Swarming caddisflies in the mid-cretaceous.

Swarming, as a special form of mating aggregation, is most noteworthy in insects of the orders Ephemeroptera, Diptera, and Trichoptera. Swarming in extant trichopterans is well understood in terms of sex composition, specific mating behaviors, and functional morphological specializations of adults, but an exploration of the evolution of such aggregative behaviors is hampered by the dearth of available examples from the fossil record as well as the ability to reliably distinguish the few gatherings as the result of swarming relative to other taphonomic or behavioral factors. Herein we describe five new fossil species of caddisflies preserved in mid-Cretaceous amber from Myanmar, all preserved as large aggregations. Monospecific aggregations of these five new species can be positively identified as swarms based on morphological traits of wing shape, as well as the presence of particular forms of sexual dimorphism. Results of a phylogenetic reconstruction of both molecular and morphological data as well as ancestral-trait reconstructions and tip-dating analyses indicate that swarming was likely present in the Triassic as a feature of the trichopteran groundplan. Since most Mesozoic insectivorous predators were diurnal based on morphological evidence, largely nocturnal caddisflies would have been freed from such pressures. The phylogeny also shows a correlation between the rise of nocturnal bat predators from the Paleocene or early Eocene and the repeated loss of swarming from various clades of caddisflies, revealing the potential impact of bat predation on reshaping the behavioral landscape of Trichoptera during the Cenozoic.

Effects of acupuncture and nicotine patch on smoking: a multicenter, randomized, controlled, double-blind clinical trial.

Aims: To evaluate the effects of acupuncture and/or nicotine patches on smoking cessation. Methods: Eighty-eight participants were randomly allocated into four groups: acupuncture combined with nicotine patch (ACNP), acupuncture combined with sham nicotine patch (ACSNP), sham acupuncture combined with nicotine patch (SACNP), and sham acupuncture combined with sham nicotine patch (SACSNP). The primary outcome was self-reported smoking abstinence verified with expiratory Carbon Monoxide (CO) after 8 weeks of treatment. The modified Fagerstrom Test for Nicotine Dependence (FTND) score, Minnesota Nicotine Withdrawal Scale (MNWS), and the Brief Questionnaire of Smoking Urge (QSU-Brief) score were used as secondary indicators. SPSS 26.0 and Prism 9 software were used for statistical analyses. Results: Seventy-eight participants completed the study. There were no significant differences in patient characteristics at baseline across the four groups. At the end of treatment, there was a statistically significant difference (χ2 = 8.492, p = 0.037) in abstaining rates among the four groups. However, there were no significant differences in the reduction in the number of cigarettes smoked daily (p = 0.111), expiratory CO (p = 0.071), FTND score (p = 0.313), and MNWS score (p = 0.088) among the four groups. There was a statistically significant difference in QUS-Brief score changes among the four groups (p = 0.005). There was no statistically significant interaction between acupuncture and nicotine patch. Conclusion: Acupuncture combined with nicotine replacement patch therapy was more effective for smoking cessation than acupuncture alone or nicotine replacement patch alone. No adverse reactions were found in the acupuncture treatment process. Clinical trial registration: http://www.chictr.org.cn/showproj.aspx?proj=61969, identifier ChiCTR2100042912.

Examining High-Risk Factors for Sleep Disorders in Depressed Patients: Evaluating the Impact of Psychological Interventions on Sleep Quality and Mental Well-Being.

