A paper-based ratiometric fluorescent sensor for NH3 detection in gaseous phase: Real-time monitoring of chilled chicken freshness.

A ratiometric fluorescence sensor platform with easy-to-use and accurate is nanoengineered for NH3 quantitative detection and visual real-time monitoring of chicken freshness using smartphones. The ratiometric fluorescent probe formed by combining the zinc ion complex and carbon dots has a double-emitted fluorescence peak. The fluorescence intensity of the complex changed can be clearly observed with the increase of the concentration of ammonia solution under 365 nm wavelength excitation. In order to detect NH3 concentration in gaseous phase, a portable paper-based sensor was designed. The sensor had a good linear relationship with NH3 concentration ranging from 10.0 to 90.0 µmol/L and the LOD value was 288 nM. This fluorescent paper-based sensor was used to check the freshness of chicken breast refrigerated at 4 °C, revealed observable shifts from blue to green. The fluorescent paper-based sensor can detect NH3 concentration in real time and simplify the monitoring process of meat freshness while ensuring accuracy and stability.

The relationship between the dimensions of frontal air sinus and skeletal malocclusions: A systematic review and meta-analysis.

Objective: The goal of this systematic review and meta-analysis was to assess whether the dimensions of the frontal air sinus correlate with skeletal malocclusion. Study selection: PubMed, Scopus, Embase, and Google Scholar were searched for relevant studies published up to May 23, 2023. The review included observational and retrospective studies that compared the dimensions of the frontal air sinus between different skeletal malocclusions. The PECOS method was used in this study ("Population, Exposure, Comparator, Outcome, and Study design"). The search was done using the following English keywords: "frontal sinus" OR "lateral cephalometric" OR "malocclusion" AND "surface area". Results: Seven studies were included, which involved 1101 participants, of whom 403 were class I, 375 were class II, and 323 were class III. These studies had a moderate risk of bias. The surface area of the frontal sinus in class III was significantly larger than in class I (standardized difference in means (SDM) = -0.971; 95 % CI = -1.147- -0.796; P < 0.001) and in class II (SDM = -1.535; 95 % CI = -1.732- -1.337; P < 0.001). Conclusion: Class III malocclusion is associated with a larger surface area of the frontal sinus compared to classes I and II.

Development of an active biogenic silver nanoparticles composite film based on berry wax and chitosan for rabbit meat preservation.

This study aimed to develop an eco-friendly active biogenic nanocomposite film through the complexation of silver nanoparticles (AgNPs), berry wax (BYW), and chitosan (CT) for maintiaing rabbit functional meat freshness. AgNPs were synthesized using Chinese medicinal paeoniaceae petal extract, and they were loaded at various concentrations (0.5 %, 0.75 %, 1.0 %, 1.25 %, and 1.5 % based on CT w/w) into the CT/BYW complex. The AgNPs exhibited an average size of 55 nm and a zeta potential of -26.3 mV with a spherical shape. The particle size and zeta potential of the film dispersions were 370.5-529.5 nm and 40.17-49.345 mV, respectively. FTIR, SEM, and XRD results showed compatibility among AgNPs and CT/BYW structure. The film water vapor permeability and light transparency decreased from 6.5 to 3.5 and 10 to 0.78 %, respectively, while opacity increased from 1.76 to 9.96 % with increasing concentrations of AgNPs. Among them, the film composite CT/BYW/AgNPs1.5% had better antioxidant and antibacterial properties, which was then applied for rabbit meat preservation at 4 °C for 16 days of storage. CT/BYW/AgNPs1.25%-packed sample had lower values of TVB-N, TBARS, TVC, and pH with greater retention of color properties compared to the control sample, which describes its ability to maintain meat freshness.

Berry wax improves the physico-mechanical, thermal, water barrier properties and biodegradable potential of chitosan food packaging film.

Chitosan (CT) is extensively applied in developing food packaging films due to its non-toxic, biodegradable, and good film-forming properties. But CT-based single polymer film has issues with poor physico-mechanical, thermal, and light barrier properties. Therefore, this study aimed to incorporate natural berry wax (BYW) at various concentrations (5 %, 10 %, 15 %, 20 %, and 25 %, wt%) into CT to improve the quality characteristics of CT film. The microstructure of the film matrix was effectively proven to be compatible with BYW through the utilization of SEM, XRD, and FTIR spectroscopy. The results demonstrated that the quality parameters of CT/BYW composite film were significantly affected by the increasing concentration of BYW. The integration of BYW with a concentration of 5 % to 20 % to CT substantially improved the film characteristics by reducing moisture content, swelling power, solubility, and water vapor permeability, increasing the film's opacity, thermal stability, and tensile strength as well as enhancing the biodegradable potential. Furthermore, CT/BYW films showed higher thermal stability and UV and visible light resistance compared to pure CT film. Taken together, the CT film with 20 % berry wax showed the best film characteristics and biodegradable potential, which could be promising for enhancing the shelf-life of various food products.

