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Osteoclasts are multinucleated bone-resorbing cells, and their formation is tightly regulated to prevent excessive bone loss. However, the mechanisms by which osteoclast formation is restricted remain incompletely determined. Here, we found that sterol regulatory element binding protein 2 (SREBP2) functions as a negative regulator of osteoclast formation and inflammatory bone loss. Cholesterols and SREBP2, a key transcription factor for cholesterol biosynthesis, increased in the late phase of osteoclastogenesis. The ablation of SREBP2 in myeloid cells resulted in increased in vivo and in vitro osteoclastogenesis, leading to low bone mass. Moreover, deletion of SREBP2 accelerated inflammatory bone destruction in murine inflammatory osteolysis and arthritis models. SREBP2-mediated regulation of osteoclastogenesis is independent of its canonical function in cholesterol biosynthesis but is mediated, in part, by its downstream target, interferon regulatory factor 7 (IRF7). Taken together, our study highlights a previously undescribed role of the SREBP2-IRF7 regulatory circuit as a negative feedback loop in osteoclast differentiation and represents a novel mechanism to restrain pathological bone destruction.
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Diferenciação Celular , Fator Regulador 7 de Interferon , Osteoclastos , Proteína de Ligação a Elemento Regulador de Esterol 2 , Animais , Osteoclastos/metabolismo , Proteína de Ligação a Elemento Regulador de Esterol 2/metabolismo , Proteína de Ligação a Elemento Regulador de Esterol 2/genética , Camundongos , Fator Regulador 7 de Interferon/metabolismo , Fator Regulador 7 de Interferon/genética , Inflamação/metabolismo , Inflamação/patologia , Camundongos Endogâmicos C57BL , Osteogênese/fisiologia , Reabsorção Óssea/metabolismo , Reabsorção Óssea/patologia , Reabsorção Óssea/genética , Camundongos Knockout , Colesterol/metabolismoRESUMO
Energy storage devices operating at low temperatures are plagued by sluggish kinetics, reduced capacity, and notorious dendritic growth. Herein, novel potassium dual-ion batteries (PDIBs) capable of superior performance at -60 °C, and fabricated by combining MXenes and polytriphenylamine (PTPAn) as the anode and cathode, respectively, are presented. Additionally, the reason for the anomalous kinetics of K+ (faster at low temperature than at room temperature) on the Ti3C2 anode is investigated. Theoretical calculations, crossover experiments, and in situ XRD at room and low temperatures revealed that K+ tends to bind with solvent molecules rather than anions at subzero temperatures, which not only inhibits the participation of PF6 - in the formation of the solid electrolyte interphase (SEI), but also guarantees co-intercalation behavior and suppresses undesirable K+ storage. The advantageous properties at low temperatures endow the Ti3C2 anode with fast K+ kinetics to unlock the outstanding performance of PDIB at ultralow temperatures. The PDIBs exhibit superior rate capability and high capacity retention at -40 °C and -60 °C. Impressively, after charging-discharging for 20,000â cycles at -60 °C, the PDIB retained 86.7 % of its initial capacity. This study reveals the influence of temperatures on MXenes and offers a unique design for dual-ion batteries operating at ultralow temperatures.
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Extreme Lateral Interbody Fusion (XLIF) is currently used in the clinical treatment of thoracic spine disorders and has achieved desirable results. In this study, we selected CT images of the thoracic spine from 54 patients and divided the intervertebral spaces into six regions (A, I, II, III, IV, P) using the Moro method. We observed the adjacent relationships between the thoracic spine and surrounding tissues such as the scapula, esophagus, thoracic aorta, and superior vena cava. We made four main findings: firstly, when the scapulae were symmetrical on both sides, over 80% of patients had the T1-4 II-III region obstructed by the scapulae; secondly, when the esophagus was located on the left side of the vertebral body, 3.7% to 24.1% of patients had the T4-9 region located in the II-III zone; furthermore, when the thoracic aorta was on the left side of the vertebral body, over 80% of individuals in the T4-9 segment occupied the II-III region, with the values being 55.5% and 20.4% for T9/10 and T10/11, respectively; finally, the superior vena cava was located on the right side of the T4/5 vertebra, with 3.7% of individuals having it in the II-III region, while on the left side of T5-9, 3.7% to 18.5% of individuals had it in the II-III region. Based on these findings, we suggest that XLIF should not be performed on the T1-4 vertebrae due to scapular obstruction. Selecting the left-sided approach for XLIF in the T4-11 segments may risk injuring the thoracic aorta, esophagus, and superior vena cava, while the T11/12 segment is considered safe and feasible. Choosing the right-sided approach for XLIF may pose a risk of injuring the superior vena cava in the T4/5 segment, but it is safe and feasible in the T5-12 segments.
