A novel score for predicting falls in community-dwelling older people: a derivation and validation study.

BACKGROUND: Early detection of patients at risk of falling is crucial. This study was designed to develop and internally validate a novel risk score to classify patients at risk of falls. METHODS: A total of 334 older people from a fall clinic in a medical center were selected. Least absolute shrinkage and selection operator (LASSO) regression was used to minimize the potential concatenation of variables measured from the same patient and the overfitting of variables. A logistic regression model for 1-year fall prediction was developed for the entire dataset using newly identified relevant variables. Model performance was evaluated using the bootstrap method, which included measures of overall predictive performance, discrimination, and calibration. To streamline the assessment process, a scoring system for predicting 1-year fall risk was created. RESULTS: We developed a new model for predicting 1-year falls, which included the FRQ-Q1, FRQ-Q3, and single-leg standing time (left foot). After internal validation, the model showed good discrimination (C statistic, 0.803 [95% CI 0.749-0.857]) and overall accuracy (Brier score, 0.146). Compared to another model that used the total FRQ score instead, the new model showed better continuous net reclassification improvement (NRI) [0.468 (0.314-0.622), P < 0.01], categorical NRI [0.507 (0.291-0.724), P < 0.01; cutoff: 0.200-0.800], and integrated discrimination [0.205 (0.147-0.262), P < 0.01]. The variables in the new model were subsequently incorporated into a risk score. The discriminatory ability of the scoring system was similar (C statistic, 0.809; 95% CI, 0.756-0.861; optimism-corrected C statistic, 0.808) to that of the logistic regression model at internal bootstrap validation. CONCLUSIONS: This study resulted in the development and internal verification of a scoring system to classify 334 patients at risk for falls. The newly developed score demonstrated greater accuracy in predicting falls in elderly people than did the Timed Up and Go test and the 30-Second Chair Sit-Stand test. Additionally, the scale demonstrated superior clinical validity for identifying fall risk.

Phosphodiesterase 4 Inhibitor Roflupram Suppresses Inflammatory Responses Using Reducing Inflammasome in Microglia After Spinal Cord Injury.

Context: Neuroinflammation after spinal cord injury (SCI) can lead to long-term damage in neural tissue, which can cause the destruction and dysfunction of the neurological system. Roflupram (ROF), a selective phosphodiesterase 4 inhibitor, may play a protective role against neuropathological diseases, but the specific role of ROF in SCI treatment is unknown. Objective: The study intended to investigate the anti-inflammatory mechanism and therapeutic effects of ROF to determine if it can attenuate lipopolysaccharide (LPS)-induced microglia that induces neuroinflammation and decrease neural-tissue damage following an SCI. Design: The research team performed an animal study. Setting: The study took place at the Fourth Affiliated Hospital of Harbin Medical University in Harbin, China. Animals: The animals were female C57BL/6 mice, aged 8 weeks and weighing approximately 20 g. Intervention: For the in-vitro study, the research team divided BV2 microglial cells into three groups: (1) the control group, which received no LPS stimuli and no ROF treatment, (2) the LPS group, which received LPS stimuli but no ROF treatment, and (3) LPS+ROF group, which received both LPS stimuli and ROF treatment. For the in-vivo study, the research team randomly divided the mice into three groups: (1) the sham group, for which the team didn't induce SCI and which received no ROF treatment (2) the SCI group, for which the team induced SCI but which received no ROF treatment, and (3) the SCI+ROF group, for which the team induced SCI and which received the ROF treatment. Outcome Measures: The research team evaluated: (1) the cell viability of the BV2 microglia cells after five doses of ROF and the RNA levels of inflammatory-activation-related factors, the inflammatory pathway; (2) in-vitro inhibition of inflammation in LPS-activated microglia; (3) the anti-neuroinflammatory role of ROF after SCI induction in vitro; and (4) the role of ROF in neural-structure protection and locomotor-function recovery in vitro. Results: In the in-vitro study, the ROF attenuated microglial inflammation through the inhibition of the NLRP3 inflammasome in vitro, reduced neuroinflammation, and protected against neuronal loss. In the in-vivo study with mice, the ROF: (1) improved the functional recovery of locomotor skills after induction of SCI; (2) acted in an anti-inflammatory role in SCI, restraining microglial inflammation by inhibition of the "nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3" (NLRP3) inflammasome and reduction of caspase-1-dependent, interleukin-1 beta (IL)-1ß; and (3) reduced neuronal death and protected against tissue loss, improving functional recovery after an SCI. Conclusions: The current study demonstrated that ROF can reduce the levels of inflammation in the tissue after spinal cord injury by modulating the AMPK/NLRP3 signaling pathway, thereby promoting the recovery of motor function in mice. ROF is a promising drug for prevention of neural-tissue damage following neural injury.

