Local therapy combined with anti-PD-1 immunotherapy for advanced lung adenocarcinoma: A case report.

ABSTRACT: Lung adenocarcinoma (LUAD) encompasses all lung epithelial cancers except small-cell lung cancer. Although programmed cell death protein 1 (PD-1) inhibitors, such as pembrolizumab, and other Food and Drug Administration-approved immune checkpoint inhibitors, offer new hope for LUAD treatment, LUAD's overall efficacy remains limited. Thus, the combination of immunotherapy with other therapeutic approaches has gained widespread attention. Local therapy is an optimal method for treating many advanced unresectable lung cancers. Herein, we present a case of a patient with multiple metastases from LUAD, who attained complete response for more than 3 years until present through local therapy combined with a PD-1 inhibitor.

A new therapeutic perspective: Erastin inhibits tumor progression by driving ferroptosis in myelodysplastic syndromes.

Ferroptosis is a recently identified and evolutionarily conserved form of programmed cell death. This process is initiated by an imbalance in iron metabolism, leading to an overload of ferrous ions. These ions promote lipid peroxidation in the cell membrane through the Fenton reaction. As the cell's antioxidant defenses become overwhelmed, a fatal buildup of reactive oxygen species (ROS) occurs, resulting in the rupture of the plasma membrane. Ferroptosis is implicated in conditions such as ischemia-reperfusion injuries and a range of cancers. In our research, we explored ferroptosis in myelodysplastic syndromes (MDS) by measuring iron levels, transferrin receptor expression, and glutathione peroxidase 4 (GPX4) mRNA. Our findings revealed that MDS patients had significantly higher Fe2+ levels in CD33+ cells and increased transferrin receptor mRNA compared to healthy individuals. GPX4 expression was also higher in MDS but not statistically significant. To investigate potential treatments for myeloid hematological diseases through ferroptosis induction, we treated the myelodysplastic syndrome cell line (SKM-1) and two myeloid leukemia cell lines (KG-1 and K562) with erastin, an iron transfer inducer. We observed that erastin treatment led to glutathione depletion, reduced GPX4 activity, and increased ROS, culminating in cell death by ferroptosis. Furthermore, combining erastin with azacitidine demonstrated a synergistic effect on MDS and leukemia cell lines, suggesting a promising approach for treating these hematological conditions with this drug combination. Our experiments confirm erastin's ability to induce ferroptosis in MDS and highlight its potential synergistic use with azacitidine for treatment.

Application of hospital-community-home linkage management model in patients with type 2 diabetic nephropathy.

OBJECTIVE: To explore the effect of the hospital-community-home (HCH) linkage management mode in patients with type 2 diabetic nephropathy (DN). METHOD: A total of 80 patients with type 2 DN hospitalised in the Department of Nephrology of our hospital between July 2021 and June 2022 were recruited and subsequently divided into the observation group and the control group using the random number table method, with 40 patients in each group. The control group received routine health education and discharge guidance. The HCH linkage management model was implemented for the observation group based on routine care. The improvements in compliance behaviour, biochemical parameters of renal function, blood glucose level and self-management ability were compared before the intervention and at 3 and 6 months after the intervention. RESULTS: After the intervention, the scores for compliance behaviour of the observation group were better than those of the control group, with a statistically significant difference (P < 0.05). The biochemical indicators of renal function and blood glucose level were significantly lower in the observation group compared with in the control group, with a statistically significant difference (P < 0.05). After the intervention, the observation group showed a great improvement in self-management ability and cognition of the disease, with significant differences (P < 0.05). CONCLUSION: The HCH linkage management mode can improve the compliance behaviour of patients with type 2 DN, effectively improve the renal function and blood sugar level of patients, enhance the self-management ability and cognition of the disease and delay the development of the disease.

Management of ectopic pregnancy after in vitro fertilization/intracytoplasmic sperm injection and embryo transfer: a case series and mini-review.

