Synthesis and anti-inflammatory activities of two new N-acetyl glucosamine derivatives.

N-acetyl glucosamine (NAG) is a natural amino sugar found in various human tissues with previously described anti-inflammatory effects. Various chemical modifications of NAG have been made to promote its biomedical applications. In this study, we synthesized two bi-deoxygenated NAG, BNAG1 and BNAG2 and investigated their anti-inflammatory properties, using an in vivo and in vitro inflammation mouse model induced by lipopolysaccharide (LPS). Among the parent molecule NAG, BNAG1 and BNAG2, BNAG1 showed the highest inhibition against serum levels of IL-6 and TNF α and the leukocyte migration to lungs and peritoneal cavity in LPS challenged mice, as well as IL-6 and TNF α production in LPS-stimulated primary peritoneal macrophages. BNAG2 displayed an anti-inflammatory effect which was comparable to NAG. These findings implied potential application of these novel NAG derivatives, especially BNAG1, in treatment of certain inflammation-related diseases.

Allosteric SHP2 inhibition enhances regorafenib's effectiveness in colorectal cancer treatment.

Colorectal cancer (CRC) is the third most common cancer globally. Regorafenib, a multi-target kinase inhibitor, has been approved for treating metastatic colorectal cancer patients who have undergone at least two prior standard anti-cancer therapies. However, regorafenib efficacy as a single agent remains suboptimal. A promising target at the crossroads of multiple signaling pathways is the Src homology 2 domain-containing protein tyrosine phosphatase (SHP2). However, a combination approach using SHP2 inhibitors (SHP099) and anti-angiogenic drugs (Regorafenib) has not been reported in current research. In this study, we conducted in vitro experiments combining SHP099 and regorafenib and established an MC-38 colon cancer allograft mouse model. Our results revealed that co-treatment with SHP099 and regorafenib significantly inhibited cell viability and altered the biological characteristics of tumor cells compared with treatment alone in vitro. Furthermore, the combination strategy demonstrated superior therapeutic efficacy compared to monotherapy with either drug. This was evidenced by reduced tumor size, decreased proliferation, increased apoptosis, normalized tumor microvasculature, and improved antitumor immune response in vivo. These findings suggest that the combination of an SHP2 inhibitor and regorafenib is a promising therapeutic approach for patients with colorectal cancer.

An ingestible near-infrared fluorescence capsule endoscopy for specific gastrointestinal diagnoses.

Early diagnosis of gastrointestinal (GI) diseases is important to effectively prevent carcinogenesis. Capsule endoscopy (CE) can address the pain caused by wired endoscopy in GI diagnosis. However, existing CE approaches have difficulty effectively diagnosing lesions that do not exhibit obvious morphological changes. In addition, the current CE cannot achieve wireless energy supply and attitude control at the same time. Here, we successfully developed a novel near-infrared fluorescence capsule endoscopy (NIFCE) that can stimulate and capture near-infrared (NIR) fluorescence images to specifically identify subtle mucosal microlesions and submucosal lesions while capturing conventional white light (WL) images to detect lesions with significant morphological changes. Furthermore, we constructed the first synergetic system that simultaneously enables multi-attitude control in NIFCE and supplies long-term power, thus addressing the issue of excessive power consumption caused by the NIFCE emitting near-infrared light (NIRL). We performed in vivo experiments to verify that the NIFCE can specifically "light up" tumors while sparing normal tissues by synergizing with probes actively aggregated in tumors, thus realizing specific detection and penetration. The prototype NIFCE system represents a significant step forward in the field of CE and shows great potential in efficiently achieving early targeted diagnosis of various GI diseases.

Epidemiological and clinicopathological features of KRAS, NRAS, BRAF mutations and MSI in Chinese patients with stage I-III colorectal cancer.

