Plant Growth-Promoting Rhizobacteria Are Key to Promoting the Growth and Furanocoumarin Synthesis of Angelica dahurica var. formosana under Low-Nitrogen Conditions.

Microbiomes are the most important members involved in the regulation of soil nitrogen metabolism. Beneficial interactions between plants and microbiomes contribute to improving the nitrogen utilization efficiency. In this study, we investigated the Apiaceae medicinal plant Angelica dahurica var. formosana. We found that under a low-nitrogen treatment, the abundance of carbon metabolites in the rhizosphere secretions of A. dahurica var. formosana significantly increased, thereby promoting the ratio of C to N in rhizosphere and nonrhizosphere soils, increasing carbon sequestration, and shaping the microbial community composition, thus promoting a higher yield and furanocoumarin synthesis. Confirmation through the construction of a synthetic microbial community and feedback experiments indicated that beneficial plant growth-promoting rhizobacteria play a crucial role in improving nitrogen utilization efficiency and selectively regulating the synthesis of target furanocoumarins under low nitrogen conditions. These findings may contribute additional theoretical evidence for understanding the mechanisms of interaction between medicinal plants and rhizosphere microorganisms.

Risk factors of high fluid absorption in patients treated with mini-PCNL: a single-center prospective study.

BACKGROUND: The factors influencing fluid absorption in mini-percutaneous nephrolithotripsy (mini-PCNL) are still unknown. We aim to investigate the factors that influence irrigation fluid absorption during mini-PCNL. METHODS: A total of 94 patients who underwent mini-PCNL were included in this prospective study. The endoscopic surgical monitoring system (ESMS) was used to measure the volume of irrigation fluid absorbed during the procedure. Irrigating time, the total volume of irrigation fluid, stone size, S.T.O.N.E. score, hemoglobin, electrolyte levels, and postoperative complications were recorded. RESULTS: A significant correlation was observed between fluid absorption and the presence of postoperative fever, and based on this phenomenon, patients were divided into low and high fluid absorption groups. The serum creatinine level in the high fluid absorption group was significantly high (7 vs. 16.5, p = 0.02). Significant differences were observed between the low and high fluid absorption groups in terms of mean stone size (21.70 mm vs. 26.78 mm), presence of stone burden ≥ 800 mm2 (4% vs. 23%), S.T.O.N.E. score > 8 (4% vs. 38%), the fluid used > 18,596 ml (19% vs. 78%), irrigation time (55.61 min vs. 91.28 min), and perfusion rate (24% vs. 45%) (all p < 0.05). The rates of postoperative fever and SIRS in the high fluid absorption group were significantly high (p < 0.05). CONCLUSIONS: Mean stone size, presence of stone burden ≥ 800 mm2, S.T.O.N.E. score > 8, the fluid used > 18596 mL, irrigation time, and perfusion rate are risk factors of intraoperative fluid absorption in mini-PCNL.

Transperitoneal vs retroperitoneal laparoscopic radical nephrectomy: a double-arm, parallel-group randomized clinical trial.

OBJECTIVE: To compare the outcomes of patients undergoing Retroperitoneal laparoscopic Radical nephrectomy (RLRN) and Transperitoneal laparoscopic Radical nephrectomy (TLRN). METHODS: A total of 120 patients with localized renal cell carcinoma were randomized into either RLRN or TLRN group. Mainly by comparing the patient perioperative related data, surgical specimen integrity, pathological results and tumor results. RESULTS: Each group comprised 60 patients. The two group were equivalent in terms of perioperative and pathological outcomes. The mean integrity score was significantly lower in the RLRN group than TLRN group. With a median follow-up of 36.4 months after the operation, Kaplan-Meier survival analysis showed no significant difference between RLRN and TLRN in overall survival (89.8% vs. 88.5%; P = 0.898), recurrence-free survival (77.9% vs. 87.7%; P = 0.180), and cancer-specific survival (91.4% vs. 98.3%; P = 0.153). In clinical T2 subgroup, the recurrence rate and recurrence-free survival in the RLRN group was significantly worse than that in the TLRN group (43.2% vs. 76.7%, P = 0.046). Univariate and multivariate COX regression analysis showed that RLRN (HR: 3.35; 95%CI: 1.12-10.03; P = 0.030), male (HR: 4.01; 95%CI: 1.07-14.99; P = 0.039) and tumor size (HR: 1.23; 95%CI: 1.01-1.51; P = 0.042) were independent risk factor for recurrence-free survival. CONCLUSIONS: Our study showed that although RLRN versus TLRN had roughly similar efficacy, TLRN outperformed RLRN in terms of surgical specimen integrity. TLRN was also significantly better than RLRN in controlling tumor recurrence for clinical T2 and above cases. TRIAL REGISTRATION: Chinese Clinical Trial Registry ( https://www.chictr.org.cn/showproj.html?proj=24400 ), identifier: ChiCTR1800014431, date: 13/01/2018.

