Dupilumab Reduces Asthma Disease Burden and Recurrent SCS Use in Patients with CRSwNP and Coexisting Asthma.

Purpose: Dupilumab significantly reduced the requirement for systemic corticosteroids (SCS) in patients with severe chronic rhinosinusitis with nasal polyps (CRSwNP). Patients with CRSwNP and coexisting asthma typically have a higher disease burden and have more difficulty in managing disease. Here, we report an analysis of asthma outcomes and SCS use in patients with CRSwNP and coexisting asthma. Patients and Methods: This was a post hoc analysis of the randomized, placebo-controlled SINUS-24 and SINUS-52 studies (NCT02912468/NCT02898454) in patients with severe CRSwNP and coexisting asthma (patient self-reported) from the pooled intention-to-treat population randomized to dupilumab 300 mg every 2 weeks or placebo. On-treatment SCS use was estimated using Kaplan-Meier analysis. Forced expiratory volume in 1 s (FEV1), percent predicted FEV1, and the 6-item Asthma Control Questionnaire (ACQ-6) were assessed at baseline and Week 24 (pooled SINUS-24/52) in patients with/without history of asthma exacerbation or prior SCS use. Results: Of 337 patients with coexisting asthma, 88 (26%) required on-treatment SCS use. The requirement for on-treatment SCS use for any reason was significantly lower with dupilumab (20/167 patients; 12%) vs placebo (68/170; 40%); hazard ratio (95% confidence interval) 0.248 (0.150-0.409); p < 0.0001. The most frequent reasons for SCS use were nasal polyps (dupilumab 3% and placebo 27%) and asthma (2% and 9%, respectively). FEV1, percent predicted FEV1, and ACQ-6 were all significantly improved at Week 24 with dupilumab vs placebo irrespective of history of asthma exacerbation or prior SCS use (all p < 0.01). Conclusion: Dupilumab significantly reduced the requirement for SCS and improved asthma outcomes irrespective of history of asthma exacerbation or prior SCS use vs placebo in patients with CRSwNP and coexisting asthma, demonstrating concomitant reduction of SCS use and asthma disease burden in these patients.

Host-Guest-Interaction Enhanced Nitric Oxide Photo-Generation within a Pillar[5]arene Cavity for Antibacterial Gas Therapy.

Supramolecular macrocycles with intrinsic cavities have been widely explored as containers to fabricate versatile functional materials via specific host-guest recognitions. However, relatively few studies have focused on the modulation of guest reactivity within a macrocyclic cavity. Here, we demonstrate the confinement effect of pillar[5]arene with an electron-rich and precise cavity that can dramatically enhance guest photoactivity and nitric oxide (NO) generation upon visible light irradiation. Mechanism studies reveal that it is achieved through increasing the ground state nitro-aromatic torsion angle, suppressing the intersystem crossing relaxation path of the S1 state, and accelerating the isomerization reaction path of guest molecules. This NO-generating system displays broad-spectrum antibacterial, biofilm inhibition, and dispersal activities. Moreover, it can accelerate the healing of methicillin-resistant Staphylococcus aureus (MRSA)-infected wounds in vivo.

Patient satisfaction with humanistic nursing in Chinese secondary and tertiary public hospitals: a cross-sectional survey.

Background: Humanistic care pertains to the abilities, attitudes, and behaviors central to patient-centered care, contributing to patients' sense of safety and wellbeing. This study aimed to assess the satisfaction of patients with humanistic nursing care in Chinese secondary and tertiary public hospitals. Methods: A national cross-sectional survey was conducted across 30 provinces and 83 hospitals in China. Patient satisfaction with humanistic care was assessed using the Methodist Health Care System Nurse Caring Instrument (NCI), which encompasses 20 items across 12 dimensions. Each item was rated on a 7-point Likert scale, yielding a total score of 140. Multiple linear regression analysis was employed to identify factors associated with patients' satisfaction. Results: Moderate satisfaction (mean score 91.26 ± 13.14) with humanistic nursing care was observed among the 17,593 participants. Factors significantly associated with patient satisfaction included age, hospital type, presence of children, educational attainment, place of residence, family monthly income, and medical insurance type. Conclusion: The study findings highlight the importance of tailored interventions, evidence-based practice guidelines, and patient-centered care in improving patients' satisfaction with humanistic nursing care. Continuous emphasis on nursing education and professional development is crucial for enhancing humanistic care and patient satisfaction.