The selection of appropriate treatment modalities based on the presence or absence of mutations in KRAS, NRAS, BRAF, and the microsatellite instability (MSI) status has become a crucial consensus in colorectal cancer (CRC) therapy. However, the distribution pattern of these genetic mutations and the prevalence of MSI status in Chinese stage I-III CRCs remain unclear. We retrospectively analyzed clinicopathological features, mutations in the KRAS, NRAS, and BRAF genes, as well as MSI status of 411 patients with stage I-III CRC who underwent surgery from June 2020 to December 2022 in the First Affiliated Hospital of Nanjing Medical University. The mutation rates of KRAS, NRAS, and BRAF were 48.9%, 2.2%, and 3.2%, respectively, and the microsatellite instability-high rate was 9.5%. KRAS mutation was independently associated with mucinous adenocarcinoma. Multivariate analysis suggested that tumor location and mucinous adenocarcinoma were independently associated with BRAF mutation. Only T stage was associated with NRAS mutations in the univariate analysis. Multivariate analysis revealed that factors such as larger tumor size, tumor location, younger age, and poor differentiation were independently associated with microsatellite instability-high status. The results illustrate the mutation frequencies of KRAS, NRAS, BRAF genes and MSI status in stage I-III CRC from the eastern region of China. These findings further validate the associations between these genes status and various clinicopathological characteristics.

Liver regeneration of living donor after liver donation for transplantation: Disparity in the left and right remnant liver.

Donor safety is crucial for living donor liver transplantation (LDLT), and sufficient liver regeneration significantly affects outcomes of living donors. This study aimed to investigate clinical factors associated with liver regeneration in living donors. The study retrospectively reviewed 380 living donors who underwent liver donation at Chang Gung Memorial Hospital in Linkou. The clinical characteristics and medical parameters of donors were analyzed and compared according to liver donation graft type. There were 355 donors (93.4%) with right hemi-liver donations and 25 donors (6.6%) with left hemi-liver donations. Left hemi-liver donors had a higher body mass index (BMI) and a larger ratio of remnant liver volume (RLV) to total liver volume (TLV). However, the 2 groups showed no significant difference in the liver regeneration ratio. The type of remnant liver (P < .001), RLV/body weight (P = .027), RLV/TLV (P < .001), serum albumin on postoperative day 7 and total bilirubin levels on postoperative day 30 were the most significant factors affecting liver regeneration in living donors. In conclusion, adequate liver regeneration is essential for donor outcome after liver donation. The remnant liver could eventually regenerate to an adequate volume similar to the initial TLV before liver donation. However, the remnant left hemi-liver had a faster growth rate than the remnant right hemi-liver in donors.

Knockout of formyl peptide receptor 1 reduces osteogenesis and bone healing.

AIMS: Formyl peptide receptor 1 (FPR1), from a G-protein coupled receptor family, was previously well-characterized in immune cells. But the function of FPR1 in osteogenesis and fracture healing was rarely reported. This study, using the FPR1 knockout (KO) mouse, is one of the first studies that try to investigate FPR1 function to osteogenic differentiation of bone marrow-derived stem cells (BMSCs) in vitro and bone fracture healing in vivo. MATERIALS AND METHODS: Primary BMSCs were isolated from both FPR1 KO and wild type (WT) mice. Cloned mouse BMSCs (D1 cells) were used to examine role of FoxO1 in FPR1 regulation of osteogenesis. A closed, transverse fracture at the femoral midshaft was created to compare bone healing between KO and WT mice. Biomechanical and structural properties of femur were compared between healthy WT and KO mice. KEY FINDINGS: FPR1 expression increased significantly during osteogenesis of both primary and cloned BMSCs. Compared to BMSCs from FPR1 KO mice, WT BMSCs displayed considerably higher levels of osteogenic markers as well as mineralization. Osteogenesis by D1 cells was inhibited by either an FPR1 antagonist cFLFLF or a specific inhibitor of FoxO1, AS1842856. In addition, the femur from WT mice had better biomechanical properties than FPR1 KO mice. Furthermore, bone healing in WT mice was remarkably improved compared to FPR1 KO mice analyzed by X-ray and micro-CT. SIGNIFICANCE: These findings indicated that FPR1 played a vital role in osteogenic differentiation and regenerative capacity of fractured bone, probably through the activation of FoxO1 related signaling pathways.

Comparison of MUSE-DWI and conventional DWI in the application of invasive breast cancer and malignancy grade prediction: A comparative study.

