RESUMEN
The development of advanced neural modulation techniques is crucial to neuroscience research and neuroengineering applications. Recently, optical-based, nongenetic modulation approaches have been actively investigated to remotely interrogate the nervous system with high precision. Here, we show that a thin-film, silicon (Si)-based diode device is capable to bidirectionally regulate in vitro and in vivo neural activities upon adjusted illumination. When exposed to high-power and short-pulsed light, the Si diode generates photothermal effects, evoking neuron depolarization and enhancing intracellular calcium dynamics. Conversely, low-power and long-pulsed light on the Si diode hyperpolarizes neurons and reduces calcium activities. Furthermore, the Si diode film mounted on the brain of living mice can activate or suppress cortical activities under varied irradiation conditions. The presented material and device strategies reveal an innovated optoelectronic interface for precise neural modulations.
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Neuronas , Optogenética , Silicio , Animales , Silicio/química , Neuronas/fisiología , Ratones , Optogenética/métodos , Calcio/metabolismo , Luz , Encéfalo/fisiologíaRESUMEN
BACKGROUND: Many urothelial bladder carcinoma (UBC) patients don't respond to immune checkpoint blockade (ICB) therapy, possibly due to tumor-associated neutrophils (TANs) suppressing lymphocyte immune response. METHODS: We conducted a meta-analysis on the predictive value of neutrophil-lymphocyte ratio (NLR) in ICB response and investigated TANs' role in UBC. We used RNA-sequencing, HALO spatial analysis, single-cell RNA-sequencing, and flow cytometry to study the impacts of TANs and prostaglandin E2 (PGE2) on IDO1 expression. Animal experiments evaluated celecoxib's efficacy in targeting PGE2 synthesis. RESULTS: Our analysis showed that higher TAN infiltration predicted worse outcomes in UBC patients receiving ICB therapy. Our research revealed that TANs promote IDO1 expression in cancer cells, resulting in immunosuppression. We also found that PGE2 synthesized by COX-2 in neutrophils played a key role in upregulating IDO1 in cancer cells. Animal experiments showed that targeting PGE2 synthesis in neutrophils with celecoxib enhanced the efficacy of ICB treatment. CONCLUSIONS: TAN-secreted PGE2 upregulates IDO1, dampening T cell function in UBC. Celecoxib targeting of PGE2 synthesis represents a promising approach to enhance ICB efficacy in UBC.
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Carcinoma de Células Transicionales , Neoplasias de la Vejiga Urinaria , Animales , Humanos , Dinoprostona , Celecoxib/farmacología , Neutrófilos/patología , Ciclooxigenasa 2/metabolismo , Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Neoplasias de la Vejiga Urinaria/genética , Neoplasias de la Vejiga Urinaria/metabolismo , Carcinoma de Células Transicionales/tratamiento farmacológico , Carcinoma de Células Transicionales/metabolismo , Linfocitos T CD8-positivos/patología , ARN/metabolismoRESUMEN
Our previous study showed that pyridoxine 5'-phosphate oxidase (PNPO) is a tissue biomarker of ovarian cancer (OC) and has a prognostic implication but detailed mechanisms remain unclear. The current study focused on PNPO-regulated lysosome/autophagy-mediated cellular processes and the potential role of PNPO in chemoresistance. We found that PNPO was overexpressed in OC cells and was a prognostic factor in OC patients. PNPO significantly promoted cell proliferation via the regulation of cyclin B1 and phosphorylated CDK1 and shortened the G2M phase in a cell cycle. Overexpressed PNPO enhanced the biogenesis and perinuclear distribution of lysosomes, promoting the degradation of autophagosomes and boosting the autophagic flux. Further, an autolysosome marker LAMP2 was upregulated in OC cells. Silencing LAMP2 suppressed cell growth and induced cell apoptosis. LAMP2-siRNA blocked PNPO action in OC cells, indicating that the function of PNPO on cellular processes was mediated by LAMP2. These data suggest the existence of the PNPO-LAMP2 axis. Moreover, silencing PNPO suppressed xenographic tumor formation. Chloroquine counteracted the promotion effect of PNPO on autophagic flux and inhibited OC cell survival, facilitating the inhibitory effect of PNPO-shRNA on tumor growth in vivo. Finally, PNPO was overexpressed in paclitaxel-resistant OC cells. PNPO-siRNA enhanced paclitaxel sensitivity in vitro and in vivo. In conclusion, PNPO has a regulatory effect on lysosomal biogenesis that in turn promotes autophagic flux, leading to OC cell proliferation, and tumor formation, and is a paclitaxel-resistant factor. These data imply a potential application by targeting PNPO to suppress tumor growth and reverse PTX resistance in OC.
