Protein kinase SnRK2.6 phosphorylates transcription factor bHLH3 to regulate anthocyanin homeostasis during strawberry fruit ripening.

Strawberry (Fragaria × ananassa) is a model plant for studying non-climacteric fruit ripening regulated by abscisic acid (ABA); however, the signaling of ABA in the regulation of fruit coloration is not fully understood. In this study, we identified the transcription factor BASIC HELIX-LOOP-HELIX 3 (bHLH3) as being key to fruit coloration via yeast two-hybrid library screening using the bait SUCROSE NONFERMENTING 1 (SNF1)-RELATED PROTEIN KINASE 2 (SnRK2.6), which is a core ABA signaling component that negatively regulates ripening. The interaction was also confirmed by firefly luciferase complementation assays and pull-down assays. RT-qPCR and western blot analysis confirmed that bHLH3 is expressed ubiquitously in strawberry tissues, and it is expressed stably during fruit development. Overexpression and RNAi of both bHLH3 and SnRK2.6 demonstrated that bHLH3 and SnRK2.6 promote and inhibit strawberry fruit coloration, respectively. Using EMSAs, we showed that bHLH3 promotes the expression of UDP-GLUCOSE: FLAVONOL-O-GLUCOSYLTRANSFERASE (UFGT), a key gene for anthocyanin biosynthesis, by directly binding to its promoter. We determined that SnRK2.6 can phosphorylate bHLH3 and that this inhibits its binding to the UFGT promoter, consequently suppressing expression. Altogether, we propose that increased ABA content during strawberry fruit ripening leads to decreased expression of SnRK2.6, which in turn releases the phosphorylation of bHLH3 and thereby enhances UFGT expression, ultimately promoting the coloration of the fruit.

Correlation between blood glucose level and poor wound healing after posterior lumbar interbody fusion in patients with type 2 diabetes.

To investigate the correlation of blood glucose level with poor wound healing (PWH) after posterior lumbar interbody fusion (PLIF) in patients with type 2 diabetes (T2D). From January 2016 to January 2023, a case-control study was conducted to analyse the clinical data of 400 patients with T2D who were treated by PLIF and internal fixation at our hospital. The following data were recorded: gender; age; body mass index (BMI); surgical stage; average perioperative blood glucose level; perioperative blood glucose variance; perioperative blood glucose coefficient of variation; glycated haemoglobin level; preoperative levels of total protein, albumin and haemoglobin; postoperative levels of total protein, albumin and haemoglobin; surgical time; intraoperative bleeding volume; operator; postoperative drainage volume; and postoperative drainage tube removal time of each group. The indicators for monitoring blood glucose variability (GV) included the SD of blood glucose level (SDBG), coefficient of variation (CV) and maximum amplitude of variation (LAGE) before and after surgery. According to the diagnostic criteria for PWH, patients with postoperative PWH were determined and assigned to two groups: Group A (good wound healing group; n = 330 patients) and Group B (poor wound healing group; n = 70 patients). The preoperative and postoperative blood GV indicators, namely SDBG, CV and LAGE, were compared between these two groups. We also determined the relationship between perioperative blood GV parameters and PWH after PLIF surgery and its predictive value through correlation analysis and receiver-operating characteristic curve. Of the 400 enrolled patients, 70 patients had PWH. Univariate analysis revealed significant differences between the two groups in the course of diabetes, mean fasting blood glucose (MFBG), SDBG, CV, LAGE, preoperative hypoglycaemic program, surgical segment, postoperative drainage time, incision length and other factors (p < 0.05). However, no significant differences were noted in factors such as gender, age, body mass index, hypertension, coronary heart disease, admission fasting blood glucose, preoperative haemoglobin A1c, surgical time, intraoperative bleeding volume, intraoperative blood transfusion volume and postoperative drainage volume (p > 0.05). The area under the curve (AUC) values of preoperative SDBG, CV and LAGE were 0.6657, 0.6432 and 0.6584, respectively. The cut-off values were 1.13 mmol/L, 6.97% and 0.75 mmol/L, respectively. The AUC values for postoperative SDBG, CV and LAGE were 0.5885, 0.6255 and 0.6261, respectively. The cut-off values were 1.94 mmol/L, 24.32% and 2.75 mmol/L, respectively. The multivariate ridge regression analysis showed that preoperative MFBG, SDBG, CV and LAGE; postoperative SDBG, CV and LAGE; postoperative long drainage time; and multiple surgical segments were independent risk factors for T2D patients to develop surgical site infection after PLIF (p < 0.05). The perioperative blood GV in patients with T2D is closely related to the occurrence of PWH after PLIF. Reducing blood GV may help to reduce the occurrence of PWH after PLIF.