Objective: To compare MUSE-DWI with conventional DWI in assessing lesions of invasive breast cancer and evaluating the ADC values for preoperative histological grading. Methods: A retrospective analysis was conducted on 63 lesions confirmed as invasive breast cancer by surgical or biopsy pathology. Preoperatively, all patients underwent MUSE-DWI, conventional DWI, and dynamic contrast-enhanced (DCE) scans. Two radiologists with over 5 years of experience (intermediate and senior levels, respectively) subjectively evaluated the images for clarity, image artifacts, and distortion. Objective evaluation included signal-to-noise ratio (SNR) of lesions and fibrous tissue, as well as the ADC values of both imaging techniques. Due to the limited number of cases classified as grade I and the insignificant difference in disease-specific survival and recurrence scores between grades I and II tumors, grades I and II were grouped as low-grade, while grade III was classified as high-grade. Receiver operating characteristic (ROC) curves were used to evaluate the efficacy of ADC values in preoperatively predicting the grading of invasive breast cancer. Results: The SNR and subjective quality scores of MUSE-DWI images were significantly higher than those of conventional DWI (p < 0.05). For the same case, the ADC values of MUSE-DWI were lower than those of conventional DWI. The AUC values for predicting the grading of invasive breast cancer were 0.849 for MUSE-DWI and 0.801 for conventional DWI. Conclusion: Compared to conventional DWI, MUSE-DWI significantly reduces artifacts and distortions, greatly improving image quality. Moreover, MUSE-DWI demonstrates higher diagnostic efficacy for preoperative histological grading of invasive breast cancer.

The diversification and potential function of microbiome in sediment-water interface of methane seeps in South China Sea.

The sediment-water interfaces of cold seeps play important roles in nutrient transportation between seafloor and deep-water column. Microorganisms are the key actors of biogeochemical processes in this interface. However, the knowledge of the microbiome in this interface are limited. Here we studied the microbial diversity and potential metabolic functions by 16S rRNA gene amplicon sequencing at sediment-water interface of two active cold seeps in the northern slope of South China Sea, Lingshui and Site F cold seeps. The microbial diversity and potential functions in the two cold seeps are obviously different. The microbial diversity of Lingshui interface areas, is found to be relatively low. Microbes associated with methane consumption are enriched, possibly due to the large and continuous eruptions of methane fluids. Methane consumption is mainly mediated by aerobic oxidation and denitrifying anaerobic methane oxidation (DAMO). The microbial diversity in Site F is higher than Lingshui. Fluids from seepage of Site F are mitigated by methanotrophic bacteria at the cyclical oxic-hypoxic fluctuating interface where intense redox cycling of carbon, sulfur, and nitrogen compounds occurs. The primary modes of microbial methane consumption are aerobic methane oxidation, along with DAMO, sulfate-dependent anaerobic methane oxidation (SAMO). To sum up, anaerobic oxidation of methane (AOM) may be underestimated in cold seep interface microenvironments. Our findings highlight the significance of AOM and interdependence between microorganisms and their environments in the interface microenvironments, providing insights into the biogeochemical processes that govern these unique ecological systems.

Catalytic fast pyrolysis of waste pine sawdust over solid base, acid and base-acid tandem catalysts.

Catalytic pyrolysis is an effective means for high-value utilization of biomass. This study investigated the effect of solid base catalysts (CaO, calcium aluminate catalysts CaAl-1, CaAl-2, CaAl-3), acid zeolite catalysts (ZSM-5, Fe/ZSM-5, Co/ZSM-5, Ni/ZSM-5, Cu/ZSM-5, Zn/ZSM-5) and base-acid tandem catalysts on pine sawdust pyrolysis using Py-GC/MS. Acid zeolite catalysts exhibited robust deoxidation and aromatization capabilities, favoring aromatics, while solid base catalysts yielded more phenols and ketones. Among the solid base catalysts, CaAl-3 (CaO-Ca12Al14O33) showed comparable deoxygenation activity to CaO and optimal aromatic selectivity with structural stability. Zn/ZSM-5 excelled in deoxygenation and aromatic selectivity (70.42%) among metal-modified ZSM-5 catalysts. Base-acid tandem catalysis promoted the formation of aliphatics and BTX (benzene, toluene, xylene) while suppressing polycyclic aromatics. The highest BTX content (44.35%) was achieved with CaO-Ca12Al14O33&Zn/ZSM-5 tandem catalysts in a 1:3 ratio. This work demonstrates base-acid tandem catalysis as a promising approach for converting pine sawdust into valuable chemicals.

