Comparison of uniport versus triport thoracoscopic single or combined basal segmentectomy for stage IA lung cancer.

Background: Single or combined basal segmentectomy (CBS), excluding common basal segmentectomy, is the most difficult of all types of segmentectomies. The purpose of this study was to compare the perioperative outcomes and oncological prognosis between uniport thoracoscopic basal segmentectomy (UTBS) and triport thoracoscopic basal segmentectomy (TTBS). Methods: This study retrospectively collected 300 patients who underwent thoracoscopic single or CBS at the West China Hospital of Sichuan University from April 2015 to May 2022, including 67 and 233 patients in the UTBS and TTBS groups, respectively. Propensity score matching (PSM) was used to reduce confounding bias between the two groups. The primary outcome was recurrence-free survival (RFS). The secondary outcomes were overall survival (OS) and perioperative outcomes. Results: After PSM, the UTBS group (n=64) had significantly less intraoperative blood loss than the TTBS group (n=64) (20 vs. 30 mL, P=0.001). Other perioperative outcomes, including the operation time, number of lymph nodes and lymph node stations harvested, duration of chest tube drainage, postoperative hospital stay, and postoperative complications, were comparable. Subgroup analysis demonstrated that the operative time in the group underwent single basal segmentectomy (SBS) was significantly shorter compared to the group underwent CBS (110 vs. 120 min, P=0.002). There were 5 cases of recurrence in the overall cohort and no recurrence in the matched cohort. No deaths were observed in the overall cohort. Therefore, a survival analysis was conducted only for RFS in the overall cohort. The RFS rate and OS rate of the overall cohort were 98.3% and 100%, respectively. The surgical approach (UTBS vs. TTBS) was not an independent risk factor for RFS (HR: 1.120, 95% CI: 0.342-13.051, P=0.879). Conclusions: UTBS provided similar perioperative outcomes and oncological prognoses compared to TTBS.

Improving the Bioactivity and Stability of Embedded Enzymes by Covalent Organic Frameworks.

De novo embedding enzymes within reticular chemistry materials have shown the enhancement of physical and chemical stability for versatile catalytic reactions. Compared to metal-organic frameworks (MOFs), covalent organic frameworks (COFs) are usually considered to be the more superior host of enzymes because of their large channels with low diffusion barriers, outstanding chemical/thermal stability, and metal-free nature. However, detailed investigations on the comparison of COFs and MOFs in enhancing biocatalytic performance have not been explored. Here, we de novo encapsulated enzymes within two COFs via a mechanochemical strategy, which avoided the extreme synthetic conditions of COFs and highly maintained the biological activities of the embedded enzymes. The enzymes@COFs biocomposites exhibited a much higher activity (3.4-14.7 times higher) and enhanced stability than those in MOFs (ZIF-8, ZIF-67, HKUST-1, MIL-53, and CaBDC), and the rate parameter (kcat/Km) of enzyme@COFs was 41.3 times higher than that of enzyme@ZIF-8. Further explorations showed that the conformation of enzymes inside MOFs was disrupted, owing to the harmful interfacial interactions between enzymes and metal ions as confirmed by ATR-FTIR, fluorescence spectroscopy, and XPS data. In contrast, enzymes that were embedded in metal-free COFs highly preserved the natural conformation of free enzymes. This study provides a better understanding of the interfacial interactions between reticular supports and enzymes, which paves a new road for optimizing the bioactivities of immobilized enzymes.

Erratum: EPHB4 Regulates the Proliferation and Metastasis of Oral Squamous Cell Carcinoma through the HMGB1/NF-κB Signalling Pathway: Erratum.

[This corrects the article DOI: 10.7150/jca.59331.].

Mechanical Behavior of Anchor Bolts for Shallow Super-Large-Span Tunnels in Weak Rock Mass.

