Structure and assembly of the α-carboxysome in the marine cyanobacterium Prochlorococcus.

Carboxysomes are bacterial microcompartments that encapsulate the enzymes RuBisCO and carbonic anhydrase in a proteinaceous shell to enhance the efficiency of photosynthetic carbon fixation. The self-assembly principles of the intact carboxysome remain elusive. Here we purified α-carboxysomes from Prochlorococcus and examined their intact structures using single-particle cryo-electron microscopy to solve the basic principles of their shell construction and internal RuBisCO organization. The 4.2 Å icosahedral-like shell structure reveals 24 CsoS1 hexamers on each facet and one CsoS4A pentamer at each vertex. RuBisCOs are organized into three concentric layers within the shell, consisting of 72, 32 and up to 4 RuBisCOs at the outer, middle and inner layers, respectively. We uniquely show how full-length and shorter forms of the scaffolding protein CsoS2 bind to the inner surface of the shell via repetitive motifs in the middle and C-terminal regions. Combined with previous reports, we propose a concomitant 'outside-in' assembly principle of α-carboxysomes: the inner surface of the self-assembled shell is reinforced by the middle and C-terminal motifs of the scaffolding protein, while the free N-terminal motifs cluster to recruit RuBisCO in concentric, three-layered spherical arrangements. These new insights into the coordinated assembly of α-carboxysomes may guide the rational design and repurposing of carboxysome structures for improving plant photosynthetic efficiency.

The FTO-CMPK2 Pathway in Fibroblast-like Synoviocytes Modulates Rheumatoid Arthritis Synovial Inflammation and Cartilage Homeostasis via mtDNA Regulation.

In rheumatoid arthritis (RA), a debilitating autoimmune disorder marked by chronic synovial inflammation and progressive cartilage degradation, fibroblast-like synoviocytes (FLS) are key pathogenic players. Current treatments targeting these cells are limited. Our study focused on the Fat Mass and Obesity-associated protein (FTO), known for its roles in cell proliferation and inflammatory response modulation, and its involvement in RA. We specifically examined the inflammatory regulatory roles of FTO and CMPK2, a mitochondrial DNA synthesis protein, in FLS. Utilizing a combination of in vitro and in vivo methods, including FTO inhibition and gene knockdown, we aimed to understand FTO's influence on RA progression and chondrocyte functionality. Our findings showed that increased FTO expression in RA synovial cells enhanced their proliferation and migration and decreased senescence and apoptosis. Inhibiting FTO significantly slowed the disease progression in our models. Our research also highlighted that the FTO-CMPK2 pathway plays a crucial role in regulating synovial inflammation through the mtDNA-mediated cGAS/STING pathway, affecting chondrocyte homeostasis. This study indicates that targeting the FTO-CMPK2 axis could be a promising new therapeutic strategy for managing RA.

The Janus face of mitophagy in myocardial ischemia/reperfusion injury and recovery.

In myocardial ischemia/reperfusion injury (MIRI), moderate mitophagy is a protective or adaptive mechanism because of clearing defective mitochondria accumulates during MIRI. However, excessive mitophagy lead to an increase in defective mitochondria and ultimately exacerbate MIRI by causing overproduction or uncontrolled production of mitochondria. Phosphatase and tensin homolog (PTEN)-induced kinase 1 (Pink1), Parkin, FUN14 domain containing 1 (FUNDC1) and B-cell leukemia/lymphoma 2 (BCL-2)/adenovirus E1B19KD interaction protein 3 (BNIP3) are the main mechanistic regulators of mitophagy in MIRI. Pink1 and Parkin are mitochondrial surface proteins involved in the ubiquitin-dependent pathway, while BNIP3 and FUNDC1 are mitochondrial receptor proteins involved in the non-ubiquitin-dependent pathway, which play a crucial role in maintaining mitochondrial homeostasis and mitochondrial quality. These proteins can induce moderate mitophagy or inhibit excessive mitophagy to protect against MIRI but may also trigger excessive mitophagy or insufficient mitophagy, thereby worsening the condition. Understanding the actions of these mitophagy mechanistic proteins may provide valuable insights into the pathological mechanisms underlying MIRI development. Based on the above background, this article reviews the mechanism of mitophagy involved in MIRI through Pink1/Parkin pathway and the receptor mediated pathway led by FUNDC1 and BNIP3, as well as the related drug treatment, aim to provide effective strategies for the prevention and treatment of MIRI.

