Photodynamic therapy based on bismuth oxyiodide nanoparticles for nondestructive tooth whitening.

Achieving a desired whitening effect through short treatments without using peroxide and without compromising the integrity of tooth enamel remains a challenge in teeth whitening. Here, we developed a highly safe and efficient photodynamic therapy (PDT) strategy based on visible light-activated bismuth oxyiodide nanoparticles for nondestructive tooth whitening. The Bi7O9I3 nanoparticles (NPs) exhibited efficient photocatalytic activity owing to their narrow band gap, effectively harnessing the broad spectrum of visible light to generate ample electrons and holes. Meanwhile, the presence of oxygen vacancies, low oxidation state Bi3+ and the high specific surface area endow Bi7O9I3 NPs with effective electron-hole separation ability and potent redox potentials. Empowered by these characteristics, Bi7O9I3 NPs effectively catalyzed O2 into radicals (O2•-), facilitating the degradation of dental surface pigment molecules for tooth whitening. Concurrently, they eradicated oral bacteria and bacterial biofilms adhering to tooth surfaces, thereby having a positive effect on the effectiveness of tooth whitening. This PDT strategy with Bi7O9I3 NPs shows broad application prospects in tooth whitening.

Cloning and Direct Evolution of a Novel 7-O-Glycosyltransferase from Cucurbita moschata and Its Application in the Efficient Biocatalytic Synthesis of Luteolin-7-O-glucoside.

Luteolin-7-O-glucoside(L7G), a glycosylation product of luteolin, is present in a variety of foods, vegetables, and medicinal herbs and is commonly used in dietary supplements due to its health benefits. Meanwhile, luteolin-7-O-glucoside is an indicator component for the quality control of honeysuckle in the pharmacopoeia. However, its low content in plants has hindered its use in animal pharmacological studies and clinical practice. In this study, a novel 7-O-glycosyltransferase CmGT from Cucurbita moschata was cloned, which could efficiently convert luteolin into luteolin-7-O-glucoside under optimal conditions (40 °C and pH 8.5). To further improve the catalytic efficiency of CmGT, a 3D structure of CmGT was constructed, and directed evolution was performed. The mutant CmGT-S16A-T80W was obtained by using alanine scanning and iterative saturation mutagenesis. This mutant exhibited a kcat/Km value of 772 s-1·M-1, which was 3.16-fold of the wild-type enzyme CmGT. Finally, by introducing a soluble tag and UDPG synthesis pathway, the strain BXC was able to convert 1.25 g/L of luteolin into 1.91 g/L of luteolin-7-O-glucoside under optimal conditions, achieving a molar conversion rate of 96% and a space-time yield of 27.08 mg/L/h. This study provides an efficient method for the biosynthesis of luteolin-7-O-glucoside, which holds broad application prospects in the food and pharmaceutical industry.

CRISPR/Cas13a-based rapid detection method for porcine deltacoronavirus.

Background: Porcine deltacoronavirus (PDCoV) is a newly discovered porcine intestinal pathogenic coronavirus with a single-stranded positive-sense RNA genome and an envelope. PDCoV infects pigs of different ages and causes acute diarrhea and vomiting in newborn piglets. In severe cases, infection leads to dehydration, exhaustion, and death in sick piglets, entailing great economic losses on pig farms. The clinical symptoms of PDCoV infection are very similar to those of other porcine enteroviruses. Although it is difficult to distinguish these viral infections without testing, monitoring PDCoV is very important because it can spread in populations. The most commonly used methods for the detection of PDCoV is qPCR, which is time-consuming and require skilled personnel and equipment. Many farms cannot meet the conditions required for detection. Therefore, it is necessary to establish a faster and more convenient method for detecting PDCoV. Aims: To establish a rapid and convenient detection method for PDCoV by combining RPA (Recombinase Polymerase Isothermal Amplification) with CRISPR/Cas13a. Methods: Specific RPA primers and crRNA for PDCoV were designed, and the nucleic acids in the samples were amplified with RPA. Fluorescent CRISPR/Cas13a detection was performed. We evaluated the sensitivity and specificity of the RPA-CRISPR/Cas13a assay using qPCR as the control method. Results: CRISPR/Cas13a-assisted detection was completed within 90 min. The minimum detection limit of PDCoV was 5.7 × 101 copies/µL. A specificity analysis showed that the assay did not cross-react with three other porcine enteroviruses. Conclusion: The RPA-CRISPR/Cas13a method has the advantages of high sensitivity, strong specificity, fast response, and readily accessible results, and can be used for the detection of PDCoV.

