Environmental colloid behaviors of humic acid - Cadmium nanoparticles in aquatic environments.

Humic acid (HA), a principal constituent of natural organic matter (NOM), manifests ubiquitously across diverse ecosystems and can significantly influence the environmental behaviors of Cd(II) in aquatic systems. Previous studies on NOM-Cd(II) interactions have primarily focused on the immobilization of Cd(II) solids, but little is known about the colloidal stability of organically complexed Cd(II) particles in the environment. In this study, we investigated the formation of HA-Cd(II) colloids and quantified their aggregation, stability, and transport behaviors in a saturated porous media representative of typical subsurface conditions. Results from batch experiments indicated that the relative quantity of HA-Cd(II) colloids increased with increasing C/Cd molar ratio and that the carboxyl functional groups of HA dominated the stability of HA-Cd(II) colloids. The results of correlation analysis between particle size, critical aggregation concentration (CCC), and zeta potential indicated that both Derjaguin-Landau-Verwey-Overbeek (DLVO) and non-DLVO interactions contributed to the enhanced colloidal stability of HA-Cd(II) colloids. Column results further confirmed that the stable HA-Cd(II) colloid can transport fast in a saturated media composed of clean sand. Together, this study provides new knowledge of the colloidal behaviors of NOM-Cd(II) nanoparticles, which is important for better understanding the ultimate cycling of Cd(II) in aquatic systems.

Oxidation-reduction process of Arabidopsis thaliana roots induced by bisphenol compounds based on RNA-seq analysis.

Bisphenol compounds (BPs) have various industrial uses and can enter the environment through various sources. To evaluate the ecotoxicity of BPs and identify potential gene candidates involved in the plant toxicity, Arabidopsis thaliana was exposed to bisphenol A (BPA), BPB, BPE, BPF, and BPS at 1, 3, 10 mg/L for a duration of 14 days, and their growth status were monitored. At day 14, roots and leaves were collected for internal BPs exposure concentration detection, RNA-seq (only roots), and morphological observations. As shown in the results, exposure to BPs significantly disturbed root elongation, exhibiting a trend of stimulation at low concentration and inhibition at high concentration. Additionally, BPs exhibited pronounced generation of reactive oxygen species, while none of the pollutants caused significant changes in root morphology. Internal exposure concentration analysis indicated that BPs tended to accumulate in the roots, with BPS exhibiting the highest level of accumulation. The results of RNA-seq indicated that the shared 211 differently expressed genes (DEGs) of these 5 exposure groups were enriched in defense response, generation of precursor metabolites, response to organic substance, response to oxygen-containing, response to hormone, oxidation-reduction process and so on. Regarding unique DEGs in each group, BPS was mainly associated with the redox pathway, BPB primarily influenced seed germination, and BPA, BPE and BPF were primarily involved in metabolic signaling pathways. Our results provide new insights for BPs induced adverse effects on Arabidopsis thaliana and suggest that the ecological risks associated with BPA alternatives cannot be ignored.

Antibacterial activity and mechanism of Stevia extract against antibiotic-resistant Escherichia coli by interfering with the permeability of the cell wall and the membrane.

Natural plant-derived compounds with broad-spectrum antimicrobial activity have become an effective strategy against multidrug-resistant bacteria. The present study was designed to compare the antibacterial activity of six chlorogenic acid (CA) isomers extracted from stevia and investigated the underlying antibacterial mechanisms involved. The results indicated that isochlorogenic acid C (ICAC) exhibited the strongest antibacterial activity against the tested bacteria, especially E. coli, at a 2 mg/mL minimum inhibitory concentration (MIC) and 8 mg/mL minimum bactericidal concentration (MBC). At the MBC, ICAC inhibited 72.66% of the clinical multidrug-resistant strains. Scanning electron microscopy (SEM) revealed that ICAC induced considerable morphological alterations in E. coli ATCC25922 and C4E2. The significant increase in the activity of extracellular alkaline phosphatase (AKP) indicated that ICAC damages the permeability of the bacterial cell wall. Additionally, the intracellular membrane (IM) permeability and the content of lipopolysaccharide (LPS), a main component of the outer membrane (OM), were determined. The significant decrease in LPS content and increased leakage of intracellular proteins and K+ from E. coli indicated that ICAC could induce the exfoliation of OM and disrupt IM permeability, resulting in the loss of barrier function. The uptake of propidium iodide (PI), a compromised cell membrane nucleic acid stain, and confocal laser scanning microscopy (CLSM) further demonstrated that ICAC disrupted IM integrity. Moreover, the bactericidal effect and damage to bacterial microstructural function occurred in a dose-dependent manner. These data demonstrate that ICAC has excellent antibacterial activity and is a promising approach for overcoming the antibiotic resistance of pathogenic bacteria.