Multi-omics study of key genes, metabolites, and pathways of periodontitis.

OBJECTIVE: This study aimed to explore the key genes, metabolites, and pathways that influence periodontitis pathogenesis by integrating transcriptomic and metabolomic studies. DESIGN: Gingival crevicular fluid samples from periodontitis patients and healthy controls were collected for liquid chromatography/tandem mass-based metabolomics. RNA-seq data for periodontitis and control samples were obtained from the GSE16134 dataset. Differential metabolites and differentially expressed genes (DEGs) between the two groups were then compared. Based on the protein-protein interaction (PPI) network module analysis, key module genes were selected from immune-related DEGs. Correlation and pathway enrichment analyses were performed for differential metabolites and key module genes. A multi-omics integrative analysis was performed using bioinformatic methods to construct a gene-metabolite-pathway network. RESULTS: From the metabolomics study, 146 differential metabolites were identified, which were mainly enriched in the pathways of purine metabolism and Adenosine triphosphate binding cassette transporters (ABC transporters). The GSE16134 dataset revealed 102 immune-related DEGs (458 upregulated and 264 downregulated genes), 33 of which may play core roles in the key modules of the PPI network and are involved in cytokine-related regulatory pathways. Through a multi-omics integrative analysis, a gene-metabolite-pathway network was constructed, including 28 genes (such as platelet derived growth factor D (PDGFD), neurturin (NRTN), and interleukin 2 receptor, gamma (IL2RG)); 47 metabolites (such as deoxyinosine); and 8 pathways (such as ABC transporters). CONCLUSION: PDGFD, NRTN, and IL2RG may be potential biomarkers of periodontitis and may affect disease progression by regulating deoxyinosine to participate in the ABC transporter pathway.

Fabrication and characterization of colorimetric indicator for Salmon freshness monitoring using agar/polyvinyl alcohol gel and anthocyanin from different plant sources.

In order to investigate the sensitivity of anthocyanins from different plant origin as indicators for salmon freshness, nine plant anthocyanins were extracted and fabricated into colorimetric sensor arrays to detect NH3, trimethylamine (TMA), dimethylamine (DMA) to indicate salmon freshness. Rosella anthocyanin had the highest sensitivity for amines, ammonia and salmon. HPLC-MSS analysis indicated that Delphinidin-3 glucoside accounted for 75.48 % of the Rosella anthocyanin. UV-visible spectral analysis showed that the maximum absorbance band of Roselle anthocyanins for acid and alkaline forms were located at 525 nm and 625 nm which showed a relatively broader spectrum than other anthocyanins. An indicator film was fabricated by combining Roselle anthocyanin with agar and polyvinyl alcohol (PVA), which showed visible changes from red to green when employed to monitor the freshness of salmon stored at 4 °C. The ΔE value of Roselle anthocyanin indicator film was changed from 5.94 to >10. The ΔE value also can predict the chemical quality indicators of salmon effectively, especially with characteristic volatile components, and the predictive correlation coefficient was above 0.98. Therefore, the proposed indicating film showed great potential monitoring salmon freshness.

Effects of sodium chloride substitutes on physicochemical properties of salted beef.

In this study, beef was marinated with different low-sodium salt substitutes and heated and aged by employing superheated steam roasting and traditional roasting to investigate the effects of the various substitutes on the physicochemical properties, texture profile, sensory properties, volatile compounds, microstructural characteristics, and safety of cured and aged beef. Twenty kilograms of beef were arbitrarily divided into five treatments and pickled with different low-sodium salt substitutes. The results revealed no significant differences in saltiness, physicochemical characteristics, texture profile, or volatile compounds between the T2 and T3 and T1 (100% NaCl, T1; 75% KCl + 25% NaCl, T2; 50% KCl + 50% NaCl, T3) samples. Furthermore, the T4 and T5 (50% NaCl + 25% KCl + 20% MgCl2 + 5% CaCl2, T4; 100% yeast extract, T5) samples had lower saltiness than the T1 sample. The plasmolysis percentage and osmotic pressure of the T2 and T3 samples were lower than those of the T1 sample. Therefore, reducing sodium by substituting NaCl with 50% KCl or 75% KCl maintained an acceptable sensory and safety profile for beef consumption.

Classification of Black Mahlab seeds (Monechma ciliatum) using GC-MS and FT-NIR and simultaneous prediction of their major volatile compounds using chemometrics.

