Efficacy and Safety of Ablative Fractional Laser in Melasma: A Meta-analysis and Systematic Review.

Melasma is a common acquired skin pigmentation disorder. The treatment is urgent but challenging. Ablative fractional laser (AFL) can improve pigmentation, but the efficacy and potential side effects are still debatable. This study aimed to evaluate the efficacy and safety of ablative fractional lasers in the treatment of melasma. A comprehensive systematic search of literature published before June 20, 2023, was conducted on online databases, including PubMed, Embase, Cochrane Library, and Web of Science. The data obtained were analyzed using Review Manager 5.4 software. Fourteen randomized controlled trials, comprising 527 patients, were included. Compared to the drug alone, the combination of AFL and the drug showed improved therapeutic efficacy in the melasma area and severity index (MASI) (MD = 1.54, 95% CI [0.16, 2.92], P = 0.03) and physician global assessment (RR = 1.61, 95% CI [1.08, 2.41], P = 0.02). However, no statistically significant results were found in patient self-assessment (RR = 1.56, 95% CI [0.88, 2.76], P = 0.12). As an individual therapy, AFL is not superior to any other lasers in terms of MASI (MD = 2.66, 95% CI [-1.32, 6.64], P = 0.19) or melanin index (MD = -7.06, 95% CI [-45.09, 30.97], P = 0.72). Common adverse events included transient erythema, burning, edema, and superficial crusting. Only a few patients experienced reversible post-inflammatory hyperpigmentation, herpes labialis, and acne breakouts. These results support the application of AFL as a viable treatment option for melasma, particularly in refractory and severe cases. Rational parameterization or combination therapy may lead to significant clinical improvement with fewer complications.

The influence of green credit on China's industrial structure upgrade: evidence from industrial sector panel data exploration.

The green credit is one of the effective tools to save energy and reduce pollution, which mainly applies in industry. Thus, this paper explores the impact of green credit on the upgrading of China's industrial structure from the perspective of industrial sectors, by means of a dynamic panel model with the dada from 2005 to 2016. The upgrading of industrial structure is divided into three dimensions to be analyzed-rationalization of industrial structure (RIS), advancement of industrial structure (AIS), and greenization of industrial structure (GIS). The empirical results are also explained by four influence mechanisms-resource allocation, technological innovation, credit catalysis, and policy guidance mechanism. This paper finds that on the national level, green credit has a positive impact on the upgrading of China's industrial structure and plays a significant role in promoting the greenization and advancement of industrial structure. However, on the regional level, the effect of green credit is more complex. First, green credit has a significant positive effect on the GIS in the eastern, central, and western regions of China, which suggests that green credit is conductive to the cleaner production of industry across the country. Second, green credit also has a positive impact on the AIS in these three regions, but the effect is only significant in the eastern region. Third, in terms of the RIS, the effect of green credit is positive but not significant in the eastern and central regions. However, it is negative, not significant as well, in the western region, which can be explained from the perspective of the resource allocation and technological innovation mechanism. In addition, there is a significant positive correlation between the previous period and the current value of RIS, AIS, and GIS, which indicates that there is a significant positive inertia dynamic feature in the upgrading of China's industrial structure.

Identification of Early Diagnostic and Prognostic Biomarkers via WGCNA in Stomach Adenocarcinoma.

Stomach adenocarcinoma (STAD) is a leading cause of cancer deaths, and the outcome of the patients remains dismal for the lack of effective biomarkers of early detection. Recent studies have elucidated the landscape of genomic alterations of gastric cancer and reveal some biomarkers of advanced-stage gastric cancer, however, information about early-stage biomarkers is limited. Here, we adopt Weighted Gene Co-expression Network Analysis (WGCNA) to screen potential biomarkers for early-stage STAD using RNA-Seq and clinical data from TCGA database. We find six gene clusters (or modules) are significantly correlated with the stage-I STADs. Among these, five hub genes, i.e., MS4A1, THBS2, VCAN, PDGFRB, and KCNA3 are identified and significantly de-regulated in the stage-I STADs compared with the normal stomach gland tissues, which suggests they can serve as potential early diagnostic biomarkers. Moreover, we show that high expression of VCAN and PDGFRB is associated with poor prognosis of STAD. VCAN encodes a large chondroitin sulfate proteoglycan that is the main component of the extracellular matrix, and PDGFRB encodes a cell surface tyrosine kinase receptor for members of the platelet-derived growth factor (PDGF) family. Consistently, Gene Ontology (GO) analysis of differentially expressed genes in the STADs indicates terms associated with extracellular matrix and receptor ligand activity are significantly enriched. Protein-protein network interaction analysis (PPI) and Gene Set Enrichment Analysis (GSEA) further support the core role of VCAN and PDGFRB in the tumorigenesis. Collectively, our study identifies the potential biomarkers for early detection and prognosis of STAD.