The complete protections induced by the oil emulsion vaccines of the novel variant infectious bursal disease viruses against the homologous challenges indicating the important roles of both VP2 and VP1 in the antigenicity and pathogenicity of the virus.

Novel variant infectious bursal disease virus (nvIBDV) is an emerging genotype (A2dB1b) that can cause severe and prolonged immunosuppression in young chickens. Despite current commercial vaccines being proven to lack complete protection against nvIBDV, it remains unclear whether the oil emulsion inactivated vaccines (OEVs) of the homologous and heterologous virus or booster immunization can provide effective protection. In this study, OEVs with two types of nvIBDV isolates QZ191002 (A-nv/B-nv) and YL160304 (A-nv/B-HLJ0504-like) were prepared and evaluated the protective effects of OEVs plus the booster immunizations with different current commercial vaccines against the challenge of nvIBDVs. The results from vaccination-challenge experiments showed that nvIBDV could break through the protection provided by only one immunization dose of the commercial vaccines, with the protection rates ranging from 40% to 60%. Interestingly, even with booster immunization with different commercial vaccines, the protection rates could only be increased to 60%-80%. As expected, only the OEVs of the homologous virus could provide 100% protection against the homologous nvIBDV, which could induce high-level specific antibodies, ameliorate target organ damage, and significantly reduce the viral load of the bursal in the challenged chickens. Notably, YL160304-OEV performed better than QZ191002-OEV, providing 100% protection not only against the challenge of homologous strain but also against that of heterologous QZ191002 strain. Antibody levels of the immunized chickens gradually increased after a short decline and reached the highest level on the age of 28 days. Similarly, the percentages of lymphocytes CD4+, CD8+ T, and B in peripheral blood lymphocytes (PBLs) were significantly increased on 21 d and 28 d. Notably, despite the nvIBDV, OEVs initially induced a delayed responses in the early stages but ultimately reach higher levels of CD4+ and CD8+ T lymphocytes. The results of study suggest that even booster immunization with different commercial vaccines cannot provide complete protection against nvIBDV, while the OEVs made by the nvIBDVs can provide full protection. Moreover, YL160304-OEV exhibits a broader protective spectrum against different nvIBDV strains, making it a potential candidate for the development of new vaccine.

Modular formation of in vitro tumor models for oncological research/therapeutic drug screening.

In recognition of the lethal nature of cancer, extensive efforts have been made to understand the mechanistic causation while identifying the effective therapy modality in hope to eradicate cancerous cells with minimal damage to healthy cells. In search of such effective therapeutics, establishing pathophysiologically relevant in vitro models would be of importance in empowering our capabilities of truly identifying those potent ones with significantly reduction of the preclinical periods for rapid translation. In this regard, wealthy progresses have been achieved over past decades in establishing various in vitro and in vivo tumor models. Ideally, the tumor models should maximally recapture the key pathophysiological attributes of their native counterparts. Many of the current models have demonstrated their utilities but also showed some noticeable limitations. This book chapter will briefly review some of the mainstream platforms for in vitro tumor models followed by detailed elaboration on the modular strategies to form in vitro tumor models with complex structures and spatial organization of cellular components. Clearly, with the ability to modulate the building modules it becomes a new trend to form in vitro tumor models following a bottom-up approach, which offers a high flexibility to satisfy the needs for pathophysiological study, anticancer drug screening or design of personalized treatment.

Life's essential 8 and cardiovascular diseases progression among adults in the United Kingdom.

