Antibiotic prophylaxis vs. on­demand antibiotic treatment in endoscopic therapy for variceal hemorrhage: A meta­analysis of randomized controlled trials.

The aim of the present study was to conduct a meta-analysis for elucidating the effects of antibiotic prophylaxis on infection, rebleeding and mortality in patients who underwent endoscopic therapy for variceal hemorrhage. Articles on antibiotic prophylaxis and on-demand antibiotic administration following endoscopic therapy for acute variceal bleeding were searched on PubMed, Embase and Cochrane Library between January 1959 and February 2024, to elucidate whether the use of prophylactic antibiotics was necessary. The quality of randomized controlled trials (RCTs) was assessed using the Cochrane risk-of-bias assessment tool and RevMan software version 5.4.1 was used for meta-analysis of the data. The current meta-analysis included four RCTs and 322 patients with acute variceal bleeding who underwent endoscopic therapy. All included studies were of high quality according to the Cochrane risk-of-bias assessment tool. According to the results of the meta-analysis, the incidence of infection in the prophylactic antibiotic group was significantly lower than that in the on-demand group [odds ratio (OR), 0.31; 95% confidence interval (CI), 0.13-0.74; P=0.009]. The prophylactic antibiotic group also exhibited a lower incidence of rebleeding compared with that of the on-demand group (OR, 0.37; 95% CI, 0.19-0.72; P=0.003). No significant differences were noted in the incidence of mortality between the two groups (OR, 0.92; 95% CI, 0.45-1.92; P=0.83). In conclusion, the data indicated that antibiotic prophylaxis is recommended to be used in patients who have undergone endoscopic therapy for variceal hemorrhage.

Compared with other methods, cyanoacrylate and lauromacrogol in treating esophagogastric varices did not increase the risk of postoperative infection.

BACKGROUND: Patients with cirrhosis commonly undergo endoscopic cyanoacrylate injection for gastric and esophageal variceal bleeding. However, postoperative infections can increase the risk of rebleeding and mortality. AIM: This study aimed to determine the risk of postoperative infections and its associated factors following cyanoacrylate injection treatment in these patients. METHODS: A retrospective analysis was conducted on 57 patients treated with ligation (ligation group), 66 patients treated with cyanoacrylate injection (injection group), and 91 patients treated with conservative treatment (control group) at the Nanchong Central Hospital. RESULTS: The rate of postoperative infection was similar among the cyanoacrylate, ligation, and conservative treatment groups, with no significant statistical difference observed (P = 0.97). Multivariate analysis identified postoperative Child-Pugh score and renal insufficiency as two independent risk factors for postoperative infection. The rebleeding rate in the injection group was significantly lower than in the other groups (P = 0.01). Mortality was significantly higher in the control group compared with the ligation and injection groups (P = 0.01). CONCLUSION: Cyanoacrylate combined with lauromacrogol injection did not significantly increase the risk of infection compared with ligation and conservative treatments, and it was more effective in reducing the risk of rebleeding. This method is safe, effective, and holds clinical value for broader application.

An improved IPT-PLL technology for single-phase grid-connected inverters in complex power grid conditions.

Aiming at the common problems of frequency variations and harmonics in complex power grids, an improved inverse Park transform phase locked loop (IPT-PLL) technology for single-phase converters suitable for micro grid systems is proposed. Firstly, in the phase detection of PLL, the α component of Park transformation is selected as the reference voltage, and its orthogonal component is constructed using a 1/4 fundamental period delay method. Secondly, Lagrange interpolation polynomials are introduced to approximate fractional delay to solve the problem of delay calculation errors caused by frequency changes. Thirdly, in order to compensate for the poor ability of traditional proportional integral (PI) regulators, multi resonant controllers are superimposed to suppress low order harmonic disturbances. Finally, the design method and system performance of the PI regulator and each resonant controller are analyzed theoretically. The experimental results show that the proposed improved IPT-PLL method has strong adaptability to complex power grids. It can significantly improve the tracking performance of power grid frequency, suppress the interference of low order harmonics and DC bias. And it has good dynamic and static performance.

Upcycling harmful algal blooms into short-chain organic matters assisted with cellulose-based flocculant.