Basketball specific agility: A narrative review of execution plans and implementation effects.

This systematic review and evaluation aim to comprehensively overview current international advanced basketball specialized agility training methods. The primary objective is to analyze and synthesize existing literature, offering insights and guidance to enhance agility training levels specifically tailored for basketball players. Methods involved a systematic literature search using keywords like "Basketball," "Agility," and "Training" in major databases (PubMed, Web of Science, and EBSCO), covering studies from 2010 to 2022. Inclusion criteria focused on studies addressing advanced agility training methods for basketball players. Data extraction and analysis were conducted to identify key trends and outcomes. A total of 563 articles were initially identified, and after reviewing titles, abstracts, and full texts, 20 articles were ultimately selected, excluding those with inconsistent outcome measures or unavailable full texts. The findings suggest that plyometric training, comprehensive speed training, and equipment-assisted training methods (SSG, TRX, Bulgarian ball, etc) have demonstrated effectiveness in improving agility indicators in basketball players.

Schisandrin B ameliorates adjuvant-induced arthritis in rats via modulation of inflammatory mediators, oxidative stress, and HIF-1α/VEGF pathway.

OBJECTIVES: Schisandrin B (Sch B) has been shown to possess anti-inflammatory and antioxidant properties, however, its antirheumatoid arthritis properties and potential mechanism remain unexplored. This study evaluated the potential of Sch B in adjuvant-induced arthritic (AIA) rats. METHODS: AIA was induced by injecting 0.1 ml of CFA into the paw of rats and the animals were administered with Sch B (50 mg/kg) for 28 days. The effects of Sch B were evaluated using arthritis severity, serum levels of oxido-inflammatory, and metabolic index parameters. KEY FINDINGS: Sch B eased arthritic symptoms by significantly reducing paw swelling and arthritic score and increased body weight gain. Moreover, Sch B alleviated the levels of oxido-inflammatory markers including interleukin-1 beta, interleukin-6, tumor necrosis factor alpha, nuclear factor kappa B, transforming growth factor ß1, inducible nitric oxide synthase and malonaldehyde, as well as increased the levels of superoxide dismutase, glutathione, and Nrf2. Sch B also remarkably restored the altered levels of triglyceride, aspartate aminotransferase, lactic acid, pyruvate, phosphoenolpyruvate carboxylase, glucose, hypoxia inducible factor-1 alpha, and vascular endothelial growth factor. In addition, Sch B markedly alleviated p65 expression in the treated AIA rats. CONCLUSION: This study suggests that Sch B alleviated AIA by reducing oxidative stress, inflammation, and angiogenesis.

Core features of callous-unemotional traits: a cross-cultural comparison of youth in four countries.

With considerable debate concerning the impact of culture on the expression of callous-unemotional (CU) traits, it is unclear whether the core features of CU traits generalize to youth across cultures. This study aimed to examine whether cultural differences are reflected in the core features of CU traits and the associations among these features. Network analysis was employed to identify the core features and to examine the network structure of CU traits operationalized by the Inventory of Callous Unemotional traits (ICU) in four community youth samples from different nations (Australia, N = 190; the UK, N = 437; the USA, N = 330; China, N = 503). The item "Apologizes to people" was identified as a cross-cultural core feature in the ICU network with a greater centrality of this item compared to others in all four samples. In addition, some items were identified as culture-specific core features in the network, differing in their centrality across samples. The network structures of the youth self-report ICU items were moderately similar across samples, while the structures of parent-report items showed substantial differences. These findings have important implications for cross-cultural research on CU traits as well as practical implications for screening and treatment. The core features of ICU appear to be generalizable in youth across cultures, although cultural-specific manifestations should be noted.

