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BACKGROUND: The aim of this study is to assess the feasibility and safety of monitored anesthesia care (MAC) versus intubated general anesthesia (IGA) for patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB). METHODS: This prospective observational study included patients scheduled for cardiac surgery involving CPB at our institution between April 2012 and February 2017. The enrolled patients were categorized into MAC and IGA groups. MAC involved local anesthesia at the sternotomy site, sedation with dexmedetomidine, analgesia with remifentanil/sufentanil, and electroacupuncture (EA). Eleven patients underwent MAC, and 13 patients received IGA. There were no instances of conversion from MAC to IGA, and both groups exhibited no major complications. The demographic characteristics, baseline parameters, and operative variables were comparable between the two groups. RESULTS: Intraoperative opioid consumption was significantly lower in the MAC group compared to the IGA group (P < 0.001). The time to oral intake of liquids was significantly shorter in the MAC group (2.14 ± 0.90 h) compared to the IGA group (22.31 ± 3.33 h) (P < 0.001). Furthermore, the intensive care unit length of stay (ICU-LOS) and perioperative vasoactive-inotropic score (VIS) were significantly reduced in the MAC group compared to the IGA group (P < 0.001). CONCLUSIONS: MAC emerges as a safe and viable alternative to general anesthesia for specific patient groups undergoing cardiac surgery with CPB. Furthermore, it may enhance postoperative recovery and minimize postoperative complications compared to IGA.
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Anestesia Geral , Procedimentos Cirúrgicos Cardíacos , Ponte Cardiopulmonar , Humanos , Masculino , Feminino , Estudos Prospectivos , Anestesia Geral/métodos , Pessoa de Meia-Idade , Ponte Cardiopulmonar/métodos , Idoso , Procedimentos Cirúrgicos Cardíacos/métodos , Procedimentos Cirúrgicos Cardíacos/efeitos adversosRESUMO
Dichromate ion (Cr2O72-) is a highly toxic chromium-containing compound that poses significant hazards to the digestive, respiratory systems, skin, and mucous membranes. Currently, the detection and adsorption of Cr2O72- face significant challenges, including the time-consuming and low sensitivity nature of traditional analytical methods. The limited efficiency and capacity of existing adsorbents hinder their practical application in real-time water quality monitoring and environmental remediation. Herein, using polyethyleneimine-functionalized (PEI) pulp fiber paper as the substrate, we developed smart paper-based materials (designated as NB-MQDs@PP) incorporated with nitrogen and boron co-doped MXene quantum dots (NB-MQDs) for rapid adsorption and sensitive detection of Cr2O72-. Compared to undoped MQDs, NB-MQDs exhibited longer excitation wavelength and enhanced oxidation stability. As anticipated, NB-MQDs achieved rapid (response time of 10 s) and sensitive (detection limit of 1.2 µM) recognition of Cr2O72- within a wide pH range with a quenching efficiency of 99.9%. Simultaneously, two on-site detection methods, immersion and cyclic filtration, were constructed based on NB-MQDs@PP. The detection limit of the immersion method was 17.0 nM, while the cyclic filtration method had a detection limit as low as 3.8 nM, surpassing the majority of those reported literatures. Remarkably, NB-MQDs@PP exhibited outstanding enrichment capacity towards Cr2O72-, with an adsorption capacity of up to 162.4 mg/g. This work provides a novel strategy for creating unique paper-based materials with excellent capture and monitoring dual-function, which can be customized according to the requirements of various application scenarios.
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Plasmopara viticola (Berk.et Curtis) Berl. Et de Toni is the pathogen that causes grape downy mildew, which is an airborne disease that severely affects grape yield and causes huge economic losses. The usage of effective control methods can reduce the damage to plants induced by grape downy mildew. Biocontrol has been widely used to control plant diseases due to its advantages of environmental friendliness and sustainability. However, to date, only a few comprehensive reviews on the biocontrol of grape downy mildew have been reported. In this review, we summarize the biological characteristics of P. viticola and its infection cycle, followed by a detailed overview of current biocontrol agents, including bacteria and fungi that could be used to control grape downy mildew, and their control effects. Furthermore, potential control mechanisms of biocontrol agents against grape downy mildew are discussed. Lastly, suggestions for future research on the biocontrol of grape downy mildew are provided. This review provides the basis for the application of grape downy mildew biocontrol.