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Derived from camelid heavy-chain antibodies, nanobodies (Nbs) are the smallest natural antibodies and are an ideal tool in biological studies because of their simple structure, high yield, and low cost. Nbs possess significant potential for developing highly specific and user-friendly diagnostic assays. Despite offering considerable advantages in detection applications, knowledge is limited regarding the exclusive use of Nbs in lateral flow immunoassay (LFIA) detection. Herein, we present a novel double "Y" architecture, achieved by using the SpyTag/SpyCatcher and Im7/CL7 systems. The double "Y" assemblies exhibited a significantly higher affinity for their epitopes, as particularly evident in the reduced dissociation rate. An LFIA employing double "Y" assemblies was effectively used to detect the severe acute respiratory syndrome coronavirus-2 N protein, with a detection limit of at least 500 pg/mL. This study helps broaden the array of tools available for the development of Nb-based diagnostic techniques.
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SARS-CoV-2 , Anticuerpos de Dominio Único , Anticuerpos de Dominio Único/química , Anticuerpos de Dominio Único/inmunología , Inmunoensayo/métodos , SARS-CoV-2/inmunología , SARS-CoV-2/aislamiento & purificación , Límite de Detección , Humanos , COVID-19/diagnóstico , COVID-19/virología , COVID-19/inmunología , Proteínas de la Nucleocápside de Coronavirus/inmunología , Proteínas de la Nucleocápside de Coronavirus/análisisRESUMEN
MAIN CONCLUSION: The three, by mutagenesis produced genes OsPi21, OsXa5, and OsBADH2, generated novel lines exhibiting desired fragrance and improved resistance. Elite sterile lines are the basis for hybrid rice breeding, and rice quality and disease resistance become the focus of new sterile lines breeding. Since there are few sterile lines with fragrance and high resistance to blast and bacterial blight at the same time in hybrid rice production, we here integrated the simultaneous mutagenesis of three genes, OsPi21, OsXa5, and OsBADH2, into Zhi 5012S, an elite thermo-sensitive genic male sterile (TGMS) variety, using the CRISPR/Cas9 system, thus eventually generated novel sterile lines would exhibit desired popcorn-like fragrance and improved resistance to blast and bacterial blight but without a loss in major agricultural traits such as yield. Collectively, this study develops valuable germplasm resources for the development of two-line hybrid rice with disease resistance, which provides a way to rapid generation of novel TGMS lines with elite traits.
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Sistemas CRISPR-Cas , Oryza , Oryza/genética , Resistencia a la Enfermedad/genética , Odorantes , Temperatura , FitomejoramientoRESUMEN
OBJECTIVE: This study aimed to reveal the urinary and serum metabolic pattern of endometrial cancer (EC) and establish diagnostic models to identify EC from controls, high-risk from low-risk EC, and type II from type I EC. METHOD: This study included 146 EC patients (comprising 79 low-risk and 67 high-risk patients, including 124 type I and 22 type II) and 59 controls. The serum and urine samples were analyzed using ultraperformance liquid chromatography mass spectrometry. Analysis was used to elucidate the distinct metabolites and altered metabolic pathways. Receiver operating characteristic (ROC) analyses were employed to discover and validate the potential biomarker models. RESULTS: Serum and urine metabolomes displayed significant differences between EC and controls, with metabolites related to amino acid and nicotinamide metabolisms. The serum and urine panels distinguished these two groups with Area Under the Curve (AUC) of 0.821 and 0.902, respectively. The panel consisting of serum and urine metabolites demonstrated the best predictive ability (AUC = 0.953 and 0.976 in discovering and validation group). In comparing high-risk and low risk EC, differential metabolites were enriched in purine and glutamine metabolism. The AUC values for serum and urine panels were 0.818, and 0.843, respectively. The combined panel exhibited better predictive accuracy (0.881 in discovering group and 0.936 in external validation). In the comparison between type I and type II group, altered folic acid metabolism was identified. The serum, urine and combined panels discriminated these two groups with the AUC of 0.829, 0.913 and 0.922, respectively. CONCLUSION: The combined urine and serum metabolome effectively revealed the metabolic patterns in EC patients, offering valuable diagnostic models for EC diagnosis and classification.