The identification of geographical origin is an important factor in assessing the quality of aromatic and medicinal seeds such as Black Mahlab (Monechma ciliatum). However, at present, there are no studies concerning Black Mahlab Seeds (BMSs). To identify the geographical origin of BMSs, we have used gas chromatography-mass spectrometry (GC-MS) and Fourier transform infrared spectroscopy (FT-NIR) combined with chemometrics. Chemometrics analysis showed that FT-NIR and GC-MS can be used to discriminate the geographical origin of BMSs. FT-NIR coupled with the partial least squares regression (PLSR) was applied to develop the calibration models. The calibration models had a coefficient of determination (Rc2) of 0.82 for coumarin and 0.81 for methyl salicylate. The prediction model (Rp2) values ranged from 0.83 for coumarin to 0.77 for methyl salicylate. Overall, the chemometrics presented correct classification, and PLSR accurately predicted the volatiles, with an RMSEP range of 0.9 to 0.16 for the two volatiles targeted.

Discrimination of rice varieties using smartphone-based colorimetric sensor arrays and gas chromatography techniques.

A smartphone-based colorimetric sensor array system was established for discrimination of rice varieties having different geographical origins. Purposely, aroma profiling of nine rice varieties was performed using solid-phase microextraction gas chromatography-mass spectrometry. Alcohols, aldehydes, alkanes, ketones, heterocyclic compounds, and organic acids represent the abundant compounds. Colorimetric sensor array system produced a characteristic color difference map upon its exposure to volatile compounds of rice. Discrimination of rice varieties was subsequently achieved using principal component analysis, hierarchical clustering analysis, and k-nearest neighbors. Rice varieties from same geographical source were clustered together in the scatter plot of principal component analysis and hierarchical clustering analysis dendrogram. The k-nearest neighbors algorithm delivered optimal results with discrimination rate of 100% for both calibration and prediction sets using sensor array system. The smartphone-based colorimetric sensor array system and gas chromatography technique were able to effectively differentiate rice varieties with the advantage of being simple, rapid, and low-cost.

Hypha-templated synthesis of carbon/ZnO microfiber for dopamine sensing in pork.

Carbon/ZnO coaxial microfibers were synthesized with the hypha of Penicillium expansum as low-cost and green template. The SEM images, XRD and Raman spectra were used to characterize the morphology and chemical components of the prepared microfibers. The formation of the coaxial structure could be attributed to the attachment of Zn2+ onto the hypha surface through coordination and electrostatic interactions. Sensing performance of the carbon/ZnO microfibers toward Dopamine (DA) were evaluated by dropping method. Results showed that the proposed sensor exhibited good selectivity, reproducibility, and stability with a detection limit of 0.106 µM. Two linear ranges were obtained from 0 to 50 and 50 to 300 µM. The practicality of the carbon/ZnO microfibers was supported by the successful detection of DA in pork with recovery ranging from 96.85% to 104.51%. Based on the excellent electrochemical performance and easy preparation, the proposed sensor provides a promising method for determination of DA.

Effect of gum arabic edible coating incorporated with African baobab pulp extract on postharvest quality of cold stored blueberries.

The marketability of blueberries over long distances has been limited because of their highly perishability. To prolong the postharvest shelf life and conserve quality properties of blueberry, various alternatives have been evaluated. We studied the influence of gum arabic (GA) alone or GA enhanced with African baobab (AB) fruit extract on blueberry during cold storage (4 °C) for 21 days. Physico-chemical properties (e.g. pH, color, firmness, and weight loss), microbial decay, antioxidant properties, polyphenol oxidase (PPO) and peroxidase (POD) activity were investigated. The fruit treated with GA combined AB indicated a significant delay in microbial decay, firmness loss, weight loss, and color change. The treatments on blueberries resulted in better preservation of total phenols and total anthocyanins delayed the increase in total soluble solids as compared to the control. The coatings lowered the activities of PPO and POD enzymes and delayed microbial decay in coated blueberry during 21 days of storage.

Recent developments in gum edible coating applications for fruits and vegetables preservation: A review.

Gums are a class of naturally occurring polysaccharides/carbohydrate polymers derived from renewable sources, which have the capacity to hydrate in water either by forming a gel or stabilizing emulsion systems. Among the substitutes recently considered to replace the application of petroleum-derived polymers against postharvest diseases and shelf life extension, gums and their derivatives have been considered as promising biocontrol products. Polysaccharide gum coatings provide a semipermeable barrier on the surface of produce to reduce respiration rate, weight loss and maintain the nutritional value. Gums have been used as excellent vehicles for active substances, also controlling the speed of diffusion of these, and improving the control of the maturation of fruit and vegetable. Additionally, plant extracts, essential oils, phenolic compounds, and vitamins can be incorporated into polysaccharides edible coatings in order to improve their mechanical barrier, antioxidant and antimicrobial properties. Gums have many advantages over the synthetic polymers, because they have been approved as GRAS by FAO, and their use is safe for the consumer and eco-friendly. This review aims to highlight the most relevant and current information in the use of polysaccharides in postharvest shelf life extension and preservation of overall quality of fruits and vegetables.

