Effects of 6-month customized home-based exercise on motor development, bone strength, and parental stress in children with simple congenital heart disease: a single-blinded randomized clinical trial.

BACKGROUND: New "noncardiac" problems in children with congenital heart disease (CHD), such as developmental delay or long-term neurodevelopmental impairments, have attracted considerable attention in recent years. It is hypothesized that exercise might attenuate CHD-associated neurodevelopmental impairments; however, this has not been thoroughly investigated. The objective of this prospective, single-blinded, randomized controlled experiment was to evaluate the impact of customized home-based exercise for children with CHD. METHODS: Children aged 0-5 years with echocardiography-confirmed simple CHD subtypes who were scheduled to undergo cardiac catheterization were screened for enrolment. Among 420 screened CHD children, 192 were enrolled and randomly assigned at a 1:1 ratio to receive a 6-month intervention (30 min daily customized home-based exercise program with supervision for no less than 5 days per week, combined with home-based exercise education) or control treatment (home-based education). The primary outcome was motor development (gross motor quotient (GMQ), fine motor quotient (FMQ), and total motor quotient (TMQ)). The secondary outcomes were cardiac function and structure, bone quality, physical development, parental anxiety, caregiver burden, and quality of life. Children and their families were assessed before and 1, 3, and 6 months after catheterization; 183 (95.3%) children were included in the primary analysis. RESULTS: After 6-month treatment, the intervention group significantly increased their motor quotient, which was consistently higher than that of the control group (GMQ p < 0.0001, FMQ p = 0.02, TMQ p < 0.001). The physical developments in height, weight, and circumferences of the upper-arm, chest, and head were also significantly improved by exercise (all p < 0.017). No significant improvements in the bone strength or the cardiac structure and function were found among patients in the intervention group (all p > 0.017). For parents, higher quality of life level (total score p = 0.016) was observed in the intervention group; while effects of exercise on the anxiety (rude score p = 0.159, standard score p = 0.159) or the Zarit caregiver burden scale score (p = 0.404) were non-significant. No adverse events occurred during the study period. CONCLUSIONS: Customized home-based exercise improved motor development in children with CHD. While the long-term effects of parent training in home-based exercise are unknown, the study results suggest positive outcomes. TRIAL REGISTRATION: A home-based exercise program in congenital heart disease children with cardiac catheterization: a randomized controlled trial. ( http://www.chictr.org.cn/ , ChiCTR-IOR-16007762, January 14, 2016).

Changes in the combination of the triglyceride-glucose index and obesity indicators estimate the risk of cardiovascular disease.

BACKGROUND: Cardiovascular disease (CVD) is closely associated with the triglyceride glucose (TyG) index and its related indicators, particularly its combination with obesity indices. However, there is limited research on the relationship between changes in TyG-related indices and CVD, as most studies have focused on baseline TyG-related indices. METHODS: The data for this prospective cohort study were obtained from the China Health and Retirement Longitudinal Study. The exposures were changes in TyG-related indices and cumulative TyG-related indices from 2012 to 2015. The K-means algorithm was used to classify changes in each TyG-related index into four classes (Class 1 to Class 4). Multivariate logistic regressions were used to evaluate the associations between the changes in TyG-related indices and the incidence of CVD. RESULTS: In total, 3243 participants were included in this study, of whom 1761 (54.4%) were female, with a mean age of 57.62 years at baseline. Over a 5-year follow-up, 637 (19.6%) participants developed CVD. Fully adjusted logistic regression analyses revealed significant positive associations between changes in TyG-related indices, cumulative TyG-related indices and the incidence of CVD. Among these changes in TyG-related indices, changes in TyG-waist circumference (WC) showed the strongest association with incident CVD. Compared to the participants in Class 1 of changes in TyG-WC, the odds ratio (OR) for participants in Class 2 was 1.41 (95% confidence interval (CI) 1.08-1.84), the OR for participants in Class 3 was 1.54 (95% CI 1.15-2.07), and the OR for participants in Class 4 was 1.94 (95% CI 1.34-2.80). Moreover, cumulative TyG-WC exhibited the strongest association with incident CVD among cumulative TyG-related indices. Compared to the participants in Quartile 1 of cumulative TyG-WC, the OR for participants in Quartile 2 was 1.33 (95% CI 1.00-1.76), the OR for participants in Quartile 3 was 1.46 (95% CI 1.09-1.96), and the OR for participants in Quartile 4 was 1.79 (95% CI 1.30-2.47). CONCLUSIONS: Changes in TyG-related indices are independently associated with the risk of CVD. Changes in TyG-WC are expected to become more effective indicators for identifying individuals at a heightened risk of CVD.

