Endogenous H2O2 Self-Replenishment and Sustainable Cascades Enhance the Efficacy of Sonodynamic Therapy.

Purpose: Sonodynamic therapy (SDT), with its high tissue penetration and noninvasive advantages, represents an emerging approach to eradicating solid tumors. However, the outcomes of SDT are typically hampered by the low oxygen content and immunosuppression in the tumor microenvironment (TME). Accordingly, we constructed a cascade nanoplatform to regulate the TME and improve the anti-tumor efficiency of SDT. Methods: In this study, we rationally design cascade nanoplatform by incorporating immunostimulant hyaluronic acid (HA) and sonosensitizer chlorin e6 (Ce6) on the polydopamine nanocarrier that is pre-doped with platinum nanozymes (designated Ce6/Pt@PDA-HA, PPCH). Results: The cascade reactions of PPCH are evidenced by the results that HA exhibits reversing immunosuppressive that converts M2 macrophages into M1 macrophages in situ, while producing H2O2, and then platinum nanozymes further catalyze the H2O2 to produce O2, and O2 produces abundant singlet oxygen (1O2) under the action of Ce6 and low-intensity focused ultrasound (LIFU), resulting in a domino effect and further amplifying the efficacy of SDT. Due to its pH responsiveness and mitochondrial targeting, PPCH effectively accumulates in tumor cells. Under LIFU irradiation, PPCH effectively reverses immunosuppression, alleviates hypoxia in the TME, enhances reactive oxygen species (ROS) generation, and enhances SDT efficacy for eliminating tumor cells in vivo and in vitro. Meanwhile, an in vivo dual-modal imaging including fluorescence and photoacoustic imaging achieves precise tumor diagnosis. Conclusion: This cascade nanoplatform will provide a promising strategy for enhancing SDT eradication against tumors by modulating immunosuppression and relieving hypoxia.

Cancer Patients with Venous Access Device Status and Influencing Factors of Path Analysis Decision Conflicts.

Objective: The study aims to investigate the status of decision-making and the influencing factors of venous access devices in cancer patients and to explore their action path. Methods: A retrospective analysis was conducted on the clinical data of 360 inpatients in the oncology department from July 2022 to October 2022 in Hebei, Shandong, and Shanxi provinces. The patients were assessed with a general information questionnaire, decision conflict scale, general self-efficacy scale, patient version of doctor-patient decision-making questionnaire, and medical version of social support scale. Further analysis was conducted on the influencing factors of decision conflict on cancer patients' status and access to venous access devices. Results: A total of 345 valid questionnaires were acquired, showing the total score of decision-making conflict regarding venous access devices in cancer patients to be 34.72 ± 12.13. A total of 245 patients exhibited decision-making conflict, with a high level in 119 patients. A negative correlation was found between the total score of decision-making conflict with that of self-efficacy, doctor-patient joint decision-making, and social support (r = 0.766, -0.816, -0.74, P < .001). The joint decision-making between doctor and patient directly negatively affected decision-making conflict (ß = -0.587, P < .001). Self-efficacy was found to exert a direct positive and negative predictive effect on the doctor-patient joint decision-making and decision-making conflict, respectively (ß = 0.415, 0.277, P < .001). Social support can contribute to decision-making conflict in a direct or indirect way through multiple modulations of self-efficacy and joint decision-making between doctors and patients (ß = -0.296, -0.237, -0.185, P < .001). Conclusion: Decisional conflicts are existing among cancer patients in intravenous access device selection, the degree of joint decisional involvement of doctors and patients makes a negative predictive effect on intravenous access device selection, and self-efficacy and social support exert direct or indirect effects. Accordingly, enhancing patients' self-efficacy and improving patients' social support from multiple perspectives could contribute to decision-making of intravenous access devices for cancer patients, which could be achieved by developing decision support programs to elevate decision quality, block related paths early, and reduce the level of patients' decision conflicts.

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.

