Rationale and design of a single-center randomized trial to compare the graft patency between the radial artery and the no-touch saphenous vein in coronary artery bypass grafting surgery (GRAFT-CAB Study).

BACKGROUND: Previous studies suggested only the radial artery and the No-touch (NT) technique were effective in reducing graft occlusion after coronary artery bypass grafting (CABG) surgery. However, there is no randomized trial comparing these 2 graft conduits. The optimum second conduit for CABG remains undetermined. MATERIALS AND METHODS: This study is a prospective, single-center randomized clinical trial, aiming to compare the graft patency between the radial artery and the NT vein graft. All patients undergoing isolated CABG with left internal mammary artery (LIMA) plus at least 2 additional grafts will be considered eligible. About 774 cases (516 in the radial artery group and 258 in the NT vein group) will be enrolled in over 1 to 2 years. Participants will be randomized and allocated to two bypass strategies: the LIMA plus 1 radial artery and 1 conventional vein graft, or the LIMA plus 2 NT vein grafts. The primary outcome is graft occlusion at 1 year after CABG evaluated by CT angiography. The secondary outcomes include graft occlusion at 3 and 5 years and major adverse cardiac or cerebrovascular events at 1, 3, and 5 years follow-ups. DISCUSSION: This study will define whether or not the NT vein has a lower graft occlusion rate than the radial artery in short and mid-term follow-ups, and provide new evidence for the second conduit choice in CABG surgery. TRIAL REGISTRATION: ClinicalTrials.gov NCT06014047. Registered on October 15th, 2023.

Clinical outcomes and prognostic factors in the surgical treatment of spinal dural arteriovenous fistulas: a retrospective study of 118 patients.

Spinal dural arteriovenous fistulas (SDAVFs) are the most common type of spinal vascular malformations (AVMs), constituting approximately 70% of all spinal AVMs. The impact of various clinical and radiologic features on the outcomes in patients with SDAVFs is still controversial. The purpose of the study is to investigate the clinical outcomes and prognostic factors in patients with surgically treated SDAVFs in a single center. A retrospective review was performed for all patients with SDAVFs from January 2013 to September 2021 who underwent surgery at our institution. Medical records and pre- and postoperative imaging data were analyzed. Neurological function status was evaluated by modified Aminoff-Logue Scale (mALS). Student's t-test, Wilcoxon rank sum test, χ2 test and logistic regression were used to find significant prognostic factors. P values < 0.05 were considered significant. One hundred and eighteen patients were ultimately included in the study. By comparing preoperative and postoperative mALS, 69 (58.5%) patients experienced improvement, and 49 (41.5%) patients showed no improvement (worse or unchanged). Wilcoxon rank sum test showed that there was a difference between the improvement group and the no improvement group in preoperative mALS Micturition score and preoperative mALS Defecation score. The logistic regression revealed that preoperative mALS Gait score was associated with clinical improvement after surgery in patients with SDAVFs. Surgical treatment of SDAVFs is a safe and effective procedure and can lead to symptom improvement or stabilization in most patients. Preoperative neurological function status was the only factor associated with clinical prognosis.

Lutein-Based pH and Photo Dual-Responsive Novel Liposomes Coated with Ce6 and PTX for Tumor Therapy.

Liposomes are considered the best nanocarrier for delivering cancer drugs such as chlorin e6 (Ce6) and paclitaxel (PTX). However, the poor stability and non-selectivity release of liposomes may severely limit their further applications. In this study, based on the characteristics of lutein (L) photo-response and orthoester (OE) acid-response, stable and dual-responsive liposomes (Dr-lips) have been prepared. The Dr-lips exhibited a spherical shape with a uniform size of approximately 58.27 nm. Moreover, they displayed a zeta potential ranging from -45.45 to -28.25 mV and showed excellent storage stability, indicating stable colloidal properties. Additionally, they achieved high drug encapsulation rates, with 92.27% for PTX and 90.34% for Ce6, respectively. Meanwhile, under near-infrared (NIR) light at 660 nm, Ce6 plays a key role in accelerating the photodegradation rate of lutein and PEG-OE-L while also enhancing tissue penetration ability. Additionally, Dr-lips loaded with Ce6 and PTX not only displayed excellent pH and photo dual-responsiveness for targeted delivering and releasing but also showed remarkable reactive oxygen species (ROS) generation capacity and impressive anti-tumor activity in vitro. Therefore, it provides a novel strategy for optimizing stability and enhancing their targeted drug delivery of liposome.