Upcycling harmful algal blooms (HABs) into short-chain organic matters (SCOMs) presents a significantly underexplored opportunity for addressing environmental concerns and achieving circular economy. But there are challenges of low HABs harvesting and SCOMs conversion efficiencies. To address these issues, a novel cellulose-based flocculant derived from abundant agricultural waste (wheat straw) was developed. This flocculant possesses high surface positive charge to aggregate negatively charged microalgae cells via charge neutralization mechanism, resulting in HABs harvesting efficiency of 97 %. Moreover, the flocculant can serve as a carbon to nitrogen (C/N) regulator to optimize the harvested slurry properties for downstream fermentation. Following hydrothermal pretreatment for one hour, the HABs-flocculant slurry was effectively converted into SCOMs with a total energy output of 64.3 kJ/L and energy conversion efficiency of 67 %, in which SCOMs was major contributor (92 %). This work may inspire eco-friendly and cost-effective approach for HABs disposal with extra benefits of SCOMs production.

Effectiveness of 13-valent pneumococcal conjugate vaccine against vaccine-serotype community acquired pneumococcal diseases among children in China: A test-negative case-control study.

BACKGROUND: In 2016, China licensed 13-valent pneumococcal conjugate vaccine (PCV13) based on a study that demonstrated its immunogenicity is non-inferior to PCV7. However, the real-world effectiveness of PCV13 against vaccine-serotype pneumococcal diseases in China has limited evidence. METHODS: A test-negative case-control study was conducted among children under 5 years old admitted to the Children's Hospital of Soochow University (SCH) with respiratory tract infections from January 2018 to December 2020. Cases were defined as children from whom the isolates were tested positive for Streptococcus pneumoniae (S. pneumoniae) with serotypes included in PCV13. Two control groups were included, one represented children with isolates positive for S. pneumoniae of non-PCV13 serotypes and the other comprised children who tested negative for S. pneumoniae. The S. pneumoniae-negative controls were selected by matching them to the cases based on gender, age and admission date in a 1:1 ratio. Vaccine effectiveness (VE) was calculated using a logistic regression model as (1- adjusted odds ratio) * 100 %. RESULTS: A total of 2371 pneumococcal isolates were included in the analysis, of which 75.0 % (1779/2371) were covered by PCV13 serotypes. Consequently, these 1779 children were classified as cases, and 592 children were designated as non-PCV13 serotype controls. Another 1779 children were correspondingly recruited as S. pneumoniae-negative controls. Overall, 40 cases (2.3 %) and 148 controls (6.2 %) had received vaccination. The overall VE in the PCV13/non-PCV13 serotypes case-control study was 50.0 % (95 % CI: 15.0, 70.7), which was lower than the VE of 74.4 % (95 % CI: 60.7, 83.3) in the matched PCV13/S. pneumoniae-negative case-control study. VE was higher for ≥ 2 or ≥ 3 doses of vaccination compared to ≥ 1 dose. VE against specific PCV13 serotypes (6B, 6A and 19F) was higher than for other serotypes. CONCLUSIONS: PCV13 vaccination demonstrates effectiveness against vaccine-serotype pneumococcal diseases in children, particularly for serotypes 6B, 6A and 19F.

Mirror-like tongue is an important predictor of acute heart failure: a cohort study of acute heart failure in Chinese patients.

