[Economic evaluation of Annao Pills combined with antihypertensive drugs in treatment of primary hypertension: a study based on decision tree model].

The purpose of this study was to evaluate the economics of Annao Pills combined with antihypertensive drugs in the treatment of primary hypertension in the Chinese medical setting. TreeAge pro 2018 was used for cost-effect analysis and sensitivity analysis of the two treatment regimens. The intervention time of the simulation model was 2 weeks. The cost parameters were derived from Yaozhi.com, and the effect parameters were based on Meta-analysis of randomized controlled trial(RCT) involving Annao Pills. The experimental group was treated with Annao Pills combined with anti-hypertensive drugs(nifedipine controlled-release tablets + losartan potassium tablets), and the control group was treated with anti-hypertensive drugs(nifedipine controlled-release tablets + losartan potassium tablets). The basic analysis showed that the incremental cost-effect ratio(ICER) of the two groups was 2 678.67 yuan, which was less than 7.26% of the per capita disposable income in 2022. That is, compared with anti-hypertensive drugs alone, Annao Pills combined with antihypertensive drugs cost 2 678.67 yuan more for each additional patient with primary hypertension. The results of sensitivity analysis verified the robustness of the basic analysis results. The probability sensitivity results showed that when the patient's personal willingness to pay the price was higher than 2 650 yuan, the probability of the regimen in the experimental group was higher, which was consistent with the results of the basic analysis. In conclusion, when the price was higher than 2 650 yuan, Annao Pills combined with anti-hypertensive drugs was more economical than anti-hypertensive drugs alone in terms of improving the response rate of the patients with primary hypertension.

Tris-assisted one-step fabrication of functional carbon dots for specific folate receptor positive-expressed cancer cell imaging.

Specific staining of cancer cells is momentous for cancer research. Nanoprobe with multivalent recognition is emerging as powerful tools for bioimaging, but the nonspecific cell uptake and complex functional modification procedures are still obstacles for specific detection and convenient synthesis. Carbon dots (CDs) with an intrinsic targeting ability, excellent optical properties and biocompatibility acquired from an efficient one-step fabrication procedure were urgently desired in specific cancer cells visualization. Herein, inspired by the interrelationships between interface and biomolecular mechanisms, we suggested that it was possible to construct CDs with the desired characteristics for folate receptor (FR) positive-expressed cancer cell imaging via rich hydroxyl groups Tris-assisted one-step hydrothermal treatment of folate acid (FA) and l-Arginine (L-Arg) precursors. The prepared small-sized F-CDs were equipped with abundant hydroxyl, pterin and negative charge surface, and possessed environmental friendliness, outstanding photostability and biocompatibility. Moreover, F-CDs had an intrinsic FR positive-expressed cancer cell targeting ability without any post-modification of the ligands. Rich hydroxyl groups play a vital role in endowing the optical properties and biological effects of F-CDs. F-CDs could be used as a promising candidate for FR-expressed cancer cell labeling and tracking. In addition, the caveolae-mediated endocytosis pathway of F-CDs was ascertained. More importantly, experimental results confirmed that the combination of physicochemical properties may provide an efficient strategy to overcome non-specific cell uptake interactions for cell labeling. Our strategy put forward a promising alternative to design fluorescent CDs for extensive chemical and biomedical applications.

DNA-Directed Assembly of Hierarchical MOF-Cellulose Nanofiber Microbioreactors with "Branch-Fruit" Structures.

Assembling metal-organic frameworks (MOFs) into ordered multidimensional porous superstructures promises the encapsulation of enzymes for heterogeneous biocatalysts. However, the full potential of this approach has been limited by the poor stability of enzymes and the uncontrolled assembly of MOF nanoparticles onto suitable supports. In this study, a novel and exceptionally robust Ni-imidazole-based MOF was synthesized in water at room temperature, enabling in situ enzyme encapsulation. Based on this MOF platform, we developed a DNA-directed assembly strategy to achieve the uniform placement of MOF nanoparticles onto bacterial cellulose nanofibers, resulting in a distinctive "branch-fruit" structure. The resulting hybrid materials demonstrated remarkable versatility across various catalytic systems, accommodating natural enzymes, nanoenzymes, and multienzyme cascades, thus showcasing enormous potential as universal microbioreactors. Furthermore, the hierarchical composites facilitated rapid diffusion of the bulky substrate while maintaining the enzyme stability, with ∼3.5-fold higher relative activity compared to the traditional enzyme@MOF immobilized in bacterial cellulose nanofibers.

