Improving vanadium removal from contaminated river water in constructed wetlands: The role of arbuscular mycorrhizal fungi.

Industrial activities pose a significant ecological risk to water resources as they pollute surrounding waters with vanadium (V). Although the contribution of plants and substrates to V removal in constructed wetlands (CWs) has been reported, the role of arbuscular mycorrhizal fungi (AMF) is unclear. The aim of the present study was to investigate the role of AMF in V removal in CWs and to elucidate the underlying mechanisms. Reed plants (Phragmites australis) were inoculated with an AMF strain (Rhizophagus irregularis) in CW columns, creating AMF-inoculated (+AMF) and non-inoculated (-AMF) treatments. Three levels of influent V concentrations (low: 0.50 mg L-1, medium: 1.14 mg L-1 and high: 1.52 mg L-1) were examined. The + AMF treatment showed higher V removal (60%-98%) than the control (40%-82%) in all three conditions, although the difference was not significant in some cases. The mean mycorrhizal effects were 75%, 19%, and 28% for low, moderate, and high influent V concentrations, respectively. The +AMF treatment showed a higher GRSP-bonded V concentration (5.5 mg g-1) than the -AMF treatment (4.0 mg g-1). Furthermore, +AMF treatment showed larger plants with higher V concentrations in their tissues, accompanied by increased biological concentration factors and biological accumulation factors. Given the remarkable positive effect of AMF on V removal, our study suggests that treating AMF in CWs is a worthwhile approach.

DWSSA: Alleviating over-smoothness for deep Graph Neural Networks.

Graph Neural Networks (GNNs) have demonstrated great potential in achieving outstanding performance in various graph-related tasks, e.g., graph classification and link prediction. However, most of them suffer from the following issue: shallow networks capture very limited knowledge. Prior works design deep GNNs with more layers to solve the issue, which however introduces a new challenge, i.e., the infamous over-smoothness. Graph representation over emphasizes node features but only considers the static graph structure with a uniform weight are the key reasons for the over-smoothness issue. To alleviate the issue, this paper proposes a Dynamic Weighting Strategy (DWS) for addressing over-smoothness. We first employ Fuzzy C-Means (FCM) to cluster all nodes into several groups and get each node's fuzzy assignment, based on which a novel metric function is devised for dynamically adjusting the aggregation weights. This dynamic weighting strategy not only enables the intra-cluster interactions, but also inter-cluster aggregations, which well addresses undifferentiated aggregation caused by uniform weights. Based on DWS, we further design a Structure Augmentation (SA) step for addressing the issue of underutilizing the graph structure, where some potentially meaningful connections (i.e., edges) are added to the original graph structure via a parallelable KNN algorithm. In general, the optimized Dynamic Weighting Strategy with Structure Augmentation (DWSSA) alleviates over-smoothness by reducing noisy aggregations and utilizing topological knowledge. Extensive experiments on eleven homophilous or heterophilous graph benchmarks demonstrate the effectiveness of our proposed method DWSSA in alleviating over-smoothness and enhancing deep GNNs performance.

Predictive Value of Fibrin Fibrinogen Degradation Products-to-Potassium Ratio for Poor Functional Outcome in Patients with Aneurysmal Subarachnoid Hemorrhage: A Retrospective Case-Control Study.