Recent advances in sonodynamic immunotherapy.

Tumor immunotherapy has become an important means of tumor therapy by enhancing the immune response and triggering the activation of immune cells. However, currently, only a small number of patients respond to immunotherapy alone, and patients may experience immune-related adverse events (irAEs) during the course of treatment. Sonodynamic therapy (SDT) can produce cytotoxic substances to tumor tissue, induce apoptosis and enhance immunity. SDT combined with immunotherapy is considered a promising strategy for cancer treatment. In this mini review, we summarize the role of SDT in immunotherapy in recent years, including the application of SDT-triggered immunotherapy and the combination of SDT and immunotherapy.

Application of family-involved smart medication management system in rural-dwelling middle-aged and older adult participants with chronic diseases: Management of chronic diseases in rural areas.

Management of patients with chronic diseases in rural areas and the use of medications need to be urgently addressed. Therefore, this study aimed to evaluate the efficacy of a family-involved smart medication management system for rural patients with chronic diseases. Between June and August 2021, 82 patients with chronic diseases were selected using convenience sampling from 2 county towns in Hebei Province, China. They were randomly divided into control (41 participants) and experimental (41 participants) groups. The control group was managed using a routine medication management model for chronic diseases. The experimental group was managed using a family-involved smart medication management system, in addition to the control group interventions. The groups were graded using the 8-item Morisky Medication Adherence Scale (MMAS-8), the Self-efficacy for Appropriate Medication Use Scale (SEAMS), the Medication Knowledge Assessment Questionnaire, and the Family Support Scale before the intervention and at 8 and 24 weeks after the intervention. Pre-intervention group differences were not statistically significant. At 8 weeks after the intervention, the control group showed no statistically significant differences in the MMAS-8, SEAMS, and Medication Knowledge Assessment scores pre-and post-intervention. These scores were higher in the experimental group than in the control group, with the post-intervention scores being higher than the pre-intervention scores. The MMAS-8, SEAMS, and Medication Knowledge Assessment scores for the experimental group were higher at 24 weeks than at 8 weeks; these scores were higher in the experimental group than in the control group. The experimental group also had higher family support scores than the control group; these scores were higher pre-intervention than post-intervention. A family-involved smart medication management system can effectively improve medication adherence, self-efficacy for appropriate medication use, medication knowledge assessment scores, and family support for rural middle-aged and older adult patients with chronic diseases.

The complete chloroplast genome sequence of Sloanea leptocarpa (Elaeocarpaceae) from China.

Sloanea leptocarpa Diels, 1931 of the Elaeocarpaceae is an endemic plant from China distributed in subtropical evergreen broad-leaved forests and an excellent ornamental tree. The only available chloroplast genomic resource of the genus at present is that of S. sinensis (Hance) Hemsl., 1900 from eastern China. Here, we report the complete chloroplast genome sequence of S. leptocarpa which is less common than S. sinensis. The complete chloroplast genome of S. leptocarpa is 158,077 bp in length, and shows quadripartite organization including a pair of inverted repeat regions (IRs) (24,963 bp) that is divided by a large single-copy (LSC) region (88,519 bp) and a small single-copy (SSC) region (19,632 bp). The circular chloroplast genome of S. leptocarpa contains 119 unique genes, composed of 74 protein-coding genes, 37 tRNA genes, and eight rRNA genes. Phylogenetic analysis involving 52 species with complete chloroplast genomes supported that S. leptocarpa is closely related to S. sinensis. This finding is in agreement with previous studies in which Elaeocarpaceae belongs to Oxalidales instead of Malvales and provides additional evidence for the monophyly of the Sloanea, a sister clade of the Elaeocarpus.

Associations between tumor grade, contrast-enhanced ultrasound features, and microvascular density in patients with clear cell renal cell carcinoma: a retrospective study.

