Breastmilk microbiome changes associated with lactational mastitis and treatment with dandelion extract.

Introduction: Dandelion (Pugongying) is one of the most frequently used Chinese herbs for treating lactational mastitis (LM). Pugongying granules, a patented medication primarily comprised of dandelion extract, have been approved by CFDA for LM treatment in China. The aims of this study were to investigate the etiology of LM and the mechanism by which Pugongying granules decrease LM symptoms, with a particular focus on the microbial communities found in breastmilk. Methods: Participants were recruited from a previously performed randomized controlled trial (Identifier: NCT03756324, ClinicalTrials.gov). Between 2019 and 2020, women diagnosed with unilateral LM at the Beijing University of Chinese Medicine Third Affiliated Hospital were enrolled. In total, 42 paired breastmilk samples from the healthy and affected breasts of the participants were collected. Additionally, 37 paired pre- and post-treatment breastmilk samples from the affected breast were collected from women who received a 3-day course of either Pugongying granules (20 women) or cefdinir (17 women). Clinical outcomes [e.g., body temperature, visual analogue scale (VAS) score for breast pain, the percentage of neutrophils (NE%)] were analyzed pre- and post-treatment, and the breastmilk samples were subjected to 16S rRNA gene sequencing to analyze the alpha and beta diversities and identify significant bacteria. Finally, the relationship between microorganisms and clinical outcomes was analyzed. Results: There was no significant difference in fever and pain between the Pugongying group and cefdinir group. The most prevalent bacterial genera in breastmilk were Streptococcus and Staphylococcus. Compared to healthy breastmilk, microbial diversity was reduced in affected breastmilk, and there was a higher relative abundance of Streptococcus. After Pugongying treatment, there was an increase in microbial diversity with significantly higher abundance of Corynebacterium. A negative correlation was found between Corynebacterium, VAS score, and NE%. Treatment with cefdinir did not affect microbial diversity. Taken together, our results show a correlation between LM and reduced microbial diversity, as well as an increased abundance of Streptococcus in affected breastmilk. Conclusion: Pugongying granules enhanced microbial diversity in breastmilk samples. Given the substantial variation in individual microbiomes, identifying specific species of Streptococcus and Corynebacterium associated with LM may provide additional insight into LM pathogenesis and treatment.

Traditional Chinese medicine for smoking cessation: An umbrella review of systematic reviews and meta-analysis of randomized controlled trials.

INTRODUCTION: Traditional Chinese medicine (TCM) may have special advantages in facilitating smoking cessation, but consensus on effectiveness is lacking. We aim to comprehensively review, update, and refine current evidence on TCM effectiveness and safety. METHODS: Nine databases were searched from their inception up to 28 February 2023. Systematic reviews (SRs) and meta-analysis of TCM for smoking cessation were identified and retrieved. Additional databases and hand searches of RCTs from included SRs were performed for data pooling. Cochrane ROB tools and AMSTAR-2 were used to evaluate the methodological quality of RCTs and SRs, respectively. RCT data are presented as relative risks (RR) or mean differences (MD) with 95% confidence intervals (CI) using RevMan 5.4. RESULTS: Thirteen SRs involving 265 studies with 33081 participants were included. Among these 265 studies, 157 were duplicates (58.36%) and 52 were non-RCTs (19.62%). Combined with the remaining 56 RCTs identified through hand searches, 88 RCTs involving 12434 participants were finally included for data synthesis. All the SRs focused on acupoint stimulation, and the majority were of low or very low quality. The methodological quality of RCTs was either unclear or high risk. For continuous abstinence rate, TCM external interventions were better than placebo in 6 months to 1 year (RR=1.60; 95% CI: 1.14-2.25; I2=27%; n=5533 participants). Compared with placebo, TCM external application was effective in reducing nicotine withdrawal symptoms, and the effect was gradually stable and obvious in the fourth week (MD= -4.46; 95% CI: -5.43 - -3.49; n=165 participants). Twelve RCTs reported adverse events as outcome indicators for safety evaluation, and no serious adverse events occurred. CONCLUSIONS: Despite the methodological limitations of the original studies, our review suggests that TCM intervention shows potential effectiveness on the continuous abstinence rate. Extending the intervention time can enhance the effect of TCM on nicotine withdrawal symptoms. Referred to adverse events, more data for safety evaluation are required.