Performance evaluation of quantitative material decomposition in slow kVp switching dual-energy CT.

BACKGROUND: Slow kVp switching technique is an important approach to realize dual-energy CT (DECT) imaging, but its performance has not been thoroughly investigated yet. OBJECTIVE: This study aims at comparing and evaluating the DECT imaging performance of different slow kVp switching protocols, and thus helps determining the optimal system settings. METHODS: To investigate the impact of energy separation, two different beam filtration schemes are compared: the stationary beam filtration and dynamic beam filtration. Moreover, uniform tube voltage modulation and weighted tube voltage modulation are compared along with various modulation frequencies. A model-based direct decomposition algorithm is employed to generate the water and iodine material bases. Both numerical and physical experiments are conducted to verify the slow kVp switching DECT imaging performance. RESULTS: Numerical and experimental results demonstrate that the material decomposition is less sensitive to beam filtration, voltage modulation type and modulation frequency. As a result, robust material-specific quantitative decomposition can be achieved in slow kVp switching DECT imaging. CONCLUSIONS: Quantitative DECT imaging can be implemented with slow kVp switching under a variety of system settings.

Transferring U-Net between low-dose CT denoising tasks: a validation study with varied spatial resolutions.

Background: Recently, deep learning techniques have been widely used in low-dose computed tomography (LDCT) imaging applications for quickly generating high quality computed tomography (CT) images at lower radiation dose levels. The purpose of this study is to validate the reproducibility of the denoising performance of a given network that has been trained in advance across varied LDCT image datasets that are acquired from different imaging systems with different spatial resolutions. Methods: Specifically, LDCT images with comparable noise levels but having different spatial resolutions were prepared to train the U-Net. The number of CT images used for the network training, validation and test was 2,400, 300 and 300, respectively. Afterwards, self- and cross-validations among six selected spatial resolutions (62.5, 125, 250, 375, 500, 625 µm) were studied and compared side by side. The residual variance, peak signal to noise ratio (PSNR), normalized root mean square error (NRMSE) and structural similarity (SSIM) were measured and compared. In addition, network retraining on a small number of image set was performed to fine tune the performance of transfer learning among LDCT tasks with varied spatial resolutions. Results: Results demonstrated that the U-Net trained upon LDCT images having a certain spatial resolution can effectively reduce the noise of the other LDCT images having different spatial resolutions. Regardless, results showed that image artifacts would be generated during the above cross validations. For instance, noticeable residual artifacts were presented at the margin and central areas of the object as the resolution inconsistency increased. The retraining results showed that the artifacts caused by the resolution mismatch can be greatly reduced by utilizing about only 20% of the original training data size. This quantitative improvement led to a reduction in the NRMSE from 0.1898 to 0.1263 and an increase in the SSIM from 0.7558 to 0.8036. Conclusions: In conclusion, artifacts would be generated when transferring the U-Net to a LDCT denoising task with different spatial resolution. To maintain the denoising performance, it is recommended to retrain the U-Net with a small amount of datasets having the same target spatial resolution.

Binary All-polymer Solar Cells with a Perhalogenated-Thiophene-Based Solid Additive Surpass 18 % Efficiency.

