Risk Assessment of Spodoptera exempta against Food Security: Estimating the Potential Global Overlapping Areas of Wheat, Maize, and Rice under Climate Change.

Spodoptera exempta, known as the black armyworm, has been extensively documented as an invasive agricultural pest prevalent across various crop planting regions globally. However, the potential geographical distribution and the threat it poses to host crops of remains unknown at present. Therefore, we used an optimized MaxEnt model based on 841 occurrence records and 19 bioclimatic variables to predict the potential suitable areas of S. exempta under current and future climatic conditions, and the overlap with wheat, rice, and maize planting areas was assessed. The optimized model was highly reliable in predicting potential suitable areas for this pest. The results showed that high-risk distribution areas for S. exempta were mainly in developing countries, including Latin America, central South America, central Africa, and southern Asia. Moreover, for the three major global food crops, S. exempta posed the greatest risk to maize planting areas (510.78 × 104 km2), followed by rice and wheat planting areas. Under future climate scenarios, global warming will limit the distribution of S. exempta. Overall, S. exempta had the strongest effect on global maize production areas and the least on global wheat planting areas. Our study offers a scientific basis for global prevention of S. exempta and protection of agricultural crops.

Systematic review and meta-analysis of endovascular therapy versus open surgical repair for the traumatic lower extremity arterial injury.

OBJECTIVE: For traumatic lower extremity artery injury, it is unclear whether it is better to perform endovascular therapy (ET) or open surgical repair (OSR). This study aimed to compare the clinical outcomes of ET versus OSR for traumatic lower extremity artery injury. METHODS: The Medline, Embase, and Cochrane Databases were searched for studies. Cohort studies and case series reporting outcomes of ET or OSR were eligible for inclusion. Robins-I tool and an 18-item tool were used to assess the risk of bias. The primary outcome was amputation. The secondary outcomes included fasciotomy or compartment syndrome, mortality, length of stay and lower extremity nerve injury. We used the random effects model to calculate pooled estimates. RESULTS: A total of 32 studies with low or moderate risk of bias were included in the meta-analysis. The results showed that patients who underwent ET had a significantly decreased risk of major amputation (OR = 0.42, 95% CI 0.21-0.85; I2=34%) and fasciotomy or compartment syndrome (OR = 0.31, 95% CI 0.20-0.50, I2 = 14%) than patients who underwent OSR. No significant difference was observed between the two groups regarding all-cause mortality (OR = 1.11, 95% CI 0.75-1.64, I2 = 31%). Patients with ET repair had a shorter length of stay than patients with OSR repair (MD=-5.06, 95% CI -6.76 to -3.36, I2 = 65%). Intraoperative nerve injury was just reported in OSR patients with a pooled incidence of 15% (95% CI 6%-27%). CONCLUSION: Endovascular therapy may represent a better choice for patients with traumatic lower extremity arterial injury, because it can provide lower risks of amputation, fasciotomy or compartment syndrome, and nerve injury, as well as shorter length of stay.

Changes in masseter muscle morphology after surgical-orthodontic treatment in patients with skeletal Class III malocclusion with mandibular asymmetry: The automatic masseter muscle segmentation model.

INTRODUCTION: This study evaluated the masseter muscle changes after surgical-orthodontic treatment in patients with a skeletal Class III malocclusion using automatic segmentation. METHODS: Images of 120 patient with skeletal Class III malocclusion were obtained and reconstructed at T0 (pretreatment), T1 (presurgery), and T2 (6-12-month postsurgery). The patients were divided into symmetrical and asymmetrical groups. The volume, major axis length, maximum cross-sectional area, horizontal cross-sectional area 5 mm above the mandibular foramen (CSAF), and orientation were calculated automatically. RESULTS: In the asymmetrical group, the volume and major axis length on the deviated side were lower than on the nondeviated side at T0, T1, and T2 (P <0.05). There were no significant differences in maximum cross-sectional area and CSAF bilaterally. The orientation was coronally more vertical and sagittally more forward on the deviated side (both P <0.001). In the symmetrical group, there were no significant bilateral differences at T0, T1, and T2. The volume, major axis length, and CSAF decreased, and the coronal orientation was more vertical on the nondeviated side at T2 than at T0 in both groups (P <0.05). The coronal plane orientation was more inclined on the deviated side at T2 than at T0 in the asymmetrical group (P <0.05). CONCLUSIONS: The smaller volume on the deviated side at T2 indicates the need for myofunctional training after surgery. The masseter muscle volume and the cross-sectional area did not recover to the preorthodontic levels. Studies with longer follow-up durations are needed to confirm these findings.

