Feature elimination and stacking framework for accurate heart disease detection in IoT healthcare systems using clinical data.

Introduction: Heart disease remains a complex and critical health issue, necessitating accurate and timely detection methods. Methods: In this research, we present an advanced machine learning system designed for efficient and precise diagnosis of cardiac disease. Our approach integrates the power of Random Forest and Ada Boost classifiers, along with incorporating data pre-processing techniques such as standard scaling and Recursive Feature Elimination (RFE) for feature selection. By leveraging the ensemble learning technique of stacking, we enhance the model's predictive performance by combining the strengths of multiple classifiers. Results: The evaluation metrics results demonstrate the superior accuracy and obtained the higher performance in terms of accuracy, 99.25%. The effectiveness of our proposed system compared to baseline models. Discussion: Furthermore, the utilization of this system within IoT-enabled healthcare systems shows promising potential for improving heart disease diagnosis and ultimately enhancing patient outcomes.

Overexpression of MD1 ameliorates pathological myocardial remodeling in diabetic cardiomyopathy by TLR4/STAT3 signaling pathway.

Diabetic cardiomyopathy (DCM) is characterized by oxidative damage and inflammatory responses. Myeloid differentiation protein 1 (MD1) exhibits antioxidant and anti-inflammatory properties. However, the specific role of MD1 in DCM has yet to be elucidated. This study aims to investigate the role of MD1 in DCM and to elucidate the underlying mechanisms. We utilized a gain-of-function approach to explore the involvement of MD1 in DCM. Diabetes was induced in MD1-transgenic (MD1-TG) mice and their wild-type (WT) counterparts via streptozotocin (STZ) injection. Additionally, a diabetes cell model was established using H9c2 cells exposed to high glucose levels. We conducted comprehensive evaluations, including pathological analyses, echocardiography, electrocardiography, and molecular assessments, to elucidate the underlying mechanisms of MD1 in DCM. Notably, MD1 expression was reduced in the hearts of STZ-induced diabetic mice. Overexpression of MD1 significantly improved cardiac function and markedly inhibited ventricular pathological hypertrophy and fibrosis in these mice. Furthermore, MD1 overexpression resulted in a substantial decrease in myocardial reactive oxygen species (ROS) accumulation, mitigating myocardial oxidative stress and reducing the levels of inflammation-related markers such as IL-1ß, IL-6, and TNF-α. Mechanistically, MD1 overexpression inhibited the activation of the TLR4/STAT3 signaling pathway, as demonstrated in both in vivo and in vitro experiments. The overexpression of MD1 significantly impeded pathological cardiac remodeling and improved cardiac function in STZ-induced diabetic mice. This effect was primarily attributed to a reduction in ROS accumulation and mitigation of myocardial oxidative stress and inflammation, facilitated by the inhibition of the TLR4/STAT3 signaling pathway.

Facile fabrication of sulfonated porous yeast carbon microspheres through a hydrothermal method and their application for the removal of cationic dye.

Water pollution containing dyes become increasingly serious environmental problem with the acceleration of urbanization and industrialization process. Renewable adsorbents for cationic dye wastewater treatment are becoming an obstacle because of the difficulty of desorbing the dye from the adsorbent surface after adsorption. To overcome this dilemma, herein, we report a hydrothermal method to fabricate sulfonic acid modified yeast carbon microspheres (SA/YCM). Different characterization techniques like scanning electron microscopy, FTIR spectroscopy, and X-ray diffraction have been used to test the SA/YCM. Decorated with sulfonic acid group, the modified yeast carbon microspheres possess excellent ability of adsorbing positively charged materials. The removal rate of Methyl blue (MB) by renewable adsorbent SA/YCM can reach 85.3% when the concentration is 500 mg/L. The SA/YCM regenerated by HCl showed excellent regeneration adsorption capacity (78.1%) after five cycles of adsorption-desorption regeneration experiment. Adsorption isotherm and kinetic behaviors of SA/YCM for methylene blue dyes removal were studied and fitted to different existing models. Owing to the numerous sulfonic acid groups on the surface, the SA/YCM showed prominent reusability after regeneration under acidic conditions, which could withstand repeated adsorption-desorption cycles as well as multiple practical applications.