Resting heart rate moderates the relationship between parental emotion socialization and callous-unemotional traits in children.

Although empirical findings have indicated that both familial and neurobiological risk factors contribute to the development of callous-unemotional (CU) traits in children, relatively few studies have investigated how these two factors interact to influence these traits. The current study focused on the combined effects of parental emotion socialization and child's resting heart rate on CU traits. Parents of Chinese children (N = 166) completed the Coping with Children's Negative Scale when children were 9.39 years old (SD = 0.92), while children's resting heart rate data were collected when they were 10.21 years old (SD = 0.72). When they were 11.15 years old (SD = 0.67), parents completed the Inventory of Callous-Unemotional Traits Short-Form. Results showed that parental supportive emotion socialization was negatively associated with CU traits and Callous behaviors in particular. In addition, resting heart rate moderated the relationship between parental emotion socialization and child's CU traits. Findings provide further evidence that an interdisciplinary approach that combines both psychosocial and biological factors is essential to further our understanding of CU traits in youth.

The Relationship between Physical Activity and Life Satisfaction among University Students in China: The Mediating Role of Self-Efficacy and Resilience.

(1) Background: Universities play a crucial role in nurturing healthy habits, and physical activity has emerged as a valuable tool for enhancing the life satisfaction, self-efficacy, and resilience of college students. Therefore, the purpose of this study was to investigate the mediating role of physical activity in the relationship between life satisfaction and self-efficacy as well as resilience among Chinese university students. (2) Method: This study used the Physical Activity Rating Scale (PARS-3), the Self-Efficacy Scale (CGES), the Mental Toughness Scale (CD-RISC), and the Life Satisfaction Scale (CSLSS) to administer questionnaires to 353 university students from two universities in Chengdu, Sichuan Province. Using a random simple sampling method, the data were processed and analyzed using SPSS 22.0 and Excel software. (3) Results: (1) Physical activity exhibited a significant positive correlation with self-efficacy, resilience, and life satisfaction; self-efficacy was significantly and positively related to resilience and life satisfaction; and resilience was significantly and positively related to life satisfaction. (2) Physical activity had a positive predictive effect on life satisfaction (ß = 0.2771; 95% confidence interval (CI): 0.1905, 0.3637, 55.51%). (3) Self-efficacy (ß = 0.0368; 95% confidence interval (CI): 0.0087, 0.0692, 7.37%) and resilience (ß = 0.137; 95% confidence interval (CI): 0.0919, 0.1894, 27.44%) mediated the relationship between physical activity and life satisfaction. Also, the chain-mediating effect of self-efficacy and resilience between physical activity and life satisfaction reached significant levels (ß = 0.0483; 95% confidence interval (CI): 0.0279, 0.0745, 9.68%). (4) Conclusion: Active participation in physical activity not only enhanced the life satisfaction of college students but also indirectly impacted their life satisfaction by improving their self-efficacy and resilience. Consequently, this led to an overall improvement in the life satisfaction of college students.

Changes of gut microbiota under different nutritional methods in elderly patients with severe COVID-19 and their relationship with prognosis.

