Secondary metabolites in host pears defense against two fruit borers and cytochrome-P450-mediated counter-defense.

Herbivorous insects have evolved metabolic strategies to survive the challenges posed by plant secondary metabolites (SMs). This study reports an exploration of SMs present in pears, which serve as a defense against invasive Cydia pomonella and native Grapholita molesta and their counter-defense response. The feeding preferences of fruit borers are influenced by the softening of two pear varieties as they ripen. The content of SMs, such as quercetin and rutin, increases due to feeding by fruit borers. Notably, quercetin levels only increase after C. pomonella feeding. The consumption of SMs affects the growth of fruit borer population differently, potentially due to the activation of P450 genes by SMs. These two fruit borers are equipped with specific P450 enzymes that specialize in metabolizing quercetin and rutin, enabling them to adapt to these SMs in their host fruits. These findings provide valuable insights into the coevolution of plants and herbivorous insects.

Advancements in LAM-based diagnostic kit for tuberculosis detection: enhancing TB diagnosis in HIV-negative individuals.

Objective: The purpose of this study was to investigate the diagnostic value of urine lipoarabinomannan (LAM) detection based on chemiluminescence assay for pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) in HIV-negative individuals. Methods: A total of 215 patients and 37 healthy individuals were included according to inclusion and exclusion criteria, including 173 cases of PTB and 42 cases of EPTB. Sputum smears, sputum culture, TB-RNA, GeneXpert, and urine LAM results were obtained from all patients before treatment. Using the composite reference standard as the reference, the diagnostic performance of these methods for PTB and EPTB was evaluated, and the diagnostic performance and cost-effectiveness of different combinations were analyzed. Results: In PTB, LAM exhibited the highest sensitivity (55.49%), followed by GeneXpert (44.51%). In EPTB, LAM also had the highest sensitivity (40.48%), followed by GeneXpert (33.33%). When combined with one method, LAM combined with GeneXpert showed the highest sensitivity for both PTB (68.79%) and EPTB (61.9%). When combined with two methods, culture, GeneXpert, and LAM showed the highest sensitivity for both PTB (73.99%) and EPTB (69.05%). In terms of cost-effectiveness analysis, the price of LAM was significantly lower than that of GeneXpert ($129.82 vs. $275.79 in PTB and 275.79 vs. 502.33 in EPTB). Among all combinations, the combination of LAM and sputum smear had the lowest cost, with prices of $124.94 for PTB and $263.72 for EPTB. Conclusion: Urine LAM detection based on chemiluminescence assay can be used as an adjunct diagnostic tool for PTB and EPTB in HIV-negative individuals. This facilitates expanding the current application of urine LAM from solely HIV-positive populations to the general population. LAM detection can overcome the limitations of obtaining clinical samples, and its ease of sample acquisition will be beneficial for its broader application in a larger scope. For economically better-off areas, we recommend using a combination of LAM + GeneXpert+culture for higher sensitivity; for economically disadvantaged areas, LAM + smear microscopy combination can provide a quick and accurate diagnosis of tuberculosis at a lower cost.

Dapagliflozin prevents kidney podocytes pyroptosis via miR-155-5p/HO-1/NLRP3 axis modulation.