The radiomics-clinical nomogram for predicting the response to initial superselective arterial embolization in renal angiomyolipoma, a preliminary study.

Purpose: The aim of this study was to explore a radiomics-clinical model for predicting the response to initial superselective arterial embolization (SAE) in renal angiomyolipoma (RAML). Materials and methods: A total of 78 patients with RAML were retrospectively enrolled. Clinical data were recorded and evaluated. Radiomic features were extracted from preoperative contrast-enhanced CT (CECT). Least absolute shrinkage and selection operator (LASSO) and intra- and inter-class correlation coefficients (ICCs) were used in feature selection. Logistic regression analysis was performed to develop the radiomics, clinical, and combined models where the fivefold cross-validation method was used. The predictive performance and calibration were evaluated by the receiver operating characteristic (ROC) curve and calibration curve. Decision curve analysis (DCA) was used to measure clinical usefulness. Results: The tumor shrinkage rate was 29.7% in total, and both fat and angiomyogenic components were significantly reduced. In the radiomics model, 12 significant features were selected. In the clinical model, maximum diameter (p = 0.001), angiomyogenic tissue ratio (p = 0.032), aneurysms (p = 0.048), and post-SAE time (p = 0.002) were significantly associated with greater volume reduction after SAE. Because of the severe linear dependence between radiomics signature and some clinical parameters, the combined model eventually included Rad-score, aneurysm, and post-SAE time. The radiomics-clinical model showed better discrimination (mean AUC = 0.83) than the radiomics model (mean AUC = 0.60) and the clinical model (mean AUC = 0.82). Calibration curve and DCA showed the goodness of fit and clinical usefulness of the radiomics-clinical model. Conclusions: The radiomics-clinical model incorporating radiomics features and clinical parameters can potentially predict the positive response to initial SAE in RAML and provide support for clinical treatment decisions.

Multi-parameter cardiac magnetic resonance imaging detects anthracycline-induced cardiotoxicity in rabbits model.

Background: Cardiac magnetic resonance (CMR) quantitative T1 and T2 mapping offers a non-invasive means to evaluate early cardiotoxicity changes. This study aimed to pinpoint the earliest CMR indicators of myocardial injury in Anthracycline-induced cardiotoxicity (AIC) and to elucidate the connections between these CMR indicators and associated pathological indicators. Methods: A total of 34 rabbits were administered doxorubicin at a dosage of 1 mg/kg/weekly. The study incorporated six 3T CMR scan time points: baseline, and at intervals of four, six, eight, twelve, and sixteen weeks. Cine, T1 and T2 mapping sequences assessed the left ventricular ejection fraction (LVEF), native T1, extracellular volume fraction (ECV), and T2 values. Following each time point, three rabbits were sacrificed for histological analysis involving Hematoxylin and eosin (H&E), Masson, TUNEL, and microvascular density (MVD) stains. Spearman correlations and linear mixed model analysis served in the statistical analysis. Results: Diverse degrees of alternation were recorded in LVEF, native T1, T2, and ECV over time. LVEF declined to 49.0 ± 2.6 % at 12 weeks from the baseline of 53.4 ± 3.2 %, p < 0.001. Native T1 values increase from the baseline (1396.5 ± 79.2 ms) until 8 weeks (1498.8 ± 95.4 ms, p < 0.001). T2 values increased from the baseline (36.6 ± 3.3 ms) within 4 weeks of initiation (37.5 ± 3.4, p = 0.02) and remained elevated through 16 weeks (42.8 ± 0.3, p < 0.01). ECV was elevated at 8 weeks (33.9 ± 3.8 %, p = 0.005) compared to the baseline (30.2 ± 2.5 %). By week 12, myocardial edema and increased CVF were apparent (p = 0.04 and = 0.001, respectively). The area under ROC curve for positive CMR presence and the gold standards were 0.87 (T2-ROC, 4 weeks) and 0.92 (LVEF&BNP-ROC, 12 weeks). Conclusion: T1 and T2 mapping are effective tools for cardiotoxicity detection and monitoring. The prolongation of T2 value emerged as the most consistent and early-onset indicator.