Background: The clinical progression of individuals afflicted with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection exhibits significant heterogeneity, particularly affecting the elderly population to a greater extent. Consequently, the association between nutrition and microbiota has garnered considerable interest. Hence, the objective of this study was to gather clinical data pertaining to the influence of diverse nutritional support interventions on the prognosis of geriatric patients with COVID-19, while additionally examining the fecal microbiota of these individuals to assess the repercussions of microecological alterations on their prognostic outcomes. Results: A total of 71 elderly patients diagnosed with severe COVID-19 were included in this study. These patients were subsequently divided into two groups, namely the enteral nutrition (EN) group and the parenteral nutrition (PN) group, based on the type of nutritional support therapy they received after admission. The occurrence of complications was observed in 10.4% of patients in the EN group, whereas it was significantly higher at 69.6% in the PN group (P<0.001). Furthermore, the 60-day mortality rate was 2.1% (1/48) in the EN group, while it was notably higher at 30.4% (7/23) in the PN group (P=0.001). To identify the independent predictors of 60-day mortality, stepwise logistic regression analysis was employed. Among different bacterial groups, Enterococcus_faecium (18.19%) and Pseudomonas_aeruginosa (1.91%) had higher average relative abundance in the PN group (P<0.05). However, the relative abundance of Ruminococcus was higher in the EN group. Further Spearman correlation analysis showed that Enterococcus_faecium was positively correlated with poor clinical prognosis, while Ruminococcus was negatively correlated with poor clinical prognosis. Conclusions: This study shows that the changes in the composition of intestinal flora in elderly COVID-19 patients receiving different nutritional support strategies may be related to different clinical outcomes. The abundance of Enterococcus_faecium in elderly COVID-19 patients receiving PN is significantly increased and is closely related to poor clinical outcomes. It highlights the potential of microbiome-centric interventions to mitigate and manage COVID-19 in older adults with different nutritional support options.

CD8+ tissue-resident memory T cells induce oral lichen planus erosion via cytokine network.

CD8+ tissue-resident memory T (CD8+ Trm) cells play key roles in many immune-inflammation-related diseases. However, their characteristics in the pathological process of oral lichen planus (OLP) remains unclear. Therefore, we investigated the function of CD8+ Trm cells in the process of OLP. By using single-cell RNA sequencing profiling and spatial transcriptomics, we revealed that CD8+ Trm cells were predominantly located in the lamina propria adjacent to the basement membrane and were significantly increased in patients with erosive oral lichen planus (EOLP) compared to those with non-erosive oral lichen planus (NEOLP). Furthermore, these cells displayed enhanced cytokine production, including IFN-γ (Interferon-gamma, a pro-inflammatory signaling molecule), TNF-α (Tumor Necrosis Factor-alpha, a cytokine regulating inflammation), and IL-17 (Interleukin-17, a cytokine involved in immune response modulation), in patients with EOLP. And our clinical cohort of 1-year follow-up was also supported the above results in RNA level and protein level. In conclusion, our study provided a novel molecular mechanism for triggering OLP erosion by CD8+ Trm cells to secrete multiple cytokines, and new insight into the pathological development of OLP.

Analysis of the relationship between the gut microbiota enterotypes and colorectal adenoma.

Introduction: The essence of enterotypes is to stratify the entire human gut microbiota, and dysregulation of gut microbiota is closely related to the development of colorectal adenoma. Enterotypes may therefore be a useful target for the prevention of colorectal adenoma. However, the relationship between gut microbiota and colorectal adenoma has not been fully elucidated. In this study, we aimed to analyze the differences in gut microbiome composition between adenoma and control populations. Methods: We recruited 31 patients with colorectal adenoma and 71 non-adenoma controls. Patient demographics, risk factors, fecal samples from each subject were collected and metagenomic sequencing was performed. LEfSe analysis was used to reveal differences in intestinal microbiome composition. Multiple logistic regression analysis was used to determine the association between enterotypes and colorectal adenoma. Results: The results showed that Prevotella enterotype (enterotype 4) is only present in adenoma group. Logistic regression analysis showed that Prevotella enterotype was an independent risk factor for colorectal adenoma. Discussion: The Prevotella enterotype may increase the occurrence of colorectal adenoma through inflammatory association and interference with glucose and lipid metabolism in human body. In conclusion, the differences we observed between different enterotypes add a new potential factor to the development of colorectal adenoma.