Based on the Xiabeishan No.2 tunnel project of the Hang-Shao-Tai high-speed railway in China, the mechanical behavior of the anchor bolts for shallow super-large-span (SSLS) tunnels in weak rock mass is comprehensively investigated through laboratory tests, numerical simulation, and field tests. Firstly, an eight-month field test is conducted in the Xiabeishan No.2 tunnel, and it is discovered that the blasting vibration created by the construction of the middle pilot tunnel caused serious damage to the temporary support, seriously affecting the development of the bolt axial force and causing great construction risks. Then, the refined finite difference model of the SSLS tunnels is formulated, and a series of field and laboratory tests are conducted to acquire the calculation parameters. By comparing the monitored and simulated bolt axial force, the reliability of the numerical model is verified. Subsequently, the influence of the rock condition, construction scheme and bolt length on the mechanical behavior of anchor bolts is discussed. It is revealed that the rock grade significantly affects the bearing characteristics of anchor bolts. The construction scheme can greatly affect the magnitude and development mode of the bolt axial force, but the final distribution characteristics of the bolt axial force do not change regardless of the construction sequence. The axial force of the anchor bolts grows rapidly with the bolt length when the bolt length is within 18 m; meanwhile, when the bolt length exceeds 18 m, increasing the bolt length has a limited effect on the improvement in the bolt support performance. Finally, some optimization measures are proposed according to the monitoring data and simulation results.

Correlations between geomagnetic field and global occurrence of cardiovascular diseases: evidence from 204 territories in different latitude.

BACKGROUND: The correlation between stable geomagnetic fields and unstable geomagnetic activities with mortality, incidence, and prevalence of cardiovascular diseases (CVDs) remains ambiguous. METHOD: To investigate the correlations between geomagnetic field (GMF) intensity and geomagnetic disturbance (GMD) and CVDs events in global, long-period scale, global and 204 countries and territories were included on the base of 2019 Global Burden of Disease study (GBD 2019). Data of GMF intensity, GMD frequency, CVDs events, weather and health economic indicators from 1996 to 2019 of included locations were collected. Linear regression and panel data modelling were conducted to identify the correlations between GMF intensity and CVDs events, multi-factor panel data analysis was also generated to adjust the effect of confounding factors. RESULTS: For the average data during 1996-2019, linear regression model revealed consistent positive correlations between total GMF (tGMF) intensity and mortality of total CVDs [coef = 0.009, (0.006,0.011 95%CI)], whereas negative correlations were found between horizonal GMF (hGMF) intensity and total CVD mortality [coef = -0.010 (-0.013, -0.007 95%CI)]. When considering the time trend, panel data analysis still demonstrated positive correlation between tGMF and total CVDs mortality [coef = 0.009, (0.008,0.009 95%CI)]. Concurrently, the hGMF negatively correlated with total CVDs mortality [coef = -0.008, (-0.009, -0.007 95%CI)]. When the panel models were adjusted for confounding factors, no reverse of correlation tendency was found between tGMF, hGMF and CVDs events. In high-income territories, positive correlation was found between geomagnetic storm (GMS) frequency and mortality of total CVDs [coef = 14.007,(2.785, 25.229 95%CI)], however, this positive trend faded away gradually with the latitude decreasing from polar to equator. CONCLUSIONS: Stable and long-term horizontal component of GMF may be beneficial to cardiac health. Unstable and short-term GMF called GMD could be a hazard to cardiac health. Our results suggest the importance of regular GMF in maintaining cardio-health state and the adverse impacts of GMD on cardiac health.

Melt-blown fiber felt for efficient all-weather recovery of viscous oil spills by Joule heating and photothermal effect.

Adsorbents play a vital role in responding to marine oil spills, yet effectively cleaning up viscous oil spills remains a technical challenge. Herein, we present a superhydrophobic oil-adsorbing felt prepared using melt-blown technology and functionally enhanced with a photoelectric composite CNT/PANI coating for effectively cleaning up high-viscosity oil spills. By virtue of its superior solar/Joule heating ability and thermally conductive fiber network, p-CNT/PANI@PP notably reduced crude oil viscosity and enhanced the oil diffusion coefficient within pores. Leveraging primarily solar heating and supplemented by Joule heating, p-CNT/PANI@PP demonstrates an impressive in-situ adsorption rate of up to 560 g/h for ultra-high-viscosity crude oil (c.a. 138000 mPa·s), alongside an adsorption capacity of 15.57 g/g. This measure enables efficient viscosity reduction and continuous day-and-night recovery of viscous crude oil, addressing the challenges posed by seasonal fluctuations in seawater temperature and adverse weather conditions. Moreover, a conveyorized collector integrated with an oil-adsorbing felt realizes continuous recovery of viscous oil spills with speed control to tackle varying thicknesses of oil film. Given the top-down material design, superior functionality, and applicability to applications, this work provides a comprehensive and feasible solution to catastrophic large-area viscous oil spills.

