Application of a single-cell-RNA-based biological-inspired graph neural network in diagnosis of primary liver tumors.

Single-cell technology depicts integrated tumor profiles including both tumor cells and tumor microenvironments, which theoretically enables more robust diagnosis than traditional diagnostic standards based on only pathology. However, the inherent challenges of single-cell RNA sequencing (scRNA-seq) data, such as high dimensionality, low signal-to-noise ratio (SNR), sparse and non-Euclidean nature, pose significant obstacles for traditional diagnostic approaches. The diagnostic value of single-cell technology has been largely unexplored despite the potential advantages. Here, we present a graph neural network-based framework tailored for molecular diagnosis of primary liver tumors using scRNA-seq data. Our approach capitalizes on the biological plausibility inherent in the intercellular communication networks within tumor samples. By integrating pathway activation features within cell clusters and modeling unidirectional inter-cellular communication, we achieve robust discrimination between malignant tumors (including hepatocellular carcinoma, HCC, and intrahepatic cholangiocarcinoma, iCCA) and benign tumors (focal nodular hyperplasia, FNH) by scRNA data of all tissue cells and immunocytes only. The efficacy to distinguish iCCA from HCC was further validated on public datasets. Through extending the application of high-throughput scRNA-seq data into diagnosis approaches focusing on integrated tumor microenvironment profiles rather than a few tumor markers, this framework also sheds light on minimal-invasive diagnostic methods based on migrating/circulating immunocytes.

Recurrent multisystem Langerhans cell histiocytosis involving the female genitalia: A case report.

BACKGROUND: Langerhans cell histiocytosis (LCH) is a histiocytic proliferative disease caused by clonal proliferation of Langerhans cells, which is currently defined as an inflammatory myeloid tumor. It is rare in adults, with an incidence of 1-2 per million, and is highly heterogeneous in clinical presentation, with unpredictable disease progression and outcome. CASE SUMMARY: A 52-year-old postmenopausal female patient presented to the gynecology department in July 2023 with bilateral vulvar masses. She was diagnosed with recurrent multisystem LCH. The patient had previously been diagnosed with a single-system and single-focal LCH in October 2021 due to a right maxillofacial mass, which resolved after surgical treatment. A chemotherapy regimen was developed after multidisciplinary consultation. Six cycles of chemotherapy resulted in partial remission, and maintenance chemotherapy is currently being administered. CONCLUSION: Recurrent LCH involving the bilateral vulva has been poorly reported. Comprehensive imaging and pathological evaluation is important for diagnosis. The model of joint multidisciplinary specialist diagnosis and treatment is worthy of clinical application.

A carbon-based bifunctional heterogeneous enzyme: toward sustainable pollution control.

We present a study on an immobilized functional enzyme (IFE), a novel biomaterial with exceptional sustainability in enzyme utility, widely employed across various fields worldwide. However, conventional carriers are prone to eroding the active functional domain of the IFE, thereby weakening its intrinsic enzyme activity. Consequently, there is a burgeoning interest in developing next-generation IFEs. In this study, we engineered a carbon-based bifunctional heterogeneous enzyme (MIP-AMWCNTs@lipase) for the intelligent recognition of di(2-ethylhexyl)phthalate (DEHP), a common plasticizer. The heterogeneous enzyme contains a bifunctional structural domain that both enriches and degrades DEHP. We investigated its dual-response performance for the enrichment and specific removal of DEHP. The imprinting factor of the carrier for DEHP was 3.4, demonstrating selectivity for DEHP. The removal rate reached up to 94.2% over a short period. The heterogeneous enzyme exhibited robust activity, catalytic efficiency, and excellent stability under harsh environmental conditions, retaining 77.7% of its initial lipase activity after 7 cycles. Furthermore, we proposed a stepwise heterogeneous enzyme reaction kinetic model based on the Michaelis-Menten equation to enhance our understanding of enzyme reaction kinetics. Our study employs a dual-effect recognition strategy of molecular blotting and enzyme immobilization to establish a method for the removal of organic pollutants. These findings hold significant implications for the fields of biomaterials and environmental science.

Efficacy of Danlou tablets in patients with acute coronary syndrome undergoing percutaneous coronary intervention: a multicenter prospective cohort study.