The relationship between triglyceride-glucose index and prospective key clinical outcomes in patients hospitalised for coronary artery disease.

BACKGROUND: The triglyceride-glucose (TyG) index is regarded as a dependable alternative for assessing insulin resistance (IR), given its simplicity, cost-effectiveness, and strong correlation with IR. The relationship between the TyG index and adverse outcomes in patients with coronary heart disease (CHD) is not well established. This study examines the association of the TyG index with long-term adverse outcomes in hospitalized CHD patients. METHODS: In this single-center prospective cohort study, 3321 patients hospitalized with CHD were included. Multivariate Cox regression models were employed to assess the associations between the TyG index and the incidence of all-cause mortality and major adverse cardiovascular events (MACEs). To examine potential nonlinear associations, restricted cubic splines and threshold analysis were utilized. RESULTS: During a follow-up period of 9.4 years, 759 patients (22.9%) succumbed to mortality, while 1291 (38.9%) experienced MACEs. Threshold analysis demonstrated a significant "U"-shaped nonlinear relationship with MACEs, with different hazard ratios observed below and above a TyG index of 8.62 (below: HR 0.71, 95% CI 0.50-0.99; above: HR 1.28, 95% CI 1.10-1.48). Notably, an increased risk of all-cause mortality was observed only when the TyG index exceeded 8.77 (HR 1.53, 95% CI 1.19-1.96). CONCLUSIONS: This study reveals a nonlinear association between the TyG index and both all-cause mortality and MACEs in hospitalized CHD patients with CHD. Assessing the TyG index, particularly focusing on individuals with extremely low or high TyG index values, may enhance risk stratification for adverse outcomes in this patient population.

Evaluation of Organic Hydride/Acid Pairs as a Type of Thermodynamic-Potential-Regulated Multisite Proton-Coupled Electron Transfer Reagents.

Organic hydride/acid pairs have been reported as multisite proton-coupled electron transfer (MS-PCET) reagents in reductive MS-PCET reactions recently. Since the key step for an organic hydride/acid pair acting as an MS-PCET reagent is a chemical process of the organic hydride/acid pair releasing a formal hydrogen atom, the bond dissociation free energy of the organic hydride/acid pair releasing a formal hydrogen atom is a valuable thermodynamic parameter for objectively evaluating the thermodynamic potential for an organic hydride/acid pair to act as an MS-PCET reagent. Now, organic hydride/acid pairs of 216 organic hydrides have been demonstrated to be a potential type of thermodynamically potential-regulated MS-PCET reagent. Without a doubt, organic hydride/acid pairs reflect the change of N-substituted organic hydrides from simple hydride reductants to thermodynamically-regulated MS-PCET reagents, which could significantly expand the availability of novel MS-PCET reagents.

Solar energy broadband capturing by metamaterial absorber based on titanium metal.

In recent years, the exploration of solar absorbers has grown in favor due to the scarcity of energy. Here, we propose an absorber with an array of a circular ring surrounding disk (RSD) for solar energy capture. The novel structure keeps above 93.5% absorption with an average absorption of 96.95% in wavelengths from 300 to 4000 nm. Meanwhile, the proposed absorber is advantageous in that the structure is generalizable to other metals and dielectric materials. Furthermore, the data results show that the absorber has polarization-independent properties as well as maintaining >90% absorption in the considered wavelength range up to an incidence angle of 52° and >95% absorption at large process tolerances. Finally, the excellent absorption under the AM1.5 solar spectrum demonstrates the RSD absorber's ability to capture solar energy. These results show the potential of the absorber for applications in electromagnetic invisibility cloaking, thermal emitters, and solar energy capture and conversion.

Square-package arrays for efficient trapping of terahertz waves.

In this paper, a broadband metamaterial absorber consisting of the doped silicon substrate and the square array of doped silicon covered by a SU-8 layer is presented. The target structure achieves an average absorption of 94.42% in the studied frequency range (0.5-8 THz). In particular, the structure exceeds 90% absorption in the frequency range of 1.44-8 THz, which is a significant increase in bandwidth relative to reported devices of the same type. Next, the near-perfect absorption of the target structure is verified by the impedance matching principle. Furthermore, through the analysis of the electric field distribution inside the structure, the physical mechanism of its broadband absorption is investigated and explained. Finally, the impact of fluctuations in the incident angle, polarization angle, and structural parameters on the absorption efficiency is examined at length. The analysis shows that the structure has characteristics, such as polarization insensitivity, wide-angle absorption, and good process tolerance. The proposed structure is advantageous for applications in THz shielding, cloaking, sensing, and energy harvesting.

