Da-Cheng-Qi decoction improves severe acute pancreatitis capillary leakage syndrome by regulating tight junction-associated proteins.

Background and aims: To investigate mechanisms underlying the effects of Da-Cheng-Qi decoction (DCQD) on severe acute pancreatitis (SAP) capillary leakage syndrome. Methods: In this study, a SAP rat model was established using retrograde perfusion of 5% sodium taurocholate into the biliopancreatic duct. The study included three randomized groups: control, SAP (modeling), and DCQD (via gavage at 2 h pre-modeling and 2 and 4 h post-modeling). HPLC was used to analyzed major components of DCQD. Pathological changes and capillary permeability in the rat pancreatic tissues were examined. mRNA levels of claudin 5, occludin, zonula occludin-1 (ZO-1), and junctional adhesion molecules (JAM-C) were assessed using qRT-PCR. Tight junction-associated protein expression was evaluated using immunofluorescence and Western blot analyses. Human umbilical vein endothelial cells (HUVECs) were used to investigate the mechanism m of DCQD. Results: Serum levels of amylase, TNF-α, IL-1ß, IL-2, and IL-6 were higher in the SAP group compared to the DCQD group (p < 0.05). DCQD treatment significantly attenuated rat pancreas damage (p < 0.05) and reduced tissue capillary permeability compared to the SAP group (p < 0.05). Claudin 5, occludin, and ZO-1 expression in the rat tissues was upregulated, but JAM-C was downregulated by DCQD treatment (p < 0.05). HUVEC permeability was improved by DCQD in a dose-time-dependent manner compared to the SAP group (p < 0.05). DCQD also upregulated claudin 5, occludin, and ZO-1 expression in vitro (p < 0.05). Conclusion: DCQD can improve capillary permeability in both in vivo and in vitro models of SAP by upregulating expression of claudin 5, occludin, and ZO-1, but not JAM-C.

The effect of flywheel complex training with eccentric-overload on muscular adaptation in elite female volleyball players.

This study aimed to compare the effects of 8 weeks (24 sessions) between flywheel complex training with eccentric overload and traditional complex training of well-trained volleyball players on muscle adaptation, including hypertrophy, strength, and power variables. Fourteen athletes were recruited and randomly divided into the flywheel complex training with an eccentric-overload group (FCTEO, n = 7) and the control group (the traditional complex training group, TCT, n = 7). Participants performed half-squats using a flywheel device or Smith machine and drop jumps, with three sets of eight repetitions and three sets of 12 repetitions, respectively. The variables assessed included the muscle thickness at the proximal, mid, and distal sections of the quadriceps femoris, maximal half-squats strength (1RM-SS), squat jump (SJ), countermovement jump (CMJ), and three-step approach jump (AJ). In addition, a two-way repeated ANOVA analysis was used to find differences between the two groups and between the two testing times (pre-test vs. post-test). The indicators of the FCTEO group showed a significantly better improvement (p < 0.05) in CMJ (height: ES = 0.648, peak power: ES = 0.750), AJ (height: ES = 0.537, peak power: ES = 0.441), 1RM-SS (ES = 0.671) compared to the TCT group and the muscle thicknes at the mid of the quadriceps femoris (ES = 0.504) after FCTEO training. Since volleyball requires lower limb strength and explosive effort during repeated jumps and spiking, these results suggest that FCTEO affects muscular adaptation in a way that improves performance in well-trained female volleyball players.

Treatment patterns and clinical outcomes of patients with resectable non-small cell lung cancer receiving neoadjuvant immunochemotherapy: A large-scale, multicenter, real-world study (NeoR-World).

