Precise Crystal Orientation Identification and Twist-Induced Giant Modulation of Optical Anisotropy in 1T'-ReS2.

The ability to precisely identify crystal orientation as well as to nondestructively modulate optical anisotropy in atomically thin rhenium dichalcogenides is critical for the future development of polarization programmable optoelectronic devices, which remains challenging. Here, we report a modified polarized optical imaging (POI) method capable of simultaneously identifying in-plane (Re chain) and out-of-plane (c-axis) crystal orientations of the monolayer to few-layer ReS2, meanwhile, propose a nondestructive approach to modulate the optical anisotropy in ReS2 via twist stacking. The results show that parallel and near-cross POI are effective to independently identify the in-plane and out-of-plane crystal orientations, respectively, while regulating the twist angle allows for giant modulation of in-plane optical anisotropy from highly intrinsic anisotropy to complete optical isotropy in the stacked ReS2 bilayer (with either the same or opposite c-axes), as well modeled by linear electromagnetic theory. Overall, this study not only develops a simple optical method for precise crystal orientation identification but also offers an efficient light polarization control strategy, which is a big step toward the practical application of anisotropic van der Waals materials in the design of nanophotonic and optoelectronic devices.

Down-regulated expression of TIPE3 inhibits malignant progression of non-small cell lung cancer via Wnt signaling.

Non-small cell lung cancer (NSCLC) accounts for approximately 80 % of all lung cancers with a low five-year survival rate. Therefore, the mechanistic pathways and biomarkers of NSCLC must be explored to elucidate its pathogenesis. In this study, we examined TIPE3 expression in NSCLC cells and investigated the molecular mechanisms underlying NSCLC regulation in vivo and in vitro. We collected tissue samples from patients with NSCLC to examine TIPE3 expression and its association with patient metastasis and prognosis. Furthermore, we evaluated the expression level of TIPE3 in NSCLC cells. Cell lines with the highest expression were selected for molecular mechanism experiments, and animal models were established for in vivo verification. The results showed that TIPE3 was significantly increased in patients with NSCLC, and this increased expression was associated with tumor metastasis and patient prognosis. TIPE3 knockdown inhibited proliferation, migration, invasion, EMT, angiogenesis, and tumorsphere formation in NSCLC cells. Moreover, it reduced the metabolic levels of tumor cells. However, overexpression of TIPE3 has the opposite effect. The in vivo results showed that TIPE3 knockdown reduced tumor volume, weight, and metastasis. Furthermore, the results showed that TIPE3 may inhibit malignant progression of NSCLC via the regulation of Wnt/ß-catenin expression. These findings suggest that TIPE3 is significantly elevated in patients with NSCLC and that downregulation of TIPE3 can suppress the malignant progression of NSCLC, which could serve as a potential diagnostic and treatment strategy for NSCLC.

miR-29b-3p targetedly regulates VEGF to inhibit tumor progression and cisplatin resistance through Nrf2/HO-1 signaling pathway in non-small cell lung cancer.

BACKGROUNDS: Non-small cell lung carcinoma (NSCLC) is a common type of lung cancer. Prior investigations have elucidated the pivotal role of miR-29b-3p in restraining tumor growth and metastasis. Nonetheless, it remains to be determined whether miR-29b-3p can effectively suppress NSCLC progression and enhance the sensitivity of NSCLC cells to cisplatin. This investigation sought to determine the mechanism by which miR-29b-3p inhibited the advancement of NSCLC and mitigated resistance to cisplatin. METHODS: We initially assessed miR-29b-3p and VEGF levels in NSCLC tissues and cell lines. Next, miR-29b-3p expression was elevated in NSCLC cell lines H1975 and A549 by overexpression plasmid transfection. Following this, a sequence of molecular biology experiments was conducted to evaluate the impact of miR-29b-3p on the biological behaviors of NSCLC cells and their resistance to cisplatin. Additionally, we predicted VEGF was a target gene of miR-29b-3p by bioinformatics analysis. We next employed western blot to evaluate the protein expression of Nrf2 and HO-1 in NSCLC cells. Finally, we elucidated the effects of VEGF and Nrf2/HO-1pathway on NSCLC progression and cisplatin resistance by in vitro assays. RESULTS: In comparison to paracancerous tissues and human normal lung epithelial cells, the expression of miR-29b-3p was notably reduced and VEGF expression was clearly elevated in NSCLC tissues and cells. Moreover, miR-29b-3p upregulated obviously suppressed the biological activities of NSCLC cells and increased their sensitivity to cisplatin. Furthermore, in NSCLC cells, miR-29b-3p bound to VEGF and negatively regulate its transcription. Additionally, miR-29b-3p overexpression also inhibited the Nrf2/HO-1 signaling pathway. Finally, the overexpression of VEGF and the activation of the Nrf2/HO-1 pathway reversed miR-29b-3p-mediated inhibitory effect on biological behaviors of NSCLC cells and increased the cisplatin resistance. CONCLUSION: Our findings indicate that miR-29b-3p impedes NSCLC cells' biological behaviors and augments their sensitivity to cisplatin by targeting VEGF to modulate the Nfr2/HO-1 signaling pathway.