BACKGROUND: The relationship of fibrin(ogen) degradation products (FDPs) and potassium with the functional outcomes of patients with aneurysmal subarachnoid hemorrhage (aSAH) is still uncertain. This study aims to evaluate the predictive value of a novel combination biomarker, the FDP-to-potassium ratio (FPR), for poor functional outcomes in patients with aSAH. METHODS: A total of 425 consecutive patients with aSAH at a single center were retrospectively enrolled in our study. An unfavorable outcome was defined as a modified Rankin Scale (mRS) score of 3-6 at 3 months after discharge. Univariate analysis and multivariable logistic regression were performed for baseline information and laboratory parameters recorded at admission. In addition, the receiver operating characteristic curve was plotted, and propensity score matching was performed based on the FPR. RESULTS: On the basis of mRS grade, 301 patients were classified as having favorable outcomes, and 124 patients were assessed as having unfavorable outcomes. FPR levels were significantly correlated with mRS grade (r[Spearman] = 0.410; P < 0.001). Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.043, 95% confidence interval [CI] 1.016-1.071; P = 0.002), white blood cell count (OR 1.150, 95% CI 1.044-1.267; P = 0.005), potassium (OR 0.526, 95% CI 0.291-0.949; P = 0.033), World Federation of Neurosurgical Societies grade (OR 1.276, 95% CI 1.055-1.544; P = 0.012), and FPR (OR 1.219, 95% CI 1.102-1.349; P < 0.001) at admission were independently associated with poor functional outcomes. The DeLong test showed that the area under the receiver operating characteristic curve of FPR was higher than that of age, white blood cell count, potassium, World Federation of Neurosurgical Societies grade, or FDP alone, indicating that FPR had better predictive potential than these other variables. After 1:1 propensity score matching (FPR ≥ 1.45 vs. FPR < 1.45), the rate of poor prognosis was still significantly increased in the high-FPR group (48/121 [39.7%] vs. 16/121 [13.2%], P < 0.001). CONCLUSIONS: Fibrin(ogen) degradation product-to-potassium ratio is an independent predictor of poor outcomes for patients with aSAH and may be a promising tool for clinicians to evaluate patients' functional prognosis.

Linggui Zhugan decoction delays ventricular remodeling in rats with chronic heart failure after myocardial infarction through the Wnt/ß-catenin signaling pathway.

CONTEXT: Traditional Chinese medicine plays an important role in the prevention and treatment of heart failure (HF). Linggui Zhugan decoction has been approved for clinical treatment of chronic HF. However, the mechanism is still unclear. OBJECTIVE: The effect of Linggui Zhugan decoction on the Wnt/ß-catenin signaling pathway in rat myocardium was studied to investigate the mechanism by Linggui Zhugan decoction effects ventricular remodeling in rats with heart failure after myocardial infarction. METHOD: A rat model of HF after myocardial infarction was prepared by ligating the left anterior descending coronary artery. After 6 weeks of intervention with Linggui Zhugan decoction, the effect of Linggui Zhugan decoction on the cardiac function of chronic HF model rats was observed. Myocardial infarct size was measured by triphenyl tetrazolium chloride (TTC) staining. Enzyme linked immunosorbent assays (ELISAs) were used to measure NT-proBNP and sST-2 concentrations in rat serum. Hematoxylin and eosin (H&E) staining, and Masson's trichrome staining were used to observe the morphology of myocardial tissue; immunohistochemistry was used to detect the protein expression of type I collagen and type III collagen in myocardial tissue; and mRNA expression levels of Wnt3a, GSK-3ß, ß-catenin, and c-Myc in the infarct marginal zone were detected using PCR. Protein expression of Wnt3a, p-GSK-3ß, GSK-3ß, and ß-catenin in the infarct marginal zone was detected using western blot. RESULTS: Compared with the control, Linggui Zhugan decoction reduced the levels of serum ST-2 and NT-proBNP, improved cardiac function, and reduced the deposition of collagen fiber. In addition, Linggui Zhugan decoction inhibited the expression of Wnt3a, p-GSK-3ß, and ß-catenin in cardiomyocytes. CONCLUSION: Linggui Zhugan decoction inhibits the expression of several key proteins in the Wnt/ß-catenin signaling pathway, delays cardiomyocyte hypertrophy and fibrosis, and improves cardiac function.

Predicting Recurrence in Pancreatic Ductal Adenocarcinoma after Radical Surgery Using an AX-Unet Pancreas Segmentation Model and Dynamic Nomogram.