Clinical outcomes of hospitalized COVID-19 patients with renal injury: a multi-hospital observational study from Wuhan.

Renal injury is common in patients with coronavirus disease 2019 (COVID-19). We aimed to determine the relationship of estimated glomerular filtration rate (eGFR) and acute kidney injury (AKI) with the characteristics, progression, and prognosis of COVID-19 in-patients. We retrospectively reviewed 1851 COVID-19 patients admitted to 3 hospitals in Wuhan, China. Clinical, laboratory, radiological, treatment, complication, and outcome data were analyzed. Patients were stratified according to levels of eGFR (≥ 90 vs. 60-89 vs. < 60 mL/min/1.73 m2). The risk of reaching the composite endpoint-intensive care unit admission, invasive ventilation, or death-was compared. On admission, 25.5% patients had renal impairment (eGFR < 90 mL/min/1.73 m2), but only 2.6% patients had chronic kidney disease (CKD). The overall in-hospital AKI incidence was 6.7%. Severe illness and comorbidities (hypertension, diabetes, CKD, and cardiovascular/cerebrovascular diseases) were more common among patients with low eGFR (< 90 mL/min/1.73 m2). Despite the more frequent use of intensive oxygen therapy, continuous blood purification, and glucocorticoid treatment, the prognosis of these patients was unsatisfactory, with the incidence of the composite endpoint (15.4% vs. 19.6% vs. 54.5%; P = 0.000) and complications (AKI, respiratory failure, cardiac injury, coagulation disorders, sepsis, etc.) increasing with decreasing eGFR. Kaplan-Meier survival analysis revealed that patients with eGFR < 90 mL/min/1.73 m2 or AKI had significantly escalated risks of reaching the composite endpoint. Multivariate regression analysis showed that renal insufficiency (eGFR < 60 mL/min/1.73 m2) on admission and in-hospital AKI independently predicted poor prognosis among COVID-19 in-patients. And renal impairment on admission was a greater predictor of poor prognosis in non-elderly patients than that in elderly patients. Early and continuous renal-function monitoring and early AKI diagnosis are necessary to predict and prevent the progression of COVID-19.

A Modified Pressure Dressing to Avoid Severe Bleeding After Circumcision With a Disposable Circumcision Suture Device and a Discussion on the Mechanism of Bleeding With the Disposable Circumcision Suture Device.

INTRODUCTION: A novel type of a disposable circumcision suture device (DCSD) has been proved to be effective and safe; however, a few cases of severe bleeding took place after circumcisions. AIM: To evaluate the effectiveness of a modified double-layer pressure dressing to avoid severe bleeding after circumcision with the DCSD, in our department in a prospective randomized controlled study, and discuss the mechanism of bleeding with DCSD. METHODS: Patients with redundant foreskin or phimosis were included between September 2018 and November 2019 and divided into 2 groups: In group A, the conventional pressure dressing was performed; in group B, an modified double-layer pressure dressing was performed. MAIN OUTCOME MEASURE: The main outcomes and complications (surgical time, incidence of glans ischemia, severe bleeding rate, infection rate, pain level, total cost, and overall satisfaction) were collected and analyzed. RESULTS: A total of 624 patients were recruited for this study. There was no difference in the average age and body mass index between 2 groups. No patient suffered obvious glans ischemia. In group B, lower pain level, lower incidences of severe bleeding, and better satisfaction were recorded. CONCLUSION: The mechanism of bleeding with the DCSD was discussed in this study, and the modified pressure dressing was proved effective, safe, and easy to perform. W Jiang, J-li Fu, W-l Guo, et al. A Modified Pressure Dressing to Avoid Severe Bleeding After Circumcision With a Disposable Circumcision Suture Device and a Discussion on the Mechanism of Bleeding With the Disposable Circumcision Suture Device. Sex Med 2021;9:100288.