Background: Clear cell renal cell carcinoma (ccRCC) comprises 70% of all renal cell carcinomas (RCCs). Currently, the most important prognostic factor for this type of carcinoma is the World Health Organization/International Society of Urological Pathology (WHO/ISUP) grade. However, nonsurgical methods are rarely used to determine a tumor's WHO/ISUP grade, thus limiting the development of nonsurgical therapies. Due to variations in microvascular density (MVD) at different stages of tumor growth, contrast-enhanced ultrasound (CEUS) features may provide a noninvasive method for evaluating the WHO/ISUP grade of ccRCC. Methods: In this study, we analyzed confirmed cases of ccRCC using CEUS features. We also used CD34 and CD31 antibodies to determine MVD. The heterogeneity of CD34 and CD31 expressions were used to determine different degrees of angiogenesis. Results: When compared to WHO/ISUP grade I/II (G1/G2) tumors, grade III/IV (G3/G4) tumors had reduced peak intensity (PI) (P=0.006), time to peak (TTP) (P<0.001), and relative enhancement percentage index (∆PI%) (P<0.001). However, the frequency of incomplete pseudocapsule (P=0.049) and slow wash-in (P=0.001) was significantly higher in G3/G4 tumors. A cut-off value of ∆PI% <33.15% (P<0.001) allowed identification of G3/G4 tumors with an area under the curve (AUC) of 0.80 [95% confidence interval (CI): 0.70 to 0.91) and a sensitivity of 80%. The mean CD34+ MVD (P<0.001) and CD31+ MVD (P<0.001) were significantly lower in G3/G4 tumors. A positive correlation was revealed between ∆PI% and MVD. There was a statistically significant difference in the density of undifferentiated vessels between the slow wash-in and fast wash-in cases (P<0.001). Conclusions: The features of CEUS are effective for differentiating G3/G4 tumors from G1/G2. There was a positive correlation detected between ∆PI% and MVD, and the density of undifferentiated vessels showed a significant difference between slow wash-in and fast wash-in cases. These findings indicate that CEUS can enable the sonographic visualization of tumor angiogenesis and thus be considered an acceptable method for the nonsurgical assessment of tumor microvascular distribution and grade.

Long-term survival of patients with unoperated single ventricle heart defect: Four case reports and literature review.

A single ventricle (SV) heart defect is a rare complex congenital cardiac malformation, accounting for approximately 1%-2% of congenital heart diseases. Surgical intervention is the mainstay treatment for SV patients, although patients who do not receive surgical intervention may also survive. We followed up four adult patients who had SV since birth without surgical intervention and they had a good prognosis. The common characteristics of four long-term SV survivors were investigated by reviewing their medical records and the literature, and the current treatment methods for SV patients were also reviewed. The clinical presentation and long-term prognosis of SV patients without surgical intervention depend on the presence or absence of pulmonary blood flow obstruction, pulmonary vascular resistance, ventricular shape and function, aortic blood flow obstruction, and the atrioventricular valve shape and function. While the Fontan operation has become a common and effective method for SV treatment, long-term outcomes are fraught with morbidity and mortality. In our opinion, such patients with balanced hemodynamic condition could be followed and treated conservatively. Major cardiac surgery which leads to gross hemodynamic adjustments should be avoided. However, additional prospective study will be necessary to verify this assertion. This report aims to improve the prognosis as well as quality of life of SV patients.

Ultrasonography findings for the diagnosis of renal oncocytoma.

Renal oncocytomas are rare benign epithelial tumors of the kidney. However, they are easily misdiagnosed as renal cancers, resulting in unnecessary radical nephrectomy. This review summarizes the use of ultrasound for the diagnosis of renal oncocytomas. On two-dimensional grayscale ultrasound, renal oncocytomas appear as solid, well-defined, round or oval, and relatively isoechoic or slightly hyperechoic masses. On color Doppler flow imaging, the "spoke-wheel" sign is evident. On power Doppler flow imaging, renal oncocytomas show mixed penetrating and peripheral patterns. Renal oncocytomas usually appear as highly enhanced on contrast-enhanced ultrasound images, and irregular nonenhanced areas in larger tumors. This review will help sonographers recognize renal oncocytomas.

