Impact of preoperative transcatheter arterial chemoembolization (TACE) on postoperative long-term survival in patients with nonsmall hepatocellular carcinoma: a propensity score matching analysis.

BACKGROUND: The purpose of this propensity score matching (PSM) analysis was to compare the effects of preoperative transcatheter arterial chemoembolization (TACE) and non-TACE on the long-term survival of patients who undergo radical hepatectomy. METHODS: PSM analysis was performed for 387 patients with hepatocellular carcinoma (HCC) (single > 3 cm or multiple) who underwent radical resection of HCC at our centre from January 2011 to June 2018. The patients were allocated to a preoperative TACE group (n = 77) and a non-TACE group (n = 310). The main outcome measures were progression-free survival (PFS) and overall survival (OS) since the treatment date. RESULTS: After PSM, 67 patients were included in each of the TACE and non-TACE groups. The median PFS times in the preoperative TACE and non-TACE groups were 24.0 and 11.3 months, respectively (p = 0.0117). The median OS times in the preoperative TACE and non-TACE groups were 41.5 and 29.0 months, respectively (p = 0.0114). Multivariate Cox proportional hazard regression analysis revealed that preoperative TACE (hazard ratio, 1.733; 95% CI, 1.168-2.570) and tumour thrombosis (hazard ratio, 0.323; 95% CI, 0.141-0.742) were independent risk factors significantly associated with OS. CONCLUSIONS: Preoperative TACE is related to improving PFS and OS after resection of HCC. Preoperative TACE and tumour thrombus volume were also found to be independent risk factors associated with OS.

NIR Plasmonic Nanozymes: Synergistic Enhancement Mechanism and Multi-Modal Anti-Infection Applications of MXene/MOFs.

Nanozymes are considered as the promising antimicrobial agents due to the enzyme-like activity for chemo-dynamic therapy (CDT). However, it remains a challenge to develop novel nanozyme systems for achieving stimuli-responsive, and efficient nanozyme catalysis with multimodal synergistic enhancement. In this work, a near-infrared (NIR) plasmonic-enhanced nanozyme catalysis and photothermal performance for effective antimicrobial applications are proposed. A Ti3 C2 MXene/Fe-MOFs composite (MXM) with NIR plasmonic-enhanced CDT combined with photothermal properties is successfully developed by loading metal-organic framework (MOF) nanozymes onto Ti3 C2 MXene. The mechanism of NIR induced localized surface plasmon resonance (LSPR)-enhanced CDT and photothermal therapy (PTT) is well explained through activation energy (Ea ), electrochemical impedance spectroscopy (EIS), X-ray photoelectron spectroscopy (XPS), fluorescence analysis experiments, and finite element simulation. It reveals that MXene nanosheets exhibit NIR plasmon exciters and generate hot electrons that can transfer to the surface of Fe-MOFs, promoting the Fenton reaction and enhances CDT. While the photothermal heating of MXene produced by LSPR can also boost the CDT of Fe-MOFs under NIR irradiation. Both in vitro and in vivo experimental results demonstrate that LSPR-induced MXM system has outstanding antimicrobial properties, can promote angiogenesis and collagen deposition, leading to the accelerated wound healing.

Antimicrobial, Antioxidant, and Anti-Inflammatory Nanoplatform for Effective Management of Infected Wounds.

