Establishment and assessment of mortality risk prediction model in patients with sepsis based on early-stage peripheral lymphocyte subsets.

This study is aimed to explore the value of lymphocyte subsets in evaluating the severity and prognosis of sepsis. The counts of lymphocytes, CD3+ T cells, CD4+ T cells, CD8+ T cells, CD19+ B cells, and NK cells significantly decreased between day 1 and day 3 in both the survivor and the non-survivor groups. The peripheral lymphocyte subsets (PLS) at day 1 were not significantly different between the survivor and the non-survivor groups. However, at day 3, the counts of lymphocytes, CD3+ T cells, CD4+ T cells, and NK cells were remarkably lower in the non-survivor group. No significant differences in CD8+ T cells, or CD19+ B cells were observed. The PLS index was independently and significantly associated with the 28-day mortality risk in septic patients (OR: 3.08, 95% CI: 1.18-9.67). Based on these clinical parameters and the PLS index, we developed a nomograph for evaluating the individual mortality risk in sepsis. The area under the curve of prediction with the PLS index was significantly higher than that from the model with only clinical parameters (0.912 vs. 0.817). Our study suggests that the decline of PLS occurred in the early stage of sepsis. The new novel PLS index can be an independent predictor of 28-day mortality in septic patients. The prediction model based on clinical parameters and the PLS index has relatively high predicting ability.

Esophageal cancer screening, early detection and treatment: Current insights and future directions.

Esophageal cancer ranks among the most prevalent malignant tumors globally, primarily due to its highly aggressive nature and poor survival rates. According to the 2020 global cancer statistics, there were approximately 604000 new cases of esophageal cancer, resulting in 544000 deaths. The 5-year survival rate hovers around a mere 15%-25%. Notably, distinct variations exist in the risk factors associated with the two primary histological types, influencing their worldwide incidence and distribution. Squamous cell carcinoma displays a high incidence in specific regions, such as certain areas in China, where it meets the cost-effectiveness criteria for widespread endoscopy-based early diagnosis within the local population. Conversely, adenocarcinoma (EAC) represents the most common histological subtype of esophageal cancer in Europe and the United States. The role of early diagnosis in cases of EAC originating from Barrett's esophagus (BE) remains a subject of controversy. The effectiveness of early detection for EAC, particularly those arising from BE, continues to be a debated topic. The variations in how early-stage esophageal carcinoma is treated in different regions are largely due to the differing rates of early-stage cancer diagnoses. In areas with higher incidences, such as China and Japan, early diagnosis is more common, which has led to the advancement of endoscopic methods as definitive treatments. These techniques have demonstrated remarkable efficacy with minimal complications while preserving esophageal functionality. Early screening, prompt diagnosis, and timely treatment are key strategies that can significantly lower both the occurrence and death rates associated with esophageal cancer.

Treatment of complex sulfur-containing solutions in ammonia desulfurization ammonium sulfate production by ultrasonic-assisted ozone technology.

In this work, the cause of abnormal color in ammonium sulfate products formed by flue gas desulfurization is revealed by investigating the conversion relationship between different sulfur-containing ions and their behavior in a sulfuric acid medium. Both thiosulfate (S2O32-) and sulfite (SO32- ＆ HSO3-) impurities affect the quality of ammonium sulfate. The S2O32- is the main reason for the yellowing of the product due to the formation of sulfur impurities in concentrated sulfuric acid. To address the yellowing of ammonium sulfate products, a unified technology (US/O3), using ozone (O3) and ultrasonic waves (US) simultaneously, is exploited to remove both thiosulfate and sulfite impurities from the mother liquor. The effect of different reaction parameters on the degree of removal of thiosulfate and sulfite is investigated. The synergistic effect of ultrasound and ozone on ion oxidation is further explored and demonstrated by the comparative experiments with O3 and US/O3. Under the optimized conditions, the thiosulfate and sulfite concentration in the solution is 2.07 and 5.93 g/L, respectively, and the degree of removal is 91.39 and 90.83%, respectively. The product obtained after evaporation and crystallization is pure white and meets the national standard requirements for ammonium sulfate products. Under the same conditions, the US/O3 process has apparent advantages, such as saving reaction time compared with the O3 process alone. Introducing an ultrasonically intensified field improves the generation of oxidation radicals ·OH, 1O2, and ·O2- in the solution. Furthermore, the effectiveness of different oxidation components in the decolorization process is studied by adding other radical shielding agents using the US/O3 process supplemented with EPR analysis. The order of the different oxidation components is O3(86.04%) > 1O2(6.53%) > â€¢OH(4.45%) > â€¢O2-(2.97%) for the oxidation of thiosulfate, and it is O3(86.28%) > â€¢OH(7.49%) > 1O2(4.99%) > â€¢O2-(1.25%) for the oxidation of sulfite.