A selected case series of idiopathic hypertrophic pachymeningitis in a single center: Pathological characteristics and case-oriented review.

Hypertrophic pachymeningitis (HP) is a relatively rare disease of the central nervous system characterized by local or diffuse fibrous thickening of the dura mater. At present, there is still insufficient research on the pathogenesis and treatment strategies of this disease. We reported a continuous case series of seven patients with idiopathic HP (IHP), and also details one case of immunoglobulin G4-related HP requiring surgical intervention. Early diagnosis and appropriate surgical intervention for IHP could prevent the progression of permanent neurological damage and spinal cord paraplegia.

Fibroblast Growth Factor 11 (FGF11) Promotes Progression and Cisplatin Resistance Through the HIF-1α/FGF11 Signaling Axis in Ovarian Clear Cell Carcinoma.

Background: A poor prognosis is often associated with ovarian clear cell carcinoma (OCCC) due to its relative resistance to platinum-based chemotherapy. Although several studies have been launched to explore the pathogenesis of OCCC, the mechanism of chemoresistance has yet to be uncovered. Methods: Nanostring nCounter PanCancer Pathways Panel was performed to explore the expression profiles of OCCC tissues from patients showing different platinum sensitivity. Bioinformatic analysis was performed to select genes associated with chemoresistance and cell function assays, including colony formation, wound healing, transwell and flow cytometric analysis, were used to explore the role of the target gene in the progression of OCCC and resistance to cisplatin (DDP). Results: Gene expression profiles and bioinformatic analysis verified that the expression of fibroblast growth factor 11 (FGF11) was significantly increased in platinum-resistant OCCC tissues and increased FGF11 expression was related to poorer survival. Downregulation of FGF11 inhibited the proliferation, migration, and invasion, reversing the DDP resistance of OCCC cells. Mechanically, FGF11 was regulated by hypoxia-inducible factor-1α (HIF-1α) to modulate the DDP sensitivity. Conclusion: FGF11 was highly expressed in platinum-resistant OCCC tissues, promoting progression and resistance to DDP through the HIF-1α/FGF11 signaling axis.

Single-cell transcriptomics reveals ependymal subtypes related to cytoskeleton dynamics as the core driver of syringomyelia pathological development.

Syringomyelia is a common clinical lesion associated with cerebrospinal fluid flow abnormalities. By a reversible model with chronic extradural compression to mimic human canalicular syringomyelia, we explored the spatiotemporal pathological alterations during syrinx development. The most dynamic alterations were observed in ependymal cells (EPCs), oligodendrocyte lineage, and microglia, as a response to neuroinflammation. Among different cell types, EPC subtypes experienced obvious dynamic alterations, which were accompanied by ultrastructural changes involving the ependymal cytoskeleton, cilia, and dynamic injury in parenchyma primarily around the central canal, corresponding to the single-cell transcripts. After effective decompression, the syrinx resolved with the recovery of pathological damage and overall neurological function, implying that for syringomyelia in the early stage, there was still endogenous repair potential coexisting with immune microenvironment imbalance. Ependymal remodeling and cilia restoration might be important for better resolution of syringomyelia and parenchymal injury recovery.

Efficacy of Tracheal Traction Exercise for Prevention of Laryngopharyngeal Complications Following Anterior Cervical Discectomy and Fusion: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

OBJECTIVE: Tracheal traction exercise (TTE) has been proposed as a preventative measure for laryngopharyngeal complications following anterior cervical discectomy and fusion. However, the exact effects of TTE remain controversial. Therefore, we conducted a systematic review and meta-analysis of randomized controlled trials to evaluate the efficacy of TTE. METHODS: We systematically searched PubMed, Web of Science, Embase, Cochrane, ClinicalTrials.gov, China National Knowledge Infrastructure, WANFANG DATA, VIP citation databases, and Chinese BioMedical Literature Database for randomized controlled trials (published between January 1, 2000, and January 23, 2023, without language restrictions) comparing the TTE group to the control group (non-TTE group). We assessed the risk of bias using Cochrane risk of bias assessment tool. Our primary end points were operation duration, the number of patients with postoperative dysphagia, and Visual Analog Scale (VAS) for laryngopharyngeal pain. We used a fixed-effects model to assess the pooled data. RESULTS: Of the 823 identified studies, 5 were eligible and included in our analysis (N = 542 participants). Compared with the control group, TTE reduced the incidence of postoperative dysphagia (relative risk = 0.41, 95% confidence interval [CI]: 0.28, 0.61, P < 0.05) and operation duration (weighted mean difference = -10.24, 95% CI: -14.48, -6.00, P < 0.05). However, no significant difference was observed in postoperative VAS between the 2 groups (weighted mean difference = -0.11, 95% CI: -0.23, 0.11, P = 0.08 > 0.05). CONCLUSIONS: TTE can effectively reduce operation duration and postoperative dysphagia. However, it does not result in a significant difference in postoperative VAS.