Different roles of FeS and FeS2 on magnetic FeSx for the selective adsorption of Hg2+ from waste acids in smelters: Reaction mechanism, kinetics, and structure-activity relationship.

Magnetic FeSx was developed as a high-performance sorbent for selectively adsorbing Hg2+ from waste acids in smelters. However, further improvement of its ability for Hg2+ adsorption was extremely restricted due to the lack of reaction mechanisms and structure-activity relationships. In this study, the roles of FeS and FeS2 on magnetic FeSx for Hg2+ adsorption were investigated with alternate adsorption of Hg2+ without/with Cl-. The structure-activity relationship of magnetic FeSx for Hg2+ adsorption and the negative effect of acid erosion were elucidated using kinetic analysis. FeS can react with Hg2+ with 1:1 stoichiometric ratio to form HgS, while FeS2 can react with Hg2+ in the presence of Cl- with novel 1:3 stoichiometric ratio to form Hg3S2Cl2. The rate of magnetic FeSx for Hg2+ adsorption was related to the instantaneous amounts of FeS and threefold FeS2 on magnetic FeSx and the amount of Hg2+ adsorbed. Meanwhile, its capacity for Hg2+ adsorption was related to the initial sum of FeS amount and threefold FeS2 amount on the surface and their ratios by acid erosion. Then, magnetic FeSx-400 was devised with adsorption rate of 2.12 mg g-1 min-1 and capacity of 1092 mg g-1 to recover Hg2+ from waste acids for centralized control.

Latitudinal pronounced variations in tintinnid (Ciliophora) community at surface waters from the South China Sea to the Yellow Sea: Oceanic-to-neritic species shift, biotic-abiotic interaction and future prediction.

The oceanic-to-neritic species shift of microzooplanktonic tintinnids and their interaction with relevant abiotic variables are two crucial processes in the marine ecosystem. However, these processes remain poorly documented in China's marginal seas. In the summer of 2022, we investigated the community structure of pelagic tintinnids in surface waters from the South China Sea (SCS) to the Yellow Sea (YS), passing through the East China Sea (ECS). A number of 58 species from 23 genera were identified, with 36 and 22 species belonging to oceanic and neritic genera, respectively. The abundance proportion of oceanic and neritic genera exhibited a decreasing and increasing trend, respectively, from the SCS to YS. Furthermore, four distinctive tintinnid community groups were classified based on cluster analysis using tintinnid species and abundance data, and the position of southern Taiwan Strait was identified as the "Shift Point" for oceanic-to-neritic species dominance. The top two tintinnid species in each group showed distinct variations in body size. Additionally, multivariate biotic-abiotic statistical analyses revealed that temperature determined tintinnid species richness, while temperature, salinity, Si(OH)4, and Chl a determined tintinnid abundance. Our study provides a substantial foundation for recognizing the oceanic-to-neritic species shift of tintinnids in the China's marginal seas, and highlights the role of biotic-abiotic factors in driving biogeochemical fluxes and the potential response of microzooplankton to future climate change.

Re-identification and characterization of grass carp Ctenopharyngodon idella TLR20.