Objective: This study aims to analyze the risk factors associated with sleep disorders in patients suffering from depression and investigate the efficacy of psychological interventions in improving these conditions. Methods: A comparative observational study was conducted and a cohort of 162 patients aged 18 to 68, admitted to outpatient or inpatient departments between October 2022 and August 2023, were included in the study. All patients were diagnosed with depression according to the ICD-10 criteria. The patients were divided into two groups: experimental group 1 received cognitive-behavioral therapy (CBT) psychological intervention, while experimental group 2 received conventional psychological treatment. Various parameters, including Hamilton Depression Rating Scale (Ham-D), Hamilton Anxiety Rating Scale (Ham-A), Social Support Rating Scale (SSRS), marital status, and occupation, were assessed and compared between the groups. Multivariate logistic regression was employed to identify risk factors for sleep disorders in depressed patients. The Pittsburgh Sleep Quality Index (PSQI) was utilized to evaluate sleep quality. Results: Logistic regression analysis revealed that depression severity, anxiety levels, subjective social support, and occupational status were significant risk factors for sleep disorders in depressed patients (P < .05). Following intervention, both groups exhibited a significant decrease in PSQI, SAS, and SDS scores, with experimental group 1 demonstrating significantly lower PSQI scores compared to experimental group 2 (P < .05). Moreover, experimental group 1 displayed significantly lower SAS and SDS scores compared to experimental group 2 (P < .05). Conclusions: The severity of depression, anxiety levels, subjective social support, and occupational status contribute to the risk of sleep disorders in depressed patients. Implementing psychological interventions for depressed patients with sleep disorders can effectively improve sleep quality, alleviate anxiety, and enhance overall psychological well-being. These interventions represent a valuable approach to manage depression and comorbid sleep disorders.

Therapeutic SHPRH-146aa encoded by circ-SHPRH dynamically upregulates P21 to inhibit CDKs in neuroblastoma.

Recent research has underscored the significance of circular RNAs (circRNAs) in various cancers, including neuroblastoma (NB). Specifically, circ-SHPRH, a unique circRNA, has been revealed to inhibit tumor growth by sequestering miRNAs or producing the SHPRH-146aa protein. To explore circ-SHPRH's involvement in NB and its potential application in gene therapy, this study examined circ-SHPRH expression in 94 NB tissues and cell lines (SK-N-BE(2), SH-SY5Y) using real-time PCR and fluorescence in situ hybridization (FISH). Functional assays encompassing both overexpression and knockdown experiments in NB cell lines, as well as in vivo investigations, were conducted. RNA-seq analysis revealed a correlation between circ-SHPRH and the pathway of P21 (CDKN1A), a pivotal cell cycle regulator. Validation through PCR and other techniques confirmed that circ-SHPRH upregulated P21 expression. Furthermore, the regulatory role of circ-SHPRH in the P21-CDK pathway was corroborated through SHPRH-146aa expression analysis. Notably, adenovirus-mediated circ-SHPRH overexpression effectively curbed NB tumor growth in NSG mice, while combining circ-SHPRH with everolimus exhibited potential for NB treatment. This study elucidates the remarkable significance of circ-SHPRH in NB and its prospective utility in gene therapy, thereby paving the way for innovative therapeutic approaches.

First fossil species of family Hyidae (Arachnida: Pseudoscorpiones) confirms 99 million years of ecological stasis in a Gondwanan lineage.

Burmese amber preserves a diverse assemblage of Cretaceous arachnids, and among pseudoscorpions (Arachnida: Pseudoscorpiones), ten species in five families have already been named. Here, we describe a new fossil species from Burmese amber in the pseudoscorpion family Hyidae, providing detailed measurements, photographs and 3D-models from synchrotron scanning. Based on morphology, the new fossil, Hya fynni sp. nov. is placed in the genus Hya, and is nearly identical to extant species in the genus, except for the position of trichobothrium est on the pedipalpal chela, thereby indicating extreme morphological stasis in this invertebrate lineage over the last 99 million years. Hya fynni represents the first described fossil species in Hyidae, and the third described Burmese fossil in the superfamily Neobisioidea. It also joins the garypinid, Amblyolpium burmiticum, in representing the oldest fossil records for extant pseudoscorpion genera. Considering proposed divergence dates, the newly described fossil species bolsters a Gondwanan origin for Hyidae, and provides evidence for the "Late Jurassic Rifting" hypothesis for the Burma Terrane, in which this landmass rifted from Gondwana in the Late Jurassic and collided with Eurasia by the Cretaceous/Eocene. Like Hya species today, H. fynni likely inhabited humicolous microhabitats in tropical forests on the Burma Terrane, supporting ecological niche stasis for this family since the Mesozoic.

