Discovery and Optimization of WDR5 Inhibitors via Cascade Deoxyribonucleic Acid-Encoded Library Selection Approach.

The DNA-encoded library (DEL) is a powerful hit generation tool for chemical biology and drug discovery; however, the optimization of DEL hits remained a daunting challenge for the medicinal chemistry community. In this study, hit compounds targeting the WIN binding domain of WDR5 were discovered by the initial three-cycle linear DEL selection, and their potency was further enhanced by a cascade DEL selection from the focused DEL designed based on the original first run DEL hits. As expected, these new compounds from the second run of focused DEL were more potent WDR5 inhibitors in the protein binding assay confirmed by the off-DNA synthesis. Interestingly, selected inhibitors exhibited good antiproliferative activity in two human acute leukemia cell lines. Taken together, this new cascade DEL selection strategy may have tremendous potential for finding high-affinity leads against WDR5 and provide opportunities to explore and optimize inhibitors for other targets.

H2H rehabilitation care promotes high quality recovery of patients with lung cancer comorbid with chronic obstructive pulmonary disease.

H2H is a patient and family-centered approach that integrates hospital and home care, emphasizing continuity, individualized rehabilitation training, and the active participation of patients and their families. However, it is still unclear whether H2H improves the efficacy for patients with COPD and lung cancer. This study investigated the efficacy of Hospital-to-Home (H2H) rehabilitation nursing for lung cancer patients with Chronic Obstructive Pulmonary Disease (COPD). We conducted a retrospective analysis to the clinical data of 95 patients treated in the Pingdingshan University Medical College from January 2018 to January 2020. We compared the effects of conventional nursing (control group, n=45) and H2H nursing (observation group, n=50) on the clinical efficacy for the patients. In this study, after nursing intervention, the quality of life and adverse emotions in the observation group were significantly improved compared to the control group (P<0.0001). Moreover, the lung function and blood oxygen saturation of patients in the H2H nursing model improved after the intervention (P<0.0001). In addition, there was no difference in the 3-year survival rate between the control group and the observation group (P=0.260). Multivariate COX regression analysis showed that the nursing scheme had no effect on the patients' 3-year survival, but the SAS score, SDS score, and CEA were independent prognostic factors affecting the 3-year survival rate (P<0.05). These results demonstrate that H2H rehabilitation care significantly improves the quality of life, emotional health, and lung function of patients with COPD and lung cancer, but does not affect the patients' 3-year survival rate.

Context and Spatial Feature Calibration for Real-Time Semantic Segmentation.

Context modeling or multi-level feature fusion methods have been proved to be effective in improving semantic segmentation performance. However, they are not specialized to deal with the problems of pixel-context mismatch and spatial feature misalignment, and the high computational complexity hinders their widespread application in real-time scenarios. In this work, we propose a lightweight Context and Spatial Feature Calibration Network (CSFCN) to address the above issues with pooling-based and sampling-based attention mechanisms. CSFCN contains two core modules: Context Feature Calibration (CFC) module and Spatial Feature Calibration (SFC) module. CFC adopts a cascaded pyramid pooling module to efficiently capture nested contexts, and then aggregates private contexts for each pixel based on pixel-context similarity to realize context feature calibration. SFC splits features into multiple groups of sub-features along the channel dimension and propagates sub-features therein by the learnable sampling to achieve spatial feature calibration. Extensive experiments on the Cityscapes and CamVid datasets illustrate that our method achieves a state-of-the-art trade-off between speed and accuracy. Concretely, our method achieves 78.7% mIoU with 70.0 FPS and 77.8% mIoU with 179.2 FPS on the Cityscapes and CamVid test sets, respectively. The code is available at https://nave.vr3i.com/ and https://github.com/kaigelee/CSFCN.

A multiple Kirkendall strategy for converting nanosized zero-valent iron to highly active Fenton-like catalyst for organics degradation.