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Fusão Vertebral , Vértebras Torácicas , Tomografia Computadorizada por Raios X , Humanos , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/cirurgia , Vértebras Torácicas/anatomia & histologia , Fusão Vertebral/métodos , Feminino , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/métodos , Idoso , Adulto , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/anatomia & histologia , Aorta Torácica/cirurgia , Escápula/diagnóstico por imagem , Escápula/anatomia & histologia , Veia Cava Superior/diagnóstico por imagem , Veia Cava Superior/anatomia & histologia , Esôfago/diagnóstico por imagem , Esôfago/anatomia & histologia , Esôfago/cirurgiaRESUMO
LiFePO4 is widely used because of its high safety and cycle stability, but its inefficient electronic conductivity combined with sluggish Li+ diffusivity restricts its performance. To overcome this obstacle, applying a layer of conductive carbon onto the surface of LiFePO4 has the greatest improvement in electronic conductivity and Li+ diffusivity. However, the rate performance of carbon-coated LiFePO4 makes it difficult to meet the application requirements. Although nitrogen doping improves electrochemical performance by providing active sites and electronic conductivity, the N-doped carbon coating is prone to agglomeration, which causes a sharp decrease in capacity when the current rate increases. In this work, a synergistic N, Mn codoping strategy is implemented to overcome the aforementioned drawbacks by disrupting the large agglomeration of C-N bonds, improving the uniformity of the surface coating layer to enhance the completeness of the conductive network and increasing the number of Li+ diffusion channels, and thus accelerating the mass transfer rate under high-rate current. Consequently, this strategy effectively improves the rate capability (119 mA h g-1 at 10 C) while maintaining excellent cycling performance (88% capacity retention over 600 cycles at 5 C). This work improves the rate of ion diffusion and the rate capability of micrometer-sized LiFePO4, thus, enabling its wider application.
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Objective: Little is known about the association between whole-blood nicotinamide adenine dinucleotide (NAD +) levels and nabothian cysts. This study aimed to assess the association between NAD + levels and nabothian cysts in healthy Chinese women. Methods: Multivariate logistic regression analysis was performed to analyze the association between NAD + levels and nabothian cysts. Results: The mean age was 43.0 ± 11.5 years, and the mean level of NAD + was 31.3 ± 5.3 µmol/L. Nabothian cysts occurred in 184 (27.7%) participants, with single and multiple cysts in 100 (15.0%) and 84 (12.6%) participants, respectively. The total nabothian cyst prevalence gradually decreased from 37.4% to 21.6% from Q1 to Q4 of NAD + and the prevalence of single and multiple nabothian cysts also decreased across the NAD + quartiles. As compared with the highest NAD + quartile (≥ 34.4 µmol/L), the adjusted odds ratios with 95% confidence interval of the NAD + Q1 was 1.89 (1.14-3.14) for total nabothian cysts. The risk of total and single nabothian cysts linearly decreased with increasing NAD + levels, while the risk of multiple nabothian cysts decreased more rapidly at NAD + levels of 28.0 to 35.0 µmol/L. Conclusion: Low NAD + levels were associated with an increased risk of total and multiple nabothian cysts.