Enhanced Intracellular Delivery and Cell Harvest Using a Candle Soot-Based Photothermal Platform with Dual-Stimulus Responsiveness.

Intracellular delivery of bioactive macromolecules and functional materials plays a crucial role in fundamental biological research and clinical applications. Nondestructive and efficient harvesting of engineered cells is also required for some specific applications. In this work, we develop a multifunctional platform based on candle soot modified with copolymer brushes containing temperature-responsive poly(N-isopropylacrylamide) (PNIPAAm) and sugar-responsive phenylboronic acid (PBA) components. This platform possesses a high cell adhesion capacity due to the inherent hierarchical structure of candle soot and the formation of boronate ester bonds between the PBA groups and glycoproteins on the cell membrane. Under the irradiation of a near-infrared laser, the excellent light-to-heat conversion ability of candle soot enables the highly efficient delivery of macromolecules into diverse cells (including hard-to-transfect cells) attached to the surface via a photothermal-poration mechanism. Owing to the temperature-responsive properties of PNIPAAm and the sugar-responsive properties of PBA, the engineered cells could be harvested nondestructively from the platform by a mild treatment using a cold fructose solution. A proof-of-concept experiment demonstrates that fibroblasts attached to the surface could be transfected by a functional plasmid encoding basic fibroblast growth factor and then harvested efficiently and recultured with improved proliferation and migration ability. The whole delivery-harvesting process required less than 1 h, allowing the cells to be engineered without compromising their viability. This platform thus provides a widely applicable method for both the intracellular delivery of diverse macromolecules efficiently as well as harvesting engineered cells simply and safely, holding great potential for biomedical applications.

Multifunctional coatings based on candle soot with photothermal bactericidal property and desired biofunctionality.

Functional coatings with desired bioactivities are required for various biomedical applications. Candle soot (CS) composed of carbon nanoparticles has attracted significant attention as a versatile component of functional coatings because of its unique physical and structural characteristics. However, the application of CS-based coatings in the biomedical field is still limited due to the lack of modification methods that can endow them with specific biofunctionality. Herein, a facile and widely applicable approach to fabricate multifunctional CS-based coatings is developed by grafting functional polymer brushes on the silica-stabilized CS. The resulting coatings not only exhibited excellent near-infrared-activated biocidal ability (the killing efficiency was over 99.99 %) due to the inherent photothermal property of CS but also showed desired biofunctions (such as antifouling property or controllable bioadhesion; the repelling efficiency and bacterial release ratio were nearly 90 %) originated from the grafted polymers. Moreover, these biofunctions were enhanced by the nanoscale structure of CS. Because the deposition of CS is a simple substrate-independent process while the grafting of polymer brushes via surface-initiated polymerization is applicable to a wide range of vinyl monomers, the proposed approach can be potentially used for the fabrication of multifunctional coatings and would extend the applications of CS in the biomedical field.

Microneedle Patch Loaded with Exosomes Containing MicroRNA-29b Prevents Cardiac Fibrosis after Myocardial Infarction.

Myocardial infarction (MI) is a cardiovascular disease that poses a serious threat to human health. Uncontrolled and excessive cardiac fibrosis after MI has been recognized as a primary contributor to mortality by heart failure. Thus, prevention of fibrosis or alleviation of fibrosis progression is important for cardiac repair. To this end, a biocompatible microneedle (MN) patch based on gelatin is fabricated to load exosomes containing microRNA-29b (miR-29b) mimics with antifibrotic activity to prevent excessive cardiac fibrosis after MI. Exosomes are isolated from human umbilical cord mesenchymal stem cells and loaded with miR-29b mimics via electroporation, which can be internalized effectively in cardiac fibroblasts to upregulate the expression of miR-29b and downregulate the expression of fibrosis-related proteins. After being implanted in the infarcted heart of a mouse MI model, the MN patch can increase the retention of loaded exosomes in the infarcted myocardium, leading to alleviation of inflammation, reduction of the infarct size, inhibition of fibrosis, and improvement of cardiac function. This design explored the MN patch as a suitable platform to deliver exosomes containing antifibrotic biomolecules locally for the prevention of cardiac fibrosis, showing the potential for MI treatment in clinical applications.