BACKGROUND: Recently, the American Heart Association introduced Life's Essential 8 (LE8) as a new cardiovascular health (CVH) metric, and studies have reported associations between LE8 and CVH outcomes. However, there is limited understanding of LE8's impact on the risk of transitions between different stages of CVH. The current study investigated whether adhering to LE8 during a healthy stage could mitigate the progression from hypertension (HT) to cardiovascular diseases (CVDs), and consequent death. METHODS: The study included 107,682 participants in the UK Biobank who were initially free of HT and CVDs. CVH were evaluated using LE8 metrics (diet, physical activity, nicotine exposure, sleep duration, body mass index, non-high-density lipoprotein cholesterol, blood glucose, and blood pressure). Multistate models were used to analyse the impacts of LE8 on the progression of CVDs. RESULTS: During a median follow-up of 12.2 years, 5727 participants developed HT, 7243 developed CVDs, and 1183 died afterwards. LE8 was negatively associated with the dynamic disease progression. A per-10 points increase of CVH scores was significantly associated with the reduced risk [Hazard ratios (95 % confidence intervals)] at 0.71 (0.69, 0.72), 0.83 (0.81, 0.85), 0.79 (0.77, 0.82), and 0.91 (0.86, 0.96) in the transition from healthy to HT, CVDs, death, and from CVDs to death, respectively. Mediation analyses indicated that HT significantly mediated LE8-reduced risks of CVDs and mortality. CONCLUSIONS: This study offered evidence that LE8 may influence the stages of CVD progression. The findings underscore the significance of adhering to LE8 in health management and CVDs management.

Long- and short-term effectiveness of traditional Chinese exercises in improving the overall physical capacity of patients with knee osteoarthritis: A systematic review and meta-analysis.

BACKGROUND: The increasing global popularity of traditional Chinese exercise (TCE) provides substantial evidence of its significant efficacy in treating knee osteoarthritis (KOA). To assess the impact of different types of TCE and varying exercise durations on KOA patients, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) on this topic. METHODS: Two investigators extensively searched four electronic databases (PubMed, Embase, Cochrane, and Web of Science) from their inception until December 16, 2023, to identify all relevant RCTs on the use of TCE for KOA treatment. The included studies were assessed for risk of bias using the Cochrane Collaboration Risk of Bias Tool (CCRBT), and data analysis was performed using Stata 15.0. RESULTS: A total of 20 RCTs, involving 1367 patients with KOA, met the inclusion criteria. Compared to the control group, TCE demonstrated significant improvement in three subscale scores of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) [Pain (SMD = -0.44; P = .0001); Stiffness (SMD = -0.35; P = .001); Physical function (SMD = -0.52; P = .0001)] and two subscale scores of the 36-item Short-Form (SF-36) [Physical score (WMD = 2.76; P = .001); Mental score (WMD = 2.49; P = .0001)] in KOA patients. Subgroup analysis showed that both long-term habitual exercise (over 12 weeks) and short-term exercise (within 12 weeks) were more effective than the control group in improving pain, joint stiffness, and physical function in KOA patients. Tai Chi, among the four TCE modalities analyzed, demonstrated improvements in all indicators. CONCLUSION: Based on the results of our meta-analysis, it can be concluded that both long-term and short-term TCE interventions are effective in alleviating the main symptoms of KOA and improving patients' physical function. However, due to limited methodological quality and inconsistent outcome measures in the included RCTs, further high-quality RCTs with larger sample sizes and longer-term interventions are necessary to validate our findings before TCE can be recommended as a treatment for KOA.

Protein ubiquitination in ovarian cancer immunotherapy: The progress and therapeutic strategy.

Ovarian cancer is a common cancer for females, and the incidence and mortality rates are on the rise. Many treatment strategies have been developed for ovarian cancer, including chemotherapy and immunotherapy, but they are often ineffective and prone to drug resistance. Protein ubiquitination is an important class of post-translation modifications that have been found to be associated with various human diseases and cancer development. Recent studies have revealed that protein ubiquitination is involved in the progression of ovarian cancer and plays an important role in the tumor immune process. Moreover, the combination of ubiquitinase/deubiquitinase inhibitors and cancer immunotherapy approaches can effectively reduce treatment resistance and improve treatment efficacy, which provides new ideas for cancer treatment. Herein, we review the role of protein ubiquitination in relation to ovarian cancer immunotherapy and recent advances in the use of ubiquitinase/deubiquitinase inhibitors in combination with cancer immunotherapy.

