Transcatheter Arterial Sclerosing Embolization for the Treatment of Giant Propranolol-Resistant Infantile Hemangiomas in the Parotid Region.

PURPOSE: To report the effectiveness and safety of transcatheter arterial sclerosing embolization (TASE) for the treatment of parotid infantile hemangiomas that did not respond appreciably to propranolol. MATERIALS AND METHODS: A total of 21 infants (12 male and 9 female) with large propranolol-resistant infantile hemangiomas in the parotid region were enrolled in this study. During TASE, the feeding arteries of the lesions were embolized using pingyangmycin-lipiodol emulsion and polyvinyl alcohol particles (300-500 µm) to reduce the blood flow rate. All children were followed up as outpatients at 2 weeks and monthly thereafter. The curative effect was evaluated at the 1- and 3-month follow-up visits. RESULTS: Nine lesions were located on the right side of the parotid gland, whereas 12 were located on the left side. The feeding arteries in all patients originated from branches of the external carotid artery. TASE was technically successful in all patients. The mean (± SD) maximal diameter of the hemangiomas significantly decreased from 6.50 cm ± 2.28 before treatment to 3.56 cm ± 1.84 at 1 month after TASE (P <. 05). Three months after TASE, the mean maximal diameter further significantly decreased to 1.94 cm ± 1.58 (P <. 05). During the follow-up period, 16 cases were rated as excellent and 5 as good; no recurrence or serious complications were noted. Minor side effects, such as slight pain, mild fever, and tissue swelling, were observed. CONCLUSIONS: TASE significantly decreased the size of the parotid hemangiomas with minor side effects during a short follow-up period.

Polidocanol Sclerotherapy for the Treatment of Pyogenic Granuloma in Children.

BACKGROUND: Pyogenic granuloma (PG) is a benign vascular lesion that is commonly observed in the skin and mucosa. Sclerotherapy is the first-line conservative treatment option for PG. OBJECTIVE: This retrospective study aimed to evaluate the efficacy of sclerotherapy with 1.0% polidocanol for the treatment of PG. MATERIALS AND METHODS: All patients who were clinically diagnosed with PG consecutively at the Pediatric Outpatient Service of Qilu Children's Hospital of Shandong University from March 2018 to October 2019 received sclerotherapy with 1.0% polidocanol. RESULT: The procedure resulted in the complete excision of PG, with inconspicuous scars. The procedure was well-tolerated, and recurrence was not observed. Allergic reactions, cutaneous necrosis, and pigmentary changes were not observed. CONCLUSION: Sclerotherapy with 1.0% polidocanol is considered an effective treatment for PGs in children. Early treatment was associated with a more favorable outcome.

Hsp27 Responds to and Facilitates Enterovirus A71 Replication by Enhancing Viral Internal Ribosome Entry Site-Mediated Translation.

Enterovirus 71 (EV-A71) is a human pathogen that causes hand, foot, and mouth disease (HFMD) and fatal neurological diseases, and no effective treatment is available. Characterization of key host factors is important for understanding its pathogenesis and developing antiviral drugs. Here we report that Hsp27 is one of the most upregulated proteins in response to EV-A71 infection, as revealed by two-dimensional gel electrophoresis-based proteomics studies. Depletion of Hsp27 by small interfering RNA or CRISPR/Cas9-mediated knockout significantly inhibited viral replication, protein expression, and reproduction, while restoration of Hsp27 restored such virus activities. Furthermore, we show that Hsp27 plays a crucial role in regulating viral internal ribosome entry site (IRES) activities by two different mechanisms. Hsp27 markedly promoted 2Apro-mediated eukaryotic initiation factor 4G cleavage, an important process for selecting and initiating IRES-mediated translation. hnRNP A1 is a key IRES trans-acting factor (ITAF) for enhancing IRES-mediated translation. Surprisingly, knockout of Hsp27 differentially blocked hnRNP A1 but not FBP1 translocation from the nucleus to the cytoplasm and therefore abolished the hnRNP A1 interaction with IRES. Most importantly, the Hsp27 inhibitor 1,3,5-trihydroxy-13,13-dimethyl-2H-pyran [7,6-b] xanthone (TDP), a compound isolated from a traditional Chinese herb, significantly protected against cytopathic effects and inhibited EV-A71 infection. Collectively, our results demonstrate new functions of Hsp27 in facilitating virus infection and provide novel options for combating EV-A71 infection by targeting Hsp27.IMPORTANCE Outbreaks of infections with EV-A71, which causes hand, foot, and mouth disease, severe neurological disorders, and even death, have been repeatedly reported worldwide in recent decades and are a great public health problem for which no approved treatments are available. We show that Hsp27, a heat shock protein, supports EV-A71 infection in two distinct ways to promote viral IRES-dependent translation. A small-molecule Hsp27 inhibitor isolated from a traditional Chinese medicinal herb effectively reduces virus yields. Together, our findings demonstrate that Hsp27 plays an important role in EV-A71 infection and may serve as an antiviral target.