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NAD , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , NAD/sangue , NAD/metabolismo , Cistos/sangue , Cistos/epidemiologia , China/epidemiologiaRESUMO
Spatial evolutionary games provide a valuable framework for elucidating the emergence and maintenance of cooperative behaviors. However, most previous studies assume that individuals are profiteers and neglect to consider the effects of memory. To bridge this gap, in this paper, we propose a memory-based spatial evolutionary game with dynamic interaction between learners and profiteers. Specifically, there are two different categories of individuals in the network, including profiteers and learners with different strategy updating rules. Notably, there is a dynamic interaction between profiteers and learners, i.e., each individual has the transition probability between profiteers and learners, which is portrayed by a Markov process. Besides, the payoff of each individual is not only determined by a single round of the game but also depends on the memory mechanism of the individual. Extensive numerical simulations validate the theoretical analysis and uncover that dynamic interactions between profiteers and learners foster cooperation, memory mechanisms facilitate the emergence of cooperative behaviors among profiteers, and increasing the learning rate of learners promotes a rise in the number of cooperators. In addition, the robustness of the model is verified through simulations across various network sizes. Overall, this work contributes to a deeper understanding of the mechanisms driving the formation and evolution of cooperation.
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A new compound xylarkarynone A (1), a first reported natural product compound xylarkarynone B (2) and eight known compounds (3-10) were isolated from Xylaria sp. HHY-2. Their structures were elucidated by spectroscopic methods, DP4+ probability analyses and electronic circular dichroism (ECD) calculations. The bioactivities of isolated compounds were assayed. Compound 1 exhibited obvious activity against A549 cells with an IC50 value of 6.12±0.28â µM. Additionally, compound 1 showed moderate antifungal activities against Plectosphaerella cucumerina and Aspergillus niger with minimum inhibitory concentrations (MICs) of both 16â µg/mL, which was at the same grade with positive control nystatin. Most compounds exhibited varying degrees of inhibitory activity against P. cucumerina, indicating that Xylaria sp. has potential as inhibitors against P. cucumerina.
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Antifúngicos , Aspergillus niger , Testes de Sensibilidade Microbiana , Sesquiterpenos , Xylariales , Humanos , Xylariales/química , Antifúngicos/farmacologia , Antifúngicos/química , Antifúngicos/isolamento & purificação , Sesquiterpenos/química , Sesquiterpenos/isolamento & purificação , Sesquiterpenos/farmacologia , Aspergillus niger/efeitos dos fármacos , Células A549 , Ensaios de Seleção de Medicamentos Antitumorais , Ascomicetos/química , Estrutura Molecular , Conformação Molecular , Relação Estrutura-Atividade , Relação Dose-Resposta a DrogaRESUMO
Spinal cord injury (SCI) is currently a highly disabling disease, which poses serious harm to patients and their families. Due to the fact that primary SCI is caused by direct external force, current research on SCI mainly focuses on the treatment and prevention of secondary SCI. Oxidative stress is one of the important pathogenic mechanisms of SCI, and intervention of oxidative stress may be a potential treatment option for SCI. Teriparatide is a drug that regulates bone metabolism, and recent studies have found that it has the ability to counteract oxidative stress and is closely related to SCI. This article summarizes the main pathological mechanisms of oxidative stress in SCI, as well as the relationship between them with teriparatide, and explores the therapeutic potential of teriparatide in SCI.
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The blood-spinal cord barrier (BSCB) is disrupted within minutes of spinal cord injury, leading to increased permeability and secondary spinal cord injury, resulting in more severe neurological damage. The preservation of blood-spinal cord barrier following spinal cord injury plays a crucial role in determining the prognosis. Teriparatide, widely used in clinical treatment for osteoporosis and promoting fracture healing, has been found in our previous study to have the effect of inhibiting the expression of MMP9 and alleviating blood-brain barrier disruption after ischemic stroke, thereby improving neurological damage symptoms. However, there are limited research on whether it has the potential to improve the prognosis of spinal cord injury. This article summarizes the main pathological mechanisms of blood-spinal cord barrier disruption after spinal cord injury and its relationship with Teriparatide, and explores the therapeutic potential of Teriparatide in improving the prognosis of spinal cord injury by reducing blood-spinal cord barrier disruption.
