Attenuated replication and pathogenicity of SARS-CoV-2 B.1.1.529 Omicron.

The Omicron (B.1.1.529) variant of SARS-CoV-2 emerged in November 2021 and is rapidly spreading among the human population1. Although recent reports reveal that the Omicron variant robustly escapes vaccine-associated and therapeutic neutralization antibodies2-10, the pathogenicity of the virus remains unknown. Here we show that the replication of Omicron is substantially attenuated in human Calu3 and Caco2 cells. Further mechanistic investigations reveal that Omicron is inefficient in its use of transmembrane serine protease 2 (TMPRSS2) compared with wild-type SARS-CoV-2 (HKU-001a) and previous variants, which may explain its reduced replication in Calu3 and Caco2 cells. The replication of Omicron is markedly attenuated in both the upper and lower respiratory tracts of infected K18-hACE2 mice compared with that of the wild-type strain and Delta (B.1.617.2) variant, resulting in its substantially ameliorated lung pathology. Compared with wild-type SARS-CoV-2 and the Alpha (B.1.1.7), Beta (1.351) and Delta variants, infection by Omicron causes the lowest reduction in body weight and the lowest mortality rate. Overall, our study demonstrates that the replication and pathogenicity of the Omicron variant of SARS-CoV-2 in mice is attenuated compared with the wild-type strain and other variants.

Coronaviruses exploit a host cysteine-aspartic protease for replication.

Highly pathogenic coronaviruses, including severe acute respiratory syndrome coronavirus 2 (refs. 1,2) (SARS-CoV-2), Middle East respiratory syndrome coronavirus3 (MERS-CoV) and SARS-CoV-1 (ref. 4), vary in their transmissibility and pathogenicity. However, infection by all three viruses results in substantial apoptosis in cell culture5-7 and in patient tissues8-10, suggesting a potential link between apoptosis and pathogenesis of coronaviruses. Here we show that caspase-6, a cysteine-aspartic protease of the apoptosis cascade, serves as an important host factor for efficient coronavirus replication. We demonstrate that caspase-6 cleaves coronavirus nucleocapsid proteins, generating fragments that serve as interferon antagonists, thus facilitating virus replication. Inhibition of caspase-6 substantially attenuates lung pathology and body weight loss in golden Syrian hamsters infected with SARS-CoV-2 and improves the survival of mice expressing human DPP4 that are infected with mouse-adapted MERS-CoV. Our study reveals how coronaviruses exploit a component of the host apoptosis cascade to facilitate virus replication.

Type-II IFN inhibits SARS-CoV-2 replication in human lung epithelial cells and ex vivo human lung tissues through indoleamine 2,3-dioxygenase-mediated pathways.

Interferons (IFNs) are critical for immune defense against pathogens. While type-I and -III IFNs have been reported to inhibit SARS-CoV-2 replication, the antiviral effect and mechanism of type-II IFN against SARS-CoV-2 remain largely unknown. Here, we evaluate the antiviral activity of type-II IFN (IFNγ) using human lung epithelial cells (Calu3) and ex vivo human lung tissues. In this study, we found that IFNγ suppresses SARS-CoV-2 replication in both Calu3 cells and ex vivo human lung tissues. Moreover, IFNγ treatment does not significantly modulate the expression of SARS-CoV-2 entry-related factors and induces a similar level of pro-inflammatory response in human lung tissues when compared with IFNß treatment. Mechanistically, we show that overexpression of indoleamine 2,3-dioxygenase 1 (IDO1), which is most profoundly induced by IFNγ, substantially restricts the replication of ancestral SARS-CoV-2 and the Alpha and Delta variants. Meanwhile, loss-of-function study reveals that IDO1 knockdown restores SARS-CoV-2 replication restricted by IFNγ in Calu3 cells. We further found that the treatment of l-tryptophan, a substrate of IDO1, partially rescues the IFNγ-mediated inhibitory effect on SARS-CoV-2 replication in both Calu3 cells and ex vivo human lung tissues. Collectively, these results suggest that type-II IFN potently inhibits SARS-CoV-2 replication through IDO1-mediated antiviral response.

Pd/Cu bimetallic nano-catalyst supported on anion exchange resin (A520E) for nitrate removal from water: High property and stability.