Functional analysis of tomato CHIP ubiquitin E3 ligase in heat tolerance.

Plants have evolved genetic and physiological mechanisms to mitigate the adverse effects of high temperature. CARBOXYL TERMINUS OF THE HSC70-INTERACTING PROTEINS (CHIP) is a conserved chaperone-dependent ubiquitin E3 ligase that targets misfolded proteins. Here, we report functional analysis of the SlCHIP gene from tomato (Solanum lycopersicum) in heat tolerance. SlCHIP encodes a CHIP protein with three tandem tetracopeptide repeat (TPR) motifs and a C-terminal U box domain. Phylogenetic analysis of CHIP homologs from animals, spore-bearing and seed plants revealed a tree topology similar to the evolutionary tree of the organisms. Expression of SlCHIP was induced under high temperature and was also responsive to plant stress hormones. Silencing of SlCHIP in tomato reduced heat tolerance based on increased heat stress symptoms, reduced photosynthetic activity, elevated electrolyte leakage and accumulation of insoluble protein aggregates. The accumulated protein aggregates in SlCHIP-silenced plants were still highly ubiquitinated, suggesting involvement of other E3 ligases in ubiquitination. SlCHIP restored the heat tolerance of Arabidopsis chip mutant to the wild type levels. These results indicate that tomato SlCHIP plays a critical role in heat stress responses most likely by targeting degradation of misfolded proteins that are generated during heat stress.

Analysis of Long Noncoding RNA ZNF667-AS1 as a Potential Biomarker for Diagnosis and Prognosis of Glioma Patients.

OBJECTIVE: Long noncoding RNAs (lncRNAs) have been strongly associated with various types of cancer. The present study aimed at exploring the diagnostic and prognostic value of lncRNA Zinc finger protein 667-antisense RNA 1 (ZNF667-AS1) in glioma patients. Patients and Methods. The expressions of ZNF667-AS1 were detected in 155 glioma tissues and matched normal brain tissue samples by qRT-PCR. The receiver operating characteristic (ROC) curve was performed to estimate the diagnostic value of ZNF667-AS1. The association between the ZNF667-AS1 expression and clinicopathological characteristics was analyzed by the chi-square test. The Kaplan-Meier method was performed to determine the influence of the ZNF667-AS1 expression on the overall survival and disease-free survival of glioma patients. The Cox regression analysis was used to evaluate the effect of independent prognostic factors on survival outcome. Cell proliferation was measured by the respective cell counting Kit-8 (CCK-8) assays. RESULTS: We observed that ZNF667-AS1 was significantly upregulated in glioma tissues compared to normal tissue samples (p < 0.01). Higher levels of ZNF667-AS1 were positively associated with the WHO grade (p = 0.018) and KPS score (p = 0.008). ROC assays revealed that the high ZNF667-AS1 expression had an AUC value of 0.8541 (95% CI: 0.8148 to 0.8934) for glioma. Survival data revealed that glioma patients in the high ZNF667-AS1 expression group had significantly shorter 5-year overall survival (p = 0.0026) and disease-free survival (p = 0.0005) time than those in the low ZNF667-AS1 expression group. Moreover, multivariate analyses confirmed that the ZNF667-AS1 expression was an independent predictor of the overall survival and disease-free survival for glioma patients. Functionally, we found that knockdown of ZNF667-AS1 suppressed the proliferation of glioma cells. CONCLUSIONS: Our results suggest that ZNF667-AS1 could be used as a potential diagnostic and prognostic biomarker in glioma.

Differential expression of microRNAs in the human fetal left and right cerebral cortex.