Injectable Decellularized Extracellular Matrix Hydrogel Containing Stromal Cell-Derived Factor 1 Promotes Transplanted Cardiomyocyte Engraftment and Functional Regeneration after Myocardial Infarction.

Transplantation of exogenous cardiomyocytes (CMs) is a hopeful method to treat myocardial infarction (MI). However, its clinical application still remains challenging due to low retention and survival rates of the transplanted cells. Herein, a stromal cell-derived factor 1 (SDF-1)-loaded injectable hydrogel based on a decellularized porcine extracellular matrix (dECM) is developed to encapsulate and deliver CMs locally to the infarct area of the heart. The soluble porcine cardiac dECM is composed of similar components such as the human cardiac ECM, which could be self-assembled into a nanofibrous hydrogel at physiological temperature to improve the retention of transplanted CMs. Furthermore, the chemokine SDF-1 could recruit endogenous cells to promote angiogenesis, mitigating the ischemic microenvironment and improving the survival of CMs. The results in vitro show that this composite hydrogel exhibits good biocompatibility, anti-apoptosis property, and chemotactic effects for mesenchymal stromal cells and endothelial cells through SDF-1-CXCR4 axis. Moreover, intramyocardial injection of this composite hydrogel to the infarcted area leads to the promotion of angiogenesis and inhibition of fibrosis, reducing the infarction size and improving the cardiac function. The combination of natural biomaterials, exogenous cells, and bioactive factors shows potential for MI treatment in the clinical application.

AROMA: real-world global registry of dupilumab for chronic rhinosinusitis with nasal polyps.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a predominantly type 2 inflammatory disease of the nasal and paranasal sinuses. Dupilumab is a monoclonal antibody that blocks the shared receptor component for interleukin-4 and interleukin-13, which are key and central drivers of type 2 inflammation. In clinical trials, dupilumab significantly improved objective and patient-reported measures of CRSwNP versus placebo and was well tolerated. Dupilumab is approved in the European Union, USA and Japan as add-on maintenance treatment for adults with inadequately controlled CRSwNP. There exists an important evidence gap between efficacy and effectiveness data for dupilumab in severe CRSwNP. In order to bridge this gap, the AROMA prospective global registry (ClinicalTrials.gov: NCT04959448) was established. AROMA will collect long-term data on the utilisation, effectiveness and safety of dupilumab for CRSwNP treatment in real-world clinical practice. AROMA will enrol approximately 1000 adults starting dupilumab for severe CRSwNP across 120 global sites. Baseline data will include patient demographics, medical/surgical history and presence of type 2 comorbidities. Effectiveness outcome assessments will include objective measures of CRSwNP assessed as part of routine clinical care and various patient-reported questionnaires. Treatment patterns, concomitant medications and long-term safety will also be recorded. Results from AROMA, the first prospective, real-world, global registry to characterise patients with severe CRSwNP starting dupilumab, will provide evidence on the real impact of dupilumab in patients with CRSwNP and complement the data from randomised clinical trials. The registry will also provide evidence on disease progression in patients with CRSwNP, including those with coexisting diseases.

[Distribution, Risk, and Influencing Factors of Microplastics in Surface Water of Huangshui River Basin].

In order to explore the distribution of microplastics in the freshwater environment of Qinghai-Tibet Plateau, 63 surface water samples were collected in Huangshui River basin of Qinghai province during the wet season, and the distribution characteristics and main influencing factors of microplastics in the surface water were analyzed by means of metallographic microscope, Fourier infrared spectroscopy, field investigation, and image data analysis. The potential ecological risks of microplastics were evaluated using risk index (H) and pollution load index (PLI) models. The abundance of microplastics in surface water ranged from 665-8780 n·m-3, with the highest average abundance of 5414 n·m-3 in Huangyuan County. The abundance of microplastics increased from upstream to downstream. The main colors of microplastics were transparent (67%) and black (17%), and the particle size was less than 50 µm (70%). Polyethylene (66%) and polypropylene (12%) were the main polymer types. The abundance of microplastics was positively correlated with cultivated land area, precipitation, and ultraviolet intensity, but the opposite results were observed in dissolved oxygen, redox potential, and wind speed. Additionally, the potential ecological risk of surface water in the Huangshui River basin was relatively low.