Background: Danlou tablets (DLTs) have been widely used to treat coronary heart disease in China. However, the benefits associated with DLT for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) in routine practice require further investigation. Purpose: To investigate the effectiveness of DLT in patients with ACS undergoing PCI. Methods: This multicenter prospective cohort study for patients with ACS undergoing PCI was conducted in 40 centers in mainland China from February 2012 to December 2018. This trial is registered under ChiCTR-OOC-14005552. Patients were assigned to either the DLT group or the conventional medicine (CM) group based on whether they used DLT prior to enrollment. The duration of DLT use (1.5 g, three times a day) was 12 months. The primary endpoint comprised of cardiac death, non-fatal myocardial infarction, and urgent revascularization. Secondary endpoint included rehospitalization owing to ACS, heart failure, stroke, and other thrombotic events. The Seattle Angina Questionnaire (SAQ) was used to assess quality of life (QOL). Primary and secondary endpoints were followed up for 36 months, and the SAQ was followed up for 12 months. The Cox proportional hazards regression model was used to analyze the independent effect of DLT on primary and secondary endpoints. Propensity score matching (PSM) analyses were performed to mitigate bias. Survival estimation was performed using Kaplan-Meier survival curves and log-rank tests in the PSM cohort, and landmark analyses were used for further evaluation of primary and secondary endpoints. Subgroup analyses and interactions confirmed the robustness of the findings. Linear mixed effects models were used to assess the QOL. Results: Overall, 936 patients were enrolled in this cohort study, of whom 875 completed follow-up. The primary and secondary endpoints had no significantly difference between the DLT and CM groups after Cox proportional hazards models. Kaplan-Meier survival curves and log-rank tests performed in the PSM cohort also found no significant differences between the two groups on primary and secondary endpoints. However, landmark analysis showed significant benefit in the primary endpoint for the DLT group after 200 days (hazard ratio [HR] 0.46, 95% confidence interval [CI] 0.22-0.93, P = 0.03). Landmark analysis also showed a significant benefit in the secondary endpoint in the DLT group within 200 days (HR 0.33, 95% CI 0.15-0.73, P = 0.006). Moreover, DLT improves the SAQ summary score, and scores in the physical limitation, treatment satisfaction, and disease perception domains for patients with ACS undergoing PCI. Conclusions: DLT combined with conventional treatment reduced the risk of the primary endpoint after 200 days and the secondary endpoint within 200 days during the 3-year follow-up. Additionally, DLT can improve the QOL without adverse effects.

Inflammatory cytokines and carpal tunnel syndrome: A causal relationship revealed.

OBJECTIVES: Carpal tunnel syndrome (CTS) and certain inflammatory cytokines have been linked in observational studies; however, the exact causative linkages remain unknown. The purpose of this study is to investigate any possible link between the onset of CTS and 91 inflammatory cytokines. METHODS: A two-sample bidirectional Mendelian randomization (MR) approach was used in this investigation. 91 circulating inflammatory cytokines' genetic variants were retrieved from the European ancestry genome-wide association study (GWAS) database. From germline GWAS, summary data for 24,766 CTS patients and 360,538 controls were gathered. The instrumental variables were single nucleotide polymorphisms (SNPs) that were highly correlated with the 91 inflammatory cytokines. The random-effects inverse-variance weighted (IVW) approach was employed in the primary analysis, and multiple comparisons were subjected to the Bonferroni correction. Sensitivity analysis was performed to evaluate the validity of the causal relationship. RESULTS: Our findings showed a negative correlation between CCL19, FGF-19, IL-5, TGF-alpha, TRAIL, and the risk of CTS. Specifically, CCL19 (odds ratio [OR]: 0.944, 95 % confidence interval [CI]: 0.894-0.996, p = 0.0349), FGF-19 (OR: 0.940, 95 % CI: 0.894-0.987, p = 0.0133), IL-5 (OR: 0.936, 95 % CI: 0.885-0.990, p = 0.0212), TGF-alpha (OR: 0.902, 95 % CI: 0.838-0.970, p = 0.0057), and TRAIL (OR: 0.926, 95 % CI: 0.881-0.974, p = 0.0026) were inversely related to CTS risk. Conversely, CCL20, IL-2RB, and IL-6 were positively associated with an increased risk of CTS. Specifically, CCL20 (OR: 1.072, 95 % CI: 1.005-1.142, p = 0.0334), IL-2RB (OR: 1.067, 95 % CI: 1.001-1.137, p = 0.0463), and IL-6 (OR: 1.088, 95 % CI: 1.005-1.177, p = 0.0365) were positively correlated with CTS risk. Reverse Mendelian randomization analyses indicated no evidence of a reverse causal relationship between CTS and inflammatory cytokines. CONCLUSION: According to this study, there is a causal link between CTS and certain inflammatory cytokines, which suggests that these cytokines may be important in the pathophysiology of CTS. To confirm these results and investigate the specific function of these cytokines in the beginning and development of CTS, more investigation is necessary.