A propensity score-matched study on the short-term outcome of ruptured blood blister-like aneurysm treated by microsurgery or endovascular surgery: a single-center study of 155 cases.

Treating blood blister-like aneurysms (BBA) is a major neurosurgical challenge. Whether endovascular repair serves as a better strategy than microsurgery remains controversial. We aim to perform a propensity score-matched (PSM) retrospective study to analyze the short-term outcome in BBA patients who received microsurgery and endovascular treatment. One hundred fifty-five eligible patients with internal carotid artery BBA were retrospectively collected with demographic and angiographic baseline in a single center. Three-month outcome and adverse events were set as outcome endpoints. PSM was used to match the microsurgery and endovascular group. Matching effect was evaluated by distribution variation analysis and love plot. The outcome of neurosurgery and endovascular treatment was then compared before and after PSM. Better WFNS levels (p = .017) and modified Fisher grade (p = .027) were noted in endovascular group before matching. Other baseline including angiographic features were comparable between two groups. Before matching, the 3-month outcome of endovascular repair surgery was more favorable than microsurgery (p < .0001). The occurrence of adverse events was also higher in the microsurgery group (p = .0079). In PSM-adjusted groups, the superior outcome effect of endovascular treatment still existed but with a reduced significance (p = .004). Similar trend was also observed in the adverse event rate (p = .038). Fatality rate was comparable between two adjusted groups regardless of PSM adjustment. Endovascular surgery of BBAs exhibits overall more favorable short-term outcome regardless of PSM matching. Microsurgery does not cause a higher fatality rate, hence it could be considered a salvage plan for those high-grade BBA patients.

Indirect carotid-cavernous sinus fistula following mechanical thrombectomy: A case report of a rare iatrogenic injury with progressive presentation.

Introduction: With the increasingly common operation of mechanical thrombectomy (MT) in acute cerebral infarction cases, iatrogenic CCFs were occasionally reported. All of cases reported type A CCFs, and patients were presented with either asymptom from generation of fistula to duration of postoperative follow-up or distinct presentations at once after MT. Case presentation: A 48-year-old postmenopausal female, without history of systemic hypertension and diabetes mellitus, underwent an operation of MT outside our institution about half a year ago. An intraoperative DSA showed an iatrogenic low-flow fistula between meningohypophyseal trunk and ICA. After 4 mouths' postoperative conservative observation, patient's presentation progressed from asymptom to serious optic signs. The patient underwent trans-arterial interventional occlusion. On postoperative day one, visual presentations of patient relieved significantly. Discussion: We discuss the reason for possibility of iatrogenic injury to meningohypophyseal trunk and clinical progressive presentation. A sudden swerve just beyond derivation of meningohypophyseal trunk is prone to being damaged by a misguided guide wire. The progression of clinical presentation, as a focal point in our case, is not reported in iatrogenic before, but some studys still find that spontaneous dural CCFs are inclined to occur in middle-aged or elderly women, especially in postmenopausal women, so age and sex are regarded as background factors of progressing. In addition, the change of drainage route is an immediate cause of progressive presentations. Conclusion: We expect that when a manipulation of MT is conducted leading an iatrogenic CCF, our neurointerventionist should maintain appropriate vigilance on sex, age, menstrual history and medical history, then take an earlier and timely interventional measure.

Integrated Analysis of Hi-C and RNA-Seq Reveals the Molecular Mechanism of Autopolyploid Growth Advantages in Pak Choi (Brassica rapa ssp. chinensis).

Polyploids generated by the replication of a single genome (autopolyploid) or synthesis of two or more distinct genomes (allopolyploid) usually show significant advantages over their diploid progenitors in biological characteristics, including growth and development, nutrient accumulation, and plant resistance. Whereas, the impacts of genomic replication on transcription regulation and chromatin structure in pak choi have not been explored fully. In this study, we observed the transcriptional and genomic structural alterations between diploid B. rapa (AA) and artificial autotetraploid B. rapa (AAAA) using RNA-seq and Hi-C. RNA-seq revealed 1,786 differentially expressed genes (DEGs) between the diploids and autotetraploids, including 717 down-regulated and 1,069 up-regulated genes in autotetraploids. Of all the 1,786 DEGs, 23 DEGs (10 down-regulated DEGs in autotetraploids) were involved in Compartment A-B shifts, while 28 DEGs (20 up-regulated DEGs in autotetraploids) participated in Compartment B-A shifts. Moreover, there were 15 DEGs in activated topologically associating domains (TADs) (9 up-regulated DEGs in diploids) and 80 DEGs in repressed TADs (49 down-regulated DEGs in diploids). Subsequently, eight DEGs with genomic structural variants were selected as potential candidate genes, including four DEGs involved in photosynthesis (BraA01003143, BraA09002798, BraA04002224, and BraA08000594), three DEGs related to chloroplast (BraA05002974, BraA05001662, and BraA04001148), and one DEG associated with disease resistance (BraA09004451), which all showed high expression in autotetraploids. Overall, our results demonstrated that integrative RNA-seq and Hi-C analysis can identify related genes to phenotypic traits and also provided new insights into the molecular mechanism of the growth advantage of polyploids.