Human brain is anatomically and functionally asymmetric. How brain asymmetry is initiated and established during fetal development is poorly understood. Accumulating evidence has shown that microRNAs (miRNAs) play crucial roles in brain development and function. In this study, we investigate miRNA expression profiles in left and right hemispheres of human fetal brains at 12 weeks post conception (PC), and identify 42 miRNAs showing differential expression between two hemispheres using Affymetrix microarray analyses. Target genes for left- and right-biased miRNAs are largely involved in developmental and functional regulations in the cortex such as axon guidance, GABAergic synapse and dopaminergic synapse pathways. Moreover, we find that predicted targets associated with canonical and non-canonical WNT signaling pathway show variations and differential expression between two hemispheres in response to left- and right-biased miRNAs. Our results highlight a potential role of miRNAs in regulating asymmetric development of human fetal brains.

A research on urban eco-security evaluation and analysis: complex system's brittle structure model.

Urban ecosystem has become a critical part of ecological security and draws much attention worldwide. It is both a result of natural ecological system development, and also an inevitable outcome of human ecological system development within a certain stage, with the objective of identifying the possible improvement space for unban ecological security evaluation from complex system perspective. Based on the brittle structure model and set pair theory, this paper firstly explored the main research methods of urban ecological security theory and its characteristics, then conducted a theory of complex system brittleness to analyze the urban ecological security brittle factors, brittle primitives, and brittle structure. Furthermore, it conducted a model of urban ecological system brittleness correlation entropy together with a set pair analysis method to discuss its brittleness. And finally, an ecological safety evaluation has been presented based on the empirical case in Chengdu City of China. The theoretical and empirical analysis shows that the brittle correlation entropy of natural subsystem in urban ecological security is the biggest one. The risks from natural subsystem collapse can easily trigger the brittleness of the entire urban system. The corresponding maximum brittle fluctuation entropy is from economic subsystem; it has a largest impact on the entropy change of urban ecosystem. The way of reducing the uncertainty of urban ecological risks is to lower difference degree coefficient in the system. Relevant decision makers should consider to reduce the increasing degree of entropy and eliminate the fluctuation of the brittle factors. Thus, the threats or risks of urban ecological system can be within the acceptable range and under control. An integrated system management combing with brittleness characters of natural, economics, and social subsystem is necessary. It is helpful for the ecological security construction.

Assessment on the effectiveness of environmental regulation in China-evidence from a panel data analysis.

In the context of global warming and environmental deterioration, the environment impact assessment is a crucial institutional guaranty to assure less or no pollution during the process of the economic growth and rapid social development. This paper selected the environmental regulation system in China as a research target and assesses the effectiveness of green tax on the environment through an empirical analysis. The panel data from 2005 to 2015 in different cities in China are employed to analyze with a two-way fixed regression model; it analyzes the impact of environmental instruments like resource tax, excise tax, vehicle purchase tax, and pollutant discharge fees on environmental pollution and finds that the modeling conditions with green tax reform can lead to higher effect on environmental pollutant constrain but is distributed differently among east, central, and west based on the empirical analysis in China. Moreover, resource tax has a significant effect in the east and midwest of China. The effectiveness of excise tax on integrated pollution is not statistically significant. Compared with the midwest, eastern China's green tax had a much better performance on reducing environmental pollution. Pollutant discharge fees indicates a significant negative correlation to integrated pollution. The consumption of the other goods (like meat consumption) plays a mediating effect between vehicle purchase tax and integrated environmental pollution. In addition, the relevant policy recommendations are proposed against different tax types.

A synthesized factor analysis on energy consumption, economy growth, and carbon emission of construction industry in China.

Climate change calls for worldwide public concern and effort to cut down carbon dioxide (CO2) emissions and globally realize sustainable development. As one of the largest energy consumers, the construction industry plays a crucial role in achieving the national carbon emission reduction goal. This paper, by employing an improved Kaya model, explored the relationships and trends among carbon emission, energy consumption, and GDP growth rate and carbon emission intensity of the Chinese construction industry. Results showed that the carbon emission of the construction industry is mainly affected by GDP growth of construction scale. The energy consumption was the main driver to the increase of carbon emissions. The carbon emissions of unit area and carbon intensity showed a decreased trend with the development of economy and the increase of construction scale. The dependence of construction activities on the fossil fuel remained despite noticeable decrease. Energy intensity helps to reduce construction carbon emissions. Low carbon economy development of construction industry calls for technological innovation, alternative energy and new technical support for further breakthrough. These findings provide scientific evidence of carbon emissions in the Chinese construction industry and useful inputs for industry-specific emission regulations.