Geospatial visualisation of food contaminant distributions: Polychlorinated naphthalenes (PCNs), potentially toxic elements (PTEs) and aflatoxins.

Large volume of multidimensional data can be summarised, both in terms of tabulated statistics, and as graphic geospatial visualisations. The latter approach allows rapid interpretation and communication of complex information to stake-holders such as regulators, risk assessors and policy makers. In the main study on polychlorinated naphthalene (PCN), individual samples representing different edible fish species were analysed from around the UK. PCNs were observed in all samples with nearly all of the twelve measured congeners being detected. Summed congener concentrations ranged from 0.7 ng/kg ww (turbot) to 265 ng/kg ww (sprats). The highest contamination levels were recorded for sprats and mackerel with mean summed concentrations of 67 ng/kg ww and 68 ng/kg ww respectively. Two ancillary studies, on potentially toxic elements (PTEs) in crabs from China and aflatoxin in children's blood from Tanzania, demonstrate the wide applicability of this approach. The PTE contents in crab showed strong dependence on the tested tissues and elements, and crabs from Tai and Yangcheng Lakes showed obviously higher PTE levels than the other lakes. Geospatial distribution of the aflatoxin biomarker AF-alb in children's serum from 3 locations showed how individual anthropometric or socio-economic data reveals the relationship between family size, socio-economic score and magnitude of serum aflatoxin levels. In addition to facilitating the flow of interpreted data to stakeholders, these techniques can direct the formulation of risk mitigation activities and help with the identification of data gaps. When combined with hierarchical cluster analyses, correlations within the data can also be predicted.

Spatial analysis of polybrominated diphenylethers (PBDEs) and polybrominated biphenyls (PBBs) in fish collected from UK and proximate marine waters.

Some commonly consumed marine fish species are considered to display a higher risk of bio-accumulating organic environmental contaminants such as PBDEs. As part of a study to investigate the spatial distribution of these contaminants, data on polybrominated diphenlyethers (PBDEs) and polybrominated biphenyls (PBBs) were collected and analysed by introducing a web-based resource which enables efficient spatial, species and concentration level representations. Furthermore, hierarchical cluster analyses permits correlations within the data to be predicted. The data provide current information on levels of PBDE and PBB occurrence, allowing identification of locations that show higher contaminant levels. 135 fish samples of various species were analysed from UK marine waters, but encompassing the waters around Norway in the North and to the Algarve in the South. PBDEs were observed in all samples with the majority of measured congeners being detected. The concentrations ranged from 0.087 µg/kg to 8.907 µg/kg whole weight (ww) for the sum of all measured PBDE congeners. PBBs occurred less frequently showing a corresponding range of <0.02 µg/kg to 0.97 µg/kg ww for the sum of seven PBB congeners. Concentrations vary depending on species and locations where landed, e.g. PBBs occurred more frequently and at higher levels in grey mullet from French waters. The high frequency of PBDE occurrence makes it prudent to continue the monitoring of these commonly consumed marine fish species. The web-based resource provides a flexible and efficient tool for assessors and policy-makers to monitor and evaluate levels within caught fish species improving evidenced-based decision processes.

Predictive value of albumin/fibrinogen ratio for 28-day mortality risk in patients with sepsis / 中华急诊医学杂志

Objective:To investigate the predictive value of albumin/fibrinogen ratio (AFR) for 28-d mortality in patients with sepsis.Methods:A total of 186 patients with sepsis admitted to the Intensive Care Unit of the First Affiliated Hospital of Xinjiang Medical University from January 2019 to December 2021 were studied retrospectively. They were divided into the survival group ( n=124) and death group ( n=62) according to the 28-d survival conditions. Clinical data of each group within 24 h after admission were recorded, including age, sex, underlying diseases, white blood cell count, albumin, fibrinogen (FIB), PCT, CRP and other laboratory examination indexes. APACHEⅡ scores and SOFA scores were recorded at the time of admission. Cox regression was used to analyze the influence of each index on the prognosis of patients. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of AFR for 28-d mortality in patients with sepsis. Kaplan-Meier method was used to draw survival curves under different AFR levels for survival analysis. Pearson correlation was used to analyze the relationship between AFR and APACHEⅡ score. Rseults:Age, number of patients with septic shock, mechanical ventilation, APACHEⅡ score, SOFA score, blood lactic acid and fibrinogen increased significantly in the death group ( P<0.05), while albumin and AFR were significantly decreased ( P<0.001). ROC curve analysis showed that the area under the curve of AFR in predicting 28-d mortality risk of patients with sepsis was 0.900. When the cut-off value of AFR was 7.64, the sensitivity was 80.0% and the specificity was 85.5%. Kaplan-Meier survival analysis showed that patients with AFR >7.64 had better prognosis. Cox regression analysis showed that AFR, APACHEⅡ score and the presence of septic shock were independent risk factors affecting the prognosis of patients with sepsis. AFR was strongly correlated with APACHEⅡ score ( r=-0.462, P<0.001). Conclusions:As a simple, effective and safe biomarker, AFR has a certain predictive value for 28-d mortality risk in patients with sepsis.