Background: Ectopic pregnancy (EP), reflecting a fertilized ovum implanted outside the normal uterine cavity, represents a frequent cause of morbidity and possibly mortality in women of reproductive age. Objective: To summarize the diagnosis and treatment of EP after in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). Methods: The medical records of patients who were diagnosed with EP after embryo transfer from 2017 to 2019, in a tertiary hospital were reviewed. Results: Of the 24 cases analyzed, 21 (87.5%) had fallopian tube involvement, while 2 (8.3%) and 1 (4.2%) had cornual and cervical pregnancies, respectively. Clinical manifestations included vaginal bleeding (58.3%) and lower abdominal pain (16.7%); 9 (42.9%) cases had no symptoms. One cornual pregnancy was misdiagnosed as acute appendicitis and later correctly diagnosed by laparoscopic exploration. There were 2 cases of multiple-site EP and 2 of heterotopic pregnancy, including one with an intrauterine pregnancy with double chorionic and four amniotic sacs and right tubal ampullary pregnancy. Five of the 21 cases with fallopian tube involvement received conservative treatment, while the remaining 16 underwent surgeries, including laparoscopic ipsilateral salpingostomy and ipsilateral salpingectomy. Discussion: Ectopic pregnancy after embryo transfer, mainly involving the fallopian tube, is very complex and is with diverse manifestations. Even with the pregnancy sac observed in the uterus, the pelvic cavity should be scanned thoroughly after embryo transfer.

Effects of grape seed procyanidins on the lipid metabolism of growing-finishing pigs based on transcriptomics and metabolomics analyses.

This study investigated how lipid metabolism in the longissimus thoracis is influenced by the diet supplemented with grape seed procyanidins (GSPs) in growing-finishing pigs. Forty-eight crossbred pigs were randomly assigned to four groups, each receiving a basal diet, or basal diet added with 150, 200, and 250 mg/kg GSPs. Transcriptomics and metabolomics were employed to explore differential gene and metabolite regulation. The expression of key lipid metabolism-related genes was tested via qRT-PCR, and the lipid and fatty acid composition of the longissimus thoracis were determined. Dietary GSPs at different concentrations upregulated lipoprotein lipase (LPL), which is involved in lipolysis, and significantly increased the mRNA expression levels of carnitine palmitoyltransferase-1B (CPT1B) and cluster of differentiation 36 (CD36), implicated in transmembrane transport of fatty acids. Dietary supplementation of GSPs at 200 or 250 mg/kg markedly reduced total cholesterol and triglyceride content in longissimus thoracis. Dietary GSPs significantly decreased the contents of low-density lipoprotein cholesterol and saturated fatty acids, while increasing unsaturated fatty acids. In conclusion, GSPs may regulate lipid metabolism, reducing cholesterol level, and improving fatty acid composition in the longissimus thoracis of growing-finishing pigs. Our findings provide evidence for the beneficial effects of GSPs as pig feed additives for improving lipid composition.

Pediatric contributions and lessons learned from the NEPTUNE cohort study.

Primary glomerular diseases are rare entities. This has hampered efforts to better understand the underlying pathobiology and to develop novel safe and effective therapies. NEPTUNE is a rare disease network that is focused on patients of all ages with minimal change disease, focal segmental glomerulosclerosis, and membranous nephropathy. It is a longitudinal cohort study that collects detailed demographic, clinical, histopathologic, genomic, transcriptomic, and metabolomic data. The goal is to develop a molecular classification for these disorders that supersedes the traditional pathological features-based schema. Pediatric patients are important contributors to this ongoing project. In this review, we provide a snapshot of the children and adolescents enrolled in NEPTUNE and summarize some key observations that have been made based on the data accumulated during the study. In addition, we describe the development of NEPTUNE Match, a program that aims to leverage the multi-scalar information gathered for each individual patient to provide guidance about potential clinical trial participation based on the molecular characterization and non-invasive biomarker profile. This represents the first organized effort to apply principles of precision medicine to the treatment of patients with primary glomerular disease. NEPTUNE has proven to be an invaluable asset in the study of glomerular diseases in patients of all ages including children and adolescents.

