Multifunctional biomimetic hydrogel dressing provides anti-infection treatment and improves immunotherapy by reprogramming the infection-related wound microenvironment.

The advancement of biomaterials with antimicrobial and wound healing properties continues to present challenges. Macrophages are recognized for their significant role in the repair of infection-related wounds. However, the interaction between biomaterials and macrophages remains complex and requires further investigation. In this research, we propose a new sequential immunomodulation method to enhance and expedite wound healing by leveraging the immune properties of bacteria-related wounds, utilizing a novel mixed hydrogel dressing. The hydrogel matrix is derived from porcine acellular dermal matrix (PADM) and is loaded with a new type of bioactive glass nanoparticles (MBG) doped with magnesium (Mg-MBG) and loaded with Curcumin (Cur). This hybrid hydrogel demonstrates controlled release of Cur, effectively eradicating bacterial infection in the early stage of wound infection, and the subsequent release of Mg ions (Mg2+) synergistically inhibits the activation of inflammation-related pathways (such as MAPK pathway, NF-κB pathway, TNF-α pathway, etc.), suppressing the inflammatory response caused by infection. Therefore, this innovative hydrogel can safely and effectively expedite wound healing during infection. Our design strategy explores novel immunomodulatory biomaterials, offering a fresh approach to tackle current clinical challenges associated with wound infection treatment.

Rheological behaviour, setting time, compressive strength and microstructure of mortar incorporating supplementary cementitious materials and nano-silica.

The setting time of the paste and the rheological properties and microstructure of the mortar after replacing OPC cement with silica fume (SF), fly ash cenosphere (FAC) and nano-silica are studied as a reference for shotcrete applications. The suggested contents of SF, FAC and nano-silica are around 5-7.5%, higher than 20% and 1-3%, respectively, to meet the initial setting time specification. Viscosity and yield stress of mortar are highly dependent on water/cement ratio and paste/sand ratio. At the higher water/cement ratio, viscosity is more based on the paste itself. For SF of 2.5-10%, viscosity and yield stress increase, and the flowability of the mixture decreases. For FAC of 5-25%, viscosity and yield stress increase with a lower rate than SF, and flowability increases at 5% and then decreases as FAC content increases, which, however, is at the same level as the control. When SF and FAC are both added, a tortuous behavior of viscosity is shown. As nano-silica is further added, significant increases in viscosity and yield stress are shown. The compressive strengths of mortar with different supplementary cementitious materials (SCMs) at early ages are close. The difference in compressive strength after 28 days of standard curing is significant. The SF5-FAC15 group exhibits the largest increase in strength for 32.82%. At the age of 2.5 h, the macropore areas distribution of SF5-FAC25-NS1.5 test groups were 31.96%, indicating the lowest macropore area distribution. The secondary hydration reaction of supplementary cementitious materials (SCMs) continuously generates products that fill the pores, and the ultrafine filling effect of nanomaterials improves the compactness of the mortar microstructure and reduces the macropore area distribution. The mercury intrusion test results of the SF5-FAC25-NS1.5 group show that the pores are concentrated within the range of 0.01 to 0.05 µm, and the most probable pore size is significantly smaller than that of the CTR group. As the overall replacement level of SCMs increases, the diffraction peak of calcium hydroxide gradually weakens.

Study on the bio-oil characterization and heavy metals distribution during the aqueous phase recycling in the hydrothermal liquefaction of As-enriched Pteris vittata L.

The hydrothermal liquefaction (HTL) of As enriched Pteris vittata L. (PVL, hyper-accumulator biomass) was performed with the recycled aqueous phase as reaction medium, aiming to dispose the biomass with high water content and produce high-quality bio-oil. After three times of aqueous phase recycling at 275 °C, 30 min, the bio-oil yield increased to 30.32% from 21.54% and the higher heating value (HHV, 28.51 MJ/kg) of the bio-oil was higher than that of the bio-oil from HTL with pure water (26.80 MJ/kg). The main compounds detected in bio-oils were phenols, ketones, hydrocarbons, and aldehydes. Acetic acid (17.21-24.77 mg/mL) was dominant in the aqueous phases, resulting in the low pH (4.31-4.89). The heavy metals (Cu, Pb, Zn, Cd) mainly remained in bio-char whereas As was transferred to aqueous phase. Thus, HTL by aqueous phase recycling could be a promising way for PVL treatment to obtain high-quality bio-oil and arsenic recovery.