Active compounds of Caodoukou () inhibit the migration, invasion and metastasis of human pancreatic cancer cells by targeting phosphoinosmde-3-kinase/ protein kinase B/mammalian target of rapamycin pathway.

OBJECTIVE: To detect the effects of active compounds of Caodoukou () (ACAK) on the proliferation, migration and invasion of pancreatic cancer, and explain the possible molecular mechanism of ACAK interacting with these processes. METHODS: Cell counting kit-8 method, cell scratch repair experiment, Transwell migration and invasion experiment, immunohistochemistry, western blot assay and real-time polymerase chain reaction experiment were used to evaluate the effect of ACAK on the proliferation, migration and invasion of pancreatic cancer cells. The levels of active molecules involved in the phosphoinosmde-3-kinase (PI3K)/Akt/the mammalian target of rapamycin (mTOR) signal transduction were detected by Western blot assay. In addition, the function of ACAK was evaluated by xenotransplantation tumor model in nude mice. RESULTS: The inhibitory effect of ACAK on the proliferation of pancreatic cancer cells showed certain time-dose dependence. The results of scratch repair test, Transwell test, Western blotting and real time polymerase chain reaction assay showed that ACAK could inhibit the migration and invasion of pancreatic cancer cells . In addition, the regulatory effect of ACAK on epithelial-mesenchymal transition (EMT) is partly attributed to PI3K/Akt/mTOR signaling pathway. The experimental results showed that ACAK regulated the development of pancreatic cancer. CONCLUSIONS: ACAK can partly inhibit the activity of EMT and matrix metallopeptidases by down-regulating the downstream proteins of PI3K/Akt/mTOR signal pathway, thus inhibiting the ability of migration and invasion of pancreatic cancer.

Perspective on pH adjustment in hydrometallurgical recycling of valuable metals from waste.

pH adjustment was considered a simple step in the hydrometallurgy process, but its complicated operation was ignored in the past. In some industrial applications, the leachate pH was slowly adjusted by a diluted alkaline solution, with the defects of doubling the leachate volume and causing droplet hydrolysis/coagulation. Up to date, promising routes have been developed for rapid pH adjustment, especially in sealed high-temperature/pressure vessels. New routes emerged in some redox/decomposition reactions of nitrate/urea and organics. Such reactions did not start and/or were slow at room temperature but started spontaneously at high temperatures to generate/consume free H+. This induced pH adjustment in a rapid and homogeneous way.

Research Progress and Discussion on Modified Cement-Based Borehole Sealing Materials for Mining.

As the concept of green mining develops, organic sealing materials are losing popularity in mining, yet the development of inorganic sealing materials for mining has become a research focus. The most common inorganic sealing materials are Portland cement (PC) and sulfate aluminate cement (SAC), but they fail to meet the performance requirements for sealing gas boreholes in complex coal seams due to their limitations. Thus, their performance needs to be modified. This study aims to explore and grasp the current development of inorganic modified cement-based materials from the perspective of improving the performance of cement-based materials of PC and SAC. First, the characteristics of the main hydration products of PC and SAC as well as the effects of these characteristics on their properties were analyzed. Next, the effects of additives such as admixtures, coagulant regulators, and nanomaterials on their properties including hydration properties, coagulation time, and strength were analyzed. Finally, the modification methods and mechanisms were discussed. It is proposed that the optimization of modification effects by various additives is of great practical significance for the development and application of modified PC and SAC in sealing gas boreholes in engineering practice.

HDAC5-mediated PRAME regulates the proliferation, migration, invasion, and EMT of laryngeal squamous cell carcinoma via the PI3K/AKT/mTOR signaling pathway.