Effects of circular RNA-SEC31A on the invasion and migration of pancreatic cancer cells and molecular mechanism / 中华胰腺病杂志

Objective:To determine the expression of circular RNA-SEC31A(circSEC31A) in pancreatic cancer and investigate the effects on the invasion and migration of pancreatic cancer cells and the underlying molecular mechanism.Methods:Differentially expressed circRNAs between pancreatic cancer cells (BXPC-3, PANC1, CaPan-2, SW1990) and human normal pancreatic cells (HPDE) were identified by qRT-PCR. Then, two cell lines with high circSEC31A expression were selected to conduct next experiments. According to the sequence of the back-splicing site in circSEC31A, siRNAs for downregulation of circSEC31A were designed and transfected by liposome to silence circSEC31A in pancreatic cancer cells, and grouped as followed siR-circSEC31A#1 and siR-circSEC31A#2. Meanwhile, siR-NC group transfected with non-specific siRNA served as control. Transwell assays and wound healing assays were operated to evaluate the functional role of circSEC31A on the invasion and migration of pancreatic cancer cells. RNA Pull-down assay with circSEC31A probe and oligo control probe was used to screen the miRNA combining with circSEC31A and the effects of miRNA on cell invasion and migration of pancreatic cancer cells were validated. The effect of miR-200c-3p and circSEC31A silencing on the expression of PDK1 mRNA was identified by qRT-PCR. The protein expression of PDK1, downstream Akt and p-Akt after circSEC31A silencing was verified by Western blotting assays.Results:The relative expression level of circSEC31A in HPDE (1.000±0.120) was obviously lower than that in BXPC-3 (1.920±0.130), SW1990 (2.93±0.528), PANC1 (4.557±0.692) and CaPan-2 (5.247±0.194), and all the differences were statistically significant ( P<0.001). Compared with the PANC1 siR-NC group (1301.3±94.6) and CaPan-2 siR-NC group (1835.0±70.1) per 100 high power field, transwell assays showed that the numbers of invasive pancreatic cancer cells was highly decreased in PANC1 siR-circSEC31A#1 group (727.3±92.9), siR-circSEC31A#2 group (792.0±18.1), CaPan-2 siR-circSEC31A#1 group (718.0±90.6), siR-circSEC31A#2 group (692.7±84.8). Wound healing assays showed that silencing circSEC31A decreased the wound healing rate of pancreatic cancer cells in PANC1 siR-circSEC31A#1 group (20.667±3.215)%, siR-circSEC31A#2 group (20.000±4.583)%, CaPan-2 siR-circSEC31A#1 group (28.000±8.185)%, siR-circSEC31A#2 group (29.667±5.686)%, compared with the PANC1 siR-NC group (55.000±4.359)% and CaPan-2 siR-NC group (69.000±3.606)%. RNA Pull-down assays showed that compared with PANC1 oligo probe group (1.000±0.091) and CaPan-2 oligo probe group (1.000±0.153), miR-200c-3p was significantly enriched in the PANC1 circSEC31A probe group (2.237±0.175) and CaPan-2 circSEC31A probe group (2.166±0.156). Compared with PANC1 siR-NC group (939.3±57.0) and CaPan-2 siR-NC group (786.7±51.5) per 100 high power field, the numbers of invasive pancreatic cancer cells were up-regulated in PANC1 siR-miR-200c-3p group (1206.0±99.1) and CaPan-2 siR-miR-200c-3p group (1838.0±105.7), while the low numbers of invasive pancreatic cancer cells were observed in PANC1 siR-miR-200c-3p+ siR-circSEC31A group (932.7±116.4) and CaPan-2 siR-miR-200c-3p+ siR-circSEC31A group (785.3±58.8). Compared with PANC1 siR-NC group (1.000±0.103) and CaPan-2 siR-NC group (1.000±0.107), the relative expression of PDK1 mRNA in PANC1 siR-miR-200c-3p group (1.898±0.159) and CaPan-2 siR-miR-200c-3p group (2.102±0.337) was upregulated. Furthermore, the expression of PDK1 mRNA was decreased in the siR-miR-200c-3p+ siR-circSEC31A group (0.980±0.070, 1.015±0.079). Western blot assays showed that the expression of PDK1 protein in PANC1 siR-NC group, siR-circSEC31A#1 group, siR-circSEC31A#2 group was 0.767±0.086, 0.281±0.191, 0.333±0.062 and in CaPan-2 siR-NC group, siR-circSEC31A#1 group, siR-circSEC31A#2 group was 0.712±0.038, 0.353±0.061, 0.308±0.018. The expression of p-Akt protein in PANC1 siR-NC group and siR-circSEC31A group was 0.741±0.050, 0.114±0.027, 0.139±0.041. In addition, p-Akt protein expression in CaPan-2 siR-NC group and siR-circSEC31A group was 0.823±0.052, 0.141±0.045, 0.280±0.089. PDK1 and p Akt expression in siR circSEC31A group was obviously lower than those in sir NC group. All the differences between either groups above were statistically significant ( P<0.05). Conclusions:circSEC31A is upregulated in pancreatic cancer cells, which facilitates the invasion and metastasis of pancreatic cancer cells via miR-200c-3p/PDK1/Akt signaling pathway, supporting that circSEC31A may function as a new diagnostic and therapeutic target for pancreatic cancer patients.