Zileuton Ameliorates Neuronal Ferroptosis and Functional Recovery After Spinal Cord Injury.

Context: Ferroptosis is a novel type of cell-death pattern characterized by iron-dependent, oxidative stress, and lipid peroxidation. Neurological pathology, especially in spinal cord injury (SCI), may involve a trace amount of ferroptosis. However, it's uncertain whether zileuton (ZIL), a selective 5-lipoxygenase (5-LO) inhibitor, can inhibit ferroptosis in SCI. Objective: The study intended to investigate the etiology of neuronal ferroptosis and the ameliorative effects of ZIL against it for SCI mice. Design: The research team performed an animal study. Setting: The study took place at the Fourth Affiliated Hospital of Harbin Medical University in Harbin, China. Animals: The animals were adult, male, C57BL/6 mice, about 20 to 25 g in weight. Intervention: The research team: (1) stimulated HT22 cells, an immortalized mouse hippocampal neuronal cell line treated with erastin, and mice induced spinal cord trauma using a moderate hit, and (2) treated the cells and mice with ZIL. Outcome measures: The research team measured: (1) motor function, (2) neurological damage, (3) iron content, (4) lipid oxidation, and (5) neuroinflammation and glial response. Results: ZIL administration attenuated ferroptosis and lipid peroxidation in the HT22 cells. Moreover, ZIL mitigated the ferroptosis and inflammation in the injured spinal cords. Hence, ZIL can decrease neurological damage and improve recovery of motor function, indicating an ameliorative role for ZIL in SCI. Conclusions: ZIL has anti-ferroptosis and anti-oxidative effects in neurons, which can contribute to recovery of motor function after induction of SCI. ZIL is a promising drug for inhibiting ferroptosis and protecting neurological functions after induction of SCI.

The applicability of high-speed counter-current chromatography for preparative separation of biosynthesis products: Glycosylation products as example.

Biosynthesis is a promising way to manufacture desired products, however, the purification of its final products is a tough work due to the huge amount of reaction matrix. Liquid stationary phase of high-speed counter-current chromatography could easily avoid the commonly disadvantages that occurred in traditional column chromatography in the field of biosynthesized products purification. This characteristic makes high-speed counter-current chromatography particularly applicable for final products separation in biosynthesis. In this study, the glycosylation products of Silybin B by one-pot glycosylation were successfully purified by high-speed counter-current chromatography to show the applicability of high-speed counter-current chromatography for preparative separation of biosynthesis products. An optimized n-hexane/ethyl acetate/methanol/water (2:5:2:3, v/v/v/v) system was applied in this study. As a result, four Silybin B glycosylation products, including 7 mg of Silybin B-5-O-ß-D-glucoside (SG-1), 12 mg of Silybin B-3-O-ß-D-glucoside (SG-2), 10 mg of Silybin B-7-O-ß-D-glucoside (SG-3), and 24 mg of Silybin B-20-O-ß-D-glucoside (SG-4), were simultaneously separated from 200 mg of glycosylation crude products, with the purity of 89.3, 95.2, 96.4, and 97.5%, respectively. Their structures were identified by spectroscopic analysis.

Knockdown of long non-coding RNA PCAT1 in glioma stem cells promotes radiation sensitivity.