Diabetic nephropathy (DN) is a significant clinical microvascular complication associated with diabetes mellitus (DM), and end-stage diabetes giving rise to kidney failure is developing into the major etiological factor of chronic kidney failure. Dapagliflozin is reported to limit podocyte damage in DM, which has proven to protect against renal failure. Mounting evidence has demonstrated that pyroptosis is associated with DM progression. Nevertheless, whether pyroptosis causes DN and the underlying molecular pathways remain obscure. In this study, we aimed to explore the antipyroptotic attributes of dapagliflozin and elucidate the underlying mechanisms of kidney damage in diabetes. In vivo, experiments were conducted in streptozotocin (STZ)-induced type 2 diabetic mice, which were administered dapagliflozin via gavage for 6 weeks. Subsequently, the specific organizational characteristics and expression of pyroptosis-related genes were evaluated. Intragastric dapagliflozin administration markedly reduced renal tissue injury. Meanwhile, dapagliflozin also attenuated the expression level of pyroptosis associated genes, including ASC, cleaved Caspase-1, GSDMD N-termini, NLRP3, IL-18, and IL-1ß in renal tissue of dapagliflozin-treated animals. Similar antipyroptotic effects were observed in palmitic acid (PA)-treated mouse podocytes. We also found that heme oxygenase 1 (HO-1) enhanced the protection of mouse podocyte clone 5 cells (MPC5). Moreover, miR-155-5p inhibition increased pyroptosis in PA-treated MPC5 cells, suggesting that miR-155-5p acts as an endogenous stimulator that increases HO-1 expression and reduces pyroptosis. Hence, our findings imply that dapagliflozin inhibits podocyte pyroptosis via the miR-155-5p/HO-1/NLRP3 axis in DM. Furthermore, dapagliflozin substitution may be regarded as an effective strategy for preventing pyroptosis in the kidney, including a therapeutic option for treating pyroptosis-related DN.

Structure, properties, and resistant starch content of modified rice flour prepared using dual hydrothermal treatment.

In this study, modified rice flour with high resistant starch (RS) content was prepared by dual hydrothermal treatment, which combined the heat-moisture treatment with the pressure-heat treatment method. The effects of dual hydrothermal treatment on the structure and properties of modified rice flour and their relationship with RS content were further discussed. The results showed that the RS content of modified rice flour was higher than that of rice flour (RF), and dual hydrothermal treatment was more effective than single hydrothermal treatment. Adhesion and aggregation occurred between the particles of modified rice flour. Both crystallinity and short-range ordering were increased in modified rice flour compared to RF. Moreover, the modified rice flour of dual hydrothermal treatment had higher crystallinity and a more ordered short-range structure of starch, which improved RS content to a certain extent. Compared to single hydrothermal treatment, the modified rice flour of dual hydrothermal treatment had a lower viscoelasticity and a better thermal stability. Both RF and modified rice flour gels were composed mainly of free water, with minimal amounts of bound and immobile water. The study may provide a reference for the production and application of modified rice flour.

Tandem Mass Tag-Labeled Quantitative Proteome Analyses Identify C1R and A2M as Novel Serum Biomarkers in Pregnant Women with Obstructive Sleep Apnea.

The aim of this study was to identify serum diagnostic biomarkers associated with the severity of obstructive sleep apnea (OSA) during pregnancy. Differentially expressed proteins (DEPs) were identified in the control (C), mild (O), and moderate (MO) OSA groups (n = 3 in each group). Bioinformatics analysis was conducted to identify the underlying functions, pathways, and networks of the proteins. Receiver operating characteristic curves were used to assess the diagnostic value of the identified DEPs. The enzyme-linked immunoassay was performed to detect serum levels of the complement C1r subcomponent (C1R) and alpha-2-macroglobulin (A2M) in 79 pregnant women with OSA (mild OSA [n = 32]; moderate OSA [n = 29], and severe OSA [n = 18]) and 65 healthy pregnant women without OSA. Pearson's correlation analysis was conducted to analyze the correlation between C1R and A2M levels and OSA clinicopathological factors. In total, 141 DEPs, 29 DEPs, and 103 DEPs were identified in the three groups (i.e., the mild OSA vs control group, the moderate OSA vs mild apnea group, and the moderate OSA vs control group, respectively). C1R and A2M were identified as continuously up-regulated proteins, and the levels of C1R and A2M were associated with OSA severity. C1R and A2M were found to be correlated with body mass index, systolic blood pressure, apnea-hypopnea index, oxygen desaturation index, time with saturation below 90%, and lowest SaO2. Adverse maternal and neonatal outcomes were observed in pregnant women with OSA. C1R and A2M have been identified as diagnostic biomarkers and are associated with the severity of OSA during pregnancy.

Effect of different heat-moisture treatment times on the structure, physicochemical properties and in vitro digestibility of japonica starch.