Combined anterior and posterior approach in treatment of ankylosing spondylitis-associated cervical fractures: a systematic review and meta-analysis.

OBJECTIVE: Cervical fractures with ankylosing spondylitis (CAS) are a specific type of spinal fracture with poor stability, low healing rate, and high disability rate. Its treatment is mainly surgical, predominantly through the anterior approach, posterior approach, and the anterior-posterior approach. Although many clinical studies have been conducted on various surgical approaches, controversy still exists concerning the choice of these surgical approaches by surgeons. The authors present here a systematic evaluation and meta-analysis exploring the utility of the anterior-posterior approach versus the anterior approach and the posterior approach. METHODS: After a comprehensive literature search of PubMed, Cochrane, Web of Science, and Embase databases, 12 clinical studies were included in the final qualitative analysis and 8 in the final quantitative analysis. Of these studies, 11 conducted a comparison between the anterior-posterior approach and the anterior approach and posterior approaches, while one examined only the anterior-posterior approach. Where appropriate, statistical advantage ratios and 95% confidence intervals were calculated. RESULTS: The present meta-analysis of postoperative neurological improvement showed no statistical difference in the overall neurological improvement rate between the anterior-posterior approach and anterior approach (OR 1.70, 95% CI 0.61 to 4.75; p = 0.31). However, the mean change in postoperative neurological function was lower in patients who received the anterior approach than in those who received the anterior-posterior approach (MD 0.17, 95% CI -0.02 to 0.36; p = 0.08). There was an identical trend between the anterior-posterior approach and posterior approach, with no statistically significant difference in the overall rate of neurological improvement (OR 1.37, 95% CI 0.70 to 2.56; p = 0.38). Nevertheless, the mean change in neurological function was smaller in patients receiving the anterior-posterior approach compared with the posterior approach, but there was no statistically significant difference between the two (MD 0.17, 95% CI -0.02 to 0.36; p = 0.08). CONCLUSIONS: The results of this review and meta-analysis suggest that the benefits of the anterior-posterior approach are different from those of the anterior and posterior approaches in the treatment of ankylosing spondylitis-related cervical fractures. In a word, there is no significant difference between the cervical surgical approach and the neurological functional improvement. Therefore, surgeons should pay more attention to the type of cervical fracture, the displacement degree of cervical fracture, the spinal cord injury, the balance of cervical spine and other aspects to comprehensively consider the selection of appropriate surgical methods.

Cobalt-Catalyzed Asymmetric Deuteration of α-Amidoacrylates for Stereoselective Synthesis of α,ß-Dideuterated α-Amino Acids.

A cobalt-catalyzed deuteration of amidoacrylates using deuterated methanol afforded α,ß-dideuterio-α-amino esters in excellent enantiomeric ratios (mostly >95 : 5) and almost complete deuteration (99 %). The new protocol was used to prepare dideuterio-α-amino acid fragments in some drugs. Furthermore, the stereoselective deuteration was applied in a concise synthesis of dideuterio l-DOPA.

Introducing molecular testing of pyrazinamide susceptibility improves multidrug-resistant tuberculosis treatment outcomes: a prospective cohort study.