Characterization and antibacterial activity of ruthenium-based shikimate cross-linked chitosan composites.

The unsustainable antibacterial activity of ruthenium antibacterial agents is an important factor limiting their applications. This present work attempts to prepare ruthenium (Ru) coordination polymer composites with chitosan quaternary ammonium polymers (CQ) and shikimic acid (SA) through the interaction of ionic bonds and covalent bonds by microwave-assisted high-pressure homogenization methods. The prepared CQ@Ru-SA was characterized by size distribution, zeta potential, TEM, UV-vis, FTIR, XPS and XRD analyses. The coordination structure and morphology of Bridge-CQ-NH-Ru-SA were verified. The CQ@Ru-SA was well-dispersed in both the aqueous or anhydrous states. MIC and MBC, time-killing curves, biofilm formation inhibition assay, mature biofilm disruption assay, SEM, Ca2+ mobilization assay and Ca2+-Mg2+-ATPase activity studies revealed that CQ@Ru-SA had a stronger inhibitory effect against S. aureus than CQ and showed sustained antibacterial properties in the dynamic time-killing curves. Meanwhile, CQ@Ru-SA had good antibacterial effects against S. aureus and inhibited their biofilm forming ability in a dose-dependent manner. Further studies on antibacterial mechanisms revealed that CQ@Ru-SA influenced cell membrane integrity, Ca2+-Mg2+-ATPase activity on the cell membrane and intracellular Ca2+ levels of S. aureus. This study will provide the necessary data for the further design and development of ruthenium-based photosensitive antibacterial agents.

Tag-Based Pull-Down Assay.

Protein-protein interactions play a crucial role in diverse biological processes. As obligate intracellular parasites, plant viruses live and reproduce in living cells and recruit host proteins through protein-protein interactions to complete their infection process. Elucidation of the protein-protein interaction network between viruses and hosts can advance knowledge in the viral infection process at the molecule level and facilitate the development of novel antiviral technologies. One of the most classic and widely used methods to discover or confirm novel protein interactions in plant cells is the pull-down assay. For plant virology research, this method begins with the expression of a tagged viral protein (such as GST- or His-tagged) as "bait" in model plant species such as Nicotiana benthamiana. The expressed "bait" protein is purified by affinity agarose resin (e.g., glutathione or cobalt chelate) followed by a series of washes. Finally, the "bait"-"prey" protein complexes are subjected to mass spectrometry or immunoblotting analysis. In this chapter, we describe a practical protocol of the tag-based pull-down assay and discuss solutions to some common problems associated with this assay.

Effect of Variety and Maturity Index on the Physicochemical Parameters Related to Virgin Olive Oil from Wudu (China).

Physical parameters (i.e., extraction yield, oil content), chemicals (i.e., fatty acids, phenolics) and oxidative stability associated with virgin olive oil (VOO) from ten varieties in Wudu, China, were analyzed as a function of maturity index and variety by multivariate analysis models. Most of the analytical parameters were significantly affected by the variety and maturity index, and the former was more influential than the latter. Phenolics were the principal factor dividing the ten varieties into four groups. High phenolic levels were observed in the 'Koroneiki' group and 'Manzanilla' group, but the oil extractability index differentiated between them, being the highest and lowest, respectively. The 'Koroneiki' group demonstrated high oil productivity and oil quality, which was worthy of promotion in large-scale cultivation. High amounts of linoleic enhanced the VOO health benefits of 'Ascolana tenera, Arbequina and Zhongshan24' group, but brought the risk of shortening the shelf-life. The 'Ulliri Bardhe, Empeltre, Ezhi8, Yuntai14 and Picual' group clustered for the higher relative value of oleic acid. The maturity index had significant negative effects on the content of total phenolics, oleacein, oleocanthal, and oleic acid, but had a positive effect on the extractability index, which suggested that varieties with low phenolics and oleic acid levels should be harvested early.