Self-organized hetero-nanodomains actuating super Li+ conduction in glass ceramics.

Easy-to-manufacture Li2S-P2S5 glass ceramics are the key to large-scale all-solid-state lithium batteries from an industrial point of view, while their commercialization is greatly hampered by the low room temperature Li+ conductivity, especially due to the lack of solutions. Herein, we propose a nanocrystallization strategy to fabricate super Li+-conductive glass ceramics. Through regulating the nucleation energy, the crystallites within glass ceramics can self-organize into hetero-nanodomains during the solid-state reaction. Cryogenic transmission electron microscope and electron holography directly demonstrate the numerous closely spaced grain boundaries with enriched charge carriers, which actuate superior Li+-conduction as confirmed by variable-temperature solid-state nuclear magnetic resonance. Glass ceramics with a record Li+ conductivity of 13.2 mS cm-1 are prepared. The high Li+ conductivity ensures stable operation of a 220 µm thick LiNi0.6Mn0.2Co0.2O2 composite cathode (8 mAh cm-2), with which the all-solid-state lithium battery reaches a high energy density of 420 Wh kg-1 by cell mass and 834 Wh L-1 by cell volume at room temperature. These findings bring about powerful new degrees of freedom for engineering super ionic conductors.

Aluminium ion doping mechanism of lithium thiophosphate based solid electrolytes revealed with solid-state NMR.

We investigate the impact of Al incorporation on the structure and dynamics of Al-doped lithium thiophosphates (Li3-3xAlxPS4) based on ß-Li3PS4. 27Al and 6Li magic-angle spinning NMR spectra confirm that Al3+ ions occupy octahedral sites in the structure. Quantitative analyses of 27Al NMR spectra show that the maximum Al incorporation is x = 0.06 in Li3-3xAlxPS4. The ionic conductivity of ß-Li3PS4 is enhanced by over a factor 3 due to Al incorporation. Further increase of the Al doping level leads to the formation of a more complicated material consisting of multiple crystalline and distorted phases as indicated by 31P NMR spectra and powder X-ray diffraction. Consequently, novel Li ion diffusion pathways develop leading to a very high ionic conductivity at room temperature. NMR relaxometry shows that the activation barrier for long-range Li ion diffusion in ß-Li3PS4 hardly changes upon Al incorporation, but the onset temperature for motional narrowing comes down significantly due to Al doping. The activation barrier in the subsequently formed multiphase material decreases significantly, however, indicating a different more efficient Li ion conduction pathway.

Exosomes from M2-polarized macrophages relieve oxygen/glucose deprivation/normalization-induced neuronal injury by activating the Nrf2/HO-1 signaling.

