Xiaoqinglong decoction mitigates nasal inflammation and modulates gut microbiota in allergic rhinitis mice.

Introduction: Allergic rhinitis (AR) is a respiratory immune system disorder characterized by dysregulation of immune responses. Within the context of AR, gut microbiota and its metabolites have been identified as contributors to immune modulation. These microorganisms intricately connect the respiratory and gut immune systems, forming what is commonly referred to as the gut-lung axis. Xiaoqinglong Decoction (XQLD), a traditional Chinese herbal remedy, is widely utilized in traditional Chinese medicine for the clinical treatment of AR. In this study, it is hypothesized that the restoration of symbiotic microbiota balance within the gut-lung axis plays a pivotal role in supporting the superior long-term efficacy of XQLD in AR therapy. Therefore, the primary objective of this research is to investigate the impact of XQLD on the composition and functionality of the gut microbiota in a murine model of AR. Methods: An ovalbumin-sensitized mouse model to simulate AR was utilized, the improvement of AR symptoms after medication was investigated, and high-throughput sequencing was employed to analyze the gut microbiota composition. Results: XQLD exhibited substantial therapeutic effects in AR mice, notably characterized by a significant reduction in allergic inflammatory responses, considerable alleviation of nasal symptoms, and the restoration of normal nasal function. Additionally, following XQLD treatment, the disrupted gut microbiota in AR mice displayed a tendency toward restoration, showing significant differences compared to the Western medicine (loratadine) group. Discussion: This results revealed that XQLD may enhance AR allergic inflammatory responses through the regulation of intestinal microbiota dysbiosis in mice, thus influencing the dynamics of the gut-lung axis. The proposal of this mechanism provides a foundation for future research in this area.

Exogenous methyl jasmonate treatment induced the transcriptional responses and accumulation of volatile terpenoids in Oenanthe javanica (Blume) DC.

Water dropwort is favored by consumers for its unique flavor and medicinal value. Terpenoids were identified as the main volatile compounds related to its flavor. In this study, water dropwort was treated with different concentrations of exogenous methyl jasmonate (MeJA). The contents of volatile terpenoids were determined under various MeJA treatments. The results indicated that 0.1 mM of MeJA most effectively promoted the biosynthesis of flavor-related terpenoids in water dropwort. Terpinolene accounted the highest proportion among terpene compounds in water dropwort. The contents of jasmonates in water dropwort were also increased after exogenous MeJA treatments. Transcriptome analysis indicated that DEGs involved in the terpenoid biosynthesis pathway were upregulated. The TPS family was identified from water dropwort, and the expression levels of Oj0473630, Oj0287510 and Oj0240400 genes in TPS-b subfamily were consistent with the changes of terpene contents under MeJA treatments. Oj0473630 was cloned from the water dropwort and designated as OjTPS3, which is predicted to be related to the biosynthesis of terpinolene in water dropwort. Subcellular localization indicated that OjTPS3 protein was localized in chloroplast. Protein purification and enzyme activity of OjTPS3 protein were conducted. The results showed that the purified OjTPS3 protein catalyzed the biosynthesis of terpinolene by using geranyl diphosphate (GPP) as substrate in vitro. This study will facilitate to further understand the molecular mechanism of terpenoid biosynthesis and provide a strategy to improve the flavor of water dropwort.

Platycodon D protects human nasal epithelial cells from pyroptosis through the Nrf2/HO-1/ROS signaling cascade in chronic rhinosinusitis.