Laryngeal squamous cell carcinoma (LSCC) is an aggressive and lethal malignant neoplasm with extremely poor prognoses. Accumulating evidence has indicated that preferentially expressed antigen in melanoma (PRAME) is correlated with several kinds of cancers. However, there is little direct evidence to substantiate the biological function of PRAME in LSCC. The purpose of the current study is to explore the oncogenic role of PRAME in LSCC. PRAME expression was analyzed in 57 pairs of LSCC tumor tissue samples through quantitative real-time PCR, and the correlation between PRAME and clinicopathological features was analyzed. The result indicated that PRAME was overexpressed in the LSCC patients and correlated with the TNM staging and lymphatic metastasis. The biological functions and molecular mechanism of PRAME in LSCC progression were investigated through in vitro and in vivo assays. Functional studies confirmed that PRAME facilitated the proliferation, invasion, migration, and epithelial-mesenchymal transition of LSCC cells, and PRAME also promoted tumor growth in vivo. HDAC5 was identified as an upstream regulator that can affect the expression of PRAME. Moreover, PRAME played the role at least partially by activating PI3K/AKT/mTOR pathways. The above findings elucidate that PRAME may be a valuable oncogene target, contributing to the diagnosis and therapy of LSCC.

Natural marsh-pasture/sugarcane field transitions greatly reduced lignin-derived pyrolysis products of soil organic matter.

Cultivation of marshes (Ma) to arable like pasture (Pa) and sugarcane (Sa) usually causes soil organic carbon (SOC) pool depletion within a short time. However, there are some uncertainties about which molecular composition of soil organic matter (SOM) is sensitive to land use change (LUC). In the present work, molecular components of SOM were investigated and compared to better understand the impacts of LUC on the carbon cycle from Ma to Pa or Sa in Louisiana and Florida. Pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS) analysis indicated that LUC greatly altered the molecular composition of SOM. More lignin, polysaccharide, and phonetic compounds were founded from Ma, and more nitrogen-containing compounds were identified from Sa. Lignin and phenolic compounds had unexpectedly the most decrease from native marsh-sugarcane/pasture transitions, showing the same trend as SOC. This meant that lignin and phenol were not as stable as expected when undergoing LUC. LUC significantly yield more molecular moieties and then resulted in higher complexities and diversities of molecular components in Pa or Sa than those in Ma. Principal component analysis implied higher contributions of old carbon to SOM in Ma, and fresh biomass input contributed more SOM in Sa. Our results implied that human activities such as LUC could not only alter carbon fluxes but also simultaneously change molecular mechanisms that drive the carbon cycle.

Buyang Huanwu Tang protects HO-induced RGC-5 cell against oxidative stress and apoptosis reactive oxygen species-mitogen-activated protein kinase signaling pathway.

OBJECTIVE: To study the molecular mechanism of Buyang Huanwu Tang() (BHT) protecting retinal ganglion cells (RGCs) from oxygen induced oxidative stress and apoptosis after anterior ischemia. METHODS: In this study, the Chinese herbs of BHT were extracted by first boiling in water, then were filtered, concentrated, and freeze-dried. The chemical profile of BHT extract was determined by liquid chromatography mass spectrometry (LC-MS). HO-induced RGC-5 cells were used as a cell model to investigate the protective effect and mechanism of BHT on RGCs. RESULTS: The survival rate of damaged RGC-5 by BHT was significantly increased by the 3-(4,5)-dimethylthiahiazo (-z-y1)-3,5-di- phenytetrazolium-romid method. Fluorescence activating cell sorter (FACS analysis) showed that BHT could significantly reduce apoptosis induced by oxidative stress the reactive oxygen species (ROS)-mitogen-activated protein kinase (MAPK)-Caspase-3 signal pathway. CONCLUSION: BHT possesses a high antioxidant capacity and could significantly reduce ROS levels of RGC-5 cells damaged by HO.Therefore, the present study has provided possible alternative strategies for the prevention and treatment of ischemic optic disease by using traditional Chinese herbal formulas.