BACKGROUND: Neoadjuvant immunotherapy has ushered in a new era of perioperative treatment for resectable non-small cell lung cancer (NSCLC). However, large-scale data for verifying the efficacy and optimizing the therapeutic strategies of neoadjuvant immunochemotherapy in routine clinical practice are scarce. METHODS: NeoR-World (NCT05974007) was a multicenter, retrospective cohort study involving patients who received neoadjuvant immunotherapy plus chemotherapy or chemotherapy alone in routine clinical practice from 11 medical centers in China between January 2010 and March 2022. Propensity score matching was performed to address indication bias. RESULTS: A total of 408 patients receiving neoadjuvant immunochemotherapy and 684 patients receiving neoadjuvant chemotherapy were included. The pathologic complete response (pCR) and major pathologic response (MPR) rates of the real-world neoadjuvant immunochemotherapy cohort were 32.8% and 58.1%, respectively. Notably, patients with squamous cell carcinoma exhibited significantly higher pCR and MPR rates than those with adenocarcinoma (pCR, 39.2% vs 16.5% [P < .001]; MPR, 66.6% vs 36.5% [P < .001]), whereas pCR and MPR rates were comparable among patients receiving different neoadjuvant cycles. In addition, the 2-year rates of disease-free survival (DFS) and overall survival (OS) rate were 82.0% and 93.1%, respectively. Multivariate analyses identified adjuvant therapy as an independent prognostic factor for DFS (hazard ratio [HR], 0.51; 95% confidence interval [CI], 0.29-0.89; P = .018) and OS (HR, 0.28; 95% CI, 0.13-0.58; P < .001). A significantly longer DFS with adjuvant therapy was observed in patients with non-pCR or 2 neoadjuvant cycles. We observed significant benefits in pCR rate (32.4% vs 6.4%; P < .001), DFS (HR, 0.50; 95% CI, 0.38-0.68; P < .001) and OS (HR, 0.61; 95% CI, 0.40-0.94; P = .024) with immunotherapy plus chemotherapy compared to chemotherapy alone both in the primary propensity-matched cohort and across most key subgroups. CONCLUSIONS: The study validates the superior efficacy of neoadjuvant immunochemotherapy over chemotherapy alone for NSCLC. Adjuvant therapy could prolong DFS in patients receiving neoadjuvant immunochemotherapy, and patients with non-pCR or those who underwent 2 neoadjuvant cycles were identified as potential beneficiaries of adjuvant therapy.

The profiles of single leg countermovement jump kinetics and sprinting in female soccer athletes.

The purposes were to evaluate kinetics in lower limbs using single leg countermovement jump (SLCMJ) and to identify the differences in SLCMJ kinetics between sprinting fast players and sprinting slow players in elite university female soccer players. Seventeen participants at the national tournament level completed the survey. SLCMJ and 30 m sprinting tests were performed. A force-plate was used to collect the data of the SLCMJ test. Significant differences of concentric maximum rate of force development (RFD), concentric RFD, concentric RFD/body weight (BW), peak net takeoff force/BW, peak power, and peak power/BW existed between both legs during the SLCMJ among all the participants. For further analysis, the participants were divided into fast group and slow group based on sprinting performance. Significant differences existed between the two groups in concentric peak velocity (nondominant, p = 0.028) and vertical velocity at takeoff (nondominant, p = 0.021). Concentric maximum RFD (p = 0.036) was significantly different between both legs in the slow group. Among elite university female soccer players, the players who presented more increased asymmetry of kinetic characteristics of jumping, also showed weak sprinting performance. Moreover, the players presented the best performance in velocity of the jumping variables and also had the best sprinting performance. Coaches and players should focus on keeping inter-limb balance and developing jumping velocity to improve sports performance. In future, the cause-and-effect relationship between jumping and sprinting should be identified.

Thoracoscopic treatment of primary spontaneous pneumothorax without a drainage tube in male patients.

OBJECTIVE: To propose a treatment approach for primary spontaneous pneumothorax (PSP) in male patients with a smaller incision and less pain. METHODS: We retrospectively studied 29 patients with PSP who underwent areola-port video-assisted thoracoscopic surgery (VATS) and 21 patients who underwent single-port VATS. The areola-port VATS technique was performed as follows. First, an arc incision was made along the lower edge of the areola, and a 5-mm-diameter thoracoscope was placed. The bullae were completely removed, and the absence of air leaks and other bullae was confirmed. A drainage tube was placed in the chest with negative pressure and then quickly pulled out, and the reserved suture line was knotted. RESULTS: All patients were male, and their mean age was 19.07 ± 2.43 years. The mean intraoperative hemorrhage volume and postoperative pain score were significantly lower in the areola-port than single-port group. The mean operative time and mean postoperative hospital stay were also shorter in the areola-port group, but without statistical significance. The incidence of complications and the 1-year postoperative recurrence rate were 0% in both groups. CONCLUSION: Our method is clinically feasible and inexpensive, has a traceless effect, and is especially suitable for adolescents.