SAG, a sonic hedgehog signaling agonist, alleviates anxiety behavior in high-fat diet-fed mice.

Anxiety is a prevalent and disabling psychiatric disorder. Mitochondrial dysfunction due to the high-fat diet (HFD) was regarded as a risk factor in the pathogenesis of anxiety. The Sonic hedgehog (SHH) pathway was known to improve mitochondrial dysfunction through antioxidant and anti-apoptotic effects on some neurological diseases. Nonetheless, its effect on anxiety has not been well studied. In this study, we aimed to explore whether SHH signaling pathway plays a protective role in anxiety by regulating mitochondrial homeostasis. SAG, a typical SHH signaling agonist, was administered intraperitoneally in HFD-fed mice. HFD-induced anxiety-like behavior in mice was confirmed using the open field and elevated plus maze tests. Immunofluorescence staining and Western blotting assays showed that the SHH signaling was downregulated in the prefrontal cortex neurons from HFD-fed mice. Electron microscopy results showed the mitochondria in the prefrontal cortex of HFD-fed mice were fragmented, which appeared small and spherical, and the area, perimeter and circularity of mitochondria were decreased. Mitofusin2 (Mfn2) and dynamin-related protein 1 (Drp1) were the key proteins involved in mitochondrial division and fusion. SAG treatment could rectify the imbalanced expression of Mfn2 and Drp1 in the prefrontal cortex of the HFD-fed mice, and alleviate the mitochondrial fragmentation. Furthermore, SAG decreased anxiety-like behavior in the HFD-fed mice. These findings suggested that SHH signal was neuroprotective in obesity and SAG relieved anxiety-like behavior through reducing mitochondrial fragmentation.

Effectiveness of functional magnetic resonance imaging for early identification of chronic kidney disease: A systematic review and network meta-analysis.

PURPOSE: The commonly used clinical indicators are not sensitive enough on detecting early chronic kidney disease (CKD), whether functional magnetic resonance imaging (fMRI) can be regarded as a new noninvasive method to identify early stages of CKD and even different stages remains unknown. We performed a network meta-analysis to explore the question. METHODS: Five databases were searched to identify eligible articles from 2000 to 2022. The outcome indicators were imaging biomarkers of fMRI techniques, including apparent diffusion coefficient (ADC) by diffusion-weighted imaging (DWI), fractional anisotropy (FA) by diffusion tensor imaging (DTI), diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) by intravoxel incoherent motion imaging (IVIM), and apparent relaxation rate (R2*) by blood oxygen level-dependent (BOLD). RESULTS: A total of 21 articles with 1472 patients were included for analysis. Cortical FA, f, and R2* values in CKD stages 1-2 were found statistically different with healthy controls (mean difference (MD), -0.03, 95% confidence interval (CI) -0.05, -0.01; MD, -0.04, 95% CI -0.06, -0.02; MD, 2.22, 95% CI 0.87, 3.57, respectively), and cortical ADC values were significantly different among different CKD stages (stages 3 and 1-2: MD, -0.15, 95% CI -0.23, -0.06; stages 4-5 and 3: MD -0.27, 95% CI -0.39, -0.14). CONCLUSION: The results indicated fMRI techniques had great efficacy in assessing early stages and different stages of CKD, among which DTI, IVIM, and BOLD exerted great superiority in differentiating early CKD patients from the general population, while DWI showed the advantage in distinguishing different CKD stages.

Insular-associated causal network of structural covariance evaluating progressive gray matter changes in major depressive disorder.