Fluoride permeation mechanism of the Fluc channel in liposomes revealed by solid-state NMR.

Solid-state nuclear magnetic resonance (ssNMR) methods can probe the motions of membrane proteins in liposomes at the atomic level and propel the understanding of biomolecular processes for which static structures cannot provide a satisfactory description. In this work, we report our study on the fluoride channel Fluc-Ec1 in phospholipid bilayers based on ssNMR and molecular dynamics simulations. Previously unidentified fluoride binding sites in the aqueous vestibules were experimentally verified by 19F-detected ssNMR. One of the two fluoride binding sites in the polar track was identified as a water molecule by 1H-detected ssNMR. Meanwhile, a dynamic hotspot at loop 1 was observed by comparing the spectra of wild-type Fluc-Ec1 in variant buffer conditions or with its mutants. Therefore, we propose that fluoride conduction in the Fluc channel occurs via a "water-mediated knock-on" permeation mechanism and that loop 1 is a key molecular determinant for channel gating.

Electroless deposition of copper nanoparticles integrates polydopamine coating on reverse osmosis membranes for efficient biofouling mitigation.

In this study, highly antimicrobial CuNPs were integrated into a hydrophilic polydopamine (PDA) coating and immobilized on a RO TFC membrane via a mild and facile reduction approach to form a stable and durable dual-functional layer. Based on the XDLVO analysis, the introduction of PDA increased the membrane-foulant total interaction energy (ΔGmwf) to 14.13 mJ/m2, resulting in improved anti-adhesive properties as demonstrated by a 37% decrease in BSA adsorption for the modified membranes. The well dispersed and high loadings of CuNPs induced by PDA conferred strong bacterial toxicity to the modified membranes, reducing the viability of E. coli by 76%. Furthermore, the presence of catechol groups on PDA favors the formation of covalent bond with CuNPs, thus prolonging the durability of the copper-based anti-biofouling membranes. The combination of PDA coating and CuNPs functionalization imparts the membrane with simultaneous anti-adhesive and anti-microbial properties, leading to a substantial reduction in biofouling propensity in dynamic biofouling experiments. Specifically, the flux decline due to biofouling observed for the modified membranes significantly decreased from 65% to 39%, and biofilm thickness and TOC biomass were 58%, and 55% lower, respectively. This study provides a facile and versatile strategy to construct high performance RO membranes with excellent anti-biofouling functionality.

Refractory Head and Neck Lymphatic Malformation in Infants Treated With Sirolimus: A Case Series.

BACKGROUND: Extensive and complex head and neck lymphatic malformations (LMs) are challenging to manage through traditional therapy. The purpose of this retrospective study was to assess the efficacy and safety of sirolimus in infants with refractory head and neck LMs. METHODS: Sirolimus was administered orally on a continuous dosing schedule. Patients were seen every month for the first three months and then subsequently every three months. The primary endpoints were safety and efficacy based on clinical and radiological evaluations. RESULTS: Eight patients, refractory to standard care, were enrolled and received sirolimus continuously. After 12 months of follow-up, the response and safety to medication was evaluated: all patients experienced reductions in LMs bulk, ranging from modest to significant. Some minor adverse effects were reported: mouth sores, eczema, gastrointestinal reaction, dyslipidemia, and neutropenia. CONCLUSION: Sirolimus was efficient in children with refractory head and neck LMs and was well tolerated.

