Prevalence and effect on prognosis of sarcopenia in patients with primary biliary cholangitis.

Background: Sarcopenia adversely affects the treatment outcomes in Cirrhosis and NAFLD. However, such research is limited in primary biliary cholangitis (PBC) patients. This study was performed to examine the prevalence of sarcopenia and its impact on PBC patients' prognoses. Methods: This study enrolled confirmed PBC patients who had an abdominal CT scan. Sarcopenia was determined by the L3-skeletal muscle index with a Chinese population-based cut-off value. Laboratory test values and liver stiffness measurements values were obtained from the electronic medical records. Results: In total, 174 PBC patients with a median age of 54 (IQR, 48, 62) years old, were enrolled. 45 (25.9%) patients among them were diagnosed with sarcopenia. Univariate and multivariate logistic regression results illustrated that male gender (OR = 9.152, 95%CI = 3.131-26.751, p < 0.001) and LSM ≥ 12.8 kPa (OR = 4.539, 95%CI = 1.651, 12.478, p = 0.003) were the independent risk factors of sarcopenia in PBC patients. In the prognosis analysis, sarcopenia was determined as a risk factor for indicating adverse events in PBC patients (HR = 4.058, 95%CI = 1.955-8.424, p < 0.001) by Cox proportional hazards regression. Conclusion: The current findings illustrate that comprehensive evaluation and management of sarcopenia may contribute to the improvement of treatment outcomes and life quality of PBC patients.

Native and engineered extracellular vesicles: novel tools for treating liver disease.

Liver diseases are classified as acute liver damage and chronic liver disease, with recurring liver damage causing liver fibrosis and progression to cirrhosis and hepatoma. Liver transplantation is the only effective treatment for end-stage liver diseases; therefore, novel therapies are required. Extracellular vesicles (EVs) are endogenous nanocarriers involved in cell-to-cell communication that play important roles in immune regulation, tissue repair and regeneration. Native EVs can potentially be used for various liver diseases owing to their high biocompatibility, low immunogenicity and tissue permeability and engineered EVs with surface modification or cargo loading could further optimize therapeutic effects. In this review, we firstly introduced the mechanisms and effects of native EVs derived from different cells and tissues to treat liver diseases of different etiologies. Additionally, we summarized the possible methods to facilitate liver targeting and improve cargo-loading efficiency. In the treatment of liver disease, the detailed engineered methods and the latest delivery strategies were also discussed. Finally, we pointed out the limitations and challenges of EVs for future development and applications. We hope that this review could provide a useful reference for the development of EVs and promote the clinical translation.

Meta-analysis of Helicobacter pylori eradication therapy using vonoprazan as an acid suppressor compared with bismuth quadruple therapy.

BACKGROUND: Vonoprazan, a novel acid suppressant, has recently emerged as a regimen for eradicating Helicobacter pylori. However, uncertainties exist about the effectiveness and safety of VPZ-based regimens compared with those of bismuth-based quadruple therapy in eradicating H. pylori. The present meta-analysis was performed to compare the effectiveness and safety of vonoprazan-based regimens with those of bismuth quadruple therapy in eradicating H. pylori. MATERIALS AND METHODS: All randomized controlled trials and non-randomized controlled trials comparing the vonoprazan-based therapy with the bismuth quadruple therapy were included in this meta-analysis. Information was also extracted by two evaluators, and if heterogeneity existed, a random-effects model was used to calculate the combined relative ratio and 95% confidence interval; otherwise, a fixed-effects model was used. And subgroup analyses were performed to explore the sources of heterogeneity. RESULTS: A total of 10 studies, comprising 2587 patients were included in the meta-analysis. The results showed that the combined eradication rate of patients treated with the vonoprazan-based regimen was significantly higher than that of patients treated with bismuth quadruple therapy, in both intention-to-treat and per-protocol analyses, and the differences were statistically significant. Among the intention-to-treat analyses results: (90.28% vs. 83.64% [odds ratio (OR) = 1.85, 95% confidence interval (CI) (1.27, 2.70), p = 0.001]); in the per-protocol analyses: (94.80% vs. 89.88%, [OR = 2.25, 95% CI (1.37, 3.69), p = 0.001]). The occurrence of adverse events was significantly lower in patients treated with vonoprazan-based regimens than in those treated with bismuth quadruple therapy, (14.50% vs. 25.89%, [OR = 0.49, 95% CI (0.32, 0.75), p = 0.001]). CONCLUSIONS: For eradicating H. pylori, vonoprazan-based regimens are remarkably advantageous over bismuth quadruple therapy. Furthermore, vonoprazan-based regimens exhibit a lower rate of adverse events than bismuth quadruple therapy.