BACKGROUND: Morphometric studies demonstrated wide-ranging distribution of brain structural abnormalities in major depressive disorder (MDD). OBJECTIVE: This study explored the progressive gray matter volume (GMV) changes pattern of structural network in 108 MDD patients throughout the illness duration by using voxel-based morphometric analysis. METHODS: The causal structural covariance network method was applied to map the causal effects of GMV alterations between the original source of structural changes and other brain regions as the illness duration prolonged in MDD. This was carried out by utilizing the Granger causality analysis to T1-weighted data ranked based on the disease progression information. RESULTS: With greater illness duration, the GMV reduction was originated from the right insula and progressed to the frontal lobe, and then expanded to the occipital lobe, temporal lobe, dorsal striatum (putamen and caudate) and the cerebellum. Importantly, results revealed that the right insula was the prominent node projecting positive causal influences (i.e., GMV decrease) to frontal lobe, temporal lobe, postcentral gyrus, putamen, and precuneus. While opposite causal effects were detected from the right insula to the angular, parahippocampus, supramarginal gyrus and cerebellum. CONCLUSIONS: This work may provide further information and vital evidence showing that MDD is associated with progressive brain structural alterations.

The interleukin-6 family in tissues is closely related to the clinical outcomes of oral lichen planus.

OBJECTIVE: We attempted to investigate the role of interleukin-6 (IL-6) family expression in local tissues as it relates to presentations and outcomes in oral lichen planus (OLP), which is a common chronic inflammatory oral disease. MATERIALS AND METHODS: A clinical follow-up cohort of OLP patients was established, and a biological sample library was constructed with categorization into erosive type (EOLP) and nonerosive type (NEOLP). Transcriptome sequencing of the lesions was then performed. A multiple regression model was used to explore the differences in IL-6 family expression among patients with different clinical types and clinical outcomes. RESULTS: OLP tissue transcriptome sequencing showed that IL-6 family expression in EOLP increased significantly. It was also found that IL-6 family factors in the OLP recurrent erosion group were significantly increased compared to the persistent nonerosion group. Based on the multiple regression analysis of the OLP clinical cohort, it was found that the increased expression of the IL-6 family was closely related to the clinical types and clinical outcomes of OLP. CONCLUSION: The high expression of the IL-6 family is closely related to the erosion of local mucosa and poor prognosis of OLP patients. IL-6-related factors may be used as therapeutic targets for OLP patients.

Risk factors for central venous catheter-related thrombosis in hospitalized children: a single-center a retrospective cohort study.

Background: This study aimed to explore the risk factors of catheter-related thrombosis (CRT) in children in Southwest China who underwent central venous catheter (CVC) insertion. Methods: An observational cohort study was conducted at a single tertiary center in southwest China between November 2019 and February 2020. All patients who received a CVC were enrolled and Doppler-ultrasound examination was performed weekly until CVC removal. All patients in this study were hospitalized and were observed and followed up in this hospital. Patient demographics, medication, biochemical indexes, catheter maintenance practice, activities after CVC placement data were analyzed. The Kaplan-Meier method was used to calculate the incidence of CRT, and the Cox regression model was used to analyze the factors influencing CRT. Results: A total of 594 children were included in the study, and the median indwelling time was 10 days, with the shortest being 1 day and the longest 60 days. The overall incidence of CRT was 26.60% (158/594), the 15-day cumulative incidence rate was 30.81%, and the 45-day cumulative incidence rate was 46.27%. After 45 days, the incidence of CRT further increased. Age <12 months [hazard ratio (HR), 1.654; 95% confidence interval (CI): 1.171-2.338], use of 20% mannitol or glycerol fructose (HR, 1.593; 95% CI: 1.058-2.398), CVC placement by a pediatric intensive care unit (PICU) doctor (HR, 1.921; 95% CI: 1.347-2.740), placement length ≥9 cm (HR, 1.633; 95% CI: 1.142-2.336), and D-dimer >1.5 mg/L (HR, 1.451; 95% CI: 1.044-2.015) were risk factors for CRT. Limb exercises (HR, 0.660; 95% CI: 0.469-0.929) after placement was a protective factor for CRT. Conclusions: The incidence of CRT was higher in children with CVCs, and the key duration of CRT monitoring should be within 15 and 45 days after placement. Patients with age <12 months, using 20% mannitol or glycerol fructose, insertion length ≥9 cm, D-dimer >1.5 mg/L before placement are more likely to happen CVC-CRT than other patient, and it is necessary to be highly vigilant and take preventive measures.