Modified starch was prepared from japonica starch (JS) by heat-moisture treatments (HMT). Under the same moisture content and HMT temperature, the effects of various HMT times on the structural, properties of JS and its in vitro digestibility properties were investigated. The results showed that adhesion occurred between the particles of japonica starch after the HMT, and there were depressions on the surface. The size of the JS particles increased, the short-range ordering and relative crystallinity of the HMT-modified starch increased and gradually decreased, reaching a peak of 36.51 % at 6 h, as the HMT time was extended. The pasting indexes of HMT-modified starch decreased and then increased with the increase of the HMT time; compared with JS, the thermal stability of HMT-modified starch increased while the pasting enthalpy decreased. All the HMT-modified starches were weakly gelatinous systems and pseudoplastic fluids. Following HMT, the amount of resistant starch (RS) and slowly digested starch (SDS) grew initially before declining. The amount of RS in HMT-modified starch peaked at 24.28 % when the HMT time was 6 h. The results of this research can serve as a theoretical foundation for the creation of modified japonica starch and its use in the food industry.

Mode of delivery and neonatal outcomes in preterm twins less than 32 weeks of gestation or birthweight under 1500 g: a systematic review and meta-analyses.

BACKGROUND: The mode of delivery for twins born before 32 weeks of gestation remains controversial. Our purpose is to conduct a meta-analysis of twin pregnancies less than 32 weeks or twin weight less than 1500 g, so as to find a suitable delivery mode. METHODS: We searched PubMed database, Cochrane Library database, and EMBASE database through December 2022. This protocol was registered with PROSPERO (CRD42023386946) prior to initiation. Studies that compared vaginal delivery to cesarean section for newborns less than 32 weeks of gestation or birthweight under 1500 g were included. The primary result was neonatal mortality rate. Secondary result was neonatal morbidity. The quality of literatures included in the research was evaluated in accordance with Newcastle-Ottawa Scale (NOS) literature quality evaluation scale. We use odds ratio (OR) as the effect index for binary variables. Point estimates and 95% confidence intervals (95% CI) were calculated. P < 0. 05 indicated statistically significant difference. RESULTS: Our search generated 5310 articles, and a total of 8 articles comprising a total of 14,703 newborns were included in the analysis. The odds ratios of neonatal mortality rate were for twins delivered by vaginal delivery compared to cesarean section were 0.84 (95% CI 0.57-1.24, P = 0.38). The 5-min Apgar score < 7 (95% CI 0.44-1.75, P = 0.72), necrotizing enterocolitis (95% CI 0.81-1.19, P = 0.82), intraventricular hemorrhage (95% CI 0.41-1.86, P = 0.71), periventricular leukomalacia (95% CI 0.16-4.52, P = 0.84), bronchopulmonary dysplasia (95% CI 0.88-1.36, P = 0.42), and respiratory distress syndrome (95% CI 0.23-2.01, P = 0.48) were not statistically significant between the two groups. CONCLUSION: We have observed that vaginal delivery does not confer an increased risk of neonatal morbidity and mortality in twins born before 32 weeks of gestation. However, the current results are affected by substantial heterogeneity and confounding factors. We still need high-quality randomized-controlled studies require to address this important question.

Endomyocardial fibrosis and apical calcification: A case report with unusual presentations of apical hypertrophic cardiomyopathy.

RATIONALE: Apical hypertrophic cardiomyopathy (ApHCM) is a phenotypic variant of hypertrophic cardiomyopathy. Endomyocardial fibrosis and endocardial calcification are especially rare in ApHCM. PATIENT CONCERNS: The main symptoms was chest tightness, palpitation, shortness of breath, and fatigue. Echocardiography and imaging examinations found apical hypertrophy along with endocardial calcification and endomyocardial fibrosis. Abnormal structural changes led to thrombosis and made the left ventricle a flat shape resembling an "apple." DIAGNOSES: The typical presentations, hypertrophic apex on echocardiography and an elevated N-terminal pro-brain natriuretic peptide level indicated the diagnosis of ApHCM and heart failure with preserved ejection fraction. INTERVENTIONS: Optimal medical therapy including the administration of ApHCM, heart failure and atrial fibrillation to improve symptoms and life quality. OUTCOMES: Since discharge, the patient could perform normal daily activities and had no discomfort based on the optimal medical therapy. LESSONS: We report a ApHCM patients with unusual presentations of endomyocardial fibrosis and apical calcification. This case highlights the importance of understanding the specific pathological changes of ApHCM for treatment and prognosis.