Relieving Macrophage Dysfunction by Inhibiting SREBP2 Activity: A Hypoxic Mesenchymal Stem Cells-Derived Exosomes Loaded Multifunctional Hydrogel for Accelerated Diabetic Wound Healing.

Macrophage dysfunction is one of the primary factors leading to the delayed healing of diabetic wounds. Hypoxic bone marrow mesenchymal stem cells-derived exosomes (hyBMSC-Exos) have been shown to play an active role in regulating cellular function through the carried microRNAs. However, the administration of hyBMSC-Exos alone in diabetic wounds usually brings little effect, because the exosomes are inherently unstable and have a short retention time at the wounds. In this study, a multifunctional hydrogel based on gallic acid (GA) conjugated chitosan (Chi-GA) and partially oxidized hyaluronic acid (OHA) is prepared for sustained release of hyBMSC-Exos. The hydrogel not only exhibits needs-satisfying physicochemical properties, but also displays outstanding biological performances such as low hemolysis rate, strong antibacterial capacity, great antioxidant ability, and excellent biocompatibility. It has the ability to boost the stability of hyBMSC-Exos, leading to a continuous and gradual release of the exosomes at wound locations, ultimately enhancing the exosomes' uptake efficiency by target cells. Most importantly, hyBMSC-Exos loaded hydrogel shows an excellent ability to promote diabetic wound healing by regulating macrophage polarization toward M2 phenotype. This may be because exosomal miR-4645-5p and antioxidant property of the hydrogel synergistically inhibit SREBP2 activity in macrophages. This study presents a productive approach for managing diabetic wounds.

Lactic acid promotes nucleus pulposus cell senescence and corresponding intervertebral disc degeneration via interacting with Akt.

The accumulation of metabolites in the intervertebral disc is considered an important cause of intervertebral disc degeneration (IVDD). Lactic acid, which is a metabolite that is produced by cellular anaerobic glycolysis, has been proven to be closely associated with IVDD. However, little is known about the role of lactic acid in nucleus pulposus cells (NPCs) senescence and oxidative stress. The aim of this study was to investigate the effect of lactic acid on NPCs senescence and oxidative stress as well as the underlying mechanism. A puncture-induced disc degeneration (PIDD) model was established in rats. Metabolomics analysis revealed that lactic acid levels were significantly increased in degenerated intervertebral discs. Elimination of excessive lactic acid using a lactate oxidase (LOx)-overexpressing lentivirus alleviated the progression of IVDD. In vitro experiments showed that high concentrations of lactic acid could induce senescence and oxidative stress in NPCs. High-throughput RNA sequencing results and bioinformatic analysis demonstrated that the induction of NPCs senescence and oxidative stress by lactic acid may be related to the PI3K/Akt signaling pathway. Further study verified that high concentrations of lactic acid could induce NPCs senescence and oxidative stress by interacting with Akt and regulating its downstream Akt/p21/p27/cyclin D1 and Akt/Nrf2/HO-1 pathways. Utilizing molecular docking, site-directed mutation and microscale thermophoresis assays, we found that lactic acid could regulate Akt kinase activity by binding to the Lys39 and Leu52 residues in the PH domain of Akt. These results highlight the involvement of lactic acid in NPCs senescence and oxidative stress, and lactic acid may become a novel potential therapeutic target for the treatment of IVDD.

Early warning and management of invasive crop pests under global warming: estimating the global geographical distribution patterns and ecological niche overlap of three Diabrotica beetles.