BACKGROUND: Pyroptosis has been demonstrated being closely associated with the inflammatory progression in chronic rhinosinusitis (CRS). However, platycodon D (PLD) has emerged as a key anti-inflammatory mediator in the inflammatory progression of various respiratory diseases. This study aims at investigating whether PLD could reduce inflammatory progression of CRS by inhibiting pyroptosis. METHODS: Nasal mucosal tissues from patients with CRS and the control group (simple nasal septal deviation) were analyzed for morphological difference using hematoxylin & eosin staining and for the expression of pyroptosis-related makers by immunofluorescence (IF). Human nasal epithelial cells (HNEpCs) were cultured and co-stimulated with lipopolysaccharide (LPS)/adenosine triphosphate (ATP) to construct an in vitro cellular model simulating CRS. After pretreatment with PLD, EthD-I staining, TUNEL staining, transmission electron microscopy (TEM), and GSDMD-NT detection were performed to evaluate pyroptosis markers. The NLRP3 inflammasome was detected by IF and western blotting (WB). Reactive oxygen species (ROS) were detected by H2DCFDA staining, and mitochondrial membrane potential was evaluated by JC-1 staining. Mitochondrial morphology and structure were observed using TEM. The Nrf2/HO-1 antioxidant signaling pathway was detected using WB. RESULTS: The nasal mucosa structure of patients with CRS exhibited significant damage, with a marked increase in the expression of pyroptosis-related proteins compared with the control group. LPS/ATP co-stimulation resulted in an increased expression of IL-18 and IL-1ß in HNEpCs, causing significant damage to nuclear and cell membranes, GSDMD-NT accumulation around the cell membrane, and intracellular NLRP3 inflammasome activation. Furthermore, it led to increased ROS expression, significantly decreased mitochondrial membrane potential, and damaged mitochondrial structure. However, pretreatment with PLD significantly reversed the aforementioned trends and activated the Nrf2/HO-1 antioxidant signaling pathway. CONCLUSIONS: The results of this study confirm that NLRP3-mediated pyroptosis plays a crucial role in the pathological process of nasal mucosal impairment in patients with CRS. PLD inhibits NLRP3-mediated pyroptosis, preventing inflammatory damage in HNEpCs of patients with CRS by activating the Nrf2/HO-1 antioxidant signaling pathway, which in turn reduces ROS production and ameliorates mitochondrial damage.

Xiaoqinglong decoction improves allergic rhinitis by inhibiting NLRP3-mediated pyroptosis in BALB/C mice.

ETHNOPHARMACOLOGICAL RELEVANCE: Xiaoqinglong decoction (XQLD), first recorded in Shang Han Lun, is a traditional Chinese medicine prescribed for the treatment of allergic rhinitis (AR). XQLD alleviates the clinical symptoms of AR by inhibiting the occurrence of an inflammatory response, but the specific regulatory mechanism remains unclear. AIM OF THE STUDY: NLRP3-mediated pyroptosis is closely related to AR pathogenesis. Hence, this study aimed to explore the potential role of NLRP3-mediated pyroptosis pathway in the AR-associated pharmacological mechanism of XQLD. MATERIALS AND METHODS: BALB/C mice models of AR was established by using ovalbumin (OVA) and aluminum hydroxide sensitization. After intragastric administration of different dosages of XQLD, nasal allergic symptoms were observed. The expression of OVA-sIgE and Th2 inflammatory factors (IL-4, IL-5, and IL-13) in serum was detected by ELISA. The histopathological morphology and expression of inflammatory factors in nasal mucosa along with pyroptosis were investigated. Molecular docking was performed to analyze the binding of representative compounds of XQLD with NLRP3. Activation of the NLRP3 inflammasome was detected by immunofluorescence and western blotting. RESULTS: XQLD significantly improved the nasal allergic symptoms of mice, reduced the degree of goblet cell proliferation, mast cell infiltration, and collagen fiber hyperplasia in nasal mucosa. Meanwhile, it could downregulate the expression of Th2 inflammatory factors (IL-4, IL-5, and IL-13) in serum and nasal mucosa. XQLD significantly reduced the number of GSDMD and TUNEL double-positive cells and IL-1ß and IL-18 expression. Molecular docking confirmed that seven representative compounds of XQLD had good binding properties with NLRP3 and were able to inhibit the activation of the NLRP3 inflammasome. CONCLUSIONS: The representative compounds of XQLD might inhibit pyroptosis in nasal mucosa mediated by the NLRP3 inflammasome to helping the recovery of AR, which provides a new modern pharmacological proof for XQLD to treat AR.

[Metabolomics of nasal lavage fluid in patients with allergic rhinitis treated by Xiaoqinglong Decoction].