The current treatment for multidrug-resistant tuberculosis (MDR-TB) takes a lengthy period of 18-24 months and has a poor cure rate of 50-60%. A multicenter, prospective cohort study was conducted to assess the role of testing for molecular susceptibility to pyrazinamide (PZA) in optimising treatment for MDR-TB.We assigned 76 patients to an optimised molecular susceptibility group and 159 patients to a regular treatment group where PZA susceptibility was not determined. Of these patients, 152 were matched after propensity score matching (76 in the optimised group and 76 in the regular group). Treatment success rate was measured in the propensity-matched cohort as the primary outcome.Patients in the optimised group achieved a higher treatment success rate than those in the regular group (76.3% versus 55.3%, p=0.006). Of 51 patients with isolates that were susceptible to PZA and who were receiving a 12-month regimen, 42 (82.4%) were treated successfully. The optimised group showed faster culture conversion than the regular group (p=0.024). After exclusion of pre-extensively drug-resistant TB (pre-XDR-TB), the treatment outcome in the optimised group was still better than the regular group (83.1% versus 62.1%, p=0.009).Introducing molecular susceptibility testing for PZA improved the treatment outcomes for MDR-TB without the use of new drugs. Introducing PZA for patients with PZA-susceptible (PZA-S) MDR-TB allows the current regimen to be shortened to 12 months with comparable success rates to the World Health Organization (WHO) recommended shorter regimen.

A pregnant woman with pre-XDR PTB giving birth to a healthy newborn: A case report.

We reported a late-pregnancy woman with pre-XDR PTB who had not received regular anti-tuberculosis treatment prior to delivery. Despite this, she successfully delivered a premature baby who exhibited normal growth and development, and subsequently completed her anti-tuberculosis treatment. This report suggests that delayed treatment for pre-XDR TB during late pregnancy does not necessarily increase the risk of treatment failure for the mother or the risk of neonatal tuberculosis.

Advanced Thermoelectric Textiles for Power Generation: Principles, Design, and Manufacturing.

Self-powered wearable thermoelectric (TE) devices significantly reduce the inconvenience caused to users, especially in daily use of portable devices and monitoring personal health. The textile-based TE devices (TETs) exhibit the excellent flexibility, deformability, and light weight, which fulfill demands of long-term wearing for the human body. In comparison to traditional TE devices with their longstanding research history, TETs are still in an initial stage of growth. In recent years, TETs to provide electricity for low-power wearable electronics have attracted increasing attention. This review summarizes the recent progress of TETs from the points of selecting TE materials, scalable fabrication methods of TE fibers/yarns and TETs, structure design of TETs and reported high-performance TETs. The key points to develop TETs with outstanding TE properties and mechanical performance and better than available optimization strategies are discussed. Furthermore, remaining challenges and perspectives of TETs are also proposed to suggest practical applications for heat harvesting from human body.

The Mechanism of Ovule Abortion in Self-Pollinated 'Hanfu' Apple Fruits and Related Gene Screening.

Apples exhibit S-RNase-mediated self-incompatibility and typically require cross-pollination in nature. 'Hanfu' is a cultivar that produces abundant fruit after self-pollination, although it also shows a high rate of seed abortion afterwards, which greatly reduces fruit quality. In this study, we investigated the ovule development process and the mechanism of ovule abortion in apples after self-pollination. Using a DIC microscope and biomicroscope, we found that the abortion of apple ovules occurs before embryo formation and results from the failure of sperm-egg fusion. Further, we used laser-assisted microdissection (LAM) cutting and sperm and egg cell sequencing at different periods after pollination to obtain the genes related to ovule abortion. The top 40 differentially expressed genes (DEGs) were further verified, and the results were consistent with switching the mechanism at the 5' end of the RNA transcript (SMART-seq). Through this study, we can preliminarily clarify the mechanism of ovule abortion in self-pollinated apple fruits and provide a gene reserve for further study and improvement of 'Hanfu' apple fruit quality.

Efficacy of surgical treatment and conservative treatment for cervical spinal cord injury without fracture and dislocation in adults: A meta-analysis.

