The outcomes of aortic arch repair between open surgical repair and debranching endovascular hybrid surgical repair: a systematic review and meta-analysis.

BACKGROUND: At present, open surgical aortic arch repair (OAR) and debranching hybrid surgical aortic arch repair (HAR) serve as significant therapeutic approaches for aortic arch aneurysm or dissection. It remains unclear which technique is preferable. Our study aimed to compare the short-term and long-term outcomes of these two procedures. METHODS: To identify comparison studies of debranching HAR and OAR, a systematic search of the PubMed, Embase, Web of Science, and Cochrane Library databases was performed from January 2002 to April 2022. This study was registered on PROSPERO (CRD42020218080). RESULTS: Sixteen publications (1316 patients), including six propensity score-matching (PSM) analysis papers, were included in this study. Compared with the HAR group, the patients who underwent OAR were younger (OAR vs HAR: 67.53 ± 12.81 vs 71.29 ± 11.0; P < .00001), had less coronary artery disease (OAR vs HAR: 22.45% vs 32.6%; P = .007), less chronic obstructive pulmonary disease (OAR vs HAR: 16.16% vs 23.92%; P = .001), lower rates of previous stroke (OAR vs HAR: 12.46% vs 18.02%; P = .05), and a lower EuroSCORE (European System for Cardiac Operative Risk Evaluation) score (OAR vs HAR: 6.27 ± 1.04 vs 6.9 ± 3.76; P < .00001). HAR was associated with less postoperative blood transfusion (OAR vs HAR: 12.23% vs 7.91%; P = .04), shorter length of intensive care unit stays (OAR vs HAR: 5.92 ± 7.58 days vs 4.02 ± 6.60 days; P < .00001) and hospital stays (OAR vs HAR: 21.59 ± 17.54 days vs 16.49 ± 18.45 days; P < .0001), lower incidence of reoperation for bleeding complications (OAR vs HAR: 8.07% vs 3.96%; P = .01), fewer postoperative pulmonary complication (OAR vs HAR: 14.75% vs 5.02%; P < .0001), and acute renal failure (OAR vs HAR: 7.54% vs 5.17%; P = .03). In the PSM subgroup, the rates of spinal cord ischemic (OAR vs HAR: 5.75% vs 11.49%; P = .02), stroke (OAR vs HAR: 5.1% vs 17.35%; P = .01), and permanent paraplegia (OAR vs HAR: 2.79% vs 6.08%; P = .006) were lower in the OAR group than that in the HAR group. Although there was no statistically significant difference in 1-year survival rates (HAR vs OAR: hazard ratio [HR]: 1.54; P = .10), the 3-year and 5-year survivals were significantly higher in the OAR group than that in the HAR group (HAR vs OAR: HR: 1.69; P = .01; HAR vs OAR: HR: 1.68; P = .01). In the PSM subgroup, the OAR group was also significantly superior to the HAR group in terms of 3-year and 5-year survivals (HAR vs OAR: HR: 1.73; P = .04; HAR vs OAR: HR: 1.67; P = .04). The reintervention rate in the HAR group was significantly higher than that in the OAR group (OAR vs HAR: 8.24% vs 16.01%; P = .01). The most common reintervention was postoperative bleeding (8.07%) in the OAR group and endoleak (9.67%) in the HAR group. CONCLUSIONS: Our meta-analysis revealed that debranching HAR was associated with fewer perioperative complications than the OAR group, except for postoperative permanent paraplegia, reintervention, and stroke events. The OAR group demonstrated better 3-year and 5-year survivals than the debranching HAR group. However, patients in the OAR group had fewer comorbid factors and were younger than those in the HAR group. High-quality studies and well-powered randomized trials are needed to further evaluate this evolving field.

Synthesis of Free-Standing Pd-Ni-P Metallic Glass Nanoparticles with Durable Medium-Range Ordered Structure for Enhanced Electrocatalytic Properties.