Wenshen Jianpi recipe induced immune reconstruction and redistribution of natural killer cell subsets in immunological non-responders of human immunodeficiency virus/acquired immune deficiency syndrome: a randomized controlled trial.

OBJECTIVE: To evaluate the effects of the Wenshen Jianpi recipe (, WJR) on immune reconstruction and natural killer (NK) cells in immunological non-responders (INRs) of people living with human immunodeficiency virus (HIV) (PLWH) and propose new therapeutic strategies for HIV. METHODS: Based on Traditional Chinese Medicine treatment principle "invigorating and warming in the spleen and kidneys", WJR combined with antire-troviral therapy (ART) therapy was performed in a randomized, double-blind, placebo-controlled study of 60 patients with non-responders. The randomized process was executed by the Clinical Evaluation Center of China Academy of Chinese Medical Sciences. Sixty patients who met the inclusion criteria obtained random numbers (that is the drug number) was randomly divided into a treatment group and a placebo control group according to a 1∶1 ratio. CD4+T cell counts and natural killer (NK) cells counts were evaluated at baseline and 12-week, 24-week follow-ups. RESULTS: Four participants received random numbers and did not enter the group due to the patient's own reasons. A total of 56 patients were enrolled, including 28 in the treatment group and 28 in the control group. CD4+T cell counts in the treatment group were significantly increased at week 24 ( = 0.01 < 0.05), which were significantly higher than those in the control group (= 0.01 < 0.05). Although no significant differences were observed between two groups, the CD56briCD16- NK cell counts in the treatment group were significantly increased after duration. and CD56dimCD16+ NK cell counts in the treatment group were significantly higher than those in the control group after 24 weeks of treatment (= 0.025 < 0.05). As compared with the control group, the treatment group had significantly lower CD56negCD16+ NK cell counts after 24 weeks of treatment (= 0.023 < 0.05). CONCLUSIONS: WJR promotes the immune reconstruction of INRs and redistribution of NK cell subsets, notably decreasing CD56negCD16+ NK cell counts in INRs. However, the redistribution of NK cell subsets is not beneficial for immune reconstruction in INRs. Further large-scale RCTs are required to evaluate the effect of WJR on immune recovery in INRs and decipher the underlying mechanism.

Clinical efficacy of gouty tea on chronic gouty arthritis and its effects on serum vascular endothelial function and inflammatory cytokines.

To observe the efficacy of Gouty Tea on chronic gouty arthritis and its effect on vascular endothelial function and inflammatory factor levels. Totally 120 patients with chronic gouty arthritis were divided into control group (allopurinol orally, 100 mg/time, tid, for 12 weeks) and observation group (Gouty Tea, 1 bag/time, tid, for 12 weeks) randomly (n=60 per group). Compared with those before treatment, the TCM symptom scores, visual analogue score (VAS) and the levels of UA and XOD of the two groups were reduced, while the levels of NO, ET-1, VEGF, vWF, CRP, IL-1ß, TNF- α and NALP3 of the two groups improved, 6 and 12 weeks after treatment (P< 0.05). Nevertheless, after 6 weeks of treatment, there were no significantly difference of the level of VAS between the two groups. After 12 weeks of treatment, in the observation group, VAS was significantly lower compared to the control group. The TCM symptom scores and the levels of UA and XOD were significantly lower, while the levels of NO, ET-1, VEGF, vWF, CRP, IL-1ß TNF- α and NALP3 were significantly better in the observation group than those of the control group 12 weeks after treatment (P< 0.05). The total effective rate was significantly higher and the incidence of adverse reactions was significantly lower in the observation group compared to the control group (P< 0.05). Gouty Tea can effectively reduce the UA, XOD levels and VAS, effectively improve the vascular endothelial function and inhibit the inflammation of patients.

Pharmacotherapies for Central Post-Stroke Pain: A Systematic Review and Network Meta-Analysis.