Differential molecular pathway expression according to chemotherapeutic response in ovarian clear cell carcinoma.

OBJECTIVE: Ovarian clear cell carcinoma (OCCC) is a distinct entity from epithelial ovarian cancer. The prognosis of advanced and recurrent disease is very poor due to resistance to chemotherapeutic agents. Our aim was to explore the molecular alterations among OCCC patients with different chemotherapeutic responses and to obtain insights into potential biomarkers. METHODS: Twenty-four OCCC patients were included in this study. The patients were divided into two groups based on the relapse time after the first-line platinum-based chemotherapy: the platinum-sensitive group (PS) and the platinum-resistant group (PR). Gene expression profiling was performed using NanoString nCounter PanCancer Pathways Panel. RESULTS: Gene expression analysis comparing PR vs. PS identified 32 differentially expressed genes: 17 upregulated genes and 15 downregulated genes. Most of these genes are involved in the PI3K, MAPK and Cell Cycle-Apoptosis pathways. In particular, eight genes are involved in two or all three pathways. CONCLUSION: The dysregulated genes in the PI3K, MAPK, and Cell Cycle-Apoptosis pathways identified and postulated mechanisms could help to probe biomarkers of OCCC platinum sensitivity, providing a research basis for further exploration of targeted therapy.

Impairment of Connexin 43 may initiate cilia decline in syringomyelia.

Ependymal cilia, which are maintained by the Connexin 43 (Cx43) and protected by the actin network, play an essential role in regulating cerebrospinal fluid (CSF) circulation. The decline of ependymal cilia has been reported in syringomyelia, but the underlying mechanism remains unclear. In this study, we used an extradural compression-induced syringomyelia rat model to investigate the changes in cilia and related pathologies during the formation of syringomyelia. We divided rats into control and syringomyelia groups and sacrificed them at three time points, 7, 14, and 28 days postoperative (dpo). Scanning electron microscopy (SEM) and immunofluorescence (IF) were used to illustrate the number and morphology of ependymal cilia. IF was also used to show the status of centrioles, actin network, and Cx43 (the main component of the gap junction). Transmission electron microscopy (TEM) was used to observe the structure of the gap junction. The results showed that most syringomyelia were located at segments (T10-12) rostral to the compression site (T13). SEM images showed that the number of cilia in the central canal (CC) declined in two phases during the development of syringomyelia (early stage, 7 dpo; later stage, 14 and 28 dpo). The number of cilia showed a significant difference between the early and later stages of syringomyelia development. Additionally, TEM showed the absence of gap junction and IF illustrated less Cx43 expression in ependymal cells (ECs) at the compression site in both the early and later stages. Actin network disruption and centrioles reduction at adjacent segments rostral to the compression site were found in the later stage. These findings indicate that the loss of Cx43 at the compression site may be related to cilia detachment at rostral adjacent segments by disrupting intercellular communication in the early stage of syringomyelia development. This early cilia decline then causes actin network disorganization, further aggravating cilia decline by exposing centrioles to CSF shear stress in the later stage. These findings suggest a potential mechanism of ependymal cilia decline in the development of syringomyelia and may provide a novel perspective for future research in this area.

Correlation Among Syrinx Resolution, Cervical Sagittal Realignment, and Surgical Outcome After Posterior Reduction for Basilar Invagination, Atlantoaxial Dislocation, and Syringomyelia.