This study aims to investigate the reliability of radiomic features extracted from contrast-enhanced computer tomography (CT) by AX-Unet, a pancreas segmentation model, to analyse the recurrence of pancreatic ductal adenocarcinoma (PDAC) after radical surgery. In this study, we trained an AX-Unet model to extract the radiomic features from preoperative contrast-enhanced CT images on a training set of 205 PDAC patients. Then we evaluated the segmentation ability of AX-Unet and the relationship between radiomic features and clinical characteristics on an independent testing set of 64 patients with clear prognoses. The lasso regression analysis was used to screen for variables of interest affecting patients' post-operative recurrence, and the Cox proportional risk model regression analysis was used to screen for risk factors and create a nomogram prediction model. The proposed model achieved an accuracy of 85.9% for pancreas segmentation, meeting the requirements of most clinical applications. Radiomic features were found to be significantly correlated with clinical characteristics such as lymph node metastasis, resectability status, and abnormally elevated serum carbohydrate antigen 19-9 (CA 19-9) levels. Specifically, variance and entropy were associated with the recurrence rate (p < 0.05). The AUC for the nomogram predicting whether the patient recurred after surgery was 0.92 (95% CI: 0.78-0.99) and the C index was 0.62 (95% CI: 0.48-0.78). The AX-Unet pancreas segmentation model shows promise in analysing recurrence risk factors after radical surgery for PDAC. Additionally, our findings suggest that a dynamic nomogram model based on AX-Unet can provide pancreatic oncologists with more accurate prognostic assessments for their patients.

Linggui Zhugan Decoction activates the SIRT1-AMPK-PGC1α signaling pathway to improve mitochondrial and oxidative damage in rats with chronic heart failure caused by myocardial infarction.

Objective: To investigate the effects of Linggui Zhugan Decoction on mitochondrial and oxidative damage in rats with chronic heart failure after myocardial infarction and the related mechanisms. Methods: Chronic heart failure after myocardial infarction was established by coronary artery ligation. Heart failure rats were randomly divided into three groups: Model group (n = 11), Linggui Zhugan Decoction group (n = 12), and captopril group (n = 11). Rats whose coronary arteries were only threaded and not ligated were sham group (n = 11). Cardiac function, superoxide dismutase (SOD), malondialdehyde (MDA) contents, soluble growth-stimulating expression factor (ST2), and N-terminal B-type brain natriuretic peptide precursor (NTproBNP) levels were analyzed after treatment. Moreover, the level of mitochondrial membrane potential was detected by JC-1 staining, the ultrastructural of myocardial mitochondria were observed by transmission electron microscopy. The related signal pathway of silent information regulator factor 2-related enzyme 1 (SIRT1), adenylate activated protein kinase (AMPK), phosphorylated adenylate activated protein kinase (p-AMPK), and peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α) is an important pathway to regulate mitochondrial energy metabolism, and to initiate mitochondrial biogenesis. The expression level was detected by Western blot and reverse transcription to explore the mechanism of the decoction. Results: Compared with the model rats, Linggui Zhugan Decoction significantly improved cardiac function (p < 0.05), reduced MDA production (p < 0.01), increased SOD activity (p < 0.05), reduced ST-2(p < 0.01), and NT-proBNP(p < 0.05) levels, increased mitochondrial membrane potential, and improved mitochondria function. In addition, Linggui Zhugan Decoction upregulated the expression of SIRT1, p-AMPK, PGC-1α protein, and mRNA in cardiac myocytes. Conclusion: Linggui Zhugan Decoction can improve the cardiac function of heart failure rats by enhancing myocardial antioxidant capacity and protecting the mitochondrial function, the mechanism is related to activating SIRT1/AMPK/PGC-1α signaling pathway.

Availability of Laboratory Diagnosis of Gonorrhoea and Its Meaning in Case Reporting in Shandong Province, China.

