Intraoperative transcutaneous electroacupoint stimulation on early postoperative fatigue in patients with Parkinson's disease undergoing deep brain stimulation surgery.

Background: In this clinical trial, we evaluated the effects of transcutaneous electroacupoint stimulation (TEAS) on postoperative fatigue (POF) in Parkinson disease (PD) patients undergoing deep brain stimulation (DBS) surgery. Methods: A total 60 PD patients undergoing DBS surgery were enrolled. They were randomized to receive either electrical stimulation [alternative frequency 2/10 Hz, dense and disperse, intensity adjusted to the maximum tolerated by the participants (6-15 mAmp)] via surface electrodes (TEAS group) or surface electrodes only without electrical stimulation (Con group) at bilateral Zusanli and Sanyinjiao acupuncture points. All participants received their assigned intervention (TEAS or Con) during the 1st stage of surgery [(except during microelectrode recording (MER)] and the entire 2nd stage of surgery. Intraoperative anesthetic requirements were adjusted based on bispectral index (BIS) monitor. POF was assessed by Christensen fatigue scales (ChrFS), along with Quality of Recovery-15 (QoR-15) and mini-mental state examination (MMSE) postoperatively over a 7-day-period. We recorded the usage of rescue analgesics and anti-emetics. Results: Fifty-nine patients' datasets were included for final analyses. Fewer patients in TEAS experienced severe POF (defined as ChrFS ≥6) at T3 than those in the Con group (TEAS vs. Con: 7 vs. 22, p < 0.001). During the 1st stage of surgery, more patients in Con group required dexmedetomidine infusion (TEAS vs. Con: 2 vs. 6; P < 0.01). Total dosages of propofol and remifanil during the 2nd stage of surgery were TEAS vs. Con: 374.7 ± 61.2 vs 421.5 ± 81.9; p < 0.001 and 572.3 ± 82.0 vs. 662 ± 148.2; P < 0.001, respectively. Postoperative rescue analgesics (TEAS vs. Con: 2 vs. 6; P < 0.001) were used less in the TEAS group. TEAS patients reported better POF, MMSE and QoR15 scores than those in the Con group during most of the assessment period. Conclusions: Intraoperative TEAS decreased the severity of POF, reduced intraoperative anesthetic requirements and facilitated post-DBS recovery in this group of PD patients.

A rat model of adenoid hypertrophy constructed by using ovalbumin and lipopolysaccharides to induce allergy, chronic inflammation, and chronic intermittent hypoxia.

BACKGROUND: Adenoid hypertrophy (AH) is a common pediatric disease that significantly impacts the growth and quality of life of children. However, there is no replicable and valid model for AH. METHODS: An AH rat model was developed via comprehensive allergic sensitization, chronic inflammation induction, and chronic intermittent hypoxia (CIH). The modeling process involved three steps: female Sprague-Dawley rats (aged 4-5 weeks) were used for modeling. Allergen sensitization was induced via intraperitoneal administration and intranasal provocation using ovalbumin (OVA); chronic nasal inflammation was induced through intranasal lipopolysaccharide (LPS) administration for sustained nasal irritation; CIH akin to obstructive sleep apnea/hypopnea syndrome was induced using an animal hypoxia chamber. Postmodel establishment, behaviors, and histological changes in nasopharynx-associated lymphoid tissue (NALT) and nasal mucosa were assessed. Arterial blood gas analysis and quantification of serum and tissue levels of (interleukin) IL-4 and IL-13, OVA-specific immunoglobulin E (sIgE), eosinophil cationic protein (ECP), tumor necrosis factor (TNF-α), IL-17, and transforming growth factor (TGF)-ß were conducted for assessment. The treatment group received a combination of mometasone furoate and montelukast sodium for a week and then was evaluated. RESULTS: Rats exhibited notable nasal symptoms and hypoxia after modeling. Histopathological analysis revealed NALT follicle hypertrophy and nasal mucosa inflammatory cell infiltration. Elevated IL-4, IL-13, IL-17, OVA-sIgE, ECP, and TNF-α levels and reduced TGF-ß levels were observed in the serum and tissue of model-group rats. After a week of treatment, the treatment group exhibited symptom and inflammatory factor improvement. CONCLUSION: The model effectively simulates AH symptoms and pathological changes. But it should be further validated for genetic, immunological, and hormonal backgrounds in the currently used and other strains and species.