Stroke is a life-threatening neurological disorder with limited therapeutic efficacy. Previous studies have demonstrated that macrophages play an important role in brain injury after a stroke. However, its underlying mechanism remains unclear and the role of exosomes derived from M2-polarized macrophages (M2-Exo) in ischemic stroke has not yet been reported. In this study, we established an in vitro oxygen/glucose deprivation and re-oxygen/glucose (OGD/R) model to investigate the potential role of M2-Exo in protecting HT22 neurons against ischemia-reperfusion injury. Interleukin-4 was used to induce the M2 phenotype in macrophages, following which the exosomes were isolated from the supernatant of M2-polarized macrophages and identified by western blotting, transmission electron microscopy, and nanoparticle tracking analysis. After co-incubation with M2-Exo, OGD/R-induced neuronal injury in HT22 cells was improved, accompanied by increased cell viability and decreased lactate dehydrogenase release. In addition, the increase in percentage of terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick end labeling-positive cells in OGD/R-treated HT22 cells was attenuated after incubation with M2-Exo. M2-Exo treatment also suppressed reactive oxygen species and malondialdehyde production and improved the reduction of superoxide dismutase activity. Moreover, M2-Exo treatment was found to activate the nuclear factor erythroid related factor 2 (Nrf2)/heme-oxygenase-1 (HO-1) signaling pathway in OGD/R-treated HT22 neurons. Importantly, inhibition of Nrf2 by ML385 partially reversed the protective effects of M2-Exo against OGD/R-induced oxidative damage. Taken together, these data demonstrated that M2-Exo exerted protective effects against OGD/R-induced oxidative damage in HT22 neurons, which was mediated by the activation of Nrf2/HO-1 signaling. Hence, our findings provide a promising therapeutic approach for ischemic stroke.

Interleukin-35 from Interleukin-4-Stimulated Macrophages Alleviates Oxygen Glucose Deprivation/Re-oxygenation-Induced Neuronal Cell Death via the Wnt/ß-Catenin Signaling Pathway.

Currently, brain stroke is one of the leading causes of death and disabilities. It results in depletion of oxygen and glucose in certain areas of the brain, leading to neuronal death. Re-oxygenation has been proven to attenuate neuronal damage; however, sudden oxygen supply may also cause oxidative stress and subsequent inflammation. Hence, therapies to suppress re-oxygenation-induced oxidative damage are urgently needed. Interleukin (IL)-35, an immunomodulator secreted by regulatory T cells and regulatory B cells, is proven to be a strong immune-repressive cytokine. Here, we investigated the potential role of IL-35 in a disease model of oxygen glucose deprivation/re-oxygenation (OGD/R) and found that M2 macrophage-derived IL-35 significantly alleviated inflammatory response induced by oxidative stress. Our results also showed that IL-35 treatment decreased OGD/R-induced neuronal cell death and inflammatory response. Additionally, we demonstrated that IL-35 suppresses inflammatory response via the Wnt/ß-catenin signaling pathway. Hence, our findings indicate that IL-35 therapy has great potential in the treatment of OGD/R-induced oxidative damage and related inflammatory diseases.

The Association Between Glucocorticoid Administration and the Risk of Impaired Efficacy of Axicabtagene Ciloleucel Treatment: A Systematic Review.

Background: Glucocorticoid is one of the common and important strategies for the treatment of chimeric antigen receptor T (CAR-T) cell therapy-related toxicity. However, there has been a theoretical concern about whether glucocorticoids use can impact the expansion of CAR-T cells and thus impair its efficacy. Hence, we reviewed studies related to the Axicabtagene ciloleucel (Axi-cel), a first-class and widely used CAR-T cell product, to elucidate the association between glucocorticoids administration and efficacy of Axi-cel. Method: We systematically searched PubMed, Embase, Web of Science, and Cochrane Library to identify studies of Axi-cel that used glucocorticoids as an intervention for the treatment of CAR-T cell-related adverse events and respectively evaluated any efficacy endpoints of intervention and controlled cohorts, published up to February 17, 2020. There were no restrictions on research type and language. Results: A total of eight studies with 706 patients were identified in the systematic review. Except for one study found that high cumulative dose, prolonged duration and early use of glucocorticoids could shorten progression-free survival and/or overall survival, and another study that found a negative effect of glucocorticoids administration on overall survival in univariate analysis but disappeared in multivariate analysis, none of other studies observed a statistically significant association between glucocorticoids administration and progression-free survival, overall survival, complete response, and overall response rate. Conclusion: Our study indicated that the association between glucocorticoids therapy and the efficacy of CAR-T cell may be affected by cumulative dose, duration, and timing. There is currently no robust evidence that glucocorticoids can damage the efficacy of CAR-T cell, but the early use of glucocorticoids should be cautiously recommended.