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IL-1ß represents an important inflammatory factor involved in the host response against GBS infection. Prior research has suggested a potential involvement of IL-1ß in the process of ferroptosis. However, the relationship between IL-1ß and ferroptosis in the context of anti-GBS infection remains uncertain. This research demonstrates that the occurrence of ferroptosis is essential for the host's defense against GBS infection in a mouse model of abdominal infection, with peritoneal macrophages identified as the primary cells undergoing ferroptosis. Further research indicates that IL-1ß induces lipid oxidation in macrophages through the upregulation of pathways related to lipid oxidation. Concurrently, IL-1ß is not only involved in the initiation of ferroptosis in macrophages, but its production is intricately linked to the onset of ferroptosis. Ultimately, we posit that ferroptosis acts as a crucial initiating factor in the host response to GBS infection, with IL-1ß playing a significant role in the resistance to infection by serving as a key inducer of ferroptosis.
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PURPOSE: Secondhand smoke significantly increases the risk of cerebrovascular diseases, prompting recent public smoking bans. We aimed to ascertain the effects of smoke-free legislation on stroke incidence and mortality. METHODS: We systematically searched Medline, Embase, Cochrane Library, and Scopus up to August 13, 2023, for studies reporting changes in stroke incidence following partial or comprehensive smoking bans. A random-effects meta-analysis was conducted on hospital admissions and mortality for stroke, stratified based on comprehensiveness of the ban ((i) workplaces-only, (ii) workplaces and restaurants, (iii) workplaces, restaurants and bars). The effect of post-ban follow-up duration was assessed visually by a forest plot, while meta-regression was employed to evaluate for any dose-response relationship between ban comprehensiveness and stroke risk. FINDINGS: Of 3987 records identified, 15 studies analysing bans across a median follow-up time of 24 months (range: 3-67) were included. WRB bans were associated with reductions in the rates of hospital admissions for stroke (nine studies; RR, 0.918; 95% CI, 0.872-0.967) and stroke mortality (three studies; RR, 0.987; 95% CI, 0.952-1.022), although the latter did not reach statistical significance. There was no significant difference in the risk of stroke admissions for studies with increased ban comprehensiveness and no minimum duration for significant post-ban effects to be observed. DISCUSSION AND CONCLUSION: Legislative smoking bans were associated with significant reductions in stroke-related hospital admissions, providing evidence for its utility as a public health intervention.
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Immunotherapies employing PD-1/PD-L1 immune checkpoint inhibitors (ICIs) are vital for primary liver cancer (PLC), but response rates remain unsatisfying. Accurate differentiation of responders from non-responders to immunotherapy is imperative. Here, single-cell-scaled mass cytometry analysis on sequential peripheral blood mononuclear cells (PBMCs) from ICI-treated PLC patients is conducted, and tissue residence of immune subpopulations is assessed via multiplex immunohistochemistry. In the discovery cohort (n = 24), responders have lower baseline B cell and HLA-DR+CD8+T cell, and higher CD14+CD16- classical monocyte (CM) proportions. CMs decrease more in responders PBMCs, while HLA-DR+CD8+T cells conformably amplify after ICI-exposure. Responsive individuals display upregulated exhaustion and activation markers in peripheral immune lineages. In the expanded cohort of 77 patients, the augment of the B cells in non-responders is re-confirmed. Responders demonstrate much higher enrichment of B cells or tertiary lymphoid structures in tumor compared to non-responders. A prospective model that excelled in early discrimination of responders is developed using generalized linear model and achieves a satisfactory AUC over 0.9 in all three independent cohorts. Integratedly, the study unveils dynamic immune landscapes in PLC patients undergoing ICI-based therapy, aiding in PLC patient stratification for ICI-based treatment and fostering new response monitoring strategies.