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Tumor microenvironment (TME) plays an important role in the tumor progression. Among TME components, cancer-associated fibroblasts (CAFs) show multiple tumor-promoting effects and can induce tumor immune evasion and drug-resistance. Regulating CAFs can be a potential strategy to augment systemic anti-tumor immunity. Here, the study observes that hydrogen treatment can alleviate intracellular reactive oxygen species of CAFs and reshape CAFs' tumor-promoting and immune-suppressive phenotypes. Accordingly, a controllable and TME-responsive hydrogen therapy based on a CaCO3 nanoparticles-coated magnesium system (Mg-CaCO3) is developed. The hydrogen therapy by Mg-CaCO3 can not only directly kill tumor cells, but also inhibit pro-tumor and immune suppressive factors in CAFs, and thus augment immune activities of CD4+ T cells. As implanted in situ, Mg-CaCO3 can significantly suppress tumor growth, turn the "cold" primary tumor into "hot", and stimulate systematic anti-tumor immunity, which is confirmed by the bilateral tumor transplantation models of "cold tumor" (4T1 cells) and "hot tumor" (MC38 cells). This hydrogen therapy system reverses immune suppressive phenotypes of CAFs, thus providing a systematic anti-tumor immune stimulating strategy by remodeling tumor stromal microenvironment.
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Fibroblastos Associados a Câncer , Hidrogênio , Fenótipo , Microambiente Tumoral , Microambiente Tumoral/imunologia , Microambiente Tumoral/efeitos dos fármacos , Fibroblastos Associados a Câncer/efeitos dos fármacos , Fibroblastos Associados a Câncer/imunologia , Fibroblastos Associados a Câncer/metabolismo , Camundongos , Animais , Hidrogênio/farmacologia , Linhagem Celular Tumoral , Modelos Animais de Doenças , Feminino , Camundongos Endogâmicos BALB C , Humanos , Nanopartículas , Carbonato de Cálcio/farmacologiaRESUMO
In layered Li-rich materials, over stoichiometric Li forms an ordered occupation of LiTM6 in transition metal (TM) layer, showing a honeycomb superstructure along [001] direction. At the atomic scale, the instability of the superstructure at high voltage is the root cause of problems such as capacity/voltage decay of Li-rich materials. Here a Li-rich material with a high Li/Ni disorder is reported, these interlayer Ni atoms locate above the honeycomb superstructure and share adjacent O coordination with honeycomb TM. These NiâO bonds act as cable-stayed bridge to the honeycomb plane, and improve the high-voltage stability. The cable-stayed honeycomb superstructure is confirmed by in situ X-ray diffraction to have a unique cell evolution mechanism that it can alleviate interlaminar lattice strain by promoting in-plane expansion along a-axis and inhibiting c-axis stretching. Electrochemical tests also demonstrate significantly improved long cycle performance after 500 cycles (86% for Li-rich/Li half cell and 82% for Li-rich/Si-C full cell) and reduced irreversible oxygen release. This work proves the feasibility of achieving outstanding stability of lithium-rich materials through superstructure regulation and provides new insights for the development of the next-generation high-energy-density cathodes.
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Low-valent transition-metal diazenido species are important intermediates in transition-metal-mediated dinitrogen reduction reactions. Isolable complexes of the type unanimously feature closed-shell diazenido ligands. Those bearing open-shell diazenido ligands have remained elusive. Herein, we report the synthesis, characterization, and reactivity of a d7 iron(I) complex featuring an open-shell silyldiazenido ligand, [(ICy)Fe(NNSiiPr3)(η2:η2-dvtms)] (1, ICy = 1,3-dicyclohexylimidazole-2-ylidene, dvtms = divinyltetramethyldisiloxane). Complex 1 is prepared in good yield by silylation of the iron(-I)-N2 complex [K(18-crown-6)][(ICy)Fe(N2)(η2:η2-dvtms)] with iPr3SiOTf and has been fully characterized by various spectroscopic methods. Theoretical studies, in combination with characterization data, established an S = 1/2 ground spin-state for 1 that can best be described as a quartet iron(I) center featuring an antiferromagnetically coupled triplet silyldiazenido ligand. The diazenido and alkene ligands in 1 are labile, as indicated by the facile disproportionation reaction of 1 at ambient temperature to transform into the iron(II) bis(diazenido) species [(ICy)(NNSiiPr3)2Fe(dvtms)Fe(NNSiiPr3)2(ICy)] (2) and the iron(0) species [(ICy)Fe(η2:η2-dvtms)] and also the alkene-exchange reaction of 1 with PhCHâCHBC8H14 to form [(ICy)Fe(NNSiiPr3)(η2-trans-PhCHâCHBC8H14)] (3). Complex 1 is light-sensitive. Upon photolysis, it undergoes a SiiPr3 radical-transfer reaction to yield [(ICy)Fe(σ:η2-MeCHSiMe2OSiMe2CHâCHSiiPr3)] (4) and N2. The reactions of 1 with the trityl radical and organic bromides yield iron(II) complexes, which indicates its reducing nature. Moreover, 1 is a weak hydrogen-atom abstractor, as indicated by its inertness toward HSi(SiMe3)3 and cyclohexa-1,4-diene and the low calculated N-H bond dissociation energy (48 kcal/mol) of its corresponding iron(II) iso-hydrazenido species.