The diagnostic value of imaging techniques for keratoacanthoma: A review.

Keratoacanthoma (KA) is a fast-growing skin tumor with solitary KA being the most common type. KAs rarely metastasize and subside spontaneously. Although histopathology is the gold standard for the diagnosis of KA, its histopathological features are sometimes difficult to distinguish from those of other skin tumors. Imaging studies have certain advantages in the preoperative diagnosis of KA; they not only show the exact shape of the lesion but can also accurately determine the extent of the lesion. Combined with histopathological examination, these findings help establish a diagnosis. By summarizing the imaging features of KA, this article aimed to improve radiologists' understanding of the disease and help in the clinical and differential diagnosis of KA.

A computational prognostic model of lncRNA signature for clear cell renal cell carcinoma with genome instability.

Long non-coding RNAs (lncRNAs) play a critical role in genomic instability and prognosis of cancer patients, but the methods to identify genomic instability-related lncRNAs have yet to be established. In the present study, to assess the prognostic value of lncRNAs associated with genomic instability in clear cell renal cell carcinoma (ccRCC).A computational framework was established based on the mutation hypothesis and combined lncRNA expression and somatic mutation profiles of the ccRCC genome. Furthermore, a prognostic model was developed using the genome instability-derived lncRNA signature GILncSig based on three lncRNA genes (LINC02471, LINC01234, and LINC00460) and verified using multiple independent patient cohorts.This study established an effective computational method to study the role of lncRNAs in genomic instability, with potential applications in identifying new genomic instability-related cancer biomarkers.

Hierarchically Ordered Macro-Microporous Polyoxometalate-Based Metal-Organic Framework Single Crystals.

Facile construction of ordered macroporous polyoxometalate-based metal-organic frameworks (POM@MOFs) to break the intrinsic microporous restriction is significant but remains challenging. On one hand, the POMs introduced improve the structural stability and modify the pores of MOFs, e.g., introducing functional catalytic and adsorptive units. Meanwhile, the acidic POMs severely affect the nucleation and growth of the POM@MOFs, resulting in complicated synthesis and difficult assembly control. Herein, a general approach has been developed to fabricate ordered macroporous POM@MOF single crystals, involving close-packed polystyrene (PS) nanosphere templates. The artificially selected polar solvents exerting strong solvent effect with POMs weaken the affinity between POMs and metal ions, thereby effectively stabilizing the precursors from assembly before filling into the PS template interstices. The weak alkaline carboxylate used regulates the in situ nucleation and growth of POM@MOFs through deprotonation of the ligands as well as coordinating modulation, affording a series of hierarchically cuboctahedral POM@MOF single crystals with ordered macropores (ca. 180 nm) and intrinsic micropores after template removal. The ordered macroporous structure and thinned microporous skeleton markedly improve mass diffusion properties, while the integral single-crystal lattice retains superior stability.

Characteristics of patients with ST-segment elevated myocardial infarction (STEMI) at the initial stage of the COVID-19 pandemic: a systematic review and meta-analysis.