Tenecteplase vs Alteplase for Patients With Acute Ischemic Stroke: The ORIGINAL Randomized Clinical Trial.

Importance: Tenecteplase is a bioengineered variant of alteplase with greater fibrin specificity and a longer half-life, allowing single-bolus administration. Evidence on the treatment effect of tenecteplase 0.25 mg/kg in Chinese patients with acute ischemic stroke (AIS) is limited. Objective: To establish the noninferiority of tenecteplase to alteplase in patients with AIS within 4.5 hours of symptom onset. Design, Setting, and Participants: The ORIGINAL study was a multicenter, active-controlled, parallel-group, randomized, open-label, blinded end point, noninferiority trial conducted between July 14, 2021, and July 14, 2023. Participants were recruited from 55 neurology clinics and stroke centers in China and were eligible if they had AIS with a National Institutes of Health Stroke Scale score of 1 to 25 with measurable neurologic deficit and were symptomatic for at least 30 minutes without significant improvement. Interventions: Patients were randomized (1:1) within 4.5 hours of symptom onset to receive intravenous tenecteplase (0.25 mg/kg) or intravenous alteplase (0.9 mg/kg). Main Outcomes and Measures: The primary outcome was the proportion of patients with a modified Rankin Scale (mRS) score of 0 or 1 (no symptoms or no significant disability) at day 90, tested for noninferiority (risk ratio [RR] margin, 0.937). Safety end points included symptomatic intracerebral hemorrhage (per European Cooperative Acute Stroke Study III definition) and 90-day all-cause mortality. Results: Among the 1489 patients randomized, 1465 patients were included in the full analysis set (732 in the tenecteplase group; 733 in the alteplase group) and 446 (30.4%) were female. The primary outcome occurred in 72.7% (532/732) of patients receiving tenecteplase and 70.3% (515/733) receiving alteplase (RR, 1.03 [95% CI, 0.97-1.09]; noninferiority threshold met). Symptomatic intracerebral hemorrhage occurred in 9 patients (1.2%) in each group (RR, 1.01 [95% CI, 0.37-2.70]). The 90-day mortality rate was 4.6% (34/732) in the tenecteplase group and 5.8% (43/736) in the alteplase group (RR, 0.80 [95% CI, 0.51-1.23]). Conclusions and Relevance: In patients with AIS eligible for intravenous thrombolysis within 4.5 hours after stroke onset, tenecteplase was noninferior to alteplase with respect to excellent functional outcome (mRS score of 0 or 1) at 90 days and had a similar safety profile. Findings from this study support tenecteplase as a suitable alternative to alteplase in this setting. Trial Registration: ClinicalTrials.gov Identifier: NCT04915729.

[A new neolignan glycoside from Acori Tatarinowii Rhizoma].

The main chemical constituents from Acori Tatarinowii Rhizoma were isolated and purified using the macroporous resin,microporous resin(MCI) and octadecylsilyl silica gel(ODS) column chromatography, as well as semi-preparative high performance liquid chromatography. Their chemical structures were elucidated by spectroscopic analyses including mass spectrometry(MS),nuclear magnetic resonance(NMR), ultraviolet(UV), infrared(IR) and circular dichoism(CD) combined with literature data.A total of 11 compounds were isolated and identified, including 4 lignan glycosides, 2 benzyl alcohol glycosides, 4 flavonoid glycosides, and 1 α-tetralone glycoside:(7S,8R)-dihydrodehydrodiconiferyl alcohol 9-O-ß-D-glucopyranosyl-9'-O-ß-D-glucopyranosyl-(1 → 6)-ß-D-glucopyranoside(1),(7S, 8R)-dihydrodehydrodiconiferyl alcohol 9-O-ß-D-glucopyranoside(2),(7S, 8R)-dihydrodehydrodiconiferyl alcohol di-9, 9'-O-ß-D-glucopyranoside(3),(+)-lyoniresinol 3α-O-ß-D-glucopyranoside(4), benzyl alcohol O-ß-D-glucopyranosyl-(1→6)-ß-D-glucopyranoside(5), benzyl alcohol O-ß-D-xylopyranosyl-(1→6)-ß-D-glucopyranoside(6), 3'-O-methylepicatechin 7-O-ß-D-glucopyranoside(7), 3'-O-methylcatechin 7-O-ß-D-glucopyranoside(8), apigenin 6-C-ß-D-glucopyranosyl-7-O-ß-D-glucopyranoside(9), isoscoparin 7-O-ß-D-glucopyranoside(10), and(4R)-8-hydroxy-α-tetralone-4-O-ß-D-glucopyranoside(11). Compound 1 is a new neolignan glycoside, and compounds 2-5 and 7-11 are isolated from genus Acorus for the first time.