Invasive alien pests (IAPs) pose a major threat to global agriculture and food production. When multiple IAPs coexist in the same habitat and use the same resources, the economic loss to local agricultural production increases. Many species of the Diabrotica genus, such as Diabrotica barberi, Diabrotica undecimpunctata, and Diabrotica virgifera, originating from the USA and Mexico, seriously damaged maize production in North America and Europe. However, the potential geographic distributions (PGDs) and degree of ecological niche overlap among the three Diabrotica beetles remain unclear; thus, the potential coexistence zone is unknown. Based on environmental and species occurrence data, we used an ensemble model (EM) to predict the PGDs and overlapping PGD of the three Diabrotica beetles. The n-dimensional hypervolumes concept was used to explore the degree of niche overlap among the three species. The EM showed better reliability than the individual models. According to the EM results, the PGDs and overlapping PGD of the three Diabrotica beetles were mainly distributed in North America, Europe, and Asia. Under the current scenario, D. virgifera has the largest PGD ranges (1615 × 104 km2). In the future, the PGD of this species will expand further and reach a maximum under the SSP5-8.5 scenario in the 2050s (2499 × 104 km2). Diabrotica virgifera showed the highest potential for invasion under the current and future global warming scenarios. Among the three studied species, the degree of ecological niche overlap was the highest for D. undecimpunctata and D. virgifera, with the highest similarity in the PGD patterns and maximum coexistence range. Under global warming, the PGDs of the three Diabrotica beetles are expected to expand to high latitudes. Identifying the PGDs of the three Diabrotica beetles provides an important reference for quarantine authorities in countries at risk of invasion worldwide to develop specific preventive measures against pests.

Gender Differences in Prognosis After Primary Resection for Retroperitoneal Liposarcoma.

BACKGROUND: Current evidence regarding gender difference in retroperitoneal liposarcoma (RLPS) is scarce, so we sought to investigate whether gender may affect prognosis after primary resection of RLPS. METHODS: We used the Surveillance, Epidemiology, and End Results (SEER) database to identify RLPS patients from January 1973 to December 2015. Multivariate cox proportional hazard analysis was adopted to generate adjusted hazard ratio (AHR) and 95% confidence intervals (CIs) of survival outcomes. RESULTS: In total, 2108 RLPS patients, including 971 women and 1137 men, were identified, with a median follow-up of 45.0 (17.0-92.0) months. The 5-year and 10-year overall survival rates were 50.5% and 31.5% for men and 60.4% and 42.5% for women. The 5-year and 10-year disease-specific survival rates for men and women were 71.5%, 57.3% and 76.3%, 62.1%, respectively. We found men were associated with an increased risk of all-cause mortality (AHR 1.3, 95% CI 1.0-1.6, P = .017) but not disease-specific mortality (AHR 1.2, 95% CI .9-1.6, P = .246). The subgroup analyses revealed that men were associated with an increased risk of all-cause mortality in patients with low-grade tumors (AHR 1.8, 95% CI 1.3-2.5) or patients who received non-radical resection (AHR 1.6, 95% CI 1.2-2.1). In the subgroup of low-grade tumors, men were also associated with an increased risk of disease-specific mortality (AHR 2.0, 95% CI 1.2-3.3). CONCLUSION: Men may have worse survival after primary resection of RLPS compared with women, especially in patients with low-grade tumors or patients who received non-radical resection. Gender-based disparities may deserve more attention in patients with RLPS.

Oversizing Consideration of Proximal Stent Graft in Hemodynamically Stable and Unstable Patients Undergoing Emergent Endovascular Aortic Repair.

Consideration for oversizing the proximal stent graft is suggested in endovascular aortic repair. However, a special recommendation for the proximal oversizing ratio (OSR) in patients with ruptured abdominal aortic aneurysm (rAAA) is ambiguous. This study aims to evaluate the effect of different degrees of the proximal oversizing ratio (OSR) on risk of type IA endoleak (TIAEL) in hemodynamically stable and unstable patients with rAAA undergoing emergency endovascular aortic repair (EVAR). Our study included 134 rAAA patients undergoing emergent EVAR, and we did not observe a significant association between hemodynamic instability and risk of T1AEL (HR 3.89, 95%CI 0.40-37.75, p = 0.24). All three T1AELs in the hemodynamically unstable subgroup were observed in patients with OSR ≤ 30%, but no significant difference was found regarding T1AEL between patients with OSR > 30% and OSR ≤ 30% (0.00% vs. 11.11%, p = 0.19). As for hemodynamically stable patients, OSR > 20% was associated with a significantly decreased risk of T1AEL (HR 0.03, 95%CI 0.01-0.53, p = 0.016). In conclusion, a proximal OSR > 20% is associated with a decreased risk of T1AEL in hemodynamically stable patients, while an OSR > 30% did not add an additional advantage of lowering the risk of T1AEL in hemodynamically unstable patients.