Soil Organic Carbon Prediction Based on Vis-NIR Spectral Classification Data Using GWPCA-FCM Algorithm.

Soil visible and near-infrared reflectance spectroscopy is an effective tool for the rapid estimation of soil organic carbon (SOC). The development of spectroscopic technology has increased the application of spectral libraries for SOC research. However, the direct application of spectral libraries for SOC prediction remains challenging due to the high variability in soil types and soil-forming factors. This study aims to address this challenge by improving SOC prediction accuracy through spectral classification. We utilized the European Land Use and Cover Area frame Survey (LUCAS) large-scale spectral library and employed a geographically weighted principal component analysis (GWPCA) combined with a fuzzy c-means (FCM) clustering algorithm to classify the spectra. Subsequently, we used partial least squares regression (PLSR) and the Cubist model for SOC prediction. Additionally, we classified the soil data by land cover types and compared the classification prediction results with those obtained from spectral classification. The results showed that (1) the GWPCA-FCM-Cubist model yielded the best predictions, with an average accuracy of R2 = 0.83 and RPIQ = 2.95, representing improvements of 10.33% and 18.00% in R2 and RPIQ, respectively, compared to unclassified full sample modeling. (2) The accuracy of spectral classification modeling based on GWPCA-FCM was significantly superior to that of land cover type classification modeling. Specifically, there was a 7.64% and 14.22% improvement in R2 and RPIQ, respectively, under PLSR, and a 13.36% and 29.10% improvement in R2 and RPIQ, respectively, under Cubist. (3) Overall, the prediction accuracy of Cubist models was better than that of PLSR models. These findings indicate that the application of GWPCA and FCM clustering in conjunction with the Cubist modeling technique can significantly enhance the prediction accuracy of SOC from large-scale spectral libraries.

Sustainable Alkali Activation: The Role of Water- and Alkali-Treated Sisal Leaf Wastewaters in Solid- Waste-Based Composite Synthesis.

The intricate composition of wastewater impedes the recycling of agricultural and industrial effluents. This study aims to investigate the potential of sisal leaf wastewater (SLW), both water-treated (WTSLW) and alkali-treated (ATSLW), as a substitute for the alkali activator (NaOH solution) in the production of slag-powder- and fly-ash-based composites, with a focus on the effects of WTSLW substitution ratios and sisal leaf soaking durations. Initially, the fresh properties were assessed including electrical conductivity and fluidity. A further analysis was conducted on the influence of both WTSLW and ATSLW on drying shrinkage, density, and mechanical strength, including flexural and compressive measures. Microstructural features were characterized using SEM and CT imaging, while XRD patterns and FTIR spectra were employed to dissect the influence of WTSLW substitution on the composite's products. The results show that incorporating 14 wt% WTSLW into the composite enhances 90-day flexural and compressive strengths by 34.8% and 13.2%, respectively, while WTSLW curtails drying shrinkage. Conversely, ATSLW increases porosity and decreases density. Organic constituents in both WTSLW and ATSLW encapsulated in the alkaline matrix fail to modify the composites' chemical composition. These outcomes underscore the potential for sustainable construction materials through the integrated recycling of plant wastewater and solid by-products.

Benchmarking produced water treatment strategies for non-toxic effluents: Integrating thermal distillation with granular activated carbon and zeolite post-treatment.