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Altimella Wang & Zhang, gen. nov., a new genus belonging to Cicurinidae, is established, and two new species are described, Altimellanedong Wang & Zhang, sp. nov. (ââ, type species) and A.ngamring Wang & Zhang, sp. nov. (ââ), from Xizang, China. Detailed descriptions of somatic features and genital characteristics, photos of the habitus, photos and drawings of the copulatory organs, and a distribution map are provided.
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To explore the impacts of galactose side-chain on the prebiotic activity of xyloglucan oligosaccharides (XGOS), XGOS and de-galactosylated XGOS (DG-XGOS) were prepared from tamarind using an enzymatic method. The differences in structural features of XGOS and DG-XGOS were systematically analyzed. Their in vitro fermentation characteristics of human fecal microbiota were explored. These results indicated that both XGOS and DG-XGOS promoted short-chain fatty acids (SCFAs) production, decreased pH, and changed the microbiota composition of the fermentation broth. Comparatively, DG-XGOS was more effective than XGOS in producing SCFAs, inhibiting the phylum Proteobacteria prevalence, and promoting the phyla Bacteroidetes and Actinobacteria prevalence. In summary, the xyloglucan degradation products exert potential prebiotic activity. Removing the galactose side-chains further enhances oligosaccharide utilization by fecal microbiota, offering a valuable approach to improve the biological efficacy of oligosaccharides.
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BACKGROUND: Currently, there are no optimal biomarkers available for distinguishing patients who will respond to immune checkpoint inhibitors (ICIs) therapies. Consequently, the exploration of novel biomarkers that can predict responsiveness to ICIs is crucial in the field of immunotherapy. METHODS: We estimated the proportions of 22 immune cell components in 10 cancer types (6,128 tumors) using the CIBERSORT algorithm, and further classified patients based on their tumor immune cell proportions in a pan-cancer setting using k-means clustering. Differentially expressed immune genes between the patient subgroups were identified, and potential predictive biomarkers for ICIs were explored. Finally, the predictive value of the identified biomarkers was verified in patients with urothelial carcinoma (UC) and esophageal squamous cell carcinoma (ESCC) who received ICIs. RESULTS: Our study identified two subgroups of patients with distinct immune infiltrating phenotypes and differing clinical outcomes. The patient subgroup with improved outcomes displayed tumors enriched with genes related to immune response regulation and pathway activation. Furthermore, CCL5 and CSF2 were identified as immune-related hub-genes and were found to be prognostic in a pan-cancer setting. Importantly, UC and ESCC patients with high expression of CCL5 and low expression of CSF2 responded better to ICIs. CONCLUSION: We demonstrated CCL5 and CSF2 as potential novel biomarkers for predicting the response to ICIs in patients with UC and ESCC. The predictive value of these biomarkers in other cancer types warrants further evaluation in future studies.
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Under large current densities, the excessive hydroxide ion (OH) consumption hampers alkaline water splitting involving the oxygen evolution reaction (OER). High OH concentration (≈30 wt.%) is often used to enhance the catalytic activity of OER, but it also leads to higher corrosion in practical systems. To achieve higher catalytic activity in low OH concentration, catalysts on magnetic frame (CMF) are built to utilize the local magnetic convection induced from the host frame's magnetic field distributions. This way, a higher reaction rate can be achieved in relatively lower OH concentrations. A CMF model system with catalytically active CoFeOx nanograins grown on the magnetic Ni foam is demonstrated. The OER current of CoFeOx@NF receives ≈90% enhancement under 400 mT (900 mA cm-2 at 1.65 V) compared to that in zero field, and exhibits remarkable durability over 120 h. As a demonstration, the water-splitting performance sees a maximum 45% magnetic enhancement under 400 mT in 1 m KOH (700 mA cm-2 at 2.4 V), equivalent to the concentration enhancement of the same electrode in a more corrosive 2 m KOH electrolyte. Therefore, the catalyst-on-magnetic-frame strategy can make efficient use of the catalysts and achieve higher catalytic activity in low OH concentration by harvesting local magnetic convection.