Morphological control of all-polymer blends is quintessential yet challenging in fabricating high-performance organic solar cells. Recently, solid additives (SAs) have been approved to be capable in tuning the morphology of polymer: small-molecule blends improving the performance and stability of devices. Herein, three perhalogenated thiophenes, which are 3,4-dibromo-2,5-diiodothiophene (SA-T1), 2,5-dibromo-3,4-diiodothiophene (SA-T2), and 2,3-dibromo-4,5-diiodothiophene (SA-T3), were adopted as SAs to optimize the performance of all-polymer organic solar cells (APSCs). For the blend of PM6 and PY-IT, benefitting from the intermolecular interactions between perhalogenated thiophenes and polymers, the molecular packing properties could be finely regulated after introducing these SAs. In situ UV/Vis measurement revealed that these SAs could assist morphological character evolution in the all-polymer blend, leading to their optimal morphologies. Compared to the as-cast device of PM6 : PY-IT, all SA-treated binary devices displayed enhanced power conversion efficiencies of 17.4-18.3 % with obviously elevated short-circuit current densities and fill factors. To our knowledge, the PCE of 18.3 % for SA-T1-treated binary ranks the highest among all binary APSCs to date. Meanwhile, the universality of SA-T1 in other all-polymer blends is demonstrated with unanimously improved device performance. This work provide a new pathway in realizing high-performance APSCs.

Perioperative outcomes and continence following robotic-assisted radical cystectomy with mainz pouch II urinary diversion in patients with bladder cancer.

PURPOSE: To present the widely unknown perioperative outcomes and continence status of bladder cancer patients following robotic-assisted radical cystectomy (RARC) with Mainz pouch II urinary diversion (UD). MATERIALS AND METHODS: From November 2020 to December 2023, 37 bladder cancer patients who underwent RARC with Mainz pouch II UD were retrospectively assessed (ChiCTR2300070279). The results, which included patient demographics, perioperative data, continence, and complications (early ≤ 30 days and late ≤ 30 days) were reported using the RC-pentafecta criteria. RC-pentafecta criteria included ≥ 16 lymph nodes removed, negative soft tissue surgical margins, absence of major (Grade III-IV) complication at 90 days, absence of clinical recurrence at ≤ 12 months, and absence of long-term UD-related sequelae. A numeric rating scale assessed patient satisfaction with urinary continence 30 days after surgery. The validated Patient Assessment of Constipation Symptoms (PAC-SYM) questionnaire was used to evaluate bowel function. The Kaplan-Meier curve was used to evaluate overall survival (OS). RESULTS: Of the 37 patients evaluated over a median (range) follow-up period of 23.0 (12.0-36.5) months. The median (range) age was 65 (40-81) years. The median (range) time to urinary continence after surgery was 2.3 (1.5-6) months. Of the 37 patients, 31 (83.8%) were continent both during the day and at night, 34 (91.9%) were continent during the day, 32 (86.5%) were continent at night, 35 (94.6%) were satisfied with their urinary continence status, and 21 (56.8%) were very satisfied. The mean (range) voiding frequency was 6 (4-10) during the day and 3 (2-5.5) at night. The mean (range) PAC-SYM total score was 9.50 (4.00-15.00). In 12 (32.4%) of the patients, RC-pentafecta was achieved, and achieving RC-pentafecta was linked to better satisfaction scores (7.3 vs. 5.5, p = 0.034). There was no significant difference between RC-pentafecta and No RC-pentafecta groups in terms of OS (25.6 vs. 21.5 months, p = 0.16). 7 (19.4%) patients experienced late complications. CONCLUSIONS: Mainz pouch II UD following RARC in bladder cancer patients results in a satisfactory continence rate. Achieving RC-pentafecta was correlated with better satisfaction scores. The intracorporeal approach to Mainz pouch II UD is beneficial for female patients due to its reduced invasiveness. TRIAL REGISTRATION: ChiCTR2300070279; Registration: 07/04/2023, Last updated version: 01/06/2023. Retrospectively registered.

Effects of elevated carbon dioxide on plant growth and leaf photosynthesis of annual ryegrass along a phosphorus deficiency gradient.