Topologically disordered metallic glass nanoparticles (MGNPs) with highly active and tailorable surface chemistries have immense potential for functional uses. The synthesis of free-standing MGNPs is crucial and intensively pursued because their activity strongly depends on their exposed surfaces. Herein, a novel laser-evaporated inert-gas condensation method is designed and successfully developed for synthesizing free-standing MGNPs without substrates or capping agents, which is implemented via pulse laser-induced atomic vapor deposition under an inert helium atmosphere. In this way, the metallic atoms vaporized from the targets collide with helium atoms and then condense into short-range-order (SRO) clusters, which mutually assemble to form the MGNPs. Using this method, free-standing Pd40 Ni40 P20 MGNPs with a spherical morphology are synthesized, which demonstrates satisfactory electrocatalytic activity and durability in oxygen reduction reactions. Moreover, local structure investigations using synchrotron pair distribution function techniques reveal the transformation of SRO cluster connection motifs of the MGNPs from face-sharing to edge-sharing modes during cyclic voltammetry cycles, which enhances the electrochemical stability by blocking crystallization. This approach provides a general strategy for preparing free-standing MGNPs with high surface activities, which may have widespread functional applications.

SNS-023 sensitizes hepatocellular carcinoma to sorafenib by inducing degradation of cancer drivers SIX1 and RPS16.

Hepatocellular carcinoma (HCC) remains challenging due to the lack of efficient therapy. Promoting degradation of certain cancer drivers has become an innovative therapy. The nuclear transcription factor sine oculis homeobox 1 (SIX1) is a key driver for the progression of HCC. Here, we explored the molecular mechanisms of ubiquitination of SIX1 and whether targeting SIX1 degradation might represent a potential strategy for HCC therapy. Through detecting the ubiquitination level of SIX1 in clinical HCC tissues and analyzing TCGA and GEPIA databases, we found that ubiquitin specific peptidase 1 (USP1), a deubiquitinating enzyme, contributed to the lower ubiquitination and high protein level of SIX1 in HCC tissues. In HepG2 and Hep3B cells, activation of EGFR-AKT signaling pathway promoted the expression of USP1 and the stability of its substrates, including SIX1 and ribosomal protein S16 (RPS16). In contrast, suppression of EGFR with gefitinib or knockdown of USP1 restrained EGF-elevated levels of SIX1 and RPS16. We further revealed that SNS-023 (formerly known as BMS-387032) induced degradation of SIX1 and RPS16, whereas this process was reversed by reactivation of EGFR-AKT pathway or overexpression of USP1. Consequently, inactivation of the EGFR-AKT-USP1 axis with SNS-032 led to cell cycle arrest, apoptosis, and suppression of cell proliferation and migration in HCC. Moreover, we showed that sorafenib combined with SNS-032 or gefitinib synergistically inhibited the growth of Hep3B xenografts in vivo. Overall, we identify that both SIX1 and RPS16 are crucial substrates for the EGFR-AKT-USP1 axis-driven growth of HCC, suggesting a potential anti-HCC strategy from a novel perspective.

Layer contribution to optical signals of van der Waals heterostructures.

The optical signals (such as Raman scattering, absorption, reflection) of van der Waals heterostructures (vdWHs) are very important for structural analysis and the application of optoelectronic devices. However, there is still a lack of research on the effect of each layer of two-dimensional materials on the optical signals of vdWHs. Here, we investigated the contribution from different layers to the optical signal of vdWHs by using angle-resolved polarized Raman spectroscopy (ARPRS) and angle-dependent reflection spectroscopy. A suitable theoretical model for the optical signal of vdWHs generated by different layers was developed, and vdWHs stacked by different two-dimensional (2D) materials were analyzed. The results revealed a strong dependence of the relative strengths of the optical signals of the upper and lower layers on the thicknesses of 2D materials and the SiO2 layer on the Si/SiO2 substrate. Interestingly, on the 285 nm SiO2/Si substrate, the contribution to the optical signal by the underlying 2D material was much greater than that by the upper layer. Furthermore, optical signals originating from different layers of twisted black phosphorus (BP) for different twist angles were studied. There is great significance for optical spectroscopy to study vdWHs, as well as the development of better twisted 2D materials and moiré physics.