Prognostic Value of GRACE Risk Score Combined With Systemic Immune-Inflammation Index in Patients With ST-Segment Elevation Myocardial Infarction After Percutaneous Coronary Intervention.

The Global Registry of Acute Coronary Events (GRACE) score and the systemic immune-inflammation index (SII) were used independently to predict adverse outcomes in patients with ST-elevation myocardial infarction (STEMI). In this study, 1041 patients with STEMI were divided into 4 groups based on GRACE scores and optimal cutoff values for SII. SII was positively correlated with GRACE score (r = 0.164; P < .001). SII (HR, hazard ratio: 2.051; 95%CI: 1.249-3.368; P = .005) and GRACE score (HR: 7.625; 95%CI: 3.692-15.746; P < .001) were independent risk predictors of short-term major adverse cardiovascular events (MACEs). Taking the low SII+low GRACE group as the reference group, the short-term MACE HR of the high SII+high GRACE group was 40.470 (95%CI: 5.547-295.253). Comparing the area under the curve, the combined use of SII and GRACE scores can significantly improve the prediction efficiency of short-term MACE compared with the single use of SII and GRACE scores. In conclusion, SII may be positively correlated with GRACE score, and the combination of the two accurately predicted the occurrence of short-term MACE in STEMI patients after percutaneous coronary intervention (PCI).

Two novel gene mutations identified in a child with pulmonary alveolar microlithiasis complicated with bronchitis obliterans: A case report and literature review.

We reported a case of a 7-year-old boy with pulmonary alveolar microlithiasis (PAM) and detected two novel compound heterozygous mutations of solute carrier family 34 member 2 (SLC34A2), EXON:2-6 duplication and c.1218 (EXON:11) C > A (p. Phe406Leu). His symptoms were nonspecific. Chest computed tomography (CCT) showed bronchiectasis, a mosaic feature, and extensive calcifications in both lungs. In addition, bronchoscopy showed bronchitis obliterans which has rarely been reported as a complication in the literature. This case aimed to explore the mechanism of PAM and emphasize the role of gene analysis in diagnosing rare pediatric diseases. Finally, we undertook a review of the current literature containing SLC34A2 gene mutations to update the gene mutation spectrum of PAM.

Endothelium-Mimetic Surface Modification Improves Antithrombogenicity and Enhances Patency of Vascular Grafts in Rats and Pigs.

We first identified thrombomodulin (TM) and endothelial nitric oxide (NO) synthase as key factors for the antithrombogenic function of the endothelium in human atherosclerotic carotid arteries. Then, recombinant TM and an engineered galactosidase responsible for the conversion of an exogenous NO prodrug were immobilized on the surface of the vascular grafts. Surface modification by TM and NO cooperatively enhanced the antithrombogenicity and patency of vascular grafts. Importantly, we found that the combination of TM and NO also promoted endothelialization, whereas it reduced adverse intimal hyperplasia, which is critical for the maintenance of vascular homeostasis, as confirmed in rat and pig models.

Transcriptomic analysis of spinal cord regeneration after injury in Cynops orientalis.