Reconstructed Global Invasion and Spatio-Temporal Distribution Pattern Dynamics of Sorghum halepense under Climate and Land-Use Change.

Sorghum halepense competes with crops and grass species in cropland, grassland, and urban environments, increasing invasion risk. However, the invasive historical dynamics and distribution patterns of S. halepense associated with current and future climate change and land-use change (LUC) remain unknown. We first analyzed the invasive historical dynamics of S. halepense to explore its invasion status and expansion trends. We then used a species distribution model to examine how future climate change and LUC will facilitate the invasion of S. halepense. We reconstructed the countries that have historically been invaded by S. halepense based on databases with detailed records of countries and occurrences. We ran biomod2 based on climate data and land-use data at 5' resolution, assessing the significance of environmental variables and LUC. Sorghum halepense was widely distributed worldwide through grain trade and forage introduction, except in Africa. Europe and North America provided most potential global suitable habitats (PGSHs) for S. halepense in cropland, grassland, and urban environments, representing 48.69%, 20.79%, and 84.82%, respectively. The future PGSHs of S. halepense increased continuously in the Northern Hemisphere, transferring to higher latitudes. Environmental variables were more significant than LUC in predicting the PGSHs of S. halepense. Future PGSHs of S. halepense are expected to increase, exacerbating the invasion risk through agricultural LUC. These results provide a basis for the early warning and prevention of S. halepense worldwide.

World Spread of Tropical Soda Apple (Solanum viarum) under Global Change: Historical Reconstruction, Niche Shift, and Potential Geographic Distribution.

Solanum viarum has become extensively invasive owing to international trade, climate change, and land-use change. As it is classified as a quarantine weed by countries such as the U.S. and Mexico, it is critical to understand the prevailing historical dispersal, ecological niche dynamics, and distribution patterns. We reconstructed the historical invasion countries and analyzed the ecological niche shift of S. viarum. Using MaxEnt based on the conservativeness of ecological niches, we studied variations in the potential geographical distributions (PGDs) of S. viarum in ecosystems and variations in suitability probabilities along latitudinal gradients. The invasion history in six continents involved three phases: lag (before 1980), spread (1980-2010), and equilibrium (2010-present). The ecological niche remains conserved. The area of S. viarum PGDs had increased by 259 km2; the PGDs will expand to reach a maximum in the 2050s, SSP5-8.5. The PGDs of S. viarum will migrate to higher latitudes under the same future climate scenarios. The latitudes subject to high threats range from 20° to 30° in forest and cropland ecosystems, 15.5° to 27.5° (northern hemisphere) and 33.1° to 42.8° (southern hemisphere) in grassland ecosystems, and 20° to 35° in urban ecosystems. Global change has led to an increased threat of S. viarum at high latitudes. These findings provide a theoretical basis to monitor and control S. viarum.

Global Potential Geographical Distribution of the Southern Armyworm (Spodoptera eridania) under Climate Change.

The southern armyworm (Spodoptera eridania), a polyphagous crop pest native to tropical America, has been found in Africa (2016) and India (2019), causing defoliation and damage to the reproductive structures of cassava, soybean, and tomato. The damage caused by this pest to crop systems has raised concerns regarding its potential risks. Therefore, we predicted the potential geographical distribution of S. eridania under climate change conditions using 19 bioclimatic variables based on an optimized MaxEnt model. The results showed that annual precipitation (bio12), mean temperature of the warmest quarter (bio10), and precipitation of the driest month (bio14) were important bioclimatic variables influencing the potential distribution. The prediction showed that the suitable habitat area was approximately 3426.43 × 104 km2, mainly concentrated in southern North America, South America, western Europe, central Africa, southern Asia, and eastern Oceania. In response to global climate change, suitable habitats for S. eridania will expand and shift to higher latitudes in the future, especially under the SSP5-8.5 scenario. Because of the current devastating effects on crop production, countries without S. eridania invasion, such as the European Union, Southeast Asian countries, and Australia, need to strengthen phytosanitary measures at border ports to prevent the introduction of this pest.