This study used nasal lavage fluid for metabolomics to explore its feasibility, and applied it to the clinical metabolomics study of Xiaoqinglong Decoction in the treatment of allergic rhinitis(AR), aiming to investigate the molecular mechanism of Xiaoqing-long Decoction in the treatment of AR through differential changes in local nasal metabolism. AR patients were selected as the research subjects, and nasal lavage fluid was collected as the sample. Metabolomics analysis using liquid chromatography-mass spectrometry was performed on normal group, AR group, and Xiaoqinglong Decoction group. The differences in metabolic profiles among the groups were compared using principal component analysis and partial least squares discriminant analysis, and differential metabolites were identified and subjected to corresponding metabolic pathway analysis. The results showed that Xiaoqinglong Decoction significantly improved the symptoms of AR patients. The metabolomics analysis revealed 20 differential metabolites between AR group and Xiaoqinglong Decoction group. The core metabolite with a trending return in comparison to normal group was trimethyladipic acid. The metabolites were involved in multiple pathways, including ß-alanine metabolism, glutathione metabolism, and phenylalanine, tyrosine, and tryptophan biosynthesis. The feasibility of applying nasal lavage fluid in nasal metabolomics was preliminarily demonstrated. Differential metabolites and enriched pathways in the treatment of AR patients with Xiaoqinglong Decoction were identified, indicating that it may improve rhinitis symptoms through the regulation of various metabolites, including antioxidant effects and correction of Th1/Th2 imbalance.

Integrated morphological, metabolome, and transcriptome analyses revealed the mechanism of exogenous gibberellin promoting petiole elongation in Oenanthe javanica.

Oenanthe javanica (Blume) DC. is a popular vegetable with unique flavor and its leaf is the main product organ. Gibberellin (GA) is an important plant hormone that plays vital roles in regulating the growth of plants. In this study, the plants of water dropwort were treated with different concentrations of GA3. The plant height of water dropwort was significantly increased after GA3 treatment. Anatomical structure analysis indicated that the cell length of water dropwort was elongated under exogenous application of GA3. The metabolome analysis showed flavonoids were the most abundant metabolites and the biosynthesis of secondary metabolites were also regulated by GA3. The exogenous application of GA3 altered the gene expressions of plant hormone signal transduction (GID and DELLA) and metabolites biosynthesis pathways to regulate the growth of water dropwort. The GA contents were modulated by up-regulating the expression of GA metabolism gene GA2ox. The differentially expressed genes related to cell wall formation were significantly enriched. A total of 22 cellulose synthase involved in cellulose biosynthesis were identified from the genome of water dropwort. Our results indicated that GA treatment promoted the cell elongation by inducing the expression of cellulose synthase and cell wall formation in water dropwort. These results revealed the molecular mechanism of GA-mediated cell elongation, which will provide valuable reference for using GA to regulate the growth of water dropwort.

Xiao-qing-long-tang ameliorates OVA-induced allergic rhinitis by inhibiting ILC2s through the IL-33/ST2 and JAK/STAT pathways.

BACKGROUND: Allergic rhinitis (AR) is a chronic inflammatory disease of the nasal mucosa that is mediated by immunoglobulin E (IgE). Xiao-qing-long-tang (XQLT) is a traditional Chinese medicine compound that is widely used to treat respiratory diseases such as AR. However, the underlying mechanism of the effect of XQLT on AR remains unclear. PURPOSE: To elucidate the effect of XQLT on ovalbumin (OVA)-induced AR and the mechanisms of action. METHODS: The therapeutic efficacy of XQLT was evaluated in a well-established OVA-induced AR mouse model. Nasal symptoms were analyzed, type 2 cytokines and OVA-sIgE levels were measured, nasal mucosa tissues were collected for histological analysis, and the changes of Group 2 innate lymphoid cells (ILC2s) and the IL-33/ST2 and JAK/STAT signaling pathways in the nasal mucosa were observed. RESULTS: XQLT significantly alleviated the nasal symptoms and histological damage to the nasal mucosa in AR mice, and reduced the levels of type 2 cytokines and OVA-sIgE. In addition, after XQLT treatment, the numbers of ILC2s in the nasal mucosa of AR mice were reduced, and the mRNA levels of the transcription factors GATA3 and ROR-α were decreased. Moreover, IL-33/ST2 signaling pathway was inhibited. The costimulatory cytokine associated JAK/STAT signaling pathway was also inhibited in ILC2s. CONCLUSION: Our study demonstrated that XQLT regulated ILC2s through the IL-33/ST2 and JAK/STAT pathways to ameliorate type 2 inflammation in OVA-induced AR. These findings suggest that XQLT might be used to treat AR.