Sacubitril/valsartan attenuated myocardial inflammation, fibrosis, apoptosis and promoted autophagy in doxorubicin-induced cardiotoxicity mice via regulating the AMPKα-mTORC1 signaling pathway.

This study aimed to investigate the potential cardioprotective effects of sacubitril/valsartan (Sac/Val) in mice with doxorubicin (DOX)-induced cardiomyopathy, a common manifestation of cancer therapy-related cardiac dysfunction (CTRCD) associated with DOX. A total of thirty-two mice were equally classified into 4 groups: control group, DOX (total 24 mg/kg), Sac/Val (80 mg/kg), and Sac/Val + DOX (Sac/Val was given from seven days before doxorubicin administration). Neonatal rat ventricular myocytes was exposed to 5 µM of DOX for 6 h in vitro to mimic the in vivo conditions. A variety of techniques were used to investigate cardiac inflammation, fibrosis, apoptosis, and autophagy, including western blot, real-time quantitative PCR (RT-qPCR), immunohistochemistry, and fluorescence. Mice with DOX-induced cardiotoxicity displayed impaired systolic and diastolic function, characterized by elevated levels of cardiac inflammation, fibrosis, cardiomyocyte hypertrophy, apoptosis, and autophagy inhibition in the heart. Treatment with Sac/Val partially reversed these effects. In comparison to the control group, the protein expression of NLRP3, caspase-1, collagen I, Bax, cleaved caspase-3, and P62 were significantly increased, while the protein expression of Bcl-2 and LC3-II were significantly decreased in the myocardial tissues of the Dox-induced cardiomyopathy group. The administration of Sac/Val demonstrated the potential to partially reverse alterations in protein expression within the myocardium of mice with DOX-induced cardiotoxicity by modulating the AMPKα-mTORC1 signaling pathway and suppressing oxidative stress. Additionally, Sac/Val treatment may mitigate Dox-induced apoptosis and inhibition of autophagy in primary cardiomyocytes. Sac/Val seems to be cardioprotective against DOX-induced cardiotoxicity in the pre-treatment mice model. These findings could be attributed to the anti-inflammatory, antioxidant, anti-apoptotic, and de-autophagy effects of Sac/Val through regulation of the AMPKα-mTORC1 signaling pathway.

Small bowel Crohn's disease neglected by gastroenterologists and anorectal surgeons with a 7-year delay in diagnosis: A case report.

RATIONAL: Small bowel Crohn's disease (SBCD) is a common site of Crohn's disease (CD). However, owing to the anatomical characteristics of the small bowel and the limitations of traditional examination methods, the detection and diagnosis of SBCD remain difficult. Gastroenterologists and anorectal surgeons should pay more attention to improving the early diagnosis rate, so as to improve the prognosis of patients and reduce the probability of surgery due to complications. PATIENT CONCERNS: Here, we presented a case of a young male with severe localized pain in the right kidney area and fever but no weight loss or diarrhea, who had a history of perianal abscess surgery 7 years ago and an elevated platelet count reviewing his previous medical examination report. DIAGNOSES: SBCD was not diagnosed until complications of intestinal fistula developed 7 years after perianal abscess surgery. INTERVENTIONS: Anti-infection treatment was administered due to elevated inflammatory markers and evidence of infection on computed tomography scan, and exclusive enteral nutrition (EEN) was then performed because of the diagnosis of SBCD. Although the infection was absorbed by the treatment with EEN, a laparoscopic modified partial enterectomy was finally performed due to the complication of intestinal fistula. OUTCOMES: The patient was discharged on the seventh postoperative day without postoperative complications and started biologic therapy 2 weeks after surgery because he had high-risk factors for postoperative recurrence. The pathological report revealed the involvement of the ileum in CD, and confirmed the existence of the intestinal fistula. LESSONS: Gastroenterologists and anorectal surgeons should be aware that perianal abscess could be the first manifestation of SBCD; even if typical CD manifestations are absent, proper further examinations are necessary based on the comprehensive analysis of clinical data of patients. In addition, the platelet count deserves attention in patients with potentially possible CD. More importantly, it is important to emphasize the importance of EEN in adult CD patients.