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Neoplasias Endometriales , Metabolómica , Femenino , Humanos , Metabolómica/métodos , Cromatografía Líquida con Espectrometría de Masas , Metaboloma , Neoplasias Endometriales/diagnóstico , Biomarcadores/orinaRESUMEN
Paclitaxel (PTX) is one of the first-line drugs for prostate cancer (PC) treatment. However, the poor water solubility, inadequate specific targeting ability, multidrug resistance, and severe neurotoxicity are far from being fully resolved, despite diverse PTX formulations in the market, such as the gold-standard PTX albumin nanoparticle (Abraxane) and polymer micelles (Genexol-PM). Some studies attempting to solve the multiple problems of chemotherapy delivery fall into the trap of an extremely complicated formulation design and sacrifice druggability. To better address these issues, this study designed an efficient, toxicity-reduced paclitaxel-ginsenoside polymeric micelle (RPM). With the aid of the inherent amphiphilic molecular structure and pharmacological effects of ginsenoside Rg5, the prepared RPM enhances the water solubility and active targeting of PTX, inhibiting chemotherapy resistance in cancer cells. Moreover, the polymeric micelles demonstrated favorable anti-inflammatory and neuroprotective effects, providing ideas for the development of new clinical anti-PC preparations.
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Resistencia a Antineoplásicos , Ginsenósidos , Micelas , Paclitaxel , Ginsenósidos/química , Ginsenósidos/farmacología , Paclitaxel/farmacología , Paclitaxel/química , Humanos , Resistencia a Antineoplásicos/efectos de los fármacos , Animales , Masculino , Ratones , Línea Celular Tumoral , Neoplasias de la Próstata/tratamiento farmacológico , Portadores de Fármacos/química , Solubilidad , Antineoplásicos Fitogénicos/farmacología , Antineoplásicos Fitogénicos/química , Sistemas de Liberación de Medicamentos/métodos , Polímeros/químicaRESUMEN
BACKGROUND: Laparoscopy-assisted gastrectomy (LG) is rapidly gaining popularity owing to its minimal invasiveness. Previous studies have found that compared with two-dimensional (2D)-LG, three-dimensional (3D)-LG showed better short-term outcomes. However, the long-term oncological outcomes in patients with locally resectable gastric cancer (GC) remain controversial. METHODS: In this noninferiority, open-label, randomized clinical trial, a total of 438 eligible GC participants were randomly assigned in a 1:1 ratio to either 3D-LG or 2D-LG from January 2015 to April 2016. The primary endpoint was operating time, while the secondary endpoints included 5-year overall survival (OS), disease-free survival (DFS), and recurrence pattern. RESULTS: Data from 401 participants were included in the per-protocol analysis, with 204 patients in the 3D group and 197 patients in the 2D group. The 5-year OS and DFS rates were comparable between the 3D and 2D groups (5-year OS: 70.6% vs. 71.1%, Log-rank P = 0.743; 5-year DFS: 68.1% vs. 69.0%, log-rank P = 0.712). No significant differences were observed between the 3D and 2D groups in the 5-year recurrence rate (28.9% vs. 28.9%, P = 0.958) or recurrence time (mean time, 22.6 vs. 20.5 months, P = 0.412). Further stratified analysis based on the type of gastrectomy, postoperative pathological staging, and preoperative BMI showed that the 5-year OS, DFS, and recurrence rates of the 3D group in each subgroup were similar to those of the 2D group (all P > 0.05). CONCLUSIONS: For patients with locally resectable GC, 3D-LG performed by experienced surgeons in high-volume professional institutions can achieve long-term oncological outcomes comparable to those of 2D-LG. REGISTRATION NUMBER: NCT02327481 ( http://clinicaltrials.gov ).