Efficacy and safety of DSA-guided percutaneous sclerotherapy for venous malformations of penile region in children.

OBJECTIVE: To describe the effectiveness and security of DSA-guided percutaneous sclerotherapy for venous malformations of penile region in children. METHODS: A total of 9 cases children with penile venous malformations treated by DSA-guided percutaneous sclerotherapy from January 2017 to June 2018 were enrolled in this study. Local angiography was performed under DSA fluoroscopy, and the shape, extent and venous drainage of the tumor nest were judged. Then sclerosing agents (Pingyangmycin and Polidocanol) were selected according to the flow rate of angiography and treated by percutaneous injection under DSA monitoring. Imaging examination (MRI) was performed to evaluate clinical improvement. RESULTS: A total of 26 interventional sclerotherapy sessions were performed in 9 children, with an average of (2.3±0.5) sessions per case. After a mean follow-up of 7.3 months, 6 cases were cured, and 3 cases were in basic remission. There were 9 cases of temporary edema secondary to the treatment site and 3 cases of mild pain. No serious complications such as ulceration, hemorrhage, infection and dysfunction occurred in any patients. CONCLUSION: DSA-guided percutaneous sclerotherapy for venous malformations of penile region in children is safe and effective, does not affect the appearance and function of penis, and is worthy of clinical promotion. TYPE OF STUDY: Treatment Study. LEVEL OF EVIDENCE: Level IV, Case series with no comparison group.

Role of pre-coagulation in ultralow pressure membrane system for Microcystis aeruginosa-laden water treatment: Membrane fouling potential and mechanism.

This work systematically studied the role of pre-coagulation in the performance of ultralow pressure membrane system for algae-laden water treatment. The membrane performance with/without pre-coagulation was compared in terms of membrane permeate flux, water quality and membrane fouling. Ultralow pressure membrane system can effectively reduce TOC of Microcystis aeruginosa-laden water from 5.8 to 2.1 mg/L, and pre-coagulation removed most large inorganic particles but few small organic particles. Interestingly, pre-coagulation aggravated the fouling of ultralow membrane system which is generally acknowledged method to alleviate the ultrafiltration membrane fouling. According to Extended Derjaguin-Landau-Verwey-Overbeek theory (XDLVO), the interaction energy of membrane-foulants (ΔGfmTOT = - 41.95mJ/m2), and foulant-foulant (ΔGffTOT = - 30.15mJ/m2) with coagulation were higher than those without coagulation (ΔGfmTOT = - 36.54mJ/m2) and (ΔGffTOT = - 15.73mJ/m2) suggesting greater adherence between membrane and foulants & foulant and foulant after coagulation, which well agreed with SEM results. Membrane fouling models were also applied to analyze the fouling mechanism of ultralow-pressure membrane filtration. Based on above analysis, the possible fouling mechanisms for membrane filtration with/without precoagulation were proposed and then confirmed by pre-filtration experiment, where large inorganic particles played important roles. Our study could be indicative for membrane fouling control of ultralow-pressure membrane filtration for the treatment of algae-laden water.

Constructing zwitterionic polymer brush layer to enhance gravity-driven membrane performance by governing biofilm formation.

In this study, zwitterionic polymer brushes with controlled architecture were grafted on the surface of gravity-driven membrane (GDM) via surface-initiated reaction to impart antifouling property. A variety of membrane characterization techniques were conducted to demonstrate the successful functionalization of zwitterionic polymers on PVDF hollow fiber membrane. The membrane underwent 90 min of reaction time possessing strong hydrophilicity and high permeability was determined as the optimal modified membrane. Long-term GDM dynamic fouling experiments operated for 30 days using sewage wastewater as feed solution indicated zwitterionic polymer modified membrane exhibit excellent membrane fouling resistance thus enhanced stable flux. Confocal laser scanning microscopy (CLSM) imaging implied that zwitterionic polymer modification significantly inhibit the adsorption of extracellular polymeric substances (EPS) which dominates fouling propensity, resulting in the formation of a thin biofilm with high porosity under synthetic functions of foulants deposition and microbial activities. Interfacial free energy prediction affirmed the presence of zwitterionic functional layer on membrane surface could substantially decrease the interactions (e.g., electrostatic attractions and hydrophobic effects) between membrane and foulants, thereby reduced flux decline and high stable flux. Our study suggests surface hydrophilic functionalization shows promising potential for improving the performance of ultra-low pressure filtration.