Tripartite-motif protein 21 knockdown extenuates LPS-triggered neurotoxicity by inhibiting microglial M1 polarization via suppressing NF-κB-mediated NLRP3 inflammasome activation.

Tripartite motif-containing 21 (TRIM21) has been confirmed to mediate the production of inflammatory mediators via NF-κB signaling. However, the function of TRIM21 in microglia-mediated neuroinflammation remains unclear. This study aimed to explore the effect of TRIM21 on LPS-activated BV2 microglia and its underlying mechanism. BV2 cells exposed to lipopolysaccharide (LPS) were used to simulated neuroinflammation in vitro. Loss-of-function and gain-of-function of TRIM21 in BV2 cells were used to assess the effect of TRIM21 on LPS-induced neuroinflammation. BV2 microglia and HT22 cells co-culture system were used to investigate whether TRIM21 regulated neuronal inflammation-mediated neuronal death. TRIM21 knockdown triggered the polarization of BV2 cells from M1 to M2 phenotype. Knockdown of TRIM21 reduced the secretion of TNF-α, IL-6, and IL-1ß, while increased the content of IL-4 in LPS-treated cells. Knockdown of TRIM21 inhibited the expression of p65 and the binding activity of NF-κB-DNA. Additionally, TRIM21 siRNA eliminated the increase in NLRP3 and cleaved caspase-1 proteins expression and caspase-1 activity induced by LPS. TRIM21 knockdown could resist cytotoxicity induced by activated microglia, including increasing the viability of co-cultured HT22 cells and reducing the emancipation of LDH. Moreover, the increased apoptosis and caspase-3 activity of HT22 neurons induced by activated BV2 cells were blocked by TRIM21 siRNA. Blocking of NF-κB abolished the effect of TRIM21 in promoting the expression of M1 phenotype marker genes. Similarly, the blockade of NF-κB pathway eliminated the promotion of TRIM21 on neurotoxicity induced by neuroinflammation. TRIM21 knockdown suppressed the M1 phenotype polarization of microglia and neuroinflammation-mediated neuronal damage via NF-κB/NLRP3 inflammasome pathway, which suggested that TRIM21 might be a potential therapeutic target for the therapy of central nervous system diseases.

Endoscopic Surgery versus Minimal Puncture Drainage Surgery for Treatment of Supratentorial Intracerebral Hemorrhage.

AIM: To compare neuroendoscopy versus minimal puncture drainage for surgical treatment of supratentorial hypertensive intracerebral hemorrhage. MATERIAL AND METHODS: A total of 108 cases involving supratentorial intracerebral hemorrhage were retrospectively analyzed. In 30 cases, endoscopic surgery was performed, while 78 cases involved puncture surgery. We compared hematoma clearance rate, postoperative rebleeding rate, incidence of postoperative complications, operation duration, and Glasgow coma score seven days after surgery. Clinical data such as early postoperative rehabilitation time, Glasgow outcome score three months after surgery, and intensive care unit (ICU) stay were also compared between the two groups. RESULTS: The results showed that endoscopic surgery was associated with a superior clinical therapeutic effect in hematoma clearance rates, GCS scores on postoperative day 7, the average ICU stay, early postoperative rehabilitation time and intracranial infection outcomes than minimal puncture drainage surgery for the treatment of supratentorial intracerebral hemorrhage (p < 0.05). Three months after surgery, the favorable prognosis rate in the endoscopic treatment group was significantly higher than that in the craniotomy group [83.3% (28/34) vs. 61.5% (31/51), respectively; ? < sup > 2 < /sup > =4.698, p=0.030]. In contrast, no significant differences in rebleeding, pulmonary infection, tracheotomy, secondary epilepsy, gastrointestinal hemorrhage, death in late postoperative period, or in baseline parameters were observed between the two groups (p > 0.05). CONCLUSION: Endoscopic surgery potentially represents a beneficial surgical procedure for treatment of supratentorial spontaneous intracerebral hemorrhage.