BACKGROUND: The aim of this study was to investigate the efficacy of surgical treatment and conservative treatment for cervical spinal cord injury without fracture and dislocation (CSCIWFD) in adults by meta-analysis. METHODS: With a time span from 2010 to 2022, PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI) and Wanfang databases were searched for all clinical randomized controlled trials on the comparison of surgical treatment and conservative treatment for CSCIWFD in adults. The Cochrane quality assessment tool was used as the standard. Stata 16.0 statistical software was used for meta-analysis. RESULTS: A total of 870 articles were retrieved, and 12 studies were finally included for meta-analysis. Among them, there were 451 patients in the observation group (surgical treatment) and 346 patients in the control group (conservative treatment). The results of meta-analysis showed that the observation group was superior to the control group in the effective rate (OR = 4.737, 95% CI [2.613, 8.586], P < .001), Japanese Orthopedic Association (JOA) score at 3 months after treatment (SMD = 1.038, 95% CI [0.417, 1.659], P = .001), 6 months after treatment (SMD = 3.135, 95% CI [2.120, 4.151], P < .001) and 12 months after treatment (SMD = 2.808, 95% CI [1.880, 3.737], P < .001). In addition, the JOA scores of patients at 12 months after surgical treatment (SMD = 6.397, 95% CI [4.654, 8.14], P < .001) and conservative treatment (SMD = 3.197, 95% CI [2.144, 4.24], P < .001) were significantly higher than those before treatment. CONCLUSIONS: Surgical treatment can improve the effective rate and JOA score of adult patients with CSCIWFD compared to conservative treatment. This suggests that surgical treatment can significantly improve the patient's spinal cord function.

The reverse function of lignin-degrading enzymes: The polymerization ability to promote the formation of humic substances in domesticated composting.

This study aimed to confirm the ability of lignin peroxidase (LiP) and manganese peroxidase (MnP) in promoting the formation of humic substances (HS) during domesticated composting. Three raw materials with different lignin types were used for composting, including rice straw, tree branches, and pine needles. Results suggested that LiP and MnP activity increased during domesticated composting. But HS formation was only promoted by LiP. The effect of MnP was insignificant, which might be caused by the lack of enzyme cofactors like Mn2+. Meanwhile, bacteria highly associated with LiP and MnP production were identified as core bacteria. Function prediction of 16S-PICRUSt2 showed that the function of core bacteria was consistent with total bacterial functions which mainly promoted compost humification. Therefore, it speculated that LiP and MnP had the ability to promote HS formation during composting. Accordingly, it is a new understanding of the role of biological enzymes in composting.

HIV-1 RNA and DNA Genotyping Drug Resistance Detection in Patients with Low-Level Viremia in Liangshan, China.

In this study, we characterized HIV-1 RNA and HIV-1 DNA genotyping drug resistance detection in patients with low-level viremia (LLV) in Liangshan, China. Whole blood samples were collected from HIV/AIDS patients who had received antiretroviral therapy (ART) for ≥6 months and whose HIV-1 RNA loads were 50-1,000 copies/mL for two consecutive times at least 1-month apart. The patients were enrolled from a county in Liangshan Yi Autonomous Prefecture, Sichuan Province, between May 2021 and May 2022. Plasma and blood cells were separated. Plasma samples were tested for HIV-1 RNA genotyping drug resistance, while blood cell samples were tested for HIV-1 DNA genotyping drug resistance. Then, HIV-1 RNA and HIV-1 DNA genotyping drug resistance outcomes were compared. Among the 32 participants, 16 were males, while 16 were females, with the median age of 34.5 years. The main HIV-1 infection route was heterosexual transmission. The median ART duration was 3.9 years. Two types of nucleoside reverse transcriptase inhibitors (NRTIs) + one non-nucleoside reverse transcriptase inhibitor (NNRTI) were the main antiviral therapeutic options. Pol region genes for 28 HIV-1 DNA samples and 10 HIV-1 RNA samples were successfully amplified. The success rate of pol region gene amplification for HIV-1 DNA was significantly higher than that of HIV-1 RNA (χ2 = 20.988, p < .05). In HIV-1 RNA and HIV-1 DNA samples, M184 (4/8) and K103 (3/8) were the most frequent drug resistance mutation sites. Among the NNRTIs, the rates of drug resistance were highest to efavirenz (EFV) (6/8) and nevirapine (NVP) (6/8), while among the NRTIs, the rates of drug resistance were highest to abacavir (ABC) (4/8), emtricitabine (FTC) (4/8), and lamivudine (3TC) (4/8). In conclusion, detection of HIV-1 RNA genotyping drug resistance combined with HIV-1 DNA genotyping drug resistance can improve the success rate of drug resistance detection in patients with LLV.