Exercise training alleviates cholesterol and lipid accumulation in mice with non-alcoholic steatohepatitis: Reduction of KMT2D-mediated histone methylation of IDI1.

Exercise training is a cornerstone treatment for non-alcoholic fatty liver disease (NAFLD). This study aims to investigate the effects of exercises on lipid accumulation in non-alcoholic steatohepatitis (NASH) and to explore the molecular mechanism. Established NASH mice were remained sedentary or subjected to moderate-intensity continuous training or high-intensity interval training (HIIT). The two training regimens, especially the latter one, reduced liver weight, steatosis, inflammation, lipid accumulation, collagen deposition, and cholesterol content in the mouse liver. Similarly, the HIIT regimen improved clinical presentation of NAFLD patients. RNA sequencing analysis revealed lysine methyltransferase 2D (Kmt2d) and isopentenyl-diphosphate delta isomerase 1 (Idi1) as two important genes downregulated in mice underwent HIIT. By using mouse hepatocytes AML12, we found that KMT2D promoted Idi1 expression by catalyzing H3K4me1 modification near its promoter. Upregulation of either KMT2D or IDI1 blocked the ameliorating effects of HIIT on mice. Meanwhile, in AML12 cells modeled by palmitic acid and oleic acid treatment, KMT2D and IDI1 were found to be correlated with lipid accumulation, cholesterol content, inflammation, and cell death and senescence. In conclusion, this study demonstrates that the ameliorating effects of exercise training on NASH might involve the downregulation of the KMT2D/IDI1 axis.

Identification of hanger damage based on deflection influence matrix.

Tied-arch bridges, a vital component of modern infrastructure, are susceptible to various forms of damage, particularly hangers. The detection and identification of such damages are crucial for maintaining structural integrity and safety. However, traditional methods face challenges in terms of accuracy and efficiency. This study aims to develop a refined method for hanger damage identification in tied-arch bridges, to address the limitations of existing techniques. By focusing on deflection changes at the anchoring points between the hangers and tie beams, we sought to enhance the precision of damage detection. We propose an innovative approach based on the concept of influence lines, introducing the 'generalized deflection difference influence line'and the 'deflection difference influence matrix'. Then proposed a new identification index for identifying the damaged hanger after matrix. An actual tied-arch bridge was used to validate the proposed approach. A detailed three-dimensional finite element model of the bridge was developed and calibrated using dynamic and static response data. Thirty different hanger-damage conditions were simulated to evaluate the effectiveness of the proposed method. Our findings reveal that the deflection difference influence matrix offers more detailed and comprehensive information on bridge distribution points than traditional methods. Our method proved effective in identifying hanger damage, irrespective of its location on the bridge. In additionally, the identification efficiency of the method can be improved by adjusting the magnitude of the applied load, with larger loads amplifying the detectability of damage. This study highlights the potential of the deflection difference influence matrix to revolutionize hanger damage identification for tied-arch bridges. Its adaptability, accuracy, and efficiency are significant advancements over existing methods. This study successfully demonstrates an innovative and reliable method for hanger damage identification.

Effect of ventilation mode on postoperative pulmonary complications among intermediate- to high-risk patients undergoing abdominal surgery: A randomized controlled trial.