Role of Nrf2/GPX4 mediated ferroptosis in intestinal injury in sepsis / 中华危重病急救医学

OBJECTIVE@#To investigate whether ferroptosis exists in sepsis induced intestinal injury, and to verify the association between ferroptosis in sepsis induced intestinal injury and intestinal inflammation and barrier function by stimulating and inhibiting the nuclear factor E2-related factor 2/glutathione peroxidase 4 (Nrf2/GPX4) pathway.@*METHODS@#Forty-eight SPF grade male Sprague-Darvley (SD) rats with a body weight of 220-250 g were divided into sham operation group (Sham group), sepsis group (CLP group), sepsis+iron chelating agent deferoxamine (DFO) group (CLP+DFO group) and sepsis+ferroptosis inducer Erastin group (CLP+Erastin group) using a random number table method, with 12 rats in each group. The sepsis model was established by cecal ligation and puncture (CLP). The Sham group was only performed with abdominal opening and closing operations. After modeling, the CLP+DFO group received subcutaneous injection of 20 mg/kg of DFO, the CLP+Erastin group was intraperitoneally injected with 20 mg/kg of Erastin. Each group received subcutaneous injection of 50 mg/kg physiological saline for fluid resuscitation after surgery, and the survival status of the rats was observed 24 hours after surgery. At 24 hours after model establishment, 6 rats in each group were selected. First, live small intestine tissue was taken for observation of mitochondrial morphology in smooth muscle cells under transmission electron microscopy and determination of reactive oxygen species (ROS). Then, blood was collected from the abdominal aorta and euthanized. The remaining 6 rats were sacrificed after completing blood collection from the abdominal aorta, and then small intestine tissue was taken. Western blotting was used to detect the expression of intestinal injury markers such as Claudin-1 and ferroptosis related proteins GPX4 and Nrf2. Observe the pathological changes of small intestine tissue using hematoxylin-eosin (HE) staining and complete Chiu score; Detection of tumor necrosis factor-α (TNF-α), interleukins (IL-1β, IL-6) levels in serum using enzyme-linked immunosorbent assay (ELISA). The levels of serum iron ions (Fe3+), malondialdehyde (MDA), and D-lactate dehydrogenase (D-LDH) were measured.@*RESULTS@#(1) Compared with the Sham group, the 24-hour survival rate of rats in the CLP group and CLP+Erastin group significantly decreased (66.7%, 50.0% vs. 100%, both P < 0.05), while there was no significant difference in the CLP+DFO group (83.3% vs. 100%, P = 0.25). (2) Western blotting results showed that compared with the Sham group, the expressions of GPX4 and Claudin-1 in the small intestine tissue of the CLP group, CLP+DFO group, and CLP+Erastin group decreased significantly, while the expression of Nrf2 increased significantly (GPX4/β-actin: 0.56±0.02, 1.03±0.01, 0.32±0.01 vs. 1.57±0.01, Claudin-1/β-actin: 0.60±0.04, 0.96±0.07, 0.41±0.01 vs. 1.40±0.01, Nrf2/β-actin: 0.88±0.02, 0.72±0.01, 1.14±0.01 vs. 0.43±0.02, all P < 0.05). Compared with the CLP group, the expressions of GPX4 and Claudin-1 were significantly increased in the CLP+DFO group, while the expression of Nrf2 was significantly reduced. In the CLP+Erastin group, the expressions of GPX4 and Claudin-1 further decreased, while the expression of Nrf2 further increased (all P < 0.05). (3) Under the light microscope, compared with the Sham group, the CLP group, CLP+DFO group, and CLP+Erastin group showed structural disorder in the small intestinal mucosa and submucosal tissue, significant infiltration of inflammatory cells, and destruction of glandular and villous structures. The Chui score was significantly higher (3.25±0.46, 2.00±0.82, 4.50±0.55 vs. 1.25±0.45, all P < 0.05). (4) Under transmission electron microscopy, compared with the Sham group, the mitochondria in the other three groups of small intestinal smooth muscle cells showed varying degrees of volume reduction, increased membrane density, and reduced or disappeared cristae. The CLP+Erastin group showed the most significant changes, while the CLP+DFO group showed only slight changes in mitochondrial morphology. (5) Compared to the Sham group, the CLP group, CLP+DFO group, and CLP+Erastin group had serum levels of TNF-α, IL-1β, IL-6, MDA, D-LDH, and ROS in small intestine tissue were significantly increased, while the serum Fe3+ content was significantly reduced [TNF-α (ng/L): 21.49±1.41, 17.24±1.00, 28.66±2.72 vs. 14.17±1.24; IL-1β (ng/L): 108.40±3.09, 43.19±8.75, 145.70±11.00 vs. 24.50±5.55; IL-6 (ng/L): 112.50±9.76, 45.90±6.52, 151.80±9.38 vs. 12.89±6.11; MDA (μmol/L): 5.61±0.49, 3.89±0.28, 8.56±1.17 vs. 1.86±0.41; D-LDH (kU/L): 39.39±3.22, 25.38±2.34, 53.29±10.53 vs. 10.79±0.52; ROS (fluorescence intensity): 90 712±6 436, 73 278±4 775, 110 913±9 287 vs. 54 318±2 226; Fe3+ (μmol/L): 22.19±1.34, 34.05±1.94, 12.99±1.08 vs. 51.74±11.07; all P < 0.05]. Compared with CLP group, the levels of TNF-α, IL-1β, IL-6, MDA, D-LDH and ROS in CLP+Erastin group were further increased, and the content of Fe3+ was further decreased, the CLP+DFO group was the opposite (all P < 0.05).@*CONCLUSIONS@#Ferroptosis exists in the intestinal injury of septic rats, and stimulating or inhibiting ferroptosis through the Nrf2/GPX4 pathway can effectively intervene in the inflammatory state and intestinal mechanical barrier of the body.