Metabolomics Analysis Reveals Metabolites and Metabolic Pathways Involved in the Growth and Quality of Water Dropwort [Oenanthe javanica (Blume) DC.] under Nutrient Solution Culture.

Water dropwort (Oenanthe javanica (Blume) DC.) is an important vegetable crop. Nutrient liquid culture has become an important cultivation method in the production of water dropwort. However, the effects of different nutrient solution cultivation methods on the growth and quality of water dropwort remains unclear. In this study, to screen the most suitable nutrient solution formula for the cultivation of water dropwort, the effects of different nutrient solution formulas (Hoagland, Cooper, Dutch greenhouse, Garden-style, Yamasaki and SCAU) on plant physiological and quality characteristics are investigated. The plant height, root length, water content (%), distribution rate of dry matter (%), chlorophyll, VC, flavonoid, total phenolic, DPPH and dietary fiber of water dropwort under different nutrient solutions were determined. According to the analytic hierarchy process (AHP) of the growth index and quality index of water dropwort under different nutrient solutions, the Yamazaki nutrient solution was considered to be the most suitable nutrient solution formula for water dropwort. To further confirm the differences of water dropwort under nutrient solution culture and soil culture, the broadly targeted metabolomics were performed. A total of 485 metabolites were detected in water dropwort under optimal nutrient solution and soil cultivation. Metabolomics analysis showed that flavonoids were the most abundant differential accumulated metabolites, and most flavonoids were up-regulated. A qRT-PCR assay indicated that the structural genes of the flavonoid biosynthesis pathway (PAL, C4H, CHS, CHI, F3H, DFR, UFGT) were significantly higher under the Yamasaki nutrient solution treatment. The current study provided a theoretical basis and technical guidance for the nutrient solution cultivation of water dropwort. Meanwhile, this study provides new insights into the study of flavonoids in water dropwort.

HDAC Downregulation of Xiaoqinglong Decoction in the Treatment of Allergic Rhinitis.

INTRODUCTION: As one of the most common allergic diseases, allergic rhinitis (AR) has attracted wide attention all over the world. More appropriate treatment of AR should be explored thoroughly. In recent years, traditional Chinese medicine has attracted more attention in AR treatment. As a classical Chinese medicine prescription, Xiaoqinglong decoction (XQLD) has been commonly used in treating AR. Even though its therapeutic effect on AR has been clinically confirmed, more molecular mechanism remains to be further investigated. Our research aimed to investigate the therapeutic mechanism of XQLD for AR management. METHODS: The study was evaluated in an ovalbumin sensitized mouse model and liquid chromatography-mass spectrometry was adopted to test the stability of XQLD's effective components. RESULTS: The results confirmed the stability and safety of the effective components of XQLD. XQLD significantly downregulated the expression of HDACs (HDAC1, HDAC3, and HDAC4) and Th2 inflammatory factors (IL4, IL5, and IL13) in AR mice. XQLD and the HDAC inhibitor JNJ-26481585 promoted the expression of epithelial tight junction proteins (claudin-1 and ZO-1) and decreased the expression of mucins (Muc5ac and Muc5b) in the nasal mucosa of AR mice. CONCLUSIONS: In conclusion, our findings present the beneficial effects of XQLD on AR and recovery of the nasal epithelium. We also identify the decreased HDAC as a potential target of XQLD for AR treatment. This study provides an important experimental proof for elucidating the therapeutic mechanism of XQLD.

Selection of suitable reference genes for qPCR normalization in different developmental stages of Oenanthe javanica.