This study aimed to investigate the function of glioma stem cells (GSCs) and the role of PCAT1. This study dissociated the differences between GSCs and glioma cells in terms of apoptosis rate and γH2AX positive cells levels after radiation. Microarray was carried out to detect that expressed PCAT1, and it was testified by RT-qPCR. After transfection, GSCs were used to investigate the influence of PCAT1 on radiation sensitivity. Sphere-formation capability was first examined. Cell apoptosis rate after radiation of 0 Gy or 6 Gy was analyzed by flow cytometry, and the level of γH2AX positive cells after 6 Gy radiation were compared. CCK8 assay was used to investigate the cell proliferation and RT-qPCR was used to examine miR-129-5p and HMGB1 expression. GSCs exhibited great capability in sphere formation and lower expression in apoptosis and γH2AX positive cells rates after 6 Gy radiation. PCAT1 had higher expression in GSCs. PCAT1 knockdown restrained the sphere-formation ability, increased the apoptosis rate and DNA damage under the treatment of radiation. Moreover, knockdown of PCAT1 inhibited the cell proliferation. In addition, silencing PCAT1 could increase the expression of miR-129-5p and decrease the expression of HMGB1. PCAT1 was overexpressed in GSCs and played a facilitating role in radiation resistance.

MiR-495 is a Predictive Biomarker that Downregulates GFI1 Expression in Medulloblastoma.

BACKGROUND: Alterations in the expression level of miR-495 were recently observed in various tumours. Medulloblastoma is the most common malignant brain tumour in children. However, the clinical significance of miR-495 in medulloblastomas remains unclear. METHODS: The expression levels of miR-495 was examined in 62 archival formalin-fixed paraffin-embedded (FFPE) medulloblastoma specimens using TaqMan Real-time Quantitative PCR arrays. Immunohistochemistry was used to determine the expression of Gfi1 in medulloblastoma tissues, and a luciferase reporter assay was carried out to confirm whether Gfi1 is a direct target of miR-495. RESULTS: MiR-495 expression is repressed in medulloblastoma samples compared with normal cerebellum tissues. Furthermore, patients with a low level of miR- 495 showed significantly poorer survival, as determined by the log-rank test (P = 0.033). The multivariate analysis results showed that the miR-495 expression levels were an independent predictor of overall survival in medulloblastoma patients (P = 0.027; hazard ratio = 0.267). Our study provides the first demonstration that miR-495 directly interacts with the Gfi1 3'UTR to regulate Gfi1 at a post-transcriptional level and that the expression level of miR-495 is inversely correlated with the Gfi1 protein level in medulloblastoma specimens. CONCLUSION: Our results suggest that miR-495 may be a prognostic predictor in medulloblastoma and that Gfi1 is a potential functional target of miR-495.

Upregulation of miR-24 promotes cell proliferation by targeting NAIF1 in non-small cell lung cancer.

Recent studies have implied that aberration of miR-24 is linked to various human cancers. However, its role in non-small cell lung cancer (NSCLC) remains obscure. Here, we found that miR-24 was significantly upregulated in NSCLC tissues and patients' serum. High expression of miR-24 in patients' serum was independently correlated with a shorter overall survival of NSCLC patients. Depletion of miR-24 inhibited cell proliferation and anchorage-independent survival ability in lung cancer cell lines and reduced tumor formation ability in nude mice. Nuclear apoptosis-inducing factor 1 (NAIF1) was identified to be a functional target of miR-24 in the human lung. Next, we observed that the NAIF1 mRNA expression level in NSCLC tissues was suppressed in comparison to that in adjacent normal tissues. Restoration of NAIF1 in lung cancer cell inhibited cell proliferation and anchorage-independent survival ability, which were found to be similar with those from transfecting a miR-24 inhibitor into lung cancer cells. In conclusion, our study demonstrated that miR-24 was upregulated in NSCLC, and suppressing the expression of miR-24 inhibited tumor characteristics. MiR-24 acted as an oncomir, at least partially through regulation of its functional target NAIF1 in NSCLC. MiR-24 may serve as a novel potential biomarker for NSCLC diagnosis and prognosis.

Paraventricular thalamus to nucleus accumbens circuit activation decreases long-term relapse of alcohol-seeking behaviour in male mice.