Blood serum levels of PACAP and migraine onset: A systematic review and meta-analysis of observational studies.

OBJECTIVE: We conducted a systematic review and meta-analysis to explore the relationship between blood pituitary adenylate cyclase-activating polypeptide (PACAP) levels and migraine. BACKGROUND: PACAP is involved in the onset of migraine, but the results from clinical studies on PACAP level variations across different periods of migraine are conflicting. METHODS: We systematically searched for observational studies that reported PACAP levels in people with migraine and non-migraine controls published in English from the PubMed, Web of Science, and Ovid electronic databases, or in Chinese from the Chinese National Knowledge Infrastructure and the WanFang Med database. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of the included studies. The quality of evidence for each outcome was assessed according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) guidelines. RESULTS: Of the 514 identified studies, 8 were eligible for inclusion. There was a "very low" level of evidence suggesting that the PACAP level is negatively correlated with migraine disease duration in adults with migraine (summary r = -0.35, 95% confidence interval [CI] -0.49 to -0.22) and that the PACAP is higher in people with migraine during the ictal period than in the interictal period (standardized mean difference = 0.41, 95% CI 0.17 to 0.66) for both adults and children with migraine. Adult patients with episodic migraine (weighted mean difference [WMD] = -9.58 pg/mL, 95% CI -13.41 to -5.75 pg/mL) or chronic migraine (WMD = -10.93 pg/mL, 95% CI -15.57 to -6.29 pg/mL) had lower blood PACAP levels than non-migraine controls during the interictal period, supported by a "low" or "very low" quality of evidence, respectively, according to the GRADE rules. CONCLUSION: There is a very low certainty of evidence suggesting that the PACAP level is negatively correlated with migraine disease duration of adults with migraine and it varies greatly among different periods of migraine of both adults and children with migraine.

Clinical study on the selection of endoscopes and microscopes for transsphenoidal surgery of non-aggressive pituitary macroadenoma and microadenoma and the influencing factors of hyposmia after endoscopic transsphenoidal surgery.