Effects of breathing exercises using home-based positive pressure in the expiratory phase in patients with COPD.

BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) commonly have higher intrinsic positive end-expiratory pressure (PEEPi). A breathing exercise programme strategy employing an appropriate PEEP may improve their pulmonary functional capacity, exercise tolerance and health-related quality of life. Breathing with an expiratory resistive load, which is a method of modulating spontaneous breathing against PEEPi, has not been fully studied in patients with COPD. The objective of this study was to investigate the role of changing spontaneous breathing in home-based conditions and regulating spontaneous breathing with breathing exercises in patients with COPD. METHODS: This was a prospective randomised trial including 64 patients with a diagnosis of stage III or IV COPD. Patients were randomised into two groups: standard treatment and standard treatment combined with breathing exercise rehabilitation. The effects of the treatments on the COPD assessment test (CAT) score, 6-minute walk test (6MWT) results and pulmonary function were compared at 0, 6, 12 and 18 months within and between the two groups. RESULTS: All outcomes showed no significant differences between the two groups at the beginning of the study, while the 6MWT and CAT scores exhibited clinically and statistically significant improvements (p<0.001) by the end of the study. At month 18, the change in the predicted percentage of forced expiratory volume in 1 s (FEV1%pred) differed between the two groups (p<0.05). In addition, there were statistically significant differences in the 6MWT results, CAT scores and FEV1%pred values between the baseline and month 18 (p<0.0001) in the intervention group. CONCLUSIONS: Improvements in 6MWT results, pulmonary function and CAT scores are associated with a successful response to breathing against PEEPi in patients with COPD. TRIAL REGISTRATION: This trial was registered at research registry.com (identifier research registry 4816).

[Status of diagnosis and management of acute appendicitis in 2017: a national multi-center retrospective study].

OBJECTIVE: To analyze the current status of diagnosis and management of acute appendicitis (AA) in China. METHODS: Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Different centers collected and summarized their data in 2017 and sent back the questionnaires for summary. RESULTS: A total of 8 766 AA patients were enrolled from 43 medical centers, including 4 711 males (53.7%) with median age of 39 years and 958 (10.9%) patients over 65 years old. Of 8 776 patients, 5 677 cases (64.6%) received one or more imaging examinations, and the other 3 099 (35.4%) did not receive any imaging examination. A total of 1 858 (21.2%) cases received medical treatment, mainly a combination of nitroimidazoles (1 107 cases, 59.8%) doublet regimen, followed by a single-agent regimen of non-nitroimidazoles (451 cases, 24.4%), a nitroimidazole-free doublet regimen (134 cases, 7.2%), a triple regimen of combined nitroimidazoles (116 cases, 6.3%), nitroimidazole alone (39 cases, 2.1%) and nitroimidazole-free triple regimen (3 cases, 0.2%). Of the 6 908 patients (78.8%) who underwent surgery, 4 319 (62.5%) underwent laparoscopic appendectomy and 2589 (37.5%) underwent open surgery. Ratio of laparotomy was higher in those patients under 16 years old (392 cases) or over 65 years old (258 cases) [15.1%(392/2 589) and 10.0%(258/2 589), respectively, compared with 8.5%(367/4 316) and 8.0%(347/4 316) in the same age group for laparoscopic surgery, χ²=91.415, P<0.001; χ²=15.915,P<0.001]. Patients with complicated appendicitis had higher ratio of undergoing open surgery as compared to those undergoing laparoscopic surgery [26.7%(692/2 589) vs. 15.6%(672/4 316), χ²=125.726, P<0.001].The cure rates of laparoscopic and open surgery were 100.0% and 99.8%(2 585/2 589) respectively without significant difference (P=0.206). Postoperative complication rates were 4.5%(121/2 589) and 4.7%(196/4 316) respectively, and the difference was not statistically significant (χ²=0.065, P=0.799). The incidence of surgical site infection was lower (0.6% vs. 1.7%, χ²=17.315, P<0.001), and hospital stay was shorter [6(4-7) days vs. 6(5-8) days, U=4 384 348.0, P<0.001] in the laparoscopic surgery group, while hospitalization cost was higher (median 12 527 yuan vs. 9 342 yuan, U=2 586 809.0, P<0.001). CONCLUSIONS: The diagnosis of acute appendicitis is still clinically based, supplemented by imaging examination. Appendectomy is still the most effective treatment at present. Laparoscopic appendectomy has become the main treatment strategy, but anti-infective drugs are also very effective.