Causal associations between gut microbiota and Cholestatic liver diseases: a Mendelian randomization study.

Background: The etiological factors of Cholestatic Liver Diseases especially primary sclerosing cholangitis (PSC) and primary biliary cholangitis (PBC) are not fully illustrated. It has been reported in previous observational studies that gut microbiota are associated with cholestatic liver diseases. However, there is uncertainty regarding the causality of this association. By using Mendelian randomization, this study aimed to examine the causal impact of gut microbiota on cholestatic liver diseases. Methods: From large-scale genome-wide association studies, genetic instruments for each gut microbiota taxa as well as primary biliary cholangitis and primary sclerosing cholangitis were developed. Subsequently, we conducted a two-sample Mendelian randomization analysis, supplemented by multiple post hoc sensitivity analyses. Additionally, we performed reverse MR analyses to investigate the possibility of the reverse causal association. Result: This two-sample MR study indicated that the order Bacillales, family Peptostreptococcaceae, family Ruminococcaceae, genus Anaerotruncu was associated with a decreased risk of developing PBC, and that order Selenomonadales, family Bifidobacteriaceae may be factors that increase the risk of PBC. On the other hand, we also identified order Selenomonadales, family Rhodospirillaceae, and genus RuminococcaceaeUCG013 were positively associated with PSC. The order Actinomycetales, family Actinomycetaceae, genus Actinomyces, genus Alloprevotella, genus Barnesiella, and genus Peptococcus were found negative associations with the risk of PSC. The reverse MR analysis demonstrated no statistically significant relationship between PBC, PSC and these specific gut microbial taxa. Conclusion: Our findings offered novel evidence that the abundance of particular bacteria contributes to the risk of PBC and PSC, which may contribute to more effective approaches to PBC and PSC therapy and prevention.

The relationship between diabetic retinopathy and diabetic nephropathy in type 2 diabetes.

Context: Diabetic retinopathy (DR) and diabetic nephropathy (DN), are major microvascular complications of diabetes. DR is an important predictor of DN, but the relationship between the severity of DR and the pathological severity of diabetic glomerulopathy remains unclear. Objective: To investigate the relationship between severity of diabetic retinopathy (DR) and histological changes and clinical indicators of diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM). Methods: Patients with T2DM (n=272) who underwent a renal biopsy were eligible. Severity of DR was classified as non-diabetic retinopathy, non-proliferative retinopathy, and proliferative retinopathy (PDR). Relationship between DN and DR and the diagnostic efficacy of DR for DN were explored. Results: DN had a higher prevalence of DR (86.4%) and DR was more severe. The sensitivity and specificity of DR in DN were 86.4% and 78.8%, while PDR was 26.4% and 98.5%, respectively. In DN patients, the severity of glomerular lesions (p=0.001) and prevalence of KW nodules (p<0.001) significantly increased with increasing severity of DR. The presence of KW nodules, lower hemoglobin levels, and younger age were independent risk factors associated with more severe DR in patients with DN. Conclusion: DR was a good predictor of DN. In DN patients, the severity of DR was associated with glomerular injury, and presence of KW nodules, lower hemoglobin levels and younger age were independent risk factors associated with more severe DR. Trial registration: ClinicalTrails.gov, NCT03865914.

Defect Regulation of Efficient Dion-Jacobson Quasi-2D Perovskite Solar Cells via a Polyaspartic Acid Interlayer.

Interfacial modification is a promising strategy to fabricate highly efficient perovskite solar cells (PSCs). Nevertheless, research studies about optimization for the performance of Dion-Jacobson (DJ)-phase quasi-2D PSCs by underlying surface modification are rarely reported. The relevant influence of interfacial modification on defect regulation in the bulk and at the interface for PSCs is still unexplored. Herein, an interlayer of polyaspartic acid (PASP) was introduced at the interface of a hole transporting layer and a perovskite absorber to regulate both the film quality and interface property for BDA-based DJ quasi-2D PSCs (n = 5). The PASP interlayer suppressed the charge recombination, restricted the interfacial charge accumulation, and promoted the charge transport in devices and therefore improved the power conversion efficiency of PSCs from 15.03 to 17.34%. Moreover, through device simulation, it was concluded that the increase of open-circuit voltage (Voc) was mainly attributed to the suppression of interface defects, while the increase of short-circuit current (Jsc) was ascribed to the restriction of interface defects and perovskite bulk defects. The improvement of both Voc and Jsc originated from the passivation of shallow defect states. The present work provides a promising route for the fabrication of efficient quasi-2D PSCs and enriches the fundamental understanding of defect regulation on photovoltaic performance.