Burn wound healing continues to pose significant challenges due to excessive inflammation, the risk of infection, and impaired tissue regeneration. In this regard, an antibacterial, antioxidant, and anti-inflammatory nanocomposite (called HPA) that combines a nanosystem using hexachlorocyclotriphosphazene and the natural polyphenol of Phloretin with silver nanoparticles (AgNPs) is developed. HPA effectively disperses AgNPs to mitigate any toxicity caused by aggregation while also showing the pharmacological activities of Phloretin. During the initial stage of wound healing, HPA rapidly releases silver ions from its surface to suppress bacterial activity. Moreover, these nanoparticles are pH-sensitive and degrade efficiently in the acidic infection microenvironment, gradually releasing Phloretin. This sustained release of Phloretin helps scavenge overexpressed reactive oxygen species in the infected microenvironment area, thus reducing the upregulation of pro-inflammatory cytokines. The antibacterial activity, free radical clearance, and regulation of inflammatory factors of HPA through in vitro experiments are validated. Additionally, its effects using an infectious burn mouse model in vivo are evaluated. HPA is found to promote collagen deposition and epithelialization in the wound area. With its synergistic antibacterial, antioxidant, and anti-inflammatory activities, as well as favorable biocompatibilities, HPA shows great promise as a safe and effective multifunctional nanoplatform for burn injury wound dressings.

Original SARS-CoV-2 monovalent and Omicron BA.4/BA.5 bivalent COVID-19 mRNA vaccines: phase 2/3 trial interim results.

This ongoing, open-label, phase 2/3 trial compared the safety and immunogenicity of the Omicron BA.4/BA.5-containing bivalent mRNA-1273.222 vaccine with the ancestral Wuhan-Hu-1 mRNA-1273 as booster doses. Two groups of adults who previously received mRNA-1273 as primary vaccination series and booster doses were enrolled in a sequential, nonrandomized manner and received single-second boosters of mRNA-1273 (n = 376) or bivalent mRNA-1273.222 (n = 511). Primary objectives were safety and the noninferiority or superiority of neutralizing antibody (nAb) responses against Omicron BA.4/BA.5 and ancestral SARS-CoV-2 with the D614G mutation (ancestral SARS-CoV-2 (D614G)), 28 days post boost. Superiority and noninferiority were based on prespecified success criteria (lower bounds of 95% CI > 1 and < 0.677, respectively) of the mRNA-1273.222:mRNA-1273 geometric mean ratios. Bivalent Omicron BA.4/BA.5-containing mRNA-1273.222 elicited superior nAb responses against BA.4/BA.5 versus mRNA-1273 and noninferior responses against ancestral SARS-CoV-2 (D614G) at day 29 post boost in participants without detectable prior SARS-CoV-2 infection. Day 29 seroresponses against Omicron BA.4/BA.5 were higher for mRNA-1273.222 than for mRNA-1273 and similar against ancestral SARS-CoV-2 (D614G), both meeting noninferiority criterion. The safety profile of mRNA-1273.222 was similar to that previously reported for mRNA-1273 with no new safety concerns identified. Continued monitoring of neutralization and real-world vaccine effectiveness are needed as additional divergent-virus variants emerge. ClinicalTrials.gov registration: NCT04927065.

DMU-212 against EGFR-mutant non-small cell lung cancer via AMPK/PI3K/Erk signaling pathway.

Although some important advances have been achieved in clinical and diagnosis in the past few years, the management of non-small cell lung cancer (NSCLC) is ultimately dissatisfactory due to the low overall cure and survival rates. Epidermal growth factor (EGFR) has been recognized as a carcinogenic driver and is a crucial pharmacological target for NSCLC. DMU-212, an analog of resveratrol, has been reported to have significant inhibitory effects on several types of cancer. However, the effect of DMU-212 on lung cancer remains unclear. Therefore, this study aims to determine the effects and underlying mechanism of DMU-212 on EGFR-mutant NSCLC cells. The data found that the cytotoxicity of DMU-212 on three EGFR-mutant NSCLC cell lines was significantly higher than that of normal lung epithelial cell. Further study showed that DMU-212 can regulate the expression of cell cycle-related proteins including p21 and cyclin B1 to induce G2/M phase arrest in both H1975 and PC9 cells. Moreover, treatment with DMU-212 significantly promoted the activation of AMPK and simultaneously down-regulated the expression of EGFR and the phosphorylation of PI3K, Akt and ERK. In conclusion, our study suggested that DMU-212 inhibited the growth of NSCLCs via targeting of AMPK and EGFR.

Preparing liposomes through frame guided assembly with high-loading functional nucleic acids.