Gene expression analysis is widely used to unravel molecular regulatory mechanisms and identify key genes in plants. Appropriate reference gene is an important prerequisite to ensure the accuracy and reliability of qPCR analysis results. Water dropwort is a plant of the Oenanthe genus in the Apiaceae family, which has high economic benefits. However, the underlying molecular regulatory mechanisms in the growth and development of water dropwort have not been fully understood and the appropriate reference genes in different developmental stages of water dropwort not yet reported. In this study, 10 candidate reference genes (ACTIN, PP2A, SAND, EF-1α, GAPDH, UBQ, MIP, TBP, RPS-18, eIF-4α) were identified and cloned from Oenanthe javanica. The qPCR primers of candidate reference genes were designed and verified. Four statistical algorithms, geNorm, NormFinder, BestKeeper and RefFinder were used to evaluate the expression stability of 10 candidate reference genes in different developmental stages of water dropwort. The results showed that TBP and UBQ were the most stable genes in different developmental stages of water dropwort, while GAPDH was the most unstable gene. The normalization of EXP1 genes at different developmental stages further confirmed the reliability of internal reference genes. The results of this study provide a theoretical basis for selecting appropriate internal reference genes in different developmental stages of water dropwort. This study also provides technical support and reliable basis for the expression analysis of key genes in different developmental stages of water dropwort.

The association between personal social capital and health-related quality of life among Chinese older people: A cross-sectional study.

Background: Lower health-related quality of life (HRQoL) can result in adverse effects on the health of older people. This study aims to explore the relationship between personal social capital (PSC) and HRQoL among Chinese elderly people from rural-and-urban perspective. Materials and methods: 4,802 samples were included from China's health-related quality of life Survey for Older Adults 2018 (CHRQLS-OA 2018). The PSC, including bonding and bridging social capital (BOC and BRC), was measured by the Chinese version of the Personal Social Capital Scale (PSCS-16). The HRQoL was evaluated by the European Five Dimensions Questionnaire (EQ-5D-3L). Linear and Tobit regression models were conducted to examine the relationship between PSC and HRQoL. Results: The BOC and BRC of rural older people were significantly lower than those of urban older people. Pain/discomfort and anxiety/depression were the most significant health problems affecting the older samples. In the five dimensions, the proportion of rural older people with problems was higher than that of urban older people. Among rural older people, BOC was significantly related to self-rated health and EQ-5D utility index (p < 0.05); while BRC was insignificantly associated with self-rated health (p > 0.05) but related to EQ-5D utility index (p < 0.05). Both BOC and BRC were significantly correlated with self-rated health and EQ-5D utility index (p < 0.05) among urban older people. Conclusion: Our study reveals older people's worrying PSC and HRQoL status. The relationship between PSC and HRQoL suggested that more social support and care of intimates should be encouraged to increase the PSC of older people, especially rural older people.

Highly Fluorescent Collagen-Based Quantum Dots as an Efficient Interlinkage in the 2D Perovskite Bulk for Improved Solar Cells.

A design-inexpensive, effective, and easy-to-prepare additive in the large-scale preparation of perovskite solar cells (PSCs) is urgently desired to alleviate the future energy crisis. Carbon-based quantum dots have demonstrated novel nanomaterials with excellent chemical stability and high electrical conductivity, which exhibit great potential as additives for perovskite optoelectronics. Herein, we designed novel highly fluorescent collagen-based quantum dots (Col-QDs) and thoroughly studied the micromorphological characteristics, photoluminescence properties, and the states of surface-functionalized groups on the Col-QDs. It is found that the introduction of Col-QDs in the two-dimensional (2D) perovskite precursor can be further confirmed as an efficient interlinkage via Col-Pb bands in the pure 2D perovskite heterojunction, which significantly improves the crystallinity, orientation, and interlayer coupling of perovskite crystal plates, as observed by grazing incidence X-ray diffraction (GIWAXS) and X-ray photoelectron spectroscopy (XPS). Finally, the champion Col-QD additive can efficiently modulate the photovoltaic performance of pure 2D PSCs with a significant increase of photoelectric conversion efficiency (PCE) from 8.18% up to 10.45%, which ranks among the best efficiencies of highly pure 2D PSCs. These results provide a facile and feasible approach to modulate the interlayer interaction of pure 2D perovskites and further improve their output of PSCs, which would further facilitate the burgeoning applications of the Col-QDs in various perovskite-based optical-related fields.