BACKGROUND: The effect of different mechanical ventilation modes on pulmonary outcome after abdominal surgery remains unclear. We evaluated the effects of three common ventilation modes on postoperative pulmonary complications (PPCs) among intermediate- to high-risk patients undergoing abdominal surgery. METHODS: This randomized clinical trial enrolled adult patients at intermediate or high risk of PPCs who were scheduled for abdominal surgery. Participants were randomized to receive one of three modes of mechanical ventilation modes: volume-controlled ventilation (VCV), pressure-controlled ventilation (PCV), and pressure-control with volume-guaranteed ventilation (PCV-VG). Lung-protective ventilation strategy was implemented in all groups. The primary outcome was the incidence of a composite of pulmonary complications within the first 7 postoperative days. Pulmonary complications within 30 postoperative days, the severity grade of PPCs, and other secondary outcomes were also analyzed. RESULTS: A total of 1365 patients were randomized and 1349 were analyzed. The primary outcome occurred in 98 (21.8%) in the VCV group, 95 (22.1%) in the PCV group, and 101 (22.5%) in the PCV-VG group (P = 0.865). Additionally, there were no statistically significant differences among the three groups in terms of the incidence of pulmonary complications within postoperative 30 days, severity grade of PPCs, and other secondary outcomes. CONCLUSION: In intermediate- to high-risk patients undergoing abdominal surgery, the choice of ventilation mode did not affect the risk of PPCs. TRIAL REGISTRATION: Chinese Clinical Trial Registry, entry ChiCTR1900025880.

Structural Basis of Main Proteases of Coronavirus Bound to Bofutrelvir.

Globally, the continuous spread and evolution of SARS-CoV-2, along with its variants, profoundly impact human well-being, health, security, and the growth of socio-economic. In the field of development of drugs against COVID-19, the main protease (Mpro) is a critical target as it plays a core role in the lifecycle of SARS-CoV-2. Bofutrelvir acts as a potent inhibitor of SARS-CoV-2 Mpro, demonstrating high efficacy and broad-spectrum antiviral activity. Compared to therapies that require pharmacokinetic boosters, such as ritonavir, the monotherapy approach of Bofutrelvir reduces the risk of potential drug interactions, making it suitable for a wider patient population. However, further studies on the potency and mechanism of inhibition of Bofutrelvir against the Mpro of COVID-19 and its variants, together with other coronaviruses, are needed to prepare for the possibility of a possible re-emerging threat from an analogous virus in the future. Here, we reveal the effective inhibition of Bofutrelvir against the Mpro of SARS-CoV-2, SARS-CoV, and HCoV-229E through FRET and crystallographic analysis. Furthermore, the inhibitory mechanisms of Bofutrelvir against two SARS-CoV-2 Mpro mutants (G15S and K90R) were also elucidated through FRET and crystallographic studies. Through detailed analysis and comparison of these crystal structures, we identified crucial structural determinants of inhibition and elucidated the binding mode of Bofutrelvir to Mpros from different coronaviruses. These findings are hopeful to accelerate the development of safer and more potent inhibitors against the Mpro of coronavirus, and to provide important references for the prevention and treatment of similar viruses that may emerge in the future.

Symptoms and Diabetes among Chinese Middle-Aged and Elderly Adults with Prediabetes: A National Cohort Study.

We aimed to assess the association between depressive symptoms and the risk of transition from prediabetes to diabetes. We included 3,956 adults with prediabetes aged 45 years and above in 2011. Participants with a ten-item Center for Epidemiologic Studies Depression (CES-D) score of 10 or higher were classified as having depressive symptoms. Incident diabetes was defined as a self-reported physician diagnosis of diabetes, or treatment with glucose-lowering medication in 2013, 2015, or 2018. Among 3, 956 participants (mean age was 59.53 years old and 53.29% were female), the proportion of depressive symptoms was 36.50% in 2011. During the 24,831 person-years of follow-up, 458 participants developed diabetes and the incidence rate was 18.44 (95% CI 16.83 to 20.21) per 1000 person-years. Depressive symptoms were significantly associated with a higher risk of incident diabetes (HR, 1.31; 95% CI, 1.07 to 1.59). In addition, the association was in a dose-response fashion (P trend < 0.001). Compared with the CES-D <10 group, the HRs (95% CI) were 1.21 (0.98 to 1.49) in the 10≤ CES-D <21 group, and 1.95 (1.38 to 2.75) in the CES-D ≥ 21 group. Depressive symptoms were shown as an independent risk factor for the progression from prediabetes to diabetes.

Household health expenditure does not improve people's subjective well-being in China.