Cynops orientalis (C. orientalis) has a pronounced ability to regenerate its spinal cord after injury. Thus, exploring the molecular mechanism of this process could provide new approaches for promoting mammalian spinal cord regeneration. In this study, we established a model of spinal cord thoracic transection injury in C. orientalis, which is an endemic species in China. We performed RNA sequencing of the contused axolotl spinal cord at two early time points after spinal cord injury - during the very acute stage (4 days) and the subacute stage (7 days) - and identified differentially expressed genes; additionally, we performed Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses, at each time point. Transcriptome sequencing showed that 13,059 genes were differentially expressed during C. orientalis spinal cord regeneration compared with uninjured animals, among which 4273 were continuously down-regulated and 1564 were continuously up-regulated. Down-regulated genes were most enriched in the Gene Ontology term "multicellular organismal process" and in the ribosome pathway at 10 days following spinal cord injury. We found that multiple genes associated with energy metabolism were down-regulated and multiple genes associated with the lysosome were up-regulated after spinal cord injury, indicating the importance of low metabolic activity during wound healing. Immune response-associated pathways were activated during the early acute phase (4 days), while the expression of extracellular matrix proteins such as glycosaminoglycan and collagen, as well as tight junction proteins, was lower at 10 days post-spinal cord injury than 4 days post-spinal cord injury. However, compared with 4 days post-injury, at 10 days post-injury neuroactive ligand-receptor interactions were no longer down-regulated, up-regulated differentially expressed genes were enriched in pathways associated with cancer and the cell cycle, and SHH, VIM, and Sox2 were prominently up-regulated. Immunofluorescence staining showed that glial fibrillary acidic protein was up-regulated in axolotl ependymoglial cells after injury, similar to what is observed in mammalian astrocytes after spinal cord injury, even though axolotls do not form a glial scar during regeneration. We suggest that low intracellular energy production could slow the rapid amplification of ependymoglial cells, thereby inhibiting reactive gliosis, at early stages after spinal cord injury. Extracellular matrix degradation slows cellular responses, represses the expression of neurogenic genes, and reactivates a transcriptional program similar to that of embryonic neuroepithelial cells. These ependymoglial cells act as neural stem cells: they migrate and proliferate to repair the lesion and then differentiate to replace lost glial cells and neurons. This provides the regenerative microenvironment that allows axon growth after injury.

Insights into the effects of natural pyrite-activated sodium percarbonate on tetracycline removal from groundwater: Mechanism, pathways, and column studies.

In-situ chemical oxidation based on sodium percarbonate (SPC) has received much attention for remediation of groundwater contaminated with organic pollutants due to the high efficiency, stable reaction, and sustainability of SPC. Currently, metal ions and their composite materials, are mainly employed for the activation of SPC. However, due to its narrow pH range, slow Fe3+/Fe2+ circulation, and generation of refractory sludge, its application in groundwater is limited. In this study, SPC was activated with natural pyrite (FeS2) to remove tetracycline, which was selected as the target pollutant. FeS2 exhibited excellent catalytic activity and stability towards the degradation of tetracycline. The tetracycline degradation efficiency of SPC/FeS2 system reached 70 % within 10 min, and nearly half of the tetracycline was degraded in the first 5 min of the reaction. The optimum SPC dosage for the tetracycline removal was 8 mM, with FeS2 dosage of 0.5 g/L. The tetracycline removal efficiency remained above 60 % after 4 cycles, indicating its good recycling efficiency of the system. SPC/FeS2 system was not significantly affected by the initial pH or the presence of Cl-, SO42-, NO3- while, HCO3-, Ca2+, Mg2+, and humid acid suppressed the reaction. The electron paramagnetic resonance spectroscopy and quenching experiments demonstrated that OH and O2- played a dominant role in tetracycline removal by the system. S22-, as an electron donor, was able to participate in the Fe3+/Fe2+ cycle. In addition, the 13 transformation products were determined by liquid chromatography-mass spectrometry predicted that the degradation pathway of tetracycline consisted of hydroxylation, demethylation, and decarbonylation reactions. Finally, the dynamic simulation experiments of SPC/FeS2 sand column showed that FeS2 effectively activated SPC and significantly reduced the toxicity in groundwater after the packed column treatment. This study reveals that FeS2 can efficiently activate SPC and has good prospects for tetracycline-contaminated groundwater remediation applications.