Background and objective: Transsphenoidal surgery, including endoscopic and microscopic resection, is the first choice of treatment for pituitary tumors. With the widespread application of neuroendoscopy in recent decades, there has been a trend to replace microscopes. In clinical practice, we have found that in transsphenoidal surgery for non-invasive microadenomas and macroadenomas, microscopy can achieve a higher total resection rate, shorter operation time, lower incidence of postoperative complications, and faster recovery of olfaction. This study aimed to explore the selection of endoscopes and microscopes for non-aggressive transsphenoidal surgery for pituitary adenomas and the factors affecting olfactory recovery. Methods: From August 2019 to October 2022, 93 patients with non-aggressive microadenomas and macroadenomas via the transsphenoidal approach were selected from the First Affiliated Hospital of Harbin Medical University and treated with rich experience in pituitary tumor subspecialty microscopy and endoscopic surgery. Different surgical methods were used to divide the patients into microscopic (n = 35) and endoscopic (n = 58) groups. The total tumor removal rate, intraoperative blood loss, operation time and cost, postoperative hospital stay, recovery of visual function, postoperative changes in hormone levels, complication rate, and recovery from complications 3 months after the operation were compared between the two groups. Results: There were no significant differences in the tumor removal rate, postoperative visual acuity, and visual field recovery between the two groups (p > 0.05). There was a significant difference in the recovery rate of olfactory function between the two groups 3 months after the operation (p < 0.05), and there was no significant difference in the incidence of other complications (p > 0.05); Compared with the two groups, the microscope group had shorter operation time, longer postoperative hospital stay, less average operation cost and less blood loss, and the difference was statistically significant (p < 0.05). The position of the nasal septum mucosal flap incision was a risk factor for hyposmia 3 months after the operation. Conclusion: Microsurgery and endoscopic surgery are suitable surgical treatments for nonaggressive microadenomas and macroadenomas. The total tumor removal and postoperative hormone remission rates of the two surgical methods were approximately the same. However, the microsurgery group had a shorter operation time, less intraoperative blood loss, faster olfactory function recovery, and a lower average operation cost. The position of the nasal septal mucosal flap incision was a risk factor for hyposmia at 3 months postoperatively. Hyposmia is less likely to occur when the superior edge of the nasal septal mucosal flap incision is not higher than the lower edge of the ipsilateral superior turbinate.

Assessing the association between age at first sexual intercourse and migraine: a Mendelian randomization study.

Background and objectives: As indicated by observational and genetic variation studies, age at first sexual intercourse (AFS) may be associated with migraine attack, but there is a lack of evidence from real-world studies due to ethical concerns. Therefore, we conducted a Mendelian randomization study to determine the causal relationship between AFS and migraine. Methods: We extracted instrumental variables from summary data of a genome-wide association study (GWAS) on AFS and migraine and then conducted two-sample Mendelian randomization analyses. GWAS data for AFS and migraine were obtained from 397,338 unrelated individuals (214,547 females and 182,791 males) and 306,314 individuals (18,477 patients and 287,837 control individuals), respectively. Results: There was a causal relationship between AFS and risk for migraine (odds ratio (OR) = 0.73, 95% confidence interval (CI) [0.61 to 0.86]), both for migraine with aura (MWA; OR = 0.72, 95% CI [0.58 to 0.89]) and migraine without aura (MOA; OR = 0.66, 95% CI [0.51 to 0.86]). Stratified analyses provided suggestive evidence of the causal relationship between delayed AFS and a decreased risk of migraine for both males (OR = 0.71, 95% CI [0.59 to 0.84]) and females (OR = 0.73, 95% CI [0.61 to 0.89]). Reverse Mendelian randomization did not reveal any effect of migraine on AFS (p > 0.05). No pleiotropy was detected. Discussion: A delayed AFS is a protective factor against migraine (for both MWA and MOA) in both males and females. This causal relationship indicates the presence of extracranial regulatory pathways of migraine.

Efficacy and safety of ketamine as an adjuvant to regional anesthesia: A systematic review and meta-analysis of randomized controlled trials.