Comparison of the Ultrathin Strut, Biodegradable Polymer Sirolimus-eluting Stent With a Durable Polymer Everolimus-eluting Stent in a Chinese Population: The Randomized BIOFLOW VI Trial.

PURPOSE: The BIOFLOW-VI (Biotronik-Safety and Clinical Performance of the Drug Eluting Orsiro Stent in the Treatment of Subjects With De Novo Coronary Artery Lesions-VI) study evaluates the angiographic efficacy, clinical safety, and effectiveness of the ultrathin strut, biodegradable polymer sirolimus-eluting stent (BP-SES) compared with a durable polymer everolimus-eluting stent (DP-EES). This randomized controlled clinical trial was designed to enable approval of new drug-eluting stents in China. METHODS: A total of 440 eligible patients from 11 sites with up to 2 de novo native coronary artery lesions were randomly assigned to receive either BP-SES (n = 220) or DP-EES (n = 220) from July 2014 to September 2016 in this prospective, multicenter, noninferiority trial. FINDINGS: The primary end point of 9-month in-stent late lumen loss (LLL) was 0.05 (0.02) mm in the BP-SES group versus 0.07 (0.02) mm in the DP-EES group, with a mean difference of -0.02 mm (95% CI, -0.06 to 0.03; P = 0.44; Pnoninferiority < 0.0001). At 1 year, the target lesion failure rate (cardiac death, target vessel myocardial infarction, and ischemia-driven target lesion revascularization) was similar between the 2 groups (BP-SES 2.3% vs DP-EES 1.4%; P = 0.50). No definite or probable stent thrombosis had occurred in any of the 2 treatment arms. IMPLICATIONS: The randomized BIOFLOW-VI trial showed that BP-SES was noninferior to DP-EES with regard to the primary end point of 9-month in-stent LLL in a Chinese population. ClinicalTrials.gov Identifier: NCT02870985.

Investigation of three lignin complexes with antioxidant and immunological capacities from Inonotus obliquus.

Mushroom Inonotus obliquus (I. obliquus), a folk medicine, has been widely used to treat several human malicious tumors since 16th century. In this study, three homogenous biomolecules (designated IOA1, IOA2 and IOA3) were prepared from the alkali extract of I. obliquus. Their molecular weights were measured to be 6.1 × 10(4), 2.9 × 10(4) and 3.5 × 10(4) g/mol respectively and all of them were characterized as lignin-carbohydrate complexes mainly comprised lignin as well as -25% carbohydrates. Antioxidant assays indicated that all of them exhibited pronounced reductive power and strong scavenging activities on DPPH and hydroxyl radicals in vitro. Immunological tests showed that they could also significantly stimulate nitric oxide production and phagocytic activity in RAW 264.7 macrophages. These results implied that the lignin-carbohydrate complexes extracted from I. obliquus might be used as novel natural antioxidants or immunostimulants in functional foods or pharmaceutical candidates.

Separation and purification of sulforaphene from radish seeds using macroporous resin and preparative high-performance liquid chromatography.

This present study described a rapid and cost-effective method for the separation and purification of natural sulforaphene from radish seeds by SP-700 macroporous resin and preparative high-performance liquid chromatography (HPLC). Sulforaphene with high purity and recovery was obtained by preparative HPLC with a C18 column and 30% methanol in ultra-pure water as the mobile phase. 12.5 kg of radish seeds, which contained 87.5 g of sulforaphene, produced 117.5 g of sulforaphene-rich extract of 65.8% sulforaphene after primary separation by SP-700 macroporous resin. 5.9 g of 96.5% sulforaphene was obtained from 9.5 g of the sulforaphene-rich extract after purification by preparative HPLC. The purified compound was assessed by analytical HPLC and characterised by ESI/MS, (1)H NMR and (13)C NMR. Standard curve was developed using the purified sulforaphene to allow quantification of sulforaphene in the extracts of radish seeds by analytical HPLC.