A photoinduced electron-transfer strategy for switchable fluorescence and phosphorescence in lanthanide-based coordination polymers.

Smart optical materials with tunable fluorescence and room temperature phosphorescence (RTP) exhibit promising application prospects in the field of intelligent switches, information security, etc. Herein, a tetraimidazole derivative was grafted to one-dimensional lanthanum-diphosphonate through H-bonds, generating a coordination polymer (CP), (H4-TIBP)·[La2Li(H2-HEDP)4(H-HEDP)]·3H2O (termed La; TIBP = 3,3,5,5-tetra(imidazole-1-yl)-1,1-biphenyl; H4-HEDP = 1-hydroxyethylidene-1,1-diphosphonic acid) with a three-dimensional supramolecular structure. La shows dynamic fluorescence from blue to red and switchable monotonous yellowish-green RTP, which can be manipulated by reversible photochromism. It is worth noting that Eu3+/Tb3+-doped CPs exhibit time-resolved (red to yellow) and monotonous green afterglow, respectively, which can be attributed to multiple emissions with different decay rates. The dynamic and multicolor luminescence endows these CPs with potential for application in the domains of optical communications, multi-step encryption, and anti-counterfeiting. This work not only integrates color-adjustable fluorescence, switchable RTP, and photochromism in one material, but also realizes the manipulation of the resultant optical performances via photochromism, paving the pathway for the design and synthesis of smart optical materials.

Polymeric phenylpropanoid derivatives crosslinked by hydroxyl fatty acids form the core structure of rape sporopollenin.

Sporopollenin, a critical innovation in the evolution of terrestrial plants, is the core building brick for the outer wall of land-plant spores and pollen. Despite its significance, the basic structure of sporopollenin remains elusive due to its extreme chemical inertness. In this study, we used ethanolamine to completely dissolve rape sporopollenin and successfully identified a total of 22 components, including fatty acids, p-coumaric acid, sterols and polymeric phenylpropanoid derivatives. After that, using NaOH treatment and partial dissolution, alongside Arabidopsis mutants analysis and spectroscopic methods, we determined that polymeric phenylpropanoid derivatives crosslinked by hydroxyl fatty acids serve as the core structure of sporopollenin. The free hydroxyl groups and carboxyl groups of the polymeric phenylpropanoid derivatives can be modified by other fatty acids (C16:0, C18:0 and C18:3) as well as alcohols/phenols (for example, naringenin, ß-sitosterol), resulting in a structure that protects pollen from terrestrial stresses. This discovery provides a basis for further exploration of sporopollenin's role in plant reproduction and evolution.

The development of RT-RPA and CRISPR-Cas12a based assay for sensitive detection of Hirame novirhabdovirus.

Hirame novirhabdovirus (HIRRV) is a highly pathogenic fish virus that poses a significant threat to the farming of a variety of economic fish. Due to no commercial vaccines and effective drugs available, sensitive and rapid detection of HIRRV at latent and early stages is important and critical for the control of disease outbreaks. However, most of the current methods for HIRRV detection have a large dependence on instruments and operations. For better detection of HIRRV, we have established a detection technology based on the reverse transcription and recombinase polymerase amplification (RT-RPA) and CRISPR/Cas12a to detect the N gene of HIRRV in two steps. Following the screening of primer pairs, the reaction temperature and time for RPA were optimized to be 40 °C and 32min, respectively, and the CRISPR/Cas12a reaction was performed at 37 °C for 15min. The whole detection procedure including can be accomplished within 1 h, with a detection sensitivity of about 8.7 copies/µl. The detection method exhibited high specificity with no cross-reaction to the other Novirhabdoviruses IHNV and VHSV, allowing naked-eye color-based interpretation of the detection results through lateral flow (LF) strip or fluorescence under violet light. Furthermore, the proliferation dynamic of HIRRV in the spleen of flounder were comparatively detected by LF- and fluorescence-based RPA-CRISPR/Cas12a assay in comparison to qRT-PCR at the early infection stage, and the results showed that the viral positive signal could be firstly detected by the two RPA-CRISPR/Cas12a based methods at 6 hpi, and then by qRT-PCR at 12 hpi. Overall, our results demonstrated that the developed RPA-CRISPR/Cas12a method is a stable, specific, sensitive and more suitable in the field, which has a significant effect on the prevention of HIRRV. RT-RPA-Cas12a-mediated assay is a rapid, specific and sensitive detection method for visual and on-site detection of HIRRV, which shows a great application promise for the prevention of HIRRV infections.