BACKGROUND: Some studies have highlighted the crucial role of aversion in addiction treatment. The pathway from the anterior paraventricular thalamus (PVT) to the shell of the nucleus accumbens (NAc) has been reported as an essential regulatory pathway for processing aversion and is also closely associated with substance addiction. However, its impact on alcohol addiction has been relatively underexplored. Therefore, this study focused on the role of the PVT-NAc pathway in the formation and relapse of alcohol addiction-like behaviour, offering a new perspective on the mechanisms of alcohol addiction. RESULTS: The chemogenetic inhibition of the PVT-NAc pathway in male mice resulted in a notable decrease in the establishment of ethanol-induced conditioned place aversion (CPA), and NAc-projecting PVT neurons were recruited due to aversive effects. Conversely, activation of the PVT-NAc pathway considerably impeded the formation of ethanol-induced conditioned place preference (CPP). Furthermore, during the memory reconsolidation phase, activation of this pathway effectively disrupted the animals' preference for alcohol-associated contexts. Whether it was administered urgently 24 h later or after a long-term withdrawal of 10 days, a low dose of alcohol could still not induce the reinstatement of ethanol-induced CPP. CONCLUSIONS: Our results demonstrated PVT-NAc circuit processing aversion, which may be one of the neurobiological mechanisms underlying aversive counterconditioning, and highlighted potential targets for inhibiting the development of alcohol addiction-like behaviour and relapse after long-term withdrawal.

Degradation of perineuronal nets in the medial prefrontal cortex promotes extinction and reduces reinstatement of methamphetamine-induced conditioned place preference in female mice.

The high rate of relapse to compulsive methamphetamine (MA)-taking and seeking behaviors after abstinence constitutes a major obstacle to the treatment of MA addiction. Perineuronal nets (PNNs), essential components of the extracellular matrix, play a critical role in synaptic function, learning, and memory. Abnormalities in PNNs have been closely linked to a series of neurological diseases, such as addiction. However, the exact role of PNNs in MA-induced related behaviors remains elusive. Here, we established a MA-induced conditioned place preference (CPP) paradigm in female mice and found that the number and average optical density of PNNs increased significantly in the medial prefrontal cortex (mPFC) of mice during the acquisition, extinction, and reinstatement stages of CPP. Notably, the removal of PNNs in the mPFC via chondroitinase ABC (ChABC) before extinction training not only facilitated the extinction of MA-induced CPP and attenuated the relapse of extinguished MA preference but also significantly reduced the activation of c-Fos in the mPFC. Similarly, the ablation of PNNs in the mPFC before reinstatement markedly lessened the reinstatement of MA-induced CPP, which was accompanied by the decreased expression of c-Fos in the mPFC. Collectively, our results provide more evidence for the implication of degradation of PNNs in facilitating extinction and preventing relapse of MA-induced CPP, which indicate that targeting PNNs may be an effective therapeutic option for MA-induced CPP memories.

FAK inhibitor PF-562271 inhibits the migration and proliferation of high-grade serous ovarian cancer cells through FAK and FAK mediated cell cycle arrest.

Focal adhesion kinase (FAK) is a promising therapeutic target for various cancers and its inhibitor development is in full swing. PF-562271 is a classic FAK inhibitor that has shown promising preclinical data and has been found to exhibit an anti-migration effect on some cancer cells. However, its anticancer effect on high-grade serous ovarian cancer (HGSOC) has not been reported. In this study, we evaluated the anti-migration and anti-proliferation effects of PF-562271 against HGSOC SKOV3 and A2780 cells, as well as the underlying mechanism. The results demonstrated that FAK was overexpressed in clinical HGSOC tissues and was positively correlated with the pathological progression of HGSOC. Moreover, HGSOC patients with high FAK expression levels exhibited low survival rates. PF-562271 treatment significantly inhibited the cell adhesion and migration of SKOV3 and A2780 cells by inhibiting p-FAK expression and decreasing the FA surface area. Additionally, PF-562271 treatment inhibited colony formation and induced cell senescence through G1 phase cell cycle arrest mediated DNA replication inhibition. Taken together, the findings demonstrated that FAK inhibitor PF-562271 significantly inhibits HGSOC cell adhesion, migration, and proliferation process through FAK and/or FAK mediated cell cycle arrest, and suggested that PF-562271 could serve as a potential oncotherapeutic agent for HGSOC targeting treatment.

Indocyanine green derived carbon dots with significantly enhanced properties for efficient photothermal therapy.

A simple yet effective strategy to enhance the properties of traditional dye indocyanine green (ICG) in all aspects was proposed and demonstrated. Specifically, indocyanine green-derived carbon dots (ICGCDs) were synthesized from ICG via a simple hydrothermal treatment. The ICGCDs exhibited significantly enhanced thermal stability and anti-photobleaching compared to ICG. Furthermore, their photothermal properties were also notably strengthened, in which a wider functional pH range, 50% improvement in photothermal conversion efficiency and superior photothermal cyclability were achieved. Thanks to these superior properties, ICGCDs were demonstrated as efficient NIR bioimaging and photothermal agents in both in vitro and in vivo experiments. Most excitingly, the strategy demonstrated in this study is likely to have broad applications in other systems.