Bone mineral density in children and young adults with idiopathic scoliosis: a systematic review and meta-analysis.

PURPOSE: Osteoporosis is a risk factor for idiopathic scoliosis (IS) progression, but it is still unclear whether IS patients have bone mineral density (BMD) loss and a higher risk of osteoporosis than asymptomatic people. This systematic review aims to explore the differences in BMD and prevalence of osteoporosis between the IS group and the control group. METHODS: We searched 5 health science-related databases. Studies that were published up to February 2022 and written in English and Chinese languages were included. The primary outcome measures consisted of BMD z score, the prevalence of osteoporosis and osteopenia, and areal and volumetric BMD. Bone morphometry, trabecular microarchitecture, and quantitative ultrasound measures were included in the secondary outcome measures. The odds ratio (OR) and the weighted mean difference (WMD) with a 95% confidence interval (CI) were used to pool the data. RESULTS: A total of 32 case-control studies were included. The pooled analysis revealed significant differences between the IS group and the control group in BMD z score (WMD -1.191; 95% CI - 1.651 to -0.732, p < 0.001). Subgroup analysis showed significance in both female (WMD -1.031; 95% CI -1.496 to -0.566, p < 0.001) and male participants (WMD -1.516; 95% CI -2.401 to -0.632, p = 0.001). The prevalence of osteoporosis and osteopenia in the group with IS was significantly higher than in the control group (OR = 6.813, 95% CI 2.815-16.489, p < 0.001; OR 1.879; 95% CI 1.548-2.281, p < 0.000). BMD measures by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography showed a significant decrease in the IS group (all p < 0.05), but no significant difference was found in the speed of sound measured by quantitative ultrasound between the two groups (p > 0.05). CONCLUSION: Both the male and female IS patients had a generalized lower BMD and an increased prevalence of osteopenia and osteoporosis than the control group. Future research should focus on the validity of quantitative ultrasound in BMD screening. To control the risk of progression in IS patients, regular BMD scans and targeted intervention are necessary for IS patients during clinical practice.

Circ-USP9X interacts with EIF4A3 to promote endothelial cell pyroptosis by regulating GSDMD stability in atherosclerosis.

Endothelial pyroptosis is a pathological mechanism of atherosclerosis (AS). Circular RNAs (circRNAs) are vital in AS progression by regulating endothelial cell functions. The study aimed to explore whether circ-USP9× regulated pyroptosis of endothelial cell to involve in AS development and the molecular mechanism. Pyroptosis was determined using lactate dehydrogenase (LDH) assay, enzyme linked immunosorbent assay (ELISA), flow cytometry, propidium iodide (PI) staining assay, and western blot. The mechanism of circ-USP9× was determined using RNA pull-down and RNA binding protein immunoprecipitation (RIP) assays. Results showed that circ-USP9× was upregulated in AS and oxidized low-density lipoprotein (ox-LDL)-treated human umbilical vein endothelial cells (HUVECs). Knockdown of circ-USP9× suppressed ox-LDL induced pyroptosis of HUVECs. Mechanically, circ-USP9× could bind to EIF4A3 in the cytoplasm. Moreover, EIF4A3 was bound to GSDMD and further affects GSDMD stability. Overexpression of EIF4A3 rescued cell pyroptosis induced by circ-USP9× depletion. In short, circ-USP9× interacted with EIF4A3 to enhance GSDMD stability, thus further promoting ox-LDL-induced pyroptosis of HUVECs. These findings suggested that circ-USP9× participates in AS progression and may be a potential therapeutic target for AS.

Essential Rule Derived from Thermodynamics and Kinetics Studies of Benzopyran Compounds.