Cretaceous crown male ant reveals the rise of modern lineages.

Most described Mesozoic ants belong to stem groups that existed only during the Cretaceous period. Previously, the earliest known crown ants were dated to the Turonian (Late Cretaceous, ca. 94-90 million years ago (Ma)) deposits found in the USA, Kazakhstan, and Botswana. However, the recent discovery of an alate male ant in Kachin amber from the earliest Cenomanian (ca. 99 Ma), representing a new genus and species, Antiquiformica alata, revises the narrative on ant diversification. Antiquiformica can be distinctly differentiated from all known male stem ants by its geniculate antennae with elongated scape, extending far beyond the occipital margin of the head and half the length of the funiculus, as well as its partly reduced forewing venation. Furthermore, the combination of a one-segmented waist with a well-developed node, elongated scape extending beyond the occipital margin, and reduced forewing venation, particularly the completely reduced m-cu and rs-m crossveins and absence of rm and mcu closed cells, firmly places the fossil within the extant subfamily Formicinae. Fourier transform infrared spectroscopy (FTIR) confirmed that the amber containing Antiquiformica alata originated from the Kachin mines in Myanmar. This discovery significantly revises our understanding of the early evolution of Formicinae. The presence of Antiquiformica in Cenomanian amber indicates that the subfamily Formicinae emerged at least by the start of the Late Cretaceous, with crown ants likely originating earlier during the earliest Cretaceous or possibly the Late Jurassic, although paleontological evidence is lacking to support the latter hypothesis.

Spatial distribution of sediment dissolved organic matter in oligotrophic lakes and its binding characteristics with Pb(II) and Cu(II).

Dissolved organic matter (DOM), the most active component in interstitial waters, determines the stability of heavy metals and secondary release in sediments. However, little is known about the composition and metal-binding patterns of DOM in interstitial water from oligotrophic lakes affected by different anthropogenic perturbations. Here, 18 interstitial water samples were prepared from sediments in agricultural, residential, tourist, and forest regions in an oligotrophic lake (Shengzhong Lake in Sichuan Province, China) watershed. Interstitial water quality and DOM composition, properties, and Cu(II)- and Pb(II)-binding characteristics were measured via physicochemical analysis, UV-vis spectroscopic, fluorescence excitation-emission matrix-parallel factor analysis (EEM-PARAFAC), and fluorescence titration methods. The DOM, which was produced mainly by microbial activities, had low molecular weights, humification degrees, and aromaticity. Based on EEM-PARAFAC results, the DOM was generally composed of tryptophan- (57.7%), terrestrial humic- (18.7%), microbial humic- (15.6%), and tyrosine-like (8.0%) substances. The DOM in the metal complexes was primarily composed of tryptophan-like substances, which accounted for ~42.6% of the DOM-Cu(II) complexes and ~72.0% of the DOM-Pb(II) complexes; however, microbial humic-like substances primarily contributed to the stability of DOM-Cu(II) (logKCu = 3.7-4.6) and DOM-Pb(II) (logKPb = 4.3-4.8). Water quality parameters did not significantly affect the stability of DOM-metal complexes. We demonstrated that the metal-binding patterns of DOM in interstitial water from oligotrophic lakes are highly dependent on microbial DOM composition and are affected by anthropogenic perturbations to a lesser extent.

Imaging performance prediction of a hypersonic target in a geosynchronous orbit based on multi-dimensional information correlation of radiation, multi-spectral, and polarization.