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Laparoscopía , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/patología , Supervivencia sin Enfermedad , Supervivencia sin Progresión , Gastrectomía/métodos , Laparoscopía/métodos , Resultado del Tratamiento , Estudios RetrospectivosRESUMEN
Due to the molecular complexity of dissolving organic matter (DOM), the vertical molecular distribution of riparian soil DOM (especially dissolved organic nitrogen (DON) and dissolved organic phosphorus (DOP)) in different land use types and their relationship with the bacterial community is still unclear. This study analyzed the spectral characteristics of riparian soil DOM from 0 to 100 cm in wild grassland, agricultural land, and bare land. The molecular distribution of DOM was revealed through Fourier-transform ion cyclotron resonance mass spectrometry (FT-ICR MS) and the specific relationship between DOM and bacterial community composition (BCC) was evaluated. The results showed that the DOM in the upper soil layer (0-40 cm) was mainly composed of recalcitrant macromolecular organics, while that in the lower layer (40-100 cm) was labile small molecular organics. In agricultural land, the total storage of DOM was lower than that in wild grassland, but with a higher abundance of recalcitrant organic carbon (lignin, etc.). At the same time, the bacterial community in agricultural land is shifting towards copiotrophs. In addition, the abundance of labile C degrading genes increases with nitrate as the main electron acceptor. However, sulfates are mainly used as electron acceptors in wild grasslands. Both DOP and DON were dominated by lignin and displayed higher chemical diversity in the upper soil. The bioavailability of DOP in three types of soil is higher than that of DON. DOM-BCC network analysis shows that the recalcitrant DON and DOP molecules in soil are positively correlated with phylum Actinobacteriota in agricultural land. These results emphasize that the DOM molecular characteristics were closely related to the function of the soil bacterial community.
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Materia Orgánica Disuelta , Suelo , Suelo/química , Lignina , Nitrógeno/análisis , Agricultura , Bacterias/genéticaRESUMEN
BACKGROUND: Textbook outcome (TO) has been widely employed as a comprehensive indicator to assess the short-term prognosis of patients with cancer. Preoperative malnutrition is a potential risk factor for adverse surgical outcomes in patients with gastric cancer (GC). This study aimed to compare the TO between robotic-assisted gastrectomy (RAG) and laparoscopic-assisted gastrectomy (LAG) in malnourished patients with GC. METHODS: According to the diagnostic consensus of malnutrition proposed by Global Leadership Initiative on Malnutrition (GLIM) and Nutrition Risk Index (NRI), 895 malnourished patients with GC who underwent RAG (n = 115) or LAG (n = 780) at a tertiary referral hospital between January 2016 and May 2021 were included in the propensity score matching (PSM, 1:2) analysis. RESULTS: After PSM, no significant differences in clinicopathological characteristics were observed between the RAG (n = 97) and LAG (n = 194) groups. The RAG group had significantly higher operative time and lymph nodes harvested, as well as significantly lower blood loss and hospital stay time compared to the LAG group. More patients in the RAG achieved TO. Logistic regression analysis revealed that RAG was an independent protective factor for achieving TO. There were more adjuvant chemotherapy (AC) cycles in the RAG group than in the LAG group. After one year of surgery, a higher percentage of patients (36.7% vs. 22.8%; P < 0.05) in the RAG group recovered from malnutrition compared to the LAG group. CONCLUSIONS: For malnourished patients with GC, RAG performed by experienced surgeons can achieved a higher rate of TO than those of LAG, which directly contributed to better AC compliance and a faster restoration of nutritional status.