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BACKGROUND: Keen Osteoarthritis (KOA) is a common chronic disabling disease characterized by joint pain and dysfunction, which seriously affects patients' quality of life. Recent studies have shown that transcranial direct current stimulation (tDCS) was a promising treatment for KOA. PURPOSE: Investigate the effects of tDCS on pain and physical function in patients with KOA. METHODS: Randomized controlled trials related to tDCS and KOA were systematically searched in the PubMed, Embase, Medline, Cochrane Library, CINHL, and Web of Science databases from inception to July 23, 2024. The pain intensity was evaluated using the visual analog scale or the numeric rating scale, and the pain sensitivity was assessed using conditioned pain modulation, pressure pain threshold, heat pain threshold, or heat pain tolerance. The physical function outcome was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index or the Knee injury and Osteoarthritis Outcome Score. Statistical analysis was performed using Review Manager 5.4. RESULTS: Seven studies with a total of 503 participants were included. Compared to sham tDCS, tDCS was effective in reducing the short-term pain intensity (SMD: -0.58; 95% CI: -1.02, -0.14; p = 0.01) and pain sensitivity (SMD: -0.43; 95% CI: -0.70, -0.16; p = 0.002) but failed to significantly improve the long-term pain intensity (SMD: -0.26; 95% CI: -0.59, 0.08; p = 0.13) in KOA patients. In addition, tDCS did not significantly improve the short-term (SMD: -0.13; 95% CI: -0.35, 0.08; p = 0.22) and long-term (SMD: 0.02; 95% CI: -0.22, 0.25; p = 0.90) physical function in patients with KOA. CONCLUSIONS: The tDCS can reduce short-term pain intensity and sensitivity but fails to significantly relieve long-term pain intensity and improve the physical function in patients with KOA. Thus, tDCS may be a potential therapeutic tool to reduce short-term pain intensity and pain sensitivity in patients with KOA.
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Osteoartrite do Joelho , Medição da Dor , Ensaios Clínicos Controlados Aleatórios como Assunto , Estimulação Transcraniana por Corrente Contínua , Humanos , Estimulação Transcraniana por Corrente Contínua/métodos , Osteoartrite do Joelho/terapia , Osteoartrite do Joelho/fisiopatologia , Resultado do Tratamento , Medição da Dor/métodos , Artralgia/terapia , Artralgia/diagnóstico , Artralgia/fisiopatologia , Artralgia/etiologia , Limiar da Dor , Manejo da Dor/métodos , Qualidade de Vida , Articulação do Joelho/fisiopatologiaRESUMO
Intestinal microbiota imbalance plays an important role in the progression of obstructive sleep apnea (OSA), and is considered to be the main mediator that triggers metabolic comorbidities. Here, we analyzed the changes in intestinal microbiota in patients with different severities of OSA based on apnea hypopnea index (AHI) classification, and explored the role of intestinal microbiota in the severity of OSA. This study included 19 healthy volunteers and 45 patients with OSA [5 ≤ AHI < 15 (n = 14), 15 ≤ AHI < 30 (n = 13), AHI ≥ 30 (n = 18)]. Relevant sleep monitoring data and medical history data were collected, and microbial composition was analyzed using 16S rRNA high-throughput sequencing technology. The diversity analysis of intestinal microbiota among different groups of people was conducted, including alpha diversity, beta diversity, species diversity, and marker species as well as differential functional metabolic pathway prediction analysis. With the increase of AHI classification, the alpha diversity in patients with OSA significantly decreased. The results revealed that the severity of OSA is associated with differences in the structure and composition of the intestinal microbiota. The abundance of bacteria producing short-chain fatty acids (such as Bacteroides, Ruminococcacea, and Faecalibacterium) in severe OSA is significantly reduced and a higher ratio of Firmicutes to Bacteroidetes. Random forest analysis showed that Parabacteroides was a biomarker genus with important discriminatory significance. The differential metabolic pathway prediction function shows that the main function of maintaining intestinal microbiota homeostasis is biosynthetic function. Our results show that the differences in the composition of intestinal microbiota in patients with different severities of OSA are mainly related to short-chain fatty acid-producing bacteria. These changes may play a pathological role in OSA combined with metabolic comorbidities.