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OBJECTIVES: To summarize the clinical data of 7 children with activated phosphoinositide 3-kinase delta syndrome (APDS) and enhance understanding of the disease. METHODS: A retrospective analysis was conducted on clinical data of 7 APDS children admitted to Hunan Provincial People's Hospital from January 2019 to August 2023. RESULTS: Among the 7 children (4 males, 3 females), the median age of onset was 30 months, and the median age at diagnosis was 101 months. Recurrent respiratory tract infections, hepatosplenomegaly, and multiple lymphadenopathy were observed in all 7 cases. Sepsis was observed in 5 cases, otitis media and multiple caries were observed in 3 cases, and diarrhea and joint pain were observed in 2 cases. Lymphoma and systemic lupus erythematosus were observed in 1 case each. Fiberoptic bronchoscopy was performed in 4 cases, revealing scattered nodular protrusions in the bronchial lumen. The most common respiratory pathogen was Streptococcus pneumoniae (4 cases). Six patients had a p.E1021K missense mutation, and one had a p.434-475del splice site mutation. CONCLUSIONS: p.E1021K is the most common mutation site in APDS children. Children who present with one or more of the following symptoms: recurrent respiratory tract infections, hepatosplenomegaly, multiple lymphadenopathy, otitis media, and caries, and exhibit scattered nodular protrusions on fiberoptic bronchoscopy, should be vigilant for APDS. Citation:Chinese Journal of Contemporary Pediatrics, 2024, 26(5): 499-505.
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Classe I de Fosfatidilinositol 3-Quinases , Humanos , Feminino , Masculino , Pré-Escolar , Criança , Classe I de Fosfatidilinositol 3-Quinases/genética , Estudos Retrospectivos , Infecções Respiratórias , Mutação , Doenças da Imunodeficiência Primária/genética , LactenteRESUMO
BACKGROUND: Crohn's disease (CD) is often misdiagnosed as intestinal tuberculosis (ITB). However, the treatment and prognosis of these two diseases are dramatically different. Therefore, it is important to develop a method to identify CD and ITB with high accuracy, specificity, and speed. AIM: To develop a method to identify CD and ITB with high accuracy, specificity, and speed. METHODS: A total of 72 paraffin wax-embedded tissue sections were pathologically and clinically diagnosed as CD or ITB. Paraffin wax-embedded tissue sections were attached to a metal coating and measured using attenuated total reflectance fourier transform infrared spectroscopy at mid-infrared wavelengths combined with XGBoost for differential diagnosis. RESULTS: The results showed that the paraffin wax-embedded specimens of CD and ITB were significantly different in their spectral signals at 1074 cm-1 and 1234 cm-1 bands, and the differential diagnosis model based on spectral characteristics combined with machine learning showed accuracy, specificity, and sensitivity of 91.84%, 92.59%, and 90.90%, respectively, for the differential diagnosis of CD and ITB. CONCLUSION: Information on the mid-infrared region can reveal the different histological components of CD and ITB at the molecular level, and spectral analysis combined with machine learning to establish a diagnostic model is expected to become a new method for the differential diagnosis of CD and ITB.