Targeting focal adhesion kinase boosts immune response in KRAS/LKB1 co-mutated lung adenocarcinoma via remodeling the tumor microenvironment.

BACKGROUND: KRAS mutation is one of the most common oncogenic drivers in NSCLC, however, the response to immunotherapy is heterogeneous owing to the distinct co-occurring genomic alterations. KRAS/LKB1 co-mutated lung adenocarcinoma displays poor response to PD-1 blockade whereas the mechanism remains undetermined. METHODS: We explored the specific characteristics of tumor microenvironment (TME) in KL tumors using syngeneic KRASG12DLKB1-/- (KL) and KRASG12DTP53-/- (KP) lung cancer mouse models. The impact of focal adhesion kinase (FAK) inhibitor on KL lung tumors was investigated in vitro and in vivo through evaluation of both KL cell lines and KL lung cancer mouse models. RESULTS: We identified KL tumors as "immune-cold" tumors with excessive extracellular matrix (ECM) collagen deposition that formed a physical barrier to block the infiltration of CD8+T cells. Mechanistically, abundant activated cancer-associated fibroblasts (CAFs) resulted from FAK activation contributed to the formation of the unique TME of KL tumors. FAK inhibition with a small molecular inhibitor could remodel the TME by inhibiting CAFs activation, decreasing collagen deposition and further facilitating the infiltration of anti-tumor immune cells, including CD8+ T cells, DC cells and M1-like macrophages into tumors, hence, converting "immune-cold" KL tumors into "immune-hot" tumors. The combined FAK inhibitor and PD-1 blockade therapy synergistically retarded primary and metastatic tumor growth of KL tumors. CONCLUSIONS: Our study identified FAK as a promising intervention target for KL tumors and provided basis for the combination of FAK inhibitor with PD-1 blockade in the management of KL lung cancers.

An electrochlorination process integrating enhanced oxidation of phosphonate to orthophosphate and elimination: Verification of matrix chloridion-induced oxidation mechanism.

Phosphonate used as scale inhibitor is a non-negligible eutrophic contaminant in corresponding polluted waters. Besides, its conversion to orthophosphate (ortho-P) is a precondition for realizing bioavailable phosphorus recovery. Due to the feeble degradation efficiency with less than 30 % from classical Fenton commonly used in industrial wastewater treatment and itself vulnerable to strong inhibition interference of matrix chloride ions, we proposed an electrochemical approach to transform the native salt in the solution into oxidizing substances, sort of achieving beneficial utilization of matrix waste, and enhanced the ortho-P conversion rate of 1-Hydroxyethane-1,1-diphosphonic acid (HEDP) to 89.2 % (± 3.6 %). In electrochlorination system, it was found that HEDP rapidly complexed with Fe(II) and then coordinated in-situ Fe(III) to release free HEDP via intramolecular metal-ligand electron transfer reaction. The subsequent degradation mainly rooted in the oxidation of pivotal reactive species HClO, FeIVO2+ and 1O2, causing C-P and CC bonds to fracture in sequence. Eventually the organically bound phosphorus of HEDP was recovered as ortho-P. This study acquainted the audiences with the rare mechanism of chloridion-triggered HEDP degradation under electrochemical way, as well as offered a feasible technology for synchronous transformation of organically bound phosphorus to ortho-P and elimination from phosphonates.

A Universal Approach for Controllable Synthesis of Homogeneously Alloyed PtM Nanoflowers toward Enhanced Methanol Oxidation.