High nitrate concentration in water can lead to eutrophication and the disruption of healthy aquatic ecosystems. Additionally, in the human digestive system, it has the potential to be reduced to nitrite, which can be damaging to people's physical health. Catalytic hydrogenation of nitrate is one of the strategies for removing nitrate from water. Using A520E resin as support, we prepared Pd/Cu nano-catalyst (Pd/Cu@A520E) according to a liquid phase reduction method. A520E could improve the transfer process of nitrate in the solution to the activity sites of Pd/Cu nanoparticles, thus increase the reaction rate of nitrate reduction. Pd/Cu bimetallic nano-particles were evenly distributed on/in the resin with a size range from 2 nm to 10 nm. The External Circulating System equipped with Venturi tube (ECSV) was designed to improve the utilization efficiency of H2 in both batch tests and long-term continuous-flow tests. Nearly 100% of nitrate removal efficiency and above 90% of N2 selectivity were achieved in both batch tests and continuous-flow tests. Coexisting Cl- and SO42- at 300 mg/L showed little impact on the property of Pd/Cu@A520E. Pd/Cu@A520E also showed high nitrate removal property and stability in continuous-flow tests of more than 800 h. NO3- was adsorbed onto the active sites (functional groups and Pd/Cu particle sites), meanwhile H2 was adsorbed onto the active sites of Pd/Cu@A520E to form Pd [H]. Then the adsorbed NO3- was reduced into N2 (main product) or NH4+ by Pd [H]. In addition, Pd/Cu@A520E showed high nitrate removal property from municipal waste water.

Electrocatalytic reduction of nitrate to ammonia by Pd/In modified Nickel foam electrode in aqueous solution.

Nitrate pollution in surface water and ground water has drawn wide attention, which has brought challenges to human health and natural ecology. Electroreduction of nitrate to NH3 in waste water was a way to turn waste into wealth, which has attracted interest of many researchers. Using Nickel foam as substrate, we prepared Pd/In bimetallic electrode (NF-Pd/In) according to a two-step electrodeposition method. There are many irregularly shaped particles in the size range of 10 nm-100 nm accumulated on the surface of prepared NF-Pd/In electrode, which could supply high specific area and more active sites for nitrate electroreduction. FESEM-EDS, XRD and XPS analysis confirmed the uniform distribution of Pd and In on the surface of prepared NF-Pd/In electrode, with a mass ratio of 4.5/1. Above 96% of 100 mg/L NO3--N was removed and 95% of NH3 selectivity was reached after 5 h of reaction under -1.6 V vs. Ag/AgCl sat. KCl when using 0.05 mol/L of Na2SO4 as electrolyte. High concentration of NaCl (0.05 mol/L) in the test solution dramatically decreased the NH3 selectivity because the produced NH3 could be further oxidized to N2 by the formed HClO from Cl-. EIS tests indicated that the prepared NF-Pd/In electrode showed much lower electrode resistance than NF due to the adsorptive property and electrocatalytic ability for nitrate removal. Density functional theory (DFT) calculations indicated that the presence of In could promote the conversion of NO3- to *NO3 during the process of nitrate electroreduction to NH3. Circulating tests demonstrated the stability of prepared NF-Pd/In electrode.

An abnormal LPA/LPAR1-NHE1 axis leads to the autophagy deficiency of trophoblast cells in recurrent spontaneous abortion.

In brief: Autophagy is important for trophoblast cells at the maternal-fetal interface during early pregnancy. This study suggests that trophoblast cells can promote the autophagy under a regulation of the LPA/LPAR 1-NHE1 axis. Abstract: The autophagy of trophoblasts is necessary for developing and maintaining a healthy pregnancy. Autophagy dysfunction in trophoblast cells is linked to recurrent spontaneous abortion (RSA). However, the mechanism underlying trophoblast autophagy is unknown. In this study, we investigated the expression of autophagy-related genes in both normal and RSA villi. We also examined the production of LPA and LPAR1 in trophoblast cells during early pregnancy. We found that the activation of the LPA-LPAR1 axis triggered the autophagy of trophoblast cells and increased the expression of NHE1. Inhibition of NHE1 suppressed the autophagy in trophoblast cells and we confirmed that NHE1 regulates LPA production in trophoblast cells. Additionally, we found decreased expression of autophagy-related genes and LPAR1 in villi from RSA patients. These observations indicate that the LPA/LPAR1-NHE1 axis regulates the autophagy of trophoblast cells during pregnancy. Insufficient autophagy and poor expression of LPAR1 in trophoblast cells may result in the dysfunction of the trophoblasts and an increased risk of spontaneous abortion. Overall, our research elucidated that a positive LPA/LPAR1-NHE1 axis can promote the autophagy of trophoblast cells and the abnormal axis leads to the autophagy deficiency of trophoblast cells in recurrent spontaneous abortion.