Background: Central post-stroke pain (CPSP) is a common condition. Several pharmacotherapies have been applied in practice. However, the comparative effectiveness among these pharmacotherapies is unknown. Aim: The aim of this study is to study the comparative effectiveness among differential pharmacotherapies for CPSP through a network meta-analysis. Methods: We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science from inception to 30 March 2022, without any language restriction. Two reviewers independently screened the retrieved articles, extracted data, and evaluated the risk of bias (RoB). The outcome of interest of the study was the change in the scores of pain intensity scales. We estimated standard mean differences (SMDs) between treatments and calculated corresponding 95% CIs. Results: Thirteen randomized controlled trials (529 participants) were included after a screen of 1774 articles. Compared with placebo, pamidronate (SMD -2.43, 95% CI -3.54 to -1.31; P - score = 0.93), prednisone (SMD -2.38, 95% CI -3.09 to -1.67; P - score = 0.92), levetiracetam (SMD -2.11, 95% CI -2.97 to -1.26; P - score = 0.87), lamotrigine (SMD -1.39, 95% CI -2.21 to -0.58; P - score = 0.73), etanercept (SMD -0.92, 95% CI -1.8 to -0.03; P - score = 0.59), and pregabalin (SMD -0.46, 95% CI -0.71 to -0.22; P - score = 0.41) had significantly better treatment effect. Pamidronate, prednisone, and levetiracetam ranked as the first three most effective treatments. In subgroup analyses, prednisone, levetiracetam, lamotrigine, and pregabalin were more effective than placebo as oral pharmacotherapies, while etanercept was more effective than placebo as injectable pharmacotherapy. Conclusions: Our study confirmed that pamidronate, prednisone, and guideline-recommended anticonvulsants were effective for reducing pain intensity for CPSP. Pamidronate and prednisone showed better effect than other pharmacotherapies, which warrants further investigation.

Novel fabrication of hydrophobic/oleophilic human hair fiber for efficient oil/water separation through one-pot dip-coating synthesis route.

Frequent oil spill accidents and industrial wastewater discharge has always been one of the most severe worldwide environmental problems. To cope with this problem, many fluorine-containing and high-cost materials with superwettability have been extensively applied for oil-water separation, which hinders its large-scale application. In this work, a novel human hair fiber (HHF)-polymerized octadecylsiloxane (PODS) fiber was fabricated with a facile one-pot dip-coating synthesis approach, inspired by the self-assembly performance and hydrophobicity of OTS modification. The benefits of prominent hydrophobic/lipophilic behavior lie in the low surface energy, and a rough PODS coating was rationally adhered on the surface of HHF. Driven solely by gravity and capillary force, the HHF-PODS showed excellent oil/water separation efficiency (> 99.0%) for a wide range of heavy and light oil/water mixtures. In addition, HHF-PODS demonstrated durability toward different harsh environments like alkaline, acid, and salty solutions.

The ETS1-LINC00278 negative feedback loop plays a role in COL4A1/COL4A2 regulation in laryngeal squamous cell carcinoma.