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Gastrectomía , Laparoscopía , Desnutrición , Procedimientos Quirúrgicos Robotizados , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/cirugía , Neoplasias Gástricas/complicaciones , Gastrectomía/métodos , Masculino , Femenino , Laparoscopía/métodos , Desnutrición/etiología , Procedimientos Quirúrgicos Robotizados/métodos , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Resultado del Tratamiento , Tiempo de Internación/estadística & datos numéricos , Tempo Operativo , Puntaje de PropensiónRESUMEN
To determine the optimal temperature range for the development and reproduction of three spider mites (Eotetranychus sexmaculatus, Eotetranychus orientalis, and Oligonychus biharensis), this study investigated their developmental period, survival rate, lifespan, and reproduction under five temperatures, 21, 24, 27, 30, and 33°C, to predict and control in the field. With the gathered data, a two-sex life table was constructed for each of them. The results revealed that as the temperature increased, both O. biharensis and E. orientalis displayed a gradual reduction in their generation period. Furthermore, an inverse relationship was observed between lifespan and temperature for all three spider mite species. When examining the survival rates at varying temperatures, E. sexmaculatus exhibited the highest rate (98%) at 33°C, while E. orientalis and O. biharensis demonstrated their highest survival rates at 24°C, reaching 90% and 100% respectively. Regarding reproduction, O. biharensis displayed the highest oviposition rates at 30°C with an average of 17.45 eggs per individual. Conversely, E. sexmaculatus and E. orientalis exhibited the highest oviposition rates at 33°C, averaging at 15.22 and 21.38 eggs per individual respectively. Significantly higher intrinsic growth rates were observed for O. biharensis and E. orientalis at 33°C, with rates of 0.22 and 0.26 respectively. In contrast, E. sexmaculatus demonstrated the highest intrinsic growth rate at 27°C. The temperature of 27°C was more suitable for the growth of the E. sexmaculatus, while 33°C was the optimal temperature for the E. orientalis and O. biharensis. The current findings provide valuable guidance for the control and prevention of these three spider mites.
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Tablas de Vida , Temperatura , Tetranychidae , Animales , Tetranychidae/fisiología , Tetranychidae/crecimiento & desarrollo , Femenino , Masculino , Reproducción , Longevidad , Oviposición , Hevea/crecimiento & desarrolloRESUMEN
Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) is a type of polyhydroxyalkanoates (PHA) that exhibits numerous outstanding properties and is naturally synthesized and elaborately regulated in various microorganisms. However, the regulatory mechanism involving the specific regulator PhaR in Haloferax mediterranei, a major PHBV production model among Haloarchaea, is not well understood. In our previous study, we showed that deletion of the phosphoenolpyruvate (PEP) synthetase-like (pps-like) gene activates the cryptic phaC genes in H. mediterranei, resulting in enhanced PHBV accumulation. In this study, we demonstrated the specific function of the PPS-like protein as a negative regulator of phaR gene expression and PHBV synthesis. Chromatin immunoprecipitation (ChIP), in situ fluorescence reporting system, and in vitro electrophoretic mobility shift assay (EMSA) showed that the PPS-like protein can bind to the promoter region of phaRP. Computational modeling revealed a high structural similarity between the rifampin phosphotransferase (RPH) protein and the PPS-like protein, which has a conserved ATP-binding domain, a His domain, and a predicted DNA-binding domain. Key residues within this unique DNA-binding domain were subsequently validated through point mutation and functional evaluations. Based on these findings, we concluded that PPS-like protein, which we now renamed as PspR, has evolved into a repressor capable of regulating the key regulator PhaR, and thereby modulating PHBV synthesis. This regulatory network (PspR-PhaR) for PHA biosynthesis is likely widespread among haloarchaea, providing a novel approach to manipulate haloarchaea as a production platform for high-yielding PHA. KEY POINTS: ⢠The repressive mechanism of a novel inhibitor PspR in the PHBV biosynthesis was demonstrated ⢠PspR is widespread among the PHA accumulating haloarchaea ⢠It is the first report of functional conversion from an enzyme to a trans-acting regulator in haloarchaea.
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Polihidroxialcanoatos , Polihidroxialcanoatos/metabolismo , Hidroxibutiratos , ADN , Poliésteres/metabolismoRESUMEN
BACKGROUND: The objective of the current study was to investigate the correlation between trajectories of maternal perinatal depression (PND) spanning from early pregnancy to one year postpartum and developmental delays observed in one-year-old children. METHODS: The dataset under examination encompassed 880 women who took part in a mother-child birth study conducted in China. Latent class growth analysis (LCGA) was employed to identify patterns in Edinburgh Postnatal Depression Scale (EPDS) scores of women, spanning from early pregnancy to one year postpartum. To assess the neurodevelopment of one-year-old children, a Chinese version of the Bayley Scale of Infant Development (BSID-CR) was employed. Logistic regression was employed to explore the association between PND trajectories and developmental delays in children, with appropriate covariate adjustments. RESULTS: The trajectories of maternal PND identified in this study included a minimal-stable symptom group (n = 155), low-stable symptom group (n = 411), mild-stable symptom group (n = 251), and moderate-stable symptom group (n = 63). Logistic regression analysis revealed that mothers falling into the moderate-stable symptom group exhibited a notably heightened risk of having a child with psychomotor developmental delays at the age of one year. CONCLUSIONS: The findings drawn from a representative sample in China provide compelling empirical evidence that bolsters the association between maternal PND and the probability of psychomotor developmental delays in children. It is imperative to develop tailored intervention strategies and meticulously design mother-infant interactive intervention programs for women with PND.