BACKGROUND: The correlation among syrinx resolution, occipitoaxial sagittal alignment, and surgical outcome in long-term follow-up seems to have not been clarified. OBJECTIVE: To further explore the relationship between the syrinx resolution and occipitoaxial realignment after posterior reduction and fixation in basilar invagination (BI)-atlantoaxial dislocation (AAD) patients with syringomyelia. METHODS: A continuous series of 32 patients with BI-AAD and syringomyelia who received direct posterior reduction met the inclusion criteria of this study. Their clinical and imaging data were analyzed retrospectively. Before surgery and at the last follow-up, we used the Japanese Orthopedic Association (JOA) score and the Neck Disability Index (NDI) to assess the neurological status, respectively. The Pearson correlation coefficient and multiple stepwise regression analysis were used to explore the relevant factors that may affect surgical outcomes. RESULTS: There were significant differences in atlantodental interval, clivus-axial angle, occiput-C2 angle (Oc-C2A), cervicomedullary angle (CMA), subarachnoid space (SAS) at the foramen magnum (FM), syrinx size, NDI, and JOA score after surgery compared with those before surgery. ΔCMA and the resolution rate of syrinx/cord as relevant factors were correlated with the recovery rate of JOA (R 2 = 0.578, P < .001) and NDI (R 2 = 0.369, P < .01). What's more, ΔSAS/FMD (SAS/FM diameter) and ΔOc-C2A were positively correlated with the resolution rate of syrinx/cord (R 2 = 0.643, P < .001). CONCLUSION: With medulla decompression and occipital-cervical sagittal realignment after posterior reduction and fusion for BI-AAD patients with syringomyelia, the structural remodeling of the craniovertebral junction and occipitoaxial realignment could contribute to syringomyelia resolution.

The impact of internet use on health status among older adults in China: The mediating role of social support.

Background: With the popularization of the Internet, the use of the Internet is becoming more and more important in the daily life of older adults. However, previous research mainly focuses on Internet use and health in general, and the mechanism of this effect remains to be studied. To bridge this gap, this study aims to explore the mediational effects of social support between Internet use and health among older adults in China. Methods: The data used in this article are from the 2021 Chinese General Social Survey (CGSS). Social support is divided into two aspects and four dimensions: informal social support (relatives support, friends support, neighbors support) and formal social support (social insurance). This article uses the nested multivariate OLS regression models to analyze the impact of Internet use on health. Furthermore, Finally, SPSS macro PROCESS is applied to test their mediation effects. Results: Informal social support positively influenced the health status among older adults, while formal social support did not. Among the three types of informal social support, relatives support and friends support significantly affected health status among Chinese older adults. Regarding social support differences between urban and rural areas, it was found that relatives support is a positively significant factor for rural older adults, while friends support is significant for urban older adults. Conclusions: Since Internet use has many ways of impacting health status, social support only plays a partial mediating role in this study. It recommends that the government should take compelling measures to encourage and promote the use of the Internet among older adults and obtain various social support to improve their health status.

Post-traumatic syringomyelia resolution following surgical treatment: the moniliform syrinx with a better prognosis.

BACKGROUND: Post-traumatic syringomyelia (PTS) presented as a serious delayed complication after spinal cord injury (SCI). In our preliminary pathological investigation of PTS in an animal model, the endogenous repair was activated during the early stage of the central canal expansion. We thought about whether there might be an "early syringomyelia state" with a better outcome. OBJECTIVE: This study aimed to further understand the pathophysiological basis of PTS's occurrence, development, and outcome. MATERIALS AND METHODS: A cross-sectional observational study from a single-center syringomyelia database prospectively maintained at China International Neuroscience Institute (CHINA-INI). A consecutive series of 28 PTS patients at our institution for surgical treatment met the inclusion criteria of this study. Their clinical and imaging data in a long-term follow-up were reviewed retrospectively. We compared the surgical outcome between moniliform and distended syringomyelia based on high­resolution MRI and syringomyelia-related symptoms. American Spinal Injury Association (ASIA) impairment scale (AIS) grade to assess their neurological status. RESULTS: Through a series of phenotypic comparisons, we found that moniliform-like syrinx belongs to a special morphological state with a shorter natural history. The patients in the moniliform group had a better surgical outcome compared with those in the distended group (P = 0.028): more obvious symptom improvement as shown in Kaplan-Meier analysis (P = 0.033, Chi square = 4.523) and a higher syringomyelia resolution rate (P = 0.024). CONCLUSION: We consider the delayed post-traumatic syringomyelia with moniliform type with a better surgical outcome and emphasize the importance of timely intervention to restore cerebrospinal fluid circulation.

Prognostic and risk factors for the surgical efficacy of central spinal cord syndrome in patients with preexisting degenerative cervical spinal cord compression.