Compounds with benzopyran as the core structure play an important role in the total synthesis of antioxidants, drugs, and natural products. Herein, the thermodynamic data of benzopyran compounds and their intermediates were measured and calculated by combining thermodynamics with kinetics. The mechanism of reactions between four benzopyran compounds and organic hydride acceptors was proven to be a one-step hydride transfer. The thermodynamic properties of these compounds and their corresponding intermediates were elucidated. The rationality and accuracy of the electrochemical measurement method were proved. Furthermore, the essential rule of unique structures being present between the C-H bond and para-substituent constants on the benzene ring, as shown in previous studies, was investigated. A simultaneous correlation between thermodynamics and kinetics was found for the hydride transfer reaction, in which the reaction site is connected with the substituent through the benzene ring, a double bond, or a N atom. The likely reason for the correlation between thermodynamic and kinetic is that the benzene ring, double bond, or N atom have the role of transferring the electronic effect. This finding can be applied to the calculation of the activation energy of hydride self-exchange reactions, the prediction of kinetic isotope effects, and explorations of selective reduction processes of hydride transfer in such organic hydride compounds.

Thermodynamics Evaluation of Selective Hydride Reduction for α,ß-Unsaturated Carbonyl Compounds.

The selective reduction of α,ß-unsaturated carbonyl compounds is one of the core reactions and also a difficult task for organic synthesis. We have been attempting to study the thermodynamic data of these compounds to create a theoretical basis for organic synthesis and computational chemistry. By electrochemical measurement method and titration calorimetry, in acetonitrile at 298 K, the hydride affinity of two types of unsaturated bonds in α,ß-unsaturated carbonyl compounds, their single-electron reduction potential, and the single-electron reduction potential of the corresponding radical intermediate are determined. Their hydrogen atom affinity, along with the hydrogen atom affinity and proton affinity of the corresponding radical anion, is also derived separately based on thermodynamic cycles. The above data are used to establish the corresponding "Molecule ID Card" (Molecule identity card) and analyze the reduction mechanism of unsaturated carbonyl compounds. Primarily, the mixture of any carbonyl hydride ions and Ac-tempo+ will stimulate hydride transfer process and create corresponding α,ß-unsaturated carbonyl compounds and Ac-tempoH from a thermodynamic point of view.

A Mechanism Study of Redox Reactions of the Ruthenium-oxo-polypyridyl Complex.

Over the years, RuIV(bpy)2(py)(O)2+([RuIVO]2+) has garnered considerable interest owing to its extensive use as a polypyridine mono-oxygen complex. However, as the active-site Ru=O bond changes during the oxidation process, [RuIVO]2+ can be used to simulate the reactions of various high-priced metallic oxides. In order to elucidate the hydrogen element transfer process between the Ruthenium-oxo-polypyridyl complex and organic hydride donor, the current study reports on the synthesis of [RuIVO]2+, a polypyridine mono-oxygen complex, in addition to 1H and 3H (organic hydride compounds) and 1H derivative: 2. Through 1H-NMR analysis and thermodynamics- and kinetics-based assessments, we collected data on [RuIVO]2+ and two organic hydride donors and their corresponding intermediates and established a thermodynamic platform. It was confirmed that a one-step hydride transfer reaction between [RuIVO]2+ and these organic hydride donors occurs, and here, the advantages and nature of the new mechanism approach are revealed. Accordingly, these findings can considerably contribute to the better application of the compound in theoretical research and organic synthesis.

The Wnt Effector TCF7l2 Promotes Oligodendroglial Differentiation by Repressing Autocrine BMP4-Mediated Signaling.

Promoting oligodendrocyte (OL) differentiation represents a promising option for remyelination therapy for treating the demyelinating disease multiple sclerosis (MS). The Wnt effector transcription factor 7-like 2 (TCF7l2) was upregulated in MS lesions and had been proposed to inhibit OL differentiation. Recent data suggest the opposite yet underlying mechanisms remain elusive. Here, we unravel a previously unappreciated function of TCF7l2 in controlling autocrine bone morphogenetic protein (BMP)4-mediated signaling. Disrupting TCF7l2 in mice of both sexes results in oligodendroglial-specific BMP4 upregulation and canonical BMP4 signaling activation in vivo Mechanistically, TCF7l2 binds to Bmp4 gene regulatory element and directly represses its transcriptional activity. Functionally, enforced TCF7l2 expression promotes OL differentiation by reducing autocrine BMP4 secretion and dampening BMP4 signaling. Importantly, compound genetic disruption demonstrates that oligodendroglial-specific BMP4 deletion rescues arrested OL differentiation elicited by TCF7l2 disruption in vivo Collectively, our study reveals a novel connection between TCF7l2 and BMP4 in oligodendroglial lineage and provides new insights into augmenting TCF7l2 for promoting remyelination in demyelinating disorders such as MS.SIGNIFICANCE STATEMENT Incomplete or failed myelin repairs, primarily resulting from the arrested differentiation of myelin-forming oligodendrocytes (OLs) from oligodendroglial progenitor cells, is one of the major reasons for neurologic progression in people affected by multiple sclerosis (MS). Using in vitro culture systems and in vivo animal models, this study unraveled a previously unrecognized autocrine regulation of bone morphogenetic protein (BMP)4-mediated signaling by the Wnt effector transcription factor 7-like 2 (TCF7l2). We showed for the first time that TCF7l2 promotes oligodendroglial differentiation by repressing BMP4-mediated activity, which is dysregulated in MS lesions. Our study suggests that elevating TCF7l2 expression may be possible in overcoming arrested oligodendroglial differentiation as observed in MS patients.