Light/Force-Responsive Room Temperature Phosphorescence in a Zinc-Organic Coordination Polymer.

A zinc-organic hybrid (1) with multifunctional room temperature phosphorescence (RTP) was synthesized. 1 presents light/force-sensitive RTP properties due to the photochromic behavior from gray to light yellow and the transition from crystalline to amorphous state, respectively. Furthermore, inkless printing and information encryption models were successfully constructed to prove their widespread application prospect.

Clinical Efficacy and Safety Analysis of Recombinant Human Brain Natriuretic Peptide Combined with Sacubitril/Valsartan in the Sequential Treatment of Senile Patients with Acute Heart Failure.

This study aims to evaluate the comparative efficacy and safety of the combination of recombinant human brain natriuretic peptide (rhBNP) and sacubitril/valsartan in the sequential treatment of senile patients with acute heart failure (AHF).The study objects were a total of 136 senile patients over 60 years old with AHF admitted to the Department of Cardiology of Anji County People's Hospital of Huzhou from August 2022 to August 2023. Using the envelope method, the patients were divided into three groups: the standard treatment group (45 patients who underwent hydragogue, digoxin, valsartan, and beta-blockers), the rhBNP group (46 patients were performed with basic treatment for AHF combined with rhBNP), and the sequential treatment group (45 patients received the basic treatment for AHF combined with rhBNP followed by sacubitril/valsartan). The clinical effects, cardiac function, safety, and prognosis among the three groups were compared.In the sequential treatment group, the duration of clinical symptom remission, the duration of hospitalization, and the improvement rate of New York Heart Association classification at discharge were (2.27 ± 0.76) days, (6.99 ± 1.96) days, and 93.3%, which were better than those in the rhBNP group ([2.58 ± 0.94] days, [7.43 ± 2.78] days, and 78.3%) and the standard treatment group ([2.89 ± 0.71] days, [8.82 ± 2.89] days, and 71.1%); the P value among all groups was lower than 0.05. In terms of cardiac function and myocardial injury, the sequential treatment group was superior to the standard treatment group and rhBNP group. The incidence of adverse reactions in the standard treatment group, the rhBNP group, and the sequential treatment group was 37.8%, 34.8%, and 26.7%, respectively, P = 0.510. In the sequential treatment group, the rate of heart failure readmitted within 6 months after discharge was 28.9% and no death occurred, which was lower than those in the rhBNP (34.8%) and the standard treatment group (35.6%).Sequential treatment with rhBNP and sacubitril/valsartan could significantly improve the clinical symptoms of elderly patients with AHF, enhance cardiac function, and reduce myocardial damage, which could also improve the prognosis.

HIV-TAT dysregulates microglial lipid metabolism through SREBP2/miR-124 axis: Implication of lipid droplet accumulation microglia in NeuroHIV.

Chronic HIV infection can dysregulate lipid/cholesterol metabolism in the peripheral system, contributing to the higher incidences of diabetes and atherosclerosis in HIV (+) individuals. Recently, accumulating evidence indicate that HIV proteins can also dysregulate lipid/cholesterol metabolism in the brain and such dysregulation could be linked with the pathogenesis of HIV-associated neurological disorders (HAND)/NeuroHIV. To further characterize the association between lipid/cholesterol metabolism and HAND, we employed HIV-inducible transactivator of transcription (iTAT) and control mice to compare their brain lipid profiles. Our results reveal that HIV-iTAT mice possess dysregulated lipid profiles and have increased numbers of lipid droplets (LDs) accumulation microglia (LDAM) in the brains. HIV protein TAT can upregulate LDs formation through enhancing the lipid/cholesterol synthesis in vitro. Mechanistically, HIV-TAT increases the expression of sterol regulatory element-binding protein 2 (SREBP2) through microRNA-124 downregulation. Cholesterol synthesis inhibition can block HIV-TAT-mediated NLRP3 inflammasome activation and microglial activation in vitro as well as mitigate aging-related behavioral impairment and memory deficiency in HIV-iTAT mice. Taken together, our results indicate an inherent role of lipid metabolism and LDAM in the pathogenesis of NeuroHIV (immunometabolism). These findings suggest that LDAM reversal through modulating lipid/cholesterol metabolism could be a novel therapeutic target for ameliorating NeuroHIV symptoms in chronic HIV (+) individuals.