Introduction: Soil phosphorus (P) deficiency limits plant growth and productivity in grassland ecosystems and may moderate the growth-promoting effects of "carbon dioxide (CO2) fertilization effect". Methods: To evaluate the interactive effects of these two factors on the growth and physiology for annual ryegrass (Lolium multiflorum Lam.), plants were grown in controlled growth chambers with a range of P supply (0.004, 0.012, 0.02, 0.06, 0.1 and 0.5 mM) under two levels of CO2 (400 and 800 µmol mol-1, respectively). Results: Elevated [CO2] dramatically increased the aboveground biomass and net photosynthetic rates of annual ryegrass by 14.5% and 25.3% under sufficient P supply (0.5 mM), respectively, whereas decreased the belowground biomass and net photosynthetic rates under lower P supply of P0.004, P0.02, and P0.06. Two-way ANOVA results showed that CO2 × P (p < 0.001) significantly affected stomatal traits, leaf photosynthesis and biomass. The stimulation of growth and photosynthesis by elevated CO2 concentration (e[CO2]) was reduced or highly suppressed, indicating that the sensitivity of annual ryegrass to P deficiency was enhanced under e[CO2]. Discussion: These results indicated that P limitation may offset the positive effects of e[CO2] on plant growth by altering stomatal traits, leaf photochemical processes and biochemical composition in annual ryegrass.

Central unit hetero-di-halogenation of acceptors enables organic solar cells with 19% efficiency.

Although peripheral hetero-di-halogenation of non-fullerene acceptors (NFAs) would allow more precise optimization of molecular properties by providing the complementary advantages of two different halogens, thus enabling further improvements of organic solar cells (OSCs), hetero-di-halogenated NFAs are seldom prepared due to the challenging construction of building blocks with two adjacent hetero-halogens. Herein, three CH-series acceptors with hetero-di-halogenated central units, named CH-FC, CH-FB and CH-CB, are constructed successfully. PM6:D18:CH-FB-based OSCs afforded an attractive PCE of 19.0% due to tighter intermolecular packing at both the single-crystal and blended-film levels, more efficient charge transfer/dissociation, and superior film morphology compared to those of PM6:D18:CH-FC (PCE 18.41%) and PM6:D18:CH-CB (PCE 18.21%). Our work highlights the effectiveness of such a CH-series molecular platform in conducting hetero-di-halogenation and achieving high-performance OSCs, and will stimulate further exploration of hetero-substitution-based acceptors.

Chiral Hybrid Germanium(II) Halide with Strong Nonlinear Chiroptical Properties.

Due to the pronounced anisotropic response to circularly polarized light, chiral hybrid organic-inorganic metal halides have been regarded as promising candidates for the application in nonlinear chiroptics, especially for the second-harmonic generation circular dichroism (SHG-CD) effect. However, designing novel lead-free chiral hybrid metal halides with large anisotropy factors and high laser-induced damage thresholds (LDT) of SHG-CD remains challenging. Herein, we develop the first chiral hybrid germanium halide, (R/S-NEA)3 Ge2 I7 ⋅H2 O (R/S-NGI), and systematically investigated its linear and nonlinear chiroptical properties. S-NGI and R-NGI exhibit large anisotropy factors (gSHG-CD ) of 0.45 and 0.48, respectively, along with a high LDT of 38.46 GW/cm2 ; these anisotropy factors were the highest values among the reported lead-free chiral hybrid metal halides. Moreover, the effective second-order nonlinear optical coefficient of S-NGI could reach up to 0.86 pm/V, which was 2.9 times higher than that of commercial Y-cut quartz. Our findings facilitate a new avenue toward lead-free chiral hybrid metal halides, and their implementation in nonlinear chiroptical applications.

A rare case of brominated small molecule acceptors for high-efficiency organic solar cells.

Given that bromine possesses similar properties but extra merits of easily synthesizing and polarizing comparing to homomorphic fluorine and chlorine, it is quite surprising very rare high-performance brominated small molecule acceptors have been reported. This may be caused by undesirable film morphologies stemming from relatively larger steric hindrance and excessive crystallinity of bromides. To maximize the advantages of bromides while circumventing weaknesses, three acceptors (CH20, CH21 and CH22) are constructed with stepwise brominating on central units rather than conventional end groups, thus enhancing intermolecular packing, crystallinity and dielectric constant of them without damaging the favorable intermolecular packing through end groups. Consequently, PM6:CH22-based binary organic solar cells render the highest efficiency of 19.06% for brominated acceptors, more excitingly, a record-breaking efficiency of 15.70% when further thickening active layers to ~500 nm. By exhibiting such a rare high-performance brominated acceptor, our work highlights the great potential for achieving record-breaking organic solar cells through delicately brominating.