Supramolecular interface decoration on a polymer conductor for an intrinsically stretchable near-infrared photodiode.

Stretchable photodiodes with near-infrared (NIR) response face the challenge of material deficiency. A supramolecular cathode with excellent optical, tensile and electrical properties was proposed. Together with a stretchable organic heterojunction, we developed an intrinsically stretchable NIR photodiode with high detectivity over 1011 Jones and that remained functional under 100% strain.

LncRNA-CBR3-AS1 promotes and enhances the malignancy of ulcerative colitis via targeting miRNA-145-5p/FN1.

Growing evidence suggested that long non-coding RNA (lncRNA) played a crucial role in the progression of ulcerative colitis (UC). Therefore, the purpose of this study is to understand how the lncRNA CBR3-AS1, which has been found to be up-regulated in UC, contributes to the bio-progression of the disease. To determine the concentration and relationship of the lncRNA CBR3-AS1, miRNA-145-5p, and FN1 in the LPS-induced Caco-2 model cells, qRT-PCR was employed in this study.  Starbase was used to predict the target sites of the lncRNA CBR3-AS1 and the miRNA-145-5p, and Targetscan was used to predict the probable linking points of the FN1 and the miRNA-145-5p, which was confirmed by a twofold luciferase reporter test. The vitality of Caco-2 cells was determined using the CCK-8 and FCM tests. Using the ELISA kit, TNF, IFN, IL-6, and IL-17 were identified. The results of the experiment show that in Caco-2 cells treated with 10 ng/mL LPS, LncRNA CBR3-AS1 was up-regulated. Additionally, Caco-2 cells' LPS-induced apoptosis and inflammatory response were inhibited by lncRNA CBR3-AS1 inhibition. Dual-luciferase reporter experiments demonstrated that miRNA-145-5p and lncRNA CBR3-AS1 might connect. Moreover, miRNA-145-5p, which was shown to be poorly expressed in UC, was found to suppress inflammatory and apoptotic responses in Caco-2 cells activated by LPS. It's significant that FN1 was confirmed to be miRNA-145-5p's downstream target. Sh-CBR3-AS1's inhibitory effects were reversed by miRNA-145-5p knockdown, and the effects of the miRNA-145-5p inhibitor were reversed by sh-FN1. In conclusion, LncRNA CBR3-AS1 may offer a unique method for treating UC by suppressing the function of miRNA-145-5p, which is implicated in the development of UC.

Topological reorganization and functional alteration of distinct genomic components in gallbladder cancer.

Altered three-dimensional architecture of chromatin influences various genomic regulators and subsequent gene expression in human cancer. However, knowledge of the topological rearrangement of genomic hierarchical layers in cancer is largely limited. Here, by taking advantage of in situ Hi-C, RNA-sequencing, and chromatin immunoprecipitation sequencing (ChIP-seq), we investigated structural reorganization and functional changes in chromosomal compartments, topologically associated domains (TADs), and CCCTC binding factor (CTCF)-mediated loops in gallbladder cancer (GBC) tissues and cell lines. We observed that the chromosomal compartment A/B switch was correlated with CTCF binding levels and gene expression changes. Increased inter-TAD interactions with weaker TAD boundaries were identified in cancer cell lines relative to normal controls. Furthermore, the chromatin short loops and cancer unique loops associated with chromatin remodeling and epithelial-mesenchymal transition activation were enriched in cancer compared with their control counterparts. Cancer-specific enhancer-promoter loops, which contain multiple transcription factor binding motifs, acted as a central element to regulate aberrant gene expression. Depletion of individual enhancers in each loop anchor that connects with promoters led to the inhibition of their corresponding gene expressions. Collectively, our data offer the landscape of hierarchical layers of cancer genome and functional alterations that contribute to the development of GBC.

Short-term clinical efficacy and safety of unilateral biportal endoscopic transforaminal lumbar interbody fusion versus minimally invasive transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases: a systematic review and meta-analysis.