Introduction: Household health expenditure plays a crucial role in the daily spending of individuals. Meanwhile, the attention of the public to subjective well-being (SWB) is constantly increasing in China. Household health expenditure could reduce real family income, harming personal SWB. However, the aim of household health expenditure is to improve the physical condition of an individual, and improvements in individual health could enhance personal SWB. Therefore, the effect of household health expenditure on personal SWB is uncertain; hence, it is essential to assess the effects of household health expenditure on the SWB of Chinese residents. Methods: The Chinese family panel studies database from 2016 to 2020 was applied in this study. A fixed effects model was used to examine the impact of household medical and health protection expenses on personal SWB. Fixed effects instrumental variable regression and propensity score matching were then used to conduct robustness testing. Results: On the basis of a fixed effects model, it was found that household medical and health protection expenditure did not improve the happiness and life satisfaction of individuals; rather, household health protection expenditure could significantly reduce personal happiness. Fixed effects instrumental variable regression and propensity score matching analysis supported these results. Household health protection expenditure had a greater negative impact on the happiness and life satisfaction of females compared with males. Conclusion: Household health expenditure does not improve the SWB of individuals in China; this has certain significance for the formulation of relevant policies.

SGLT2 inhibitor promotes ketogenesis to improve MASH by suppressing CD8+ T cell activation.

During the progression of metabolic dysfunction-associated steatohepatitis (MASH), the accumulation of auto-aggressive CD8+ T cells significantly contributes to liver injury and inflammation. Empagliflozin (EMPA), a highly selective inhibitor of sodium-glucose co-transporter 2 (SGLT2), exhibits potential therapeutic benefits for liver steatosis; however, the underlying mechanism remains incompletely elucidated. Here, we found that EMPA significantly reduced the hepatic accumulation of auto-aggressive CD8+ T cells and lowered granzyme B levels in mice with MASH. Mechanistically, EMPA increased ß-hydroxybutyric acid by promoting the ketogenesis of CD8+ T cells via elevating 3-hydroxybutyrate dehydrogenase 1 (Bdh1) expression. The ß-hydroxybutyric acid subsequently inhibited interferon regulatory factor 4 (Irf4), which is crucial for CD8+ T cell activation. Furthermore, the ablation of Bdh1 in T cells aggravated the manifestation of MASH and hindered the therapeutic efficacy of EMPA. Moreover, a case-control study also showed that SGLT2 inhibitor treatment repressed CD8+ T cell infiltration and improved liver injury in patients with MASH. In summary, our study indicates that SGLT2 inhibitors can target CD8+ T cells and may be an effective strategy for treating MASH.

Exploring Prostate Cancer Incidence Trends and Age Change in Cancer Registration Areas of Jiangsu Province, China, 2009 to 2019.

(1) Background: Over the past few decades, Jiangsu Province, China, has witnessed a remarkable surge in the incidence of prostate cancer (PCa), accompanied by notable demographic shifts; (2) Methods: PCa data for Jiangsu Province from 2009 to 2019 were obtained from the Jiangsu Cancer Registry. We calculated crude and age-specific incidence rates (ASIRs), average age at onset, and age-specific composition ratios. Standardization was performed based on the Segi's world population. Birth cohorts (1929-2019) were analyzed to assess PCa incidence by birth year. Trend analysis was conducted using the Joinpoint Regression Model, and average annual percent changes (AAPCs) with corresponding 95% confidence interval (CI) were computed. A linear regression model was used to analyze the relationship between the average age at diagnosis and calendar years; (3) Results: The ASIRs of PCa in Jiangsu Province increased significantly, with an AAPC of 11.25% (95%CI: 10.09%, 12.42%) from 2009 to 2019. This increase was observed across all age groups, particularly among those aged 0-59 years. Birth cohort analysis revealed a rising trend with earlier birth years showing higher incidence, notably in the 1959 cohort. In rural areas, the age-standardized average age at onset of PCa decreased from 75.45 years in 2009 to 73.39 years in 2019, and the peak age group shifted from 75-79 years in 2009 to 70-74 years in 2019; (4) Conclusions: The rising incidence of PCa in Jiangsu Province, along with an increased proportion of cases in younger age groups, highlights the need for targeted interventions.