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Doença de Crohn , Enterite , Tuberculose Gastrointestinal , Humanos , Doença de Crohn/diagnóstico , Doença de Crohn/patologia , Espectroscopia de Infravermelho com Transformada de Fourier , Diagnóstico Diferencial , Parafina , Tuberculose Gastrointestinal/diagnóstico , Tuberculose Gastrointestinal/patologia , Enterite/diagnóstico , Aprendizado de Máquina , Proteínas Mutadas de Ataxia TelangiectasiaRESUMO
BACKGROUND: Sleep quality may be related to benign prostatic hyperplasia (BPH), however causal associations have not been established. This study aimed to evaluate causal relationships between six sleep traits ([i] day time napping, [ii] daytime sleepiness, [iii] insomnia, [iv] long sleep duration, [v] short sleep duration, and [vi] sleep duration per hour) and BPH through a bidirectional Mendelian randomization (MR) study. METHODS: Genome-wide association summary statistics of sleep traits and BPH were downloaded from public databases. Inverse variance weighting (IVW) was used as the main approach for causal inference. For causal estimates identified by IVW, various sensitivity analyses were performed to assess the reliability of the results: (i) four additional MR methods to complement IVW; (ii) Cochran's Q test to assess heterogeneity; (iii) MR-Egger intercept test and MR-PRESSO global test to assess horizontal pleiotropy; and (iv) leave-one-out method to assess stability. RESULTS: Forward MR analyses indicated that genetically predicted insomnia symptom significantly increased BPH risk (OR = 1.267, 95% CI: 1.003-1.601, P = 0.048), while reverse MR analyses identified that genetically predicted liability to BPH significantly increased the incidence of insomnia (OR = 1.026, 95% CI: 1.000-1.052, P = 0.048). In a replicate MR analysis based on summary statistics including exclusively male participants, the finding of increased risk of BPH due to genetically predicted insomnia symptom was further validated (OR = 1.488, 95% CI: 1.096-2.022, P = 0.011). No further causal links were identified. In addition, sensitivity tests demonstrated the reliability of the MR results. CONCLUSION: This study identified that a higher prevalence of genetically predicted insomnia symptoms may significantly increase the risk of BPH, while genetically predicted liability to BPH may in turn increase the incidence of insomnia symptom. Therefore, improving sleep quality and reducing the risk of insomnia could be a crucial approach for the prevention of BPH.
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Hiperplasia Prostática , Distúrbios do Início e da Manutenção do Sono , Humanos , Masculino , Distúrbios do Início e da Manutenção do Sono/genética , Hiperplasia Prostática/complicações , Hiperplasia Prostática/genética , Estudo de Associação Genômica Ampla , Análise da Randomização Mendeliana , Reprodutibilidade dos TestesRESUMO
Spiking neural networks (SNNs) are attracting widespread interest due to their biological plausibility, energy efficiency, and powerful spatiotemporal information representation ability. Given the critical role of attention mechanisms in enhancing neural network performance, the integration of SNNs and attention mechanisms exhibits tremendous potential to deliver energy-efficient and high-performance computing paradigms. In this article, we present a novel temporal-channel joint attention mechanism for SNNs, referred to as TCJA-SNN. The proposed TCJA-SNN framework can effectively assess the significance of spike sequence from both spatial and temporal dimensions. More specifically, our essential technical contribution lies on: 1) we employ the squeeze operation to compress the spike stream into an average matrix. Then, we leverage two local attention mechanisms based on efficient 1-D convolutions to facilitate comprehensive feature extraction at the temporal and channel levels independently and 2) we introduce the cross-convolutional fusion (CCF) layer as a novel approach to model the interdependencies between the temporal and channel scopes. This layer effectively breaks the independence of these two dimensions and enables the interaction between features. Experimental results demonstrate that the proposed TCJA-SNN outperforms the state-of-the-art (SOTA) on all standard static and neuromorphic datasets, including Fashion-MNIST, CIFAR10, CIFAR100, CIFAR10-DVS, N-Caltech 101, and DVS128 Gesture. Furthermore, we effectively apply the TCJA-SNN framework to image generation tasks by leveraging a variation autoencoder. To the best of our knowledge, this study is the first instance where the SNN-attention mechanism has been employed for high-level classification and low-level generation tasks. Our implementation codes are available at https://github.com/ridgerchu/TCJA.