Organic acid and sugar components accumulation and flavor associated metabolites dynamic changes in yellow- and white-fleshed seedless loquats (Eriobotrya japonica).

Triploid loquats are divided into yellow- and white-fleshed cultivars. To better understand taste variations in triploid loquat fruits, we used a UPLC-ESI-QTRAP-MS/MS-based widely targeted metabolomic analysis to examine the metabolic composition of two different color fleshed triploid loquats with a sample size of 54 and external validation method within a confidence level of P＜0.05. We identified key flavor-related differentially accumulated metabolites using the variable importance in projection (VIP) value (VIP ≥ 1.0) and fold change ≥ 2 or ≤ 0.5. Furthermore, the results of the HPLC analysis showed that white-fleshed loquats had a low malic acid content. We also performed the UPLC-MS/MS system to investigate the carotenoids contents and lipidome in four triploid cultivars. In the fruits of white-fleshed varieties, the carotenoids contents were significantly downregulated, but the contents of most glycerolphospholipids were increased. Our results reveal the metabolomic changes between the yellow- and white-fleshed cultivars.

Extracellular vesicles: powerful candidates in nano-drug delivery systems.

Extracellular vesicles (EVs), which are nanoparticles that are actively released by cells, contain a variety of biologically active substances, serve as significant mediators of intercellular communication, and participate in many processes, in health and pathologically. Compared with traditional nanodrug delivery systems (NDDSs), EVs have unique advantages due to their natural physiological properties, such as their biocompatibility, stability, ability to cross barriers, and inherent homing properties. A growing number of studies have reported that EVs deliver therapeutic proteins, small-molecule drugs, siRNAs, miRNAs, therapeutic proteins, and nanomaterials for targeted therapy in various diseases. However, due to the lack of standardized techniques for isolating, quantifying, and characterizing EVs; lower-than-anticipated drug loading efficiency; insufficient clinical production; and potential safety concerns, the practical application of EVs still faces many challenges. Here, we systematically review the current commonly used methods for isolating EVs, summarize the types and methods of loading therapeutic drugs into EVs, and discuss the latest progress in applying EVs as NDDs. Finally, we present the challenges that hinder the clinical application of EVs.

Krüppel-like factor 15 counteracts endoplasmic reticulum stress and suppresses lung fibroblast proliferation and extracellular matrix accumulation.

The incidence of pulmonary fibrosis is on the rise, and existing treatments have limited efficacy in improving patient survival. The purpose of this study was to reveal the potential of Krüppel-like factor (KLF)15 activation in alleviating pulmonary fibrosis. Transforming growth factor beta (TGF-ß) was utilized to induce lung fibroblasts to establish an in vitro model of pulmonary fibrosis. The impacts of TGF-ß and KLF15 level on cell proliferation, migration, extracellular matrix (ECM) accumulation, and endoplasmic reticulum stress (ERS) were assessed. Additionally, tunicamycin, an ERS agonist, was used to investigate the role of ERS in KLF15 regulation. The results showed that KLF15 was dropped in response to TGF-ß treatment. However, KLF15 overexpression reduced cell proliferation, migration, ECM accumulation, and ERS, alleviating the effects of TGF-ß stimulation. Subsequent treatment with tunicamycin diminished the effects of KLF15 overexpression, demonstrating that ERS mediated the modulation of KLF15. KLF15 acts against ERS and suppresses excessive proliferation and ECM accumulation in lung fibroblast. These findings suggest that activating KLF15 is a promising strategy for alleviating pulmonary fibrosis.

EjFAD8 Enhances the Low-Temperature Tolerance of Loquat by Desaturation of Sulfoquinovosyl Diacylglycerol (SQDG).