Are high-risk heavy metal(loid)s contaminated vegetables detrimental to human health? A study of incorporating bioaccessibility and toxicity into accurate health risk assessment.

Heavy metal(loid)s in the environment threaten food safety and human health. Health risk assessment of vegetables based on total or bioaccessible heavy metal(loid)s was widely used but can overestimate their risks, so exploring accurate methods is urgent for food safety evaluation and management. In this study, a total of 224 frequently consumed vegetables and their corresponding grown soils were collected from Yunnan, Southwest China. The total contents and bioaccessibilities of heavy metal(loid)s in vegetables were measured, their health risks were evaluated using the non-carcinogenic and carcinogenic risk models provided by USEPA. Besides, the gastrotoxicity of high-risk vegetables was also evaluated using a human cell model. Results showed that 6.25-43.8 % of Cr, Cd, and Pb contents in Zea mays L., Coriandrum sativum L., or Allium sativum L. exceeded the maximum permissible level of China, which were not consistent with those in corresponding soils. The bioaccessibility of Cr, Cd, As, Pb, Cu, Zn, Ni, and Mn in vegetables in the gastric phase was 0.41-93.8 %. Health risks based on bioaccessibility were remarkably decreased compared with total heavy metal(loid)s, but the unacceptable carcinogenic risk (CR > 10-4) was found even considering the bioaccessibility. Interestingly, gastric digesta of high-risk vegetables did not trigger adverse effects on human gastric mucosa epithelial cells, indicating existing health risk assessment model should be adjusted by toxic data to accurately reflect its hazards. Taken together, both bioaccessibility and toxicity of heavy metal(loid)s in vegetables should be considered in accurate health risk assessment and food safety-related policy-making and management.

Removal of inferior vena cava filter by open surgery after failure of endovenous retrieval.

Background: The permanent placement of inferior vena cava (IVC) filters may lead to numerous complications and their removal is recommended once the risk of pulmonary embolism is reduced. Removal of IVC filters by endovenous means is preferred. But failure of endovenous removal happens when recycling hooks penetrate the vein wall and filters are left in place for too long time. In these scenarios, open surgery may be effective for removal of IVC filters. We aimed to describe the surgical approach, outcomes, and 6-month follow-up of the removal of IVC filter by open surgery, after the failure of removal via the endovenous method. Methods: A total of 1,285 patients with retrievable IVC filters were admitted from July 2019 to June 2021, including 1,176 (91.5%) endovenous filter removals, and 24 (1.9%) open surgical IVC filter removals after the failure by endovenous method, of whom 21 (1.6%) were followed-up and eligible for analysis of the study. Patient characteristics, filter type, filter removal rate, IVC patency rate, and complications were retrospectively analyzed. Results: Twenty-one patients were left with IVC filters for 26 (10, 37) months, of which 17 (81.0%) patients had non-conical filters and 4 (19.0%) had conical filters; all 21 filters were successfully removed, with a 100% removal rate, no deaths, no serious complications, and no symptomatic pulmonary embolism. At the 3rd month follow-up after surgery and 3rd month follow-up after discontinuation of anticoagulation therapy, only 1 case (4.8%) had IVC occlusion, but without any occurrence of new lower limb deep venous thrombosis and silent pulmonary embolism. Conclusion: Open surgery can be used for the removal of IVC filters after failure of removal by endovenous method or when accompanied by complications without symptoms of pulmonary embolism. Open surgical approach can be used as an adjunctive clinical intervention for the removal of such filters.

An improved approach for calculating energy landscape of gene networks from moment equations.