Practical application of Pd-based bimetallic catalysts with enhanced selectivity supported by chelating resin for catalytic nitrate reduction in real water.

An innovative Pd-Me (Pd-Cu, Pd-In and Pd-Sn) bimetallic catalyst supported on porous chelating DOWEX M4195 resin (D) was established to reduce the nitrate almost entirely and achieved high selectivity to the expected harmless form of nitrogen. In this study, sodium borohydride (NaBH4) was applied in preparing bimetallic catalysts by liquid-phase reduction as the prestoring reductant. Pd-In/D and Pd-Sn/D groups performed well in N2selectivity (all above 97%). In addition, Pd-In and Pd-Sn bimetallic catalysis yields higher selectivity towards N2than the Pd-Cu pair in the presence of HCO3-, Cl-, SO42-and humic acid. Likewise, in terms of N2selectivity, Pd-In/D and Pd-Sn/D bimetallic catalysts were superior to that of Pd-Cu/D (72.16%) in the municipal wastewater treatment plant sewage. The current results provide insight into the superb reactivity, excellent stability, and most important-extremely high harmless N2selectivity of Pd-In and Pd-Sn-based bimetallic catalysts in practical application and provide new ideas for enhancing the feasibility of the catalytic reduction of nitrate by minimizing environmentally harmful by-products.

Trimethylamine N-oxide Promotes Atherosclerosis by Regulating Low-Density Lipoprotein-Induced Autophagy in Vascular Smooth Muscle Cells Through PI3K/AKT/mTOR Pathway.

The research aimed to study the mechanism of how trimethylamine N-oxide (TMAO) regulates autophagy to promote atherosclerosis (AS). The AS in vitro model was constructed with vascular smooth muscle cells (VSMCs) treated with ox-LDL. The Cell Counting Kit-8 (CCK-8) trial was chosen to examine VSMCs' absorbance (OD) value. A transmission electron microscope (TEM) was selected for monitoring autophagosomes. Western blotting (WB) was adopted for examining the expression of Beclin-1, p62, LC3, α-SMA, SM22-α, OPN, PI3K, AKT, mTOR, p-PI3K, p-AKT, and p-mTOR proteins. Real-time fluorescent quantitative PCR (RT-qPCR) was accepted for testing the expression of α-SMA, SM22-α, OPN, PI3K, AKT, mTOR, Beclin-1, p62, and LC3 genes. The transwell assay was employed to examine the ability of migration in VSMCs. Oil red O staining assay was accepted to stain lipid droplets in VSMCs. TMAO noticeably promoted autophagy inhibition and the phenotypic transformation of AS. Protein expressions of p-PI3K/PI3K, p-AKT/AKT, p-mTOR/mTOR, and p62 of the TMAO+ox-LDL group were higher than the ox-LDL group, while Beclin-1 and LC3 were lower than the ox-LDL group. Gene expressions of PI3K, AKT, mTOR, and p62 of the TMAO+ox-LDL group were higher than the ox-LDL group, while Beclin-1 and LC3 were lower than the ox-LDL group. The intervention of LY294002 reversed the regulation of the corresponding proteins and genes. The study proved that TMAO could promote autophagy inhibition of AS via activating the PI3K/AKT/mTOR pathway. It supplied a reliable basis for improving clinical diagnostic methods and developing targeted AS drugs.

Gut microbiome modulation by probiotics, prebiotics, synbiotics and postbiotics: a novel strategy in food allergy prevention and treatment.

Food allergy has caused lots of global public health issues, particularly in developed countries. Presently, gut microbiota has been widely studied on allergy, while the role of dysbiosis in food allergy remains unknown. Scientists found that changes in gut microbial compositions and functions are strongly associated with a dramatic increase in the prevalence of food allergy. Altering microbial composition is crucial in modulating food antigens' immunogenicity. Thus, the potential roles of probiotics, prebiotics, synbiotics, and postbiotics in affecting gut bacteria communities and the immune system, as innovative strategies against food allergy, begins to attract high attention of scientists. This review briefly summarized the mechanisms of food allergy and discussed the role of the gut microbiota and the use of probiotics, prebiotics, synbiotics, and postbiotics as novel therapies for the prevention and treatment of food allergy. The perspective studies on the development of novel immunotherapy in food allergy were also described. A better understanding of these mechanisms will facilitate the development of preventive and therapeutic strategies for food allergy.