OBJECTIVE: To reveal that mirror-like tongue, observed via a noninvasive inspection, is a powerful indicator of the severity and prognosis of patients with acute heart failure (AHF). METHODS: This was an observational, prospective study. A total of 408 patients who met the inclusion criteria and were diagnosed with AHF for the first time at Taicang Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from August 2019 to January 2021 were selected as the research subjects. According to their tongue fur, the patients were divided into group A (mirror-like tongue group) and group B (non-mirror-like tongue group). The clinical characteristics and incidence of major adverse cardiovascular events (MACEs) within 1 year of follow-up were systematically compared between the two groups. RESULTS: Sixty-five patients were included in group A, and 343 patients were included in group B. There were 32 males and 33 females in group A and 168 males and 175 females in group B. The average age of the overall population was 64 years old, and the average age of group A was significantly higher than that of group B (74 vs 62 years, P < 0.001). Compared with that in group B, the left ventricular ejection fraction (LVEF) in group A was significantly lower (35% vs 42%, P < 0.001), and the log N-terminal pro B-type natriuretic peptide (NT-proBNP) level was significantly higher (4.0 vs 3.4, P < 0.001). The proportion of the combined application of vasoactive drugs in group A was significantly higher than that in group B (64% vs 38%, P < 0.001). Group B had a higher proportion of coronary angiography (29.5% vs 16.9%, P = 0.038). Group A was more inclined to require mechanical ventilation than group B (33.9% vs 22.5%, P = 0.049). The length of hospital stay in group A was significantly longer than that in group B (13.1 vs 7.6, P < 0.001). The incidence of MACEs, such as recurrence of AHF, new myocardial infarction and stroke, in group A within one year was higher than that in group B (P = 0.007, 0.009, < 0.001). The incidence of cumulative MACEs in group A was significantly higher than that in group B [hazard ratio = 2.76, 95% confidence interval (1.73, 4.41), P < 0.001]. Univariate and multivariate Cox regression analyses showed that mirror-like tongue, age, length of stay, LVEF and log NT-proBNP were independent predictors of MACEs in patients with AHF within one year. CONCLUSIONS: Noninvasive tongue inspection technology can be used as a powerful tool for assessing the severity of illness and predicting prognosis in patients with AHF. A mirror-like tongue is an independent risk factor for MACEs in patients with AHF during the first year and has a combination effect with age, length of hospital stay, ejection fraction and NT-proBNP on the occurrence of MACEs.

Systematic review and meta-analysis of stress management intervention studies in patients with metabolic syndrome combined with psychological symptoms.

BACKGROUND: Metabolic syndrome is affected by many factors, including lifestyle, mood, etc. Self-management of chronic diseases has attracted significant attention from researchers. Some studies have shown that patient self-management is a very important link, which can effectively alleviate the risk of further deterioration of the disease. However, so far, there has been no report on the basis of the summary of self-management intervention programs based on emotion management, which needs further in-depth discussion by researchers. METHODS: The Medline (PubMed), Embase (Elsevier), PsycINFO (Ovid), CBM, CNKI and Wanfang databases were searched from the establishment of the databases to June 2022, and a total of 25 studies were traced. The inclusion criteria on stress management in patients of metabolic syndrome complicated with psychological symptoms uses meta-analysis. Two investigators independently assessed the risk of bias for each study using the Cochrane risk of bias tool.16 studies and 2687participants and relevant characteristics of studies. RESULTS: In the effects of intervention measures based on stress management on depression, fasting plasma glucose, 2hFPG, high-density cholesterol, self-management behavior and quality of life in patients with psychological symptoms (depression, anxiety, and schizophrenia) complicated with metabolic diseases, there are statistically significant differences between the intervention group and the control group (P < .05). CONCLUSIONS: Stress management intervention can effectively improve the health outcomes of patients. In all included analysis indicators, the results of the experimental group are better than those of the control group.

Effects on the Microstructure Evolution and Properties of Graphene/Copper Composite during Rolling Process.

Rolling treatments have been identified as a promising fabrication and deformation processing technique for graphene/metal composites with high performance. However, it is still a challenge to choose appropriate rolling parameters to achieve high strength, ductility and electrical conductivity of the composite simultaneously. In this study, graphene/Cu composites were prepared with an in situ growth method and rolling treatment. The effects of rolling deformation and temperature on the microstructural evolution of graphene and Cu grains, interface bonding between graphene and the matrix, mechanical and electrical properties were systemically investigated. The cold-rolled composite with 85% deformation displayed a maximum ultimate strength of 548 MPa, a high elongation of 8.8% and a good electrical conductivity of 86.2% IACS. This is attributed to oriented graphene arrangement and matrix grain refinement. Our research provides a comprehensive understanding for the rolling behavior of graphene/Cu composites, and can promote the development of graphene-based composites with high performance.

Infiltrated IL-17A-producing gamma delta T cells play a protective role in sepsis-induced liver injury and are regulated by CCR6 and gut commensal microbes.