Freeze-Tolerant Hydrogel Electrolyte with High Strength for Stable Operation of Flexible Zinc-Ion Hybrid Supercapacitors.

Constructing ionic conductive hydrogels with diversified properties is crucial for portable zinc-ion hybrid supercapacitors (ZHSCs). Herein, a freeze-tolerant hydrogel electrolyte (AF PVA-CMC/Zn(CF3 SO3 )2 ) is developed by forming a semi-interpenetrating anti-freezing polyvinyl alcohol-carboxymethyl cellulose (AF PVA-CMC) network filled with the ethylene glycol (EG)-containing Zn(CF3 SO3 )2 aqueous solution. The semi-interpenetrating AF PVA-CMC/Zn(CF3 SO3 )2 possesses enhanced mechanical properties, realizes the uniform zinc deposition, and impedes the dendrite growth. Notably, the interaction between PVA and EG suppresses the ice crystal formation and prevents freezing at -20 °C. Due to these advantages, the designed hydrogel owns high ionic conductivity of 1.73/0.75 S m-1 at 20/-20 °C with excellent tensile/compression strength at 20 °C. Impressively, the flexible AF quasi-solid-state ZHSC employing the hydrogel electrolyte achieves a superior energy density at 20/-20 °C (87.9/60.7 Wh kg-1 ). It maintains nearly 84.8% of the initial capacity after 10 000 cycles and a low self-discharge rate (1.77 mV h-1 ) at 20 °C, together with great tolerance to corrosion. Moreover, this device demonstrates a stable electrochemical performance at -20 °C under deformation. The obtained results provide valuable insights for constructing durable hydrogel electrolytes in cold environments.

Thermally tunable broadband metamaterial absorbers based on ionic liquids.

In this paper, we propose an interesting thermally tunable broadband metamaterial absorber based on ionic liquids at the microwave band, which has distinct modulation characteristics in different frequency bands. Numerical simulation results show that the absorption decreases with the increase of temperature in the low-frequency band from 2-10GHz, which decreases to 60% at 100 °C. Meanwhile, the absorption increases with the increase in temperature in the high-frequency band from 25GHz to 48GHz. In addition, the absorber still has good broadband absorption without the metal substrate, and the absorption reaches more than 80% in the frequency band of 13.96-34.10GHz. As an all-dielectric metamaterial absorber, its absorption increases with the increase in temperature, which reaches more than 90% in the range of 20.44-50GHz at 100 °C. At last, the designed metamaterial absorbers have been fabricated based on ionic liquids, and experimental results are presented to demonstrate the validity of the proposed structure. Furthermore, the simple design and wide frequency tuning range of the absorbers can promise a great potential application in sensors, detection, and frequency-selective thermal emitters.

Discovering and Evaluating the Reducing Abilities of Polar Alkanes and Related Family Members as Organic Reductants Using Thermodynamics.

In this work, the pKa values of 69 polar alkanes (YH2) in acetonitrile were computed using the method developed by Luo and Zhang in 2020, and representative 69 thermodynamic network cards on 22 elementary steps of YH2 and related polar alkenes (Y) releasing or accepting H2 were naturally established. Potential electron reductants (YH-), hydride reductants (YH-), antioxidants (YH2 and YH-), and hydrogen molecule reductants (YH2) are unexpectedly discovered according to thermodynamic network cards. It is also found that there are great differences between YH2 and common hydrogen molecule reductants (XH2), such as Hantzsch ester (HEH2), benzothiazoline (BTH2), and dihydro-phenanthridine (PH2), releasing two hydrogen ions to unsaturated compounds. During the hydrogenation process, XH2 release hydrides first, then the oxidation state XH+ release protons. However, in the case of YH2, YH2 release protons first, then YH- release hydrides. It is the differences on acidic properties of YH2 and XH2 that result in the behavioral and thermodynamic differences on YH2 and XH2 releasing two hydrogen ions (H--H+). The redox mechanisms and behaviors of Y, YH-, and YH2 as electron, hydrogen atom, hydride, and hydrogen molecule donors or acceptors in the chemical reaction are reasonably investigated and discussed in this paper using thermodynamics.