The energy landscape theory has widely been applied to study the stochastic dynamics of biological systems. Different methods have been developed to quantify the energy landscape for gene networks, e.g., using Gaussian approximation (GA) approach to calculate the landscape by solving the diffusion equation approximately from the first two moments. However, how high-order moments influence the landscape construction remains to be elucidated. Also, multistability exists extensively in biological networks. So, how to quantify the landscape for a multistable dynamical system accurately, is a paramount problem. In this work, we prove that the weighted summation from GA (WSGA), provides an effective way to calculate the landscape for multistable systems and limit cycle systems. Meanwhile, we proposed an extended Gaussian approximation (EGA) approach by considering the effects of the third moments, which provides a more accurate way to obtain probability distribution and corresponding landscape. By applying our generalized EGA approach to two specific biological systems: multistable genetic circuit and synthetic oscillatory network, we compared EGA with WSGA by calculating the KL divergence of the probability distribution between these two approaches and simulations, which demonstrated that the EGA provides a more accurate approach to calculate the energy landscape.

Attention-based dual-branch deep network for sparse-view computed tomography image reconstruction.

Background: The widespread application of X-ray computed tomography (CT) imaging in medical screening makes radiation safety a major concern for public health. Sparse-view CT is a promising solution to reduce the radiation dose. However, the reconstructed CT images obtained using sparse-view CT may suffer severe streaking artifacts and structural information loss. Methods: In this study, a novel attention-based dual-branch network (ADB-Net) is proposed to solve the ill-posed problem of sparse-view CT image reconstruction. In this network, downsampled sinogram input is processed through 2 parallel branches (CT branch and signogram branch) of the ADB-Net to independently extract the distinct, high-level feature maps. These feature maps are fused in a specified attention module from 3 perspectives (channel, plane, and spatial) to allow complementary optimizations that can mitigate the streaking artifacts and the structure loss in sparse-view CT imaging. Results: Numerical simulations, an anthropomorphic thorax phantom, and in vivo preclinical experiments were conducted to verify the sparse-view CT imaging performance of the ADB-Net. The proposed network achieved a root-mean-square error (RMSE) of 20.6160, a structural similarity (SSIM) of 0.9257, and a peak signal-to-noise ratio (PSNR) of 38.8246 on numerical data. The visualization results demonstrate that this newly developed network can consistently remove the streaking artifacts while maintaining the fine structures. Conclusions: The proposed attention-based dual-branch deep network, ADB-Net, provides a promising alternative to reconstruct high-quality sparse-view CT images for low-dose CT imaging.

Highly Efficient and Stable FA-Based Quasi-2D Ruddlesden-Popper Perovskite Solar Cells by the Incorporation of ß-Fluorophenylethanamine Cations.

2D Ruddlesden-Popper (2D RP) perovskite, with attractive environmental and structural stability, has shown great application in perovskite solar cells (PSCs). However, the relatively inferior photovoltaic efficiencies of 2D PSCs limit their further application. To address this issue, ß-​fluorophenylethanamine (ß-​FPEA) as a novel spacer cation is designed and employed to develop stable and efficient quasi-2D RP PSCs. The strong dipole moment of the ß-​FPEA enhances the interactions between the cations and [PbI6 ]4- octahedra, thus improving the charge dissociation of quasi-2D RP perovskite. Additionally, the introduction of the ß-​FPEA cation optimizes the energy level alignment, improves the crystallinity, stabilizes both the mixed phase and a-FAPbI3 phase of the quasi-2D RP perovskite film, prolongs the carrier diffusion length, increases the carrier lifetime and decreases the trap density. By incorporating the ß-​FPEA, the quasi-2D RP PSCs exhibit a power conversion efficiency (PCE) of 16.77% (vs phenylethylammonium (PEA)-based quasi-2D RP PSCs of 12.81%) on PEDOT:PSS substrate and achieve a champion PCE of 19.11% on the PTAA substrate. It is worth noting that the unencapsulated ß-​FPEA-based quasi-2D RP PSCs exhibit considerably improved thermal and moisture stability. These findings provide an effective strategy for developing novel spacer cations for high-performance 2D RP PSCs.

Clinical outcomes of AngioJet pharmacomechanical thrombectomy versus catheter-directed thrombolysis for the treatment of filter-related caval thrombosis.