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OBJECTIVE: To investigate whether Naoxueshu Oral Liquid (NXS) could promote hematoma absorption in post-craniotomy hematoma (PCH) patients. METHODS: This is an open-label, multicenter, and randomized controlled trial conducted at 9 hospitals in China. Patients aged 18-80 years with post-craniotomy supratentorial hematoma volume ranging from 10 to 30 mL or post-craniotomy infratentorial hematoma volume less than 10 mL, or intraventricular hemorrhage following cranial surgery were enrolled. They were randomly assigned at a 1:1 ratio to the NXS (10 mL thrice daily for 15 days) or control groups using a randomization code table. Standard medical care was administered in both groups. The primary outcome was the percentage reduction in hematoma volume from day 1 to day 15. The secondary outcomes included the percentage reduction in hematoma volume from day 1 to day 7, the absolute reduction in hematoma volume from day 1 to day 7 and 15, and the change in neurological function from day 1 to day 7 and 15. The safety was closely monitored throughout the study. Moreover, subgroup analysis was performed based on age, gender, history of diabetes, and etiology of intracerebral hemorrhage (ICH). RESULTS: A total of 120 patients were enrolled and randomly assigned between March 30, 2018 and April 15, 2020. One patient was lost to follow-up in the control group. Finally, there were 119 patients (60 in the NXS group and 59 in the control group) included in the analysis. In the full analysis set (FAS) analysis, the NXS group had a greater percentage reduction in hematoma volume from day 1 to day 15 than the control group [median (Q1, Q3): 85% (71%, 97%) vs. 76% (53%, 93%), P<0.05]. The secondary outcomes showed no statistical significance between two groups, either in FAS or per-protocol set (P>0.05). Furthermore, no adverse events were reported during the study. In the FAS analysis, the NXS group exhibited a higher percentage reduction in hematoma volume on day 15 in the following subgroups: male patients, patients younger than 65 years, patients without diabetes, or those with initial cranial surgery due to ICH (all P<0.05). CONCLUSIONS: The administration of NXS demonstrated the potential to promote the percentage reduction in hematoma volume from day 1 to day 15. This intervention was found to be safe and feasible. The response to NXS may be influenced by patient characteristics. (Registration No. ChiCTR1800017981).
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Craniotomia , Hematoma , Humanos , Masculino , Feminino , Hematoma/etiologia , Pessoa de Meia-Idade , Craniotomia/efeitos adversos , Idoso , Adulto , Medicamentos de Ervas Chinesas/uso terapêutico , Medicamentos de Ervas Chinesas/administração & dosagem , Medicamentos de Ervas Chinesas/efeitos adversos , Idoso de 80 Anos ou mais , Adolescente , Adulto Jovem , Administração OralRESUMO
Previous studies indicated conflicting findings regarding the association between vitamin D and abnormal spermatozoa. Herein, we assessed the causal association between circulating 25-Hydroxyvitamin D (25OHD) levels and the risk of abnormal spermatozoa by utilizing bidirectional Mendelian randomization (MR) analysis. Genome-wide association study summary statistics for 25OHD and abnormal spermatozoa were obtained from publicly accessible databases. Single nucleotide polymorphisms (SNPs) associated with 25OHD and SNPs associated with abnormal spermatozoa were used as instrumental variables (IVs) for forward MR analysis and reverse MR analysis, respectively. Inverse variance weighted (IVW) was the main MR approach, while weighted median, MR-Egger, and maximum likelihood methods were employed to supplement IVW. In addition, several sensitivity tests assessed the reliability of MR analysis. Forward MR analysis showed that elevated 25OHD levels significantly reduced abnormal spermatozoa risk (odds ratio [OR]â¯=â¯0.75, 95â¯% confidence interval [CI]: 0.56-1.00, Pâ¯=â¯4.98E-02), and the effect remained statistically significant after excluding SNPs associated with confounders (ORâ¯=â¯0.73, 95â¯% CI: 0.54-0.98, Pâ¯=â¯3.83E-02) or only utilizing SNPs located near 25OHD-associated genes only as IVs (ORâ¯=â¯0.58, 95â¯% CI: 0.41-0.81, Pâ¯=â¯1.67E-03). Reverse MR analysis indicated abnormal spermatozoa not affecting 25OHD level (Pâ¯>â¯0.05). Sensitivity tests showed that MR analyses were not affected by heterogeneity and horizontal polytropy. Overall, the present MR study supports that elevated 25OHD levels reduce the risk of abnormal spermatozoa. Therefore, ensuring adequate vitamin D intake and maintaining stable levels of 25OHD may be effective strategies to optimize reproductive outcomes.