Nickel-Catalyzed Desulfonylative Reductive Cross-Coupling of Aryl Sulfones with Aryl Bromides.

Herein, a nickel catalysis system for desulfonylative C(sp2)-C(sp2) reductive cross-coupling reactions of aryl sulfone derivatives with a range of aryl bromides has been established to form diverse biaryl compounds. The complex Ar-Ni(II)-SO2CF3 bearing a phosphine ligand through oxidative addition of aryl sulfone to Ni(0) species was isolated and confirmed by an X-ray, which provides solid evidence for the understanding of the C(Ar)-SO2 bond activation and reaction mechanism.

Evaluation of Renal Impairment in Patients with Diabetic Kidney Disease by Integrated Chinese and Western Medicine.

OBJECTIVE: To investigate the factors related to renal impairment in patients with diabetic kidney disease (DKD) from the perspective of integrated Chinese and Western medicine. METHODS: Totally 492 patients with DKD in 8 Chinese hospitals from October 2017 to July 2019 were included. According to Kidney Disease Improving Global Outcomes (KDIGO) staging guidelines, patients were divided into a chronic kidney disease (CKD) 1-3 group and a CKD 4-5 group. Clinical data were collected, and logistic regression was used to analyze the factors related to different CKD stages in DKD patients. RESULTS: Demographically, male was a factor related to increased CKD staging in patients with DKD (OR=3.100, P=0.002). In clinical characteristics, course of diabetes >60 months (OR=3.562, P=0.010), anemia (OR=4.176, P<0.001), hyperuricemia (OR=3.352, P<0.001), massive albuminuria (OR=4.058, P=0.002), atherosclerosis (OR=2.153, P=0.007) and blood deficiency syndrome (OR=1.945, P=0.020) were factors related to increased CKD staging in patients with DKD. CONCLUSIONS: Male, course of diabetes >60 months, anemia, hyperuricemia, massive proteinuria, atherosclerosis, and blood deficiency syndrome might indicate more severe degree of renal function damage in patients with DKD. (Registration No. NCT03865914).

Unilateral pulmonary vein atresia presenting with recurrent hydrothorax in an adult: A case report.

UPVA (Unilateral pulmonary vein atresia) is the failure of connection between the common pulmonary vein and the left atrium. UPVA is a rare malformation of common pulmonary vein caused by embryonic development defects. Isolated UPVA is uncommon, the diagnosis commonly occurs during early childhood because of asthma, recurrent pneumonia or hemoptysis, but diagnosis in adults is unusual. Some patients can be asymptomatic until adulthood. In this report, we describe a case about UPVA presenting with recurrent hydrothorax in an adult. We gradually carried out routine diagnostic methods and eventually confirmed the rare UPVA according to the two common clinical manifestations of repeated pleural effusion and hilar soft tissue shadow.

C(sp2)-C(sp2) Reductive Cross-Coupling of Triarylphosphines with Aryl Halides by Palladium/Nickel Co-catalysis.

Herein, we report the first general C(sp2)-C(sp2) reductive cross-coupling reaction of diverse triarylphosphines with a wide range of aryl halides by palladium/nickel co-catalysis. This protocol offers a unique route for the synthesis of biaryl compounds via the activation of inert C(Ar)-P bonds. The mechanistic studies demonstrate that the formation of the phosphonium salts in situ plays a key role in the catalytic cycle.

Cascade of C(sp2)-H Addition to Carbonyl and C(sp2)-CN/C(sp2)-H Coupling Enabled by Brønsted Acid: Construction of Benzo[a]carbazole Frameworks.

Herein, we report an unprecedented cascade reaction of C(sp2)-H addition to carbonyl and the C(sp2)-CN/C(sp2)-H coupling of 2-(2-oxo-2-arylethyl)benzonitriles with indoles enabled by commercially available TsOH·H2O. The protocol represents the first metal-free C(sp2)-CN/C(sp2)-H coupling, affording a new route for the synthesis of various benzo[a]carbazole derivatives with a broad substrate scope, high yields, and simple conditions.

Insight into the Catalytic Activity of Amorphous Multimetallic Catalysts under a Magnetic Field toward the Oxygen Evolution Reaction.