HCV Genotype Distribution and Clinical Characteristics of HCV Mono-Infected and HCV/HIV Co-Infected Patients in Liangshan Prefecture, Sichuan Province, China.

Objective: The present study aimed to characterize the genotype distribution and clinical characteristics of HCV monoinfected and HCV/HIV coinfected patients in the Liangshan Prefecture, Sichuan Province, China. Methods: All the patients were divided into HCV monoinfection and HCV/HIV coinfection groups according to whether they were complicated with HIV infection. The data from the two groups were collected. Results: In this study, HCV genotype 3 was the most common genotype in both groups, while HCV genotype 6 was significantly higher in the coinfection group than in the monoinfection group (p = 0.046). The white blood cell count, total bilirubin level, and HCV RNA were significantly higher in the HCV monoinfection group than that in the HCV/HIV coinfection group (p = 0.031; p < 0.001; p = 0.027, respectively). Conclusion: HCV prevalence was high in HIV-positive patients in the Liangshan Prefecture. Thus, incorporating screening and management of HCV monoinfection and HCV/HIV coinfection is needed in local region programs.

A case report of intracardiac bone cement embolization after posterior decompression and cement-enhanced pedicle screw fixation for osteoporosis and lumbar degeneration.

RATIONALE: Bone cement leakage is a common complication of percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) surgery and has also been reported in posterior decompression and cement-enhanced pedicle screw fixation. When bone cement leaks through the venous system, it will have serious consequences and even endanger the life of the patient, especially when the bone cement causes intracardiac embolism. PATIENT CONCERNS: A 70-year-old woman developed chest tightness and decreased blood oxygen saturation following posterior decompression and cement-enhanced pedicle screw fixation. DIAGNOSIS: After the patient was given symptomatic treatment, the symptoms were not relieved, the high-sensitivity troponin I level continued to rise, the electrocardiogram results were abnormal, and chest computed tomography (CT) revealed multiple flaky and strip-shaped dense shadows in the heart. INTERVENTION: The patient underwent removal of foreign bodies from the heart under cardiopulmonary bypass and tricuspid valvuloplasty, removal of intracardiac bone cement, and repair of the tricuspid valve and chordae. OUTCOME: The patient recovered well postoperatively and was discharged from the hospital after 3 weeks. There were no intracardiac foreign bodies observed on chest CT after the operation. LESSONS: For patients with cardiopulmonary discomfort after posterior decompression and bone cement-enhanced pedicle screw fixation, in view of the limitations of radiographic examination, we recommend performing chest CT examination to confirm the diagnosis. For patients with intravascular foreign body embolism, multidisciplinary team joint treatment saves lives.

Multiple tophi deposits in the spine: A case report.

BACKGROUND: Spinal gout (SG) is a rare condition. So far, a limited number of cases have been reported. Herein, we reported a single case of a 42-year-old male patient with SG involving the cervicothoracic and lumbar spine who underwent cervicothoracic segmental surgery. CASE SUMMARY: The patient presented to the hospital with neck pain and limb weakness lasting for one month. He had a history of gout for more than 10 years. Clinical and imaging findings indicated bone and joint tophus erosion, and the patient underwent standard tophi excision and internal fixation with a nail-and-rod system. Histopathological examination suggested gout-like lesions. After the operation, the patient's spinal nerve symptoms disappeared, and muscle strength gradually returned to normal. The patient maintained a low-purine diet and was recommended to engage in healthy exercises. The patient recovered well. CONCLUSION: Clinicians should highly suspect SG when patients with chronic gout presented with low back pain and neurological symptoms. Early decompression and debridement surgery are important to relieve neurological symptoms and prevent severe secondary neurological deficits.