Non-volatile and volatile compound changes in blueberry juice inoculated with different lactic acid bacteria strains.

BACKGROUND: Lactic acid bacteria (LABs) are widely present in foods and affect the flavour of fermented cultures. This study investigates the effects of fermentation with Lactobacillus acidophilus JYLA-16 (La), Lactobacillus plantarum JYLP-375 (Lp), and Lactobacillus rhamnosus JYLR-005 (Lr) on the flavour profile of blueberry juice. RESULTS: This study showed that all LABs strains preferentially used glucose rather than fructose as the carbon source during fermentation. Lactic acid was the main fermentation product, reaching 7.76 g L-1 in La-fermented blueberry juice, 5.86 g L-1 in Lp-fermented blueberry juice, and 6.41 g L-1 in Lr-fermented blueberry juice. These strains extensively metabolized quinic acid, whereas oxalic acid metabolism was almost unaffected. Sixty-four volatile compounds were identified using gas chromatography-ion mobility spectrometry (GC-IMS). All fermented blueberry juices exhibited decreased aldehyde levels. Furthermore, fermentation with La was dominated by alcohols, Lp was dominated by esters, and Lr was dominated by ketones. Linear discriminant analysis of the electronic nose and principal component analysis of the GC-IMS data effectively differentiated between unfermented and fermented blueberry juices. CONCLUSION: This study informs LABs selection for producing desirable flavours in fermented blueberry juice and provides a theoretical framework for flavour detection. © 2023 Society of Chemical Industry.

Upregulation of S100A6 and its relation with CD34+ cells apoptosis in high-risk myelodysplastic syndromes patients.

Objectives: Myelodysplastic syndromes (MDS) are a group of myeloid malignancies characterized by peripheral blood cytopenia and hematopoietic dysplasia that often progress to acute myeloid leukemia (AML). Increased apoptosis of normal hematopoietic cells and decreased apoptosis of malignant clonal hematopoietic cells in patients with MDS is some of the mechanisms leading to ineffective hematopoietic cells in the bone marrow. S100 calcium-binding protein A6 (S100A6) is upregulated in many malignancies. The overexpression of S100A6 in these malignancies has been associated with proliferation, migration, and invasion phenotypes in cancer cells, and we aimed to investigate the expression of S100A6 in CD34+ cells and the relationship between S100A6 expression and apoptosis of CD34+ cells in high-risk patients with MDS. Methods: We measured S100A6 mRNA expression in bone marrow (BM) CD34+ cells from high-risk patients with MDS using RT-PCR. Next, we examined S100A6 expression in CD34+ cells using flow cytometry. We also analyzed the correlation between CD34+ cell apoptosis and S100A6 expression in high-risk patients with MDS. Results: Our data showed increased S100A6 mRNA expression in CD34+ cells in patients with MDS (1.05 ± 0.69 vs. 0.17 ± 0.12; P＜0.01). The expression of S100A6 in BM CD34+ cells also increased (58.40 ± 13.18 vs. 45.83 ± 15.01). The expression of S100A6 in CD34+ cells and apoptosis of CD34+ cells were negatively correlated in patients (r = -0.75; P < 0.01). Conclusions: Collectively, S100A6 may be a potential marker of CD34+ cells in high-risk patients with MDS and may participate in the pathological behaviors of CD34+ cells, such as evasion of apoptosis. Thus, S100A6 may be a potential target for eliminating minimal residual disease.

The diagnostic value of lipoprotein-associated phospholipase A2 in early diabetic nephropathy.