Early and 1-year postsurgical stability and its factors in patients with complicated skeletal Class â ¢ malocclusion treated by conventional and surgery-first approach: A prospective cohort study.

INTRODUCTION: This study aimed to compare postsurgical stability between conventional (CSA) and surgery-first (SFA) approaches and investigate its prognostic factors in patients with a skeletal Class Ⅲ extraction. METHODS: Twenty and 19 patients treated with LeFort I osteotomy and bilateral sagittal split ramus osteotomy (BSSRO) with premolar extraction were enrolled in SFA and CSA groups, respectively. Serial cone-beam computed tomography images obtained before surgery, immediately after surgery (T1), 3 months after surgery, and 12 months after surgery were used for 3-dimensional quantitative analysis. The condyle was segmented for analyzing volumetric changes. Repeated measures analysis of variance, independent t test, and chi-square test were used to compare time-course and intergroup differences. Pearson and Kendall correlation and multivariate linear regression analyses were used to explore prognostic factors affecting skeletal stability. RESULTS: In both CSA and SFA, postsurgical relapse mainly occurred in the mandible sagittal and vertical dimensions and during the first 3 months after surgery. Stability in SFA was significantly less than that in CSA. Intraoperatively, inferolateral condylar displacement with proximal segment inwards, clockwise rotation, and return movements after surgery were observed regardless of the treatment approach. The condylar volume remained stable over time. Multivariate regression analysis showed that posterior vertical dimension (VD) at T1 (-1.63 mm), surgical amount of mandibular setback (-10.33 mm), surgical condylar downwards displacement (-1.28 mm), and anterior overjet at T1 (6.43 mm) were the most important predictors of early mandibular relapse (r2 = 0.593). CONCLUSIONS: The risk of early relapse could be reduced by controlling the anterior, middle, and posterior constraints provided by the prediction model.

Dominance of felsic continental crust on Earth after 3 billion years ago is recorded by vanadium isotopes.

The transition from mafic to felsic upper continental crust (UCC) is crucial to habitability of Earth, and may be related to the onset of plate tectonics. Thus, defining when this crustal transition occurred has great significance for the evolution of Earth and its inhabitants. We demonstrate that V isotope ratios (reported as δ51V) provide insights into this transition because they correlate positively with SiO2 and negatively with MgO contents during igneous differentiation in both subduction zones and intraplate settings. Because δ51V is not affected by chemical weathering and fluid-rock interactions, δ51V of the fine-grained matrix of Archean to Paleozoic (3 to 0.3 Ga) glacial diamictite composites, which sample the UCC at the time of glaciation, reflect the chemical composition of the UCC through time. The δ51V values of glacial diamictites systematically increase with time, indicating a dominantly mafic UCC at ~3 Ga; the UCC was dominated by felsic rocks only after 3 Ga, coinciding with widespread continental emergence and many independent estimates for the onset of plate tectonics.

Predictive Factors for Major Adverse Cardiac and Cerebrovascular Events in Octogenarians after Elective Endovascular Aneurysm Repair.