Nanosized zero-valent iron (nZVI) is a promising persulfate (PS) activator, however, its structurally dense oxide shell seriously inhibited electrons transfer for O-O bond cleavage of PS. Herein, we introduced sulfidation and phosphorus-doped biochar for breaking the pristine oxide shell with formation of FeS and FePO4-containing mixed shell. In this case, the faster diffusion rate of iron atoms compared to shell components triggered multiple Kirkendall effects, causing inward fluxion of vacancies with further coalescing into radial nanocracks. Exemplified by trichloroethylene (TCE) removal, such a unique "lemon-slice-like" nanocrack structure favored fast outward transfer of electrons and ferrous ions across the mixed shell to PS activation for high-efficient generation and utilization of reactive species, as evidenced by effective dechlorination (90.6%) and mineralization (85.4%) of TCE. [Formula: see text] contributed most to TCE decomposition, moreover, the SnZVI@PBC gradually became electron-deficient and thus extracted electrons from TCE with achieving nonradical-based degradation. Compared to nZVI/PS process, the SnZVI@PBC/PS system could significantly reduce catalyst dosage (87.5%) and PS amount (68.8%) to achieve nearly complete TCE degradation, and was anti-interference, stable, and pH-universal. This study advanced mechanistic understandings of multiple Kirkendall effects-triggered nanocrack formation on nZVI with corresponding rational design of Fenton-like catalysts for organics degradation.

Discovery, SAR Study of GST Inhibitors from a Novel Quinazolin-4(1H)-one Focused DNA-Encoded Library.

The DNA-encoded library (DEL) is a powerful hit-generation tool in drug discovery. This study describes a new DEL with a privileged scaffold quinazolin-4(3H)-one developed by a robust DNA-compatible multicomponent reaction and a series of novel glutathione S-transferase (GST) inhibitors that were identified through affinity-mediated DEL selection. A novel inhibitor 16 was subsequently verified with an inhibitory potency value of 1.55 ± 0.02 µM against SjGST and 2.02 ± 0.20 µM against hGSTM2. Further optimization was carried out via various structure-activity relationship studies. And especially, the co-crystal structure of the compound 16 with the SjGST was unveiled, which clearly demonstrated its binding mode was quite different from the known GSH-like compounds. This new type of probe is likely to play a different role compared with the GSH, which may provide new opportunities to discover more potent GST inhibitors.

Multi-centre, prospective randomized comparison of three different substrate ablation strategies for persistent atrial fibrillation.

AIMS: The optimal strategy for persistent atrial fibrillation (PerAF) is poorly defined. We conducted a multicentre, randomized, prospective trial to compare the outcomes of different ablation strategies for PerAF. METHODS AND RESULTS: We enrolled 450 patients and randomly assigned them in a 1:1:1 ratio to undergo pulmonary vein isolation and subsequently undergo the following three different ablation strategies: anatomical guided ablation (ANAT group, n = 150), electrogram guided ablation (EGM group, n = 150), and extensive electro-anatomical guided ablation (EXT group, n = 150). The primary endpoint was freedom from atrial fibrillation (AF) lasting longer than 30 s at 12 months after a single ablation procedure. After 12 months of follow-up, 72% (108) of patients in the EXT group were free from AF recurrence, as compared with the 64% (96) in the EGM group (P = 0.116), and 54% (81) in the ANAT group (P = 0.002). The EXT group showed less AF/atrial tachycardia recurrence than the EGM group (60% vs. 50%, P = 0.064) and the ANAT group (60% vs. 37.3%, P < 0.001). The EXT group showed the highest rate of AF termination (66.7%), followed by 56.7% in the EGM group, and 20.7% in the ANAT group. The AF termination signified less AF recurrence at 12 months compared to patients without AF termination (30.1% vs. 42.7%, P = 0.008). Safety endpoints did not differ significantly between the three groups (P = 0.924). CONCLUSIONS: Electro-anatomical guided ablation achieved the most favourable outcomes among the three ablation strategies. The AF termination is a reliable ablation endpoint.

Usage of procalcitonin and sCD14-ST as diagnostic markers for postoperative spinal infection.