Re-vitrectomy for recurrent retinal detachment in post-vitrectomy eyes of rhegmatogenous retinal detachment.

BACKGROUND: Recurrent retinal detachment (Re-RD) usually affects the prognosis of surgery for rhegmatogenous retinal detachment (RRD). Previous clinical studies of Re-RD were not specific. This study aimed to analyze the clinical characteristics of Re-RD in post-vitrectomy eyes with RRD and surgical outcomes after revitrectomy without combining it with retinectomy or scleral buckling. METHODS: This is a retrospective case series analyzed the ocular characteristics of 20 recurrent and contralateral eyes, evaluated the significance of the associations between variables before reoperation and the final best-corrected visual acuity (BCVA), and calculated the outcome of revitrectomy. RESULTS: Patients with phakic eyes, those undergoing only one surgery, and those with more than one break had better final BCVA. The final BCVA was negatively correlated with the axial length and positively correlated with the preoperative BCVA. Among the 12 eyes with no break detected before surgery, 11 (92%) were found to have a small crevice-like break beside the pigment scar of a large number of original laser spots. The single-operation complete retinal reattachment rate was 75%, the complete retinal reattachment rate was 80%, and the final incomplete retinal reattachment rate was 90%. The BCVA improved from 1.2 ± 0.6LogMAR (0.06 ± 0.25) before surgery to 0.8 ± 0.7LogMAR (0.15 ± 0.2) at the last follow-up. The BCVA of 16 patients with complete retinal reattachment improved from 1.0 ± 0.5LogMAR (0.1 ± 0.3) to 0.6 ± 0.4LogMAR (0.25 ± 0.4). In the contralateral eyes, 15% already had vision-damaging disease, and the incidence of eyesight-threating lesions was 5.9% during follow-up. CONCLUSIONS: Revitrectomy without retinectomy or scleral buckling can effectively treat Re-RD in post-vitrectomy eyes. In Re-RD patients with no definite retinal break detected preoperatively, the retinal hole usually shows small crevice-like changes alongside a large number of original laser pigment scars.

Three-dimensional corrective exercise therapy for idiopathic scoliosis: study protocol for a prospective non-randomized trial.

BACKGROUND: Although physiotherapeutic scoliosis-specific exercises (PSSEs) with or without other conservative treatments may improve scoliotic deformities, the evidence is insufficient. Three-dimensional corrective exercises (TDCEs) for scoliosis are based on the theory of PSSEs and are characterized by a combination of outpatient treatment and home-based exercise. This study aims to evaluate the effectiveness of TDCEs for idiopathic scoliosis (IS). METHODS: The participants will be divided into two age- and sex-matched groups: an experimental group (EG) treated with three-dimensional corrective exercise therapy (TDCET) and a control group (CG) receiving generalized exercise therapy. In each arm, mild and moderate IS cases will be reclassified based on the Cobb angle and biopsy results. The primary endpoint is the change in the largest Cobb angle; the secondary endpoints are the sagittal index, forced vital capacity, peak oxygen uptake, and peak oxygen uptake. Sixty-six patients with mild IS and 78 patients with moderate IS will be included. DISCUSSION: This study is the first controlled trial to systematically assess the effectiveness of TDCEs for IS. In addition to TDCET including three-dimensional corrective exercises, family rehabilitation and basic body awareness therapy may help patients adopt supportive attitudes and appropriate behaviours, thus enhancing their compliance with exercises and achieving better outcomes. TRIAL REGISTRATION: The study protocol was registered at www.clinicaltrials.gov (number identifier: NCT04539522 ). Registered on August 27, 2020.

Cell metabolomics study on synergistic anti-hepatocellular carcinoma effect of Aidi injection combined with doxorubicin.