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Microbioma Gastrointestinal , RNA Ribossômico 16S , Apneia Obstrutiva do Sono , Humanos , Microbioma Gastrointestinal/genética , Apneia Obstrutiva do Sono/microbiologia , Masculino , Pessoa de Meia-Idade , Feminino , Adulto , RNA Ribossômico 16S/genética , Índice de Gravidade de Doença , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Estudos de Casos e Controles , Fezes/microbiologiaRESUMO
The tomato leafminer, Tuta absoluta (Meyrick), one of the most economically destructive pests of tomato, causes severe yields losses of tomato production globally. Rapid evolution of insecticide resistance requires the development of alternative control strategy for this pest. RNA interference (RNAi) represents a promising, innovative control strategy against key agricultural insect pests, which has recently been licensed for Colorado Potato Beetle control. Here two essential genes, voltage-gated sodium channel (Nav) and NADPH-cytochrome P450 reductase (CPR) were evaluated as targets for RNAi using an ex vivo tomato leaf delivery system. Developmental stage-dependent expression profiles showed TaNav was most abundant in adult stages, whereas TaCPR was highly expressed in larval and adult stages. T. absoluta larvae feeding on tomato leaflets treated with dsRNA targeting TaNav and TaCPR showed significant knockdown of gene expression, leading to reduction in adult emergence. Additionally, tomato leaves treated with dsRNA targeting these two genes were significantly less damaged by larval feeding and mining. Furthermore, bioassay with LC30 doses of λ-cyholthin showed that silencing TaNav and TaCPR increased T. absoluta mortality about 32.2 and 17.4%, respectively, thus indicating that RNAi targeting TaNav and TaCPR could increase the susceptibility to λ-cyholthin in T. absoluta. This study demonstrates the potential of using RNAi targeting key genes, like TaNav and TaCPR, as an alternative technology for the control of this most destructive tomato pests in the future.
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Inseticidas , Larva , Folhas de Planta , Interferência de RNA , Solanum lycopersicum , Animais , Solanum lycopersicum/parasitologia , Solanum lycopersicum/genética , Inseticidas/farmacologia , Larva/efeitos dos fármacos , Larva/genética , Mariposas/efeitos dos fármacos , Mariposas/genética , Mariposas/crescimento & desenvolvimento , Proteínas de Insetos/genética , Proteínas de Insetos/metabolismo , Canais de Sódio Disparados por Voltagem/genética , Canais de Sódio Disparados por Voltagem/metabolismo , Resistência a Inseticidas/genética , PiretrinasRESUMO
To date, it remains challenging to precisely and efficiently construct structurally intriguing polycarbocycles with densely packed stereocenters in organic synthesis. Niduterpenoid B, a naturally occurring ERα inhibitor, exemplifies this complexity with its intricate polycyclic network comprising 5 cyclopentane and 1 cyclopropane rings, featuring 13 contiguous stereocenters, including 4 all-carbon quaternary centers. In this work, we describe the first total synthesis of niduterpenoid B using a structural reorganization strategy. Key features include the following: (1) an efficient methoxy-controlled cascade reaction that precisely forges a highly functionalized tetraquinane (A-D rings) bearing sterically hindered contiguous quaternary stereocenters; (2) a rhodium-catalyzed [1 + 2] cycloaddition that facilitates the construction of a strained 3/5 bicycle (E-F rings) angularly fused with ring D.
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Forests, the largest terrestrial carbon sinks, play an important role in carbon sequestration and climate change mitigation. Although forest attributes and environmental factors have been shown to impact aboveground biomass, their influence on biomass stocks in species-rich forests in southern China, a biodiversity hotspot, has rarely been investigated. In this study, we characterized the effects of environmental factors, forest structure, and species diversity on aboveground biomass stocks of 30 plots (1 ha each) in natural forests located within seven nature reserves distributed across subtropical and marginal tropical zones in Guangxi, China. Our results indicate that forest aboveground biomass stocks in this region are lower than those in mature tropical and subtropical forests in other regions. Furthermore, we found that aboveground biomass was positively correlated with stand age, mean annual precipitation, elevation, structural attributes and species richness, although not with species evenness. When we compared stands with the same basal area, we found that aboveground biomass stock was higher in communities with a higher coefficient of variation of diameter at breast height. These findings highlight the importance of maintaining forest structural diversity and species richness to promote aboveground biomass accumulation and reveal the potential impacts of precipitation changes resulting from climate warming on the ecosystem services of subtropical and northern tropical forests in China. Notably, many natural forests in southern China are not fully stocked. Therefore, their continued growth will increase their carbon storage over time.