Modulation of autophagy in traumatic brain injury.

Traumatic brain injury (TBI) is defined as a traumatically induced structural injury or physiological disruption of brain function as a result of external forces, leading to adult disability and death. A growing body of evidence reveals that alterations in autophagy-related proteins exist extensively in both experimentally and clinically after TBI. Of note, the autophagy pathway plays an essential role in pathophysiological processes, such as oxidative stress, inflammatory response, and apoptosis, thus contributing to neurological properties of TBI. With this in mind, this review summarizes a comprehensive overview on the beneficial and detrimental effects of autophagy in pathophysiological conditions and how these activities are linked to the pathogenesis of TBI. Moreover, the relationship between oxidative stress, inflammation, apoptosis, and autophagy occur TBI. Ultimately, multiple compounds and various drugs targeting the autophagy pathway are well described in TBI. Therefore, autophagy flux represents a potential clinical therapeutic value for the treatment of TBI and its complications.

Safety-Enhanced Polymer Electrolytes for Sodium Batteries: Recent Progress and Perspectives.

Sodium batteries (SBs) have aroused increasing attention due to the abundance and low cost of elemental sodium. In recent decades, intensive efforts have been under way to exploit advanced SBs for practical applications. However, conventional liquid electrolytes used in SBs suffer from serious safety hazards (high volatility, inflammability, and leakage), severe side reactions between electrodes and electrolytes, and inevitable sodium dendrite problems, which are greatly detrimental to battery performance. Notably, polymer electrolytes are recognized as the optimal solution to resolve the above-mentioned bottlenecks. Herein, we mainly summarize a series of polymer electrolytes based on polymers containing ethoxylated units, poly(vinylidene fluoride-hexafluoropropylene) (P(VDF-HFP)), poly(methyl methacrylate) (PMMA), polyacrylonitrile (PAN), poly(vinylpyrrolidone) (PVP), single-ion conductors, polysaccharides, and so on. Notably, this review demonstrates the natural merits of polymer electrolytes for SBs (such as high safety, suppression of sodium dendrite formation, and reduced electrolyte decomposition), presents the requirements for ideal polymer electrolytes for the first time, and provides concrete discussions into recent progress of various polymer electrolytes as well. Furthermore, potential challenges and perspectives of polymer electrolytes for advanced SBs are also envisioned at the end of this review. Overall, we hope this discussion will make sense to resolve fundamental research and practical issues of polymer electrolytes for advanced SBs.

Wnt/ß-catenin signaling cascade: A promising target for glioma therapy.

Glioma is one of the most treatment-refractory intracranial tumors, and the aberrant expressed Wnt/ß-catenin pathway is closely associated with glioma malignancy. In this regard, Wnt/ß-catenin signaling has been reported to play an essential role in cellular proliferation, migration, invasion, and angiogenesis, therefore contributing to glioma progression. However, the underlying mechanisms of Wnt/ß-catenin signaling involvement in gliomagenesis remain unknown. Here, we present an overview of the Wnt components and then go on to summarize the current knowledge describing the multitude of roles of Wnt/ß-catenin in glioma, which are mediated by transcription factors, microRNAs, long noncoding RNAs, and so on. In the latter portion of the review, we elaborate the increasing apparent crosstalk of Wnt/ß-catenin pathway with PI3K/AKT signaling involved in these processes. Ultimately, compounds targeting the Wnt/ß-catenin are described in glioma. As better understanding of the regulatory mechanisms to glioma malignancies increases, Wnt/ß-catenin cascade may represent an area of developmental glioma therapeutics focus.

Integrated Interface Strategy toward Room Temperature Solid-State Lithium Batteries.