Preparing Pd/Sn modified nickel foam electrode for nitrate removal from aqueous solutions.

Nitrate pollution in ground water and surface water has been becoming a worldwide problem that poses a great challenge to steady water ecosystem and human health. Electrochemical reduction is a promising way to remove nitrate from water because of advantages. We prepared Pd/Sn modified nickel foam (NF) electrode according to a two-step electrodeposition method. The prepared NF-Pd/Sn electrode showed a micromorphology like "Karst Fengcong" with peaks, saddles and nadirs intertwined with each other. Pd0 and Sn0 were detected on the NF-Pd/Sn electrode and the mass ratio of Pd/Sn was 4.3/1. The NF-Pd/Sn electrode showed the highest reaction rate (kobs: 0.543 h-1) and removal efficiency (94%) under the condition of 100 mg N/L, 0.05 mol/L Na2SO4 and -1.6 V vs. Ag/AgCl sat. KCl. The highest N2-selectivity (100%) was reached under the condition of 100 mg N/L, 0.05 mol/L NaCl and -1.6 V vs. Ag/AgCl sat. KCl. The microstructure of NF-Pd/Sn electrode like "Karst Fengcong" could provide large specific surface area and more active sites for nitrate adsorption and electrocatalytic reduction in aqueous solution. The adsorption and the reduction reaction of nitrate on the surface of NF-Pd/Sn could increase the electric current response in the test system.

IL-17: an important pathogenic factor in endometriosis.

Interleukin-17 (IL-17) is known as a Th17-cell-derived proinflammatory cytokine, which plays a pivotal role in several inflammatory and autoimmune diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis, and psoriasis. Emerging evidence has shown that IL-17 is linked to endometriosis, although the etiology of endometriosis is still unknown. The IL-17 expression is up-regulated in serum, peritoneal fluid (PF) and endometriotic lesions from patients with endometriosis but the related regulation mechanisms are complex and obscure. Meanwhile, the specific roles of IL-17 in endometriosis are also worthy of further exploration. Through the integration and summary of literature, we conclude that the secretion of IL-17 increases under the regulation of ectopic microenvironment and other factors, and then IL-17 is deeply involved in endometriosis in the regulation of immune microenvironment, the invasion and growth of ectopic lesions, and so on, which implies its therapeutic value in this disorder.

Hormone-Glutamine Metabolism: A Critical Regulatory Axis in Endocrine-Related Cancers.

The endocrine-related cancers and hormones are undoubtedly highly interconnected. How hormones support or repress tumor induction and progression has been extensively profiled. Furthermore, advances in understanding the role of glutamine metabolism in mediating tumorigenesis and development, coupled with these in-depth studies on hormone (e.g., estrogen, progesterone, androgen, prostaglandin, thyroid hormone, and insulin) regulation of glutamine metabolism, have led us to think about the relationship between these three factors, which remains to be elucidated. Accordingly, in this review, we present an updated overview of glutamine metabolism traits and its influence on endocrine oncology, as well as its upstream hormonal regulation. More importantly, this hormone/glutamine metabolism axis may help in the discovery of novel therapeutic strategies for endocrine-related cancer.

Galectins: Important Regulators in Normal and Pathologic Pregnancies.

Galectins (Gal) are characterized by their affinity for galactoside structures on glycoconjugates. This relationship is mediated by carbohydrate recognition domains, which are multifunctional regulators of basic cellular biological processes with high structural similarity among family members. They participate in both innate and adaptive immune responses, as well as in reproductive immunology. Recently, the discovery that galectins are highly expressed at the maternal-fetal interface has garnerd the interest of experts in human reproduction. Galectins are involved in a variety of functions such as maternal-fetal immune tolerance, angiogenesis, trophoblast invasion and placental development and are considered to be important mediators of successful embryo implantation and during pregnancy. Dysregulation of these galectins is associated with abnormal and pathological pregnancies (e.g., preeclampsia, gestational diabetes mellitus, fetal growth restriction, preterm birth). Our work reviews the regulatory mechanisms of galectins in normal and pathological pregnancies and has implications for clinicians in the prevention, diagnosis and treatment of pregnancy-related diseases.

HIF1A-induced heme oxygenase 1 promotes the survival of decidual stromal cells against excess heme-mediated oxidative stress.