OBJECTIVE: The aim of this study was to investigate diagnosis of lipoprotein-associated phospholipase A2 (Lp-PLA2) in early diabetic nephropathy (DN). METHODS: A total of 342 type 2 diabetes mellitus (T2DM) patients hospitalized in department of metabolism and nephrology in our hospital from January 2019 to December 2019 were randomly selected. Patients were divided into three groups via urine albumin level: diabetes mellitus (DM) group, simple diabetes group (114 patients, urinary albumin creatinine ratio (UACR) < 30 mg/g); DN1 group, early DN group (114 patients, UACR: 30-300 mg/g); DN2 group: clinical DN group (114 patients, UACR > 300mg/g). Eighty healthy adults were examined at the same time. Lp-PLA2, fasting blood glucose (FBG), creatinine (Cr), triglyceride (TG), total cholesterol (TCHOL), high-density lipoprotein (HDL), low-density lipoprotein (LDL), haemoglobin A1c (HbA1c), blood urea nitrogen/creatinine (BUN/Cr), estimated glomerular filtration rate (eGFR), 24-h urine protein, albumin and creatinine of all subjects were detected and compared. Pearson's correlation analysis and multiple ordered logistic regression were used to investigate the correlation between serum Lp-PLA2 level and DN. The possibility of Lp-PLA2 in the diagnosis of early DN was studied by using the subject working curve. RESULTS: Lp-PLA2 level in DN1 and DN2 groups was significantly higher than that in DM group, with statistical difference (p < .05). With the progression of DN, the level of Lp-PLA2 gradually increased p < .05. Lp-PLA2 was positively correlated with FBG, TG, LDL and HbA1c (R = 0.637, p < .01; R = 0.314, p = .01; R = 0.213, p = .01; R = 0.661, p ≤ .01), was negatively correlated with HDL (r = -0.230, p < .01). The results showed that Lp-PLA2 was an independent factor in the evaluation of early DN. The area under the curve for the evaluation of serum Lp-PLA2 level in early DN was 0.841, the optimal critical value was 155.9 ng/mL, the sensitivity was 88% and the specificity was 76.2%. CONCLUSIONS: Lp-PLA2 is an independent factor for the evaluation of early DN, and can be used as an important potential specific indicator for the diagnosis of early DN, meanwhile monitoring the progression of DN.

Genome-wide association study of drought tolerance traits in sugar beet germplasms at the seedling stage.

Introduction: Sugar beets are an important crop for global sugar production. Intense drought and the increasing lack of water resources pose a great threat to sugar beet cultivation. It is a priority to investigate favourable germplasms and functional genes to improve the breeding of drought tolerant plants. Methods: Thus, in this study, 328 sugar beet germplasms were used in a genome-wide association study (GWAS) to identify single nucleotide polymorphism (SNP) markers and candidate genes associated with drought tolerance. Results: The results showed that under drought stress (9% PEG-6000), there were 11 significantly associated loci on chromosomes 2, 3, 5, 7, and 9 from the 108946 SNPs filtered using a mixed linear model (MLM). Genome-wide association analysis combined with qRT-PCR identified 13 genes that were significantly differentially expressed in drought-tolerant extreme materials. Discussion: These candidate genes mainly exhibited functions such as regulating sugar metabolism, maintaining internal environmental stability and participating in photosystem repair. This study provides valuable information for exploring the molecular mechanisms of drought tolerance and improvement in sugar beet.

Effects of grape seed procyanidins on antioxidant function, barrier function, microbial community, and metabolites of cecum in geese.