A new amine isolated from Urtica thunbergiana Siebold & Zucc.

One new amine 2-dimethyl-Penidilamine (1), together with seventeen known compounds (2-18) were isolated from the 95% ethanol extract of Urtica thunbergiana Siebold & Zucc. Their structures were characterised by extensive spectroscopic analysis including NMR, mass spectra and single X-ray crystallography. Among them, compound 1 is a new compound, and compounds 3, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 17 and 18 were isolated from Urtica thunbergiana Siebold & Zucc for the first time. Among them, compound 1, 10, 15, 17 and 18 exhibited significant α-glucosidase inhibitory activity with an IC50 value of 65.12 µM, 7.42 µM, 26.24 µM, 71.31 µM and 72.55 µM, respectively. Our study provided the scientific report for the medicinal value of Urtica thunbergiana Siebold & Zucc.

Female rats prefer to forage food from males, an effect that is not influenced by stress.

As social beings, animals and humans alike make real life decisions that are often influenced by other members. Most current research has focused on the influence of same-sex peers on individual decision-making, with potential opposite sex effect scarcely explored. Here, we developed a behavioral model to observe food foraging decision-making in female rats under various social situations. We found that female rats preferred to forage food from male over female rats or from the no-rat storage side. Female rats were more likely to forage food from familiar males than from unfamiliar. This opposite-sex preference was not altered by the lure of sweet food, or with estrous cycle, nor under stress conditions. These results suggest that the opposite sex influences food foraging decision-making in female rats. The behavioral model established could facilitate future investigation into the underlying neurobiological mechanisms.

Classification of cognitive impairment in older adults based on brain functional state measurement data via hierarchical clustering analysis.

Introduction: Cognitive impairment (CI) is a common degenerative condition in the older population. However, the current methods for assessing CI are not based on brain functional state, which leads to delayed diagnosis, limiting the initiatives towards achieving early interventions. Methods: A total of one hundred and forty-nine community-dwelling older adults were recruited. Montreal Cognitive Assessment (MoCA) and Mini-Mental State Exam (MMSE) were used to screen for CI, while brain functional was assessed by brain functional state measurement (BFSM) based on electroencephalogram. Bain functional state indicators associated with CI were selected by lasso and logistic regression models (LRM). We then classified the CI participants based on the selected variables using hierarchical clustering analysis. Results: Eighty-one participants with CI detected by MoCA were divided into five groups. Cluster 1 had relatively lower brain functional states. Cluster 2 had highest mental task-switching index (MTSi, 13.7 ± 3.4), Cluster 3 had the highest sensory threshold index (STi, 29.9 ± 7.7), Cluster 4 had high mental fatigue index (MFi) and cluster 5 had the highest mental refractory period index (MRPi), and external apprehension index (EAi) (21.6 ± 4.4, 35.4 ± 17.7, respectively). Thirty-three participants with CI detected by MMSE were divided into 3 categories. Cluster 1 had the highest introspective intensity index (IIi, 63.4 ± 20.0), anxiety tendency index (ATi, 67.2 ± 13.6), emotional resistance index (ERi, 50.2 ± 11.9), and hypoxia index (Hi, 41.8 ± 8.3). Cluster 2 had the highest implicit cognitive threshold index (ICTi, 87.2 ± 12.7), and cognitive efficiency index (CEi, 213.8 ± 72.0). Cluster 3 had higher STi. The classifications both showed well intra-group consistency and inter-group variability. Conclusion: In our study, BFSM-based classification can be used to identify clinically and brain-functionally relevant CI subtypes, by which clinicians can perform personalized early rehabilitation.

Cage-Confinement Induced Emission Enhancement.