New 11-Methoxymethylgermacranolides from the Whole Plant of Carpesium divaricatum.

Eight new 11-methoxymethylgermacranolides (1-8) were isolated from the ethanol extract of the whole plant of Carpesium divaricatum. The planar structures and relative configurations of the new compounds were determined by detailed spectroscopic analysis. The absolute configuration of 1 was established by electronic circular dichroism (ECD) spectrum and X-ray crystallographic analysis, and the stereochemistry of the new compounds 2-8 were determined by similar ECD data with 1. The absolute configurations of 5 and 7 were further confirmed by using quantum chemical electronic circular dichroism (ECD) calculations. Compound 4 exhibited weak cytotoxicity against MCF-7 cells. Compound 8 could potently decrease PGE2 productions in LPS-induced RAW 264.7 cells.

Bioactive constituents from Gerbera piloselloides with anti-inflammatory and antiproliferative activities.

A phytochemical investigation of the 95% ethanol extract from Gerbera piloselloides obtained fourteen compounds, including three undescribed phenone-monoterpenes (1a/1b and 2), seven undescribed chromone-monoterpenes (3a/3b-5a/5b and 6), and one undescribed coumarin-monoterpene (8). Among them, four pairs of enantiomers (1a/1b and 3a/3b-5a/5b) were successfully isolated by the chiral-phase HPLC resolution. The structures and absolute configurations were unambiguously determined based on comprehensive spectroscopic data, electronic circular dichroism (ECD) data, and X-ray diffraction analysis. Structurally, compound 1 is the first 5-methylphenone monoterpene formed through a circular 6-membered carbocycle. And their anti-inflammatory and antiproliferative activities were evaluated via LPS stimulated RAW 264.7 cells and five human cancer lines (HepG2, MDA-MB-231, SCG-7901, A549 and MCF-7), respectively. Compounds 4b, 5a and 5b showed moderate inhibitory effect against nitric oxide (NO) production with IC50 values ranging from 12.52 to 15.75 µM. Compound 8 significantly inhibited the proliferation of MDA-MB-231 human cancer line in a dose-dependent manner. Furthermore, the connection between phenone-monoterpenes, chromone-monoterpenes, and coumarin-monoterpenes in biosynthesis were also discussed.

New phenylpropanoids from the fruits of Xanthium sibiricum and their anti-inflammatory activity.

Seven new phenylpropanoids, including two pairs of enantiomers of 8-O-4'-type neolignans, named (±)-xanthiifructins A-B (1a/1b-2a/2b), a pair of simple phenylpropanoid derivatives (±)-xanthiifructins C (3a/3b), and a racemic phenylpropanoid derivative xanthiifructin D (4), together with four known analogues (5-8) were isolated from the fruits of Xanthium sibiricum. Racemic xanthiifructins A-C were separated on chiral HPLC columns. Their structures were elucidated by comprehensive spectroscopic data analysis and comparison with the literatures. The anti-inflammatory and cytotoxic activities were evaluated for all isolates. Among them, (-)-xanthiifructin C (3b) exhibited potent inhibitory effect against nitric oxide production in lipopolysaccharide-activated RAW 264.7 mouse macrophage cells with an IC50 value of 9.94 ± 0.57 µM. All compounds obviously were inactive for three human tumor cell lines (MCF-7, HepG2, and A549) with IC50 values much more than 10 µM.

Effects of topical application of different molecular weight marine fish skin collagen oligopeptides on UVB-induced photoaging rat skin.