Loquat (Eriobotrya japonica Lindl.) is an evergreen fruit tree of Chinese origin, and its autumn-winter flowering and fruiting growth habit means that its fruit development is susceptible to low-temperature stress. In a previous study, the triploid loquat (B431 × GZ23) has been identified with high photosynthetic efficiency and strong resistance under low-temperature stress. Analysis of transcriptomic and lipidomic data revealed that the fatty acid desaturase gene EjFAD8 was closely associated with low temperatures. Phenotypic observations and measurements of physiological indicators in Arabidopsis showed that overexpressing-EjFAD8 transgenic plants were significantly more tolerant to low temperatures compared to the wild-type. Heterologous overexpression of EjFAD8 enhanced some lipid metabolism genes in Arabidopsis, and the unsaturation of lipids was increased, especially for SQDG (16:0/18:1; 16:0/18:3), thereby improving the cold tolerance of transgenic lines. The expression of ICE-CBF-COR genes were further analyzed so that the relationship between fatty acid desaturase and the ICE-CBF-COR pathway can be clarified. These results revealed the important role of EjFAD8 under low-temperature stress in triploid loquat, the increase expression of FAD8 in loquat under low temperatures lead to desaturation of fatty acids. On the one hand, overexpression of EjFAD8 in Arabidopsis increased the expression of ICE-CBF-COR genes in response to low temperatures. On the other hand, upregulation of EjFAD8 at low temperatures increased fatty acid desaturation of SQDG to maintain the stability of photosynthesis under low temperatures. This study not only indicates that the EjFAD8 gene plays an important role in loquat under low temperatures, but also provides a theoretical basis for future molecular breeding of loquat for cold resistance.

Perioperative transcutaneous electrical acupoint stimulations as part of an enhanced recovery after surgery protocol for living donors undergoing nephrectomy: A randomized, controlled clinical trial.

Objective: Living kidney donors (LKDs) experience perioperative anxiety. We designed the following study to evaluate the anxiolytic effect of transcutaneous electrical acupoint stimulation (TEAS) during the perioperative period in a group of LKDs undergoing laparotomy nephrectomy. Methods: LKDs were randomly assigned to either the TEAS or control group. Participants in the TEAS group received 30min of intervention (6-15 mA, 2-100 Hz), at Yintang (EX-HN-3), bilateral Taichong (LR3) and Neiguan (PC6) one day before surgery (D0), before induction of anesthesia (D1) and one day after surgery (D2). The participants in the control group received the same placement of electrodes but without electrical stimulation. Venous blood was collected before each intervention. Anxiety levels and recovery profiles were recorded. Results: LKDs in the TEAS group had lower anxiety level than those in the control group at D1, D2 and three days after surgery (D3). The percentage differences were: 33.3%, 25.0%, and 22.2%; [95% confidence interval (CI), (-55.1%, -11.6%), (-47.4%, -2.6%), and (-42.3%, -2.2%); P = 0.005, P = 0.034, and P = 0.035; respectively]. LKDs who received TEAS had better sleep quality and short-term recovery profiles than those in the control group. The plasma levels of 5-hydroxytryptamine (5-HT) and melatonin (MT) in the TEAS group were significantly higher than those in the control group at D1 and D2 (5-HT: P = 0.001, and P < 0.001; MT: P = 0.006, and P = 0.001). At the 3-month follow up, fewer LKDs in the TEAS group had incisional pain when compared to the control group (P = 0.032). Conclusions: Perioperative TEAS decreased perioperative anxiety and facilitated postoperative recovery in the LKDs, and potential decreased the development of chronic pain. Trial Registration: Registered at ChiCTR2000029891, http://www.chictr.org.cn/listbycreater.aspx.

[Contribution Analysis of External Source Pollution Load and Environmental Capacity Estimation of Reservoirs in Central Yunnan Plateau].