The management of produced water (PW) generated during oil and gas operations requires effective treatment and comprehensive chemical and toxicological assessment to reduce the environmental risks associated with reuse or discharge. This study evaluated a treatment train that included a low-temperature thermal distillation pilot system followed by granular activated carbon (GAC) and zeolite post-treatment for processing hypersaline Permian Basin PW. Our study provides a unique and comprehensive assessment of the treatment efficiency considering a targeted chemical scheme together with whole effluent toxicity (WET) tests across four trophic levels regarding aquatic critical receptors of concern (ROC): Raphidocelis subcapitata, Vibrio fischeri, Ceriodaphnia dubia, and Danio rerio. The distillate from the thermal distillation process met various numeric discharge standards for salinity and major ions. However, it did not meet toxicity requirements established by the United States National Pollutant Discharge Elimination System program. Subsequent post-treatment using GAC and zeolite reduced the concentration of potential stressors, including volatile organics, NH3, Cd, Cr, Zn, and Mn in the final effluent to below detection limits. This resulted in a consistent toxicity reduction across all WET tests, with no observable adverse effects for R. subcapitata, C. dubia, and D. rerio (no observed effect concentration >100%), and V. fischeri effects reduced to 19%. This study realizes the feasibility of treating PW to non-toxic levels and meeting reuse and discharge requirements. It underscores the importance of implementing integrated treatment trains to remove the contaminants of concern and provides a systematic decision framework to predict and monitor environmental risks associated with PW reuse.

RAB37-mediated autophagy guards ovarian homeostasis and function.

Loss of ovarian homeostasis is associated with ovary dysfunction and female diseases; however, the underlying mechanisms responsible for the establishment of homeostasis and its function in the ovary have not been fully elucidated. Here, we showed that conditional knockout of Rab37 in oocytes impaired macroautophagy/autophagy proficiency in the ovary and interfered with follicular homeostasis and ovary development in mice. Flunarizine treatment upregulated autophagy, thus rescuing the impairment of follicular homeostasis and ovarian dysfunction in rab37 knockout mice by reprogramming of homeostasis. Notably, both the E2F1 and EGR2 transcription factors synergistically activated Rab37 transcription and promoted autophagy. Thus, RAB37-mediated autophagy ensures ovary function by maintaining ovarian homeostasis.

Cephalopod-Inspired Nanomaterials for Optical and Thermal Regulation: Mechanisms, Applications and Perspectives.

The manipulation of interactions between light and matter plays a crucial role in the evolution of organisms and a better life for humans. As a result of natural selection, precise light-regulatory systems of biology have been engineered that provide many powerful and promising bioinspired strategies. As the "king of disguise", cephalopods, which can perfectly control the propagation of light and thus achieve excellent surrounding-matching via their delicate skin structure, have made themselves an exciting source of inspiration for developing optical and thermal regulation nanomaterials. This review presents cutting-edge advancements in cephalopod-inspired optical and thermal regulation nanomaterials, highlighting the key milestones and breakthroughs achieved thus far. We begin with the underlying mechanisms of the adaptive color-changing ability of cephalopods, as well as their special hierarchical skin structure. Then, different types of bioinspired nanomaterials and devices are comprehensively summarized. Furthermore, some advanced and emerging applications of these nanomaterials and devices, including camouflage, thermal management, pixelation, medical health, sensing and wireless communication, are addressed. Finally, some remaining but significant challenges and potential directions for future work are discussed. We anticipate that this comprehensive review will promote the further development of cephalopod-inspired nanomaterials for optical and thermal regulation and trigger ideas for bioinspired design of nanomaterials in multidisciplinary applications.

SBL-LCGL: sparse Bayesian learning based on Laplace distribution for robust cone-beam x-ray luminescence computed tomography.

OBJECTIVE: To address the quality and accuracy issues in the distribution of nanophosphors using Cone-beam X-ray luminescence computed tomography (CB-XLCT) by proposing a novel reconstruction strategy. APPROACH: This paper introduces a sparse Bayesian learning reconstruction method termed SBL-LCGL, which is grounded in the Lipschitz continuous gradient condition and the Laplace prior to overcome the ill-posed inverse problem inherent in CB-XLCT. MAIN RESULTS: The SBL-LCGL method has demonstrated its effectiveness in capturing the sparse features of nanophosphors and mitigating the computational complexity associated with matrix inversion. Both numerical simulation and in vivo experiments confirm that the method yields satisfactory imaging results regarding the position and shape of the targets. SIGNIFICANCE: The advancements presented in this work are expected to enhance the clinical applicability of CB-XLCT, contributing to its broader adoption in medical imaging and diagnostics.