Effect of Leg Half-Squat Training With Blood Flow Restriction Under Different External Loads on Strength and Vertical Jumping Performance in Well-Trained Volleyball Players.

Purpose: To examine the effect of blood flow restriction resistance training under different external loads on the muscle strength and vertical jumping performance in volleyball players. Methods: 18 well-trained collegiate male volleyball players were randomly divided into 3 groups: high-load resistance training group (HL-RT, 70% 1RM, n = 6), low-load blood flow restriction resistance training group (LL-BFR-RT, 30% 1RM, 50% arterial occlusion, n = 6), and high-load blood flow restriction resistance training group (HL-BFR-RT, 70% 1RM, 50% arterial occlusion, n = 6). Participants performed leg half-squat exercise 3 times per week for 8 weeks. Measurements of Isokinetic peak torque of knee extension and flexion, 1RM leg half-squat, squat jump, and 3 footed take-off were obtained before and after training. A two-way repeated-measures analysis of variance was used to examine differences among the 3 groups and between the 2 testing time (pre-test vs post-test). Results: (1) The HL-RT group was significantly greater in muscle strength than that in the LL-BFR-RT group (P < .05), but no improvement in vertical jumping performance (P >.05). (2) Improvement in muscle strength and vertical jumping performance was significantly greater in the HL-BFR-RT group than that in the LL-BFR-RT group (P <.05). (3) The HL-BFR-RT group had greater but not significant improvement in muscle strength and vertical jumping performance than that in the HL-RT group. Conclusions: Although increases in muscle strength were observed between training groups, HL-BFR-RT increased not only muscle strength but vertical jumping performance to a greater extent compared to LL-BFR-RT and HL-RT.

Acute effects of vibration foam rolling and local vibration during warm-up on athletic performance in tennis players.

Athletes are currently fond of vibration foam rollers (VFRs) and commercial portable vibration percussion devices (PVPDs). It is still unknown whether using these devices during warm-up has an immediate impact on athletic performance. A randomized block design was used in this study. The acute effects of VFR and PVPD on tennis players' athletic performance during warm-up were compared. For the countermovement jump (CMJ), reactive strength index (RSI), and hexagon test (HT), the difference in performance between all interventions was significant (p = 0.007-0.034, η2p = 0.266-0.364). Only those who received VFR had significantly different CMJ and HT results when compared to the control group (CMJ height = 53.18 ±4.49 cm, p = 0.03, d = 1.26; HT time = 10.73 ±0.4 s, p = 0.03, d = 1.12). Participants' RSI values were significantly different after VFR (RSI = 2.01 ±0.11 cm·mm-1, p = 0.012, d = 1.76) and PVPD (RSI = 1.99 ±0.11 cm·mm-1, p = 0.025, d = 1.52) compared to the control group. Therefore, when using VFR and PVPD as part of warm-up protocols for tennis players of varying skill levels, VFR could have an immediate positive effect on power, reactive strength, and change of direction performance, while PVPD could immediately improve reactive strength performance.

Sepsis Due to Bloodstream Ralstonia mannitolilytica Infection After Surgical Treatment of Perianal Abscess: A Case Report.

BACKGROUND: Ralstonia mannitolilytica can cause opportunistic infections. Reports on this pathogen identified in the bloodstream are rare worldwide, especially in China. CASE DESCRIPTION: We describe a 48-year-old man who developed sepsis due to bloodstream Ralstonia mannitolilytica infection after surgery for a perianal abscess. His condition deteriorated into multiple organ dysfunction syndromes until susceptible antibiotics (ceftriaxone and levofloxacin) were administrated based on the drug sensitivity test results. The patient had a satisfactory recovery with no complications during a 6-month follow-up period. CONCLUSION: Ralstonia mannitolilytica blood-borne infection in patients evolves rapidly. The inconsistent sensitivity to antibiotics makes timely treatment difficult and can lead to serious complications. We report the clinical presentations and treatment outcomes for this patient here to remind clinicians about this rare opportunistic pathogen and to highlight the importance of bacterial culture, especially for immunocompromised patients.