To explore the source of the pollution load and its contribution rate in the upper reaches of the plateau reservoir and to analyze the water environment capacity of the reservoir, we selected the Chaishitan Reservoir in the Yunnan Plateau as the research object, applied the pollutant discharge coefficient method to estimate the source of external pollution in the upstream basin of the reservoir, used the simultaneous monitoring data of hydrology and water quality to calculate pollution load into the reservoir, and used the eutrophication model to calculate the maximum capacity of TN and TP in the reservoir under different water quality target scenarios. The results showed that:① the main characteristic pollutants in Chaishitan Reservoir and the above basin were TN and TP. ② COD and TP in the upper reaches of the reservoir mainly came from rural non-point source pollution, with contribution rates of 49.40% and 50.11%, respectively; NH4+-N and TN mainly came from urban domestic pollution sources, with contribution rates of 45.76% and 33.77%, respectively. Among the contributions of rural non-point source pollution, the contribution rates of COD and TP in Luliang District were 34.82% and 36.82%, respectively. The contributions of COD, NH4+-N, TN, and TP to urban domestic pollution were the highest in Qilin District, all of which were up to 65%. ③ The inflows of COD, NH4+-N, TN, and TP were 28050.90, 2465.16, 4680.54, and 870.93 t·a-1, respectively. The inflow of TN and TP pollution load was 4637.80 t·a-1 and 125.04 t·a-1, respectively. ④ When the target of water quality was Class Ⅲ, and the requirements of the Water Function Zoning of Yunnan province were met, the environmental capacities of TN and TP were 1102.62 t·a-1 and 54.85 t·a-1, respectively. Rural non-point source pollution and urban domestic pollution sources were the main sources of pollution in the upper reaches of Chaishitan Reservoir, which were priority control sources. These research results can provide a scientific theoretical basis for pollution source treatment in the plateau reservoir basin.

Genome assembly of wild loquat (Eriobotrya japonica) and resequencing provide new insights into the genomic evolution and fruit domestication in loquat.

Wild loquats (Eriobotrya japonica Lindl.) provide remarkable genetic resources for studying domestication and breeding improved varieties. Herein, we generate the first high-quality chromosome-level genome assembly of wild loquat, with 45 791 predicted protein-coding genes. Analysis of comparative genomics indicated that loquat shares a common ancestor with apple and pear, and a recent whole-genome duplication event occurred in loquat prior to its divergence. Genome resequencing showed that the loquat germplasms can be distinctly classified into wild and cultivated groups, and the commercial cultivars have experienced allelic admixture. Compared with cultivated loquats, the wild loquat genome showed very few selected genomic regions and had higher levels of genetic diversity. However, whole-genome scans of selective sweeps were mainly related to fruit quality, size, and flesh color during the domestication process. Large-scale transcriptome and metabolome analyses were further performed to identify differentially expressed genes (DEGs) and differentially accumulated metabolites (DAMs) in wild and cultivated loquats at various fruit development stages. Unlike those in wild loquat, the key DEGs and DAMs involved in carbohydrate metabolism, plant hormone signal transduction, flavonoid biosynthesis, and carotenoid biosynthesis were significantly regulated in cultivated loquats during fruit development. These high-quality reference genome, resequencing, and large-scale transcriptome/metabolome data provide valuable resources for elucidating fruit domestication and molecular breeding in loquat.

Metasurfaces enabled polarization-multiplexing heralded single photon imaging.

Quantum imaging has non-negligible advantages in terms of sensitivity, signal-to-noise ratio, and novel imaging schemes. Based on metasurfaces, the information density and stability of the quantum imaging system can be further improved. Here we experimentally demonstrate that two patterns, simultaneously and independently superimposed on a high-efficiency dielectric metasurface, can be remotely switched via polarization-entangled photon pairs. Furthermore, using the time-correlated property of entangled photon pairs, the information carried by quantum light can be remarkably discriminated from background noise. This work confirms that the phase manipulation of quantum light with metasurfaces has a huge potential in the field of quantum imaging, quantum state tomography, and also promises real-world quantum metasurface devices.

Reversible lateral optical force on phase-gradient metasurfaces for full control of metavehicles.

Photonics is currently undergoing an era of miniaturization thanks in part to two-dimensional (2D) optical metasurfaces. Their ability to sculpt and redirect optical momentum can give rise to an optical force, which acts orthogonally to the direction of light propagation. Powered by a single unfocused light beam, these lateral optical forces (LOFs) can be used to drive advanced metavehicles and are controlled via the incident beam's polarization. However, the full control of a metavehicle on a 2D plane (i.e. forward, backward, left, and right) with a sign-switchable LOF remains a challenge. Here we present a phase-gradient metasurface route for achieving such full control while also increasing efficiency. The proposed metasurface is able to deflect a normally incident plane wave in a traverse direction by modulating the plane wave's polarization, and results in a sign-switchable recoil LOF. When applied to a metavehicle, this LOF enables a level of motion control that was previously unobtainable.