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OBJECTIVES: Four and a half LIM domain 2 protein (FHL2) was reported to regulate the progression of various cancers and this study aimed to clarify the intrinsic mechanism of FHL2 facilitating the progression of lung adenocarcinoma. METHODS: In this study, bioinformatic analysis and immunohistochemistry staining were used to confirm the FHL2 levels in patients with lung adenocarcinoma. The potential influence of FHL2 on the biological function of lung adenocarcinoma cells was verified in vitro and in vivo. To uncover the potential mechanism contributing to the advance of lung adenocarcinoma, liquid chromatographyâmass spectrometry and immunoprecipitation assays were performed to detect the partners of FHL2. RESULTS: FHL2 levels were upregulated in lung adenocarcinoma and contributed to a dismal prognosis. Moreover, in vitro and in vivo assays suggested that genetic inhibition of FHL2 undermined the viability, migration and invasion of lung adenocarcinoma cells, while forced expression of FHL2 showed the opposite trend. Mechanistically, liquid chromatographyâmass spectrometry and coimmunoprecipitation assays revealed that FHL2 could function as a scaffold to enhance TRIM63-mediated ubiquitination of APC. The degradation of APC further stabilized ß-catenin and activated Wnt signaling pathway. CONCLUSION: Collectively, this study uncovered the underlying mechanism by which FHL2 regulates the biological characteristics of tumors and provided a novel target for lung adenocarcinoma treatment.
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BACKGROUND: Fruquintinib has received approval for the management of patients with chemotherapy-resistant metastatic colorectal cancer (mCRC). However, combination of fruquintinib with immune checkpoint inhibitors (ICIs) is yet to be extensively studied. This study aims to assess the clinical efficacy, safety, and prognostic indicators of treatment regimen combining fruquintinib with ICIs in mCRC patients. METHODS: We analyzed data from mCRC patients who were administered fruquintinib either as a monotherapy or in conjunction with ICIs following conventional chemotherapy. Parameters such as the objective response rate (ORR), disease control rate (DCR), overall survival (OS), progression-free survival (PFS), and incidence of adverse events were meticulously evaluated. Furthermore, the relationship between blood markers and patient prognosis was examined. RESULTS: A total of 72 mCRC patients were included in this study, with a median observation period of 48 months, 19 were treated with fruquintinib alone, while 53 received a combination therapy involving fruquintinib and ICIs. The combined therapy group exhibited superior ORR and DCR compared to the fruquintinib monotherapy group. Additionally, significant improvements in OS and PFS were observed in the combined treatment group. The occurrence of adverse events was generally manageable and well-tolerated across both groups, with no significant difference in incidence rates. Notably, albumin levels were identified as a prognostic marker for PFS and OS in the univariate Cox regression analysis. CONCLUSIONS: The combination of fruquintinib with ICIs demonstrated enhanced clinical efficacy and improved survival outcomes compared to fruquintinib monotherapy in mCRC patients. The safety of the combination regimen was deemed manageable and acceptable.