Platinum (Pt)-based alloys have received considerable attention due to their compositional variability and unique electrochemical properties. However, homogeneous element distribution at the nanoscale, which is beneficial to various electrocatalytic reactions, is still a great challenge. Herein, a universal approach is proposed to synthesize homogeneously alloyed and size-tunable Pt-based nanoflowers utilizing high gravity technology. Owing to the significant intensification of micro-mixing and mass transfer in unique high gravity shearing surroundings, five typical binary/ternary Pt-based nanoflowers are instantaneously achieved at room temperature. As a proof-of-concept, as-synthesized Platinum-Silver nanoflowers (PtAg NFs) demonstrate excellent catalytic performance and anti-CO poisoning ability for anodic methanol oxidation reaction with high mass activity of 1830 mA mgPt -1 , 3.5 and 3.2 times higher than those of conventional beaker products and commercial Pt/C, respectively. The experiment in combination with theory calculations suggest that the enhanced performance is due to additional electronic transmission and optimized d-band center of Pt caused by high alloying degree.

Inactivation of Escherichia Coli by mixed-valent nanoparticles in-situ generated during Fe electrocoagulation.

Electrocoagulation (EC) is promising for the removal of chemical and microbial contaminants. Although the removal of pathogens from wastewater is efficient by conventional Fe-EC in the presence of dissolved oxygen (DO), the non-inactivated pathogens in the sediment still have a risk. Herein, the inactivation of Escherichia coli (E. coli) with the mixed-valent iron nanoparticles, magnetite and green rust (GR), in-situ generated from Fe-EC process in the absence of DO was investigated. The inactivation efficiency was significantly higher with magnetite (4.7 log cells) and GR (3.2 log cells) compared with FeOOH (0.7-1.7 log cells) generated at 50 mA in 10 min. The unstable in-situ generated magnetite with positive charges was prone to adsorb onto E. coli, damaging the cell membrane, inactivating the bacteria. The unstable in-situ generated GR was prone to coagulate with E. coli, delivering Fe2+ into the cell and inducing the generation of endogenous ROS, inactivating the bacteria. Fe-EC in the absence of DO was proved to be efficient for the inactivation of E. coli (4.2-4.3 log cells) in real wastewater. These findings identified the ignored inactivation effect and mechanism of E. coli with magnetite and GR generated in situ from Fe-EC process, which will provide theoretical support for real applications.

Efficacy and safety of berberine for premature ventricular contractions: a meta-analysis and systematic review of randomized controlled trials.

CONTEXT: Berberine is a potential drug that can effectively treat cardiovascular diseases, including premature ventricular contractions (PVCs). OBJECTIVE: This study was conducted to assess the efficacy and safety of berberine for PVCs. METHODS: The literature was searched using PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang, and Chinese Biomedical Literature Database (CBM) for randomized controlled trials (RCTs) from inception to October 1, 2022. The risk of bias was assessed using the Revised Cochrane risk-of-bias tool for randomized trials, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to assess the quality of evidence. RESULTS: Ten RCTs with 896 participants were included in the meta-analysis. The results showed that compared to antiarrhythmic drugs (AD), berberine (BE) combined with AD had a higher effective rate (RR = 1.26; 95% CI:1.12, 1.42; p = 0.0001) with no significant incidence of adverse reactions (RR = 0.93; 95% CI:0.33, 2.57; p = 0.88), and BE alone had no significant difference in effective rate (RR = 0.91; 95% CI:0.77, 1.07; p = 0.23), and a lower incidence of adverse reactions (RR = 0.38; 95% CI:0.15, 0.97; p = 0.04) and recurrence rate (RR = 0.40; 95% CI:0.18, 0.88; p = 0.02). CONCLUSIONS: The results suggest that BE is an effective and safe adjunctive method for PVCs. In addition, BE is recommended for patients with PVCs who had severe adverse reactions after administrating AD as an alternative therapy.

Greatly Intensified Guest Exchange Strategy for Highly-Efficient Activation of Metal-Organic Frameworks.