The present study aimed to investigate LINC00278 expression in laryngeal squamous cell carcinoma (LSCC) and its involvement in the process of proliferation, migration, and invasion, providing a rationale for mining potential diagnostic and therapeutic targets of LSCC. Univariate and multivariate Cox regression analyses were performed to identify optimal prognostic lncRNAs. MTS, colony formation, wound healing, and Transwell invasion assays were used to determine the effects of LINC00278 overexpression on the proliferation, migration, and invasion of cancer cells. The expressions of signaling pathway-related proteins and epithelial-mesenchymal transition (EMT) marker proteins were detected using western blot. The chromatin immunoprecipitation (ChIP) and dual-luciferase reporter assays were performed to demonstrate the binding of ETS proto-oncogene 1, transcription factor (ETS1), and LINC00278 promoter region. The molecular targets of LINC00278 were identified by RNA sequencing analysis and co-expression analysis. Kaplan-Meier analysis and CIBERSORT algorithm were used to analyze survival and immune cell infiltration based on LINC00278, COL4A1, and COL4A2. Multivariate Cox regression was used to establish a six-gene prognostic model. LINC00278 expression was low in LSCC tissues, and it was significantly associated with the TNM (tumors/nodes/metastases) stage (p<0.001), lymphatic metastasis (p<0.01), and pathological differentiation (p<0.01). LINC00278 overexpression significantly reduced LSCC cell proliferation, migration, and invasion in TU686, TU177, and AMC-HN-8 cell lines. E-cadherin protein expression was increased, while N-cadherin, Vimentin, Zeb1, and Snail protein expression was decreased in the LINC00278 group, compared to the pcDNA3.1 group. Additionally, in AMC-HN-8 and FaDu cell lines, the LINC00278-treated group had significantly lower p-AKT and p-mTOR protein levels than the control group. ETS1 is a direct transcriptional regulator of the LINC00278 gene based on luciferase reporter assays and ChIP experiments. Western blot analysis demonstrated that high LINC00278 expression inhibited both ETS1 expression and phosphorylation. COL4A1/COL4A2 were identified as potential downstream targets of LINC00278. Meanwhile, the LINC00278/COL4A1/COL4A2-dominated low-risk group showed higher antigen-presenting activity and a higher immune score than the high-risk group. The findings indicated that ETS1 upregulated LINC00278 expression on the Y chromosome, which in turn inhibited LSCC growth in vivo and in vitro by inhibiting the AKT/mTOR signaling pathway via downregulation of COL4A1/COL4A2.

Efficacy and safety of Mianyi granules (+mianyi+) for reversal of immune nonresponse following antiretroviral therapy of human immunodeficiency virus-1: a randomized, double-blind, multi-center, placebo-controlled trial.

OBJECTIVE: To investigate whether Mianyi granules (+mianyi+) are effective and safe in reversing immune nonresponse following antiretroviral therapy (ART) in individuals with human immunodeficiency virus (HIV) infection. METHODS: Randomized, double-blind, multi-center, placebo-controlled trial (factorial design) of daily oral Mianyi granules versus placebo for 72 weeks. A total of 361 HIV-positive individuals receiving ART at five Class III Grade I hospitals in China between September 2013 and January 2016 completed the study. The primary endpoints were frequencies of CD3+, CD4+, CD8+, and CD45RA+ cells at seven timepoints over the 72 weeks. Secondary endpoints included viral loads, clinical symptoms, and quality of life at 72 weeks. RESULTS: A total of 400 participants were enrolled in the study and randomized, of whom 361 completed the study: 189 individuals (140 men and 49 women) in the Mianyi granule group and 172 individuals (135 men and 37 women) in the placebo group. In the intent-to-treat population, CD4+ T cell counts increased from (193 ± 71) cells/mm at baseline to (288 ± 131) cells/mm post-treatment in the Mianyi granule group and from (200 ± 75) cells/mm at baseline to (264 ± 124) cells/mm post-treatment in the placebo group. Patients treated with Mianyi granule had higher increases in CD4+ T cell counts than those treated with placebo ( = 0.045). Reversal of immune nonresponse was defined as a CD4+ T cell increase of more than 100 cells/mm3. After treatment for 72 weeks, Mianyi granule was effective in reversing immune nonresponse in a higher proportion of individuals (20.2%) compared with placebo (9.7%). CD45RA+ cell counts increased from (34 ± 32) cell/mm at baseline to (51 ± 61) cells/mm post-treatment in the Mianyi granule group and from (37 ± 33) cells/mm at baseline to (48 ± 37) cells/mm post-treatment in the placebo group. Mianyi granules were more effective than placebo in increasing CD45RA+ cell counts. CONCLUSIONS: In ART-treated HIV-positive adults with immune nonresponse, treatment with Mianyi granules for 72 weeks was safe and significantly increased CD4+ and CD45RA+ cell counts, thereby promoting immune reconstitution.

Planar Heterojunction of Ultrathin CrTe3 and CrTe2 van der Waals Magnet.