Introduction: Sepsis is a common but serious disease in intensive care units, which may induce multiple organ dysfunctions such as liver injury. Previous studies have demonstrated that gamma delta (γδ) T cells play a protective role in sepsis. However, the function and mechanism of γδ T cells in sepsis-induced liver injury have not been fully elucidated. IL-17A-producing γδ T cells are a newly identified cell subtype. Methods: We utilized IL-17A-deficient mice to investigate the role of IL-17A-producing γδ T cells in sepsis using the cecum ligation and puncture (CLP) model. Results: Our findings suggested that these cells were the major source of IL-17A and protected against sepsis-induced liver injury. Flow cytometry analysis revealed that these γδ T cells expressed Vγ4 TCR and migrated into liver from peripheral post CLP, in a CCR6-dependent manner. When CLP mice were treated with anti-CCR6 antibody to block CCR6-CCL20 axis, the recruitment of Vγ4+ γδ T cells was abolished, indicating a CCR6-dependent manner of migration. Interestingly, pseudo germ-free CLP mice treated with antibiotics showed that hepatic IL-17A+ γδ T cells were regulated by gut commensal microbes. E. coli alone were able to restore the protective effect in pseudo germ-free mice by rescuing hepatic IL-17A+ γδ T cell population. Conclusion: Our research has shown that Vγ4+ IL-17A+ γδ T cells infiltrating into the liver play a crucial role in protecting against sepsis-induced liver injury. This protection was contingent upon the recruitment of CCR6 and regulated by gut commensal microbes.

Identifying circRNA-associated-ceRNA networks in juvenile spondyloarthropathies patients.

BACKGROUND: Juvenile spondyloarthropathies (JSpA) are defined as a heterogeneous group of diseases that start before the age of 16. The study aimed to identify key genes and pathways that are influenced by circRNAs and to screen potential therapeutic agents for JSpA. The study involved the analysis of circRNA expression profiles, identification of circRNA-miRNA-mRNA regulatory networks, and functional annotation of differentially expressed genes. The results of the study may have provided insights into the molecular mechanisms underlying JSpA and potential therapeutic targets for this disease. METHODS: In this study, sequencing data of circRNA, miRNA, and mRNA were obtained from the GEO datasets. The data were then analyzed to identify candidates for constructing a circRNA-miRNA-mRNA network based on circRNA-miRNA interactions and miRNA-mRNA interactions. Functional enrichments of genes were performed using the DAVID database. A PPI network was constructed using the STRING database and visualized using Cytoscape software. The MCODE plugin app was used to explore hub genes in the PPI network. The expression changes in immune cells were assessed using the online CIBERSORT algorithm to obtain the proportion of various types of immune cells. Finally, the Connectivity Map L1000 platform was used to identify potential agents for JSpA treatment. Overall, this study aimed to provide a comprehensive understanding of the molecular mechanisms underlying JSpA and to identify potential therapeutic agents for this disease. RESULTS: A total of 225 differentially expressed circRNAs (DEcircRNAs), 23 differentially expressed miRNAs (DEmiRNAs) and 1324 differentially expressed mRNAs (DEmRNAs) were identified. We integrated 5 overlapped circRNAs, 7 miRNAs and 299 target mRNAs into a circRNA-miRNA-mRNA network. We next identified 10 hub genes based on the PPI network. KEGG pathway analysis revealed that the DEGs were mainly associated with JAK-STAT signal pathway. We found that neutrophils accounted for the majority of all enriched cells. In addition, we discovered several chemicals as potential treatment options for JSpA. CONCLUSIONS: Through this bioinformatics analysis, we suggest a regulatory role for circRNAs in the pathogenesis and treatment of JSpA from the view of a competitive endogenous RNA (ceRNA) network.

Three-Dimensional Macroporous rGO-Aerogel-Based Composite Phase-Change Materials with High Thermal Storage Capacity and Enhanced Thermal Conductivity.

Three-dimensional porous network encapsulation strategy is an effective means to obtain composite phase-change materials (PCMs) with high heat storage capacity and enhanced thermal conductivity. Herein, macroporous reduced graphene oxide (rGO) aerogels with adjustable pore size are prepared by the emulsion template method and hydrothermal reduction process. Further, the shape-stabilized rGO-aerogel-based composite PCMs are constructed after the combination of 3D porous rGO supports and paraffin wax (PW) through vacuum melting infiltration. By regulating the pore structure of the rGO aerogel network, the rGO-based composite PCMs achieve excellent energy storage properties with a phase-change enthalpy of 179.94 J/g for the loading amount of 95.61 wt% and an obvious enhancement in thermal conductivity of 0.412 W/m-1·K-1, which is 54.89% higher than pristine PW and enduring thermal cycling stability. The obtained macroporous rGO-aerogel-based composite PCMs with high thermal storage and heat transfer performance effectively broaden the application of PCMs in the field of thermal energy storage.