Modulation of photothermal anisotropy using black phosphorus/rhenium diselenide heterostructures.

Manipulating the polarization of an incident beam using two-dimensional materials has become an important research direction towards the development of nano-optical devices. Black phosphorus (BP) and rhenium diselenide (ReSe2) possess excellent in-plane optical anisotropy with optical birefringence in the visible region, which has led to novel applications in polarizing optics and optoelectronics. Herein, the polarization-dependent absorption of BP and ReSe2 and a modulated pump beam is utilized to obtain the photothermal signal from them. The photothermal anisotropy of BP and ReSe2 has been explored using photothermal detection. Then we have defined the photothermal contrast using the ratio of the maximum to the minimum of the photothermal signal. The photothermal contrast of BP and ReSe2 can be obtained accurately by the relationship between the polarization angle of the pump light and the photothermal signal. We demonstrate that a layered BP with different thicknesses can remarkably change the photothermal contrast. In contrast, the photothermal contrast of ReSe2 does not change with the different thicknesses of the samples. Further, the photothermal anisotropies of BP/ReSe2 heterostructures were also explored. The photothermal contrasts of samples were observed to change with different stacking angles indicating that the photothermal anisotropy of heterostructures is dependent on the stacking angle. Our findings provide new prospects for designing novel optical devices based on two-dimensional anisotropic materials, with potential applications in electronics, photonics, and optoelectronics.

OsELF3 is involved in circadian clock regulation for promoting flowering under long-day conditions in rice.

Heading date is a critical trait that determines cropping seasons and regional adaptability in rice (Oryza sativa). Research efforts during the last decade have identified some important photoperiod pathway genes that are conserved between Arabidopsis and rice. In this study, we identified a novel gene, Oryza sativa ELF3 (OsELF3), which is a putative homolog of the ELF3 gene in Arabidopsis thaliana. OsELF3 was required for the control of heading date under long-day conditions. Its Tos17-tagging mutants exhibited a delayed heading date phenotype only under long-day, but not short-day, conditions. OsELF3 was highly expressed in leaf blades, and the OsELF3 protein was localized in the nucleolus. An obvious diurnal rhythm of OsELF3 transcript level was observed, with a trough in the early day and a peak in the late night in wild-type plants. However, this expression pattern was disrupted in oself3 mutants. Further investigations showed that the expression of OsGI and Ghd7 was up-regulated in the oself3 mutant, indicating that OsELF3 acts as a negative regulator upstream of OsGI and Ghd7 in the flowering-time control under long-day conditions. The rhythmic expression of circadian clock-related genes, including some OsPRR members, was obviously affected in oself3 mutants. Our results indicated that OsELF3 acts as a floral activator in the long-day photoperiodic pathway via its crosstalk with the circadian clock in rice.

[Female genital toxicities of high-frequency electromagnetic field on rats].