Efficient Randomness Certification by Quantum Probability Estimation.

For practical applications of quantum randomness generation, it is important to certify and further produce a fixed block of fresh random bits with as few trials as possible. Consequently, protocols with high finite-data efficiency are preferred. To yield such protocols with respect to quantum side information, we develop quantum probability estimation. Our approach is applicable to device-independent as well as device-dependent scenarios, and it generalizes techniques from previous works [Miller and Shi, SIAM Journal on Computing 46, 1304 (2017); Arnon-Friedman et al., Nature Communications 9, 459 (2018)]. Quantum probability estimation can adapt to changing experimental conditions, allows stopping the experiment as soon as the prespecified randomness goal is achieved, and can tolerate imperfect knowledge of the input distribution. Moreover, the randomness rate achieved at constant error is asymptotically optimal. For the device-independent scenario, our approach certifies the amount of randomness available in experimental results without first searching for relations between randomness and violations of fixed Bell inequalities. We implement quantum probability estimation for device-independent randomness generation in the CHSH Bell-test configuration, and we show significant improvements in finite-data efficiency, particularly at small Bell violations which are typical in current photonic loophole-free Bell tests.

The arterial-ligation-alone method for identifying the intersegmental plane during thoracoscopic anatomic segmentectomy.

BACKGROUND: Currently, methods for identifying the intersegmental plane during anatomical segmentectomy can be classified into 2 categories: the bronchial method and the vascular method. One of the vascular methods, the arterial-ligation-alone method, has not yet been validated or objectively evaluated in a large case series. We thus aimed to confirm that the arterial-ligation-alone method could effectively and accurately identify the intersegmental plane. METHODS: We retrospectively reviewed the records of 104 patients who were scheduled for thoracoscopic anatomic segmentectomy. Preoperative three-dimensional (3D) reconstruction was performed on all the affected lungs to distinguish the targeted segmental arteries, veins and bronchi. The procedure was as follows: first, based on the 3D reconstruction of the lung, the targeted segmental arteries were distinguished and ligated. Second, bilateral pulmonary ventilation was performed with pure oxygen. When the affected lung had completely inflated, contralateral pulmonary ventilation was performed. After waiting for some time, the first intersegmental plane could be obtained, and the time was recorded as T1, with an electric coagulation hook being used for marking. Thirdly, when the targeted segmental veins and bronchi had been ligated, the second intersegmental plane could be obtained by the inflation-deflation method as before, with the waiting time being recorded as T2. The differences between the 2 intersegmental planes were evaluated by 2 experienced chief thoracic surgeons. RESULT: In a total of 99 (95.2%) patients, the intersegmental planes were successfully and accurately identified by the arterial-ligation-alone method. Ultimately, 85 (81.7%) patients underwent thoracoscopic anatomic segmentectomy. The results for evaluating the differences between the 2 planes were as follows: completely consistent (94 cases, 94.9%), basically consistent (5 cases, 5.1%), and discrepant (0 cases, 0%). The mean T1 was 13.6±2.7 minutes (range, 8-25 minutes), and the mean T2 was 13.0±2.6 minutes (range, 8-23 minutes), with P=0.100 (95% CI). For 99 patients, the mean nodule size was 1.1±0.34 cm. In the 85 patients who underwent segmentectomy, the mean margin width was 2.84±0.51 cm, the mean operative duration was 165.6±18.3 minutes, the mean operative hemorrhage was 52.1±20.2 mL, and the mean duration of chest tube drainage was 3.9±1.3 days. Postoperative complications related to operative procedures occurred in 2 cases. CONCLUSIONS: The arterial-ligation-only method can effectively, accurately and inexpensively identify the intersegmental plane, and is especially suitable for the patients whose veins or bronchi are difficult to anatomize. Whether the target bronchus is ligated has no effect on the intersegmental plane.

Prolonged endotracheal intubation: a feasible option for tracheomalacia after retrosternal goitre surgery.