BACKGROUND: The inferior vena cava filter is utilized worldwide to intercept thrombi and to reduce the risk of fatal pulmonary embolism (PE). However, filter-related thrombosis is a complication of filter implantation. Endovascular methods such as AngioJet rheolytic thrombectomy (ART) and catheter-directed thrombolysis (CDT) can treat filter-related caval thrombosis, but the clinical outcomes of both treatment modalities have not been determined. AIM: To compare the treatment outcomes of AngioJet rheolytic thrombectomy vs catheter-directed thrombolysis in patients with filter-related caval thrombosis. METHODS: In this single-center retrospective study, 65 patients (34 males and 31 females; mean age: 59.0 ± 13.43 years) with intrafilter and inferior vena cava thrombosis were enrolled between January 2021 and August 2022. These patients were assigned to either the AngioJet group (n = 44) or the CDT group (n = 21). Clinical data and imaging information were collected. Evaluation measures included thrombus clearance rate, periprocedural complications, urokinase dosage, incidence of PE, limb circumference difference, length of stay, and filter removal rate. RESULTS: Technical success rates were 100% in the AngioJet and CDT groups. In the AngioJet group, grade II and grade III thrombus clearance was achieved in 26 (59.09%) and 14 (31.82%) patients, respectively. In the CDT group, grade II and grade III thrombus clearance was accomplished in 11 (52.38%) patients and 8 (38.10%) patients, respectively (P > 0.05).The peridiameter difference of the thigh was significantly reduced in patients from both groups after treatment (P < 0.05). The median dosage of urokinase was 0.08 (0.02, 0.25) million U in the AngioJet group and 1.50 (1.17, 1.83) million U in the CDT group (P < 0.05). Minor bleeding was shown in 4 (19.05%) patients in the CDT group, and when it was compared with that in the AngioJet group, the difference was statistically significant (P < 0.05). No major bleeding occurred. Seven (15.91%) patients in the AngioJet group had hemoglobinuria and 1 (4.76%) patient in the CDT group had bacteremia. There were 8 (18.18%) patients with PE in the AngioJet group and 4 (19.05%) patients in the CDT group before the intervention (P > 0.05). Computed tomography angiopulmonography (CTA) showed that PE was resolved after the intervention. New PE occurred in 4 (9.09%) patients in the AngioJet group and in 2 (9.52%) patients in the CDT group after theintervention (P > 0.05). These cases of PE were asymptomatic. The mean length of stay was longer in the CDT group (11.67 ± 5.34 d) than in the AngioJet group (10.64 ± 3.52 d) (P < 0.05). The filter was successfully retrieved in the first phase in 10 (47.62%) patients in the CDT group and in 15 (34.09%) patients in the AngioJet group (P > 0.05).Cumulative removal was accomplished in 17 (80.95%) out of 21 patients in the CDT group and in 42 (95.45%) out of 44 patients in the ART group (P > 0.05). The median indwelling time for patients with successful retrieval was 16 (13139) d in the CDT group and 59 (12231) d in the ART group (P > 0.05). CONCLUSION: Compared with catheter-directed thrombolysis, AngioJet rheolytic thrombectomy can achieve similar thrombus clearance effects, improve the filter retrieval rate, reduce the urokinase dosage and lower the risk of bleeding events in patients with filter-related caval thrombosis.

Is Anti-Reflux Anastomosis an Advantage in an Orthotopic Ileal Neobladder? A Systematic Review and Meta-Analysis.

INTRODUCTION: We conducted a systematic review and meta-analysis to assess the available literature regarding the postoperative effects of anti-reflux anastomosis and direct anastomosis in orthotopic ileal neobladder (ONB). METHODS: We searched PubMed, Embase, and the Cochrane Library in October 2021. We included 11 studies of patients with bladder cancer who underwent radical cystectomy and ONB as urinary diversion. Outcomes evaluated in this review were ureteroenteric anastomotic stricture (UEAS), vesicoureteral reflux, renal function (RFn) impairment, and pyelonephritis. All data were analyzed using Review Manager 5.4.4 and subgroup analyses were applied. RESULTS: A total of 11 studies were eligible for meta-analysis. The synthetic data suggested that anti-reflux anastomosis and direct anastomosis were comparable in terms of RFn impairment (odds ratio (OR) = 1.69; 95% confidence interval (CI): 0.18-15.6; p = 0.65, I2 = 69%) and pyelonephritis (OR = 1.13; 95% CI: 0.65-1.99; p = 0.66, I2 = 1%) without significant difference in each group statistically. The pooled study data showed a significantly higher incidence of UEAS (OR = 2.84; 95% CI: 1.75-4.61, p < 0.0001, I2 = 50%) and a lower incidence of vesicoureteral reflux (OR = 0.24; 95% CI: 0.10-0.59; p = 0.002, I2 = 75%) in anti-reflux anastomosis compared to direct anastomosis. In subgroup analysis, anti-reflux anastomosis was more likely to result in UEAS than direct anastomosis, especially when ureteral stent was removed within 14 days. CONCLUSION: Although meta-analysis showed that overall incidence of vesicoureteral reflux was higher with direct anastomosis than anti-reflux anastomosis, the rate of vesicoureteral reflux was not directly related to impairment of RFn. The anti-reflux mechanism of ONB was positively associated with a higher incidence of significant UEAS compared to the direct approach, which can lead to kidney damage and an increased risk of secondary surgical procedures.