BACKGROUND: The aim of this study was to comprehensively evaluate the short-term clinical efficacy and safety of unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) versus minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for the treatment of lumbar degenerative diseases by meta-analysis. METHODS: A computer-based search of PubMed, Embase, Web of Science, Cochrane Database, China National Knowledge Infrastructure (CNKI), Wanfang Database, and Chinese Science and Technology Journal Database (VIP) was conducted from the inception of the each database to April 2023. The searched literature was then screened according to strict inclusion and exclusion criteria. The critical data were extracted and analyzed using Review Manager software5.4.1. Pooled effects were calculated on the basis of data attributes by mean difference (MD) or odds ratio (OR) with 95% confidence interval (CI). The Newcastle-Ottawa Scale was used to assess the quality of the studies. RESULTS: A total of 13 studies and 949 patients met the inclusion criteria for this meta-analysis, 445 in the UBE-LIF group and 504 in the MIS-TLIF group. UBE-TLIF was superior to MIS-TLIF in terms of intraoperative blood flow, postoperative drainage flow, duration of hospital stay, VAS score for low back pain and ODI score, but the operative time was longer than MIS-TLIF group. There were no significant differences between the two groups in terms of total complication rate, modified Macnab grading criteria, fusion rate, VAS score of leg pain, lumbar lordosis, intervertebral disk height. CONCLUSION: Both UBE-TLIF and MIS-TLIF are effective surgical modalities for the treatment of degenerative lumbar spine diseases. They have similar treatment outcomes, but UBE-TLIF has the advantages of less intraoperative blood loss, shorter postoperative hospital stay, and faster recovery. TRIAL REGISTRATION: This study has been registered at INPLASY.COM (No. INPLASY202320087).

Effect of novel prefabricated auxiliary devices attaching to scan bodies on the accuracy of intraoral scanning of complete-arch with multiple implants: An in-vitro study.

OBJECTIVES: To examine the effect of novel prefabricated auxiliary devices with different geometric features called Scan Body Clasp (SBC) at different levels on the accuracy of intraoral scanning of complete-arch with multiple implants. METHODS: An edentulous maxilla 4-implant model and SBCs with different geometric features (flat or curved) were fabricated by a 3D printer (AccuFab-C1s, 3DShining, Hangzhou, China). Test scans were performed using an intraoral scanner (Aoralscan 3, 3DShining, Hangzhou, China) software version 1.0.0.3104 under different scenarios: group A (CO), without any SBCs; group B&C (LC&HC), with curved SBCs adjacent to and away from the mucosa; group D&E (LF&HF), with flat SBCs adjacent to and away from the mucosa. 20 scans were done for each group (CO, LC, HC, LF and HF). Reference Scans were obtained by digitizing the model in group A using a dental laboratory scanner (D2000, 3Shape, Copenhagen, Denmark). The related files were imported into inspection software for trueness and precision assessment. Statistical analysis was performed with One-way ANOVA, Independent-Sample T test for trueness values. Kruskal-Wallis test and Mann-Whitney test were used to assess the precision values. The level of significance was set at α=.05. RESULTS: Groups with SBCs demonstrated trueness enhancement, among which LF revealed the best trueness. Significant differences were also found between LF and HC (p < .01), LF and HF (p < .001), LC and HF (p < .01). LF and HF showed precision enhancement. The best precision was LF, which was found to be more precise than LC (p < .001) and HC (p < .001). HF was more precise than LC (p < .001) and HC (p < .001). CONCLUSIONS: Attaching the scan bodies with SBCs at different levels significantly influenced the scanning accuracy. The SBCs near the mucosa result in superior trueness, while the flat morphology benefits the precision. CLINICAL SIGNIFICANCE: The results demonstrated the feasibility of the SBCs in enhancing intraoral complete-arch implant scanning accuracy. Among the configurations tested in the present study, low-level and flat surfaces of the artificial landmarks may be the potential pivotal elements to optimizing long-span scanning accuracy.

MXene/Graphene modified cellulose aerogel for photo-electro-assisted all-weather cleanup of high-viscous crude oil from spill.

The frequent occurrence of oil spills has led to serious environmental pollution and ecological issues. Given the high-viscosity of crude oil, it is essential to develop sorbents with efficient viscosity reduction and sorption capacity in various environmental conditions. Herein, a superhydrophobic carboxymethyl cellulose (CMC) aerogel co-modified by MXene and graphene jointly (M-Mxene/Gr CA) with aligned channels structure was prepared. The aligned channels structure can effectively improve the longitudinal thermal conductivity and reduce the sorption resistance. Through the modification of MXene and graphene, the aerogel realized efficient photo/electro-thermal conversion, thus ensuring its adaption to various working environments. The rapid heat generation can significantly reduce the viscosity of crude oil, achieving rapid recovery. Under one sun illumination (1.0 kW/m2), the surface temperature of M-Mxene/Gr CA can reach 72.6 °C and its sorption capability for high-viscous crude oil reaches 18 g/g. Combining photo-thermal and electro-thermal (0.5 kW/m2 and 23 V), the average sorption rate of crude oil can reach 1.3 × 107 g m-3 s-1. Finally, we present a continuous sorption system to recover offshore oil spills under the assistance of a pump. This work provides a new option for tackling high-viscous offshore oil spills due to its environmental friendliness and fast sorption capacity.