STUDY OBJECTIVE: To identify whether adding ketamine to the local anesthetics (LA) in the regional anesthesia could prolong the duration of analgesia. DESIGN: A Systematic review and meta-analysis of randomized controlled trials. SETTING: The major dates were obtained in the operating room and the postoperative recovery ward. PATIENTS: A total of 1011 patients at ASA physical status I and II were included in the analysis. Procedure performed including cesarean section, orthopedic, radical mastectomy, urological or lower abdominal surgery and intracavitary brachytherapy implants insertion. INTERVENTIONS: After an extensive search of the electronic database, patients received regional anesthesia combined or not combined general anesthesia and with or without adding ketamine to LA were included in the analysis. The regional anesthesia includes spinal anesthesia, brachial plexus block, pectoral nerve block, transversus abdominis plane block and femoral and sciatic nerve block. MEASUREMENT: The primary outcome was the duration of analgesia. Secondary outcomes were the duration and onset time of motor and sensory block as well as the ketamine-related adverse effect. Data are expressed in mean differences in continuous data and odds ratios (OR) for dichotomous data with 95% confidence intervals. The risk of bias of the included studies was evaluated using the revised Cochrane risk of bias tool for randomized trials. The quality of evidence for each outcome was rated according to the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) Working Group system. MAIN RESULT: Twenty randomized controlled trials were included in the analysis. When ketamine was used as an adjuvant to LA, the duration of analgesia could be prolonged(172.21 min, 95% CI, 118.20 to 226.22; P<0.00001, I2 = 98%), especially in the peripheral nerve block(366.96 min, 95% CI, 154.19 to 579.74; P = 0.0007, I2 = 98%). Secondary outcomes showed ketamine could prolong the duration of sensory block(29.12 min, 95% CI, 10.22 to 48.01; P = 0.003, I2 = 96%) but no effect on the motor block(6.94 min, 95% CI,-2.65 to 16.53;P = 0.16, I2 = 84%), the onset time of motor and sensory block (motor onset time, -1.17 min, 95% CI, -2.67 to 0.34; P = 0.13, I2 = 100%; sensory onset time, -0.33 min, 95% CI,-0.87 to 0.20; P = 0.23, I2 = 96%) as well as the ketamine-related adverse effect(OR, 1.97, 95% CI,0.93 to 4.17;P = 0.08, I2 = 57%). CONCLUSION: This study indicates that ketamine could be an ideal adjuvant to local anesthetics regardless of the types of anesthesia. Overall, the quality of the evidence is low.

Efficacy of Transcutaneous Electrical Acupoint Stimulation on Chronic Postsurgical Pain After Video-Assisted Thoracoscopic Lobectomy: Study Protocol for a Prospective Randomized Controlled Trial.

INTRODUCTION: Patients undergoing video-assisted thoracoscopic lobectomy (VATL) often experience chronic postsurgical pain (CPSP). Postoperative pain can affect the recovery of postoperative lung function, prolong postoperative recovery time, and increase patient hospitalization expenses. Transcutaneous electrical acupoint stimulation (TEAS) is an alternative therapy based on acupuncture that has shown promise in postoperative recovery and pain management across various medical fields. However, research specifically focused on the improvement of CPSP after VATL is currently lacking. The purpose of this study is to evaluate whether TEAS can effectively reduce the severity and occurrence of chronic postsurgical pain in patients undergoing VATL. By investigating the potential benefits of TEAS in mitigating CPSP after VATL, this study aims to provide valuable clinical evidence to support the integration of TEAS into postoperative care protocols for patients undergoing VATL. METHODS: This study is a prospective, single-center, double-blinded, randomized controlled trial to be conducted at the 920th Hospital of Joint Logistics Support Force. Eighty patients undergoing VATL will be randomly divided into an experimental group (TEAS group) and a control group (sham group). The experimental group will receive TEAS at bilateral PC6, LI4, LR3, LU5, TE5, and LI11. The control group will not receive TEAS at the same acupoints. Both groups will receive TEAS or no TEAS before anesthesia induction and 1-7 days after surgery, with each session lasting 30 min. PLANNED OUTCOMES: The primary outcome will be the incidence of CPSP at 3 months after surgery. Secondary outcomes will include the incidence of CPSP at 6 months after surgery, the numerical rating scale (NRS) scores at 3 and 6 months after surgery, as well as the NRS scores at 24, 48, and 72 h after surgery, remifentanil consumption during general anesthesia, demand for rescue analgesics, number and duration of indwelling chest tubes, incidence of postoperative nausea and vomiting, and changes of norepinephrine (NE), cortisol (Cor), tumor necrosis factor (TNF- α), and interleukin 6 (IL-6) in serum. TRIAL REGISTRATION: ChiCTR2300069458. Registered on March 16, 2023.

Activation and Regulation of Pancreatic Stellate Cells in Chronic Pancreatic Fibrosis: A Potential Therapeutic Approach for Chronic Pancreatitis.