Hypersonic target detection based on infrared intensity characteristics is easily disturbed by sea surface and cloud flares when detected by space-based optical systems, which results in a low detection rate, high false alarm, and difficulty in stable detection. This paper explores a method to improve target detection performance based on the correlation of infrared radiation, multi-spectral and polarization. Firstly, the comprehensive factors that influence complex ambient illumination, atmospheric transmission, and clutter background on spectral-polarization characteristics of hypersonic targets are analyzed. Based on the global radiation scattering theory, the temperature distribution model of the hypersonic target is established by using FLUENT. The polarization emission and pBRDF model of the target is established, and the radiation polarization transfer model is generated. Secondly, the sea surface temperature distribution is obtained by inversion of Landsat8 remote sensing data. The radiation polarization transfer model of the sea surface is established based on the Cox-Munk model combined with pBRDF and the polarization emission model. Thirdly, the polarization scattering effect of atmospheric particles on the upward radiation of the interaction of the target with the sunlight is considered comprehensively, and the 6SV radiative transfer model is used to calculate the polarization effect of atmospheric particles on the upward radiation transmission of the target and the background. Then, combined with the point diffusion of the optical system and the photoelectric conversion of the detector, the multi-dimensional full-chain imaging prediction model of the hypersonic target-sea background-ambient atmosphere-optical system-detector is established. The imaging characteristics and detection performance of the target in different imaging dimensions are simulated and analyzed with the signal-to-clutter ratio (SCR). The research shows that in the direction of reflected sunlight from the sea surface, the sea surface glare is suppressed and the target is highlighted through a target detection method of multi-dimensional information. This method has better detection results than the infrared multi-spectral detection method.

Systematics Review and Phylogeny of Cyrtophyllitinae Zeuner, 1935 sensu Gorochov, Jarzembowski & Coram, 2006 (Ensifera, Haglidae), with Description of Two New Species.

A phylogeny of Cyrtophyllitinae Zeuner, 1935 sensu Gorochov, Jarzembowski & Coram, 2006, based on wing morphology, is presented including all genera. Cyrtophillitinae is found to be paraphyletic. Except for Cyrtophyllites rogeri Oppenheim, 1888, all other species were moved from the subfamily Cyrtophyllitinae (Hagloidea, Haglidae). Consequently, a new subfamily Archaboilinae subfam. nov. was erected and accommodates most of the previous cyrtophillitine taxa, except Cyrtophyllites rogeri. The type genus Archaboilus Martynov, 1937 of the new subfamily was designated; a new genus, Pararchaboilus gen. nov., was erected with the designation of type species Pararchaboilus cretaceus comb. nov. From the Middle Jurassic deposits of China, two new species, Archaboilus ornatus sp. nov. and Vitimoilus gigantus sp. nov., are described.

The Role of Astrocytes in Migraine with Cortical Spreading Depression: Protagonists or Bystanders? A Narrative Review.

Cortical spreading depression (CSD) is a slow wave of cortical depolarization closely associated with migraines with an aura. Previously, it was thought that CSD depolarization was mainly driven by neurons, with characteristic changes in neuronal swelling and increased extracellular potassium (K+) and glutamate. However, the role of astrocytes, a member of the neurovascular unit, in migraine with CSD has recently received increasing attention. In the early stages of CSD, astrocytes provide neurons with energy support and clear K+ and glutamate from synaptic gaps. However, in the late stages of CSD, astrocytes release large amounts of lactic acid to exacerbate hypoxia when the energy demand exceeds the astrocytes' compensatory capacity. Astrocyte endfoot swelling is a characteristic of CSD, and neurons are not similarly altered. It is primarily due to K+ influx and abnormally active calcium (Ca2+) signaling. Aquaporin 4 (AQP-4) only mediates K+ influx and has little role as an aquaporin. Astrocytes endfoot swelling causes perivascular space closure, slowing the glymphatic system flow and exacerbating neuroinflammation, leading to persistent CSD. Astrocytes are double-edged swords in migraine with CSD and may be potential targets for CSD interventions.

Chemical constituents with antioxidant activity from the branches and leaves of Hultholia mimosoides.