Recently, a frame guided assembly (FGA) has been demonstrated as a robust tool to prepare liposomes with customized morphologies. However, the potential application of FGA liposomes in delivering nucleic acid drugs is still limited by the low payload. In this study, by systemically investigating the correlation between the leading hydrophobic group (LHG) density and the initial detergent concentration, it has been demonstrated that frames with a low LHG density, which may facilitate the increase of the load of the nucleic acid drug, could be guided to form liposomes at low initial detergent concentrations. By capitalizing on this phenomenon, FGA liposomes with a high loading of ASO/siRNA have been successfully prepared and applied to treat pathogenic genes.

[Application of transport ventilator in the inter-hospital transport of critically ill children]. / è½¬è¿å‘¼å¸æœºåœ¨å±é‡æ‚£å„¿é™¢é™ è½¬è¿ä¸­çš„åº”ç”¨ç ”ç©¶.

OBJECTIVES: To study the application value of transport ventilator in the inter-hospital transport of critically ill children. METHODS: The critically ill children in Hunan Children's Hospital who were transported with or without a transport ventilator were included as the observation group (from January 2019 to January 2020; n=122) and the control group (from January 2018 to January 2019; n=120), respectively. The two groups were compared in terms of general data, the changes in heart rate, respiratory rate, and blood oxygen saturation during transport, the incidence rates of adverse events, and outcomes. RESULTS: There were no significant differences between the two groups in sex, age, oxygenation index, pediatric critical illness score, course of disease, primary disease, heart rate, respiratory rate, and transcutaneous oxygen saturation before transport (P>0.05). During transport, there were no significant differences between the two groups in the changes in heart rate, respiratory rate, and transcutaneous oxygen saturation (P>0.05). The incidence rates of tracheal catheter detachment, indwelling needle detachment, and sudden cardiac arrest in the observation group were lower than those in the control group during transport, but the difference was not statistically significant (P>0.05). Compared with the control group, the observation group had significantly shorter duration of mechanical ventilation and length of stay in the pediatric intensive care unit and significantly higher transport success rate and cure/improvement rate (P<0.05). CONCLUSIONS: The application of transport ventilator in the inter-hospital transport can improve the success rate of inter-hospital transport and the prognosis in critically ill children, and therefore, it holds promise for clinical application in the inter-hospital transport of critically ill children.

Polyphosphazene-derived P/S/N-doping and carbon-coating of yolk-shelled CoMoO4 nanospheres towards enhanced pseudocapacitive lithium storage.

Transition metal oxides as potentialanodes of lithium-ion batteries (LIBs) possess high theoretical capacity but suffer from large volume expansion and poor conductivity. To overcome these drawbacks, we designed and fabricated polyphosphazene-coated yolk-shelled CoMoO4 nanospheres, in which polyphosphazene with abundant C/P/S/N species was readily converted into carbon shells and provided P/S/N dopants. This resulted in the formation of P/S/N co-doped carbon-coated yolk-shelled CoMoO4 nanospheres (PSN-C@CoMoO4). The PSN-C@CoMoO4 electrode exhibits superior cycle stability of 439.2 mA h g-1at 1000 mA g-1after 500 cycles and rate capability of 470.1 mA h g-1at 2000 mA g-1. The electrochemical and structural analyses reveal that PSN-C@CoMoO4 with yolk-shell structure, coated with carbon and doped with heteroatom not only greatly enhances the charge transfer rate and reaction kinetics, but also efficiently buffers the volume variation upon lithiation/delithiation cycling. Importantly, the use of polyphosphazene as coating/doping agent can be a general strategy for developing advanced electrode materials.

Covalent Immobilization of Natural Biomolecules on Chitin Nanocrystals.