Relationship between blood transfusion factors and early postoperative outcomes in patients undergoing orthotopic liver transplantation / 中华麻醉学杂志

Objective:To evaluate the relationship between blood transfusion factors (massive transfusion, transfusion of stored red blood cells and anhepatic transfusion) and early postoperative outcomes in the patients undergoing orthotopic liver transplantation.Methods:Patients with end-stage liver disease who underwent orthotopic liver transplantation and intraoperative blood transfusion from January 2021 to March 2022 in our hospital were retrospectively selected, and their clinical data were collected. The patients were divided into massive transfusion group (M group, total red blood cell transfusion ≥10 U) and non-massive transfusion group (NM group) according to the amount of intraoperative blood transfused. The patients were divided into fresh blood group (NS group) and stored blood group (S group, red blood cell storage time > 2 weeks) according to the storage time of red blood cells transfused. The patients were divided into transfusion in anhepatic stage group (group T) and nontransfusion in anhepatic stage group (group NT) according to whether blood was transfused in the anhepatic stage. Multivariate logistic regression, generalized linear model and generalized linear mixed model were used to analyze the relationship between blood transfusion factors and primary outcome measures (postoperative pulmonary complications, circulation overload, acute kidney injury, abdominal infection, thrombosis) and between blood transfusion factors and secondary outcome measures (duration of ICU stay, postoperative hospitalization, postoperative temperature ≥38.5 ℃ at any time point after surgery, postoperative liver and kidney function index, coagulation function index, platelet count and preoperative difference).Results:One hundred and six patients were enrolled in this study. The results of multivariate logistic regression analysis: Massive blood transfusion and infusion of stored blood were risk factors for postoperative pulmonary complications, massive blood transfusion was a risk factor for abdominal infection, Child-Turcotte-Pugh score for liver function and time of anhepatic phase were risk factors for postoperative acute kidney injury, Child-Turcotte-Pugh score was a risk factor for circulatory overload, and age and massive blood transfusion were risk factors for thrombosis ( P<0.05). The results of generalized linear model analysis: Intraoperative stored blood transfusion and blood transfusion during the anhepatic phase were risk factors for prolonged duration of ICU stay, massive blood transfusion, intraoperative stored blood transfusion and blood transfusion during the anhepatic phase were risk factors for prolonged hospitalization ( P<0.05), and there was no correlation between massive blood transfusion, intraoperative stored blood transfusion and blood transfusion during the anhepatic phase and temperature ≥38.5 ℃ at any time point after surgery ( P>0.05). The results of generalized linear mixed model analysis: There was statistically significant difference in the difference between preoperative and postoperative liver and kidney function indexes, coagulation function indexes and platelet counts in the patients with or without massive transfusion, stored blood transfusion or blood transfusion during the anhepatic phase ( P<0.05). Conclusions:Massive blood transfusion and infusion of stored blood are the main risk factors for early adverse outcomes after orthotopic liver transplantation in the patients.