Background: Gonorrhea, caused by the bacterium Neisseria gonorrhoeae (NG), is a major public health concern worldwide. Aim of the Study: The aim of this study is to understand the availability of laboratory diagnosis of gonorrhoea in Shandong province and its meaning in case reporting. Methods: Two surveys were conducted among hospitals providing clinical services for sexually transmitted infection (STI) in Shandong Province in 2012 and 2018. The availability of laboratory tests for NG and distribution of reported gonorrhea cases were compared among different hospitals provided clinical services for STI in Shandong province. Descriptive analysis and Chi-square were used for statistical analysis. Results: Smear, culture and PCR tests for NG were used among 301(74.69%), 123(30.52%), 43(10.67%) hospitals in 2012 and 356(74.48%), 176(36.82%) and 73(15.27%) hospitals in 2018, respectively. Significant differences were observed in the availability of smear among hospitals at different levels (X2=12.159, p=0.000) and with different affiliations (X2=4.551, p=0.033) in 2018. Significant differences were observed in the availability of culture and PCR tests among hospitals at different levels both in 2012 (X2=34.532, p=0.000; X2=7.380, p=0.007) and 2018 (X2=49.820, p=0.000; X2=21.658, p=0.000). The availability of culture and PCR tests for NG among hospitals in 2018 was higher than that in 2012 (X2=3.870, p=0.049; X2=4.050, p=0.044). More hospitals reported gonorrhea cases in 2018 than in 2012 (X2=6.768, p=0.009). A significant difference was observed in distribution of case reporting among hospitals at different levels in 2018 (X2=6.975, p=0.008) and among different types of hospital both in 2012 (X2=52.362, p=0.000) and 2018 (X2=74.478, p=0.000). Conclusion: Poor availability of NG laboratory tests affects case reporting, and which is a crucial reason leading to underreporting of gonorrhea cases in Shandong province.

Full-length EFOP3 and EFOP4 proteins are essential for pollen intine development in Arabidopsis thaliana.

Pollen development is critical to plant reproduction, but the underlying regulatory molecular mechanisms have not been fully elucidated. The Arabidopsis (Arabidopsis thaliana) EFR3 OF PLANT 3 (EFOP3) and EFR3 OF PLANT 4 (EFOP4) genes encode members of the Armadillo (ARM) repeat superfamily that play key roles in pollen development. Herein, we demonstrate that EFOP3 and EFOP4 are co-expressed in pollen at anther stages 10-12, but loss-of-function of both EFOP3 and EFOP4 leads to male gametophyte sterility, irregular intine, and shriveled pollen grains at anther stage 12. We further established that full-length EFOP3 and EFOP4 specifically localize to the plasma membrane, and the integrity of these proteins is essential for pollen development. We observed uneven intine, less organized cellulose and reduced pectin content in mutant pollen compared with the wild-type. These, together with the misexpression of several genes related to cell wall metabolism in efop3-/- efop4+/- mutants, suggest that EFOP3 and EFOP4 may indirectly regulate the expression of these genes to affect intine formation, thus controlling Arabidopsis pollen fertility in a functionally redundant manner. Moreover, transcriptome analysis showed that the absence of EFOP3 and EFOP4 function affects multiple pollen development pathways. These results enhance our understanding of EFOPs proteins and their role in pollen development.

A systematic review and Bayesian meta-analysis of the antibiotic treatment courses in AECOPD.

Background: No consensus exists on the antibiotic treatment course for patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Former studies indicate that shorter courses might have the same efficacy with fewer adverse events, which is inconsistent with guidelines and general practice. Existing evidence allows us to conduct a systematic review and Bayesian analysis on this topic. Methods: Four databases were searched from their inception to January 5, 2023. All statistical estimations were performed using R. "Gemtc" was the core package of analysis. CINeMA was used to assess the grade of confidence of the results. Results: Fourteen studies were included in the Bayesian meta-analysis. No difference in the clinical success rate of antibiotic treatment was observed from a super short course (1-3 days) to a long course (≥10 days). Considering the adverse events, the short course (4-6 days) might be the safest. The majority of results were of high or moderate confidence grade. Conclusion: Short course might cause the fewest adverse events. The clinical efficacy of antibiotics might not depend on the course length. Undeniably, more systematic explorations are warranted to investigate the clinical application of a shorter course of antibiotic treatment.

Synoptic view of an unprecedented red Noctiluca scintillans bloom in the Beibu Gulf, China.