As a proof-of-concept study, Imi-cage and Phos-cage organic molecular cages (OMCs) containing the triphenylphosphine (TPP) moiety, a nonclassic AIE luminogen (AIEgen), have been designed to demonstrate the cage-confinement induced emission enhancement (CCIEE). Thanks to the confinement effect of OMCs, the rigid Imi-cage exhibits much higher photoluminescence (PL) quantum yield (ΦPL) than the open-shell Semicage and small molecule TPP in both solution and amorphous solid states. The emission of Phos-cage could be further enhanced in crystalline solid state with a remarkably high ΦPL of 97.6% (vs 3.47% of crystalline TPP) benefiting from AIE enabled by the highly ordered molecular packing. The novel strategy of CCIEE via confining an AIEgen into an OMC to achieve a significant emission enhancement will shed light on the development of solid-state highly fluorescent materials. The fluorescent nature of Imi-cage was further exploited for the ultrahighly sensitive detection of the explosive picric acid.

Application of CT Medical Imaging Combined with Deep Learning 3D Reconstruction in the Diagnosis and Rehabilitation of Anterior Cruciate Ligament Injury in Table Tennis Players.

Because of the intense competition, table tennis requires players to bear a strong physiological load, which increases the risk of sports injury. Anterior cruciate ligament (ACL) is an important structure of the knee joint to maintain forward stability and rotational stability and is also a common sports injury in table tennis players. ACL has poor self-repair ability after injury. Therefore, the purpose of this study is to provide a more comprehensive, reliable, and representative theoretical basis for the diagnosis and rehabilitation of anterior cruciate ligament injury in table tennis players, and three-dimensional reconstruction of ACL using dual-source computed tomography (DSCT) combined with deep learning was conducted. For this purpose, a number of table tennis players with ACL injuries were collected, and each patient underwent arthroscopic anterior cruciate ligament reconstruction. DSCT scanning was performed on several knee joints, the 3D model of the knee joint was reconstructed using a CT image postprocessing workstation, and the medial wall of the femoral lateral condyle was reconstructed, as well as the reconstructed single tract of bony canal, tibial plateau, and bony canal. Then, the Lysholm score was used to score the cases, with scores greater than 75 as the excellent group and below 75 as the poor group. The relative positions of the central points of the femoral and tibial canals were marked and measured. The results were as follows: 3D-CT reconstruction could clearly reflect the situation after anterior cruciate ligament reconstruction. In clinic, it is used to evaluate the relationship between bone tunnel location and graft shape so as to guide the surgeon to improve the operation.

Facile and Sensitive Detection of Nitrogen-Containing Organic Bases with Near Infrared C-Dots Derived Assays.

In this article, we have designed both colorimetric (including solution and test paper type) and spectral sensors (including UV-vis and PL type) for the quick and sensitive detection of general nitrogen-containing organic bases (NCOBs); the limit of detection could reach as low as 0.50 nM. NCOBs included 11 examples, covering aliphatic and aromatic amines, five- and six-membered heterocyclics, fused-ring heterocyclics, amino acids, and antibiotics. Furthermore, the assays demonstrated high reliability in sensing NCOBs and excellent ability to distinguish NCOBs from oxygen and sulfur containing organics. The assays developed could find important applications for the detection of NCOBs in the fields of biomedicine, chemistry, and agriculture.

Dysbiosis of Gut Microbiota Is Associated With the Progression of Radiation-Induced Intestinal Injury and Is Alleviated by Oral Compound Probiotics in Mouse Model.

The acute radiation-induced intestinal injury (RIII) has raised much concerns and is influenced by non-cytocidal radiation effects including the perturbations in gut microbiota. Although a number of studies have reported alteration in gut microbiota following radiation, little is known about its dynamic variation in the progression of acute RIII. In this study, mouse model were treated with total body irradiation (TBI) of 0, 4, 8 and 12 Gy, and the intestinal tissues and fecal samples were collected at 6 h, 3.5 d and 7 d post radiation. We found that the intestinal injuries were manifested in a radiation dose-dependent manner. Results from 16S rRNA gene sequencing demonstrated that the diversity of gut microbiota was not significantly affected at the prodromal stage of acute RIII, after 6 h of radiation. At the critical stage of acute RIII, after 3.5 d of radiation, the composition of gut microbiota was correlated with the radiation dose. The Pearson's correlation analysis showed that the relative abundances of phylum Proteobacteria, genera Escherichia-Shigella and Eubacterium xylanophilum_group, and species Lactobacillus murinus exhibited linear correlations with radiation dose. At the recovery stage of acute RIII, after 7 d of radiation, the diversity of gut microbiota decreased as a whole, among which the relative abundance of phyla Proteobacteria and Bacteroides increased, while that of phylum Tenericutes and genus Roseburia decreased. The intra-gastric administration of compound probiotics for 14 days improved the survival duration of mice exposed to 9 Gy TBI, alleviated the intestinal epithelial injury and partially restored the diversity of gut microbiota. Our findings suggest that acute RIII is accompanied by the dysbiosis of gut microbiota, including its decreased diversity, reduced abundance of beneficial bacteria and increased abundance of pathogens. The gut microbiota cannot be used as sensitive biomarkers at the prodromal stage in acute RIII, but are potential biomarkers at the critical stage of acute RIII. The dysbiosis is persistent until the recovery stage of acute RIII, and interventions are needed to restore it. The administration of probiotics is an effective strategy to protect against acute RIII and subsequent dysbiosis.