Integrative Analysis of Long- and Short-Read Transcriptomes Identify the Regulation of Terpenoids Biosynthesis Under Shading Cultivation in Oenanthe javanica.

Water dropwort (Oenanthe javanica) is a popular vegetable with high nutritional value and distinctive flavor. The flavor is mainly correlate with the biosynthesis of terpenoids. Shading cultivation was used to improve the flavor in the production of water dropwort. However, the changes of terpenoids and the genes involved in terpenoids biosynthesis under shading treatment remains unclear. In this study, the long- and short-reads transcriptomes of water dropwort were constructed. In total, 57,743 non-redundant high-quality transcripts were obtained from the transcriptome. 28,514 SSRs were identified from non-redundant transcripts and the mono-nucleotide repeats were the most abundant SSRs. The lncRNAs of water dropwort were recognized and their target genes were predicted. The volatile compound contents in petioles and leaf blades of water dropwort were decreased after the shading treatment. The DEGs analysis was performed to identify the terpenoids biosynthesis genes. The results indicated that 5,288 DEGs were differentially expressed in petiole, of which 22 DEGs were enriched in the terpenoids backbone biosynthesis pathway. A total of 12 DEGs in terpenoids biosynthesis pathway were selected and further verified by qRT-PCR assay, demonstrating that the terpenoids biosynthesis genes were down-regulated under shading treatment. Here, the full-length transcriptome was constructed and the regulatory genes related to terpenoids biosynthesis in water dropwort were also investigated. These results will provide useful information for future researches on functional genomics and terpenoids biosynthesis mechanism in water dropwort.

Efficacy and safety of the Chinese herbal medicine Xiao-qing-long-tang for allergic rhinitis: A systematic review and meta-analysis of randomized controlled trials.

ETHNOPHARMACOLOGICAL RELEVANCE: The classic Chinese herbal medicine formula Xiao-qing-long-tang (XQLT) is commonly recommended to manage allergic rhinitis (AR), but the treatment efficacy and safety of XQLT are uncertain. AIM OF THE STUDY: This study aimed to evaluate the effectiveness and safety of XQLT in treating AR. MATERIALS AND METHODS: Nine databases were searched from their inception to April 2021. Randomized controlled trials (RCTs) evaluating XQLT for AR were included. The methodological quality of the studies was assessed using the Cochrane risk-of-bias tool. A meta-analysis and a subgroup meta-analysis were conducted to evaluate the effectiveness of XQLT. RESULTS: Twenty-four RCTs were included in this meta-analysis. XQLT was compared to both placebo and Western medicine (WM), and XQLT combined with WM was compared with WM alone. Meta-analyses were conducted for total nasal symptom scores (TNSS), four individual nasal symptom scores, quality of life (QoL), effective rate, and recurrence rate. The TNSS decreased after XQLT treatment and combination treatment (mean difference (MD): -0.79; 95% confidence interval (CI) [-1.20, -0.38], standardized mean difference (SMD): -1.42; 95% CI [-1.59, -1.24], and SMD: -1.84; 95% CI [-2.08, -1.60]). The two individual nasal symptom scores decreased after XQLT treatment and combination treatment; these nasal symptoms comprised rhinorrhea (SMD: -0.30; 95% CI [-0.58, -0.02] and SMD: -0.48; 95% CI [-0.70, -0.26]), and nasal obstruction (SMD: -0.54; 95% CI [-0.78, -0.30] and SMD: -0.54; 95% CI [-0.76, -0.32). XQLT and XQLT combined with WM achieved a better effective rate than WM (risk ratio (RR): 1.18; 95% CI [1.11, 1.25] and RR: 1.16; 95% CI [1.10, 1.23]) and a lower recurrence rate than WM (RR: 0.24; 95% CI [0.13, 0.43] and RR: 0.47; 95% CI [0.31, 0.72]). XQLT was well tolerated in patients being treated for AR. CONCLUSION: Our results indicated that oral XQLT may alleviate the TNSS, rhinorrhea scores, and nasal obstruction scores of AR and is safe to use in clinical practice. However, more RCTs that follow rigorous methodologies and evaluate well-accepted outcome measures are required to evaluate the effectiveness of XQLT.