An unprecedented red Noctiluca scintillans (RNS) bloom in February 2021 in the Beibu Gulf, China was investigated using multi-sensor imagery. The location and spatial extent of the RNS patches were delineated based on the spectral signature. A combination of satellite remote sensing and numerical model data over the region was used to detect and monitor the development and progress of the RNS bloom and figure out the possible mechanism. Multi-sensor satellite imagery demonstrates a total coverage area of >20,000 km2 for the two-phase bloom event from Feb 13 to 26, with abrupt dissipation on Feb 17 and reappearance on Feb 20. Analysis of the initialization mechanism of the bloom suggests that nutrients conveyed from the western coast of Guangdong through Qiongzhou Strait and from convective transport in the offshore area together stimulated the outbreak of the bloom. The most distinctive finding is the negative correlation between the area of RNS patches and wind speed. The abrupt disappearance of the RNS bloom deserves further study.

Comparison of the relationship between cognitive function and future falls in Chinese community-dwelling older adults with and without diabetes mellitus.

OBJECTIVE: The aim of this study was to determine whether cognitive function is associated with future falls in older patients with diabetes mellitus (DM) compared with those without DM. Cognitive function was divided into several domains to further analyze. METHODS: A total of 678 individuals met the inclusion criteria and comprised the final study population. The mean age was 74.35 ± 5.35 years, and 58.9% of the participants were female (n = 400). At the baseline, cognitive function was measured by the Mini Mental State Examination (MMSE), and DM diagnoses were determined by medical records. The self-reported any falls data were obtained via face-to-face questioning at the 1-year follow-up. RESULTS: At baseline, 15.6% of participants (n = 106) were diagnosed with DM. According to whether they had any falls during 1-year follow-up, there was a significant difference between the two group in fasting plasma glucose (p = 0.012) and DM (p = 0.036) at baseline. Among the older adults with DM, those who had experienced any falls had poorer cognitive function (p = 0.014). After adjusting for various covariates, we found that MMSE (95% CI 0.790-0.991, p = 0.034), orientation to place (95% CI 0.307-0.911, p = 0.022) and registration (95% CI 0.162-0.768, p = 0.009) were significantly associated with falls in the follow-up. CONCLUSION: Our study found that in patients with DM, cognitive function is related to future falls. Not only overall cognitive function, but also orientation to place and registration were all associated with future falls in older adults with DM. When completing the fall risk assessment of elderly patients with DM, clinicians should give more attention to the testing of cognitive function.

Xianling Gubao attenuates high glucose-induced bone metabolism disorder in MG63 osteoblast-like cells.

Diabetes mellitus (DM) patients are prone to osteoporosis, and high glucose (HG) can affect bone metabolism. In the present study, we investigated the protective effects of traditional Chinese herbal formulation Xianling Gubao (XLGB) on HG-treated MG63 osteoblast-like cells. MG63 cells were incubated with control (mannitol), HG (20 mM glucose) or HG + XLGB (20 mM glucose+200 mg/L XLGB) mediums. Cell proliferation, apoptosis, migration and invasion were examined using CCK8, colony-formation, flow cytometry, Hoechst/PI staining, wound-healing and transwell assays, respectively. ELISA, RT-PCR and western blot analysis were used to detect the levels of osteogenesis differentiation-associated markers such as ALP, OCN, OPN, RUNX2, OPG, and OPGL in MG63 cells. The levels of the PI3K/Akt signaling pathway related proteins, cell cycle-related proteins, and mitochondrial apoptosis-related proteins were detected using western blot analysis. In HG-treated MG63 cells, XLGB significantly attenuated the suppression on the proliferation, migration and invasion of MG63 cells caused by HG. HG downregulated the activation of the PI3K/Akt signaling pathway and the expressions of cell cycle-related proteins, while XLGB reversed the inhibition of HG on MG63 cells. Moreover, XLGB significantly reduced the promotion on the apoptosis of MG63 cells induced by HG, the expressions of mitochondrial apoptosis-related proteins were suppressed by XLGB treatment. In addition, the expressions of osteogenesis differentiation-associated proteins were also rescued by XLGB in HG-treated MG63 cells. Our data suggest that XLGB rescues the MG63 osteoblasts against the effect of HG. The potential therapeutic mechanism of XLGB partially attributes to inhibiting the osteoblast apoptosis and promoting the bone formation of osteoblasts.