The gut is the first line of defense for body health and is essential to the overall health of geese. Grape seed procyanidins (GSPs) are proverbial for their antioxidant, anti-inflammatory, and microflora-regulating capabilities. This study aimed to inquire into the influences of dietary GSPs on the intestinal antioxidant function, barrier function, microflora, and metabolites of geese based on 16S rRNA sequencing and metabolomics. In total, 240 twenty-one-day-old Sichuan white geese were randomly divided into 4 groups, each of which was supplied with 1 of 4 diets: basal diet or a basal diet supplemented with 50, 100, or 150 mg/kg GSPs. Diets supplemented with GSPs at different concentrations significantly increased the total antioxidant capacity and superoxide dismutase activity in cecal mucosa (P < 0.001). Dietary supplementation with 50 or 100 mg/kg GSPs significantly increased catalase activity (P < 0.001). The serum diamine oxidase, D-lactic acid, and endotoxin concentrations were decreased by GSP supplementation in the goose diet. Dietary GSP supplementation increased microbial richness and diversity, enhanced the relative abundance of Firmicutes, and decreased that of Bacteroidetes in the cecum. Diets supplemented with 50 or 100 mg/kg GSPs enriched Eubacterium coprostanoligenes and Faecalibacterium. Dietary GSPs substantially raised the acetic and propionic acid concentrations in the cecum. The butyric acid concentration increased when the GSP dosage was 50 or 100 mg/kg. Additionally, dietary GSPs increased the levels of metabolites that belong to lipids and lipid-like molecules or organic acids and derivatives. Dietary GSP supplementation at 100 or 150 mg/kg reduced the levels of spermine (a source of cytotoxic metabolites) and N-acetylputrescine, which promotes in-vivo inflammation. In conclusion, dietary supplementation with GSPs was beneficial to gut health in geese. Dietary GSPs improved antioxidant activity; protected intestinal barrier integrity; increased the abundance and diversity of cecal microflora; promoted the proliferation of some beneficial bacteria; increased the production of acetic, propionic, and butyric acids in the cecum; and downregulated metabolites associated with cytotoxicity and inflammation. These results offer a strategy for promoting intestinal health in farmed geese.

Fabrication of dual heteroatom-doped graphitic carbon from waste sponge with "killing two birds with one stone" strategy for advanced aqueous zinc-ion hybrid capacitors.

Emerging aqueous zinc-ion hybrid capacitors (AZICs) are considered a promising energy storage because of their superior electrochemical performance. The pore structure, suitable heteroatom content, and graphitization degree (GD) of carbon-based cathodes significantly influence the electrochemical performance of AZICs. The N, S dual-doped porous graphitic carbon materials (LC-750) with the combined characteristics of high GD (1.11) and large specific surface area (1678.38 m2 g-1) are successfully developed by a facile "killing two birds with one stone" strategy using K3Fe(C2O4)3·3H2O as the activating and graphitizing agent, and waste sponge (WS) and coal tar pitch (CTP) as the heteroatom and carbon resource, respectively. Results show that the LC-750 cathode displays high capacities of 185.3 and 95.2 mAh g-1 at 0.2 and 10 A g-1. Specifically, the assembled LC-750//Zn capacitor can offer a maximal energy density of 119.5 Wh kg-1, a power density of 20.3 kW kg-1, and a capacity retention of 87.8% after 15,000 cycles at 10 A g-1. Density functional theory simulations demonstrate that N and S dual-doping can promote the adsorption kinetics of Zn ions. This design strategy is a feasible and cost-effective method for the preparation of dual heteroatom-doped graphitic carbon electrodes, which enables recycling of WS and CTP into high-valued products.

Clinical Analysis and Prognostic Prediction Model for Patients with Uterine Leiomyosarcoma at FIGO Stage I.