No-Touch Versus Conventional Vein Harvesting Techniques at 12 Months After Coronary Artery Bypass Grafting Surgery: Multicenter Randomized, Controlled Trial.

BACKGROUND: Vein graft occlusion is deemed a major challenge in coronary artery bypass grafting. Previous studies implied that the no-touch technique for vein graft harvesting could reduce occlusion rate compared with the conventional approach; however, evidence on the clinical benefit and generalizability of the no-touch technique is scare. METHODS: From April 2017 to June 2019, we randomly assigned 2655 patients undergoing coronary artery bypass grafting at 7 hospitals in a 1:1 ratio to receive no-touch technique or conventional approach for vein harvesting. The primary outcome was vein graft occlusion on computed tomography angiography at 3 months and the secondary outcomes included 12-month vein graft occlusion, recurrence of angina, and major adverse cardiac and cerebrovascular events. The generalized estimate equation model was used to account for the cluster effect of grafts from the same patient. RESULTS: During the follow-up, 2533 (96.0%) participants received computed tomography angiography at 3 months after coronary artery bypass grafting and 2434 (92.2%) received it at 12 months. The no-touch group had significantly lower rates of vein graft occlusion than the conventional group both at 3 months (2.8% versus 4.8%; odds ratio, 0.57 [95% CI, 0.41-0.80]; P<0.001) and 12 months (3.7% versus 6.5%; odds ratio, 0.56 [95% CI, 0.41-0.76]; P<0.001). Recurrence of angina was also less common in the no-touch group at 12 months (2.3% versus 4.1%; odds ratio, 0.55 [95% CI, 0.35-0.85]; P<0.01). Rates of major adverse cardiac and cerebrovascular events were of no significant difference between the 2 groups. The no-touch technique was associated with higher rates of leg wound surgical interventions at 3-month follow-up (10.3% versus 4.3%; odds ratio, 2.55 [95% CI, 1.85-3.52]; P<0.001). CONCLUSIONS: Compared with the conventional vein harvesting approach in coronary artery bypass grafting, the no-touch technique significantly reduced the risk of vein graft occlusion and improved patient prognosis. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03126409.

Brassica carinata genome characterization clarifies U's triangle model of evolution and polyploidy in Brassica.

Ethiopian mustard (Brassica carinata) in the Brassicaceae family possesses many excellent agronomic traits. Here, the high-quality genome sequence of B. carinata is reported. Characterization revealed a genome anchored to 17 chromosomes with a total length of 1.087 Gb and an N50 scaffold length of 60 Mb. Repetitive sequences account for approximately 634 Mb or 58.34% of the B. carinata genome. Notably, 51.91% of 97,149 genes are confined to the terminal 20% of chromosomes as a result of the expansion of repeats in pericentromeric regions. Brassica carinata shares one whole-genome triplication event with the five other species in U's triangle, a classic model of evolution and polyploidy in Brassica. Brassica carinata was deduced to have formed ∼0.047 Mya, which is slightly earlier than B. napus but later than B. juncea. Our analysis indicated that the relationship between the two subgenomes (BcaB and BcaC) is greater than that between other two tetraploid subgenomes (BjuB and BnaC) and their respective diploid parents. RNA-seq datasets and comparative genomic analysis were used to identify several key genes in pathways regulating disease resistance and glucosinolate metabolism. Further analyses revealed that genome triplication and tandem duplication played important roles in the expansion of those genes in Brassica species. With the genome sequencing of B. carinata completed, the genomes of all six Brassica species in U's triangle are now resolved. The data obtained from genome sequencing, transcriptome analysis, and comparative genomic efforts in this study provide valuable insights into the genome evolution of the six Brassica species in U's triangle.

Repair of traumatic ventricular septal defect and left ventricular aneurysm after blunt chest trauma.

Blunt chest trauma can cause a variety of cardiac injuries, either immediately or days after the trauma. We report a case of traumatic ventricular septal defect and ribbonlike left ventricular aneurysm, which was diagnosed 15 years after the initial blunt chest trauma. It was successfully repaired using the endoventricular patch technique with a satisfactory 1-year follow-up result.