Retrospectively analyze and compare the efficacy and safety of thoracoscopic-assisted Nuss repair of pectus excavatum under intubation anesthesia and non-intubation anesthesia.

Background: Thoracoscopic-assisted Nuss repair is a commonly used method for treating pectus excavatum, which has always been performed under tracheal intubation and general anesthesia. However, general anesthesia with endotracheal intubation can produce intubation and anesthetic drug related complications. In non-intubation anesthesia, laryngeal mask is used instead of tracheal intubation without muscle relaxants and small doses of sedative and analgesic drugs. Therefore, non-intubation anesthesia can reduce complications and speed up postoperative recovery. This study retrospectively analyzed the clinical impact of these two anesthesia methods on thoracoscopic-assisted Nuss repair for the treatment of pectus excavatum. Methods: A total of 115 pectus excavatum patients who underwent thoracoscopic-assisted Nuss procedure repair in the Department of Thoracic Surgery of Yunnan First People's Hospital from January 2017 to January 2022 were included. All subjects in this study underwent thoracoscopic assisted Nuss repair in the same thoracic surgical team. According to different anesthesia methods, they were divided into non-intubation anesthesia group (n=62) and intubation anesthesia group (n=53). The intubation time, intraoperative mean heart rate, postoperative complications, postoperative first oral food intake, water intake, ambulation, defecation time, postoperative blood drawing results, postoperative hospital stay and total hospitalization cost were compared between the two groups. Results: There were no significant differences in clinical characteristics and preoperative examination indexes between the two groups, which were comparable. Compared with the intubation anesthesia group, the non-intubation anesthesia group had less anesthesia intubation time, lower intraoperative mean heart rate, less postoperative complications, such as pneumothorax, pleural effusion, and lung infection. In the non-intubation anesthesia group, the first time to eat, drink, get out of bed, and defecate were all earlier. Routine blood results 24 h after surgery indicated that the non-intubation anesthesia group had lower white blood cell, neutrophil and lymphocyte, an earlier postoperative discharge time, and lower total hospitalization expenses. Conclusions: Non-intubation anesthesia in thoracoscopic-assisted Nuss procedure for the repair of pectus excavatum can make the postoperative recovery of patients faster and has better safety and efficacy.

Plasmonic fiber-optic sensing system for in situ monitoring the capacitance and temperature of supercapacitors.

Compared with ex situ measurement, the in situ measurement is more suitable for inspecting complex electrochemical reactions and improving the intelligent energy storage management. However, most of the in situ investigation instruments are bulky and expensive. Here we demonstrate a miniaturized, portable, and low-cost fiber-optic sensing system for in situ monitoring the capacitance and temperature. It can help evaluate the self-discharge rate in supercapacitors (SCs). The fiber-optic sensing system with two probes are implanted inside the SCs to monitor the capacitance and temperature, respectively. The dual fiber-optic probes can work independently and avoid cross-interference through structure design. The fiber-optic localized surface plasmon resonance (LSPR) probe near the electrode surface can detect the capacitance in real-time by monitoring ion aggregation on the opposite electrode. The fiber-optic surface plasmon resonance (SPR) probe encapsulated in the thermosensitive liquid can independently detect the temperature change. The measurement uncertainties of the two sensing probes are 5.6 mF and 0.08 ℃, respectively. The proposed tiny and flexible fiber-optic sensing system provides a promising method for in situ monitoring the critical parameters. It is also a powerful tool for investigating electrochemical reactions in various energy storage devices.

Comparative effectiveness of interventional therapeutic modalities for unresectable hepatocellular carcinoma: A systematic review and network meta-analysis.