BACKGROUND: The aim of this study was to identify risk factors of major adverse cardiac and cerebrovascular events (MACCEs) in octogenarians who received elective endovascular aneurysm repair (EVAR). METHODS: Consecutive patients aged ≥ 80 years undergoing elective EVAR from 2009 to 2020 were retrospectively evaluated. The primary outcome was long-term MACCE. All independent risk factors for outcomes were determined by multivariate logistic analysis or Cox regression analysis. RESULTS: A total of 163 patients were enrolled in this study. The median age was 81 (interquartile range, 80-84) years and 85.9% (140/163) of them were male. MACCE happened in 2.5% (4/163) patients within 30 days. With median follow-up of 28 (interquartile range, 15-46) months, the incidence of long-term MACCE was 26.4% (43/163). Arrhythmia was significantly associated with long-term MACCE (hazard ratio [HR], = 2.64; 95% confidence interval [CI], 1.16-6.03, P = 0.021). Carotid artery disease was found significantly associated with 2-year MACCE (odds ratio [OR], = 6.50, 95% CI, 1.07-39.51, P = 0.042). Besides, we found that arrhythmia and congestive heart failure (CHF) were predictors for overall survival (arrhythmia, HR = 2.56, 95% CI, 1.05-6.28, P = 0.039; CHF, HR = 8.96, 95% CI, 2.12-37.79, P = 0.003). CONCLUSIONS: EVAR in octogenarians had an acceptable perioperative risk and long-term outcome. Considering high risk of 2-year MACCE, intervention strategy should be more cautious for patients with carotid artery disease. Octogenarians with arrhythmia and CHF should receive stricter postoperative management in case of MACCE.

Increased Invasion Risk of Tagetes minuta L. in China under Climate Change: A Study of the Potential Geographical Distributions.

Tagetes minuta L., a member of the Tageftes genus belonging to the Asteraceae family, is a well-documented exotic plant native to South America that has become established in China. In this study, 784 occurrence records and 12 environmental variables were used to predict the potential geographical distributions (PGDs) of T. minuta under current and future climatic changes using an optimized MaxEnt model. The results showed that (1) three out of the twelve variables contributed the most to the model performance: isothermality (bio3), precipitation in the driest quarter (bio17), and precipitation in the warmest quarter (bio18); (2) the PGDs of T. minuta under the current climate covered 62.06 × 104 km2, mainly in North, South, and Southwest China; and (3) climate changes will facilitate the expansion of the PGDs of T. minuta under three shared socioeconomic pathways (SSP 1-2.6, SSP2-4.5, and SSP5-8.5) in both the 2030s and 2050s. The centroid of suitable habitats under SSP2-4.5 moved the longest distance. T. minuta has the capacity to expand in China, especially in Yunnan, where there exist no occurrence records. Customs, ports, and adjacent regions should strengthen the quarantine of imported goods and mobile personnel for T. minuta, and introduced seedlings should be isolated to minimize their introduction risk.

Spatiotemporal variations and relationships of absorbing aerosol-radiation-gross primary productivity over China.

High-load carbonaceous and dust aerosols can significantly reduce direct radiation (DIRR), which would affect photosynthesis in terrestrial ecosystems, thereby further affecting the productivity of vegetation. Based on this, a variety of remote sensing data were used to study the spatiotemporal distributions and changing tendencies of the absorbing aerosols, CO, DIRR, and gross primary productivity (GPP) in China during 2005-2019; then, the relationships were analyzed between different types of absorbing aerosols and DIRR as well as GPP. The results showed that the annual mean absorbing aerosols index (AAI) in China during 2005-2019 was 0.39, with a slow growth rate of 0.02 year-1, and the emission of CO showed a decreasing trend with each passing year, especially in North China Plain and Sichuan Basin. Carbonaceous and dust aerosols were predominantly bounded by Hu line. The east of Hu line was the dominant area of carbonaceous aerosols, and the west of Hu line was the topographical region of dust aerosols. Near the Hu line was the dominant area of carbonaceous-dust aerosols. However, the Karamay-Urumqi-Hami area and Northeast China Plain were exceptional. During the vegetation growing season, different types of absorbing aerosols significantly negatively affected GPP. From a perspective of regional scale variation pattern, the negative effect of absorbing aerosols on vegetation productivity was the most significant in Northeast China; from the perspective of the effects of different vegetation types, the negative effect of absorbing aerosols on grasslands was greater than that of woodlands; from the perspective of the composition characteristics of aerosols, the negative effect of dust aerosols on GPP was greater than that of carbonaceous aerosols.

Pretreatment of nucleus pulposus mesenchymal stem cells with appropriate concentration of H2O2 enhances their ability to treat intervertebral disc degeneration.