OBJECTIVES: To analyze the prognostic and risk factors related to surgical treatment of central spinal cord syndrome (CSS) and to find out the optimal timing of operative management. METHODS: From January 2011 to January 2019, a consecutive series of 128 patients with CSS confirmed by magnetic resonance imaging (MRI) were retrospectively analyzed including their clinical records and radiologic data from a prospectively maintained database in a single center. RESULTS: According to the prognosis evaluated by the modified Japanese Orthopedic Association (mJOA), American Spinal Injury Association (ASIA) motor score (AMS), and ASIA impairment scale (AIS) grade, the overall postoperative outcome was good. Finally, it was found that surgical timing, presence of myelopathy or not at baseline, AMS at admission, and compression ratio were independent factors affecting the prognosis. Surgery as soon as possible after the occurrence of CSS is still advocated. CONCLUSION: Cervical myelopathy at baseline, compression ratio, and AMS score on admission were independent prognostic factors for the surgical treatment of CSS. If surgical indications are clear, early surgical intervention should be actively considered.

Microsurgical treatment of blood blister-like aneurysms: efficacy of clip-on-wrapping with autologous dura mater.

OBJECTIVE: To present a consecutive 20-year series of blood blister-like aneurysms (BBAs) to show that clip-on-wrapping with a Y-shaped autologous dura mater enables treatment of BBAs with a low complication rate and a satisfactory curative result. METHODS: A retrospective review was performed from patients with BBAs of the internal carotid artery (ICA) at the Affiliated Hospital of Qingdao University from 1999 to 2019. Diagnosis and treatment options were analyzed. Outcome was assessed using the modified Rankin scale (mRS). RESULTS: A total of 30 patients with BBAs of the ICA were included. Among these patients, 20 patients underwent microsurgical treatment (15 patients were treated by clip-on-wrapping with a Y-shaped autologous dura mater), the other 10 patients underwent endovascular treatment. All patients presented with subarachnoid hemorrhage (SAH). Four angiograms were initially negative. For all patients, intraoperative rupture occurred in five cases, but no postoperative aneurysm rupture occurred in this series. Three cases with clinical or radiologic cerebral infarctions were observed. The outcome was favorable in 26 patients. CONCLUSIONS: Clip-reinforced wrapping technique using a Y-shaped autologous dura mater may be an effective method for treating BBAs.

Comparison of 3D-printed Navigation Template-assisted Pedicle Screws versus Freehand Screws for Scoliosis in Children and Adolescents: A Systematic Review and Meta-analysis.

BACKGROUND: There is a lack of attention to screw placement techniques for surgical treatment of scoliosis in children and adolescents. This meta-analysis aims to compare the accuracy and safety of pedicle screw placement between the 3D-printed navigation template technique and the freehand technique during corrective surgery for scoliosis in children and adolescents. METHODS: A comprehensive search was conducted for relevant articles up to December 2021 in databases including PubMed, Embase, MEDLINE, Cochrane, and Web of Science. The systematic meta-analysis compared the efficacy of pedicle screw placement between the two techniques, including accuracy of pedicle screw placement, complication rate, operation time, blood loss, mean placement time per screw, and mean times for fluoroscopy. RESULTS: The seven articles analyzed in this study involved 229 patients altogether. A total of 2,805 pedicle screws were placed by the two methods. Our results revealed that the 3D-printed guide template technique was more accurate than the freehand technique in pedicle screw placement (odds ratio [OR] =2.96; 95% confidence interval [CI]: 2.24-3.91; p < 0.000) with a lower complication rate (OR = 0.21; 95% CI: 0.06-0.78; p = 0.02). The operation time (mean difference [MD] = -34.37; 95% CI: -67.47 to -1.28; p = 0.04) and mean placement time per screw (MD = -3.11; 95% CI: -6.13 to -0.09; p = 0.04) and mean times for fluoroscopy (MD = -6.60; 95% CI: -8.66 to -4.55; p < 0.000) significantly decreased among patients in the 3D-printed navigation template group compared with those in the freehand technique group. In addition, the two techniques had no significant statistical difference in blood loss. CONCLUSIONS: Compared with the traditional freehand technique, the 3D-printed guide template is a promising technique with higher accuracy and safety in screw placement for surgical treatment of scoliosis in children and adolescents, and is worth popularizing and validating through more prospective clinical studies.