Bilateral pediatric pial arteriovenous fistulas accompanying a giant arachnoid cyst with torticollis: A case report.

RATIONALE: Pial arteriovenous fistula (PAVF) occurs when intracranial arteries communicate directly with veins. PAVFs are very rare congenital vascular lesions that are commonly seen in infants and children. Arachnoid cysts are congenital cavitation often filled with cerebrospinal fluid. We present a very rare associated occurrence of bilateral pediatric PAVF and a giant arachnoid cyst presenting as torticollis in a child. So far, this is the first case. PATIENT CONCERNS: A 6-year-old male child was referred to our facility from a local hospital due to severe torticollis. DIAGNOSES: An enhanced computed tomography scan revealed 2 slightly high-density masses at the anterior pontine cistern, right circumferential cistern, as well as left posterior occipital region. The same computed tomography scan revealed a giant arachnoid cyst in the left occipital as well as the temporal region with a thin cerebral cortex adjacent to the cyst. INTERVENTIONS: Digital subtraction angiography confirmed that the 2 high-flow lesions were PAVFs. The patient was treated with a combination of detachable coils and Onyx Liquid Embolic System (Onyx HD-500) (Covidien/ev3 Neurovascular) via the transarterial endovascular route while the giant arachnoid cyst was managed conservatively. OUTCOMES: The torticollis resolved 2 days after the procedure. He is currently well with no neurologic deficit. LESSONS: We advocate that in cases of PAVF with accompanying cyst, the cyst should be managed conservatively if it is not associated with intracranial hemorrhage or focal neurologic deficit.

Characterization and Cytotoxicity of Polyprenol Lipid and Vitamin E-TPGS Hybrid Nanoparticles for Betulinic Acid and Low-Substituted Hydroxyl Fullerenol in MHCC97H and L02 Cells.

BACKGROUND: This study demonstrated an innovative formulation including the polyprenol (GBP) lipid and vitamin E-TPGS hybrid nanoparticles (NPs) which was aimed to control the transfer of betulinic acid (BA) and low-substituted hydroxyl fullerenol (C60(OH)n). Additionally, it developed BA-C60(OH)n-GBP-TPGS-NPs delivery system and researched the anti-hepatocellular carcinoma (HCC) effects. MATERIALS AND METHODS: The NPs were prepared by nanoprecipitation with ultrasonic-assisted emulsification (UAE) method. It was characterized by scanning electronic microscopy (SEM), transmission electron microscopy (TEM), FTIR spectrum, size distribution and zeta potential. Physical and chemical properties were evaluated through measurement of drug release, stability studies, drug loading efficiency (DE) and encapsulation efficiency (EE). Biological activities were evaluated through measurement of MTT assay, lactate dehydrogenase leakage assay (LDH), cell proliferation assays, cell apoptosis analysis, comet assay, wound healing assay, cell invasion and Western blot analysis. RESULTS AND CONCLUSIONS: The NPs exhibited clear distribution characteristics, improved solubility and stability. BA and C60(OH)n for the NPs displayed a biphasic release pattern with sustained drug release properties. The mixture of C60(OH)n with different hydroxyl groups may have a certain effect on the stability of the NPs system itself. The NPs could effectively inhibit MHCC97H cell proliferation, migration and invasion in vitro. Combined use of C60(OH)n and BA in GBP lipids may improve the inhibit effect of C60(OH)n or BA against HCC cells and reduce cytotoxicity and genotoxicity of C60(OH)n for normal cells. We concluded that one of the important mechanisms of BA-C60(OH)n-GBP-TPGS-NPs inhibiting MHCC97H cells is achieved by up-regulating the expression of Caspase-3, Caspase-8 and Caspase-9.

Cloning and Functional Analysis of BcMYB101 Gene Involved in Leaf Development in Pak Choi (Brassica rapa ssp. Chinensis).