Predictors for Treatment Outcomes in Patients with Multi-drug Resistant Tuberculosis - China, 2018-2020.

What is already known about this topic?: Multi-drug resistant tuberculosis (MDR-TB) is a critical global public health problem. What is added by this report?: Sputum cultures and lung images show a strong association with treatment outcomes, serving as a multi-dimensional approach to identify MDR-TB patients with poor outcomes. What are the implications for public health practice?: The results imply that funds and policy investments should be increased by early monitoring of MDR-TB patients, especially regarding imaging and sputum bacterium. By informing physicians on changes to the therapeutic schedule, treatment outcomes can be improved.

Patient pathway analysis of tuberculosis diagnostic delay: a multicentre retrospective cohort study in China.

OBJECTIVES: Delay in diagnosis of tuberculosis (TB) is an important but under-appreciated problem. Our study aimed to analyse the patient pathway and possible risk factors of long diagnostic delay (LDD). METHODS: We enrolled 400 new bacteriologically diagnosed patients with pulmonary TB from 20 hospitals across China. LDD was defined as an interval between the initial care visit and the confirmation of diagnosis exceeding 14 days. Its potential risk factors were investigated by multivariate logistic regression and multilevel logistic regression. Hospitals in China were classified by increasing size, from level 0 to level 3. TB laboratory equipment in hospitals was also evaluated. RESULTS: The median diagnostic delay was 20 days (IQR: 7-72 days), and 229 of 400 patients (57.3%, 95%CI 52.4-62.1) had LDD; 15% of participants were diagnosed at the initial care visit. Compared to level 0 facilities, choosing level 2 (OR 0.27, 95%CI 0.12-0.62, p 0.002) and level 3 facilities (OR 0.34, 95%CI 0.14-0.84, p 0.019) for the initial care visit was independently associated with shorter LDD. Equipping with smear, culture, and Xpert at initial care visit simultaneously also helped to avoid LDD (OR 0.28, 95%CI 0.09-0.82, p 0.020). The multilevel logistic regression yielded similar results. Availability of smear, culture, and Xpert was lower in level 0-1 facilities than in level 2-3 facilities (p < 0.001, respectively). CONCLUSIONS: Most patients failed to be diagnosed at the initial care visit. Patients who went to low-level facilities initially had a higher risk of LDD. Improvement of TB laboratory equipment, especially at low-level facilities, is urgently needed.

Incidence of scoliosis among junior high school students in Zhongshan city, Guangdong and the possible importance of decreased miR-30e expression.

OBJECTIVE: We investigated scoliosis incidence among junior high school students in Zhongshan city, Guangdong, China and the expression of miR-30e among those with scoliosis. METHODS: A total 41,258 students were included. From July 2015 to December 2017, all students underwent screening including routine observation of the standing and sitting posture, Adam's forward bend test, dorsal tilt angle measurement, and X-ray examination. Age, sex, height, weight, and body mass index (BMI) were recorded. Reverse transcription-quantitative polymerase chain reaction was used to assess miR-30e expression among students with scoliosis and 200 healthy students. RESULTS: Overall, 743 students were diagnosed with scoliosis, with an incidence rate of 1.80%. A total 646 (86.9%) students were diagnosed with idiopathic scoliosis, 38 (5.1%) with congenital scoliosis, and 59 (7.9%) with other scoliosis types. Compared with healthy students, height was significantly greater whereas weight and BMI were significantly lower among students with scoliosis, and expression of miR-30e was significantly lower. However, no significant difference was found in height, weight, BMI, and mean Cobb angle between high/low miR-30e groups. CONCLUSION: The incidence rate for scoliosis was 1.80%, Compared with healthy students, those with scoliosis were taller, had lower weight and BMI, and miR-30e expression was significantly downregulated.