OBJECTIVE: Identifying biomarkers for early diagnosis of postoperative spinal infection is essential to avoid complications after spine surgery. The presented study evaluated serum levels of procalcitonin (PCT), C-reactive protein (CRP), and soluble CD14 subtype (sCD14-ST) in patients who underwent spinal surgery to assess the diagnosis values of PCT and sCD14-ST. METHODS: Serum levels of PCT, CRP, and sCD14-ST were measured in 490 (289 male/201 female) patients who underwent spinal surgery (SS) before and 1 day after surgery. PCT and sCD14-ST levels of patients diagnosed with postoperative infection (PI) and patients diagnosed with postoperative non-infection (PN) were compared. RESULTS: Serum levels of PCT, CRP, and sCD14-ST were significantly increased after surgery (F = 58.393, P = 0.000). In patients diagnosed as having a PI, serum levels of PCT and sCD14-ST were positively correlated with each other (r = 0.90, P < 0.01) and with operation duration (r = 0.92, 0.88, P < 0.01). Receiver operating characteristic (ROC) models showed that both PCT (AUC = 0.817, optimal cutoff: 0.69 ng/ml, P = 0.000) and sCD14-ST (AUC = 0.824, optimal cutoff: 258.27 pg/ml, P = 0.000) can distinguish PI versus PN patients well. CONCLUSION: Our results demonstrated that serum levels of PCT and sCD14-ST have the potential to be used as a diagnostic markers for postoperative spinal infection.

Management of catheter ablation in arrhythmia patients during the coronavirus disease 2019 epidemic.

AIMS: Health care providers have reduced outpatient services and delayed elective cardiac surgeries during the coronavirus disease 2019 (COVID-19) epidemic, while a large number of patients face more cardiovascular risks compared with those of the pandemic. The present study attempted to explore the management of catheter ablation in arrhythmia patients during the pandemic. METHODS AND RESULTS: From 1 January 2020 to 24 March 2020, a total of 269 arrhythmia patients hospitalized for catheter ablation under strict risk assessments and careful infection prevention were retrospectively analysed and considered for our analysis at our centre. Preventive measured included a 14 day quarantine, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid detection, adoption of personal protection equipment, application of hand disinfectant, management of hospital visitors, and maintenance of environmental hygiene. Three patients who had fever following ablation and were finally excluded from SARS-CoV-2 infection, and no hospital infection occurred during the 3.1 ± 1.5 day hospitalization period. Additionally, 258/269 (95.9%) patients were free from arrhythmia after a median 133 day follow-up (Q1, 81; Q3, 143; ending 1 June 2020), and no SARS-CoV-2 infections occurred at follow-up. CONCLUSIONS: By adopting strict risk assessments and careful infection prevention measures, catheter ablation in patients with arrhythmia can be safely and effectively performed during the COVID-19 epidemic in well-controlled areas.

Five-year outcomes after catheter ablation for atrial fibrillation in patients with hypertrophic cardiomyopathy.

BACKGROUND: Catheter ablation (CA) is a promising option in most patients with refractory atrial fibrillation (AF). However, data on over 5 years' outcomes with larger numbers in hypertrophic cardiomyopathy (HCM) patients with AF have not been reported. We assessed the outcome of 120 HCM patients following CA compared with a non-CA group and general patients without AF matched by HCM type with a 61.9 ± 31.6-month follow-up. METHODS AND RESULTS: A total of 120 patients (age 61 ± 9.8 years, female n = 43, 35.8%) with paroxysmal AF (n = 60, 50%) and persistent AF (n = 60, 50%) were enrolled. Of the 120 patients, 48 (40%) required redo procedures, and 82 (68.3%) were in sinus rhythm at the last evaluation. The composite clinical events rate following the initial CA was lower than that in the non-CA group (P = .023) and was also comparable to that in general patients without AF matched by HCM type (P = .729). Female (HR 2.358, 95% CI, 1.151-4.831; P = .019), NYHA functional class III-IV (HR 2.422, 95% CI, 1.032-5.685; P = .042) and left atrial diameter ≥50 mm (HR 3.319, 95% CI, 1.469-7.499; P = .004) were predictors of AF recurrence after multiple procedures. CONCLUSIONS: CA was successful in restoring long-term sinus rhythm and improving symptomatic status in most HCM patients with refractory AF especially for those patients with small atrial size and mild symptoms. In addition, CA may contribute to the prevention of major clinical adverse events in the long-term clinical course.