In the complex progression of fibrosis in chronic pancreatitis, pancreatic stellate cells (PSCs) emerge as central figures. These cells, initially in a dormant state characterized by the storage of vitamin A lipid droplets within the chronic pancreatitis microenvironment, undergo a profound transformation into an activated state, typified by the secretion of an abundant extracellular matrix, including α-smooth muscle actin (α-SMA). This review delves into the myriad factors that trigger PSC activation within the context of chronic pancreatitis. These factors encompass alcohol, cigarette smoke, hyperglycemia, mechanical stress, acinar cell injury, and inflammatory cells, with a focus on elucidating their underlying mechanisms. Additionally, we explore the regulatory factors that play significant roles during PSC activation, such as TGF-ß, CTGF, IL-10, PDGF, among others. The investigation into these regulatory factors and pathways involved in PSC activation holds promise in identifying potential therapeutic targets for ameliorating fibrosis in chronic pancreatitis. We provide a summary of recent research findings pertaining to the modulation of PSC activation, covering essential genes and innovative regulatory mediators designed to counteract PSC activation. We anticipate that this research will stimulate further insights into PSC activation and the mechanisms of pancreatic fibrosis, ultimately leading to the discovery of groundbreaking therapies targeting cellular and molecular responses within these processes.

Pathogenesis of Depression in Alzheimer's Disease.

Depression is a prevalent occurrence among Alzheimer's disease (AD) patients, yet its underlying mechanism remains unclear. Recent investigations have revealed that several pathophysiological changes associated with Alzheimer's disease can lead to mood disorders. These alterations include irregularities in monoamine neurotransmitters, disruptions in glutamatergic synaptic transmission, neuro-inflammation, dysfunction within the hypothalamic-pituitary-adrenocortical (HPA) axis, diminished levels of brain-derived neurotrophic factor (BDNF), and hippocampal atrophy. This review consolidates research findings from pertinent fields to elucidate the mechanisms underlying depression in Alzheimer's disease, aiming to provide valuable insights for the study of its mechanisms and clinical treatment.

Mechanisms associated with post-stroke depression and pharmacologic therapy.

Stroke is one of the most common cerebrovascular diseases, which is the cause of long-term mental illness and physical disability, Post-stroke depression (PSD) is the most common neuropsychiatric complication after stroke, and its mechanisms are characterized by complexity, plurality, and diversity, which seriously affects the quality of survival and prognosis of patients. Studies have focused on and recognized neurotransmitter-based mechanisms and selective serotonin-reuptake inhibitors (SSRIs) can be used to treat PSD. Neuroinflammation, neuroendocrinology, neurotrophic factors, and the site of the stroke lesion may affect neurotransmitters. Thus the mechanisms of PSD have been increasingly studied. Pharmacological treatment mainly includes SSRIs, noradrenergic and specific serotonergic antidepressant (NaSSA), anti-inflammatory drugs, vitamin D, ect, which have been confirmed to have better efficacy by clinical studies. Currently, there is an increasing number of studies related to the mechanisms of PSD. However, the mechanisms and pharmacologic treatment of PSD is still unclear. In the future, in-depth research on the mechanisms and treatment of PSD is needed to provide a reference for the prevention and treatment of clinical PSD.

Merkel Cell Carcinoma in an Elderly Male With Extensive Local Disease.

Merkel cell carcinoma (MCC) is a rare, highly aggressive neuroendocrine carcinoma of the skin. It is often found in the sun-exposed skin areas of elderly individuals of Caucasian descent. MCC has a tendency for local recurrence and the potential to invade nearby lymph nodes and spread to distant sites in the body. Here, we present the case of an 83-year-old male with a history of multiple comorbidities, including congestive heart failure, obesity, hypertension, benign prostatic hyperplasia, and sarcoidosis, who presented with a slow-growing, fungating lesion on his left lower leg. Histopathological examination revealed MCC with extensive necrosis and involved resection margins. Additional skin lesions on the left knee were confirmed to be MCC. Follow-up CT scans showed lymphadenopathy and a femoral lesion. The patient was deemed a poor candidate for resection and placed on immunotherapy treatment. The low incidence rate and indistinct clinical manifestations of MCC make a conclusive diagnosis dependent on examining histological features and immunohistochemical markers through a lesioned biopsy or resection. Due to the aggressive nature of MCC and the tendency for asymptomatic and painless lesions to escape notice, it is important to raise awareness about this condition. This will lead to earlier detection and intervention, potentially enhancing patient survival rates.

Prospect of Mesenchymal Stem-Cell-Conditioned Medium in the Treatment of Acute Pancreatitis: A Systematic Review.