BACKGROUND: Nucleus pulposus mesenchymal stem cells (NPMSCs) transplantation is a promising treatment for intervertebral disc degeneration (IVDD). However, the transplanted NPMSCs exhibited weak cell proliferation, high cell apoptosis, and a low ability to resist the harsh microenvironment of the degenerated intervertebral disc. There is an urgent need to explore feasible methods to enhance the therapeutic efficacy of NPMSCs transplantation. OBJECTIVE: To identify the optimal concentration for NPMSCs pretreatment with hydrogen peroxide (H2O2) and explore the therapeutic efficacy of NPMSCs transplantation using H2O2 pretreatment in IVDD. METHODS: Rat NPMSCs were pretreated with different concentrations (range from 25 to 300 µM) of H2O2. The proliferation, reactive oxygen species (ROS) level, and apoptosis of NPMSCs were detected by cell counting kit-8 (CCK-8) assay, 5-ethynyl-2'-deoxyuridine (EdU) staining, and flow cytometry in vitro. The underlying signalling pathways were explored utilizing Western blotting. A rat needle puncture-stimulated IVDD model was established. X-ray, histological staining, and a multimode small animal live imaging system were used to evaluate the therapeutic effect of H2O2-pretreated NPMSCs in vivo. RESULTS: NPMSCs pretreated with 75 µM H2O2 demonstrated the strongest elevated cell proliferation by inhibiting the Hippo pathway (P < 0.01). Meanwhile, 75 µM H2O2-pretreated NPMSCs exhibited significantly enhanced antioxidative stress ability (P < 0.01), which is related to downregulated Brd4 and Keap1 and upregulated Nrf2. NPMSCs pretreated with 75 µM H2O2 also exhibited distinctly decreased apoptosis (P < 0.01). In vivo experiments verified that 75 µM H2O2-pretreated NPMSCs-transplanted rats exhibited an enhanced disc height index (DHI% = 90.00 ± 4.55, P < 0.01) and better histological morphology (histological score = 13.5 ± 0.5, P < 0.01), which means 75 µM H2O2-pretreated NPMSCs can better adapt to the environment of degenerative intervertebral discs and promote the repair of IVDD. CONCLUSIONS: Pretreatment with 75 µM H2O2 was the optimal concentration to improve the proliferation, antioxidative stress, and antiapoptotic ability of transplanted NPMSCs, which is expected to provide a new feasible method to improve the stem cell therapy efficacy of IVDD.

Comparison of BARD®LIFESTREAM™ covered balloon-expandable stent versus GORE® VIABAHN™ covered self-expandable stent in treatment of aortoiliac obstructive disease: study protocol for a prospective randomized controlled trial (NEONATAL trial).

BACKGROUND: Covered stent has become one of the mainstream therapies for aortoiliac obstructive disease (AIOD), with a higher patency rate than bare metal stent. Covered balloon-expandable (CBE) stent can be placed more accurately with higher a radial support force, while covered self-expanding (CSE) stent has greater elasticity and higher trackability. However, there is no level I evidence regarding the comparison safety and efficacy between the CSE stent and CBE stent in AIOD to date. Therefore, this study aims to compare the efficacy and safety of CBE stent (BARD®LIFESTREAM™) and CSE stent (GORE® VIABAHN™) in AIOD. METHODS: This trial is a prospective, single-center, parallel, noninferiority, randomized controlled trial. A total of 106 patients will be enrolled and these patients will be randomized to either the CBE stent group or the CSE stent group. The primary end point of the study is the occurrence of target lesion revascularization (TLR) at 12 months after the intervention. DISCUSSION: To our knowledge, the ballooN sElf cOver steNt AorToiliAc occuLusive (NEONATAL) trial is the first RCT to compare CBE and CSE stent in AIOD patients. The main aim is to compare the TLR of the target lesion between CBE stent and CSE stent at 12 months post-procedure. The results of clinical trials may contribute to establishing a strategic guideline for choosing the optimal type of covered stent in the treatment of AIOD patients. TRIAL REGISTRATION: Chinese Clinical Trials Registry ChiCTR2100046734. Registered on 27 May 2021.