Diagnostic and surgical challenges of progressive neck and upper back painless masses in Madelung's disease: A case report and review of literature.

BACKGROUND: Madelung's disease (MD) is a chronic alcoholism-associated metabolic syndrome characterized by symmetrical subcutaneous deposition of adipose tissue in the head, neck, shoulders, back, trunk, and nerve roots of the upper and lower limbs. It is relatively rare in Asian individuals and is prone to misdiagnosis. Herein, we report a case of a patient with MD who had undergone surgical management at our hospital, and we discuss the pathogenesis, diagnosis, and treatment of MD. CASE SUMMARY: We report a case of MD in a 65-year-old man of Han descent. The patient had multiple, painless progressive masses for more than five years in the neck and more than 30 years in the upper back. Because of neck mobility limitations and progressive cosmetic deformities caused by the masses, he was admitted to our hospital. He drank approximately 500 mL of liquor per day and smoked heavily for more than 30 years. Contrast-enhanced computed tomography of the neck and chest documented abundant unencapsulated, subcutaneous fatty deposits. We prepared a staged operation plan. The patient was diagnosed with MD; he was advised to abstain from alcohol and was followed up regularly. After a 3-month follow-up, no recurrence of fat accumulation was found in the surgical areas. CONCLUSION: This report presents a case of surgical treatment for MD to improve clinicians' understanding of the disease.

Implementing an intermittent spin-coating strategy to enable bottom-up crystallization in layered halide perovskites.

Two-dimensional halide perovskites (2D PVSKs) have drawn tremendous attentions owing to their outstanding ambient stability. However, the random orientation of layered crystals severely impedes the out-of-plane carrier transport and limits the solar cell performance. An in-depth understanding coupled with an effective control of the crystallization in 2D PVSKs is the crux for highly efficient and durable devices. In this contribution, we accidentally discovered that the crystallization of 2D PVSKs can be effectively regulated by so-called 'intermittent spin-coating (ISC)' process. Combined analyses of in(ex)-situ grazing-incidence wide-angle X-ray scattering with time-of-flight secondary ion mass spectrometry distinguish the interface initialized bottom-up crystallization upon ISC treatment from the bi-directional one in the conventional spin-coating process, which results in significantly enhanced crystal orientation and thus facilitated carrier transport as confirmed by both electrical measurements and ultrafast spectroscopies. As a result, the p-i-n architecture planar solar cells based on ISC fabricated paradigm PEA2MA3Pb4I13 deliver a respectable efficiency of 11.2% without any treatment, which is three-fold improvement over their spin-coated counterparts and can be further boosted up to 14.0% by NH4Cl addition, demonstrating the compatibility of ISC method with other film optimization strategies.

Nonconfinement Structure Revealed in Dion-Jacobson Type Quasi-2D Perovskite Expedites Interlayer Charge Transport.

Dion-Jacobson (DJ) type 2D perovskites with a single organic cation layer exhibit a narrower distance between two adjacent inorganic layers compared to the corresponding Ruddlesden-Popper perovskites, which facilitates interlayer charge transport. However, the internal crystal structures in 2D DJ perovskites remain elusive. Herein, in a p-xylylenediamine (PDMA)-based DJ perovskite bearing bifunctional NH3 + spacer, the compression from confinement structure (inorganic layer number, n = 1, 2) to nonconfinement structure (n > 3) with the decrease of PDMA molar ratio is unraveled. Remarkably, the nonconfined perovskite displays shorter spacing between 2D quantum wells, which results in a lower exciton binding energy and hence promotes exciton dissociation. The significantly diminishing quantum confinement promotes interlayer charge transport leading to a maximum photovoltaic efficiency of ≈11%. Additionally, the tighter interlayer packing arising from the squeezing of inorganic octahedra gives rise to enhanced ambient stability.

Benefiting from Spontaneously Generated 2D/3D Bulk-Heterojunctions in Ruddlesden-Popper Perovskite by Incorporation of S-Bearing Spacer Cation.