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Desarrollo Infantil , Depresión , Femenino , Humanos , Lactante , Embarazo , Pueblo Asiatico , China/epidemiología , Depresión/epidemiología , Relaciones Madre-HijoRESUMEN
Irisin, a myokine identified in 2012, has garnered research interest for its capacity to induce browning of adipocytes and improve metabolic parameters. As such, the potential therapeutic applications of this exercise-induced peptide continue to be explored. Though present across diverse animal species, sequence analysis has revealed subtle variation in the irisin protein. In this review, we consider the effects of irisin on disease states in light of its molecular evolution. We summarize current evidence for irisin's influence on pathologies and discuss how sequence changes may inform development of irisin-based therapies. Furthermore, we propose that the phylogenetic variations in irisin could potentially be leveraged as a molecular clock to elucidate evolutionary relationships.
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Adipocitos , Fibronectinas , Animales , Fibronectinas/genética , Filogenia , Adipocitos/metabolismo , Evolución MolecularRESUMEN
OBJECTIVE: This study aimed to evaluate the oncological and reproductive outcomes of fertility-preserving re-treatment in progestin-resistant endometrial carcinoma (EC) and atypical endometrial hyperplasia (AEH) women who desire to maintain their fertility. METHODS: Our study included 61 progestin-resistant EC/AEH patients. These patients underwent treatment with gonadotropin-releasing hormone agonist (GnRHa) solely or a combination of GnRHa with levonorgestrel-releasing intrauterine system (LNG-IUD) or aromatase inhibitor (AI). Histological evaluations were performed every 3-4 months. Upon achieving complete remission (CR), we recommended maintenance treatments including LNG-IUD, cyclical oral contraceptives, or low-dose cyclic progestin until they began attempting conception. Regular follow-up was conducted for all patients. The chi-square method was utilized to compare oncological and fertility outcomes, while the Cox proportional hazards regression analysis helped identify risk factors for CR, recurrence, and pregnancy. RESULTS: Overall, 55 (90.2%) patients achieved CR, including 90.9% of AEH patients and 89.7% of EC patients. The median re-treatment time was 6 months (ranging from 3 to 12 months). The CR rate for GnRHa alone, GnRHa + LNG-IUD and GnRHa + AI were 80.0%, 91.7% and 93.3%, respectively. After a median follow-up period of 36 months (ranging from 3 to 96 months), 19 women (34.5%) experienced recurrence, 40.0% in AEH and 31.4% in EC patients, with the median recurrence time of 23 months (ranging from 6 to 77 months). Among the patients who achieved CR, 39 expressed a desire to conceive, 20 (51.3%) became pregnant, 11 (28.2%) had successfully deliveries, 1 (5.1%) was still pregnant, while 8 (20.5%) suffered miscarriages. CONCLUSION: GnRHa-based fertility-sparing treatment exhibited promising oncological and reproductive outcomes for progestin-resistant patients. Future larger multi-institutional studies are necessary to confirm these findings.