As a highly crystalline and renewable natural polymer nanomaterial, chitin nanocrystals (ChNCs) have attracted intense interest in the biomedical field. The structure of a ChNC is composed of an acetylglucosamine unit containing two hydroxyl groups and an acetyl group. The acetyl group can be converted to the active amino group through deacetylation, which is under the condition of maintaining the rod-like morphology and high crystalline property and is beneficial for the following modification and potential application. We investigated the relationship between different treatments and varied crystallinities of the modified ChNC, which obtained surface amino groups and aldehyde groups and retained high crystallinity. The natural biomolecules were covalently immobilized on the surface of the ChNC. The etherification was performed based on the hydroxyl groups. Based on the amino groups and the aldehyde groups, the carboxyamine and Knoevenagel condensation reactions were realized on ChNCs. Finally, natural biomolecule-modified ChNCs showed no or low cytotoxicity, antibacterial properties, and high antioxidant properties, which extended their potential biomedical applications.

Prognosis of male lung cancer patients with urinary cancer: a study from a national population-based analysis.

Lung cancer accounts for the most cancer-related deaths in the world. Our previous study suggested the improved survival of lung cancer patients, mainly female patients, with subsequent metachronous primary breast cancer. However, whether the survival advantages of the two primaries are associated with patients' sex and the specific breast cancer is unclear. Whether male lung cancer patients with another primary may encounter the same survival advantage as female patients is also uncertain. The uncertainty hinders these patients from the potential benefit of lung cancer clinical trial. A total of 343 male lung adenocarcinoma patients with subsequent bladder papillary transitional cell carcinoma (LCBC), 1539 lung adenocarcinoma patients with prior bladder papillary transitional cell carcinoma (BCLC), 1181 lung adenocarcinoma patients with subsequent prostate adenocarcinoma (LCPC), 7426 lung adenocarcinoma patients with prior prostate adenocarcinoma (PCLC), and patients with single bladder/prostate/lung (SLC) cancer were identified from the Surveillance, Epidemiology, and End Results. Patients were classified into simultaneous two primary cancer (sTPC), metachronous two primary cancer 1 (mTPC1), or mTPC2 groups when interval time between two cancers was within 6 months, between 7 and 60 months, or over 60 months, respectively. Propensity matching score program was executed to match the two primary cancers with single primary. Cox regression and competing risk regression were performed to identify confounders associated with all-cause and cancer-specific survival, respectively. The major cancer-related and non-cancer-related death in the two primaries were lung cancer and heart disease, respectively. Median overall survival times since lung primary of LCBC and SLC were 97 and 17 months, respectively, and incidence of all-cause and cancer-specific death in LCBC since lung malignancy was significantly lower (Coef. - 1.24, 95% CI - 1.49 to 0.99; SHR 0.42, 95% CI 0.33-0.53). Among the categorized groups, prognosis values of sTPC and mTPC2 groups were not statically different from that of the matched single lung cancer, whereas increased overall survival time and decreased incidence of all-cause and cancer-specific death relative to the matched patients were observed in mTPC1 group (H.R 0.28, 95% CI 0.19-0.41; SHR 0.33, 95% CI 0.23-0.47). Similar prognosis of LCPC relative to SLC was also observed. Furthermore, a generally improved survival relative to SLC was observed in PCLC (median survival times of PCLC and SLC were 17 and 12 months, respectively; Coef. - 0.32, 95% CI - 0.43 to 0.22; SHR 0.77, 95% CI 0.69-0.85), whereas prognosis of BCLC was similar to the matched ones. These results hinted that survival of lung cancer patients might vary with prior cancer history. Further analysis among groups with the two primaries suggested that advanced bladder cancer was not associated with prognosis of patients with LCBC and BCLC. On the contrary, advanced prostate cancer was associated with all-cause and cancer-specific death in patients with PCLC but not in patients with LCPC. Compared with patients with single lung cancer, male lung cancer patients with subsequent bladder/prostate primary over 6 months experienced generally improved survival. These results were similar to our previous study regarding female lung cancer patients with another breast primary. On the contrary, male lung cancer patients with prior primary malignancy encountered varied prognosis: improved survival relative to single lung primary was observed in lung cancer with prior prostate cancer, whereas prognosis of lung cancer with prior bladder cancer was not different. Therefore, great attention was required to characterize prognosis of lung cancer patients with another primary in advance, which was essential to eliminate the potential bias when these patients were included into the clinical trials.