Four undescribed homoisoflavanoids (1-4), one homoflavonoid (5), ten dibenzoxocin derivatives (6a-10a and 6b-10b), one dibenzoxocin-derived phenolic compound (11), one diterpenoid (13), three aliphatic dicarboxylic acid derivatives (14-16), together with the known diterpenoid 12-O-ethylneocaesalpin B (12) were obtained from the branches and leaves of Hultholia mimosoides. Their structures were elucidated by extensive spectroscopic techniques. Notably, each of the dibenzoxocins 6-10 existed as a pair of interconvertible atropisomers and the conformation for these compounds was clarified by NMR and ECD analyses. Protosappanin F (11) was a previously undescribed dibenzoxocin-derived compound in which one of the benzene rings was hydrogenated to a polyoxygenated cyclohexane ring and an ether linkage was established between C-6 and C-12a. The isolated polyphenols were tested for induction of quinone reductase and compounds 3 and 8 showed potent QR-inducing activity in Hepa-1c1c7 cells.

Molecular mechanism of the influence of related genes expression in synovium tissue around shoulder joint of secondary frozen shoulder model rats on angiogenesis.

The study aimed to explore the pathogenesis of secondary frozen shoulder and its influence on synovium tissue and angiogenesis by constructing a rat secondary frozen shoulder model along with transforming growth factor. 40 healthy male rats aged 8 weeks were divided into Sham group (n=10, no modeling treatment), Control group (n=10, modeling treatment), Low group (n=10, modeling treatment, and 10 mL/d transforming growth factor), and High group (n=10, modeling treatment, and 20 mL/d transforming growth factor). Hematoxylin and Eosin (HE) method was used for histological detection, and Reverse Transcription-Polymerase Chain Reaction (RT-PCR) and immunohistochemical staining method were adopted to detect the expression of Matrix metalloproteinase-14 (MMP-14), mitogen-activated protein kinase (p38MAPK), and Vascular endothelial growth factor (VEGF). Compared with Sham group, the range of abduction and external rotation of rat glenohumeral joint in Control group, Low group, and High group was significantly reduced, and High group had the smallest range. Compared with the Sham group, the synovium in the Control group, the Low group, and the High group had obvious hyperplasia, and the blood vessels were significantly increased. Immunohistochemical staining and RT-PCR results showed that compared with Sham group, MMP-14, p38 MAPK, and VEGF in Control group, Low group, and High group all increased significantly, among which High group increased most. The secondary frozen shoulder is mainly manifested as synovial hyperplasia and increased blood vessels, which are related to the induction of MMP-14, p38 MAPK, and VEGF by transforming growth factor, which reveals the pathogenesis of secondary frozen shoulder to a certain extent, and lays a foundation for subsequent clinical treatment of secondary frozen shoulder.

A New Genus of Praeaulacidae (Hymenoptera: Evanioidea) from Mid-Cretaceous Kachin Amber: Insights into a Putative New Praeaulacinae Subclade.

A new praeaulacid genus and species, Azygdellitha nova gen. et sp. nov., is described and illustrated based on a male specimen from mid-Cretaceous Kachin amber from Hukawng Valley, Myanmar. This newly discovered taxon increased the diversity of praeaulacid wasps during the Cretaceous period. While this new taxon shares similarities of wing venation with most species of the subfamily Praeaulacinae, it strongly differs from that of three genera previously described from mid-Cretaceous Kachin amber: Mesevania, Paleosyncrasis, and Praegastrinus. We explore the possibility that these genera constitute a distinct tribe within the Praeaulacinae, distinguished by their wing venation. We provide illustrations and emphasize the potentially diagnostic traits supporting this classification.

Single-cell transcriptional profiling in osteosarcoma and the effect of neoadjuvant chemotherapy on the tumor microenvironment.