RT-Seg: A Real-Time Semantic Segmentation Network for Side-Scan Sonar Images.

Real-time processing of high-resolution sonar images is of great significance for the autonomy and intelligence of autonomous underwater vehicle (AUV) in complex marine environments. In this paper, we propose a real-time semantic segmentation network termed RT-Seg for Side-Scan Sonar (SSS) images. The proposed architecture is based on a novel encoder-decoder structure, in which the encoder blocks utilized Depth-Wise Separable Convolution and a 2-way branch for improving performance, and a corresponding decoder network is implemented to restore the details of the targets, followed by a pixel-wise classification layer. Moreover, we use patch-wise strategy for splitting the high-resolution image into local patches and applying them to network training. The well-trained model is used for testing high-resolution SSS images produced by sonar sensor in an onboard Graphic Processing Unit (GPU). The experimental results show that RT-Seg can greatly reduce the number of parameters and floating point operations compared to other networks. It runs at 25.67 frames per second on an NVIDIA Jetson AGX Xavier on 500*500 inputs with excellent segmentation result. Further insights on the speed and accuracy trade-off are discussed in this paper.

ECNet: Efficient Convolutional Networks for Side Scan Sonar Image Segmentation.

This paper presents a novel and practical convolutional neural network architecture to implement semantic segmentation for side scan sonar (SSS) image. As a widely used sensor for marine survey, SSS provides higher-resolution images of the seafloor and underwater target. However, for a large number of background pixels in SSS image, the imbalance classification remains an issue. What is more, the SSS images contain undesirable speckle noise and intensity inhomogeneity. We define and detail a network and training strategy that tackle these three important issues for SSS images segmentation. Our proposed method performs image-to-image prediction by leveraging fully convolutional neural networks and deeply-supervised nets. The architecture consists of an encoder network to capture context, a corresponding decoder network to restore full input-size resolution feature maps from low-resolution ones for pixel-wise classification and a single stream deep neural network with multiple side-outputs to optimize edge segmentation. We performed prediction time of our network on our dataset, implemented on a NVIDIA Jetson AGX Xavier, and compared it to other similar semantic segmentation networks. The experimental results show that the presented method for SSS image segmentation brings obvious advantages, and is applicable for real-time processing tasks.

Effect of Electroacupuncture at Different Acupoints on the Expression of NMDA Receptors in ACC and Colon in IBS Rats.

OBJECTIVE: To observe the effects of electroacupuncture (EA) at different acupoints on the expression of N-methyl-D-aspartate receptor (NMDA receptor ) and behaviors in irritable bowel syndrome (IBS) rats. METHODS: Wistar rats were randomly divided into blank control group (blank group, n=10) and model preparation group (n=50); experimental rat model of IBS was established by the "neonatal maternal separation and acetic acid enema" combined with "colorectal distension stimulation" method. A total of 50 IBS rats were randomly assigned to five groups of 10 each: model group, Yintang (GV29) group, Neiguan (PC6) group, Tianshu (ST25) group, and Zusanli (ST36) group. Rats in four treatment groups, aged 9 weeks old, were treated with EA by HANS with a sparse-dense wave with a frequency of 2/100 Hz, current of 0.1-0.3mA, and 20 min/stimulation, every other day for a total of 5 sessions. After treatment, the abdominal visceral sensitivity was evaluated by abdominal withdrawal reflex (AWR), and the psychological and emotional behavior of rats were evaluated by the open-field test (OFT). The expression of NMDA receptors in anterior cingulate cortex (ACC) was detected by Quantitative Real-time PCR, and the positive expression of NMDA receptors in colon was detected by immunohistochemistry. RESULTS: The IBS rat's abdomen is more sensitive and irritable; NR1, NR2A, and NR2B in ACC and NR1 and NR2B in colon of rats significantly increased in the model group versus the normal group (P<0.01) and were inhibited in all treatment groups (P<0.01, P<0.05). Additionally, NR2A and NR2B in ACC reduced more in GV29 group (P<0.01) than in other treatment groups (P all<0.05) compared with the model group. The expression of NR2B in colon was significantly inhibited in ST36 group (P<0.01) and inhibited in GV29 group and ST25 group (P all <0.05) compared with the model group. And the expression of NR2B in colon was more inhibited in ST36 group than in PC6 group (P<0.01). CONCLUSIONS: EA at different acupoints could obviously relieve abdominal pain and abnormal behaviors in IBS rats in different degrees of effects. The effect of abdominal pain-relief, from greatest to least, is ST25, ST36, GV29, and PC6, while the effect of relieving abnormal behaviors caused by IBS, from greatest to least, is GV29, PC6, ST36, and ST25. There are significant differences in the expressions of NMDA receptors in ACC and colon among different acupoints. This difference should be related to the location distribution and indications of acupoints.