OBJECTIVE: The objective of this work was to develop a peptide production process of the exact molecular weight propitious to topical application for cosmetics and to investigate the effects of enzymolysis-derived peptide on UVB-induced photoaging rat skin. METHODS: The chum salmon fish skins were hydrolyzed by alkaline protease and neutral protease and spray-dried at different conditions, and three kinds of molecular weight peptide (MFSOP) were obtained. A total of 66 ICR rats (female, 20 ± 1 g) were randomly divided into eleven groups, including the normal, model, and experimental groups. The three kinds of MFSOP were dissolved at different dosages (5‰, 2.5%, and 5%) and then applied on the ICR hairless back skins prior to exposing UVB irradiation of 3000mJ/cm2 to them 4 h later. After 8 weeks, the rats were killed and the hair-shaved skins were tested for skin moisture, hyaluronic acid, hydroxyproline, antioxidant activity, and RNA expression. RESULTS: Three kinds of MFSOP were obtained, with the average molecular weights of 495.16, 1194.00, and 2032.46 Dalton, respectively. The MFSOPs, especially the MFSOP of average molecular weight of 1194.00 Dalton, played an important role in the recovery of the UVB-injured skin tissue in lock in moisture, in antioxidant activity and in promotion in collagen and elastin protein to some extent. CONCLUSION: MFSOPs, especially MFSOP of average molecular weight of 1194.00 Dalton, derived from enzymolysis are potential materials to apply in cosmetics for the UVB9-induced anti-photoaging activity (lock in moisture, antioxidant activity, and promotion in collagen and elastin protein).

Lyciiterpenoids A-D, four new rearranged eudesmane sesquiterpenoids from Lycii Cortex.

Four new rearranged eudesmane sesquiterpenoids, Lyciiterpenoids A-D (1-4), together with four known compounds (5-8) were isolated from the aqueous extract of Lycii Cortex. Their structures were elucidated by spectroscopic analysis, and the absolute configurations of compounds 1-4 were determined by the quantum chemical ECD calculations. The absolute configuration of 1 was further confirmed by X-ray crystallographic data analysis. All the isolated compounds were evaluated for their cytotoxicity against three human cancer cell lines (MCF-7, HepG2, and A549). However, no significant activities were detected even with a concentration up to 100 µM.

Pea-derived peptides, VLP, LLP, VA, and LL, improve insulin resistance in HepG2 cells via activating IRS-1/PI3K/AKT and blocking ROS-mediated p38MAPK signaling.

This study evaluated the effect of four peptides, VLP, LLP, LL, and LL from pea on regulating glucose metabolism and antioxidant through IRS-1/PI3K/AKT and p38MAPK signal pathway in IR-HepG2 cell induced by 10-6 M insulin. The genes expression of PEPCK, G6Pase, GLUT2, and IRS-1 and proteins of IRS-1, p(Ser307)-IRS-1, AKT, p(Ser473)-AKT, p38MAPK, and p-p38MAPK were determined by RT-PCR and western blotting, respectively. Results show that they displayed highly potent on stimulation glucose metabolism and relief oxidative stress in IR-HepG2 cells. VLP, LLP, VA, and LL reduced Ser307 phosphorylation of IRS-1 and promoted Ser473 phosphorylation of AKT. Among them, LLP, VA, and LL increased the expression both gene and protein of GLUT2, and VLP and LL reduced p38MAPK phosphorylation showing strong antioxidant capacity. Therefore, pea oligopeptides have considerable potential for reversing the metabolic abnormalities associated with type 2 diabetes. PRACTICAL APPLICATIONS: This paper examined the intervention effect of VLP, LLP, VA, and LL that from pea on insulin resistance, and the mechanisms were detected by western blotting. The results provide a theoretical knowledge for the prevention of insulin resistance in T2D of pea-derived peptides and lay the foundation for the development of functional products and drugs in the future.

Prognostic Indicators for Gastrointestinal Stromal Tumors: A Review.

Gastrointestinal stromal tumors (GISTs) are potentially malignancies that can occur anywhere in the digestive tract. Tyrosine kinase inhibitors (TKIs) such as imatinib have proven effective since the discovery of KIT and PDGFRA. The current version of NCNN, ESMO and EURACAN guidelines recognized that the three main prognostic factors are the mitotic rate, tumor size and tumor site. In addition, tumor rupture is also recognized as an independent risk factor. However, recent evidence shows that various types of gene mutations are associated with prognosis, and influencing factors such as gastrointestinal bleeding and high Ki67 index have been associated with poor prognosis. It shows that the current risk classification is still insufficient and controversial. With the emergence of more and more lack mutation in KIT/PDGFRA GISTs (KIT/PDGFRA wild-type GISTs) or drug resistance genes, primary and secondary drug resistance problems are caused, which makes the treatment of late or metastatic GIST face challenges. Therefore, this article will review the clinicopathological characteristics of GIST, the special molecular subtypes and other factors that may affect prognosis. We will also explore reliable prognostic markers for better postoperative management and improve the prognosis of patients with GIST.