The Relationship between Parental Emotional Warmth and Rural Adolescents' Hope: The Sequential Mediating Role of Perceived Social Support and Prosocial Behavior.

Parental emotional warmth plays a prominent role in adolescents' hope, but few studies have examined the underlying mechanism between parental emotional warmth and hope in rural adolescents, or have compared the gender differences in the mediation models between parental emotional warmth and hope. Based on the developmental contextualism theory and Bernardo's hope theory, this study examined the sequential mediating effect of perceived social support and prosocial behavior between parental emotional warmth and hope and test the gender differences between them. Seventeen hundred and one rural adolescents were surveyed with the Short-Form Egna Minnen av Barndoms Uppfostran (s-EMBU-C), Perceived Social Support Scale (PSSS), Prosocial Tendency Measure (PTM), and Hope Scale (HS). Correlation analysis showed that there were positive correlations between parental emotional warmth, perceived social support, prosocial behavior, and hope. The structural equation model showed that parental emotional warmth indirectly affected hope through the separate and sequential mediation of perceived social support and prosocial behavior. Multi-group analysis showed that boys were significantly higher than girls in the relationship between perceived social support and prosocial behavior. The results emphasized that improving parental emotional warmth, perceived social support, and encouraging rural adolescents' prosocial behavior could effectively promote their hope.

Mind-body therapies in traditional Chinese medicine for Neuropathic Pain: A Systematic Review of Randomized Controlled Trials.

OBJECTIVES: To evaluate the effectiveness and safety of traditional Chinese medicine (TCM) mind-body therapies in patients with neuropathic pain. DESIGN: This systematic review was undertaken according to the PRISMA 2020 statement. DATA SOURCES: We searched randomized controlled trials (RCTs) in seven English databases and four Chinese databases up to March 2022. REVIEW/ANALYSIS METHODS: The Cochrane Risk of Bias 2 was used for the quality assessment, and the mean difference with a 95% confidence interval for data pooling. The review was registered in the INPLASY (INPLASY202240016). RESULTS: Twenty-three RCTs were identified, including 1,693 patients with lumbar herniated discs (LHD), cervical spondylotic radiculopathy (CSR), sympathetic cervical spondylosis (SCS), trigeminal neuralgia, and central poststroke pain. Pooled results showed that for LHD, TCM mind-body therapy used alone (MD: -0.57, [-0.77, -0.36], P＜0.01, week 8) or combined with physiotherapy (MD: -1.02, [-1.12, -0.91], P＜0.01, week 4) showed advantages over physiotherapy alone on pain relief. However, there was no statistical difference on physical function. For CSR, TCM mind-body movement combined with physiotherapy had better effect than physiotherapy alone on pain relief (MD: -1.15, [-1.37, -0.94], P＜0.01, week 4). Six trials reported safety. Nausea, dizziness, fatigue, and pain at the acupuncture point were observed. CONCLUSIONS: Low-quality evidence showed that TCM mind-body therapies might reduce pain intensity and improve physical function when used as an adjuvant therapy or monotherapy. There is a need to conduct high-quality trials to confirm the effectiveness and safety of TCM mind-body therapies for neuropathic pain.

The Physiological Occlusion of the Central Canal May Be a Prerequisite for Syringomyelia Formation.

OBJECTIVE: Syringomyelia is a common central nervous system disease characterized by the dilation of the central canal (CC). Regarding the pathogenesis of syringomyelia, cerebrospinal fluid (CSF) circulation obstruction in the subarachnoid space (SAS) of the spinal cord has been widely accepted. However, clinical and animal studies on obstructing the CSF in SAS failed to form syringomyelia, challenging the theory of SAS obstruction. The precise pathogenesis remains unknown. METHODS: We utilized an extradural compression rat model to investigate the pathogenesis underlying syringomyelia. Magnetic resonance imaging enabled detection of syringomyelia formation. To assess CSF flow within the SAS, Evans blue was infused into the cisterna magna. Histological analysis allowed morphological examination of the CC. Furthermore, CSF flow through the CC was traced using Ovalbumin Alexa-Flour 647 conjugate (OAF-647). Scanning electron microscopy (SEM) enabled visualization of ependymal cilia. RESULTS: The findings showed that the dura mater below the compression segment exhibited lighter coloration relative to the region above the compression, indicative of partial obstruction within the SAS. However, the degree of SAS occlusion did not significantly differ between syringomyelia (SM-Y group) and those without (SM-N group). Intriguingly, hematoxylin and eosin staining and CSF tracing revealed occlusion of the CC accompanied by reduced CSF flow in the SM-Y group compared to SM-N and control groups. SEM images uncovered impairment of ependymal cilia inside the syringomyelia. CONCLUSION: CC occlusion may represent a physiological prerequisite for syringomyelia formation, while SAS obstruction serves to initiate disease onset. The impairment of ependymal cilia appears to facilitate progression of syringomyelia.