The preservation and accessibility of pores are prerequisites to the application of metal-organic frameworks (MOFs). Activation is a key step to eliciting rich features of pores, but it needs a repeated solvent-exchange process which is tedious and time/cost-consuming. Herein, a facile strategy for highly-efficient activation of MOFs utilizing rotating packed bed is proposed. With the tremendous enhancement of molecular mixing and mass transfer in high-gravity and strong-shearing surrounding, nine representative MOFs are completely activated within 2 h without structural change. Compared with conventional process, this activation displays surprising efficiency by accelerating the diffusion of solvents and redissolution of residual reactants in the pores. The complete activation time can be significantly shortened by over 90%. As a proof-of-concept, the methane storage of as-activated UiO-66 is five times that of as-synthesized UiO-66. This strategy provides a potential platform with industrial worth for the activation of MOF materials with ultra-high efficiency and versatility.

Multi-parameter estimation resistant to the random polarization effect for coherent optical receivers.

Optical parameter estimation based on the data obtained by coherent optical receivers is critical for optical performance monitoring (OPM) and the stable operation of the receiver digital signal processing (DSP). A robust multi-parameter estimation is intricate due to the interference of various system effects. By resorting to the cyclostationary theory, we are able to formulate a chromatic dispersion (CD), frequency offset (FO), and optical signal-to-noise ratio (OSNR) joint estimation strategy that is resistant to the random polarization effect, including polarization mode dispersion (PMD) and polarization rotation. The method uses data directly after the DSP resampling and matched filtering. Both numerical simulation and field optical cable experiment validate our method.

The efficacy and safety of transcutaneous auricular vagus nerve stimulation in the treatment of depressive disorder: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Transcutaneous auricular vagus nerve stimulation (taVNS) is used for treating depression but the efficacy and safety have not been well assessed. This study was conducted to evaluate the efficacy and safety of taVNS in depression. METHODS: The retrieval databases included English databases of PubMed, Web of Science, Embase, the Cochrane Library and PsycINFO, and Chinese databases of CNKI, Wanfang, VIP and Sino Med, and the retrieval period was from their inception to November 10, 2022. The clinical trial registers (ClinicalTrials.gov and Chinese Clinical Trial Registry) were also searched. Standardized mean difference and the risk ratio were used as the effect indicator and the effect size was represented by the 95 % confidence interval. Revised Cochrane risk-of-bias tool for randomized trials and the Grades of Recommendation, Assessment, Development and Evaluation system were used to assess the risk of bias and quality of evidence respectively. RESULTS: Totally, 12 studies of 838 participants were included. taVNS could significantly improve depression and reduce Hamilton Depression Scale scores. Low to very low evidence showed that taVNS had higher response rates than sham-taVMS and comparable response rates compared to antidepressants (ATD) and that taVNS combined with ATD had comparable efficacy to ATD with fewer side effects. LIMITATIONS: The number of studies in subgroups was small and the evidence quality was low to very low. CONCLUSIONS: taVNS is an effective and safe method for alleviating depression scores and had a comparable response rate to ATD.

Diagnostic value of imaging modalities in primary squamous cell carcinoma of the liver.

Primary squamous cell carcinoma of the liver (PSCCL) is rare. PSCCL's lack of specific clinical manifestations and laboratory tests necessitate preoperative diagnosis via imaging examination. Conventional ultrasound (US) demonstrates a mass with mixed echogenicity, and contrast-enhanced US shows a circular pattern of "fast forward, fast backward or slow backward, high enhancement." Enhanced computed tomography (CT) showed enhancement in the center or edge of the lesion, and the density of the enhanced lesion was lower than that of the liver tissue in the same layer. Positron emission tomography-CT demonstrates an inhomogeneous low-density mass with increased 18F-FDG metabolism. Magnetic resonance imaging shows low signal intensity on T1-weighed images (T1WI) and high signal on T2-weighed images (T2WI). By summarizing the imaging characteristics of PSCCL, this review aims to improve clinicians' understanding of PSCCL and its diagnosis.

Non-anticoagulant heparin derivatives for COVID-19 treatment.