MIL-101(CuFe) Nanozymes with Excellent Peroxidase-like Activity for Simple, Accurate, and Visual Naked-Eye Detection of SARS-CoV-2.

The COVID-19 pandemic has spread to every corner of the world and seriously affected our health and daily activities in the past three years; thereby, it is still urgent to develop various simple, quick, and accurate methods for early detection of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. Nanozymes, a kind of nanomaterial with intrinsic enzyme-mimicking activity, have emerged as a suitable alternative for both therapy and diagnosis of SARS-CoV-2. Here, ultrasensitive and ultrafast MIL-101(CuFe)-CD147 biosensors are established for the detection of SARS-CoV-2 by a simple colorimetric method. A MIL-101(CuFe) metal-organic framework has excellent peroxidase-like activity due to the synergistic effect of Fe and Cu atoms. In addition, the MIL-101(CuFe)-CD147 biosensor shows great potential to detect the various variants of SARS-CoV-2 due to the universal receptor of CD147. The enzyme-based biosensor for the detection of SARS-CoV-2 achieves a very low limit of detection (about 3 PFU/mL) within 30 min. Therefore, the present method provides a new generation of an alternative approach for highly sensitive and visual diagnosis of COVID-19.

Tingli Dazao Decoction pretreatment ameliorates mitochondrial damage induced by oxidative stress in cardiomyocytes.

ETHNOPHARMACOLOGICAL RELEVANCE: Tingli Dazao Decoction (TLDZD) recorded in "Synopsis of Prescriptions of the Golden Chamber" is a classical prescription used for the treatment of heart failure nowadays. The studies of TLDZD were mainly focused on clinical practice where the formula was usually combined with other medicinal herbs. Chemical composition and cardiovascular pharmacological research of TLDZD were still insufficient. AIM OF THE STUDY: This study aimed to investigate the chemical constituents of TLDZD, evaluate the effects of TLDZD on mitochondria of myocardial cells under oxidative stress, and identify its potential cardioprotective components. MATERIALS AND METHODS: Chemical composition analysis of TLDZD was performed by ultra-performance liquid chromatography-quadrupole-time of flight-mass spectrometry. An in vitro oxidative stress model of cardiomyocytes was established by treating H9c2 cells with tert-butyl hydroperoxide (tBHP). The impact of TLDZD and its components on the production of cellular reactive oxygen species (ROS) and mitochondrial ROS (mROS), the level of malonaldehyde as well as the structure and function of mitochondria were evaluated. The effect of TLDZD on AKT/Nrf2/HO-1 signaling pathway in cardiomyocytes under oxidative stress were observed. RESULTS: Seventy-eight compounds were characterized from TLDZD, among which flavonoids, glucosinolates and phenylpropanoids were abundant, and a small number of cardiac glycosides and alkaloids also existed in TLDZD. Pretreatment with TLDZD significantly attenuated cell death, accompanied by decreased ROS and mROS production, reduced malonaldehyde level, lower mitochondrial membrane potential and adenosine triphosphate content in H9c2 cells stimulated with tBHP. The active components were mainly flavonoids of TLZ represented by quercetin-3-O-ß-D-glucose-7-O-ß-D-gentiobioside. In mechanism, the cardioprotective effect of TLDZD was proved to be associated with the activation of the AKT/Nrf2/HO-1 signaling pathway. CONCLUSIONS: The chemical profile of TLDZD was comprehensively investigated. Flavonoids with quercetin-3-O-ß-D-glucose-7-O-ß-D-gentiobioside as the representative, were the main component in TLDZD responsible for attenuating mitochondrial oxidative damage in cardiomyocytes.