EGFR-TKI Combined with Pemetrexed versus EGFR-TKI Monotherapy in Advanced EGFR-mutated NSCLC: A Prospective, Randomized, Exploratory Study / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#We aimed to evaluate whether the addition of pemetrexed is effective in improving progression-free survival (PFS) in epidermal growth factor receptor (EGFR)–mutated patients with or without concomitant alterations. @*Materials and Methods@#This multicenter clinical trial was conducted in China from June 15, 2018, to May 31, 2019. A total of 92 non–small cell lung cancer (NSCLC) patients harboring EGFR-sensitive mutations were included and divided into concomitant and non-concomitant groups. Patients in each group were randomly treated with EGFR–tyrosine kinase inhibitor (TKI) monotherapy or EGFR-TKI combined with pemetrexed in a ratio of 1:1. PFS was recorded as the primary endpoint. @*Results@#The overall median PFS of this cohort was 10.1 months. There were no significant differences in PFS between patients with and without concomitant and between patients received TKI monotherapy and TKI combined with pemetrexed (p=0.210 and p=0.085, respectively). Stratification analysis indicated that patients received TKI monotherapy had a significantly longer PFS in non-concomitant group than that in concomitant group (p=0.002). In concomitant group, patients received TKI combined with pemetrexed had a significantly longer PFS than patients received TKI monotherapy (p=0.013). Molecular dynamic analysis showed rapidly emerging EGFR T790M in patients received TKI monotherapy. EGFR mutation abundance decreased in patients received TKI combined chemotherapy, which supports better efficacy for a TKI combined chemotherapy as compared to TKI monotherapy. A good correlation between therapeutic efficacy and a change in circulating tumor DNA (ctDNA) status was found in 66% of patients, supporting the guiding role of ctDNA minimal residual disease (MRD) in NSCLC treatment. @*Conclusion@#EGFR-TKI monotherapy is applicable to EGFR-sensitive patients without concomitant alterations, while a TKI combined chemotherapy is applicable to EGFR-sensitive patients with concomitant alterations. CtDNA MRD may be a potential biomarker for predicting therapeutic efficacy.

Robotic urologic surgery using the KangDuo-Surgical Robot-01 system: A single-center prospective analysis / 中华医学杂志(英文版)

BACKGROUND@#The KangDuo-Surgical Robot-01 (KD-SR-01) system is a new surgical robot recently developed in China. The aim of this study was to present our single-center experience and mid-term outcomes of urological procedures using the KD-SR-01 system.@*METHODS@#From August 2020 to April 2023, consecutive urologic procedures were performed at Peking University First Hospital using the KD-SR-01 system. The clinical features, perioperative data, and follow-up outcomes were prospectively collected and analyzed.@*RESULTS@#A total of 110 consecutive patients were recruited. Among these patients, 28 underwent partial nephrectomy (PN), 41 underwent urinary tract reconstruction (26 underwent pyeloplasty, 3 underwent ureteral reconstruction and 12 underwent ureterovesical reimplantation [UR]), and 41 underwent radical prostatectomy (RP). The median operative time for PN was 112.5 min, 157.0 min for pyeloplasty, 151.0 min for ureteral reconstruction, 142.5 min for UR, and 138.0 min for RP. The median intraoperative blood loss was 10 mL for PN, 10 mL for pyeloplasty, 30 mL for ureteral reconstruction, 20 mL for UR, and 50 mL for RP. All procedures were successfully completed without conversion, and there were no major complications in any patient. The median warm ischemia time of PN was 17.3 min, and positive surgical margin was not noted in any patient. The overall positive surgical margin rate of RP was 39% (16/41), and no biochemical recurrence was observed in any RP patient during the median follow-up of 11.0 months. The surgical success rates of pyeloplasty and UR were 96% (25/26) and 92% (11/12) during the median follow-up of 29.5 months and 11.5 months, respectively.@*CONCLUSION@#The KD-SR-01 system appears feasible, safe, and effective for most urological procedures, based on our single-center experience.