Slow kinetics in the oxygen evolution reaction (OER) remains a Gordian knot to develop an efficient and cost-effective electrocatalyst in electrochemical water splitting. In recent studies, either a synergistic effect on multimetallic catalysts or spin polarization in ferromagnetic materials is considered as a desirable way to improve water electrolysis. Herein, the OER performance of amorphous FeNiCo-based multimetallic catalysts with adjustable composition was investigated from the perspective of atomic structure. Mössbauer spectra results demonstrate that the OER activities exhibit a significant dependence on the local structure of catalysts in which a catalyst with a high content of Fe clusters of low coordination numbers tends to obtain higher activity. Furthermore, benefiting from the spin polarization of these ferromagnetic catalysts, the OER activity is notably enhanced in the presence of a magnetic field. In particular, overpotential reduction exceeding 20 mV (above 100 mA cm-2) in alkaline OER performance is observed for strong ferromagnetic catalysts in comparison with the weak ferromagnetic ones. An increment of 65.2% in turnover frequency is achieved for the catalyst with the strongest ferromagnetism. This magnetic enhancement strategy affords an effective way of improving the water oxidation performance on amorphous ferromagnetic catalysts.

Protocol for evaluation and validation of TLR8 antagonists in HEK-Blue cells via secreted embryonic alkaline phosphatase assay.

Toll-like receptor 8 (TLR8) is a pattern recognition receptor that senses RNA degradation products and initiates immune responses. TLR8 overactivation is associated with autoimmune diseases. Herein, we describe the evaluation and validation of TLR8 antagonists in HEK-Blue cells via secreted embryonic alkaline phosphatase (SEAP) assay, WST assay, ITC and immunoblotting. These assays can facilitate the development of TLR8 antagonists; this protocol can also be adapted to analyze agonists and antagonists for other TLRs. For complete details on the use and execution of this protocol, please refer to Hu et al. (2018).

Tetrasubstituted imidazoles as incognito Toll-like receptor 8 a(nta)gonists.

Small-molecule modulators of TLR8 have drawn much interests as it plays pivotal roles in the innate immune response to single-stranded RNAs (ssRNAs) derived from viruses. However, their clinical uses are limited because they can invoke an uncontrolled, global inflammatory response. The efforts described herein culminate in the fortuitous discovery of a tetrasubstituted imidazole CU-CPD107 which inhibits R848-induced TLR8 signaling. In stark contrast, CU-CPD107 shows unexpected synergistic agonist activities in the presence of ssRNA, while CU-CPD107 alone is unable to influence TLR8 signaling. CU-CPD107's unique, dichotomous behavior sheds light on a way to approach TLR agonists. CU-CPD107 offers the opportunity to avoid the undesired, global inflammation side effects that have rendered imidazoquinolines clinically irrelevant, providing an insight for the development of antiviral drugs.

An Anionic Indium-Organic Framework with Spirobifluorene-Based Ligand for Selective Adsorption of Organic Dyes.

Ionic metal-organic frameworks (MOFs) with an ionic skeleton and unique porous structures could selectively adsorb charged dyes with specific dimensions. However, the ion-exchange-based and size-exclusion-based process as a chromatography method needs to be further explored. In this study, a new microporous anionic MOF, JUC-210, was synthesized using a spirobifluorene-based ligand and trivalent metal indium. JUC-210 has a two-fold interpenetrated pts framework with a large void space, possessing suitable pore sizes and an anionic skeleton for efficient separation of certain organic dyes. Different types of dyes were used to observe the selective adsorption ability of the as-synthesized MOF. JUC-210 displayed high selective adsorption toward the cationic dye methylene blue with positive charges based on ion exchange and size exclusion. Moreover, the effect of solvent on the selective adsorption behaviors of JUC-210 was investigated. The exploration of novel MOF materials would provide potential efficient adsorbents for separation of organic dyes.

Rationally Designed Small-Molecule Inhibitors Targeting an Unconventional Pocket on the TLR8 Protein-Protein Interface.

Rational designs of small-molecule inhibitors targeting protein-protein interfaces have met little success. Herein, we have designed a series of triazole derivatives with a novel scaffold to specifically intervene with the interaction of TLR8 homomerization. In multiple assays, TH1027 was identified as a highly potent and specific inhibitor of TLR8. A successful solution of the X-ray crystal structure of TLR8 in complex with TH1027 provided an in-depth mechanistic insight into its binding mode, validating that TH1027 was located between two TLR8 monomers and recognized as an unconventional pocket, thereby preventing TLR8 from activation. Further biological evaluations showed that TH1027 dose-dependently suppressed the TLR8-mediated inflammatory responses in both human monocyte cell lines, peripheral blood mononuclear cells, and rheumatoid arthritis patient specimens, suggesting a strong therapeutic potential against autoimmune diseases.