Global, Regional, and National Burdens of Hearing Loss for Children and Adolescents from 1990 to 2019: A Trend Analysis.

This study presents a comprehensive analysis of global, regional, and national trends in the burden of hearing loss (HL) among children and adolescents from 1990 to 2019, using data from the Global Burden of Disease study. Over this period, there was a general decline in HL prevalence and years lived with disability (YLDs) globally, with average annual percentage changes (AAPCs) of -0.03% (95% uncertainty interval [UI], -0.04% to -0.01%; p = 0.001) and -0.23% (95% UI, -0.25% to -0.20%; p < 0.001). Males exhibited higher rates of HL prevalence and YLDs than females. Mild and moderate HL were the most common categories across all age groups, but the highest proportion of YLDs was associated with profound HL [22.23% (95% UI, 8.63%-57.53%)]. Among females aged 15-19 years, the prevalence and YLD rates for moderate HL rose, with AAPCs of 0.14% (95% UI, 0.06%-0.22%; p = 0.001) and 0.13% (95% UI, 0.08%-0.18%; p < 0.001). This increase is primarily attributed to age-related and other HL (such as environmental, lifestyle factors, and occupational noise exposure) and otitis media, highlighting the need for targeted research and interventions for this demographic. Southeast Asia and Western Sub-Saharan Africa bore the heaviest HL burden, while High-income North America showed lower HL prevalence and YLD rates but a slight increasing trend in recent years, with AAPCs of 0.13% (95% UI, 0.1%-0.16%; p < 0.001) and 0.08% (95% UI, 0.04% to 0.12%; p < 0.001). Additionally, the analysis revealed a significant negative correlation between sociodemographic index (SDI) and both HL prevalence (r = -0.74; p < 0.001) and YLD (r = -0.76; p < 0.001) rates. However, the changes in HL trends were not significantly correlated with SDI, suggesting that factors beyond economic development, such as policies and cultural practices, also affect HL. Despite the overall optimistic trend, this study emphasizes the continued need to focus on specific high-risk groups and regions to further reduce the HL burden and enhance the quality of life for affected children and adolescents.

Main group metal elements enhance electrochemical nitrogen reduction reaction of vanadium-based single atom catalysts through d-p orbital hybridization.

Developing active sites with flexibility and diversity is crucial for single atom catalysts (SACs) towards sustainable nitrogen fixation at ambient conditions. Herein, the effects of doping main group metal elements (MGM) on the stability, catalytic activity, and selectivity of vanadium-based SACs is systematically investigated based on density functional theory calculations. It is found that the catalytic activity of V site can be significantly enhanced by the synergistic effect between MGM and vanadium atoms. More importantly, a volcano curve between the catalytic activity and the adsorption free energy of NNH* can be established, in which V-Pb dimer embedded on N-coordinated graphene (VPb-NG) exhibits optimal NRR activity due to its location at the top of volcano. Further analysis of electronic structures reveals that the unoccupancy ratio (eg/t2g) of V site is dramatically increased by the strong d-p orbital hybridization between V and Pb atoms, subsequently, N2 is activated to a larger extent. These interesting findings may provide a new path for designing active sites in SACs with excellent performance.

Technological Advances Are Associated With Better Clinical Outcomes of Percutaneous Coronary Intervention in Patients With Unprotected Left Main Disease.