DC and AC characteristics of Si/SiGe based vertically stacked complementary-tunneling FETs.

In this paper, electrical characteristics of a complementary tunneling field effect transistor (CTFET) is studied computationally for the first time. The design of CTFET is carried with 3D vertically stacked channels (multiple) of n-TFET on top of the p-TFET with gate-all-around (GAA) nanosheet SiGe options. The CTFET technology (using CFETs) is examined for emerging technology nodes as a potential alternative to conventional TFETs. Here, the device level design of CTFET is strictly monitored with DC characteristic behavior under the influence of process variability conditions (traps and temperature). The performance analysis is extended to analyze the capability of CTFET under critical dimensions of vertical pitch (n- top-TFET separation), where it is identified with high scalability. The results of CTFET-inverter show high- noise margin (NM) and voltage gains compared to the conventional strained-Si GAATFETs at the supply range (VDD) from 0.7 ≥ VDD≥ 0.2 V. In addition, the CTFET-inverter circuit performance is analyzed with miller capacitance, power delay product, and intrinsic delay, respectively. With better circuit performance, 12.5% and 21.5% improvements in low and high NMs (NMLand NMH) are seen in CTFETs compared to conventional TFETs.

Low glucose metabolite 3-phosphoglycerate switches PHGDH from serine synthesis to p53 activation to control cell fate.

Glycolytic intermediary metabolites such as fructose-1,6-bisphosphate can serve as signals, controlling metabolic states beyond energy metabolism. However, whether glycolytic metabolites also play a role in controlling cell fate remains unexplored. Here, we find that low levels of glycolytic metabolite 3-phosphoglycerate (3-PGA) can switch phosphoglycerate dehydrogenase (PHGDH) from cataplerosis serine synthesis to pro-apoptotic activation of p53. PHGDH is a p53-binding protein, and when unoccupied by 3-PGA interacts with the scaffold protein AXIN in complex with the kinase HIPK2, both of which are also p53-binding proteins. This leads to the formation of a multivalent p53-binding complex that allows HIPK2 to specifically phosphorylate p53-Ser46 and thereby promote apoptosis. Furthermore, we show that PHGDH mutants (R135W and V261M) that are constitutively bound to 3-PGA abolish p53 activation even under low glucose conditions, while the mutants (T57A and T78A) unable to bind 3-PGA cause constitutive p53 activation and apoptosis in hepatocellular carcinoma (HCC) cells, even in the presence of high glucose. In vivo, PHGDH-T57A induces apoptosis and inhibits the growth of diethylnitrosamine-induced mouse HCC, whereas PHGDH-R135W prevents apoptosis and promotes HCC growth, and knockout of Trp53 abolishes these effects above. Importantly, caloric restriction that lowers whole-body glucose levels can impede HCC growth dependent on PHGDH. Together, these results unveil a mechanism by which glucose availability autonomously controls p53 activity, providing a new paradigm of cell fate control by metabolic substrate availability.

Design, synthesis and biological evaluation of chalcone derivatives as potent and orally active hCYP3A4 inhibitors.