Toll-like receptors (TLRs) play a crucial role in the recognition of microbial-associated molecular patterns in the innate immune system. Fish TLRs have undergone significant gene expansion to adapt to complex aquatic environments. Among them, TLR20 from the TLR11 family actively responds to viral and bacterial invasions. Previous studies have reported two TLR20s in grass carp (Ctenopharyngodon idella), and in this study, we revised this conclusion. Based on the latest grass carp genome, we identified a new TLR20 member. These three TLR20s are arranged in tandem on chromosome 9, indicating that they are generated by gene duplication events. They were renamed CiTLR20.1 to CiTLR20.3 based on their chromosomal positions. The CiTLR20s in C. idella exhibit higher similarities with those in Danio rerio, Cyprinus carpio, and Megalobrama amblycephala, and lower similarities with those in other distantly related fish species. Selective pressure analysis revealed low conservation and negative evolution of TLR20s during evolution. The 3D structures of the three TLR20s showed significant differences, reflecting functional variations and different downstream adaptor molecule recruitment. Transcriptome data revealed tissue distribution differences of TLR20s, with TLR20.1 showing relatively low expression levels in all the tissues, while TLR20.2 and TLR20.3 showed higher expression in the head kidney, spleen, and gill. Additionally, TLR20.2 and TLR20.3 actively responded to GCRV-II infection, with higher upregulation of TLR20.2 in response to Aeromonas hydrophila challenge. In conclusion, this study corrected the number of grass carp TLR20 members and analyzed TLR20 from an evolutionary and structural perspective, exploring its role in antiviral and antibacterial defense. This study provides reference for future research on fish TLR20.

Aerosol Inhalation of Chimpanzee Adenovirus Vectors (ChAd68) Expressing Ancestral or Omicron BA.1 Stabilized Pre-Fusion Spike Glycoproteins Protects Non-Human Primates against SARS-CoV-2 Infection.

Current COVID-19 vaccines are effective countermeasures to control the SARS-CoV-2 virus pandemic by inducing systemic immune responses through intramuscular injection. However, respiratory mucosal immunization will be needed to elicit local sterilizing immunity to prevent virus replication in the nasopharynx, shedding, and transmission. In this study, we first compared the immunoprotective ability of a chimpanzee replication-deficient adenovirus-vectored COVID-19 vaccine expressing a stabilized pre-fusion spike glycoprotein from the ancestral SARS-CoV-2 strain Wuhan-Hu-1 (BV-AdCoV-1) administered through either aerosol inhalation, intranasal spray, or intramuscular injection in cynomolgus monkeys and rhesus macaques. Compared with intranasal administration, aerosol inhalation of BV-AdCoV-1 elicited stronger humoral and mucosal immunity that conferred excellent protection against SARS-CoV-2 infection in rhesus macaques. Importantly, aerosol inhalation induced immunity comparable to that obtained by intramuscular injection, although at a significantly lower dose. Furthermore, to address the problem of immune escape variants, we evaluated the merits of heterologous boosting with an adenovirus-based Omicron BA.1 vaccine (C68-COA04). Boosting rhesus macaques vaccinated with two doses of BV-AdCoV-1 with either the homologous or the heterologous C68-COA04 vector resulted in cross-neutralizing immunity against WT, Delta, and Omicron subvariants, including BA.4/5 stronger than that obtained by administering a bivalent BV-AdCoV-1/C68-COA04 vaccine. These results demonstrate that the administration of BV-AdCoV-1 or C68-COA04 via aerosol inhalation is a promising approach to prevent SARS-CoV-2 infection and transmission and curtail the pandemic spread.

Nanopeptide CI20 remarkably enhances growth performance and disease resistances by improving the mucosal structure, antioxidant capacity, and immunity in mandarin fish (Siniperca chuatsi).

Soybean meal, excessively used in place of fish meal (FM) in aquaculture, has a detrimental impact on fish. In this study, the nanopeptide CI20, which was created by conjugating antimicrobial peptide gcIFN-20H and CMCS, were evaluated the feeding effect in mandarin fish (Siniperca chuatsi). Compared with the control group, 150 mg/kg C-I20-fed fish showed the second highest growth performance with no significant changes in body composition. C-I20-fed fish showed more goblet cells and thicker mucin after feeding. The 150 mg/kg CI20 diet boosted the antioxidant capacity, immunity, and digestive enzymes. After Aeromonas hydrophila and infection spleen and kidney necrosis virus infection, the survival rates in the 150 mg/kg CI20 group were highest. Meanwhile, many tissues in the 150 mg/kg CI20 group had significantly lower pathogen loads than the other groups. Treatment with 150 mg/kg CI20 was effective in increasing antioxidant capacity and immunity. The minimum tissue lesions were observed in the 150 mg/kg CI20 group. The goblet cell number and mucin thickness were significantly increased by CI20 treatment after infection. The study results herein showed that a reasonable dietary concentration of CI20 feed promoted growth performance and disease resistances in fish, suggesting a prospective nano antimicrobial peptide for the aquaculture.