BACKGROUND: Few large-scale studies have evaluated the effectiveness of percutaneous coronary intervention (PCI) technological advances in the treatment of patients with unprotected left main coronary artery disease (LM-CAD). We aim to identify independent factors that affect the prognosis of PCI in patients with unprotected LM-CAD and to assess the impact of PCI technological advances on long-term clinical outcomes. METHODS AND RESULTS: A total of 4512 consecutive patients who underwent unprotected LM-CAD PCI at Fuwai Hospital from 2004 to 2016 were enrolled. Multivariable Cox proportional hazards model was used to identify which techniques can independently affect the incidence of major adverse cardiac events (MACEs; a composite of cardiac death, myocardial infarction, or target vessel revascularization). The incidence of 3-year MACEs was 9.0% (406/4512). Four new PCI techniques were identified as the independent protective factors of MACEs, including second-generation drug-eluting stents (hazard ratio [HR], 0.61 [95% CI, 0.37-0.99]), postdilatation (HR, 0.75 [95% CI, 0.59-0.94]), final kissing balloon inflation (HR, 0.78 [95% CI, 0.62-0.99]), and using intravascular ultrasound (HR, 0.78 [95% CI, 0.63-0.97]). The relative hazard of 3-year MACEs was reduced by ≈50% with use of all 4 techniques compared with no technique use (HR, 0.53 [95% CI, 0.32-0.87]). CONCLUSIONS: PCI technological advances including postdilatation, second-generation drug-eluting stent, final kissing balloon inflation, and intravascular ultrasound guidance were associated with improved clinical outcomes in patients who underwent unprotected LM-CAD PCI.

Computation-Guided Discovery of Diazole Monosubstituted Tetrazines as Optimal Bioorthogonal Tools.

Monosubstituted tetrazines are important bioorthogonal reactive tools due to their rapid ligation with trans-cyclooctene. However, their application is limited by the reactivity-stability paradox in biological environments. In this study, we demonstrated that steric effects are crucial in resolving this paradox through theoretical methods and developed a simple synthetic route to validate our computational findings, leading to the discovery of 1,3-azole-4-yl and 1,2-azole-3-yl monosubstituted tetrazines as superior bioorthogonal tools. These new tetrazines surpass previous tetrazines in terms of high reactivities and elevated stabilities. The most stable tetrazine exhibits a reasonable stability (71% remaining after 24 h incubation in cell culture medium) and an exceptionally high reactivity (k2 > 104 M-1 s-1 toward trans-cyclooctene). Due to its good stability in biological systems, a noncanonical amino acid containing such a tetrazine side chain was genetically encoded into proteins site-specifically via an expanded genetic code. The encoded protein can be efficiently labeled using cyclopropane-fused trans-cyclooctene dyes in living mammalian cells with an ultrafast reaction rate exceeding 107 M-1 s-1, making it one of the fastest protein labeling reactions reported to date. Additionally, we showed its superiority through in vivo reactions in living mice, achieving an efficient local anchoring of proteins. These tetrazines are expected to be optimal bioorthogonal reactive tools within living systems.

Feasibility study of a single-primer extension-based microhaplotype NGS system.

DNA degradation has been a thorny problem in forensic science. Shortening the amplicon length of the genetic markers improves the analysis of degraded DNA effectively. Microhaplotype (MH) has been proposed as a potential genetic marker that can be used for degraded DNA analysis. In the present study, a 146-plex MH-next-generation sequencing (NGS) system with an average Ae of 6.876 was constructed. Unlike other MH studies, a single-primer extension (SPE)-based NGS library preparation method was used to improve the detection of MH markers for degraded DNA. SPE employs a locus-specific and universal primer to amplify target fragments, reducing the necessity for complete fragment sequences. SPE might effectively mitigate the impact of degradation on amplification. However, SPE produces amplicons of varying lengths, posing challenges in allele calling for SPE-NGS data. To address this issue, this study proposed a flexible allele-calling strategy to improve amplicon detection. In addition, this study evaluated the forensic efficacy of the system using 12 low-template samples (from 1 ng to 7.8 pg), 10 mock-degraded DNA with various degrees of degradation, and 8 forensic casework samples. When the template is as low as 7.8 pg, our system can accurately detect at least 37 loci and achieves a random match probability (RMP) of 10-30 using the complete allele-calling strategy. Eighty-two loci can be detected, and RMP can reach 10-54 using a flexible allele-calling strategy. After 150 min of 98°C treatment, 36 loci can still be detected, and an RMP of 10-5 can be obtained using the flexible allele-calling strategy. Furthermore, the number of single nucleotide polymorphism detected at different DNA amounts and degradation levels suggests that the SPE method combined with a flexible allele-calling strategy is effective.