Purpose: To reveal the clinical status and construct a predictive prognostic model for patients with uterine leiomyosarcoma (uLMS) at International Federation of Gynecology and Obstetrics (FIGO) stage I. Patients and Methods: The medical records of patients with stage I uLMS during the study period were retrospectively reviewed. Multiple imputation, Martingale residuals and restricted cubic spline were used for data processing. Univariate and multivariate analyses were used to determine independent prognostic factors. The Schoenfeld individual test was used to verify the proportional hazards (PH) assumption. The predictive ability of the nomogram was validated internally. Results: Ultimately, 102 patients were included. The median age at diagnosis was 51 years old. During the medium follow-up time of 68 months, 55 (53.9%) patients developed recurrence. The median recurrence interval was 32 months. The most common metastatic site was the lung (27 cases). Eventually, 38 (37.3%) patients died of uLMS. The 3-year and 5-year overall survival rates were 66.0% and 52.0%, respectively. Age at diagnosis >49 years, larger tumor size, MI>10/10HPF, presence of LVSI and Ki-67 labeling index (LI) >25% (P=0.0467, 0.0077, 0.0475, 0.0294, and 0.0427, respectively) were independent prognostic factors. The PH assumption remained inviolate. The concordance index was 0.847, the area under the time-dependent receiver operating characteristic curve surpassed 0.7, and the calibration curve showed gratifying consistency. Conclusion: Age at diagnosis, tumor size, MI, LVSI, and Ki-67 LI were identified as independent prognostic factors for stage I uLMS. This prognostic nomogram would provide personalized assessment with superior predictive performance.

Targeted multi-omic analysis of human skin tissue identifies alterations of conventional and unconventional T cells associated with burn injury.

Burn injuries are a leading cause of unintentional injury, associated with a dysfunctional immune response and an increased risk of infections. Despite this, little is known about the role of T cells in human burn injury. In this study, we compared the activation and function of conventional T cells and unconventional T cell subsets in skin tissue from acute burn (within 7 days from initial injury), late phase burn (beyond 7 days from initial injury), and non-burn patients. We compared T cell functionality by a combination of flow cytometry and a multi-omic single-cell approach with targeted transcriptomics and protein expression. We found a significantly lower proportion of CD8+ T cells in burn skin compared to non-burn skin, with CD4+ T cells making up the bulk of the T cell population. Both conventional and unconventional burn tissue T cells show significantly higher IFN-γ and TNF-α levels after stimulation than non-burn skin T cells. In sorted T cells, clustering showed that burn tissue had significantly higher expression of homing receptors CCR7, S1PR1, and SELL compared to non-burn skin. In unconventional T cells, including mucosal-associated invariant T (MAIT) and γδ T cells, we see significantly higher expression of cytotoxic molecules GZMB, PRF1, and GZMK. Multi-omics analysis of conventional T cells suggests a shift from tissue-resident T cells in non-burn tissue to a circulating T cell phenotype in burn tissue. In conclusion, by examining skin tissue from burn patients, our results suggest that T cells in burn tissue have a pro-inflammatory rather than a homeostatic tissue-resident phenotype, and that unconventional T cells have a higher cytotoxic capacity. Our findings have the potential to inform the development of novel treatment strategies for burns.

Myeloid-derived suppressor cells inhibit natural killer cells in myelodysplastic syndromes through the TIGIT/CD155 pathway.

OBJECTIVE: This experiment will explore the role of TIGIT/PVR signaling pathway in the pathogenesis of MDS immune tolerance through in vitro co-culture of NK cells and MDSC cells. METHODS: Flow cytometry was used to detect the expression percentage of MDSCs and CD155 on MDSCs in the bone marrow of MDS patients and controls. The expression of NK cell surface receptors (NKG2D, NKp30, NKp46), secreted cytokines (perforin, granzyme B, CD107a, IFN-γ) and NK cell apoptosis rate were detected by flow cytometry to evaluate the effect of MDSCs on NK cell function. RESULTS: The number of MDSCs in bone marrow of MDS patients was notably higher than that of the control group (8.39 ± 7.01 vs 2.31 ± 1.65, P = 0.0001). Compared with the control group, the expression of CD155 on MDSCs in MDS group was increased (31.81 ± 21.33 vs. 10.49 ± 6.53, P < 0.0001). After NK cells were co-cultured with MDSCs, NKG2D, NKp30, NKp46, CD107a, IFN-γ, perforin and granzyme B were decreased, and the NK function partially recovered after the addition of inhibitors. CONCLUSION: Compared with the normal control, MDSCs and CD155 on MDSCs were highly expressed in MDS patients. After co-culture with MDSCs, the expression of NK cells' surface receptors decreased, the secretion of cytokines decreased and the apoptosis rate increased. After blocking TIGIT/CD155 pathway, NK cell function was reversed, but NK cell apoptosis was not reduced.