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Estudo de Associação Genômica Ampla , Análise da Randomização Mendeliana , Polimorfismo de Nucleotídeo Único , Espermatozoides , Vitamina D , Humanos , Masculino , Vitamina D/análogos & derivados , Vitamina D/sangueRESUMO
Objective: To explore the application of serum cardiac troponin T (cTnT), brain natriuretic peptide (BNP) levels, and electrocardiogram changes in the treatment and prognosis evaluation of severe pneumonia in children. Methods: 120 children with severe pneumonia (severe group) admitted to our hospital from June 2020 to December 2022 were selected as the study subjects with prospective study. They were divided into survival group (n=78) and death group (n=42) based on their survival status; 120 children with mild pneumonia were selected as the control group. Compare the levels of serum cTnT and BNP, as well as the changes in electrocardiogram, to analyze their predictive value for the prognosis of pediatric patients and the influencing factors of prognosis. Results: The proportion of children with cTnT, BNP, and abnormal electrocardiogram after treatment was lower than before treatment (P<0.05). The proportion of children with cTnT, BNP, and abnormal electrocardiogram in the severe group was higher than that in the mild group (P<0.05). The proportion of children with serum cTnT, BNP levels, and abnormal electrocardiogram in the death group after treatment was higher than that in the survival group (P<0.05). Bundle branch block, low or inverted T waves, cTnT, and BNP are prognostic factors for children with severe pneumonia (P<0.05). The combined prediction of serum cTnT and BNP for the prognosis of severe pneumonia in children is better than that of single prediction (Z combined detection - cTnT=2.474, Z combined detection - BNP=2.494, P=0.013, 0.013). Conclusion: The proportion of abnormal cTnT, BNP, and electrocardiogram is increased in patients with severe pneumonia, and those with high expression and abnormalities have poor prognosis. cTnT and BNP have high predictive value for the prognosis of children with severe pneumonia.
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To evaluate the current incidence of pulmonary hemorrhage and the potential factors contributing to its increased risk after percutaneous CT-guided pulmonary nodule biopsy and to summarize the technical recommendations for its treatment. In this observational study, patient data were collected from ten medical centers from April 2021 to April 2022. The incidence of pulmonary hemorrhage was as follows: grade 0, 36.1% (214/593); grade 1, 36.8% (218/593); grade 2, 18.9% (112/593); grade 3, 3.5% (21/593); and grade 4, 4.7% (28/593). High-grade hemorrhage (HGH) occurred in 27.2% (161/593) of the patients. The use of preoperative breathing exercises (PBE, p =0.000), semiautomatic cutting needles (SCN, p = 0.004), immediate contrast enhancement (ICE, p =0.021), and the coaxial technique (CoT, p = 0.000) were found to be protective factors for HGH. A greater length of puncture (p =0.021), the presence of hilar nodules (p = 0.001), the presence of intermediate nodules (p = 0.026), a main pulmonary artery diameter (mPAD) larger than 29 mm (p = 0.015), and a small nodule size (p = 0.014) were risk factors for high-grade hemorrhage. The area under the curve (AUC) was 0.783. These findings contribute to a deeper understanding of the risks associated with percutaneous CT-guided pulmonary nodule biopsy and provide valuable insights for developing strategies to minimize pulmonary hemorrhage.