Probiotics for functional constipation in children: an overview of overlapping systematic reviews.

Background: This overview of systematic reviews (SRs) and meta-analysis (MAs) aimed to systematically collate, appraise and synthesize evidence of probiotics for functional constipation (FC) in children. Methods: SRs/MAs of probiotics for FC in children were systematic identified by searching Cochrane Library, PubMed, Embase, and Web of science. Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) were unitized by two reviewers independently to assess the methodological quality, reporting quality, and quality of evidence, respectively. Results: Seven SRs/MAs met the eligibility criteria and were included in this study. According to AMSTAR-2, a very low methodological quality assessment was given to the included SRs/MAs due to the limitations of items 2, 4 and 7. For the PRISMA statement, the overall quality of reporting was unsatisfactory due to the lack of reporting on protocol, risk of bias across studies, synthesis of results, and additional analysis. According to GRADE, the quality of evidence for outcomes was rated as very low to moderate. Conclusions: Probiotics may be beneficial in improving FC in children. Because of limitations and inconsistent conclusions, further rigorous, normative and comprehensive SRs/MAs are needed to provide robust evidence for definitive conclusions.

Downregulation of hsa-miR-135b-5p Inhibits Cell Proliferation, Migration, and Invasion in Colon Adenocarcinoma.

Colon cancer is the most common malignant tumor of the gastrointestinal tract, and approximately 80%-90% of colon cancers are colon adenocarcinomas (COADs). This study aimed to screen key microRNAs (miRNAs) associated with COAD. Differentially expressed (DE) miRNAs were screened between COAD and adjacent cancer samples based on the Gene Expression Omnibus (GEO) and the Cancer Genome Atlas obtained from datasets. The miRNAs of interest were validated using quantitative real-time polymerase chain reaction. Moreover, the effects of hsa-miR-135b-5p on the biological behavior of COAD cells were observed. To obtain the target genes of hsa-miR-135b-5p, transcriptome sequencing of the SW480 cells was performed, followed by protein-protein interaction (PPI) network and hsa-miR-135b-5p-target gene regulatory network construction and prognostic analysis. Downregulation of hsa-miR-135b-5p significantly inhibited SW480 cell proliferation, migration, and invasion and significantly facilitated apoptosis (P < 0.05). A total of 3384 DEmRNAs were screened, and enrichment analysis showed that the upregulated mRNAs were enriched in 25 Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways and 326 Gene Ontology Biological Processes (GO-BPs) while the downregulated mRNAs were enriched in 20 KEGG pathways and 276 GO-BPs. A PPI network was then constructed, and H2BC14, H2BC3, and H4C11 had a higher degree. In addition, a total of 352 hsa-miR-135b-5p-gene regulatory relationships were identified. Prognostic analysis showed that FOXN2, NSA2, MYCBP, DIRAS2, DESI1, and RAB33B had prognostic significance (P < 0.05). In addition, the validation analysis results showed that FOXN2, NSA2, and DESI1 were significantly expressed between the miR-135b-5p-inhibitor and negative control groups (P < 0.05). Therefore, downregulation of hsa-miR-135b-5p inhibits cell proliferation, migration, and invasion in COAD, and carcinogenesis may function by targeting FOXN2, NSA2, MYCBP, DIRAS2, DESI1, and RAB33B.