Heme oxygenase 1 (HO-1, encoded by the HMOX1 gene) is the rate-limiting enzyme that catalyzes heme degradation, and it has been reported to exert antioxidative effects. Recently, decidualization has been reported to confer resistance to environmental stress signals, protecting against oxidative stress. However, the effects and regulatory mechanism of HO-1 in decidual stromal cells (DSCs) during early pregnancy remain unknown. Here, we verified that the levels of HO-1 and heme in DSCs are increased compared with those in endometrial stromal cells. Additionally, the upregulation of HIF1A expression led to increased HMOX1 expression in DSCs possibly via nuclear factor erythroid 2-related factor (encoded by the NFE2L2 gene). However, addition of the competitive HO-1 inhibitor zinc protoporphyrin IX resulted in an increase in HIF1A expression. Hydrogen peroxide (H2O2) induced the production of reactive oxygen species (ROS), decreased the cell viability of DSCs in vitro, and upregulated the level of heme. As an HO-1 inducer, cobalt protoporphyrin IX decreased ROS production and significantly reversed the inhibitory effect of H2O2 on cell viability. More importantly, patients with unexplained spontaneous abortion had low levels of HO-1 that were insufficient to protect against oxidative stress. This study suggests that the upregulation of HO-1 expression via HIF1A protects DSCs against excessive heme-mediated oxidative stress. Furthermore, the excessive oxidative stress injury and impaired viability of DSCs associated with decreased HO-1 expression should be associated with the occurrence and/or development of spontaneous abortion.

Performance of Pd/Sn catalysts supported by chelating resin prestoring reductant for nitrate reduction in actual water.

Catalytic hydrogen reduction has appeared as a promising strategy for chemical denitrification with advantages of high activity and simple operation. However, the risk and low utilization of H2 is the disadvantage of catalytic hydrogen reduction. In recent years, catalytic reduction reactions in the presence of sodium borohydride (NaBH4) have been extensively studied. NaBH4 can be used as an electron source to generate electrons on the surface of the catalyst and can catalyze the reduction of pollutants. But it makes commercialization costly and causes significant environmental pollution if widely use NaBH4. In this study, we prepared supported Pd/Sn bimetallic nanoparticles which could adsorb NaBH4 during the preparation of the Pd/Sn bimetallic catalyst as the prestoring reductant. No additional reducing agent is required during nitrate reduction process. The performance and mechanism for nitrate reduction by using Pd/Sn bimetallic nanoparticles were discussed. Moreover, the catalyst D-Pd1/Sn1 reached a complete nitrate removal in the municipal wastewater treatment plant effluent water within 3 h. The results provide a prospect for denitrification in biological wastewater treatment plants.

Efficient removal of triclosan via peroxymonosulfate activated by a ppb level dosage of Co(II) in water: Reaction kinetics, mechanisms and detoxification.

Triclosan (TCS), an extensively used broad-spectrum antimicrobial agent, has raised significant environmental concerns regarding its widespread occurrence in waters. In this study, the removal of TCS in aqueous solution via peroxymonosulfate (PMS) activated by an extremely low-level Co2+ (0.02 µM) was systematically investigated. During preliminary test, TCS (10 µM) was totally degraded in 30 min by using 0.1 µM Co2+ and 40 µM PMS at pH 7.0 with a degradation rate constant of 0.1219 min-1. A first-order apparent degradation rate of TCS was found with respect to the PMS concentrations. At extremely low dosage of Co2+ (0.02 µM), the presence of NO3-, HCO3-, PLFA, and SRHA within test concentrations significantly inhibited TCS removal, while a dual effect of Cl- on the degradation rate of TCS was observed. The quenching experiments verified that SO4- was the dominant reactive oxygen species (ROS) rather than OH. Six major intermediates were identified using TOF-LC-MS, based on which we proposed three associated reaction pathways including hydroxylation, ether bond breakage, and dechlorination. Toxicity predictions by ECOSAR software exhibited aquatic toxicity reduction of TCS after Co2+/PMS treatment. We outlook these findings to advance the feasibility of organic contaminants removal via Co2+/PMS system with Co2+ at extremely low levels.

Upregulation of MGP by HOXC8 promotes the proliferation, migration, and EMT processes of triple-negative breast cancer.