Choice of injection time of conscious sedation and its impact on pain control in colonoscopy.

Purpose: The aim of this study was to identify the effect of different injection times on pain during colonoscopy procedure. Methods: In this retrospective study, the data of patients who underwent colonoscopy from June 2020 to September 2020 were assessed to investigate the effect of different injection time of sedative drugs (midazolam and dezocine). The primary endpoint was evaluating the pain intensity of the patients using visual analogue scale (VAS) immediately after colonoscopy . Results: A total of 152 patients were eligible for this study. Of them, 76 received midazolam and dezocine injection 1 min prior to the colonoscopy procedure (the 1 Min group) and the other 76 patients received the injection 3 min prior to the procedure (the 3 Min group). The vital signs of all patients were stable except for one patient who was diagnosed with inflammatory bowel disease in the 3 Min group. A transient drop in blood pressure for this patient was observed during colonoscopy but returned to normal after general treatment. The two groups had similar rates of cecal intubation (84.21% vs. 90.97%, P = 0.22), addition of sedative drugs during procedure (2.63% vs. 5.26%, P = 0.68), and adequate bowel preparation (Boston Bowel Preparation Scale ≥6, 61.84% vs. 61.84%, P = 1.0). However, patients in the 3 Min group had significantly lower VAS than those in the 1 Min group [0 (0, 1) vs. 1 (0, 2), P = 0.041]. Conclusion: The timing of drug injection during conscious sedation may affect pain control during colonoscopy, with 3 min prior to the procedure showing lower VAS.

Effectiveness of Microecological Preparations for Improving Renal Function and Metabolic Profiles in Patients With Chronic Kidney Disease.

Background: Determining whether microecological preparations, including probiotics, prebiotics, and synbiotics, are beneficial for patients with chronic kidney disease (CKD) has been debated. Moreover, determining which preparation has the best effect remains unclear. In this study, we performed a network meta-analysis of randomized clinical trials (RCTs) to address these questions. Methods: MEDLINE, EMBASE, PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials were searched. Eligible RCTs with patients with CKD who received intervention measures involving probiotics, prebiotics, and/or synbiotics were included. The outcome indicators included changes in renal function, lipid profiles, inflammatory factors, and oxidative stress factors. Results: Twenty-eight RCTs with 1,373 patients were ultimately included. Probiotics showed greater effect in lowering serum creatinine [mean difference (MD) -0.21, 95% confidence interval (CI) -0.34, -0.09] and triglycerides (MD -9.98, 95% CI -19.47, -0.49) than the placebo, with the largest surface area under the cumulative ranking curve, while prebiotics and synbiotics showed no advantages. Probiotics were also able to reduce malondialdehyde (MDA) (MD -0.54, 95% CI -0.96, -0.13) and increase glutathione (MD 72.86, 95% CI 25.44, 120.29). Prebiotics showed greater efficacy in decreasing high-sensitivity C-reactive protein (MD -2.06, 95% CI -3.79, -0.32) and tumor necrosis factor-α (MD -2.65, 95% CI -3.91, -1.39). Synbiotics showed a partially synergistic function in reducing MDA (MD -0.66, 95% CI -1.23, -0.09) and high-sensitivity C-reactive protein (MD -2.01, 95% CI -3.87, -0.16) and increasing total antioxidant capacity (MD 145.20, 95% CI 9.32, 281.08). Conclusion: The results indicated that microbial supplements improved renal function and lipid profiles and favorably affected measures of oxidative stress and inflammation in patients with CKD. After thorough consideration, probiotics provide the most comprehensive and beneficial effects for patients with CKD and might be used as the best choice for microecological preparations. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022295497, PROSPERO 2022, identifier: CRD42022295497.