[Relativity and integrality of the acupoint effect specificity].

The researches on the acupoint effect specificity were summarized to explore whether the integrality of the acupoint effect specificity existed and analyze the connection between the relativity and integrality of the acupoint effect specificity. The literature on the clinical and experimental researches relevant with the acupoint effect specificity was retrieved through CNKI from January 2007 to October 2017. A total of 39 papers met the retrieving criteria. Separately, in terms of the holism of TCM theory, the holism of meridian theory and modern research, the integrality of acupoint effect specificity was analyzed. The relativity and the integrality are indicated in the acupoint effect specificity. The integrality of acupoint effect specificity is closely related to the holism of TCM theory as well as the meridians. Just because of its integrality, the acupoint effect specificity is relative, rather than absolute.

[Comparison of effects of electroacupuncture at "Dachangshu" (BL 25) or "Tianshu" (ST 25) on visceral sensitivity, c-kit and TRPV1 of irritable bowel syndrome rats].

OBJECTIVE: To compare the effects of electroacupuncture (EA) at "Dachangshu" (BL 25) or "Tianshu" (ST 25) for visceral sensitivity, gene expression product c-kit of colonic Cajal interstitial cells (ICC) and capsaicin receptor 1 (TRPV1) of irritable bowel syndrome (IBS) rats, so as to investigate the effect and mechanism differences of EA at the back shu point and the front mu point of large intestine for IBS rats. METHODS: Forty-two Wistar neonatal rats were randomly divided into a blank group (9 rats) and a model group (33 rats). IBS model was established with mother and child separation, acetic acid enema in young rats and colorectal dilatation method. Twenty-seven IBS rats in life were randomly divided into a model control group, a Dachangshu group and a Tianshu group, 9 rats in each group. EA (disperse-dense wave, 2 Hz/100 Hz, 0.1-0.3 mA) for 20 min was used at "Dachangshu" (BL 25) and "Tianshu" (ST 25) respectively in the Dachangshu and Tianshu groups, once every other day, totally 5 times. The rats in the model control group were fixed with soft cloth sleeve for 20 min, without acupuncture. No intervention was used in the blank group. The stool property Bristol grading score was recorded before and after intervention in each group. The visceral sensitivity was evaluated by abdominal withdrawal reflex. The latency until the first systolic wave occurred and the number of systolic wave within 90 s were observed. Immunohistochemical was used to detect the positive expressions of c-kit and TRPV1, the ICC colon specific marker. RESULTS: Compared with the blank group, the Bristol score increased，latency period shortened, systolic wave number increased, c-kit and TRPV1 positive expressions increased in the model control group (all P<0.01). Compared with the model control group, the Bristol score decreased, latency period increased, systolic wave number decreased, c-kit and TRPV1 positive expressions decreased after intervention in the Dachangshu and Tianshu groups (P<0.05, P<0.01). Compared with the Dachangshu group, the TRPV1 positive expression decreased after intervention in the Tianshu group (P<0.05). CONCLUSION: EA at "Dachangshu" (BL 25) or "Tianshu"(ST 25) can improve the diarrhea in IBS model rats, reduce the visceral sensitivity, and its mechanism may be related to regulating the expressions of colon c-kit and TRPV1. EA at "Tianshu" (ST 25) is more apparent for TRPV1 than at "Dachangshu" (BL 25).

[Effect of Electroacupuncture at "Neiguan" (PC 6) and "Tianshu" (ST 25) for Colonic Motility and D 2 Receptor in Irritable Bowel Syndrome Rats].