The ongoing pandemic of COVID-19, caused by the infection of SARS-CoV-2, has generated significant harm to the world economy and taken numerous lives. This syndrome is characterized by an acute inflammatory response, mainly in the lungs and kidneys. Accumulated evidence suggests that exogenous heparin might contribute to the alleviation of COVID-19 severity through anticoagulant and various non-anticoagulant mechanisms, including heparanase inhibition, chemokine and cytokine neutralization, leukocyte trafficking interference, viral cellular-entry obstruction, and extracellular cytotoxic histone neutralization. However, the side effects of heparin and potential drawbacks of administering heparin therapy need to be considered. Here, the current heparin therapy drawbacks were covered in great detail: structure-activity relationship (SAR) mystery, potential contamination, and anticoagulant activity. Considering these unfavorable effects, specific non-anticoagulant heparin derivatives with antiviral activity could be promising candidates to treat COVID-19. Furthermore, a structurally diverse library of non-anticoagulant heparin derivatives, constructed by chemical modification and enzymatic depolymerization, would contribute to a deeper understanding of SAR mystery. In short, targeting non-anticoagulant mechanisms may produce better therapeutic effects, overcoming the side effects in patients suffering from COVID-19 and other inflammatory disorders.

Structure-activity relationship and biological evaluation of xanthine derivatives as PCSK9 inhibitors for the treatment of atherosclerosis.

Developing non-statin small molecules for the treatment of hypercholesterolemia remains challenging. The proprotein convertase subtilisin/kexin type 9 (PCSK9)-targeted therapies have attracted considerable attentions. Forty-five 7030B-C5 derivatives were synthesized and evaluated for the PCSK9 repression activity, taking the PCSK9 transcriptional inhibitor 7030B-C5 as the lead. Structure-activity relationship (SAR) analysis at C8 and N7-position was carried out, and compound 3s and 5r exhibited comparable PCSK9 transcriptional inhibitory activity but much lower cytotoxicity with the therapeutic index (TI) values doubled of that of 7030B-C5. In the in vitro assay, both compounds significantly reduced the level of PCSK9 protein and increased LDL receptor (LDLR) protein level. What's more, both compounds promoted LDL cholesterol (LDL-C) clearance more efficiently than 7030B-C5 in HepG2 cells. Most importantly, compound 3s reduced the atherosclerotic plaque areas with promising lipid-lowing effects in ApoE KO mice with a higher in vivo activity and lower toxicity. The regulatory mechanism of 3s was explored that it might target the transcription factor HNF1α and/or HINFP upstream of PCSK9 transcription, similar to that of 7030B-C5. Thus, 3s was considered as a potential anti-atherosclerosis drug candidate as a novel PCSK9 down-regulatory agent, worthy of further investigations.

Enhanced photoelectrocatalytic decomplexation of Ni-EDTA and simultaneous recovery of metallic nickel via TiO2/Ni-Sb-SnO2 bifunctional photoanode and activated carbon fiber cathode.

In order to enhance Ni-EDTA decomplexation and Ni recovery via photoelectrocatalytic (PEC) process, TiO2/Ni-Sb-SnO2 bifunctional electrode was fabricated as the photoanode and activated carbon fiber (ACF) was introduced as the cathode. At a cell voltage of 3.5 V and initial solution pH of 6.3, the TiO2/Ni-Sb-SnO2 bifunctional photoanode exhibited a synergetic effect on the decomplexation of Ni-EDTA with the pseudo-first-order rate constant of 0.01068 min-1 with 180 min by using stainless steel (SS) cathode, which was 1.5 and 2.4 times higher than that of TiO2 photoanode and Ni-Sb-SnO2 anode, respectively. Moreover, both the efficiencies of Ni-EDTA decomplexation and Ni recovery were improved to 98% from 86% and 73% from 41% after replacing SS cathode with ACF cathode, respectively. Influencing factors on Ni-EDTA decomplexation and Ni recovery were investigated and the efficiencies were favored at acidic condition, higher cell voltage and lower initial Ni-EDTA concentration. Ni-EDTA was mainly decomposed via ·OH radicals which generated via the interaction of O3, H2O2, and UV irradiation in the contrasted PEC system. Then, the liberated Ni2+ ions which liberated from Ni-EDTA decomplexation were eventually reduced to metallic Ni on the ACF cathode surface. Finally, the stability of the constructed PEC system on Ni-EDTA decomplexation and Ni recovery was exhibited.