TNFα-induced IDH1 hyperacetylation reprograms redox homeostasis and promotes the chemotherapeutic sensitivity.

The heterogeneity and drug resistance of colorectal cancer (CRC) often lead to treatment failure. Isocitrate dehydrogenase 1 (IDH1), a rate-limiting enzyme in the tricarboxylic acid cycle, regulates the intracellular redox environment and mediates tumor cell resistance to chemotherapeutic drugs. The aim of this study was to elucidate the mechanism underlying the involvement of IDH1 acetylation in the development of CRC drug resistance under induction of TNFα. We found TNFα disrupted the interaction between SIRT1 and IDH1 and increased the level of acetylation at K115 of IDH1. Hyperacetylation of K115 was accompanied by protein ubiquitination, which increased its susceptibility to degradation compared to IDH1 K115R. TNFα-mediated hyperacetylation of K115 sensitized the CRC cells to 5FU and reduced the NADPH/NADP ratio to that of intracellular ROS. Furthermore, TNFα and 5FU inhibited CRC tumor growth in vivo, while the K115R-expressing tumor tissues developed 5FU resistance. In human CRC tissues, K115 acetylation was positively correlated with TNFα infiltration, and K115 hyperacetylation was associated with favorable prognosis compared to chemotherapy-induced deacetylation. Therefore, TNFα-induced hyperacetylation at the K115 site of IDH1 promotes antitumor redox homeostasis in CRC cells, and can be used as a marker to predict the response of CRC patients to chemotherapy.

A Novel Joint Adversarial Domain Adaptation Method for Rotary Machine Fault Diagnosis under Different Working Conditions.

In real-world applications of detecting faults, many factors-such as changes in working conditions, equipment wear, and environmental causes-can cause a significant mismatch between the source domain on which classifiers are trained and the target domain to which those classifiers are applied. As such, existing deep network algorithms perform poorly under different working conditions. To solve this problem, we propose a novel fault diagnosis method named Joint Adversarial Domain Adaptation (JADA) for fault detection under different working conditions. Our approach simultaneously aligns marginal distribution and conditional distribution across the source and target through a unified adversarial learning process. JADA aims to construct domain-invariant and category-discriminative feature representation that is effective and robust for substantial distribution difference caused by working conditions. We also introduce a supervision signal, namely center loss, that penalizes the distances between the deep features and their corresponding class centers. This makes the learned features better equipped with more discriminative structures and effectively prevents mode collapse. Twenty-four transfer fault diagnosis tasks based on two experimental platforms were conducted to evaluate the effectiveness of the proposed methods. Extensive experiments verified that the JADA can significantly outperform several popular methods under different transfer diagnosis tasks.

PA-MSHA induces inflamed tumor microenvironment and sensitizes tumor to anti-PD-1 therapy.

A low response rate to immune checkpoint inhibitor (ICI) therapy has impeded its clinical use. As reported previously, an inflamed tumor microenvironment (TME) was directly correlated with patients' response to immune checkpoint blockade (ICB). Thus, restoring the cytotoxic effect of immune cells in the TME is a promising way to improve the efficacy of ICB and overcome primary resistance to immunotherapy. The effect of Pseudomonas aeruginosa mannose-sensitive-hemagglutinin (PA-MSHA) in facilitating T cell activation was determined in vitro and in vivo. Subsets of immune cells were analyzed by flow cytometry. Proteomics was carried out to comprehensively analyze the discriminated cellular kinases and transcription factors. The combinational efficacy of PA-MSHA and αPD-1 therapy was studied in vivo. In this study we demonstrated that PA-MSHA, which is a clinically used immune adjuvant, effectively induced the anti-tumor immune response and suppressed the growth of non-small cell lung cancer (NSCLC) cells. PA-MSHA showed great potential to sensitize refractory "cold" tumors to immunotherapy. It effectively enhanced macrophage M1 polarization and induced T cell activation. In vivo, in combination with αPD-1, PA-MSHA suppressed tumor growth and prolonged the survival time of allograft model mice. These results indicate that PA-MSHA is a potent agent to stimulate immune cells infiltration into the TME and consequently induces inflammation in tumors. The combination of PA-MSHA with αPD-1 is a potential strategy to enhance the clinical response rate to ICI therapy.