2D Ruddlesden-Popper (RP) perovskite solar cells have manifested superior operation durability yet inferior charge transport compared to their 3D counterparts. Integrating 3D phases with 2D RP perovskites presents a compromise to maintain respective advantages of both components. Here, the spontaneous generation of 3D phases embedded in 2D perovskite matrix is demonstrated at room temperature via introducing S-bearing thiophene-2-ethylamine (TEA) as both spacer and stabilizer of inorganic lattices. The resulting 2D/3D bulk heterojunction structures are believed to arise from the compression-induced epitaxial growth of the 3D phase at the grain boundaries of the 2D phase through the Pb-S interaction. The as-prepared 2D TEA perovskites exhibit longer exciton diffusion length and extended charge carrier lifetime than the paradigm 2D phenylethylamine (PEA)-based analogues and hence demonstrate an outstanding power conversion efficiency of 7.20% with significantly increased photocurrent. Dual treatments by NH4Cl and dimethyl sulfoxide are further applied to ameliorate the crystallinity and crystal orientation of 2D perovskites. Consequently, TEA-based devices exhibit a stabilized efficiency over 11% with negligible hysteresis and display excellent ambient stability without encapsulation by preserving 80% efficiency after 270 h storage in air with 60 ± 5% relative humidity at 25 °C.

Unveiling Excitonic Dynamics in High-Efficiency Nonfullerene Organic Solar Cells to Direct Morphological Optimization for Suppressing Charge Recombination.

Nonfullerene acceptors (NFAs)-based organic solar cells (OSCs) have recently drawn considerable research interests; however, their excitonic dynamics seems quite different than that of fullerene acceptors-based devices and remains to be largely explored. A random terpolymer of PBBF11 to pair with a paradigm NFA of 3,9-bis(2-methylene-(3-(1,1-dicyanomethylene)-indanone)-5,5,11,11-tetrakis(4-hexylphenyl)-dithieno[2,3-d:2',3'-d']-s-indaceno[1,2-b:5,6-b']dithiophene (ITIC) such that both complementary optical absorption and very small offsets of both highest occupied molecular orbital and lowest unoccupied molecular orbital energy levels are acquired is designed and synthesized. Despite the small energy offsets, efficient electron/hole transfer between PBBF11 and ITIC is both clearly observed from steady-state photoluminescence and transient absorption spectra and also supported by the measured low exciton binding energy in ITIC. Consequently, the PBBF11:ITIC-based OSCs afford an encouraging power conversion efficiency (PCE) of 10.02%. Although the good miscibility of PBBF11 and ITIC induces a homogenous blend film morphology, it causes severe charge recombination. The fullerene acceptor of PC71BM with varying loading ratios is therefore added to modulate film morphology to effectively reduce the charge recombination. As a result, the optimal OSCs based on PBBF11:ITIC:PC71BM yield a better PCE of 11.4% without any additive or annealing treatment.

Air-Stable and Self-Driven Perovskite Photodiodes with High On/Off Ratio and Swift Photoresponse.

Recent years have witnessed rapid developments in organic-inorganic hybrid perovskites, among which 2D Ruddlesden-Popper (RP) perovskites stand out due to their outstanding ambient stability. In photodetector applications, 2D RP perovskites are mostly limited to lateral device configuration because of their preferred in-plane charge transportation within quantum well structures. In this work, the low-temperature solution construction of 2D RP perovskite-based photodiodes in vertical device architecture is demonstrated. The paradigm phenylethylamine (PEA) spacer cation-based 2D perovskites are fabricated and optimized by exploiting a combination of a NH4 Cl additive and dimethyl sulfoxide solvent (DMSO) solvent. They show increased crystallinity, extended photoluminescence lifetimes, and importantly a generation of 3D phases embedded within 2D perovskites, which efficiently promotes charge transfer. As a result, the photodetectors exhibit a high on/off ratio up to 2 × 104 , a large photocurrent of 0.34 mA cm-2 , and rapid rise (5.8 ms) and decay time (4.6 ms). Of critical importance is the outstanding film/device stabilities demonstrated by storage in air (at 25 °C with 60% relative humidity) for 15 days as well as under UV illumination for 1.5 h and after 1500 bending cycles on flexible substrate.