It is unclear whether hepatic artery infusion chemotherapy (HAIC) or transcatheter arterial chemoembolization (TACE) is more efficient in the combination therapy of hepatocellular carcinoma (HCC). Head-to-head comparisons among HAIC-related therapies are lacking. For this network meta-analysis, PubMed, EMBASE and Cochrane Library databases were searched up to April 1, 2022. Randomized controlled trials (RCTs) were eligible if they evaluated the use or prolongation of TACE or HAIC in patients with advanced HCC and reported or collected survival data. A network meta-analysis was performed to synthesize data and make direct and indirect comparisons between treatments. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to explore the efficacy of various treatment options on overall survival (OS), odds ratios (ORs) with 95% CI were used for overall response rate (ORR), whereas risk ratios (RRs) with 95% CI were used for serious adverse events (SAEs). The analysis of 7 trials including a total of 1,073 patients found that sorafenib with HAIC-oxaliplatin improved survival (HR=0.33, 95% CI: 0.25-0.44); the ORR was also improved in patients treated with sorafenib plus HAIC-oxaliplatin and sorafenib plus PF-HAIC (OR=22.18, 95% CI: 10.69-52.56; and OR=2.72, 95% CI: 1.43-5.36, respectively). The incidence of liver injury was elevated in patients treated with sorafenib plus TACE (OR=5.93, 95% CI: 2.70-15.41). However, no differences in the incidences of other SAEs were identified among the treatment groups. The present meta-analysis provides preliminary evidence for the comparative safety and efficacy of HAIC and TACE combined with sorafenib, and indicates the dominance of HAIC-oxaliplatin in HCC interventional therapy. However, high-quality RCTs are required to further confirm the efficacy of HAIC-oxaliplatin. The present study has been registered with PROSPERO (registration no. CRD42021288497).

Using proton pump inhibitors increases the risk of hepato-biliary-pancreatic cancer. A systematic review and meta-analysis.

Background: More and more studies are focusing on the adverse effects and damage caused by PPI abuse, we carried out a systematic review and meta-analysis for assessing whether the proton pump inhibitor (PPI) leads to hepato-biliary-pancreatic cancer. Methods: PubMed, EMBASE and Web of Science were searched until 1 July 2022, 25 studies (17 case-control and 8 cohort studies; 2741853 individuals) included in this study. Pooled Odd Ratios (ORs) were used for random effect models. Sensitivity analysis and dose-response analysis, subgroup analysis were all conducted. Results: The aggregate OR of the meta-analysis was 1.69 (95% confidence interval (CI): 1.42-2.01, p = 0.01) and heterogeneity (I 2 = 98.9%, p < 0.001) was substantial. According to stratified subgroup analyses, the incidence of hepato-biliary-pancreatic cancer was associated, expect for study design, study quality and region. Risk of hepato-biliary-pancreatic cancer is highest when people is treated with normal doses of PPI. The risks decrease and become insignificant when the cumulative defined daily dose (cDDD) increases. Conclusion: The use of PPI may be associated with an increased risk of hepato-biliary-pancreatic cancer. Hence, caution is needed when using PPIs among patients with a high risk of hepato-biliary-pancreatic cancer.

Safety and efficacy of p38 mitogen-activated protein kinase inhibitors (MAPKIs) in COPD.

Introduction: Chronic inflammation is the core mechanism of the development of chronic obstructive pulmonary disease (COPD). Corticosteroid resistance in COPD limits its anti-inflammatory potency. p38 MAPKIs were suggested as an alternative to corticosteroids despite the fact that there is currently no systematic review evaluating existing evidence. Methods: This randomized controlled trials (RCT)-based systematic review with meta-analysis was conducted following the PRISMA statement. RCTs were searched and screened from 8 databases. Three types of data, including basic information of included studies, pre-defined outcome data, and quality assessment information were extracted. Pooling values and associated 95 % confidence intervals were deemed as statistically significant only when two-tailed p values were smaller than 0.05. Results: This study included 10 RCTs with a total population of 1,751 [age, mean (SD) = 64.39 (8.06)]. Safety and several efficacy indicators of lung function, inflammatory biomarkers, and quality of life were meta-analyzed. Despite the improvement of post-bronchodilator-forced vital capacity (FVC), no difference between p38 MAPKIs and placebo was found in both safety and efficacy. Conclusion: Compared with placebo, p38 MAPKIs are safe but did not show any significant effects in the COPD population. Results of this study should be regarded with caution due to the small number of included studies and heterogeneity from combining different p38 MAPKIs as a whole. Systematic Review registration: PROSPERO #CRD42022302890.