Downregulation of microRNA­574 in cancer stem cells causes recurrence of prostate cancer via targeting REL.

miR­574­5p has been reported involved in the pathogenesis of numerous human malignancies such as colorectal and lung cancer. In this study, we aimed to explore the roles of REL and miR­574 in the recurrence of prostate cancer (PCa) and to identify the underlying molecular mechanisms. Our literature search found that miR­574 is regulated in cancer stem cells (CSCs), and next we used the microRNA (miRNA) database (www.mirdb.org) to find REL as a target of miR­574. Luciferase assay was performed to verify the miRNA/target relationship. Oligo-transfection, real­time PCR and western blot analysis were used to support the conclusions. We validated REL to be the direct gene via luciferase reporter assay system, and real­time PCR and western blot analysis were also conducted to study the mRNA and protein expression level of REL between different groups (recurrence and non­recurrence) or cells treated with scramble control, miR­574 mimics, REL siRNA and miR­574 inhibitors, indicating the negative regulatory relationship between miR­574 and REL. We also investigated the relative viability of prostate CSCs when transfected with scramble control, miR­574 mimics, REL siRNA and miR­574 inhibitors to validate miR­574 to be positively interfering with the viability of prostate CSCs. We then investigated the relative apoptosis of prostate CSCs when transfected with scramble control, miR­574 mimics, REL siRNA and miR­574 inhibitors. The results showed miR­574 inhibited apoptosis. In conclusion, miR­574 might be a novel prognostic and therapeutic target in the management of PCa recurrence.

[Transanal total mesorectal excision: the operative platform and potential issues].

In recent 20 years, the most important advancement of rectal cancer surgery is the total mesorectal excision(TME) and laparoscopic minimal invasive surgery. However, visualization of the distal rectum is still troublesome because of narrow pelvic, bulky tumor, and especially obese male patients. A possible solution for this situation is distal rectal mobilization by transanal minimally invasive surgery (TAMIS), or even pure transanal total mesorectal excision (taTME). When people applaud a new era of rectal cancer surgery is coming, we must also concern about the patients selection, the long-term follow up results and even the operative safety.

Correlation study of chronic nonbacterial prostatitis with the levels of COX-2 and PGE2 in prostatic secretion.

OBJECTIVE: The prostatitis syndrome is a multifactorial condition of largely unknown etiology. This study is to analyze the relationship between cyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2) with the chronic nonbacterial prostatitis (CNBP). METHODS: A total of 172 CNBP patients and 151 healthy males were recruited as CNBP and control group, respectively. The prostatic fluid was collected and tested by pre- and post-massage test. White blood cell (WBC) number was counted, and the contents of COX-2 and PGE2 were determined by double antibody-based sandwich enzyme-linked immuno-sorbent assay. The pain and discomfort of each patient were scored according to the National Institutes of Health chronic prostatitis symptom index. RESULTS: Compared with the control group, CNBP group displayed significantly higher WBC count, COX-2 level, and PGE2 level. Contents of COX-2 and PGE2 in prostatic secretion of CNBP group were positively correlated with pain scores (r = 0.855 and 0.675, respectively, P < 0.01) and total symptom scores (r = 0.674 and 0.566, respectively, P < 0.01). A significantly positive correlation between COX-2 and PGE2 levels was also discovered (r = 0.493, P < 0.05). The WBC number was not obviously correlated with the accumulations of COX-2 and PGE2 or the clinic symptoms of CNBP. CONCLUSION: Increase in PGE2 concentration caused by activated COX-2 pathway may contribute to the pain or discomfort symptom of the CNBP patients. Our results indicate that selective COX-2 inhibitors have application prospect in CNBP treatment.