Interleukin-10 induces expression of CD39 on CD8+T cells to potentiate anti-PD1 efficacy in EGFR-mutated non-small cell lung cancer.

BACKGROUND: Anti-PD-1(L1) therapies are less efficacious in patients with EGFR-mutated non-small-cell lung cancer. However, the underlying mechanism is poorly understood. METHODS: The characteristics of T cells in EGFR-mutated and wild-type tumors were analyzed based on The Cancer Genome Atlas database and clinical samples. Plasma levels of 8 T-cell-related cytokines were evaluated and its association with immunotherapy efficacy were explored. Association between EGFR signaling pathway and IL-10 was examined through tumor cell lines and clinical tumor samples. In vitro restimulation model of human CD8+T cells isolated from peripheral blood was used to analyze the impact of IL-10 on T cells. Doxycycline-inducible transgenic EGFRL858R mouse models were used to investigate the efficacy of combining recombinant mouse IL-10 protein and PD-1 blockade and its underlying mechanism in vivo. RESULTS: EGFR-mutated tumors showed a lack of CD8+T cell infiltration and impaired CD8+T cell cytotoxic function. The incompetent CD8+T cells in EGFR-mutated tumors were characterized as absence of CD39 expression, which defined hallmarks of cytotoxic and exhausted features and could not be reinvigorated by anti-PD-1(L1) treatment. Instead, CD39 expression defined functional states of CD8+T cells and was associated with the therapeutic response of anti-PD-1(L1) therapies. Mechanically, IL-10 upregulated CD39 expression and was limited in EGFR-mutated tumors. IL-10 induced hallmarks of CD8+T cells immunity in CD39-dependent manner. Using autochthonous EGFR L858R-driven lung cancer mouse models, combining recombinant mouse IL-10 protein and PD-1 blockade optimized antitumor effects in EGFR-mutated lung tumors. CONCLUSIONS: Our study suggested that owing to low level of IL-10 to induce the expression of CD39 on CD8+T cells, fewer phenotypically cytotoxic and exhausted CD39+CD8+T cells in EGFR-mutated tumors could be potentially reinvigorated by anti-PD-1(L1) treatment. Hence, IL-10 could potentially serve as a cytokine-based strategy to enhance efficacy of anti-PD-1(L1) treatment in EGFR-mutated tumors.

Three-Fluid Nozzle Spray Drying Strategy for Efficient Fabrication of Functional Colloidosomes.

Colloidosomes as Pickering emulsion microcapsules are expected to serve various applications, including encapsulation of drugs and loading of functional materials. Normally, when using colloidosomes for drug encapsulation, the latex particles as shell materials need to be mixed with drugs before the assembly process. However, this procedure may cause aggregation of latex particles, thereby resulting in disordered assembled shells or a low loading efficiency. Herein, we propose a three-fluid nozzle spray drying process to efficiently assemble latex particles of P(styrene (St)-co-butyl acrylate (BA)) into colloidosomes. The three-fluid nozzle spray drying equipment allows for the preparation for drug encapsulation without advance mixing of drug and shell materials. This strategy enables the construction of colloidosomes with uniform and controllable pores and the loading of functional materials. The effects of the compressed air flow rate, inlet temperature, feed rate, and solid content were explored, revealing the formation mechanism of colloidosomes during the spray drying process. Doxycycline hydrochloride (DH) was encapsulated in colloidosomes for controllable release, and the sustained release time is up to 100 h. The release rate can be adjusted by varying the glass transition temperature (Tg) and size of latex particles. Furthermore, Fe3O4 nanoparticle (NP)-loaded colloidosomes were constructed by this strategy. The magnetic response intensity of colloidosomes can be modulated by varying the amount of Fe3O4 NPs. The anticancer drug encapsulation and loading of other functional particles were also explored to expand applications.

PtCuRu Nanoflowers with Ru-Rich Edge for Efficient Fuel-Cell Electrocatalysis.