Mesenchymal stem cells (MSCs) have demonstrated potential in both clinical and pre-clinical research for mitigating tissue damage and inflammation associated with acute pancreatitis (AP) via paracrine mechanisms. Hence, there has been a recent surge of interest among researchers in utilizing MSC cultured medium (CM) and its components for the treatment of AP, which is recognized as the primary cause of hospitalization for gastrointestinal disorders globally. A systematic review was conducted by searching the MEDLINE, EMBASE, and Web of Science databases. Studies that involve the administration of MSC-CM, extracellular vesicles/microvesicles (EVs/MVs), or exosomes to AP animal models are included. A total of six research studies, including eight experiments, were identified as relevant. The findings of this study provide evidence in favor of a beneficial impact of MSC-CM on both clinical and immunological outcomes. Nevertheless, prior to clinical trials, large animal models should be used and prolonged observation periods conducted in pre-clinical research. Challenges arise due to the lack of standardization and consensus on isolation processes, quantifications, and purity testing, making it difficult to compare reports and conduct meta-analyses in MSC-CM-based therapies.

Role of iron manganese plaque in the safe production of rice (Oryza sativa L.) grains: Field evidence at plot and regional scales in cadmium-contaminated paddy soils.

The relationship between iron manganese plaque (IP) and cadmium (Cd) accumulation by rice in the microenvironment of rice rhizosphere at varying field scales needs to be further explored. In this study, we selected different rice varieties and implemented tailored amendments to ensure the safe production of rice grains in heavily Cd-contaminated farmland situated around an E-waste dismantling site. Through regional surveys, we elucidated the role of IP in facilitating safe rice production. The selection of low-Cd accumulating rice varieties and application of appropriate amendments with sufficient dosages allowed for the effective reduction of Cd transport from soil to rice, resulting in a safe concentration of Cd in rice grains. Analysis using a random forest algorithm indicated that iron (Fe) played a more pivotal role than manganese in soil-rice systems in mitigating Cd accumulation in brown rice. The presence of Fe in IP (IP-Fe) at a low loading mass was unfavorable to the Cd-safe production of rice, while at an IP-Fe loading mass of 52 g/kg, the Cd content in brown rice decreased to a safe level. Furthermore, precipitation, coprecipitation, and complexation of surface functional groups contributed to Cd fixation on IP, as indicated by scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy, electron probe microanalysis, and Fourier-transform infrared spectroscopy with attenuated total reflection. Our results highlighted the key role of IP in the production of Cd-safe rice at different field scales.

Inorganic amendments improve acidic paddy soils: Effects on soil properties, Al fractions, and microbial communities.

Alkaline soil inorganic amendments (SIAs) have been extensively used to improve acidic soils. In this study, we arranged 9 treatments of low, medium, and high application dosages of silicon calcium magnesium potassium fertilizer, calcium magnesium phosphate fertilizer, and lime in the field to study the mechanism of SIAs in improving acidic soils. The Al sequential extraction experiment showed that the application of SIAs tended to transform from active to stable fractions of Al. By amplicon sequencing, it was observed that the application of SIAs significantly affected microbial community compositions in rhizosphere soils. With the decrease in soil acidity, the microbial function was also enhanced, especially the activity of dehydrogenase. In this study, the acidity-related indicators in soils (pH, exchangeable acid, and exchangeable base cations) were first integrated into an index-AIV (acidity improvement value), which was used to assess the relationship with other soil properties. The redundancy analysis and correlation network between soil chemical and biological indexes indicated that SIAs did not greatly affect the fungi community structure, while greatly increased or decreased the abundance of bacteria, especially Acidobacteria, Nitrospirae, and Crenarchaeota. Our data revealed the SIAs optimized soil environment for rice growth jointly by decreasing Al mobility, improving soil microbial function, and increasing soil fertility.

Heavy metal pollution risk of desulfurized steel slag as a soil amendment in cycling use of solid wastes.