A HER2-targeting antibody-MMAE conjugate RC48 sensitizes immunotherapy in HER2-positive colon cancer by triggering the cGAS-STING pathway.

Human epidermal growth factor receptor 2 (HER2) is a protein that is overexpressed in some types of cancer, including breast and urothelial cancer. Here we found that HER2 was present in a portion of colon cancer patients, raising the possibility of using anti-HER2 therapy. RC48, a novel antibody-drug conjugate (ADC) comprising cytotoxic monomethyl auristatin E (MMAE) and an anti-HER2 antibody tethered via a linker, showed a comparable therapeutic effect in both HER2 low expressed (IHC2+/FISH- or IHC+) and high expressed urothelial cancer patients. In vitro studies using colon cancer cell lines showed that RC48 effectively impeded the proliferation of HER2-positive cells, indicating its potential as a treatment for HER2-positive colon cancer. Mechanism study showed that RC48 not only induces cell cycle arrest but also disrupts HER2-mediated restain of cGAS-STING signaling, potentially activating an immune response against the cancer cells. The administration of RC48 significantly reduced the growth of HER2-positive colon cancer and made HER2-positive colon cancer cells more susceptible to immunotherapy. The results of our study will contribute to determining the feasibility of RC48 as a therapeutic option for HER2-positive colon cancer.

Where is the optimal plane to mobilize the anterior rectal wall in female patients undergoing total mesorectal excision?

BACKGROUND: Since Heald proposed the total mesorectal excision (TME) procedure, the prognosis of patients with rectal cancer has been significantly improved. But Heald did not specifically describe the anterior surgical plane in female patients. And the surgical plane for mobilizing the anterior rectal wall during TME surgery in female patients remains controversial. AIM: To investigate the anatomy of the female pelvis and identify the optimal plane for mobilizing the anterior rectal wall. METHODS: We retrospectively collected surgical procedure videos and clinical data of female patients diagnosed with middle or low rectal cancer who underwent the TME procedure between January 2020 and October 2022 across six hospitals. The patients were divided into two groups based on the surgical approach used to mobilize the anterior rectal wall: The experimental group was to open the peritoneum at the lowest point of the peritonea reflection and enter the plane for mobilizing, while the control group was cut at 0.5-1 cm above the peritoneal reflection and enter another plan. Then, we compared the preoperative and postoperative information between the two groups. We also dissected and observed ten adult female pelvises to analyze the anatomic structure and compare the entry plane between the two approaches. Finally, we researched the pathological structure between the rectum and the vagina. RESULTS: Finally, 77 cases that met the criteria were included in our study. Our observations revealed that the experimental group underwent a smooth procedure, entering the plane amidst the mesorectal fascia and adventitia of the vagina, whereas the control group entered the plane between the vaginal adventitia and muscle layers. Compared to the control group, the experimental group showed a significant decrease in intraoperative bleeding [22.5 (19.5-50) mL vs 17 (5-20) mL, P = 0.01], as well as a shorter duration of hospitalization [9 (7-11.25) d vs 7 (6-10) d, P = 0.03]. Through the examination of surgical videos and cadaveric studies, we discovered that Denonvilliers' fascia is absent in females. Additionally, pathological sections further revealed the absence of Denonvilliers' fascia in females, with only loose connective tissue present between the mesorectal fascia and adventitia of the vagina. CONCLUSION: The plane amidst the mesorectal fascia and vaginal adventitia is the optimal surgical plane to mobilize the anterior rectal wall for female patients undergoing the TME procedure.

Wide-Field and Real-Time Super-Resolution Optical Imaging By Titanium Dioxide Nanoparticle-Assembled Solid Immersion Lens.