Rupestonic Acid Derivative YZH-106 Promotes Lysosomal Degradation of HBV L- and M-HBsAg via Direct Interaction with PreS2 Domain.

Hepatitis B surface antigen (HBsAg) is not only the biomarker of hepatitis B virus (HBV) infection and expression activity in hepatocytes, but it also contributes to viral specific T cell exhaustion and HBV persistent infection. Therefore, anti-HBV therapies targeting HBsAg to achieve HBsAg loss are key approaches for an HBV functional cure. In this study, we found that YZH-106, a rupestonic acid derivative, inhibited HBsAg secretion and viral replication. Further investigation demonstrated that YZH-106 promoted the lysosomal degradation of viral L- and M-HBs proteins. A mechanistic study using Biacore and docking analysis revealed that YZH-106 bound directly to the PreS2 domain of L- and M-HBsAg, thereby blocking their entry into the endoplasmic reticulum (ER) and promoting their degradation in cytoplasm. Our work thereby provides the basis for the design of a novel compound therapy to target HBsAg against HBV infection.

Effective remediation of agricultural drainage at three influent strengths by bioaugmented constructed wetlands filled with mixture of iron­carbon and organic solid substrates: Performance and mechanisms.

Agricultural drainage containing a large quantity of nutrients can cause quality deterioration and algal blooming of receiving water bodies, thus needs to be effectively remediated. In this study, iron­carbon (FeC) composite-filled constructed wetlands (Fe-C-CWs) were employed to treat farmland drainage at three pollution levels, and organic solid substrates (walnut shells) and phosphate-accumulating denitrifying bacteria (Pseudomonas sp. DWP1) were supplemented to enhance the treatment performance. The results showed that the Fe-C-CWs exhibited notably superior removal efficiency for total nitrogen (TN, 52.0-58.2 %), total phosphorus (TP, 67.8-70.2 %) and chemical oxygen demand (COD, 56.7-70.4 %) than the control systems filled solely with gravel (28.5-32.5 % for TN, 33.2-40.5 % for TP and 30.2-55.0 % for COD) at all influent strengths, through driving autotrophic denitrification, Fe-based dephosphorization, and organic degradation processes. The addition of organic substrates and functional bacteria markedly enhanced pollutant removal in the Fe-C-CWs. Furthermore, use of FeC and organic substrates and denitrifier inoculation decreased CO2 and CH4 emissions from the CWs, and reduced global warming potential of the CWs at low influent strength. Pollutant removal efficiencies in the CWs were only marginally impacted by the increasing influent loads except for NO3--N, and pollutant removal mass was largely increased with the increase of influent strengths. The microbial community in the FeC composite-filled CWs exhibited distinct distribution patterns compared to the gravel-filled CWs regardless of the influent strengths, with obviously higher proportions of dominant genera Trichococcus, Geobacter and Ferritrophicum. Keystone taxa associated with pollutant removal in the Fe-C-filled CWs were identified to be Pseudomonas, Geobacter, Ferritrophicum, Denitratisoma and Sediminibacterium. The developed augmented Fe-C-filled CWs show great promises for remediating agricultural drainage with varied pollutant loads.

High-pressure effects on the electronic properties and photoluminescence of Ag-doped CsCu2I3.

CsCu2I3 is a popular lead-free metal halide perovskite with good thermal and air stability. To facilitate its applications in optoelectronics, Ag doping and high pressure are employed in this work to improve the optoelectronic properties of CsCu2I3. Using first-principles calculations and experiments, the structural phase change of 10% Ag-doped CsCu2I3 is found to occur at about 4.0 GPa. This reveals the regulation of band structures by hydrostatic pressure. In addition, the high pressure not only increases the emission energy of photoluminescence of 10% Ag-doped CsCu2I3 by more than 0.2 eV, but also increases the emission intensity by multiple times. Finally, the origin of luminescence in 10% Ag-doped CsCu2I3 is attributed to the I vacancies. This work provides insight into the structure and optoelectronic properties of 10% Ag-doped CsCu2I3, and offers significant guidance for the design and manufacturing of future luminescence devices.