Diagnosis based on electromagnetic navigational bronchoscopy-guided biopsied peripheral lung lesions in a 10-year-old girl: A case report.

BACKGROUND: Electromagnetic navigational bronchoscopy (ENB) is an emerging diagnostic tool that enables practitioners to biopsy peripheral lung tissues that were previously only accessible under computed tomography (CT) guidance. However, few studies have investigated ENB use in children. Here, we report a case of a 10-year-old girl with peripheral lung lesions who complained of a 7-d persistent fever. She was diagnosed with Streptococcus parasanguinis infection based on findings obtained using ENB-guided transbronchial lung biopsy (TBLB). CASE SUMMARY: A 10-year-old girl presented with constitutional symptoms of cough and fever of 7 days' duration. Chest CT scans detected peripheral lung lesions and no endobronchial lesions. TBLB performed under the guidance of an ENB Lungpro navigation system was safe, well-tolerated, and effective for biopsying peripheral lung lesions. Examination of biopsied samples indicated the patient had a pulmonary Streptococcus parasanguinis infection, which was treated with antibiotics instead of more invasive treatment interventions. The patient's symptoms resolved after she received a 3-wk course of oral linezolid. Comparisons of pre-treatment and post-treatment CT scans revealed absorption of some lung lesions within 7 mo of hospital discharge. CONCLUSION: ENB-guided TBLB biopsying of peripheral lung lesions in this child is a safe, well-tolerated, and effective alternative to conventional interventions.

Effective Value Analysis of Fuzzy Similarity Relation in HQSS for Efficient Granulation.

Hierarchical quotient space structure (HQSS), as a typical description of granular computing (GrC), focuses on hierarchically granulating fuzzy data and mining hidden knowledge. The key step of constructing HQSS is to transform the fuzzy similarity relation into fuzzy equivalence relation. However, on one hand, the transformation process has high time complexity. On the other hand, it is difficult to mine knowledge directly from fuzzy similarity relation due to its information redundancy, i.e., sparsity of effective information. Therefore, this article mainly focuses on proposing an efficient granulation approach for constructing HQSS by quickly extracting the effective value of fuzzy similarity relation. First, the effective value and effective position of fuzzy similarity relation are defined according to whether they could be retained in fuzzy equivalence relation. Second, the number and composition of effective values are presented to confirm that which elements are effective values. Based on these above theories, redundant information and sparse effective information in fuzzy similarity relation could be completely distinguished. Next, both isomorphism and similarity between two fuzzy similarity relations are researched based on the effective value. The isomorphism between two fuzzy equivalence relations is discussed based on the effective value. Then, the algorithm with low time complexity for extracting effective values of fuzzy similarity relation is introduced. On the basis, the algorithm for constructing HQSS is presented to realize efficient granulation of fuzzy data. The proposed algorithms could accurately extract effective information from the fuzzy similarity relation and construct the same HQSS with the fuzzy equivalence relation while greatly reducing the time complexity. Finally, relevant experiments on 15 UCI datasets, 3 UKB datasets, and 5 image datasets are shown and analyzed to verify the effectiveness and efficiency of the proposed algorithm.

[Current situation of acupuncture and moxibustion patents in China and abroad].

The patents of acupuncture and moxibustion in China and abroad was analyzed, aiming to provide support for the innovative development of acupuncture industry. With the China Think Tank of Patent of Traditional Chinese Medicine and the PatSnap database as data sources, based on the mathematical statistics method, the application trend, legal status, patent types, transformation and distribution of major technical fields of acupuncture patents in China and abroad were analyzed. As a result, a total of 53,422 acupuncture patents were screened, involving 49 countries and 4 organizations. The patent types were mainly utility model patents. Although the application number of acupuncture patent had increased rapidly, the average patent conversion rate was generally low, approximately 4%. In the context of global economic integration, the acupuncture industry is developing at a high speed. It is suggested to take advantage of the "Belt and Road Initiative" to improve the international acceptance of acupuncture and moxibustion, adhere to the principle of attaching equal importance to the number and quality of patents, promote the in-depth cooperation of industry-university-research, and promote high-quality development of acupuncture and moxibustion.