BACKGROUND: Tracheomalacia may be caused by long-standing compression of retrosternal goitre because of destruction of support of tracheal cartilages. Life-threatening airway collapses may occur after surgical removal of goitre. However, available literature on management methods of tracheomalacia is sparse. Our study highlights prolonged endotracheal intubation as a feasible treatment method. METHODS: This retrospective study analysed 106 thyroidectomies for retrosternal goitre performed between 1994 and 2019. We recorded each patient's clinical profile. Severe tracheomalacia was confirmed through the following: soft and floppy trachea on intra-operative palpation and the collapse of cross-sectional tracheal area measured in computed tomography (CT) images by >80%. We assessed the extent of airway stenosis of these cases. All severe cases were treated by prolonged endotracheal intubation. RESULTS: Surgical treatment was successfully performed in all 106 retrosternal goitre patients with no mortality. Seventeen severe tracheomalacia cases were confirmed. The extent of airway stenosis was assessed: the minimal tracheal diameter of compressed trachea was 0.2-0.4 [mean 0.31, standard deviation (SD) 0.06] cm, and the narrow tracheal length was 4-6.7 (mean 5.1, SD 0.6) cm. These patients underwent endotracheal intubation for 17-47 h after surgery. All patients were transferred to the general ward after extubation and successfully discharged. There were no cases of tracheal stenosis on follow-up. CONCLUSIONS: Tracheomalacia is a rare but serious complication of retrosternal goitre surgery. Based on our experience, prolonged endotracheal intubation is a feasible treatment for tracheomalacia after retrosternal goitre surgery.

Experimental Low-Latency Device-Independent Quantum Randomness.

Applications of randomness such as private key generation and public randomness beacons require small blocks of certified random bits on demand. Device-independent quantum random number generators can produce such random bits, but existing quantum-proof protocols and loophole-free implementations suffer from high latency, requiring many hours to produce any random bits. We demonstrate device-independent quantum randomness generation from a loophole-free Bell test with a more efficient quantum-proof protocol, obtaining multiple blocks of 512 random bits with an average experiment time of less than 5 min per block and with a certified error bounded by 2^{-64}≈5.42×10^{-20}.

SKA1 overexpression is associated with the prognosis of esophageal squamous cell carcinoma and regulates cell proliferation and migration.

Spindle and kinetochore­associated protein 1 (SKA1), a microtubule­binding subcomplex of the outer kinetochore, is essential for complete chromosomal separation. SKA1 has been suggested as a potential biomarker for various types of cancer. However, the exact role of SKA1 in esophageal squamous cell carcinoma (ESCC) remains unclear. The present study investigated whether SKA1 affects the biological behavior of ESCC. The expression of SKA1 in ESCC tissues was measured using immunohistochemistry and reverse transcription­quantitative polymerase chain reaction. In addition, a SKA1­silencing lentivirus was constructed, which was transfected into TE­1 cells to establish stable SKA1­knockdown TE­1 cells. Proliferation was analyzed using a Celigo image cytometer and a MTS assay. Cell cycle progression and apoptosis were analyzed by flow cytometry, while cell migration was assessed using a Transwell assay. SKA1 was significantly overexpressed in ESCC tissues, and SKA1 overexpression was significantly associated with differentiation, pathological N stage and pathological tumor­node­metastasis stage. SKA1 was determined to be an independent prognostic factor for ESCC. Furthermore, SKA1 was significantly overexpressed in ESCC cells, and SKA1­silencing inhibited cell proliferation and migration, arrested the cell cycle and promoted cell apoptosis. In summary, SKA1 may serve as a potential therapeutic target and prognostic biomarker for ESCC.

Local Randomness: Examples and Application.

When two players achieve a superclassical score at a nonlocal game, their outputs must contain intrinsic randomness. This fact has many useful implications for quantum cryptography. Recently it has been observed (C. Miller, Y. Shi, Quant. Inf. & Comp. 17, pp. 0595-0610, 2017) that such scores also imply the existence of local randomness - that is, randomness known to one player but not to the other. This has potential implications for cryptographic tasks between two cooperating but mistrustful players. In the current paper we bring this notion toward practical realization, by offering a near-optimal bound on local randomness for the CHSH game, and also proving the security of a cryptographic application of local randomness (single-bit certified deletion).