Solid-state lithium batteries have drawn wide attention to address the safety issues of power batteries. However, the development of solid-state lithium batteries is substantially limited by the poor electrochemical performances originating from the rigid interface between solid electrodes and solid-state electrolytes. In this work, a composite of poly(vinyl carbonate) and Li10SnP2S12 solid-state electrolyte is fabricated successfully via in situ polymerization to improve the rigid interface issues. The composite electrolyte presents a considerable room temperature conductivity of 0.2 mS cm-1, an electrochemical window exceeding 4.5 V, and a Li+ transport number of 0.6. It is demonstrated that solid-state lithium metal battery of LiFe0.2Mn0.8PO4 (LFMP)/composite electrolyte/Li can deliver a high capacity of 130 mA h g-1 with considerable capacity retention of 88% and Coulombic efficiency of exceeding 99% after 140 cycles at the rate of 0.5 C at room temperature. The superior electrochemical performance can be ascribed to the good compatibility of the composite electrolyte with Li metal and the integrated compatible interface between solid electrodes and the composite electrolyte engineered by in situ polymerization, which leads to a significant interfacial impedance decrease from 1292 to 213 Ω cm2 in solid-state Li-Li symmetrical cells. This work provides vital reference for improving the interface compatibility for room temperature solid-state lithium batteries.

Multifunctional Sandwich-Structured Electrolyte for High-Performance Lithium-Sulfur Batteries.

Due to its high theoretical energy density (2600 Wh kg-1), low cost, and environmental benignity, the lithium-sulfur (Li-S) battery is attracting strong interest among the various electrochemical energy storage systems. However, its practical application is seriously hampered by the so-called shuttle effect of the highly soluble polysulfides. Herein, a novel design of multifunctional sandwich-structured polymer electrolyte (polymer/cellulose nonwoven/nanocarbon) for high-performance Li-S batteries is demonstrated. It is verified that Li-S battery with this sandwich-structured polymer electrolyte delivers excellent cycling stability (only 0.039% capacity decay cycle-1 on average exceeding 1500 cycles at 0.5 C) and rate capability (with a reversible capacity of 594 mA h g-1 at 4 C). These electrochemical performances are attributed to the synergistic effect of each layer in this unique sandwich-structured polymer electrolyte including steady lithium stripping/plating, strong polysulfide absorption ability, and increased redox reaction sites. More importantly, even with high sulfur loading of 4.9 mg cm-2, Li-S battery with this sandwich-structured polymer electrolyte can deliver high initial areal capacity of 5.1 mA h cm-2. This demonstrated strategy here may open up a new era of designing hierarchical structured polymer electrolytes for high-performance Li-S batteries.

miR-137 acts as a tumor suppressor in astrocytoma by targeting RASGRF1.

Astrocytoma is one of the most common primary central nervous system tumors and has both high mortality and a poor 5-year survival rate. MicroRNAs (miRNAs) play important roles in carcinogenesis by acting on multiple signaling pathways. Although we have demonstrated that miR-137 is downregulated in astrocytoma tissues, the role of miR-137 in astrocytoma still remains unknown. In the present study, we aimed to investigate the function of miR-137 and its possible target genes in astrocytoma. miR-137 was significantly downregulated in astrocytoma tissues, and its expression level was inversely correlated with the clinical stage. Restoring miR-137 was able to dramatically inhibit cell proliferation, migration, and invasion and enhance apoptosis in vitro, whereas silencing its expression inhibited these processes. By overexpressing or inhibiting miR-137 in cancer cells, we experimentally confirmed that miR-137 directly recognized the 3'-UTR (3'-untranslated region) of the RASGRF1 (Ras protein-specific guanine nucleotide-releasing factor 1) transcript and regulated RASGRF1 expression. Furthermore, an inverse correlation was observed between miR-137 levels and RASGRF1 protein levels, but not mRNA levels, in astrocytoma samples. The silencing of RASGRF1 resulted in similar effects to miR-137 restoration in cancer cells. Finally, overexpression of RASGRF1 rescued the inhibitory effects of miR-137. Taken together, our results indicate that miR-137 acts as a tumor suppressor in astrocytoma by targeting RASGRF1. These findings suggest that miR-137 may serve as a novel therapeutic target in astrocytoma treatment.