Enhanced MCM5 Level Predicts Bad Prognosis in Acute Myeloid Leukemia.

Acute myeloid leukemia (AML) is a fatal heterogeneous hematologic malignancy. There is an urgent need to identify potential biomarkers to better classify sufferers with bad outcomes that might need more advanced treatment. The objective of this study was to investigate prognostic indicators that predict the outcome of sufferers with AML. The datasets of AML sufferers including mRNA sequencing data and clinical information were acquired from GEO datasets (GSE38865) and TCGA datasets. Kaplan-Meier curves and Cox regression analysis to screen genes correlated to survival. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses biological process analysis were utilized in verifying the function of various genes. Sufferers with elevated MCM5 level exhibited a worse prognosis, according to the survival analysis. It was indicated through multivariate and univariate analysis that MCM5 level was an independent adverse prognostic element for over survival in AML sufferers based on GEO and TCGA datasets. Meanwhile, MCM5 level in AML samples was higher than in normal samples. Additionally, it was indicated through PPI network and functional enrichment analyses that through accelerating cell cycle and DNA replication, MCM5 promoted AML progression. In conclusions, MCM5 level was an independent poor prognostic element in AML sufferers based on GEO and TCGA datasets. This is the first time that MCM5 is reported to be a biomarker of poor prognosis in AML.

Research Progress on Bacterial Membrane Vesicles and Antibiotic Resistance.

As a result of antibiotic overuse, bacterial antibiotic resistance has become a severe threat to worldwide public health. The development of more effective antimicrobial therapies and alternative antibiotic strategies is urgently required. The role played by bacterial membrane vesicles (BMVs) in antibiotic resistance has become a current focus of research. BMVs are nanoparticles derived from the membrane components of Gram-negative and Gram-positive bacteria and contain diverse components originating from the cell envelope and cytoplasm. Antibiotic stress stimulates the secretion of BMVs. BMVs promote and mediate antibiotic resistance by multiple mechanisms. BMVs have been investigated as conceptually new antibiotics and drug-delivery vehicles. In this article, we outline the research related to BMVs and antibiotic resistance as a reference for the intentional use of BMVs to combat antibiotic resistance.

Versatile platform of nonlocal metasurfaces for both spectral and spatial control of light waves.

Multifunctional nonlocal metasurfaces based on quasi-bound states in the continuum are experimentally demonstrated, which shapes the wavefronts at the resonant wavelengths while have no effect on other wavelengths. By means of cascade and orthogonal perturbations, the nonlocal metasurface devices can be extended to a versatile platform with multifunction.

Bacterial outer membrane vesicles as a candidate tumor vaccine platform.

Cancer represents a serious concern for human life and health. Due to drug resistance and the easy metastasis of tumors, there is urgent need to develop new cancer treatment methods beyond the traditional radiotherapy, chemotherapy, and surgery. Bacterial outer membrane vesicles (OMVs) are a type of double-membrane vesicle secreted by Gram-negative bacteria in the process of growth and life, and play extremely important roles in the survival and invasion of those bacteria. In particular, OMVs contain a large number of immunogenic components associated with their parent bacterium, which can be used as vaccines, adjuvants, and vectors to treat diseases, especially in presenting tumor antigens or targeted therapy with small-molecule drugs. Some OMV-based vaccines are already on the market and have demonstrated good therapeutic effect on the corresponding diseases. OMV-based vaccines for cancer are also being studied, and some are already in clinical trials. This paper reviews bacterial outer membrane vesicles, their interaction with host cells, and their applications in tumor vaccines.

Class-specific diffractive cameras based on deep learning-designed surfaces.

Recently, a new diffractive camera design based on transmissive surfaces structured using deep learning is proposed. It performs class-specific imaging of target objects and all-optical deletion of other classes of objects, which will promote the development of privacy-preserving digital cameras and mission-specific data.

Perioperative Acupuncture Optimizes Surgical Outcomes: Theory, Clinical Practice and Future Perspectives.