BACKGROUND: The COVID-19 pandemic has become a new challenge to the medical system in various countries. The patients with ST-segment elevated myocardial infarction (STEMI) were also affected. METHODS: We used a random-effects mode to analyze the differences of the baseline characteristics and therapeutic features between STEMI patients admitted before and after the start of the COVID-19 pandemic. RESULTS: Thirty eight studies involving 79,753 patients were included in this analysis. The number of hospitalized STEMI patients decreased by 26% after the start of the COVID-19 pandemic. There were no differences in age, sex, prevalence of diabetes, hypertension, dyslipidemia or percutaneous coronary intervention rate between the STEMI patients before and after the start of the COVID-19 pandemic. However, the STEMI patients admitted after the start of the COVID-19 pandemic had a significantly increased time from symptom onset to first medical contact (standard mean difference: 0.51, 95% confidence interval: 0.24-0.78, p < .001) and an increased in-hospital mortality (odds ratio: 1.70, 95% confidence interval:1.14-2.56, p < .001); The in-hospital mortality of the STEMI patients with COVID-19 was 24% (95% confidence interval: 0.15-0.33); The in-hospital mortality of the STEMI patients with COVID-19 was significantly higher than that of the STEMI patients without COVID-19 at the initial stage of the COVID-19 pandemic (odds ratio: 7.28, 95% confidence interval: 2.75-19.28, p < .001). CONCLUSION: The number of admitted STEMI patients was reduced while the in-hospital mortality and the time from symptom onset to first medical contact were increased during the COVID-19 pandemic.

Solar water oxidation using TaON-BiVO4 photoanodes functionalized with WO3.

Efficient solar-powered water oxidation over BiVO4-based anodes requires coupling photoactive semiconductors to improve inferior activity and stability. Herein, we examine how functionalization with coated tungsten trioxide WO3 affects the photoelectrocatalytic performance of TaON-BiVO4 photoanodes prepared by the doctor-blade method. The effects of the formation of the particularly-porous microstructure and PEC performance of the resulting anodes are explored. Significant enhancements were achieved in water oxidation photocurrent densities at 1.23 V (vs. RHE) with the use of TaON-BiVO4/WO3 photoanodes compared to unmodified TaON-BiVO4. All the composites and photoanodes were studied via numerous characterization methods. Besides, the formation process and probable transfer mechanism of photoinduced carriers were also investigated in detail.

Ultrasonographic Diagnosis of Intussusception in Children: A Systematic Review and Meta-Analysis.

Ultrasonography offers a unique advantage in the clinical diagnosis of intussusception. We aimed to evaluate the diagnostic accuracy of ultrasonography in pediatric intussusception. The PubMed, Embase, Web of Science, Cochrane Library databases, and African Journals Online database were searched for studies pertaining to ultrasonographic diagnosis of intussusception in children. Finally, 14 studies (combined n = 2367) were found eligible for inclusion. Pooled sensitivity and specificity were 0.94 (95% confidence interval: 0.91-0.96) and 0.96 (95% confidence interval: 0.93-0.98), respectively. In conclusion, ultrasonography has high sensitivity and specificity in the diagnosis of intussusception.

Two new combinations in Oreocharis (Gesneriaceae) based on morphological, molecular and cytological evidence.

The newly-circumscribed genus Oreocharis is recently enlarged by incorporating ten other genera with high floral diversity. In this study, our morphological, molecular and cytological evidence supports our adding two species from other two different genera (Boeica and Beccarinda) to Oreocharis. The special corolla shape (campanulate or flat-faced) and related short filament of these two new combinations, Oreocharis guileana and O. baolianis, further enrich the diversity of floral characters of the enlarged Oreocharis. Meanwhile, some supplementary and amended descriptions of these two species are made here. Our morphological, molecular and geographical data indicate that O. guileana is related to O. pilosopetiolata to a certain extent. For O. baolianis, however, our current dataset does not allow conclusions on the species relationship within Oreocharis.

Diagnostic value of ultrasonography and other imaging examinations in patients with intramuscular myxoma: A case series and literature review.

Intramuscular myxoma (IM) is a rare benign soft tumor of mesenchymal origin. Most IMs are located in the large skeletal muscles, and they are typically painless slow-growing masses that are detected incidentally. Surgical excision of IM usually has a good prognosis. Because of its rarity, diagnosing IM via imaging modalities such as ultrasonography (US), computed tomography, positron emission tomography/computed tomography, and magnetic resonance imaging (MRI) can be challenging. Relevant literature and cases were selected as per the inclusion and exclusion criteria. Characteristic imaging findings include a well-defined, ovoid mass with regular morphology and an orientation whereby the long axis is aligned with the course of muscle fibers. In US, IMs exhibit solid cystic mixed echo without obvious blood flow signal. However, MRI reveals hypointensity on T1-weighted images and hyperintensity on T2-weighted images with mild and patchy enhancement. In cases of suspected or potential IM, US and MRI can provide excellent resolution at a reasonable cost. This report aims to improve the recognition rate of IM. Herein, we review imaging characteristics that can contribute to the differential diagnosis of IM.