Au Nanoparticles (NPs) Decorated Co Doped ZnO Semiconductor (Co400-ZnO/Au) Nanocomposites for Novel SERS Substrates.

Au nanoparticles were decorated on the surface of Co-doped ZnO with a certain ratio of Co2+/Co3+ to obtain a novel semiconductor-metal composite. The optimal substrate, designated as Co400-ZnO/Au, is beneficial to the promotion of separation efficiency of electron and hole in a semiconductor excited under visible laser exposure, which the enhances localized surface plasmon resonance (LSPR) of the Au nanoparticles. As an interesting finding, during Co doping, quantum dots of ZnO are generated, which strengthen the strong semiconductor metal interaction (SSSMI) effect. Eventually, the synergistic effect effectively advances the surface enhancement Raman scattering (SERS) performance of Co400-ZnO/Au composite. The enhancement mechanism is addressed in-depth by morphologic characterization, UV-visible, X-ray diffraction, photoluminescence, X-ray photoelectron spectroscopy, density functional theory, and finite difference time domain (FDTD) simulations. By using Co400-ZnO/Au, SERS detection of Rhodamine 6G presents a limit of detection (LOD) of 1 × 10-9 M. As a real application, the Co400-ZnO/Au-based SERS method is utilized to inspect tyramine in beer and the detectable concentration of 1 × 10-8 M is achieved. In this work, the doping strategy is expected to realize a quantum effect, triggering a SSSMI effect for developing promising SERS substrates in future.

Tong-Qiao-Huo-Xue decoction activates PI3K/Akt/mTOR pathway to reduce BMECs autophagy after cerebral ischemia/reperfusion injury.

ETHNOPHARMACOLOGICAL RELEVANCE: Tong-Qiao-Huo-Xue Decoction (TQHXD) is a traditional classic Chinese Medicinal Formula (CMF) used for clinical treatment of ischemic stroke. TQHXD leads to improvement in the symptoms of the acute period of cerebral infarction and recovery period after stroke. Our previous studies also showed that TQHXD produced a significant protective effect on the brain after cerebral ischemia-reperfusion (I/R) injury. It is reported that autophagy is closely related to ischemic brain injury; however, the functional contribution of TQHXD to brain microvascular endothelial cell (BMEC) autophagy and its underlying mechanism remains unclear. AIM OF THE STUDY: The purpose of this study was to investigate the effects and mechanism of TQHXD in inhibiting cerebral ischemia-induced endothelial autophagy. MATERIALS AND METHODS: The high-performance liquid chromatography (HPLC) fingerprint of the chemical constituents from TQHXD was established for the quality control, and the Longa method was used to evaluate the efficacy of TQHXD in rats with middle cerebral artery occlusion (MCAO). The expression of LC3 was determined by immunofluorescence double staining. To evaluate the protective effects of TQHXD-containing cerebrospinal fluid (CSF) on BMECs injured by oxygen-glucose deprivation and reperfusion, cell survival rate was determined using the CCK-8 assay and cell apoptosis was determined by fluorescein isothiocyanate (FITC)-Annexin V/PI. Autophagy was detected using transmission electron microscopy. RESULTS: The results showed that TQHXD-CSF significantly ameliorated oxygen-glucose deprivation/reperfusion (OGD/R)-induced injury in BMECs. Confocal microscopy and Western blot results showed that TQHXD-CSF reduced autophagy-related protein expression and autophagosome number. The results of the western blotting indicated that TQHXD-CSF caused a marked increase in the phosphorylation of protein kinase B and phosphoinsotide-3 kinase (Akt/p-Akt and PI3K/p-PI3K, respectively) and their expression levels were down-regulated after treatment with pathway inhibitor, ZSTK474. Furthermore, in a MCAO model in rats, TQHXD markedly increased p-PI3K, p-Akt and p-mTOR, whereas the autophagy related proteins decreased. CONCLUSIONS: Taken together, these findings demonstrate that TQHXD protects against ischemic insult by inhibiting autophagy through the regulation of the PI3K/Akt/mammalian target of rapamycin (mTOR) pathway and that TQHXD may have therapeutic value for protecting BMECs from cerebral ischemia.