Endoscopic interventional therapies for tracheoesophageal fistulas in children: A systematic review.

Methods: An electronic literature search was performed using the keywords "tracheoesophageal fistula," "endoscopic," and "children" in the four major medical databases (Ovid, Embase, PubMed, and Web of Science) right from inception to September 2022. All English language articles describing the endoscopic interventional therapies of TEF in children were reviewed. Two independent researchers screened eligible articles at the title and abstract level. Full texts of potentially relevant articles were then screened again, and reference lists were screened manually to identify additional studies. Relevant data were extracted and analyzed. A synthesis of the relevant data was presented in descriptive form because of the heterogeneity of the included articles. The Chi-Squared test was used with a significance level of 5% (P < 0.05). Results: Among the 1,167 retrieved papers, a total of 46 studies describing 170 TEF patients with an age range of 0.3-175 months were included, including 11 cases of acquired tracheoesophageal fistula, 144 cases of recurrent tracheoesophageal fistula, and 15 cases of congenital tracheoesophageal fistula (H-type TEF). A total of 119 out of 170 fistulas were successfully blocked via endoscopic techniques with an overall success rate of 70.0%, while 48 fistulas failed to close by endoscopic interventions, following which the procedure was converted to open surgery. No obviously severe intraoperative/postoperative complications occurred during the follow-up period, but only a mild esophageal stricture was noticed in six patients and grade II tracheal stenosis in one patient. Two patients died from causes unrelated to endoscopic procedures, with a mortality rate of approximately 1.2%. A comparative assessment of different endoscopic interventional techniques for TEF that detected endotracheal stenting was performed in six patients and one fistula was successfully blocked (16.7%). De-epithelialization alone was performed in 65 patients and the fistula healed in 47 of them (72.3%), with the mean number of successful treatments required being 2.3 times. Chemical sealant injection was administered in 33 patients and success was achieved in 21 (63.6%). The average requirement for endoscopic procedures was 1.5 times. De-epithelialization, in combination with chemical sealant injection, was performed in 62 patients, achieving the highest success rate of 77.4% (48 patients). Other treatment methods were performed in four patients and successfully treatment outcomes were reported in two of them (50.0%). The mean number of successful treatments required was four times, and a treatment was converted to surgery in one patient (25.0%). An assessment of different TEF types showed that 9 out of 15 congenital TEFs, 7 out of 11 acquired TEFs, and 103 out of 144 recurrent TEFs were successfully occluded. A comparison of the success rate across multiple groups showed a significant difference with a score of P < 0.05, while there was no significant difference in the success rate of different TEF-type groups (P > 0.05). Conclusion: Endoscopic intervention is currently a preferred treatment modality for children with TEF because of its less-invasive nature, less complications, and high success rate. Among all interventional techniques, de-epithelialization, in combination with chemical sealant, has a higher success rate than other techniques. However, due to the limited number of cases reported for implementing many kinds of techniques, an ideal endoscopic interventional technique has yet to be devised, often necessitating more treatment applications and close follow-up.

Hotspots and comparative analysis of international acupuncture research over the past decade via Web of Science / 数字中医药（英文）