Computed Tomography Imaging Measurements as a Surrogate for Clinical Outcomes After Surgical Management of Acute Type A Aortic Dissection: A Systematic Review.

BACKGROUND: Postoperative computed tomography imaging surveillance is an essential component of care after acute type A aortic dissection (ATAAD) repair. Prognostic imaging factors after ATAAD repair have not been systematically reviewed. METHODS AND RESULTS: We performed a systematic review to summarize postoperative computed tomography measurements including aortic diameter, cross-sectional area, volume, growth rate, and false lumen thrombosis in addition mid- to long-term clinical outcomes after ATAAD repair. Searches were conducted in Medline, Embase, and CENTRAL in October 2022. Studies were included if they reported clinical outcomes such as mortality or aortic reintervention after 1 year and included aforementioned computed tomography findings. Studies of chronic aortic dissection and studies of exclusive patient populations such as those with connective tissue diseases were excluded. Risk of bias was assessed with the Newcastle-Ottawa Scale. Searches retrieved 6999 articles. Sixty-eight studies met inclusion criteria (7885 patients). Extended repairs were associated with improved false lumen thrombosis, decreased aortic growth rate, and decreased rates of reintervention but not improved survival. Growth rates of the aorta post-ATAAD repair were highest in the descending thoracic aorta. The most frequent prognostic imaging factors reported were a patent/partially thrombosed false lumen and postoperative aortic diameter >40 to 45 mm. CONCLUSIONS: Established measurements of positive aortic remodeling, including complete false lumen thrombosis and stabilization of postoperative aortic diameter and growth are the most studied prognostic indicators for improved clinical outcomes after ATAAD repair. Growth rate of the aorta remains significant after ATAAD repair. Future studies should prospectively evaluate and compare prognostic factors for improved surveillance and management.

Anti-Heat Shock Protein 70 Autoantibodies from Patients with Idiopathic Pulmonary Fibrosis Epigenetically Enhance Lung Fibroblast Apoptosis Resistance and Bcl-2 Expression.

IgG autoantibodies to heat shock protein 70 (HSP70) are found in many immune-mediated clinical syndromes, and their presence among patients with idiopathic pulmonary fibrosis (IPF) portends especially poor outcomes. However, pathological effects of IPF anti-HSP70 have not been studied extensively. IPF lung fibroblasts are apoptosis resistant, and this dysregulation contributes to the accumulation of fibroblasts that characterizes the disease. During stress, HSP70 protein is exported extracellularly, where it binds to cognate cell surface receptors that mediate a variety of functional effects, including apoptosis inhibition. We hypothesized anti-HSP70 could engage HSP70-receptor complexes on fibroblasts that alter their apoptosis susceptibility. We found HSP70 is ubiquitously expressed on primary human lung fibroblasts. Treatment with anti-HSP70 isolated from patients with IPF with acute exacerbations increased Bcl-2 expression in human lung fibroblasts and reduced their susceptibility to staurosporine-induced apoptosis. Chromatin immunoprecipitation assays showed Bcl-2 gene promoter regions are enriched with the active histone mark H4 lysine 16 acetylation, and this was increased in the autoantibody-treated fibroblasts. When H4 lysine 16 acetylation was decreased by knocking down its acetyltransferase, MOF (males absent on the first), the anti-HSP70 treatments failed to upregulate Bcl-2. This study describes a heretofore unknown, to our knowledge, pathogenic consequence of autoimmunity in which autoantibodies affect the epigenetic regulation of fibroblast apoptosis. In addition to IPF, this autoimmune process could also have relevance in other immunological syndromes characterized by anti-HSP70 autoimmunity. These findings lend credence to the importance of autoimmunity in IPF and illustrate pathways that could be targeted in innovative therapies for this morbid, medically refractory lung disease.