AX-Unet: A Deep Learning Framework for Image Segmentation to Assist Pancreatic Tumor Diagnosis.

Image segmentation plays an essential role in medical imaging analysis such as tumor boundary extraction. Recently, deep learning techniques have dramatically improved performance for image segmentation. However, an important factor preventing deep neural networks from going further is the information loss during the information propagation process. In this article, we present AX-Unet, a deep learning framework incorporating a modified atrous spatial pyramid pooling module to learn the location information and to extract multi-level contextual information to reduce information loss during downsampling. We also introduce a special group convolution operation on the feature map at each level to achieve information decoupling between channels. In addition, we propose an explicit boundary-aware loss function to tackle the blurry boundary problem. We evaluate our model on two public Pancreas-CT datasets, NIH Pancreas-CT dataset, and the pancreas part in medical segmentation decathlon (MSD) medical dataset. The experimental results validate that our model can outperform the state-of-the-art methods in pancreas CT image segmentation. By comparing the extracted feature output of our model, we find that the pancreatic region of normal people and patients with pancreatic tumors shows significant differences. This could provide a promising and reliable way to assist physicians for the screening of pancreatic tumors.

A Novel Functionalized Ionic Liquid for Highly Selective Extraction of TcO4.

Due to the highly acidic and high-salinity nature of the high-level radioactive waste liquid (HLLW), selective extraction of TcO4- from HLLW remains to be a challenging task. Traditional anion exchangers show low selectivity and unsatisfactory extraction performance due to the lack of functional groups that can interact strongly with TcO4-. In this work, a tailor-made binding site was constructed by decorating two acetamide functional groups on imidazolium cation to fabricate a new Tc separation material, which exhibits high selectivity. Unlike most reported Tc separation materials, which can only perform well under low acidic, neutral, or alkaline conditions, this material still has good extraction performance in highly acidic solutions. In the simulated high-level waste liquid of 3 M nitric acid, the extraction efficiency of 0.5 mol/L organic phase for Tc can reach 96.5% through the first-stage extraction. Our theoretical simulations suggest that ReO4-/TcO4- anions were adsorbed on the top of the imidazolium ring during the extraction process, with p-π and p-p interactions acting as the driving forces.

The NCOA1-CBP-NF-κB transcriptional complex induces inflammation response and triggers endotoxin-induced myocardial dysfunction.

Inflammatory pathways represented by TLR4/NF-κB (Toll-like receptor 4/Nuclear factor-κB) axis signaling are activated in the pathogenesis of endotoxin-induced myocardial dysfunction (EIMD). However, the underlying mechanism by which NF-κB coordinates with other transcriptional coactivators/corepressors to regulate the expression of proinflammatory cytokine genes remains unclear. We established an EIMD-mouse model by intraperitoneal injection of lipopolysaccharides (LPS), and we discovered that NCOA1 (nuclear receptor coactivator 1) assembled with CBP (CREB binding protein) and NF-κB subunits to form a transcriptional complex that specifically bound to promoters of proinflammatory cytokine genes to activate their expression. LPS treatment also inhibited DNMT1 (DNA methyltransferase 1) expression, thereby decreasing DNA methylation of a CpG island located on the promoter of NCOA1 and causing NCOA1 overexpression. Screening small molecules that abolished NCOA1-CBP interaction in a yeast system identified a compound PSSM2126 that effectively blocked the NCOA1-CBP interaction in vitro and in vivo. Administration of PSSM2126 to EIMD mice significantly alleviated the inflammation response and improved cardiac function. Collectively, our results reveal that an NCOA1-dependent transactivation mechanism can regulate proinflammatory cytokine expression, thereby improving our understanding of the activation of NF-κB targets. The promising inhibition of the NCOA1-CBP interaction by PSSM2126 may provide a new therapeutic option for EIMD.