Huaier extract synergizes with tamoxifen to induce autophagy and apoptosis in ER-positive breast cancer cells.

Tamoxifen (TAM) is the most widely used endocrine therapy for estrogen receptor (ER)-positive breast cancer patients, but side effects and the gradual development of insensitivity limit its application. We investigated whether Huaier extract, a traditional Chinese medicine, in combination with TAM would improve treatment efficacy in ER-positive breast cancers. MTT, colony formation, and invasion and migration assays revealed that the combined treatment had stronger anticancer effects than either treatment alone. Huaier extract enhanced TAM-induced autophagy, apoptosis, and G0/G1 cell cycle arrest, as measured by acidic vesicular organelle (AVO) staining, TUNEL, flow cytometry, and western blot. Additionally, combined treatment inhibited tumorigenesis and metastasis by suppressing the AKT/mTOR signaling pathway. Huaier extract also enhanced the inhibitory effects of TAM on tumor growth in vivo in a xenograft mouse model. These results show that Huaier extract synergizes with TAM to induce autophagy and apoptosis in ER-positive breast cancer cells by suppressing the AKT/mTOR pathway.

Nitidine chloride induces apoptosis, cell cycle arrest, and synergistic cytotoxicity with doxorubicin in breast cancer cells.

Medicinal plant extracts have been widely used for cancer treatment. Nitidine chloride (NC) is a natural bioactive alkaloid that has recently been reported to have diverse anticancer properties. We aimed to investigate the cytotoxic effects of NC and the effectiveness of combinatorial treatment including NC and doxorubicin in breast cancer cells. Using MTT and flowcytometry assays, we found that NC induced cell growth inhibition and G2/M cell cycle arrest in a time- and dose-dependent manner both in MCF-7 and MDA-MB-231 breast cancer cell lines. Cancer cell growth inhibition was associated with increased levels of the p53 and p21 proteins. Apoptosis induction by NC treatment was confirmed by JC-1 mitochondrial membrane potential, annexin V-positive cell, and TUNEL staining. Using western blot analysis, we found that NC upregulated the pro-apoptotic proteins Bax, cleaved caspase-9 and -3 and cleaved PARP and that it downregulated the anti-apoptotic proteins Bcl-2 and PARP. By using the PI3K/Akt inhibitor LY294002, we further demonstrated that NC-induced apoptosis might be Akt-specific or dependent. In addition, NC exhibited a synergistic effect with doxorubicin on the growth inhibition of the human breast cancer cell lines MCF-7 and MDA-MB-231. Our study demonstrated the anticancer effect of NC on breast cancer and highlighted the potential clinical application of NC.

[Clinical observation on meridian detection and diagnosis in 66 patients with hypertension].

OBJECTIVE: To observe the meridian reaction in patients with hypertension, to explore the significance of meridian diagnosis. METHODS: Sixty-six patients with hypertension received two different methods of meridian detection. Kang Wei Human Body Meridian Analysis and Diagnosis System was applied to detect the volt-ampere characteristic curve on the Yuan (source) point of the 12 meridians. Five minutes after the first examination, the traditional method of meridian detection was used to examine the meridian reactions, such as pressing pain, tuber and cord-like reactants along the 12 meridians at forearms, lower limb, head and back. RESULTS: There were sixty-five cases of abnormal volt-ampere characteristic curve among sixty-six patients with hypertension. The number of cases about Kidney Meridian of Foot-Shaoyin and Bladder Meridian of Foot-Taiyang were both 28 with the highest abnormal rate being 43.1%; Using traditional method of meridian detection, there were 41 cases of abnormal meridian reactions, about 28 cases of Governor Vessel, with the highest abnormal rate being 68.3%. CONCLUSION: The abnormal meridian reactions exist in Governor Vessel, Kidney Meridian and Bladder Meridian in patients with hypertension. Therefore, this finding provides clinical evidence in meridian diagnosis.

[Efficacy of whole body gamma-knife radiotherapy combined with thermochemotherapy on locally advanced pancreatic cancer].