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Resistencia a Antineoplásicos , Hiperplasia Endometrial , Neoplasias Endometriales , Preservación de la Fertilidad , Progestinas , Humanos , Femenino , Neoplasias Endometriales/tratamiento farmacológico , Neoplasias Endometriales/patología , Adulto , Estudios Retrospectivos , Preservación de la Fertilidad/métodos , Hiperplasia Endometrial/tratamiento farmacológico , Hiperplasia Endometrial/patología , Progestinas/administración & dosificación , Progestinas/uso terapéutico , Estudios de Seguimiento , Embarazo , Resistencia a Antineoplásicos/efectos de los fármacos , Hormona Liberadora de Gonadotropina/agonistas , Levonorgestrel/administración & dosificación , Persona de Mediana Edad , Pronóstico , Dispositivos Intrauterinos Medicados , Recurrencia Local de Neoplasia/tratamiento farmacológico , Recurrencia Local de Neoplasia/patología , Índice de Embarazo , Inhibidores de la Aromatasa/uso terapéutico , Inhibidores de la Aromatasa/administración & dosificación , Antineoplásicos Hormonales/uso terapéutico , Antineoplásicos Hormonales/administración & dosificaciónRESUMEN
BACKGROUND: The descending genicular artery (DGA) and medial thigh region have been underused as donor sites for perforator flaps. This study evaluated the anatomical relationship between the perforators of the DGA and the saphenous vein (SV) to review the clinical applications of the free descending genicular artery perforator (DGAP) flap for locoregional reconstruction. METHODS: Fifteen cadavers were arterially perfused with red latex and dissected. Thirty-one patients with extremity tissue defects were treated with a free DGAP flap, including six patients who received a chimeric flap. The minimum distance between the DGAP and the SV was measured during surgery. RESULTS: In all patients, the skin branch of the descending genicular artery was found in the medial femoral condyle plane in front of the SV. The average distance between the descending genicular artery perforator and the SV was 3.71 ± 0.38 cm (range: 2.9-4.3 cm). Thirty flaps survived completely, and one flap developed partial necrosis; however, this flap healed two weeks after skin grafting. The average follow-up time was 11.23 months. CONCLUSIONS: We conclude that the SV can be preserved when harvesting the descending genicular artery perforator flap, causing less damage to the donor site and having no effect on flap survival. The free descending genicular artery perforator flap without the SV is a better therapy for complicated tissue defects.
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Cadáver , Colgajo Perforante , Procedimientos de Cirugía Plástica , Vena Safena , Humanos , Colgajo Perforante/irrigación sanguínea , Masculino , Femenino , Vena Safena/trasplante , Persona de Mediana Edad , Anciano , Adulto , Procedimientos de Cirugía Plástica/métodosRESUMEN
BACKGROUND: Brachial plexus injury is recognized as one of the most severe clinical challenges due to the complex anatomical configuration of the brachial plexus and its propensity for variation, which complicates safe clinical interventions. This study aimed to ascertain the prevalence and characterize the types of brachial plexus variations, and to elucidate their clinical implications. MATERIALS AND METHODS: We conducted meticulous dissections of 60 formalin-fixed cadavers' upper arm, axilla and lower neck to reveal and assess the roots, trunks, divisions, cords, and branches of the brachial plexus. The pattern of branching was noted by groups of dissecting medical students and confirmed by the senior anatomists. The variations discovered were record and photographed using a digital camera for further analysis. RESULTS: Variations in the brachial plexus were identified in 40 of the 60 cadavers, yielding a prevalence rate of 66.7%. These variations were classified into root anomalies (2.1%), trunk anomalies (8.5%), division anomalies (2.1%), and cord anomalies (4.3%). Notably, anomalies in communicating branches were observed in 39 cadavers (83.0%): 14 with bilateral anomalies, 14 with anomalies on the left side, and 11 on the right side. These communicating branches formed connections between the roots and other segments, including trunks, cords, and terminal nerves, and involved the median, musculocutaneous, and ulnar nerves. CONCLUSION: The frequency and diversity of brachial plexus variations, particularly in communicating branches, are significant in cadavers. It is imperative that these variations are carefully considered during the diagnostic process, treatment planning, and prior to procedures such as supraclavicular brachial plexus blocks and nerve transfers, to mitigate the risk of iatrogenic complications.
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Variación Anatómica , Plexo Braquial , Cadáver , Humanos , Plexo Braquial/anatomía & histología , Plexo Braquial/anomalías , Femenino , Masculino , Adulto , Disección , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Relevancia ClínicaRESUMEN
Atmospheric microplastics are important contributors to environmental contamination in aquatic and terrestrial systems and pose potential ecological risks. However, studies on atmospheric microplastics are still limited in urban regions of the Tibetan Plateau, a sentinel region for climate and environmental change under a warming climate. In this study, the occurrence and potential ecological risk of atmospheric microplastics were investigated in samples of suspended atmospheric microplastics collected in Lhasa city during the Tibetan New Year in February 2023. The results show that the average abundance of atmospheric microplastics in Lhasa was 7.15 ± 2.46 MPs m-3. The sizes of the detected microplastics ranged from 20.34 to 297.18 µm, approximately 87% of which were smaller than 100 µm. Fragmented microplastics (95.76%) were the dominant shape, followed by fibres (3.75%) and pellets (0.49%). The primary polymer chemical components identified were polyamide (68.73%) and polystyrene (16.61%). The analysis of meteorological data and the backwards trajectory model indicated the air mass in Lhasa mainly controlled by westwards, and the atmospheric microplastics mainly originated from long-distance atmospheric transport. The potential ecological risk index assessment revealed that the atmospheric microplastic pollution in Lhasa was relatively low. This study provides valuable insights and a scientific foundation for future research on the prevention and control of atmospheric microplastic pollution in Lhasa and other ecologically sensitive cities.