As one of the largest transcription factor families, MYB transcription factors are widely present, and they are involved in a diverse range of physiological activities in plants, such as leaf development. GAMYB genes belong to the R2R3-MYB subfamily, which includes the MYB33/65/101 gene, and these genes are studied well in seed germination and flowering, but their roles in leaf development are poorly understood. In the current study, we isolated a GAMYB transcription factor from pak choi, BcMYB101, and analyzed its characteristics and function. The sequence structure analysis indicated that BcMYB101 has a highly conserved R2R3 DNA-binding domain in the N-terminal region and three GAMYB-specific motifs (Box1, Box2, and Box3). The expression pattern of diverse tissues revealed that BcMYB101 has a higher transcript level in the petiole, leaf, root, and floral organs. Furthermore, the expression level was significantly elevated after GA (gibberellin) treatment, suggesting that the BcMYB101 response was positively regulated by GA. Subcellular localization exhibited that BcMYB101 was only present in the nuclear region, consistent with the characterization of the transcription factor. The overexpression of BcMYB101 elucidated that BcMYB101 increased leaf number and resulted in downward-curling cauline leaves. Moreover, the virus-induced BcMYB101 silencing displayed that BcMYB101 is involved in the regulation of curly leaves. Furthermore, we discovered that BcMYB101 has two trans-activation activities and one interaction protein, BcTCH4, using a trans-activation activity assay and a yeast two-hybrid assay, respectively. In this study, we firstly isolated the BcMYB101 gene and explored its function in leaf development, thereby providing a solid foundation for further research on the regulatory mechanism of leaf shape in Brassica or other species.

Nuclear autophagy degrades a geminivirus nuclear protein to restrict viral infection in solanaceous plants.

Autophagy is an evolutionarily conserved degradation pathway in the cytoplasm and has emerged as a key defense mechanism against invading pathogens. However, there is no evidence showing nuclear autophagy in plants. Here, we show that a geminivirus nuclear protein, C1 of tomato leaf curl Yunnan virus (TLCYnV) induces autophagy and interacts directly with the core autophagy-related protein ATG8h. The interaction between ATG8h and C1 leads to the translocation of the C1 protein from the nucleus to the cytoplasm and the decreased protein accumulation of C1, which is dependent on the exportin1-mediated nuclear export pathway. The degradation of C1 is blocked by autophagy inhibitors and compromised when the autophagy-related genes (ATGs) ATG8h, ATG5, or ATG7 are knocked down. Similarly, silencing of these ATGs also promotes TLCYnV infection in Nicotiana benthamiana and Solanum lycopersicum plants. The mutation of a potential ATG8 interacting motif (AIM) in C1 abolishes its interaction with ATG8h in the cytoplasm but favors its interaction with Fibrillarin1 in the nucleolus. TLCYnV carrying the AIM mutation displays enhanced pathogenicity in solanaceous plants. Taken together, these data suggest that a new type of nuclear autophagy-mediated degradation of viral proteins through an exportin1-dependent nuclear export pathway restricts virus infection in plants.

Characterization, Cytotoxicity and Genotoxicity of Graphene Oxide and Folate Coupled Chitosan Nanocomposites Loading Polyprenol and Fullerene Based Nanoemulsion Against MHCC97H Cells.

Hepatocellular carcinoma (HCC) is one of the most lethal diseases worldwide. Ginkgo Biloba Leaves polyprenol (GBP) is considered potential efficacy in the treatment of HCC. This study involved oil-in-water type nanoemulsion (NE) loading GBP and Fullerene C60 (C60F) were prepared by dissolving GBP and C60F in NE using inversed phase emulsification (EIP) with ultrasonic-assisted emulsification (UAE) method. Folic acid (FA) coupled Chitosan (CS) and Graphene oxide (GO) nanocomposites (NCs): FA-CS-GO-NCs were fabricated by ionic cross-linking of positively charged FA-CS-GO solution conjugates and negative charged NE with TPP. We combined these materials for preparing NCs loading GBP and C60F (GBP-C60F-FA-CS-GO-NCs) based GBP-C60F-NE. GBP-C60F-FA-CS-GO-NCs in the NE were the mean size was 44.9 nm, PdI was 0.267 and the mean zeta potential was 47.8 mV. And they had good drug loading efficiency, encapsulation efficiency, drug release property and storage stability. In this cytotoxic study, it demonstrated the GBP-C60F-FA-CS-GO-NCs were greater inhibition capacity on MHCC97H cells compared with GBP-NE, C60F-NE, GBP-C60F-NE, GBP-FA-CS-GO-NCs and C60F-FA-CS-GO-NCs. In this genotoxic study, GBP-C60F-FA-CS-GO-NCs at low C60F concentration showed low genotoxicity on MHCC97H and L02 cells. By comparison, GBP-C60F-FA-CS-GO-NCs had higher cytotoxicity on MHCC97H than L02 cells. By the cell apoptosis analysis, the results revealed that GBP-C60F-NE and GBP-C60F-FA-CS-GO-NCs could obviously induce MHCC97H cell apoptosis, especially high concentration GBP-C60F-FA-CS-GO-NCs had the strongest apoptosis inducing ability. The treatment against MHCC97H cells with moderate C60F concentrations of GBP-C60F-FA-CS-GO-NCs effectively inhibited the overexpressions of Akt1 and Akt2, and significantly increased the expression of PTEN. Our results suggest that PTEN, Akt1 and Akt2 might play an important role in the aspect of GBP-C60F-FA-CS-GO-NCs inhibiting against HCC cells. It provides further evidence to speculation that up-regulated PTEN expression and down-regulated Akt1 and Akt2 expression might be one of the important mechanisms for GBP-C60F-FA-CS-GO-NCs inhibiting HCC cells. All these results suggest that GBP-C60F-FA-CS-GO-NCs effectively inhibited the HCC malignant development and has potentially important value in the HCC treatment.