Screening of anti-heart failure active compounds from fangjihuangqi decoction in verapamil-induced zebrafish model by anti-heart failure index approach.

Heart failure is the end stage of various cardiovascular diseases. Fangjihuangqi Decoction (FJHQD) is a famous traditional Chinese medicine (TCM) formula, which is clinically effective in the treatment of chronic heart failure. However, the anti-heart failure ingredients of FJHQD have not been clarified, and the related mechanisms of action are rarely studied. In the present study, through quantification analysis of heart rate and ventricular area changes, a heart failure model and cardiac function evaluation system in cardiomyocytes-labelled Tg (cmlc2: eGFP) transgenic zebrafish larvae were constructed, and the anti-heart failure index (AHFI) that can comprehensively evaluate the cardiac function of zebrafish was proposed. Based on this model, FJHQD, its mainly botanical drugs, components and ingredients were evaluated for the anti-heart failure effects. The results showed that FJHQD and its botanical drugs exhibited potent anti-heart failure activity. Furthermore, total alkaloids from Stephania tetrandra S. Moore, total flavonoids from Astragalus mongholicus Bunge and total flavonoids from Glycyrrhiza uralensis Fisch. ex DC. were identified to be the main components exerting the anti-heart failure activity of FJHQD. Then, we screened the main ingredients of these components, and glycyrrhizic acid, licochalcone A and calycosin were found to exhibit excellent cardioprotective effects. Finally, we found that FJHQD, glycyrrhizic acid, licochalcone A and calycosin may improve cardiac function in zebrafish by regulating oxidative stress, inflammatory response and apoptosis-related pathways. Taken together, our findings offer biological evidences toward the anti-heart failure effect of FJHQD, and provide guidance for the clinical application of FJHQD.

Evaluation of mRNA-1273 Vaccine in Children 6 Months to 5 Years of Age.

BACKGROUND: The safety, reactogenicity, immunogenicity, and efficacy of the mRNA-1273 coronavirus disease 2019 (Covid-19) vaccine in young children are unknown. METHODS: Part 1 of this ongoing phase 2-3 trial was open label for dose selection; part 2 was an observer-blinded, placebo-controlled evaluation of the selected dose. In part 2, we randomly assigned young children (6 months to 5 years of age) in a 3:1 ratio to receive two 25-µg injections of mRNA-1273 or placebo, administered 28 days apart. The primary objectives were to evaluate the safety and reactogenicity of the vaccine and to determine whether the immune response in these children was noninferior to that in young adults (18 to 25 years of age) in a related phase 3 trial. Secondary objectives were to determine the incidences of Covid-19 and severe acute respiratory syndrome coronavirus 2 infection after administration of mRNA-1273 or placebo. RESULTS: On the basis of safety and immunogenicity results in part 1 of the trial, the 25-µg dose was evaluated in part 2. In part 2, 3040 children 2 to 5 years of age and 1762 children 6 to 23 months of age were randomly assigned to receive two 25-µg injections of mRNA-1273; 1008 children 2 to 5 years of age and 593 children 6 to 23 months of age were randomly assigned to receive placebo. The median duration of follow-up after the second injection was 71 days in the 2-to-5-year-old cohort and 68 days in the 6-to-23-month-old cohort. Adverse events were mainly low-grade and transient, and no new safety concerns were identified. At day 57, neutralizing antibody geometric mean concentrations were 1410 (95% confidence interval [CI], 1272 to 1563) among 2-to-5-year-olds and 1781 (95% CI, 1616 to 1962) among 6-to-23-month-olds, as compared with 1391 (95% CI, 1263 to 1531) among young adults, who had received 100-µg injections of mRNA-1273, findings that met the noninferiority criteria for immune responses for both age cohorts. The estimated vaccine efficacy against Covid-19 was 36.8% (95% CI, 12.5 to 54.0) among 2-to-5-year-olds and 50.6% (95% CI, 21.4 to 68.6) among 6-to-23-month-olds, at a time when B.1.1.529 (omicron) was the predominant circulating variant. CONCLUSIONS: Two 25-µg doses of the mRNA-1273 vaccine were found to be safe in children 6 months to 5 years of age and elicited immune responses that were noninferior to those in young adults. (Funded by the Biomedical Advanced Research and Development Authority and National Institute of Allergy and Infectious Diseases; KidCOVE ClinicalTrials.gov number, NCT04796896.).