The by-product of wet flue gas desulfurization, desulfurized steel slag (DS), had chemical characteristics like natural gypsum that can be used to improve saline-sodic soil. However, contamination risk of heavy metals for cycling utilization of DS in agriculture was concerned mostly. Both pot and field experiments were conducted for evaluating the potential pollution risk of DS as the amendment of saline-sodic soil. Results showed that application of DS decreased the contents of Cd, Cu, Zn, and Pb, while significantly increasing chromium (Cr) content in DS-amended soils. The field experiment demonstrated that the migration of heavy metals (Cd, Zn, Cu, and Pb) in the soil profile was negligible. The application of DS at the dosage of 22.5-225 tons/ha significantly increased the Cr content in alfalfa (Medicago sativa L.) but lower than the national standard for feed in China (GB 13078-2017). DS altered the chemical fraction of heavy metals (Zn, Cu, and Pb), transferred exchangeable, reducible into oxidizable and residual forms in DS-amended soil. Application of DS combined with fulvic acid (FA) could effectively reduce the movement of heavy metals in soil and the accumulation of Cr in alfalfa. Based on our results, DS was a safe and feasible material for agricultural use and presented relatively little pollution risk of heavy metals. However, the results also showed that DS to a certain extent had a potential environmental risk of Cr if larger dosages of DS were used.

Clinical differences between menstrual migraine and nonmenstrual migraine: a systematic review and meta-analysis of observational studies.

BACKGROUND AND PURPOSE: Approximately 60% of female migraineurs experience menstrual migraine (MM). Whether MM is a distinct clinical entity with more severe migraine attacks and a worse prognosis than nonmenstrual migraine (nMM) is still under debate. We conducted a systematic review and meta-analysis to investigate clinical differences between MM and nMM patients. METHODS: A systematic literature search was performed to identify observational studies comparing MM and nMM patients' clinical characteristics. Quality of evidence grades of the synthesized effect estimates for each outcome were determined following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. RESULTS: Of 1837 identified studies, 16 were eligible for inclusion. MM patients had more migraine attacks per month (MD 0.65, 95% CI 0.05-1.24) than nMM patients; however, the quality of evidence was "low" according to the GRADE assessment. They also had more headache days (MD 0.86, 95% CI 0.12-1.60) per month, a higher rate of family history of migraine (OR 1.41 95% CI 1.12-1.78), migraine aggravation with physical activity (OR 1.60, 95% CI 1.35-1.89), a younger age at migraine onset (MD - 0.99, 95% CI - 1.78 to - 0.19), and a higher risk of accompanying symptoms (OR 2.31, 95% CI 1.72-3.10) than nMM patients; however, the quality of evidence was "very low". CONCLUSIONS: There were differences between MM and nMM, showing that MM patients have a worse profile than nMM patients, but the quality of evidence is too low to draw definite conclusions on the separation/unification of the two clinical entities.

Is discectomy effective for treating low back pain in patients with lumbar disc herniation and Modic changes? A systematic review and meta-analysis of cohort studies.

BACKGROUND CONTEXT: Previous low-quality evidence has suggested preoperative Modic changes (MC) showed a trend toward less improvement in low back pain in patients with lumbar disc herniation (LDH) undergoing discectomy. However, a recent meta-analysis concluded that the presence of preoperative MC did not significantly impact clinical outcomes following lumbar discectomy. PURPOSE: To compare low back pain and functional outcomes of patients after discectomy for LDH with preoperative MC. STUDY DESIGN: Systematic review and meta-analysis of cohort studies. METHODS: This comprehensive systematic review and meta-analysis used English-language articles identified through searches using Pubmed, Web of Science, Embase, and Cochrane library until August 2022. The included studies identified publications that concentrated on the patients suffering from LDH with different preoperative MCs treated by discectomy. The Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI) were the two main metrics to evaluate outcomes. RESULTS: A series of 2,299 LDH patients with a definitive type of MC were included in four retrospective and five prospective studies. Overall, there is moderate to high quality evidence suggesting no significant difference between normal and MC groups for pain outcomes as well as normal and Modic type 2 groups in terms of pain or functional outcomes at one or two-year follow up. There are less functional outcomes in LDH patients with preoperative MC compared with no MC at 2-year follow up and showed no significant difference at 1-year follow-up. However, above all results may due to heterogeneity. Subgroup analysis revealed that only Modic type 1 showed statistically lower functional scores (mean difference in ODI scores range from 0 to 100) compared with Modic type 2 or compared with no MC at 2-year follow-up and showed no significant difference at 1-year follow-up (MC1 vs. MC0, p=.24, MD= -2.70; 95% CI, -7.15 to 1.76 for 1-year;p<.00001, MD= -7.92; 95% CI, -11.19 to -4.66 for 2 years. MC1 vs. MC2, p=.58, MD= -1.29; 95% CI, -5.83 to 3.25 for 1-year;p<.0001, MD= -6.77; 95% CI, -9.94 to -3.61 for 2 years). CONCLUSIONS: These data suggest LDH patients with or without preoperative MCs show a similar improvement of low back pain at 1 and 2-year follow-up and functional scores after discectomy at one-year follow-up. LDH patients with preoperative Modic type 1 are associated with worse functional status after discectomy at 2-year follow-up. However, high-quality randomized controlled trials and prospective cohort studies which focus on analyzing the risk and confounding factors are lacking.