Halogen Engineering Strategy-Induced Color-Tunable Room Temperature Phosphorescence in Metal-Organic Halides.

Color-tunable room temperature phosphorescence (RTP) materials possess potential applications in multicolor imaging, multichannel anticounterfeiting, and information encryption. Herein, we synthesized two zero-dimensional cadmium-organic halides, (H-aepy)2CdX4 (referred to as CdX-aepy; X = Cl-, Br-; aepy = 3-(2-aminoethyl)pyridine), both of which exhibit long-lived excitation wavelength- and time-dependent RTP. Experimental and theoretical results suggest that the multicolor RTP can be ascribed to the coemission of pristine H-aepy ligands and halogen-affected H-aepys, supporting that suitably introducing halogens can be an efficient strategy for constructing multicolor RTP materials. Additionally, we also demonstrate that the two phosphors can be applied in multichannel anticounterfeiting and information encryption. This work reports two hybrids with color-tunable RTP, as well as provides new insight into the effect of halogens on the regulation of RTP.

Effective extraction and detection of aflatoxins in cereals using nitrogen-rich benzodiimidazole linkage magnetic covalent organic framework based solid phase extraction and HPLC-MS/MS analysis.

Cereals are frequently contaminated by aflatoxins (AFs). The objective of this study was to develop an efficient extraction materials for rapidly extracting and detecting AFs. A novel amino-functionalized benzodiimidazole linkage magnetic covalent organic framework (Fe3O4@BB-COF) was simply fabricated by one-step cyclization and aromatization. The Fe3O4@BB-COF, having multiple N-containing active sites, exhibited excellent extraction capability towards AFs due to synergistic interactions, including the π-π interactions, hydrogen bonding interactions, polar interactions, electrostatic interactions and Lewis acid-base interactions. The Fe3O4@BB-COF based MSPE method for detecting aflatoxins has advantages of simple operation, short extraction time (6 min), and low material consumption (2 mg). This method exhibited satisfactory linearity (0.05-20 µg/kg), and sensitivity (0.01-0.45 µg/L for the detection limits) and accuracy (76.8-97.1 % for recovery) and was successfully applied for extracting and detecting AFs in cereals.

Rational selection of 4,4',4″-(1,3,5-triazine-2,4,6-triyl) trianiline-based covalent organic framework as adsorbent for effective co-extraction of aflatoxins, zearalenone and its metabolites from food and biological samples.

Aflatoxins, zearalenone and its metabolites, as representative hazard mycotoxins cause adverse effects on food safety and human health. Developing a sensitive and reliable extraction and detection method is of great importance for monitoring their residue and exposure levels. In contrast to traditional trial-and-error selection steps, 4,4',4″-(1,3,5-triazine-2,4,6-triyl) trianiline covalent-bonding with 2,5-dihydroxyterephthalaldehyde, namely TAPT-OH-COF was screened as a potential adsorbent utilizing density functional theory calculations prior to the synthesis procedure. After experimental verification, magnetic TAPT-OH-COFs were prepared, characterized and applied for the extraction of aflatoxins, zearalenone and its metabolites from food and biological samples, coupled with high-performance liquid chromatography tandem mass spectrophy detection. Under the optimal conditions, the developed method exhibited low limits of quantification (0.05-0.50 µg/kg), satisfactory recoveries (75.8 %-110.9 %) and good precision with intraday and interday relative standard deviations (RSDs) not exceeding 12.2 %. This study may provide great potential for the selection of candidate adsorbents for multi-mycotoxins extraction from complex samples.

Effectiveness and Safety of Qishen Yiqi Dripping Pill in Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention: 3-Year Results from a Multicentre Cohort Study.