Human cytochrome P450 3A4 (hCYP3A4), one of the most important drug-metabolizing enzymes, catalyze the metabolic clearance of ∼50% therapeutic drugs. CYP3A4 inhibitors have been used for improving the in vivo efficacy of hCYP3A4-substrate drugs. However, most of existing hCYP3A4 inhibitors may trigger serious adverse effects or undesirable effects on endogenous metabolism. This study aimed to discover potent and orally active hCYP3A4 inhibitors from chalcone derivatives and to test their anti-hCYP3A4 effects both in vitro and in vivo. Following three rounds of screening and structural optimization, the isoquinoline chalcones were found with excellently anti-hCYP3A4 effects. SAR studies showed that introducing an isoquinoline ring on the A-ring significantly enhanced anti-CYP3A4 effect, generating A10 (IC50 = 102.10 nM) as a promising lead compound. The 2nd round of SAR studies showed that introducing a substituent group at the para position of the carbonyl group on B-ring strongly improved the anti-CYP3A4 effect. As a result, C6 was identified as the most potent hCYP3A4 inhibitor (IC50 = 43.93 nM) in human liver microsomes (HLMs). C6 also displayed potent anti-hCYP3A4 effect in living cells (IC50 = 153.00 nM), which was superior to the positive inhibitor ketoconazole (IC50 = 251.00 nM). Mechanistic studies revealed that C6 could potently inhibit CYP3A4-catalyzed N-ethyl-1,8-naphthalimide (NEN) hydroxylation in a competitive manner (Ki = 30.00 nM). Moreover, C6 exhibited suitable metabolic stability in HLMs and showed good safety profiles in mice. In vivo tests demonstrated that C6 (100 mg/kg, orally administration) significantly increased the AUC(0-inf) of midazolam by 3.63-fold, and strongly prolonged its half-life by 1.66-fold compared with the vehicle group in mice. Collectively, our findings revealed the SARs of chalcone derivatives as hCYP3A4 inhibitors and offered several potent chalcone-type hCYP3A4 inhibitors, while C6 could serve as a good lead compound for developing novel, orally active CYP3A4 inhibitors with improved druglikeness properties.

Preclinical Evaluation of a Protein-Based Nanoscale Contrast Agent for MR Angiography at an Ultralow Dose.

Purpose: BSA-biomineralized Gd nanoparticles (Gd@BSA NPs) have been recognized as promising nanoscale MR contrast agents. The aim of this study was to carry out a preclinical evaluation of these NPs in a middle-sized animal model (rabbits). Methods: New Zealand white rabbits were treated intravenously with Gd@BSA NPs (0.02 mmol Gd/kg) via a clinically-used high-pressure injector, with commercial Gd-diethylene triamine pentaacetate (Gd-DTPA)-injected group as control. Then MR angiography was performed according to the standard clinical protocol with a 3.0-T MR scanner. The SNR and CNR of the main arteries and branches were monitored. Pharmacokinetics and bioclearance were continuously evaluated in blood, urine, and feces. Gd deposition in vital organs was measured by ICP‒MS. Weight monitoring, HE staining, and blood biochemical analysis were also performed to comprehensively estimate systemic toxicity. Results: The ultrasmall Gd@BSA NPs (<6 nm) exhibited high stability and T1 relaxivity. Compared to Gd-DTPA, Gd@BSA NPs demonstrated superior vascular system imaging performance at ultralow doses, especially of the cardiac artery and other main branches, and exhibited a significantly higher SNR and CNR. Notably, the Gd@BSA NPs showed a shorter half-life in blood, less retention in organs, and improved biocompatibility. Conclusion: The preclinical evaluations here demonstrated that Gd@BSA NPs are promising and advantageous MR CA candidates that can be used at a low dose with excellent MR imaging performance, thus suggesting its further clinical trials and applications.

The management of non-culprit vessel(s) in patients with unstable angina/non-ST elevation myocardial infarction and chronic kidney dysfunction.

BACKGROUND AND AIMS: The clinical effects of multivessel interventions in patients with unstable angina/non-ST-segment elevation myocardial infarction (UA/NSTEMI), multivessel disease (MVD) and chronic kidney disease (CKD) remain uncertain. This study aimed to investigate the safety and effectiveness of intervention in non-culprit lession(s) among this cohort. METHODS: We consecutively included patients diagnosed with UA/NSTEMI, MVD and CKD between January 2008 and December 2018 at our centre. After successful percutaneous coronary intervention (PCI), we compared 48-month overall mortality between those undergoing multivessel PCI (MV-PCI) through a single-procedure or staged-procedure approach and culprit vessel-only PCI (CV-PCI) after 1:1 propensity score matching. We conducted stratified analyses and tests for interaction to investigate the modifying effects of critical covariates. Additionally, we recorded the incidence of contrast-induced nephropathy (CIN) to assess the perioperative safety of the two treatment strategies. RESULTS: Of the 749 eligible patients, 271 pairs were successfully matched. Those undergoing MV-PCI had reduced all-cause mortality (hazard ratio (HR): 0.67, 95% confidence interval (CI): 0.48-0.67). Subgroup analysis showed that those with advanced CKD (estimated glomerular filtration rate (eGFR) ≤ 30 mL/min/1.73 m2 ) could not benefit from MV-PCI (P = 0.250), and the survival advantage also tended to diminish in diabetes (P interaction < 0.01; HR = 0.95, 95% CI = 0.65-1.45). Although the staged-procedure approach (N = 157) failed to bring additional survival benefits compared to single-procedure MV-PCI (N = 290) (P = 0.460), it showed a tendency to decrease the death risk. CIN risks in MV-PCI and CV-PCI groups were not significantly different (risk ratio = 1.60, 95% CI = 0.94-2.73). CONCLUSION: Among patients with UA/NSTEMI and non-diabetic CKD and an eGFR > 30 mL/min/1.73 m2 , MV-PCI was associated with a reduced risk of long-term death but did not increase the incidence of CIN during the management of MVD compared to CV-PCI. And staged procedures might be a preferable option over single-procedure MV-PCI.