OBJECTIVE: To observe and compare the effects of electroacupuncture (EA) at "Tianshu" (ST 25) and "Neiguan" (PC 6) for colonic motility and the expression of colon dopamine D 2 in irritable bowel syndrome (IBS) rats, and to explore the specificity of different meridians and different acupoints. METHODS: Forty Wistar newborn rats were randomly divided into blank, model, Tianshu and Neiguan groups. Separation of mother and child and acetic acid coloclyster combined with colorectal distension were used to establish IBS model in the model, Tianshu and Neiguan groups. At the age of 9 weeks, EA at bilateral ST 25 and PC 6 were applied in the corresponding groups 5 times, once every other day. After the intervention, the Bristol fecal score, the latent period of abdominal retraction reflex and the number of contraction waves were recorded. The expression of dopamine D 2 receptor was detected by immunohistochemistry. RESULTS: Compared with the blank group, the Bristol fecal score of the model group was higher (P<0.01), the 1st contraction wave latent period was shorter (P<0.01), the number of contraction waves in 90 s increased (P<0.01), the immunoreactive expression of D 2 receptor in colon decreased (P<0.01). Compared with the model group, the Bristol fecal scores of the Tianshu and Neiguan groups decreased (P<0.01), the 1st contraction wave latent periods were longer (P<0.01), the numbers of contraction waves in 90 s decreased (P<0.01), the positive expressions of D 2 receptor in colon increased (P<0.01, P<0.05). Compared with the Tianshu group, the immunoreactive expression of D 2 receptor in the Neiguan group decreased (P<0.01). CONCLUSION: EA at ST 25 and PC 6 can improve the symptoms of colonic motility in IBS rats. The effect of EA at ST 25 is better, which indicates that different meridians and different acupoints play specific effects.

[Effect of Electroacupuncture at "Yintang" (GV 29) and "Tianshu" (ST 25) on the Ethology and the Expression of TRPV 1 Receptor in Colon of Irritable Bowel Syndrome Rats].

OBJECTIVE: To observe the ethology and expression of transient receptor potential vanilloid-1(TRPV 1) in colon of irritable bowel syndrome (IBS) rats treated by electroacupuncture (EA) at "Yintang" (GV 29) and "Tianshu" (ST 25), so as to explore the different effectiveness of different acupoints and its related mechanism underlying improvement of the symptoms of somatopsychic illness. METHODS: Thirty-two neonatal Wistar rats were randomly divided into blank control group, model group, Yintang (GV 29) group, and Tianshu (ST 25) group (n=8 in each group). IBS model was established by neonatal maternal separation and acetic acid enema combined with colon and rectum expansion stimulation. Rats of the GV 29 and ST 25 groups were given EA treatment at age of 9 weeks old, 20 minutes, once every other day for 5 times. Latency of the 1st time contraction wave and numbers of contractive wave in 90 s were recorded to evaluate abdominal visceral sensitivity by abdominal withdrawal reflex. Horizontal and vertical movements were observed to assess the emotional and psychological behavior of rats by open field test. TRPV 1 expression in colon was detected by immunohistochemistry method. RESULTS: Compared with the black control group, latency of the 1st time contractive wave was significantly shortened and the wave numbers in 90 s were increased significantly in the model group (P<0.01), while the numbers of vertical and horizontal movements were also significantly reduced (P<0.01), accompanied with increased TRPV 1 expression in the colon (P<0.05). Compared with the model group, After EA intervention, the levels of the above-mentioned 5 indexes were significantly reversed in the GV 29 and ST 25 groups (P<0.01,P<0.05), except the number of horizontal movement in the ST 25 group (P>0.05). The expression level of TRPV 1 was significantly lower in the ST 25 group than in the GV 29 group (P<0.01). CONCLUSIONS: EA at GV 29 and ST 25 can alleviate the abdominal pain and improve the mental and emotional disorders in IBS rats. GV 29 has a better effect on relieving the depressive-like psychoemotional behavior of IBS rats, while ST 25 is more effective in treating abdominal pain. There is significantly different influence on TRPV 1 expression in colon between these two treatment groups, which may contribute to their different effect in pain relieving.