Cancer-associated fibroblast infiltration in osteosarcoma: the discrepancy in subtypes pathways and immunosuppression.

Introduction: Osteosarcoma (OS), the primary malignant bone tumor, has a low survival rate for recurrent patients. Latest reports indicated that cancer-associated fibroblasts (CAFs) were the main component of tumor microenvironment, and would generate a variable role in the progression of tumors. However, the role of CAFs is still few known in osteosarcoma. Methods: The processed RNA-seq data and the corresponding clinical and molecular information were retrieved from the Cancer Genome Atlas Program (TCGA) database and processed data of tumor tissue was obtained from Gene Expression Omnibus (GEO) database. Xcell method was used in data processing, and Gene set variation analysis (GSVA) was used to calculates enrichment scores. Nomogram was constructed to evaluate prognostic power of the predictive model. And the construction of risk scores and assessment of prognostic predictive were based on the LASSO model. Results: This study classified Cancer Genome Atlas (TCGA) cohort into high and low CAFs infiltrate phenotype with different CAFs infiltration enrichment scores. Then TOP 9 genes were screened as prognostic signatures among 2,488 differentially expressed genes between the two groups. Key prognostic molecules were CGREF1, CORT and RHBDL2 and the risk score formula is: Risk-score = CGREF1*0.004 + CORT*0.004 + RHBDL2*0.002. The signatures were validated to be independent prognostic factors to predict tumor prognosis with single-factor COX and multi-factor COX regression analyses and Norton chart. The risk score expression of risk score model genes could predict the drug resistance, and significant differences could be found between the high and low scoring groups for 17-AAG, AZD6244, PD-0325901 and Sorafenib. Discussion: To sum up, this article validated the prediction role of CAF infiltration in the prognosis of OS, which might shed light on the treatment of OS.

Progress of research on tumor organoids: A bibliometric analysis of relevant publications from 2011 to 2021.

Background: Research on tumor organoids has developed rapidly over the past 20 years, but a systematic analysis of current research trends is lacking. Researchers in the field need relevant references and knowledge of current research hot spots. Bibliometric analysis and visualization is a systematic method of acquiring an in-depth understanding of the status of research on tumor organoids. Methods: CiteSpace, VOSviewer and the Bibliometric Online Analysis Platform from the Web of Science Core Collection were used to analyze and predict publishing trends and research hot spots worldwide in the field of tumor organoids. Results: A total of 3,666 publications on tumor organoids were retrieved, and 2,939 eligible articles were included in the final analysis. The number of publications has grown significantly, with the United States of America as the leading country for research on tumor organoids. Among journals, Cancers published the largest number of articles. Harvard Medical School published the highest number of articles among all institutions. The Chinese Academy of Sciences was ranked highest among all contributing institutions on the importance of their publications. A trend in multi-disciplinary collaboration was observed in studies on tumor organoids. Keywords indicated that the current research largely concentrated on optimizing the construction of organoid models to use for medication development and screening in the clinical setting, and to provide patients with individualized treatment for gastric cancer and colorectal cancer, which are newly emerging research hotspots. Gastric and colorectal cancers were the top two tumors that have received increasing attention and have become the focal points of recent studies. Conclusion: This study analyzed 2,939 publications covering the topic of tumor organoids. Although optimizing the construction of organoid models has always been a hot topic in this field, the application of tumor organoids to the development of medications and screenings will foster individualized treatment for patients, which is another emerging hot spot in this field of research.

Decoupling between Economic Growth and Carbon Emissions: Based on Four Major Regions in China.

This paper constructs a decoupling model for four major economic regions of China, based on the Tapio decoupling index method and VAR model for carbon emissions to compare and measure the impact of decoupling between carbon emissions and economic growth in China during 1997 to 2019. The results show that the degree of decoupling between economic growth and carbon emissions varies among different economic regions, and the decoupling status is better in all regions at the beginning of the 21st century. In general, the decoupling status in the eastern and western regions is more ideal than that in the central and northeastern regions. The impulse response and variance decomposition results show that renewable energy consumption could always reduce the growth of carbon emission intensity, and its effects are most significant in the western region. The above findings help to reveal the link between economic growth, renewable energy consumption and carbon emissions in China in recent years, and how to ensure a stable economic growth in China while increasing the share of clean energy consumption in each region to achieve carbon neutrality.