Polyoxometalates acting as a hole-transfer mediator and crystallization accelerant in a perovskite photoanode for the photoelectrocatalytic oxidation of benzene into phenol.

Organic metal halide perovskite (OMHP) material shows promising applications in the photoelectrocatalytic field, but its efficiencies are unsatisfactory due to the bulk and surface carrier recombination. In this work, we used dual polyoxometalates (C4H9N)3PW12O40 and [Ag10[{Co(H2O)3}2{CoBi2W19O66(OH)4}] to modify the OMHP photoanode; the former acted to improve the quality of the perovskite film and the latter could facilitate hole transfer. Such dual modifications effectively reduce carrier recombination and thus obviously boost photoelectrocatalytic efficiency. Hence, we explored the photoelectrocatalytic oxidation of benzene into phenol in aqueous solution by using the modified OMHP photoanode. The yield of phenol in the reaction using the modified OMHP photoanode reached about 31.8%, which was obviously superior to that using the pure OMHP photoanode. Furthermore, we carried out radical scavenger studies to investigate the active species involved in the photoelectrocatalytic benzene oxidation reaction, and thus proposed the plausible mechanism of the photoelectrocatalytic oxidation of benzene into phenol over the OMHP photoanode. These results provide new insights into the development of high performance OMHP photoanodes for photoelectrocatalytic organic transformation.

Conventional Ultrasound and Contrast-Enhanced Ultrasound in the Diagnosis of Splenic Diseases: A Systematic Review and Meta-analysis.

Accurate diagnosis of splenic diseases is important for timely and accurate treatment. The objective of this study was to compare the accuracy of contrast-enhanced ultrasound (CEUS) and conventional ultrasound (US) in detecting splenic lesions. A systematic literature search was undertaken, and 8 studies met the inclusion criteria. The sensitivity and specificity of the consolidated results of CEUS were 0.95 (95% confidence interval [CI], 0.92-0.97) and 0.97 (95% CI, 0.90-0.99), respectively (I2 = 27.4%; area under the curve [AUC] from a summary receiver operating characteristic curve = 0.97). The sensitivity and specificity of the consolidated results of conventional US were 0.70 (95% CI, 0.56-0.80) and 0.96 (95% CI, 0.76-0.99; I2 = 83.4%; AUC = 0.84). In this systematic review and meta-analysis, the sensitivity and specificity of CEUS were higher than those of conventional US in diagnosing splenic lesions. Contrast-enhanced US is a promising method for accurately diagnosing splenic lesions.

Complete chloroplast genome sequence of the rose apple, Syzygium jambos (Myrtaceae).

Plants in the genus Syzygium have been widely used as traditional medicine, fruit crops, and ornamental trees. In this study, we reported the complete chloroplast genome of Syzygium jambos (L.) Alston which was known as rose apple. The chloroplast genome of this species is 158541 bp in length, including a pair of inverted repeat regions (IRs) (26076 bp) that is divided by a large single copy area (LSC) (88036 bp) and a small single copy area (SSC) (18353 bp). The circular chloroplast genome of S. jambos contains 132 unique genes, composing of 85 protein-coding genes, 39 tRNA genes and 8 rRNA genes. Phylogenetic analysis indicates that S. jambos is clustered with species in genus Syzygium. This complete chloroplast genome of S. jambos will provide a powerful tool to accelerate breeding, biotechnological and phylogenetic study.