@#【Objective】 This study aims to summarize the hotspots of acupuncture research in China and abroad in recent 10 years. 【Methods】 The core collection of Web of Science was retrieved, and the literature on experimental and clinical research of acupuncture in China and abroad was collected from January 1, 2012 to December 31, 2021. The included literature was visually analyzed using CiteSpace 6.1.R3. Statistical analysis was carried out in the annual number of papers, authors, countries, and journals. According to the author's country, the literature was divided into Chinese and global categories for keywords clustering analysis and co-citation references analysis independently to obtain hotspots and trends in acupuncture research. 【Results】 There are 1 215 articles in acupuncture experimental medicine, 3 805 articles in acupuncture clinical medicine in China; 551 articles in acupuncture experimental medicine, and 4 538 articles in acupuncture clinical medicine abroad. The number of articles on acupuncture abroad remains stable and flat, whereas the annual number of domestic papers shows a continuously growth trend. LIU Cunzhi from Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University in China is the author who has published the most articles in the field of acupuncture in the recent decade. China is the most productive country in publishing such research articles. Evidence-based Comprehensive and Alternative Medicine is the journal with the most published articles. The mechanisms of acupuncture on nerve regeneration or nerve recovery and research on the mechanisms of acupuncture analgesia are hotspots in experimental acupuncture research, and the treatment of neuropathic pain and dysfunctional diseases with acupuncture are hotspots in clinical acupuncture research in China. Research on the mechanism of protection of the cardiovascular system by acupuncture and research on the mechanism of analgesia by acupuncture are hotspots in experimental research on acupuncture abroad. Studies on the amelioration of inflammatory pain and psychological or psychiatric disorders by acupuncture also serve as hotspots in clinical research on acupuncture abroad. 【Conclusion】 Acupuncture research in China focuses on the treatment of internal diseases and visceral pain, while acupuncture research abroad concentrates on the alleviation and improvement of cancer and psychological and mental diseases. Treatment of internal diseases and mental diseases with acupuncture is the trend of future research.

Inhibition of bromodomain-containing protein 4 enhances the migration of esophageal squamous cell carcinoma cells by inducing cell autophagy.

BACKGROUND: Esophageal squamous cell carcinoma (ESCC), the predominant type of esophageal cancer, has a 5-year survival rate less than 20%. Although the cause of poor prognosis is the high incidence and mortality of ESCC, the high rate of metastasis after esophageal cancer surgery is the main cause of death after the surgery. Bromodomain-containing protein 4 (BRD4), an epigenetic reader of chromatin-acetylated histones in tumorigenesis and development, plays an essential role in regulating oncogene expression. BRD4 inhibition and BRD4 inhibition-based treatment can potentially suppress ESCC growth. However, the effects and mechanisms of action of BRD4 on ESCC cell migration remain unclear. AIM: To explore the effect of BRD4 on cell migration of ESCC in vitro and its possible molecular mechanism. METHODS: Human ESCC cell lines KYSE-450 and KYSE-150 were used. The 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide assay was performed to examine cell proliferation, and the transwell migration assay was conducted to test ESCC cell migration. JQ1, a BRD4 inhibitor, was applied to cells, and BRD4 siRNA was transfected into ESCC cells to knockdown endogenous BRD4. GFP-RFP-LC3 adenovirus was infected into ESCC cells to evaluate the effect of JQ1 on autophagy. Western blotting was performed to determine the protein levels of BRD4, E-cadherin, vimentin, AMP-activated protein kinase (AMPK), and p-AMPK. RESULTS: BRD4 was either downregulated by small interfering RNA or pretreated with JQ1 in ESCC cells, leading to increased tumor migration in ESCC cells in a dose- and time-dependent manner. Inhibition of BRD4 not only significantly suppressed cell proliferation but also strongly increased cell migration by inducing epithelial-mesenchymal transition (EMT). The protein expression of vimentin was increased and E-cadherin decreased in a dose-dependent manner, subsequently promoting autophagy in KYSE-450 and KYSE-150 cells. Pretreatment with JQ1, a BRD4 inhibitor, inhibited BRD4-induced LC3-II activation and upregulated AMPK phosphorylation in a dose-dependent manner. Additionally, an increased number of autophagosomes and autolysosomes were observed in JQ1-treated ESCC cells. The autophagy inhibitor 3-methyladenine (3-MA) reversed the effects of BRD4 knockdown on ESCC cell migration and blocked JQ1-induced cell migration. 3-MA also downregulated the expression of vimentin and upregulation E-cadherin. CONCLUSION: BRD4 inhibition enhances cell migration by inducing EMT and autophagy in ESCC cells via the AMPK-modified pathway. Thus, the facilitating role on ESCC cell migration should be considered for BRD4 inhibitor clinical application to ESCC patients.