Prediction model for Cd accumulation of rice (Oryza sativa L.) based on extractable Cd in soils and prediction for high Cd-risk regions of southern Zhejiang Province, China.

Soil environmental quality in China for agricultural land always considers the effect of total cadmium (Cd) in soil, ignoring the bioavailability of soil Cd. The 139 paired rice (Oryza sativa L.) and soil samples were collected from the Cd-contaminated paddy fields of southern Zhejiang Province, China. The objectives of this study were to establish accurate prediction models for Cd accumulation in brown rice based on bioavailable Cd and physiochemical properties of soils and to evaluate the safety of rice production in Cd-contaminated paddy. The bioavailable Cd in soils was extracted and evaluated by using CaCl2, HNO3, diethylenetriamine pentaacetic acid (DTPA), diffusive gradients in thin-films technique (DGT), and sequential extraction method proposed by the European Community Bureau of Reference; 100 pairs of data were used as training sets, and the remaining 39 sets were used as validation sets. Stepwise multiple linear regression analysis and random forest analysis showed that total Cd in soil could roughly indicate the content of Cd in rice, while extractable Cd could better explain the accumulation of Cd in rice grain and DTPA and DGT extractive technologies are the most evaluative. The validation sets also showed that the prediction model has a good fit. Based on the prediction model for Cd in brown rice based on soil pH and DGT extractive Cd, the Monte Carlo simulation showed that 74.32% and 89.35% of the estimated brown rice hazard quotient (HQ) of the daily Cd intake of adults and children in safe utilization paddy sites could exceed the safe level of 1, respectively. Additionally, the threshold values for extractable Cd by DGT or DTPA for rice safe production were 3.4 µg/kg or 0.13 mg/kg when the pH in soils was below 5.5. The results further proved the threshold concentration of extractable Cd for predicting high-risk soils of Cd contamination in brown rice.

Case Report: Left bundle branch pacing in an amyloid light-chain cardiac amyloidosis patient with atrioventricular block.

Introduction: Amyloid light-chain cardiac amyloidosis is a progressive infiltrative disease characterized by the deposition of amyloid fibrils in the cardiac tissue, which can cause serious atrioventricular block requiring pacemaker implantation. Left bundle branch pacing has emerged as an alternative method for delivering physiological pacing to achieve electrical synchrony of the left ventricle. However, left bundle branch pacing in patients with amyloid light-chain cardiac amyloidosis has not been studied in detail. Therefore, in this study, we present a case of left bundle branch pacing in a patient with amyloid light-chain cardiac amyloidosis. Case summary: A 66-year-old male patient with amyloid light-chain cardiac amyloidosis presented with syncope for 1 month. Holter monitoring revealed intermittent third-degree atrioventricular block. Left bundle branch pacing was performed successfully. During the 1-year follow-up, it was observed that the left bundle branch capture threshold remained stable without any pacemaker-related complications or left ventricle systolic dysfunction, and there was no recurrence of syncope. Conclusion: Left bundle branch pacing appears to be a safe and feasible option for patients with amyloid light-chain cardiac amyloidosis experiencing atrioventricular block.