Fabrication of Crystalline Microporous Membrane from 2D MOF Nanosheets for Gas Separation.

Metal-organic frameworks (MOFs)-based membranes have shown great potentials as applications in gas separation. In this work, a uniform membrane based on 2D MOF Ni3 (HITP)2 (HITP=2,3,6,7,10,11-hexaaminotriphenylene) was fabricated on ordered macroporous AAO via the filtration method. To fabricate the membrane, we obtained the Ni3 (HITP)2 nanosheets as building blocks via a soft-physical exfoliation method successfully that were confirmed by AFM and TEM. We also studied the H2 , CO2 and N2 adsorption isotherms of Ni3 (HITP)2 powder at room temperature, which shows Ni3 (HITP)2 has high heats of adsorption for CO2 and high selectivity of CO2 over N2 . Gas permeation tests indicate that the Ni3 (HITP)2 membrane shows high permeance and selectivity of CO2 over N2 , as well as good selectivity of H2 over N2 . The ideal separation factors of CO2 /N2 and H2 /N2 from sing-gas permeances are 13.6 and 7.8 respectively, with CO2 permeance of 3.15×10-6  mol⋅m-2 ⋅s-1 ⋅Pa-1 . The membrane also showed good stability, durability and reproducibility, which are of potential interest for practical applications in the CO2 separations.

Peglated-H1/pHGFK1 nanoparticles enhance anti-tumor effects of sorafenib by inhibition of drug-induced autophagy and stemness in renal cell carcinoma.

BACKGROUND: Tumor targeting small molecular inhibitors are the most popular treatments for many malignant diseases, including cancer. However, the lower clinical response and drug resistance still limit their clinical efficacies. HGFK1, the first kringle domain of hepatocyte growth factor, has been defined as a potent anti-angiogenic factor. Here, we aimed to develop and identify novel nanoparticles-PH1/pHGFK1 as potential therapeutic agents for the treatment of renal cell carcinoma (RCC). METHODS: We produced a novel cationic polymer-PH1 and investigated the anti-tumor activity of PH1/pHGFK1 nanoparticle alone and its combination therapy with sorafenib in RCC cell line xenografted mice model. Then, we figured out its molecular mechanisms in human RCC cell lines in vitro. RESULTS: We firstly demonstrated that intravenous injection of PH1/pHGFK1 nanoparticles significantly inhibited tumor growth and prolonged the survival time of tumor-bearing mice, as well as synergistically enhanced anti-tumor activities of sorafenib. Furthermore, we elucidated that recombinant HGFK1 improved sorafenib-induced cell apoptosis and arrested cell cycle. In addition, HGFK1 could also decrease sorafenib-induced autophagy and stemness via blockading NF-κB signaling pathway in RCC both in vitro and in vivo. CONCLUSIONS: HGFK1 could inhibit tumor growth, synergistically enhance anti-tumor activities of sorafenib and reverse its drug resistance evolution in RCC. Our results provide rational basis for clinical application of sorafenib and HGFK1 combination therapy in RCC patients.

A novel galactose-PEG-conjugated biodegradable copolymer is an efficient gene delivery vector for immunotherapy of hepatocellular carcinoma.

Successful immunogene therapy depends not only on the therapeutic gene but also on the gene delivery vector. In this study, we synthesized a novel copolymer consisting of low-molecular-weight polyethylenimine (PEI) cross-linked by myo-inositol (INO) and conjugated with a galactose-grafted PEG chain, named LA-PegPI. We characterized the chemical structure and molecular weight of the copolymer and particle properties of LA-PegPI/pDNA. Furthermore, we showed that LA-PegPI/pDNA polyplexes possessed excellent stability in physiological salt solution, low cytotoxicity, and high transfection efficiency in the asialoglycoprotein receptor (ASGPR)-positive liver cells in vitro. Importantly, we also showed that through intraperitoneal injection of LA-PegPI/pDNA nanoparticles, the reporter gene was forcefully expressed in the liver hepatocytes of mice. Finally, we documented that intraperitoneal injection of LA-PegPI/pIL15 nanoparticles effectively suppressed tumor growth and prolonged survival time of tumor-bearing mice via activation of CD8+ T cells and NK cells and upregulation of the cytokines IFN-γ, TNF, and IL12 in an orthotopic hepatocellular carcinoma mouse model. Interestingly, LA-PegPI/pluc nanoparticles could effectively stimulate the proliferation of NK cells and inhibit tumor growth in this model. In summary, LA-PegPI is a useful gene vector for immunogene therapy of hepatocellular carcinoma, and its potential for clinical application warrants further study.