A growing body of evidence supports the use of perioperative acupuncture as part of an enhanced postsurgical recovery protocol. Data from both clinical trials and animal studies has shown that the integration of acupuncture into perioperative patient care leads to a reduction of perioperative complications such as preoperative anxiety, intraoperative hemodynamic instability, postoperative pain, postoperative cognitive dysfunction, and postoperative nausea and vomiting in surgical patients. Despite these favorable outcomes, perioperative acupuncture has yet to be widely adopted in current anesthesia practice. This review summarized data from clinical perioperative acupuncture studies and cites recent discoveries regarding the anatomical location and characteristics of acupoint(s), acupuncture stimulation techniques, and treatment practice protocols, as well as identified the areas of deficiency in perioperative acupuncture applications. To facilitate acupuncture integration in perioperative care practice, the authors propose to establish a perioperative acupuncture registry which can be used for data mining as well as a resource for studying the underlying mechanisms of acupuncture. Through this acupuncture registry, clinical guidelines and research protocols can be established, additional large/multi-center clinical and pragmatic trials can be easily performed to determine if the integration and expansion of perioperative acupuncture practice is cost-effective.

Pixel-level Bayer-type colour router based on metasurfaces.

The three primary colour model, i.e., red, green, and blue model, based on the colour perception of the human eye, has been widely used in colour imaging. The most common approach for obtaining colour information is to use a Bayer colour filter, which filters colour light with four pixels of an imaging sensor to form an effective colour pixel. However, its energy utilization efficiency and colour collection efficiency are limited to a low level due to the three-channel filtering nature. Here, by employing an inverse-design method, we demonstrate a pixel-level metasurface-based Bayer-type colour router that presents peak colour collection efficiencies of 58%, 59%, and 49% for red, green and blue light, and an average energy utilization efficiency as high as 84% over the visible region (400 nm-700 nm), which is twice as high as that of a commercial Bayer colour filter. Furthermore, by using a 200 µm × 200 µm metasurface-based colour router sample working with a monochromatic imaging sensor, colour imaging is further realized, obtaining an image intensity twice that achieved by a commercial Bayer colour filter. Our work innovates the mechanism of high-efficiency spectrum information acquisition, which is expected to have promising applications in the development of next-generation imaging systems.

Developing and validating a prediction model for in-hospital mortality in patients with ventilator-associated pneumonia in the ICU.

BACKGROUND: Ventilator-associated pneumonia (VAP) is a common nosocomial infection in the intensive care unit (ICU), with high in-hospital mortality. Current scoring systems are limited in predicting nosocomial death of VAP. This study aimed to develop and validate a more accurate and effective prediction model for in-hospital mortality in ICU patients with VAP. METHODS: This was a retrospective cohort study. The demographic and clinical data of 8,182 adult patients with VAP were extracted from the Medical Information Mart for Intensive Care (MIMIC-III) database. All patients were randomly classified as a training set (n=4,629) and a test set (n=1,984) with a ratio of 7:3. The outcome was in-hospital mortality and the follow-up was terminated at discharge. Univariate and multivariate logistic regression analyses were used to identify the independent predictors and develop the prediction model in the training set, and internal validation was carried out in the test set. The receiver operating characteristic (ROC) curve and calibration curve were plotted to evaluate the performance of the model. RESULTS: Ethnicity, lung cancer history, septicemia history, hospital length of stay (LOS), fraction of inspired oxygen (FIO2) level, oxygen saturation (SPO2) level, Simplified Acute Physiology Score (SAPS II) score, Sequential Organ Failure Assessment (SOFA) score, and duration of invasive ventilation were all independently associated with the mortality of VAP. The algorithm of the prediction model was as follows: lnP/(1-P) = -0.700 + 0.493 Other Ethnicity + 0.789 Lung Cancer (Yes) + 0.693 Septicemia (Yes) - 0.074 Hospital LOS - 0.008 FIO2 - 0.032 SPO2 + 0.104 SOFA Score + 0.047 SAPS II + 0.004 Invasive Ventilation. The AUC was 0.837 in the training set and 0.817 in the test set, which indicated that the model performed well. The calibration curve also confirmed good calibration. CONCLUSIONS: A model with good performance was developed to predict the individual death risk of VAP patients in the ICU, which might have the potential to provide ancillary data to support decision-making by physicians. External validation requires further evaluation of the model performance.