Identification and immunological characterization of lipid metabolism-related molecular clusters in nonalcoholic fatty liver disease.

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is now the major contributor to chronic liver disease. Disorders of lipid metabolism are a major element in the emergence of NAFLD. This research intended to explore lipid metabolism-related clusters in NAFLD and establish a prediction biomarker. METHODS: The expression mode of lipid metabolism-related genes (LMRGs) and immune characteristics in NAFLD were examined. The "ConsensusClusterPlus" package was utilized to investigate the lipid metabolism-related subgroup. The WGCNA was utilized to determine hub genes and perform functional enrichment analysis. After that, a model was constructed by machine learning techniques. To validate the predictive effectiveness, receiver operating characteristic curves, nomograms, decision curve analysis (DCA), and test sets were used. Lastly, gene set variation analysis (GSVA) was utilized to investigate the biological role of biomarkers in NAFLD. RESULTS: Dysregulated LMRGs and immunological responses were identified between NAFLD and normal samples. Two LMRG-related clusters were identified in NAFLD. Immune infiltration analysis revealed that C2 had much more immune infiltration. GSVA also showed that these two subtypes have distinctly different biological features. Thirty cluster-specific genes were identified by two WGCNAs. Functional enrichment analysis indicated that cluster-specific genes are primarily engaged in adipogenesis, signalling by interleukins, and the JAK-STAT signalling pathway. Comparing several models, the random forest model exhibited good discrimination performance. Importantly, the final five-gene random forest model showed excellent predictive power in two test sets. In addition, the nomogram and DCA confirmed the precision of the model for NAFLD prediction. GSVA revealed that model genes were down-regulated in several immune and inflammatory-related routes. This suggests that these genes may inhibit the progression of NAFLD by inhibiting these pathways. CONCLUSIONS: This research thoroughly emphasized the complex relationship between LMRGs and NAFLD and established a five-gene biomarker to evaluate the risk of the lipid metabolism phenotype and the pathologic results of NAFLD.

Aluminum soap nanoparticles-lignin powder form phase-selective gelator as an efficient sorbent for oils/water separation.

Rapid and efficient recovery of oil spill is the key link for oil spill remediation, and also a great challenge. Here, the organogelator-polymerized porous matrix composed of adsorbents and organogelators can provide a new strategy for solving this problem. The gelling mechanism of aluminum 12-hydroxystearate (Al HSA) to form spherical nano micelles in solvents was investigated via UV-vis, FT-IR, and XRD. A creative method for aluminum soap-lignin gelator (OTS-AL/Al HSA) syntheses was put forward through the saponification of 12-hydroxystearic acid (HSA) and lignin via epichlorohydrin (ECH) crosslinking. By adjusting the ECH content, the growth of Al HSA nanoparticles (15-40 nm) on lignin can be realized, and the accordingly increased roughness endowed gelator with better hydrophobicity (WCA of 134.6°) before octadecyltrichlorosilane (OTS) modification. Thanks to the porous structures, the gelator powder exhibited a high sorption capacity in the range of 3.5-5.2 g g-1 for oils and organic solvents. Rheological studies demonstrated high mechanical strength of gels (>1.6 × 105 pa) and the gelator still retained 70% sorption capacity after 6 gelation-distillation cycles. The gelation characteristics of OTS-AL/Al HSA were attributed to the rapid sorption of oils by lignin and the self-assembly of Al HSA nano micelles on lignin to form an aggregated network structure trapping oils, thus realizing the synergistic effect of oil sorption-gelation.