Radiofrequency ablation of the great saphenous vein in the treatment of varicose veins of the lower extremities.

OBJECTIVE: The present study aims to investigate the therapeutic effect and safety of radiofrequency ablation (RFA) of the great saphenous vein in the treatment of varicose veins of the lower extremities. METHODS: Sixty-nine affected limbs of 45 patients were treated with RFA of the great saphenous vein. All patients underwent retrograde puncture of the distal great saphenous vein under the guidance of B-ultrasound. An RFA catheter was introduced 1 cm below the junction of the great saphenous vein and the femoral vein. A tumescent solution was injected around the femoral vein, and the great saphenous vein was ablated section by section from the upper part to the lower part. Twelve months after RFA, color Doppler ultrasound was used to evaluate the closure of great saphenous vein, and changes in the clinical class, etiology, anatomy, pathology (CEAP) classification before and after treatment were compared. The visual analogue score (VAS) was used to evaluate the local pain on the first and third day after operation. The incidence of complications (e.g., phlebitis, thrombosis, infection) was also evaluated. RESULTS: The ablation of the 69 affected limbs in all the 45 patients was successful. Instant B-ultrasound revealed occlusion of the great saphenous vein and the disappearance of blood flow immediately after ablation. There was no reoccurrence in all patients at the 12 month follow-up. The CEAP classification grade after treatment was significantly lower than that before the treatment, and the difference was statistically significant (χ2 = 4.188, P<0.05). The VAS scores on the first and third days after operation were 1.85 ± 0.35 and 0.59 ± 0.21, respectively. Pain was mild, and only two patients required painkillers. No complications were noted, with the exception of five cases of local ecchymosis. CONCLUSION: RFA of the great saphenous vein may represent an effective method for treating varicose veins of the lower extremities. RFA has the advantages of producing less trauma, fewer complications, and a lower incidence of recurrence. KEY WORDS: B-ultrasonography, Pain, Radiofrequency ablation, Varicose veins.

Clinical study on acupuncture treatment of COVID-19: A protocol for a systematic review and meta-analysis.

BACKGROUND: COVID-19 is an acute respiratory infectious disease, which makes people difficult to breathe; in addition, it is often accompanied by headache, olfaction, and taste disorders of the neurological manifestations. Acupuncture has been proved to have a therapeutic effect on various neurologic manifestations. This study is designed to evaluate the effectiveness and safety of acupuncture for the neurologic manifestations in COVID-19. METHODS: Randomized controlled trials from December 2019 to July 2021 will be included without restrictions on language or publication date. PubMed, EMBASE, Cochrane Library, Web of Science, Chinese Biomedical Databases (CBM), China National Knowledge Infrastructure (CNKI), Wanfang database, and VIP database will be searched. Two researchers will independently select studies, extract data, and evaluate study quality. Cochrane risk of bias tool for randomized trials will be used to assess the risk of bias of included studies. Statistical analyses will be performed using the Review Manager V.5.3 and stata 14.0. ETHICS AND DISSEMINATION: This study will not involve personal information. Ethical approval will not be required. We will publish the results in a peer-reviewed journal. PROSPERO TRIAL REGISTRATION NUMBER: CRD42021265699.