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Protocolos de Quimioterapia Combinada Antineoplásica , Benzofuranos , Neoplasias Colorretais , Inibidores de Checkpoint Imunológico , Humanos , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/patologia , Neoplasias Colorretais/mortalidade , Masculino , Feminino , Inibidores de Checkpoint Imunológico/uso terapêutico , Inibidores de Checkpoint Imunológico/farmacologia , Pessoa de Meia-Idade , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Benzofuranos/administração & dosagem , Benzofuranos/uso terapêutico , Benzofuranos/farmacologia , Adulto , Sinergismo Farmacológico , Prognóstico , Quinazolinas/uso terapêutico , Quinazolinas/administração & dosagem , Estudos Retrospectivos , Metástase Neoplásica , Idoso de 80 Anos ou maisRESUMO
BACKGROUND AND PURPOSE: Tenecteplase is a thrombolytic agent with pharmacological advantages over alteplase and has been shown to be noninferior to alteplase for acute ischemic stroke in randomized trials. However, evidence pertaining to the safety and efficacy of tenecteplase in patients from different ethnic groups is lacking. The aim of this systematic review and metaanalysis was to investigate ethnicity-specific differences in the safety and efficacy of tenecteplase versus alteplase in patients with acute ischemic stroke. METHODS: Following an International Prospective Register of Systematic Reviews (PROSPERO)- registered protocol (CRD42023475038), three authors conducted a systematic review of the PubMed/MEDLINE, Embase, Cochrane Library, and CINAHL databases for articles comparing the use of tenecteplase with any thrombolytic agent in patients with acute ischemic stroke up to November 20, 2023. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Two independent authors extracted data onto a standardized data collection sheet. A pairwise meta-analysis was conducted in risk ratios (RR). RESULTS: From 34 studies (59,601 participants), the rate of complete recanalization was significantly higher (P<0.01) in Asian (RR: 1.91, 95% confidence interval [CI]: 1.30 to 2.80) versus Caucasian patients (RR: 0.99, 95% CI: 0.87 to 1.14). However, Asian patients (RR: 1.18, 95% CI: 0.87 to 1.62) had significantly higher (P=0.01) rates of mortality compared with Caucasian patients (RR: 1.10, 95% CI: 1.00 to 1.22). Caucasian patients were also more likely to attain a modified Rankin Scale (mRS) score of 0 to 2 at follow-up (RR: 1.14, 95% CI, 1.10 to 1.19) compared with Asian (RR: 1.00, 95% CI, 0.95 to 1.05) patients. There was no significant difference in the rate of symptomatic intracranial hemorrhage (P=0.20) and any intracranial hemorrhage (P=0.83) between Asian and Caucasian patients. CONCLUSION: Tenecteplase was associated with significantly higher rates of complete recanalization in Asian patients compared with Caucasian patients. However, tenecteplase was associated with higher rates of mortality and lower rates of mRS 0 to 2 in Asian patients compared with Caucasian patients. It may be beneficial to study the variations in response to tenecteplase among patients of different ethnic groups in large prospective cohort studies.
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An unusual cascade C-H activation, vinylation and 6π-electrocyclization of 2-pyridyl aldimines with vinyl bromides/triflates was achieved using catalysis with a unique CCC pincer NHC-Ru(iii) complex (Cat B). This reaction was found to enable a rapid and diverse synthesis of polycyclic 4H-pyrido[1,2-a]pyrimidine derivatives in mostly good to high yields, and with a broad substrate scope. A mechanistic study suggested the formation of a semi-opened Ru(iii) intermediate chelating/activating the aldimine, and the occurrence of single-electron transfer (SET) to generate a vinyl radical, followed by vinylation and then an intramolecular 6π-electrocyclization of 1N,3N-hexatrene to form the product. This protocol provides a convenient approach for preparing and seeking new drug candidates.
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Human Enterovirus 71 (EV71) has emerged as one of the predominant causative agents of hand, foot and mouth disease (HFMD) with global impact. Despite the inactivated vaccine being licensed, other vaccine candidates based on advanced technology platforms are under development. In this report, we rationally designed and constructed two DNA-launched live attenuated vaccine candidates (pDL-EV71) under the control of specific promoters. In vitro and in vivo transfection with pDL-EV71 driven by the CMV promoter successfully yielded fully infectious EV71. More importantly, the administration of pDL-EV71 did not cause clinical symptoms following intracranial or intramuscular inoculation in neonatal and IFNα/ßR-/- mice, demonstrating its safety profile. Moreover, a single-dose or two-dose immunization with pDL-EV71 elicited robust neutralizing antibodies against EV71 as well as an antigen-specific cellular response in mice. A single-dose immunization with 10 âµg of pDL-EV71 conferred complete protection against lethal EV71 infection in neonates born to immunized maternal mice. Overall, our present results demonstrate that pDL-EV71 is a safe and effective vaccine candidate against EV71 for further development.