BACKGROUND & OBJECTIVE: Radiotherapy and chemotherapy are major therapies for locally advanced pancreatic cancer. This study was to evaluate the efficacy of three-dimensional conformal gamma-knife radiotherapy combined with thermochemotherapy on locally advanced pancreatic cancer. METHODS: From December 2001 to January 2006, 75 patients with locally advanced pancreatic cancer were divided into radiotherapy group (37 patients) and combination group (38 patients). All patients received gamma-knife radiotherapy using Stereotactic Radiotherapy Gamma Rays System, with iso-dose curves of 50%-60%, tumor encircling dose of 3.0-4.5 Gy per fraction, 8-11 fractions. The patients in combination group received simultaneous thermotherapy at 41.5-43.5 celsius (1 h/fraction, twice a week for 6 times), and chemotherapy with venous administration of tegafur (0.5-1.0 g) and calcium folinate (CF, 0.2 g) for 4-6 times, or venous administration of gemcitabine (0.6-1.0 g/m2) on Days 1 and 8 and cisplatin (DDP) (20-30 mg/m2) on Days 1-3, repeated every 28 days for 3-6 cycles. RESULTS: At 3 months after treatment, the total response (complete remission and partial remission) rate was 70.7% (53/75); the response rate was 73.7% in combination group and 67.5% in radiotherapy group. The 1-year survival rate was 48.3%, and the 2-year survival rate was 22.1%. The 1-and 2-year survival rates were 51.2% and 26.5% in combination group, and 45.2% and 17.6% in radiotherapy group. No serious complications, such as perforation, bleeding and high fever, were seen during treatment and follow-up. CONCLUSION: 3-D conformal gamma-knife radiotherapy combined with thermochemotherapy is well tolerated and is relatively effective for most patients with locally advanced pancreatic cancer.

Lexical/semantic processing in dorsal left inferior frontal gyrus.

Previous studies have not determined whether the dorsal left inferior frontal gyrus has a lexical or semantic function. This study conducted an event-related functional MRI experiment to explore its function using Japanese words and nonsense words in a syllable counting task. The word task activated a dorsal area (BA6/44) and a ventral area (BA45/47) more extensively than did the nonsense word task. The results indicate that the dorsal area also has lexical or semantic functions, despite that it has been related to phonological processing from studies using written stimuli. The more extensive activation by the word task might result from the same level of effort during phonological processing of Japanese words and nonsense words.

Function segregation in the left inferior frontal gyrus: a listening functional magnetic resonance imaging study.

Function segregation in the left inferior frontal gyrus was investigated in a functional magnetic resonance imaging experiment using a passive listening task, in which Japanese volunteers were required to passively listen to words and nonsense words in Japanese and English. The statistical analysis results showed that the dorsal part of the left inferior frontal gyrus was more extensively activated by listening to English words and nonsense words than to those of Japanese, respectively, which suggests automatic articulatory representation access for non-native stimuli perception, and that the ventral part was more extensively activated by listening to English and Japanese words than to nonsense words in either language, which suggests a lexical or semantic processing function.

[Change of Bcl-2 expression and telomerase during apoptosis induced by oridonin on human hepatocelluar carcinoma cells].

OBJECTIVE: To investigate the change of Bcl-2 expression and telomerase during the apoptosis induced by oridonin on human hepatocelluar carcinoma BEL7402 cells. METHOD: BEL-7402 cells in culture medium were given 8,16,24,32 micromol x L(-1) different concentrations of oridonin. The cell apoptotic rate was detected by flow cytometry (FCM), morphology of cell apoptosis was observed by Hoechst 3325 staining. Bcl-2 and Bax expressions were detected by Western blotting. Reverse transcriptase polymerase chain reaction (RT-PCR) and PCR enzyme-linked immunosorbent assay (ELISA) were used to detect hTERT mRNA expression and telomerase activity. RESULT: Oridonin induced BEL-7402 cells apoptosis significantly, and the apoptosis rate was both in time-and dose-dependent manner. Marked morphological changes of cell apoptosis were observed very clearly by Hoechst 33258 staining after the cells exposed to oridonin for 60 hours; Western blotting showed that Bcl-2 expression was down-regulated and Bax expression up-regulated concurrently along with the apoptotic process, and the expression of hTERT mRNA as well as activity of telomerase were decreased concurrently. CONCLUSION: Oridonin could decrease the expression of hTERT mRNA and telomerase activity as well as down-regulation of Bcl-2 and up-regulation of Bax expression during the apoptosis of BEL-7402 cells.