OBJECTIVES: To evaluate the effectiveness and safety of Qishen Yiqi Dripping Pill (QSYQ) in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). METHODS: This multicentre prospective cohort study was conducted at 40 centers in China. Patients with ACS after PCI entered either the QSYQ or Western medicine (WM) groups naturally based on whether they had received QSYQ before enrollment. QSYQ group received QSYQ (0.52 g, 3 times a day for 12 months) in addition to WM. The primary endpoint included cardiac death, non-fatal myocardial infarction, and urgent revascularization. The secondary endpoint included rehospitalization due to ACS, heart failure, stroke, and other thrombotic events. Quality of life was assessed by the Seattle Angina Questionnaire (SAQ). RESULTS: A total of 936 patients completed follow-up of the primary endpoint from February 2012 to December 2018. Overall, 487 patients received QSYQ and WM. During a median follow-up of 566 days (inter quartile range, IQR, 517-602), the primary endpoint occurred in 46 (9.45%) and 65 (14.48%) patients in QSYQ and WM groups respectively [adjusted hazard ratio (HR) 0.60, 95% confidence interval (CI) 0.41-0.90; P=0.013]. The secondary endpoint occurred in 61 (12.53%) and 74 (16.48%) patients in QSYQ and WM groups, respectively (adjusted HR 0.76, 95% CI 0.53-1.09; P=0.136). In sensitivity analysis, the results still demonstrated that WM combined with QSYQ reduced the risk of the primary endpoint (HR 0.67, 95% CI 0.46-0.98; P=0.039). Moreover, QSYQ improved the disease perception domain of the SAQ (P<0.05). CONCLUSION: In patients with ACS after PCI, QSYQ combined with WM reduced the incidence of the primary endpoint. These findings provide a promising option for managing ACS after PCI and suggest the potential treatment for reducing the risk of primary endpoint included cardiac death, non-fatal myocardial infarction, and urgent revascularization through intermittent administration of QSYQ (Registration No. ChiCTR-OOC-14005552).

Effect of steam explosion pretreatment on the fermentation characteristics of polysaccharides from tea residue.

Green tea residues are the by-product of tea processing and they contain a large number of bioactive ingredients. Steam explosion has been recognized as one of the most innovative pretreatments for modifying the physicochemical characteristic of polysaccharides from lignocellulosic materials. However, the comparison of biological activity of steam exploded (SE-GTR) and unexploded (UN-GTR) green tea residue polysaccharides was still unclear, which prompted the determination of the efficacy of steam explosion in tea residue resource utilization. In this study, the effects of two extracted polysaccharides UN-GTR and SE-GTR on human gut microbiota in vitro fermentation were conducted. The results showed that after steam explosion pretreatment, SE-GTR displayed more loose and porous structures, resulting in higher polysaccharide content (2483.44±0.5 µg/mg) compared to UN-GTR (1903.56±2.6 µg/mg). In addition, after 24 h fermentation, gut microbiota produced more beneficial metabolites by SE-GTR. The largest SCFAs produced among samples was acetic acid, propionic acid and butyric acid. Furthermore, SE-GTR could regulate the composition and diversity of microbial community, increasing the abundance of beneficial bacteria, such as Bifidobacterium. These results revealed that steam explosion pretreatment could be a promising and efficient approach to enhance the antioxidant activity and bioavailability of polysaccharides isolated from tea residues.

Combining PCT with CRP is better than separate testing for patients with bacteriuria in the intensive care unit: a retrospective study.

BACKGROUND: Previous studies on PCT for urinary tract infections (UTI) have focused primarily on minors. This study investigated the predictive value of the neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP) level and procalcitonin (PCT) level in adult patients with bacteriuria in IUC. METHODS: This case‒control study included 85 patients with bacteriuria (PB) in the ICU from March 2021 to Jan 2024 based on positive urine culture results and a control group (n = 136) from Jan 2024 to March 2024. Patient data were collected using a hospital information management system. ROC curves of the NLR, CRP and PCT were use to predict the PB. RESULTS: The AUCs of the NLR, CRP and PCT for the prediction of PB in ICU were 0.711 (95% CI 0.644-0.772), 0.855 (95% CI 0.800-0.900), and 0.884 (95% CI 0.832-0.924), respectively; the optimal thresholds were 8.02, 18.52 mg/L, and 0.215 ng/mL, respectively; the sensitivities were 69.0 (95% CI 56.9-79.5), 90.1 (95% CI 80.7-95.9), and 83.1 (95% CI 72.3-91.0), respectively; and the specificities were 67.6 (95% CI 59.1-75.4), 68.4 (95% CI 59.9-76.1), and 80.9 (95% CI 73.3-87.1), respectively. The negative predictive value (NPV) of CRP is greater than that of PCT. In bacteriuria caused by Candida infections, CRP and PCT have higher sensitivity and NPV. CONCLUSIONS: Combined CRP and PCT testing is more helpful for diagnosing bacteriuria. CRP and PCT have higher sensitivity and NPV in diagnosing bacteriuria caused by Candida infection.