Osteosarcoma (OS), a malignant tumor, originates from the bone marrow. Currently, treatment for OS remains limited, making it urgent to understand the immune response in the tumor microenvironment of patients with OS. A comprehensive bioinformatics analysis was performed, including cell clustering subgroups, differential expression genes screening, proposed temporal order, and genomic variant analysis on single-cell RNA-sequencing data, from ten pre-chemotherapy patients and eleven post-chemotherapy patients. Subsequently, we analyzed the differentiation trajectories of osteoblasts, osteoclasts, fibroblasts, myeloid cells, and tumor-infiltrating lymphocytes (TILs) in detail to compare the changes in cell proportions and differential genes pre- and post-chemotherapy. The nine cell types were identified, including fibroblasts, myeloid cells, osteoblasts, TILs, osteoclasts, proliferative osteoblasts, pericytes, endothelial cells, and B cells. Post-chemotherapy treatment, the proportions of myeloid cells and TILs in OS were declined, while the number of osteoblasts was elevated. Besides, a decrease was observed in CD74, FTL, FTH1, MT1X and MT2A, and an increase in PTN, COL3A1, COL1A1, IGFBP7 and FN1. Meanwhile, EMT, DNA repair, G2M checkpoint, and E2F targets were highly enriched post-chemotherapy. Furthermore, there was a down-regulation in the proportions of CD14 monocytes, Tregs, NK cells and CD1C-/CD141-DCs, while an up-regulation was observed in the proportions of SELENOP macrophages, IL7R macrophages, COL1A1 macrophages, CD1C DCs, CD4+ T cells and CD8+ T cells. Overall, these findings revealed changes in the tumor microenvironment of OS post-chemotherapy treatment, providing a new direction for investigating OS treatment.

Specialized ovipositor sensilla of Cretaceous wasps (Insecta: Hymenoptera) possibly reveal a unique way of host detection.

Insects have evolved complex sensory systems that are important for feeding, defence and reproduction. Parasitoid wasps often spend much time and effort in searching for concealed hosts with the help of specialized sensilla. However, the early evolution of such behaviour and sensilla is poorly known. We describe two fossil female wasps, †Tichostephanus kachinensis sp. nov. and †Tichostephanus longus sp. nov., from mid-Cretaceous Kachin amber. Phylogenetic analyses based on morphological data retrieved †Tichostephanus as deeply nested within Evanioidea and closely related to extant Gasteruptiidae and Evaniidae. Both of these Cretaceous wasps possess features, e.g. coronal tubercles and flexible ovipositor sheaths, that indicate that they might have laid eggs in wood where their larvae possibly parasitized insect larvae. They have a peculiar and unique 'bottle brush' of sensilla close to the apex of their ovipositor sheaths, which has not been observed in any extant parasitoid wasps. These sensilla comprise many regularly arranged plate-shaped setae, attached in relatively large sockets and with rows of longitudinal ridges. Such specialized sensilla perhaps served to enhance the ability to detect hosts inside wood.

Primitive new termites (Blattodea, Termitoidae) in Cretaceous amber from Myanmar.

Mastotermitidae, the first-diverging extant family of termites, has only one relic extant species; however, this family had greater richness during the Mesozoic and Cenozoic eras. Fossil termites from the Cretaceous provide information on the early evolution of termites and the transition between extinct families. Herein, two new Mastotermitidae species found in upper Cretaceous (Cenomanian) Kachin amber are reported. One is a female imago described as Angustitermesreflexusgen. et sp. nov. and assigned to the subfamily Mastotermitinae. The other is Mastotermesreticulatussp. nov., which is described from an isolated forewing. With the comparison especially of the antenna and venation, these new mastotermitids further increase our knowledge of the diversity and morphology of Mastotermitidae during the Mesozoic.

A Retrospective Study of Biological Risk Factors Associated with Primary Knee Osteoarthritis and the Development of a Nomogram Model.