Triple-negative breast cancer (TNBC) is the most aggressive breast cancer subtype which accounts for 15%-20% of all breast cancer cases. The management of TNBC has remained a challenge due to its lack of targeted therapy. Previously, we reported that homeobox C8 (HOXC8) was involved in metastasis and migration of breast cancer cells. By chromatin immunoprecipitation and luciferase assays, we found that HOXC8 functioned as a transcription factor to activate the transcription of matrix Gla protein (MGP) gene, leading to an increase in the proliferation, anchorage-independent growth, and migration of TNBC cells. We further demonstrated that MGP expression promoted the epithelial-mesenchymal transition (EMT) process of TNBC cells, but not the other subtypes of breast cancer, suggesting that MGP induced EMT to promote proliferation and migration of TNBC cells. Moreover, we found that MGP was upregulated in clinical breast specimens compared to normal breast tissues and high MGP expression was statistically associated with poor, relapse-free survival for TNBC patients, indicating that MGP is probably a novel biomarker or therapeutic target for TNBC patients. Together, our results showed that the HOXC8-MGP axis played an important role in the tumorigenesis of TNBC and might be a promising therapeutic target for TNBC treatment.

Risk Factors Associated With Postoperative Recurrence in Patients With Tenosynovial Giant Cell Tumor of the Hand: A Retrospective Cohort Study.

Identification of risk factors for recurrence of tenosynovial giant cell tumors of the hand is crucial to provide adequate preoperative counseling and tailor surgical treatment. However, the risk factors are still controversial, which are the subject of this research.Recently, we conducted a retrospective cohort study of 135 consecutive patients with giant cell tumors of the tendon sheath of the hand from January 2010 to July 2016. All patients underwent surgical excision, received necessary imaging examinations, and had routine follow-up and thus were identified as those who had recurrence by confirmation of reoperation, and the duration ranged from 24 to 103 months (mean, 53.5 ± 21.4 months). There were 14 local recurrences (10.4%) within 6 to 24 months, respectively, after surgery. Data pertaining to sex, age, tumor sites, tumor size, tumor number, course of disease, bone erosion, tumor growth patterns, anesthesia mode, and the surgeon's experience were all extracted, and Cox regression models were used to estimate recurrence rate with adjustment for potential confounders.According to the Cox regression analysis, the recurrence rate after surgery was significantly higher in patients with a diffused form than in those with a localized one (P = 0.001); in addition, patients with 2 or more tumors had a much higher postoperative recurrence rate than did those with only 1 tumor (P = 0.023).This study suggested that the recurrence rate of tenosynovial giant cell tumors of the hand was closely related to the tumor number and tumor growth patterns.

Treatment of Intraosseous Ganglion Cyst of the Lunate: A Systematic Review.

PURPOSE: Intraosseous ganglion cyst (IGC) is a rare disease, particularly in lunate. The objective of this study was to summarize current knowledge on the treatment of IGC of the lunate, through a literature review, to provide a therapeutic strategy for this rare disease. METHODS: The PubMed, ISI Web of Science, Cochrane Library, EMBASE, Science Direct database were searched with a set of predefined inclusion and exclusion criteria. Manual searches for references were performed to find potential relevant studies. The authors extracted data from the articles selected. RESULTS: Different treatment modalities of IGC of the lunate were described, all of which were divided into 3 categories: conservative treatment, classical surgical procedures, and novel surgical procedures. An overview on the main treatment modalities for IGC of the lunate was provided. CONCLUSIONS: Conservative treatments can be the doctors' first choice for patients with IGC. Surgical procedure is advised when conservative treatment fails. Traditional surgical curettage with autologous bone grafting is the mainstay of treatment with satisfactory outcomes; however, novel surgical techniques like arthroscopically assisted minimally invasive technique or filling with bone cement are considered as more promising attempts with less trauma and shorter recovery period. Nonetheless, studies with high levels of evidence are guaranteed for developing widely accepted clinical treatment guidelines.

Effect of optimized three-component antiscalant mixture on calcium carbonate scale deposition.

The mixture of 1-hydroxyethane-1,1-diphosphonic acid (HEDP), and polyacrylic acid (PAA) and synthesized hydrolyzed polymaleic anhydride (HPMA) was optimized by using simplex lattice of Design-Expert software through calcium carbonate precipitation method. The optimum mass ratio of HEDP, PAA and synthesized HPMA was obtained at 10/10/80, which showed excellent performance on controlling calcium carbonate deposition. The antiscale efficiency of the optimum mixture was 84% and 95%, respectively, in the calcium carbonate precipitation test and the calcium carbonate scale deposit test. The optimum mixture could disturb the crystal growth of calcium carbonate and then affect the morphology and crystal structure of the calcium carbonate precipitates.