Size effect of cellulose nanocrystals in cellular internalization and exosome-packaging exocytosis.

With the purpose of investigating the bio-interaction between CNC and cells, the end-fluorescence CNC (FCNC) and surface-adsorbed glucosamine [(g)FCNC] were prepared by the region-selective modification and electrostatic adsorption strategy in this study. The cell growth was arrested in a time dependent manner when incubated with CNC in the low glucose environment. The small-size FCNC was preferred by the cells with the observation of higher affinity. Specifically, the affinity of (g)FCNC to the phagocytic cell RAW264.7 cell and kidney derived cell 293 t was generally increased in response to the "Warburg effect", which on the contrary was observed with the weak effect in the tumor cells. We confirmed the exocytosis of internalized rod-like nanocrystal was achieved by the packaging effect of exosomes. Our results revealed the underappreciated bio-interaction between CNC and different cells, which contributed the evidence of an inspiration for this natural nanomaterial in the cell-level application.

Nanotechnology-based chimeric antigen receptor T-cell therapy in treating solid tumor.

Chimeric Antigen Receptor (CAR) T cells have changed the therapeutic landscape of hematological malignancies with overwhelming success. The clinical success of CAR T-cell therapy in hematologic malignancies has fueled interest in exploring the technology in solid tumors. However, the treatment of solid tumors presents a unique set of challenges compared to hematological tumors. The biggest impediments to the success of CAR T cell treatment are the paucity of tumor-specific antigens that are produced selectively and uniformly and the immunosuppressive tumor microenvironment. To overcome these significant challenges, nanotechnology has been involved to improve the efficacy of CAR-T cells. In this review, we systematically introduced the components of different generations of CARs and summarized recent innovations in nano-based CAR-T cell therapy to conquer therapeutically resistant non-hematologic malignancies, including mRNA and hydrogel-based CAR T cells delivery, photothermal-remodeling, and tumor microenvironment-based CAR T cell therapy. These nanotechnologies remarkably facilitate in vivo generation of CAR T cells and hold promise as a therapeutic platform to treat solid tumors and even other diseases.

[Theoretical innovation of component-based Chinese medicine and its exemplary practice: the study on creating Guanxinning Tablets].

Upholding the wisdom of traditional Chinese medicine that the therapeutic principle, method, formula and medicine are coherent with each other, we propose the technical methodology for intelligent creation of component-based Chinese medicine by integrating multidisciplinary knowledge such as artificial intelligence, pharmaceutical informatics, system pharmacology and phytochemistry. Taking the creation of Guanxinning Tablets as an example, we expound the technical principle for creating component-based Chinese medicine and briefly describe the design method for optimizing the entity of Chinese medicine efficacy by rational combination of active components. Our research sought to "clarify and explain" the mechanism of its clinical treatment action through multi-modal and multi-scale systematic pharmacology studies. This work emphatically demonstrates the pilot workshop and engineering validation platform based on the intelligent simulation of whole production process, and outlines the design principles of the intelligent production line for innovative Chinese medicine. The results of industrial research show that the ourself established method for evaluating the process quality controllability and intelligent production line can be applied to manufacturing Guanxining Tablets with high quality. Through the innovative research of multidisciplinary cross-border integration, the present work explored a new way for the creation of modern Chinese medicine.