Neurosyphilis Presenting as Psychiatric Symptoms at Younger Age: A Case Report.

Neurosyphilis is a central nervous system infection caused by Treponema pallidum that imitates various neurological and mental disorders. Therefore, patients with this disease are prone to misdiagnoses. Here, we report a case of neurosyphilis with a psychotic disorder as the main manifestation. A young girl exhibited mental and behavioural abnormalities after a heartbreak, which manifested as alternating low mood, emotional irritability, and a lack of interest in social relations, followed by memory loss. The cerebrospinal fluid protein - Treponema pallidum particle agglutination test was positive, the toluidine red unheated serum test titre was 1:4, the white blood cell count was 5 × 10^6/L, the cerebrospinal fluid protein level was 0.97 g/L, and the brain CT was abnormal. After admission, the possibility of neurosyphilis was considered and the patient received intravenous penicillin G treatment. The patient's clinical symptom ms improved. This case emphasises that doctors should maintain clinical suspicion of Treponema pallidum infection in adolescent patients with mental abnormalities.

Long-term, 13-year survival after immune cell therapy combined with chemotherapy for extensive-stage small-cell lung cancer: a case report.

While the incidence of small-cell lung cancer is low, it has a poor prognosis. Patients with extensive small-cell lung cancer account for about 70% of all cases of small-cell lung cancer, with a median overall survival duration of 8-13 months and a 5-year overall survival rate of only 1%-5%. Herein, we report small-cell lung cancer diagnosed by bronchoscopic biopsy in an adult male patient in 2011. The patient had a clinical stage of cT2N2M1 and stage IV disease (i.e., extensive small-cell lung cancer). Still, he survived for 13 years through a combination of chemotherapy, radiotherapy, and cytokine-induced killer (CIK) immunocell thera. Comprehensive tumor markers, lymphocyte subsets, and lung CT images were obtained through long-term follow-up. After 12 cycles of chemotherapy (CE/IP regimen) and 5940cgy/33f radiotherapy, we found that the patient was in an immunosuppressive state, so the patient was given CIK cell therapy combined with chemotherapy. After 2 years of immunocell-combined chemotherapy, there were no significant changes in the primary lesion or other adverse events. In the 13 years since the patient's initial diagnosis, we monitored the changes in the patient's indicators such as CEA, NSE, CD4/CD8 ratio, and CD3+CD4+ lymphocytes, suggesting that these may be the factors worth evaluating regarding the patient's immune status and the effectiveness of combination therapy. In this case, CIK cell immunotherapy combined with chemotherapy was applied to control tumor progression. With a good prognosis, we concluded that CIK cell immunotherapy combined with chemotherapy can prolong patient survival in cases of extensive small-cell lung cancer, and the advantages of combined therapy are reflected in improving the body's immune capacity and enhancing the killing effect of immune cells.

Metformin prevents the onset and progression of intervertebral disc degeneration: New insights and potential mechanisms (Review).

Metformin has been the go­to medical treatment for addressing type 2 diabetes mellitus (T2DM) as a frontline oral antidiabetic. Obesity, cancer and bone deterioration are linked to T2DM, which is considered a metabolic illness. Numerous diseases associated with T2DM, such as tumours, cardiovascular disease and bone deterioration, may be treated with metformin. Intervertebral disc degeneration (IVDD) is distinguished by degeneration of the spinal disc, accompanied by the gradual depletion of proteoglycans and water in the nucleus pulposus (NP) of the IVD, resulting in lower back pain. The therapeutic effect of metformin on IVDD has also attracted much attention. By stimulating AMP­activated kinase, metformin could enhance autophagy and suppress cell senescence, apoptosis and inflammation, thus effectively delaying IVDD. The present review aimed to systematically explain the development of IVDD and mechanism of metformin in the treatment and prevention of IVDD to provide a reference for the clinical application of metformin as adjuvant therapy in the treatment of IVDD.