Traditional Chinese medicine for the COVID-19 pandemic: An online cross-sectional survey among health care workers.

Background: : During the coronavirus disease (COVID-19) pandemic, health care workers (HCWs) have faced a heightened risk of infection. Preventative measures are critical to mitigate the spread of COVID-19 and protect HCWs. Traditional Chinese medicine (TCM) has been recommended to prevent and treat COVID-19 in China. We conducted this survey to investigate the use of infection control behaviors, preventative and therapeutic interventions, and outcomes among HCWs during the surge of Omicron variant infections to explore the association of preventative measures with outcomes and to investigate the factors influencing the adoption of TCM as a preventative measure. Methods: : The questionnaire consisted of 23 sections with 154 questions intended for HCWs. The targeted respondents comprised all HCWs from Xiamen Hospital Affiliated of Beijing University of Chinese Medicine. The recruitment process was open between March 17 and June 1, 2022. Chi-square test was used to estimate the relationship between prevention and outcomes. Multivariable logistic regression was used to investigate factors influencing the use of TCM as a preventative measure. Results: : Among the 1122 participants who completed the questionnaire, 79.71% took preventative measures, including TCM (56.21%), physical activities (52.37%) and food supplements (26.99%). Xiamen preventative formula (a government-approved fixed prescription) (45.22%) and Lianhua Qingwen preparations (18.95%) were the most commonly used Chinese medicines. Thirty-six participants reported flu-like symptoms and three were diagnosed with COVID-19. Flu-like symptoms were not associated with prevention, vaccination, or TCM. Frontline working experience (OR = 0.61, 95% CI: 0.46-0.80), good knowledge of post-COVID-19 syndrome (OR = 0.57, 95% CI: 0.39-0.84), Western medicine qualifications (OR = 2.41, 95% CI: 1.51-3.86), nurses (OR = 1.70, 95% CI: 1.21-2.40), and medical technicians (OR = 2.27, 95% CI: 1.25-4.10) were associated with the willingness of using TCM as a preventative measure. Conclusion: : Complementary medicine, especially TCM, could be used for COVID-19 prevention. Knowledge of COVID-19 may prompt people to use TCM to prevent COVID-19. Multicenter studies and prospective cohort follow-up studies are needed to provide further insights into the use of TCM for COVID-19 management.

IRF1 expression might be a biomarker of CD8+ T cell infiltration in cutaneous melanoma.

OBJECTIVE: This study aimed to explore the expression profile of interferon regulatory factor (IRF) genes in skin cutaneous melanoma (SKCM), their association with CD8 + T cell infiltration, and the potential regulatory network in melanoma and non-melanoma cells. METHODS: Bioinformatic analysis was conducted using the SKCM subset of The Cancer Genome Atlas (TCGA) Pan-Cancer, Genotype-Tissue Expression Project (GTEx), and single-cell RNA-seq data from the Human Protein Atlas and Jerby-Arnon et al. 2018's dataset. RESULTS: IRF1 expression is robustly associated with moderate to strong CD8 + T cell infiltration in the tumor microenvironment. It is ubiquitously expressed in tumor and non-tumor cells in melanoma. Melanoma tumor cells and macrophages had 16/36 and 9/27 cell-specific IRF1-correlated genes, respectively. The methylation of four CpG sites (cg00255919, cg21138405, cg15375424, and cg27587780) within the IRF1 gene locus showed moderate to strong negative correlations with IRF1 expression. CONCLUSION: IRF1 expression might serve as a biomarker indicating CD8 + T cell infiltration in skin melanoma. It might exert different regulatory effects in melanoma and non-melanoma cells in the tumor microenvironment. Cg00255919, cg21138405, cg15375424, and cg27587780 are four critical CpG sites that might modulate the transcription of IRF1.