagnosis of suprasellar arachnoid cysts, analyze its characteristics and put forward the diagnostic basis and differential points. Methods: The clinical data fo 97 cases of suprasellar arachnoid cysts diagnosed and treated in the neurosurgery department of Beijing Tiantan Hospital and Hebei General Hospital from March 2015 to March 2019 were analyzed retrospectively. All patients underwent CT and MRI scans with obstructive hydrocephalus. 13 cases were misdiagnosed, including 7 males and 6 females. First visit age 1-31 years old, with an average age of 6.3 years. There were 10 patients younger than 6 years old. The remaining 15-year-old patients, 31-year-old patients and 26-year-old patients each have one case. 11 cases were misdiagnosed as obstructive hydrocephalus, 2 cases as cystic craniopharyngioma. Results: 13 cases were misdiagnosed and mistreated, 11 cases were treated with intraventricular and abdominal shunt, 9 cases were treated with neuroendoscopy and recovered well. One cases of intracranial hematomas underwent craniotomy again, the hematomas were removed again and the bone slise were decompressed. One case had fissured stable after shunt. There were no operative deaths and no complications in this group. After endoscopic reoperation, CT and/or MRI scans showed that the ventricle narrowed in varying degrees, some of them returned to normal size and the flow of cerebrospinal fluid (cerebrospinal fluid) was unobstruct at the end of magnetic resonance cerebrospinal fluid angiography (MRI) fistula after endoscopic reoperation. Conclusions: The incidence of suprasellar arachnoid cysts is low, it is rare in clinic and it is easy to misdiagnose and mistreate. At present, it is recognized that the best treatment methods are partial resection of endoscope cyst wall, cyst ventricle fistula and third ventricle floor fisthla.