Super-resolution optical imaging techniques can break the optical diffraction limit, thus providing unique opportunities to visualize the microscopic world at the nanoscale. Although near-field optical microscopy techniques have been proven to achieve significantly improved imaging resolution, most near-field approaches still suffer from a narrow field of view (FOV) or difficulty in obtaining wide-field images in real time, which may limit their widespread and diverse applications. Here, the authors experimentally demonstrate an optical microscope magnification and image enhancement approach by using a submillimeter-sized solid immersion lens (SIL) assembled by densely-packed 15 nm TiO2 nanoparticles through a silicone oil two-step dehydration method. This TiO2 nanoparticle-assembled SIL can achieve both high transparency and high refractive index, as well as sufficient mechanical strength and easy-to-handle size, thus providing a fast, wide-field, real-time, non-destructive, and low-cost solution for improving the quality of optical microscopic observation of a variety of samples, including nanomaterials, cancer cells, and living cells or bacteria under conventional optical microscopes. This study provides an attractive alternative to simplify the fabrication and applications of high-performance SILs.

Synergic Effect of Robot-Assisted Rehabilitation and Antispasticity Therapy: A Narrative Review.

BACKGROUND: Stroke and spinal cord injury are neurological disorders that cause disability and exert tremendous social and economic effects. Robot-assisted training (RAT), which may reduce spasticity, is widely applied in neurorehabilitation. The combined effects of RAT and antispasticity therapies, such as botulinum toxin A injection therapy, on functional recovery remain unclear. This review evaluated the effects of combined therapy on functional recovery and spasticity reduction. MATERIALS AND METHODS: Studies evaluating the efficacy of RAT and antispasticity therapy in promoting functional recovery and reducing spasticity were systemically reviewed. Five randomized controlled trials (RCTs) were included. The modified Jadad scale was applied for quality assessment. Functional assessments, such as the Berg Balance Scale, were used to measure the primary outcome. Spasticity assessments, such as the modified Ashworth Scale, were used to measure the secondary outcome. RESULTS: Combined therapy improves functional recovery in the lower limbs but does not reduce spasticity in the upper or lower limbs. CONCLUSIONS: The evidence supports that combined therapy improves lower limb function but does not reduce spasticity. The considerable risk of bias among the included studies and the enrolled patients who did not receive interventions within the golden period of intervention are two major factors that should be considered when interpreting these results. Additional high-quality RCTs are required.

Geochemical Characteristics of Rare-Metal, Rare-Dispersed, and Rare-Earth Elements and Depositional Environments in the Shanxi Formation Coal, Huainan Coalfield, Anhui, China.

Coal, being one of the major energy sources for power generation, contains several critical trace elements. There is a growing scarcity and expense of these critical elements as a result of the increased demand and limitation of mining sources. To explore the geochemical characteristics of the rare-metal, rare-dispersed (scattered), and rare-earth elements (TREs) in coal, 25 coal seam samples of the Shanxi Formation in the Huainan coalfield were collected. The major element oxides, minerals, and TREs were analyzed by X-ray fluorescence spectroscopy (XRF), X-ray diffraction (XRD), and inductively coupled plasma-mass spectrometry (ICP-MS). The results revealed that the coal of the Shanxi Formation had ultra-low moisture and low ash yield and was medium-high-volatility with low sulfur content and high calorific value. Concerning minerals, the coal was mainly composed of kaolinite, illite, quartz, calcite, dolomite, and pyrite. Compared with Chinese coal and world hard coal, rare-metal element Li and rare-dispersed element Se were enriched, whereas Ga and Ta were only slightly enriched. The average content of REYs was 51.34 µg/g, which is lower than the average content of REYs in Chinese coal. It has the enrichment characteristics of light REYs. In the vertical direction, the content of most TREs was higher in the roof and floor of the coal seam and the parting, indicating that the sedimentary microenvironment plays an important role in controlling the migration and enrichment of elements. The experimental results of sequential chemical extraction and correlation analysis showed that the TREs in the Shanxi Formation coal mainly exist in a residual and carbonate bound state, and occur in clay minerals and carbonate minerals. The enrichment of Se may be due to its high organic form ratio. The C-value, B content, w(Sr)/w(Ba), and REY geochemical parameters indicated that the Shanxi Formation Coal seam was developed in a transitional, semi-saline, deltaic sedimentary environment. With their development affected by seawater, REYs in coal are greatly supplied by terrigenous clastics. The complex sedimentary environment is an important reason for the varying occurrence states of TREs in the Shanxi Formation coals.