OBJECTIVE: To study on the effects of sub-chronic exposures to high-frequency electromagnetic field (HF-EMF) on the estrous cycle, ovarian pathological changes and related hormones and preliminarily investigate the female genital toxicities of HF-EMF in rats. METHODS: 60 Wistar female adult rats were randomly divided into five groups based on body weight and radiated with different levels of 30 MHz electromagnetic field (0, 25, 100, 400 and 1600 V/m) for eight hours daily. Weekly the rats were continuously exposed five days. From the 48th day the four stage of estrus cycle were observed with smear method of the vaginal cell. Fifty-six days later the serum levels of sexual hormones were detected with the radioimmunoassay on estrus stage. The constituent ratio of the distinct follicle number on ovaries were observed with the HE staining and the ultrastructure was observed with the transmission electron microscope. Meanwhile, the ovarian humid weight and organ coefficient were observed. RESULTS: There was no significant difference in ovarian humid weight and organ coefficient between the exposure and the control groups. The time of proestrus in the 100 V/m group, the 400 V/m group and the 1600 V/m group was decreased significantly [(15.00 +/- 5.06), (11.40 +/- 2.05) and (10.56 +/- 0.96) h in the exposure group compared with (18.70 +/- 2.96) h in the control group, P < 0.01], and the time of Anestrum in the 400 V/m group and the 1600 V/m group were increased significantly [(101.20 +/- 17.81) and (115.33 +/- 19.28) h in the exposure group compared with (69.80 +/- 11.42) h in the control group, P < 0.01)]. Serum LH in the 400 V/m and 1600 V/m group was increased significantly [(11.02 +/- 1.11) and (14.70 +/- 1.94) mU/ml in the exposure groups compared with (8.70 +/- 0.53) mU/ml in the control group, P < 0.01], and serum E2 was decreased significantly [(57.16 +/- 31.56) and (50.57 +/- 25.16) pg/ml in the exposure groups compared with (95.04 +/- 32.62) pg/ml in the control group, P < 0.01]. The composition ratio of the corpus luteum/albicans number in the 400 V/m group and the 1600 V/m group was increased significantly (19.75% and 19.04% in the exposure groups compared with 14.01% in the control group, P < 0.05). The composition ratio of the atretic follicle number was increased significantly in the 100 V/m, the 400 V/m and the 1600 V/m group (8.45%, 9.95% and 11.70% in the exposure groups compared with 7.72% in the control group, P < 0.01). The composition ratio of the mature follicle and the pri/sec follicle was decreased significantly in the 400 V/m and the 1600 V/m group (1.50% and 1.55% in the exposure groups compared with 3.36% in the control group. 22.24% and 21.09% in the exposure groups compared with 26.60% in the control group, P < 0.01). Along with the increase of radiation dose, the ultrastructure of cell on the ovaries appeared more abnormal. CONCLUSIONS: The toxicities of female gonads are closely associated with exposures to HF-EMF. The nonage damage of female gonadal toxicities might emerge on the ovaries.

[Therapeutic comparison between procedure for prolapse and hemorrhoids and Ligasure technique for hemorrhoids].

OBJECTIVE: To investigate and compare the clinical effects of procedure for prolapse and hemorrhoids (PPH) and Ligasure technique (LT) for the treatment of severe hemorrhoids. METHODS: Patients with prolapsed hemorrhoids were randomly divided into two groups treated with PPH (n=44) and LT (n=42). The outcomes were evaluated postoperatively (i.e., operation time, length of hospital stay, pain intensity scoring, relapse of prolapse, bleeding and cost). RESULTS: (1)The average operating time for patients treated by LT was (12.0+/- 4.1) min, while for those by PPH was(19.0+/- 6.4)min (P < 0.05). (2)The average scores of visual analogue scale (VAS) for PPH and LT patients were 3.1 points (2 approximately 6) and 5.4 points (3~8) respectively(P < 0.05). (3)The average costs for LT group and PPH group were (4838+/- 301) yuan and (7796+/- 492) yuan respectively (P < 0.05). (4)In PPH group, 4 patients were complicated with hemorrhage (over 50 ml) and 1 patients with relapse, while there were no complications occurred in LT group. (5)Six months after operation, the self scores of postoperative pain,defecation and total satisfaction were 95.0%, 100% and 100% in PPH group, and 87.2%, 97.4% and 97.4% in LT group respectively. CONCLUSIONS: Compared with PPH, LT has the advantages of shorter operation time, less hemorrhage and expense, but more postoperative pain. Both LT and PPH are effective procedures for severe hemorrhoids.