Effect of prone and supine treatment positions for postoperative treatment of rectal cancer on target dose coverage and small bowel sparing using intensity-modulated radiation therapy.

BACKGROUND: To evaluate the influence of patient positioning on target dose coverage and dose distribution to the small bowel in intensity-modulated radiation therapy (IMRT) for rectal cancer patients. METHODS: Twenty-four consecutive rectal cancer patients undergoing postoperative radiation were selected and set up in either a prone or supine position. All patients received computed tomography (CT) scans before and during treatment (1-4 weeks). The CT images were defined as plan, 1W, 2W, 3W, or 4W. The plan, 1W, 2W, 3W and 4W CT images were fused. The clinical target volume (CTV) and planning target volume (PTV) delineated on the plan CT were copied onto the 1-4W CT. The treatment plans based on the plan CT were also copied onto the 1-4W CT. The target dose coverage rate was assessed. The couch-position data of the linear accelerator were acquired. RESULTS: Failure rates of the CTV and PTV target dose coverage were higher in the prone group than in the supine group (18.60% vs. 0% and 69.76% vs. 53.65%) during the treatment. The total couch-position deviation for the prone group (1.23±0.76 cm) was significantly greater than that of the supine group (0.28±0.18 cm; P=0.001). Compared with the supine group, the prone group had significantly less irradiated small bowel volume at V5 (P=0.003) and V10 (P=0.004). CONCLUSIONS: The supine position maintained better target dose coverage and setup reproducibility in rectal cancer patients treated with IMRT. The prone position combined with the belly board can reduce the dose received by the small bowel.

Green tea derivative (-)-epigallocatechin-3-gallate (EGCG) confers protection against ionizing radiation-induced intestinal epithelial cell death both in vitro and in vivo.

Radiation-induced intestinal injury (RIII) occurs during instances of intentional or accidental radiation exposure. However, there are few effective treatments available for the prevention or mitigation of RIII currently. (-)-Epigallocatechin-3-gallate (EGCG), a major polyphenol in green tea, possesses potent antioxidant activity and has been shown to be effective in ameliorating many oxidative stress-related diseases. The therapeutic effects and mechanism of EGCG on RIII have not yet been determined. In the present study, we investigated whether EGCG confers radioprotection against RIII. Our data demonstrated that administration of EGCG not only prolonged the survival time of lethally irradiated mice, but also reduced radiation-induced intestinal mucosal injury. Treatment with EGCG significantly increased the number of Lgr5+ intestinal stem cells (ISCs) and their progeny Ki67+ cells, and reduced radiation-induced DNA damage and apoptosis. Besides, EGCG displayed the same radioprotective effects in human intestinal epithelial HIEC cells as in mice, characterized by a decrease in the number of γH2AX foci and ferroptosis. Moreover, EGCG decreased the level of reactive oxygen species (ROS) and activated the transcription factor Nrf2 and its downstream targets comprising antioxidant proteins Slc7A11, HO-1 and GPX4. Treatment with the Nrf2 inhibitor ML385 abolished the protective effects of EGCG, indicating that Nrf2 activation is essential for EGCG activity. Taken together, our findings demonstrated that EGCG protects against RIII by scavenging ROS and inhibiting apoptosis and ferroptosis through the Nrf2 signal pathway, which could be a promising medical countermeasure for the alleviation of RIII.