Aim: A high percentage of the elderly suffer from knee osteoarthritis (KOA), which imposes a certain economic burden on them and on society as a whole. The purpose of this study is to examine the risk of KOA and to develop a KOA nomogram model that can timely intervene in this disease to decrease patient psychological burdens. Methods: Data was collected from patients with KOA and without KOA at our hospital from February 2021 to February 2023. Initially, a comparison was conducted between the variables, identifying statistical differences between the two groups. Subsequently, the risk of KOA was evaluated using the Least Absolute Shrinkage and Selection Operator method and multivariate logistic regression to determine the most effective predictive index and develop a prediction model. The examination of the disease risk prediction model in KOA includes the corresponding nomogram, which encompasses various potential predictors. The assessment of disease risk entails the application of various metrics, including the consistency index (C index), the area under the curve (AUC) of the receiver operating characteristic curve, the calibration chart, the GiViTi calibration band, and the model for predicting KOA. Furthermore, the potential clinical significance of the model is explored through decision curve analysis (DCA) and clinical influence curve analysis. Results: The study included a total of 582 patients, consisting of 392 patients with KOA and 190 patients without KOA. The nomogram utilized age, haematocrit, platelet count, apolipoprotein a1, potassium, magnesium, hydroxybutyrate dehydrogenase, creatine kinase, and estimated glomerular filtration rate as predictors. The C index, AUC, calibration plot, Giviti calibration band, DCA and clinical influence KOA indicated the ability of nomogram model to differentiate KOA. Conclusion: Using nomogram based on disease risk, high-risk KOA can be identified directly without imaging.

New findings of dipteromantispids (Insecta: Neuroptera) from Upper Cretaceous Myanmar amber.

A new genus and two new species, Tholimantispa zuoae gen. et sp. nov. and Mantispidipterella curvis sp. nov. are described from the Upper Cretaceous of northern Myanmar amber collected in 2015. Tholimantispa zuoae gen. et sp. nov. is characterized by its distinct pterostigma, broad costal space, bifurcate humeral veinlets, and so forth, and Mantispidipterella curvis sp. nov. is different from Mantispidipterella longissima Liu, Lu et Zhang, 2017 in its ScP (subcosta posterior) distinctly curved at fusing point with RA (radius anterior), RP (radius posterior) abruptly and angularly curved at ra-rp (crossvein between RA and RP), AA3 (third branches of the anterior anal vein) present. The new fossil species enrich the diversity of Dipteromantispidae in the Cretaceous.

Link between mutations in ACVRL1 and PLA2G4A genes and chronic intestinal ulcers: A case report and review of literature.

BACKGROUND: Genetic factors of chronic intestinal ulcers are increasingly garnering attention. We present a case of chronic intestinal ulcers and bleeding associated with mutations of the activin A receptor type II-like 1 (ACVRL1) and phospholipase A2 group IVA (PLA2G4A) genes and review the available relevant literature. CASE SUMMARY: A 20-year-old man was admitted to our center with a 6-year history of recurrent abdominal pain, diarrhea, and dark stools. At the onset 6 years ago, the patient had received treatment at a local hospital for abdominal pain persisting for 7 d, under the diagnosis of diffuse peritonitis, acute gangrenous appendicitis with perforation, adhesive intestinal obstruction, and pelvic abscess. The surgical treatment included exploratory laparotomy, appendectomy, intestinal adhesiolysis, and pelvic abscess removal. The patient's condition improved and he was discharged. However, the recurrent episodes of abdominal pain and passage of black stools started again one year after discharge. On the basis of these features and results of subsequent colonoscopy, the clinical diagnosis was established as inflammatory bowel disease (IBD). Accordingly, aminosalicylic acid, immunotherapy, and related symptomatic treatment were administered, but the symptoms of the patient did not improve significantly. Further investigations revealed mutations in the ACVRL1 and PLA2G4A genes. ACVRL1 and PLA2G4A are involved in angiogenesis and coagulation, respectively. This suggests that the chronic intestinal ulcers and bleeding in this case may be linked to mutations in the ACVRL1 and PLA2G4A genes. Oral Kangfuxin liquid was administered to promote healing of the intestinal mucosa and effectively manage clinical symptoms. CONCLUSION: Mutations in the ACVRL1 and PLA2G4A genes may be one of the causes of chronic intestinal ulcers and bleeding in IBD. Orally administered Kangfuxin liquid may have therapeutic potential.