The Effectiveness of Lumbar Drainage in the Management of Delayed or Recurrent Cerebrospinal Fluid Leaks: A Retrospective Case Series in a Single Center.

OBJECTIVE: Little is known about the effectiveness of lumbar drainage (LD) in the treatment of delayed or recurrent cerebrospinal fluid (CSF) leaks. We report our institutional experience and the effectiveness of LD in the management of delayed or recurrent CSF leaks. METHODS: Between January 2014 and December 2018, a total 21 patients with delayed or recurrent CSF leaks were enrolled in the research. All patients were treated conservatively for 48 hours, and LD was prescribed if CSF leaks still existed after 48 hours. If LD failed, endoscopic endonasal surgery (EES) was performed as soon as possible. Medical records were collected to analyze the effectiveness of LD. RESULTS: Among 21 patients, 4 patients experienced resolution with conservative treatment, and 17 patients were treated by CSF diversion by LD. The total cure rate of LD was 9/17 (52.9%). The cure rate was not statistically significantly different (relative risk = 3.33; Fisher exact test P = 0.131) between the traumatic group (8/12, 66.7%) and the transsphenoidal surgery group (1/5, 20.0%). During the follow-up time, no recurrence of CSF leaks was observed. CONCLUSIONS: The cure rate of LD in delayed or recurrent CSF leaks was lower than that of initial treatment with LD. The cure rate in the traumatic group tended to be higher than that in the transsphenoidal surgery group. EES can be used as a remedial treatment for patients in whom LD has failed.

Reoperation With Coronary Reimplantation After Takeuchi Repair of Bland-White-Garland Syndrome.

We present a 1-year-old boy with Bland-White-Garland syndrome (anomalous origin of the left coronary artery from the pulmonary artery) who underwent coronary reimplantation. He had previously undergone a Takeuchi procedure at 7 months of age. He was hospitalized because the patency of the intrapulmonary tunnel to the left coronary could not be confirmed by routine computed tomography in an outpatient facility. The left coronary reimplantation was performed by extending the coronary artery with an autologous pulmonary artery wall. The postoperative course was uneventful. The patient's left ventricular function had improved to a normal state at the 12-month follow-up visit.

Separation of polyprenols from Ginkgo biloba leaves by a nano silica-based adsorbent containing silver ions.

Polyprenols extracted from Ginkgo biloba leaves is a kinds of unsaturated compound containing double bonds. Traditionally, the separation methods for the polyprenols are lack of selectivity and their separation efficiency are low. We synthesized two kinds of functional nano-silica containing silver ions materials (AgTCM and AgTCN) which have selectivity for unsaturated compounds to separate Ginkgo biloba leaves polyprenols for the first time. AgTCN displays exceptionally high selectivity for polyprenols and high stability under extended heat and light exposure, while silver is virtually immobile during solvent elution. Importantly, the exceptional stability of AgTCN gives rise to much higher polyprenols recovery than conventional silica gel during the chromatographic elution. In addition, we found that the adsorption of polyprenols onto the AgTCN conforms to pseudo-second-order kinetic model and AgTCN has strong affinity with polyprenols by analyzing Langmuir, Freundlich, Temkin-Pyzhev, and Dubinin-Radushkevich isotherms. The calculation results of thermodynamic parameters demonstrate that decrease of temperature in favor of increasing the adsorbing capacity of polyprenols onto the AgTCN, and the adsorption process of which is exothermic reaction. Our results pave the way for the novel separation methods of polyprenols from Ginkgo biloba leaves.