The fabrication of planar heterojunctions with magnetic van der Waals ultrathin crystals is essential for constructing miniaturized spintronic devices but is yet to be realized. Here, we report the growth of CrTe3 and CrTe2 ultrathin films with molecular beam epitaxy and characterize their morphological and electronic structure through low-temperature scanning tunneling microscopy/spectroscopy. The former is identified as a Mott insulator, and the latter has shown a robust magnetic order previously. Through vacuum annealing, CrTe3 can be transformed into CrTe2, whose relative ratio is controlled via the annealing time. This renders the feasibility of constructing CrTe3-CrTe2 planar heterojunctions, which express atomically sharp interfaces and smooth band bending. We also identified a superstructure conceivably formed via hybrid units of CrTe3 and CrTe2, whose electronic structure exhibits stunning tunability with the length of the superstructure. Our study sets a foundation for the development of magnetic tunneling junctions for building spintronic circuits and engineering electronic states in artificial superlattice structures.

Knowledge, Attitude, and Prescription Practice on Antimicrobials Use Among Physicians: A Cross-Sectional Study in Eastern China.

Over-prescription of antimicrobials for patients is a major driver of bacterial resistance. The aim of the present study was to assess the knowledge, attitude, and prescription practices regarding antimicrobials among physicians in the Zhejiang province in China, and identify the determining factors. A total of 600 physicians in public county hospitals and township health institutions were surveyed cross-sectionally using a structured electronic questionnaire. The questionnaire was completed by 580 physicians and the response rate was 96.67%. The mean score of 11 terms related to antimicrobial knowledge was 6.81, and an average of 32.1% of patients with upper respiratory tract infections (URTIs) were prescribed antimicrobials. Multivariate analysis indicated that young general practitioners with less training are more likely to contribute to more frequent antimicrobial prescriptions (P < .05). In contrast, older physicians with more training are more willing to provide patients with the correct knowledge regarding antimicrobials and less likely to prescribe antimicrobials for URTIs. Correlation analysis showed that the level of physician's knowledge, attitude, and prescription practice is related (P < .05). In conclusion, proper prescription of antimicrobials depends on adequate knowledge and regular training programs for physicians.

The matrix metalloproteinase gene family: a significant prognostic gene lineage correlated with immune infiltrates in laryngeal squamous cell carcinoma.

This study aimed to elucidate the potential genes of the matrix metalloproteinase (MMP) family, responsible for the progression of laryngeal squamous cell carcinoma (LSCC). Besides, we ascertained the changes in common malignant behaviors in vitro by knocking down MMP1. TCGA, GEO, Oncomine, and microarray data were conducted to analyze the expression levels of MMPs and to find tissue-specific genes in LSCC. Univariate and multivariate Cox regression analyses were established in the construction of a prognostic model based on expression profiles and clinical information of LSCC in TCGA. We then comprehensively analyzed survival, co-expression network, and immune infiltration based on a prognostic model by Kaplan-Meier analysis, WGCNA, and CIBERSORT. Thereafter, qRT-PCR, proliferation, Transwell, and wound-healing assays were used to assess the accuracy of the bioinformatics data. A total of seven genes in the MMP family were identified as differentially expressed genes (DEGs) by integrating three public databases and microarray data. Additionally, multivariate Cox regression was used to establish a four-gene (MMP1/3/8/10) prognostic model, which exhibited a better predictive accuracy than the TNM (tumors/nodes/metastases) based model. The prognostic model was related to plasma cells, CD8+ T cells, follicular helper T cells, resting NK cells, and M0 macrophages infiltration. The expression of MMP1, MMP3, and MMP10 was the highest in head and neck squamous cell carcinoma (HNSC) compared to other cancer in the Oncomine and GEPIA dataset. Further, MMP1 demonstrated significant upregulation in 40 paired LSCC tissues. Eventually, MMP1 downregulation inhibited cell viability, colony formation, and cell migration in TU686 and FaDu cells. Our findings suggest that the four-gene signature might be associated with the prognosis. Further, we revealed that MMP1 is a pivotal biomarker for the biotherapy and prognostic evaluation of patients with LSCC.