Enhancing the catalytic activity of Pt-based alloy by a rational structural design is the key to addressing the sluggish kinetics of direct alcohol fuel cells. Herein, a facile one-pot method is reported to synthesize PtCuRu nanoflowers (NFs). The synergetic effect among Pt, Cu, and Ru can lower the d-band center of Pt, regulate the morphology, generate Ru-rich edge, and allow the exposure of more high index facets. The optimized Pt0.68 Cu0.18 Ru0.14 NFs exhibit outstanding electrocatalytic performances and excellent anti-poisoning abilities. The specific activities for the methanol oxidation reaction (MOR) (7.65 mA cm-2 ) and ethanol oxidation reaction (EOR) (7.90 mA cm-2 ) are 6.0 and 7.1 times higher than commercial Pt/C, respectively. The CO stripping experiment and the chronoamperometric (5000 s) demonstrate the superior anti-poisoning property and durability performance. Density functional theory calculations confirm that high metallization degree leads to the decrease of d-band center, the promotion of oxidation of CO, and improvement of the inherent activity and anti-poisoning ability. A Ru-rich edge exposes abundant high index facets to accelerate the reaction kinetics of rate-determining steps by decreasing the energy barrier for forming *HCOOH (MOR) and CC bond breaking (EOR).

Quality and fragility of meta-analyses assessing the efficacy and safety of Ginkgo biloba preparation: protocol for a methodological study.

BACKGROUND: Ginkgo biloba L. (GB) is an ancient plant with high medicinal value. GB preparations are widely used to treat diseases such as angina pectoris, ischemic stroke, and dementia. Many meta-analyses of GB preparations for these diseases have recently been published. However, the methodological and reporting quality of relevant meta-analyses have not been systematically evaluated and reported to date. Therefore, the present methodological study was designed to fill this knowledge gap. METHODS: PubMed, Embase, CNKI, WanFang, and the Chinese Biomedical Literature Database will be comprehensively searched from inception to June 2022. Meta-analyses on the efficacy and safety of GB preparations for humans with health conditions will be included. Two researchers will independently screen the literature, extract the data, and evaluate the methodological and reporting quality through AMSTAR-2 and PRISMA 2020. Spearman correlation coefficient will be used to evaluate the correlation between methodological and reporting quality. Five factors potentially affecting the methodological quality will be evaluated through univariate and multivariate linear analyses. The fragility index of statistically significant binary outcomes will be calculated to assess the robustness of pooled results. Stata 16.0 and Excel 2016 will be utilized to conduct the statistical analysis, and P<0.05 will be considered statistically significant. DISCUSSION: This is the first research to thoroughly investigate the methodological and reporting quality of GB preparations for health conditions. The results of this investigation will improve the quality of future studies and clinical decision-making.

CNS tumor with BCOR internal tandem duplication: Clinicopathologic, molecular characteristics and prognosis factors.

The central nervous system tumor with BCOR internal tandem duplication (CNS tumor with BCOR ITD) is a recently identified rare tumor entity, the complete morphologic characteristic, genetic alteration, classification, clinical outcomes and optimal treatment for this tumor entity have not been fully clarified. Here, two new cases of CNS tumor with BCOR ITD were reported and the clinicopathologic, molecular characteristics, and prognosis were analyzed through reviewing of the reported literature. The histological features included a clear border with adjacent brain parenchyma, an extensively microcystic background, and the cells with round to oval nuclei containing delicate chromatin, ependymoma-like perivascular pseudorosettes, and palisading necrosis. Immunohistochemical features showed strong and diffuse positive expression for BCOR, scattered positive expression for OLIG2, and negative expression for GFAP, Syn, and EMA. PCR and direct DNA sequencing analysis identified exon 15 ITD of the BCOR gene in both cases. Interestingly, both cases revealed two duplication segments, which had not been reported in the literature. A review of the literature shows that CNS tumor with BCOR ITD has a poor prognosis with a median survival of 1.7 years; surgical gross total resection is a good prognostic factor. A combination of radiation treatment and chemotherapy, while trending towards significance, does not reach statistical significance. On the contrary, the OS is not associated with age, gender, and tumor location. In conclusion, CNS tumor with BCOR ITD is a rare tumor entity with characteristic morphologic and molecular features and a poor prognosis. The optimal treatment strategies need further studies.