Hepatocellular carcinoma (HCC) is the sixth most common cancer worldwide and the second most common cause of cancer deaths. This study aimed to explore the inhibitory effect and mechanism of Aidi injection (ADI) combined with doxorubicin (DOX) in HCC treatment. The drug concentrations in the combined therapy was determined by investigating the effect of various concentrations of ADI and DOX on the viability of H22 cells. The combination index was also calculated. A metabolomic strategy based on a ultrahigh-performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) platform was established to analyze the metabolites. As a result, the combination index values were less than 1, indicating that the combination of ADI and DOX exerted a synergistic effect on HCC treatment. The combination of 40‰ ADI and 1 µmol/l DOX had the strongest inhibitory effect and was used for subsequent metabolomic analysis. A total of 19 metabolic markers were obtained in metabolomic analysis, including amino acids (l-glutamic acid, l-arginine and l-tyrosine), organic acids (succinic acid and citric acid), adenosine and hypoxanthine. Compared with the treatment using DOX or ADI alone, the combined therapy further regulated the levels of metabolic markers in HCC, which may be the reason for the synergistic effect. Seven metabolic pathways were significantly enriched, including phenylalanine, tyrosine and tryptophan biosynthesis, d-glutamine and d-glutamate metabolism, alanine, aspartate and glutamate metabolism, phenylalanine metabolism, arginine biosynthesis, the tricarboxylic acid cycle and purine metabolism. These findings demonstrated that ADI combined with DOX can effectively inhibit the viability of H22 cells, which may exert a synergistic antitumor effect by balancing the metabolism of amino acids and energy-related substances.

Comparison between 1,2-Dihydropyridine and 1,4-Dihydropyridine on Hydride-Donating Ability and Activity.

In this paper, detailed comparisons of the driving force in thermodynamics and intrinsic force in the kinetics of 1,2-dihydropyridine and 1,4-dihydropyridine isomers of PNAH, HEH, and PYH in hydride transfer reactions are made. For 1,2-PNAH and 1,4-PNAH, the values of the thermodynamic driving forces, kinetic intrinsic barriers, and thermo-kinetic parameters are 60.50 and 61.90 kcal/mol, 27.92 and 26.34 kcal/mol, and 44.21 and 44.12 kcal/mol, respectively. For 1,2-HEH and 1,4-HEH, the values of the thermodynamic driving forces, kinetic intrinsic barriers, and thermo-kinetic parameters are 63.40 and 65.00 kcal/mol, 31.68 and 34.96 kcal/mol, and 47.54 and 49.98 kcal/mol, respectively. For 1,2-PYH and 1,4-PYH, the order of thermodynamic driving forces, kinetic intrinsic barriers, and thermo-kinetic parameters are 69.90 and 72.60 kcal/mol, 33.06 and 25.74 kcal/mol, and 51.48 and 49.17 kcal/mol, respectively. It is not difficult to find that thermodynamically favorable structures are not necessarily kinetically favorable. In addition, according to the analysis of thermo-kinetic parameters, 1,4-PNAH, 1,2-HEH, and 1,4-PYH have a strong hydride-donating ability in actual chemical reactions.

Comparison of the Hydride-Donating Ability and Activity of Five- and Six-Membered Benzoheterocyclic Compounds in Acetonitrile.

In this work, we compared the hydride-donating ability of five-membered benzoheterocyclic compounds (FMB) and six-membered benzoheterocyclic compounds (SMB), isomers of DMBI and DMIZ and of DMPZ and DMPX, using detailed thermodynamic driving forces [ΔGo (XH)], kinetic intrinsic barriers (ΔG≠XH/X), and thermo-kinetic parameters [ΔG≠° (XH)]. For DMBI and DMIZ, the values of ΔGo (XH), ΔG≠XH/X, and ΔG≠° (XH) are 49.2 and 53.7 kcal/mol, 35.88 and 42.04 kcal/mol, and 42.54 and 47.87 kcal/mol, respectively. For DMPZ and DMPX, the values of ΔGo (XH), ΔG≠XH/X, and ΔG≠° (XH) are 73.2 and 79.5 kcal/mol, 35.34 and 25.02 kcal/mol, and 54.27 and 52.26 kcal/mol, respectively. It is easy to see that the FMB isomers are thermodynamically dominant and that the SMB isomers are kinetically dominant. Moreover, according to the analysis of ΔG≠° (XH), compared to the SMB isomers, the FMB isomers have a stronger hydride-donating ability in actual chemical reactions.