Safety and feasibility of neoadjuvant chemotherapy as a surgical bridge for acute left-sided malignant colorectal obstruction: a retrospective study.

BACKGROUND: For colorectal cancer, preoperative (neoadjuvant) chemotherapy is more effective than postoperative chemotherapy because it not only eradicates micrometastases more effectively but also reduces the risk of incomplete intraoperative resection and tumor cell shedding. For the treatment of acute left-sided malignant colorectal obstruction, colorectal stents as well as stoma are being used to relieve the obstructive colorectal cancer, and as a bridge to surgery, allowing easy mobilization and resection of the colon. Neoadjuvant chemotherapy combined with self-expandable metal stents (SEMS) or neoadjuvant chemotherapy combined with decompressing stoma (DS) can be used as a bridge to elective surgery (BTS) as an alternative to emergency surgery in patients with acute left-sided malignant colorectal obstruction, but its benefit is uncertain. The purpose of this study was to evaluate the safety and feasibility of neoadjuvant chemotherapy as a bridge to surgery in the treatment of acute left-sided malignant colorectal obstruction. METHODS: Data from patients who were admitted with acute left-sided malignant colorectal obstruction between January 2012 and December 2020 were retrospectively reviewed, and patients with gastrointestinal perforation or peritonitis were excluded. We performed one-to-two propensity score matching to compare the stoma requirement, postoperative complications, and other short-term oncological outcomes between the neoadjuvant chemotherapy group and surgery group. RESULTS: There were no differences in intraoperative blood loss, operative time, one-year postoperative mortality, and postoperative tumor markers between the two groups. The 1-year recurrence-free survival (RFS) rates of neoadjuvant chemotherapy group and surgery group were 96.8 and 91.3% (p = 0.562). The neoadjuvant chemotherapy group was able to reduce stoma rate 1 year after surgery (p = 0.047). Besides, the neoadjuvant group significantly reduced postoperative bowel function time (p < 0.001), postoperative hospital stay (p < 0.001), total hospital stay (p = 0.002), postoperative complications (p = 0.017), reduction in need to stay in the intensive care unit (ICU) (p = 0.042). CONCLUSIONS: Neoadjuvant chemotherapy as a bridge to elective surgery in patients with acute left-sided malignant colorectal obstruction is safe and has many advantages. Prospective multicenter studies with large samples are needed to further evaluate the feasibility of neoadjuvant chemotherapy.

Loss of superiority illusion in bipolar depressive disorder: A combined functional and structural MRI study.

Superiority illusion (SI) is a positive cognitive bias related to self, manifested as overestimated self-appraisal. Negative self-schema is a core feature of the cognitive model of depression, including bipolar depressive disorder (BDD). However, only little research has explored the impaired self-processing in BDD. The potential alteration of positive self-bias and the corresponding neural mechanism in BDD remains unclear. This study aimed to investigate the underlying neural mechanism of self-processing in BDD combining task-related functional magnetic resonance imaging and high-resolution T1 structural imaging. Forty-three BDD and forty-eight healthy controls were recruited and underwent a self-related task, where participants were required to evaluate how they compared with their average peers on a serial of positive and negative traits. We defined the ratio of neural activation and gray matter volume (GMV) in a region as the functional-structural coupling index to detect the changes of brain image in BDD. Furthermore, we used moderation analysis to explore the relationship among functional-structural coupling, behavioral scores and depression symptoms. BDD exhibited decreased task activation, GMV, and functional-structural coupling in bilateral anterior insula (AI) and inferior parietal lobule (IPL). The associations between functional-structural coupling in the right AI, IPL and negative trait self-rating scores were moderated by depressive symptom severity. The study revealed disturbed self-related processing and provided new evidences to neuropsychological dysfunction in BDD.