Asunto(s)
Contaminantes Atmosféricos , Ciudades , Monitoreo del Ambiente , Microplásticos , Microplásticos/análisis , Contaminantes Atmosféricos/análisis , Medición de Riesgo , Tibet , Atmósfera/química , Tamaño de la PartículaRESUMEN
This review identified clinical practice guidelines (CPGs) and consensus statements (CSs) that include recommendations on long-term care for community-dwelling older adults. Additionally, it assessed their quality using the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool to determine high-quality guidelines and synthesis recommendations from high-quality guidelines and evaluate the quality of these guidelines using the AGREE-Recommendation Excellence (AGREE-REX) tool. A systematic search was performed (November 2023) in MEDLINE, PubMed, Guidelines International Network (GIN), National Institute for Health and Care Excellence (NICE), New Zealand Guidelines Group (NZGG), Registered Nurses' Association of Ontario (RNAO), National Guideline Clearinghouse (NGC), and Scottish Intercollegiate Guidelines Network (SIGN). Two reviewers independently selected and assessed the articles using AGREE II. A meeting was held to appraise the quality of the guidelines (AGREE II mean score >70 %) using AGREE-REX. The analysis included 14 CPGs and 2 CSs. Of these, 7 CPGs reached the standard of >70 %, the 'Scope and purpose' domain obtained the highest score with 85.43 (± 17.87), and the 'Applicability' domain scored lowest with 46.93 (± 26.74). Regarding the score of AGREE-REX, the seven CPGs were considered as 'moderate', with the 'Clinical Applicability' domain having the highest score of 61.29 % (±10.80) and the 'Values and Preferences' domain having the lowest score of 38.14 % (±9.26). Four themes were synthesised from the seven high-quality CPGs: planning and delivering person-centred home care, cognitive impairment, and screening for impaired vision and falls. The quality of CPGs and CSs on long-term care for community-dwelling older adults has room for improvement, and higher-quality guidelines are required to meet the long-term care needs of community-dwelling older adults.
Asunto(s)
Consenso , Vida Independiente , Cuidados a Largo Plazo , Guías de Práctica Clínica como Asunto , Humanos , AncianoRESUMEN
The Tibetan Plateau, known as the "Third Pole", is currently in a state of perturbation caused by intensified human activity. In this study, 56 samples were obtained at the five sampling sites in typical area of Lhasa city and their physical and chemical properties were investigated by TEM/EDS, STXM, and NEXAFS spectroscopy. After careful examination of 3387 single particles, the results showed that Fe should be one of the most frequent metal elements. The Fe-containing single particles in irregular shape and micrometer size was about 7.8% and might be mainly from local sources. Meanwhile, the Fe was located on the subsurface of single particles and might be existed in the form of iron oxide. Interestingly, the core-shell structure of iron-containing particles were about 38.8% and might be present as single-, dual- or triple-core shell structure and multi-core shell structure with the Fe/Si ratios of 17.5, 10.5, 2.9 and 1.2, respectively. Meanwhile, iron and manganese were found to coexist with identical distributions in the single particles, which might induce a synergistic effect between iron and manganese in catalytic oxidation. Finally, the solid spherical structure of Fe-containing particles without an external layer were about 53.4%. The elements of Fe and Mn were co-existed, and might be presented as iron oxide-manganese oxide-silica composite. Moreover, the ferrous and ferric forms of iron might be co-existed. Such information can be valuable in expanding our understanding of Fe-containing particles in the Tibetan Plateau atmosphere.