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Cisplatin is a common chemotherapy drug for multiple solid tumors; however, due to the nitrification of peroxynitrite (ONOO - ), a series of side effects seriously affect its dose and efficacy. Considering that the reactivity of ONOO - is significantly affected by pH in vitro, revealing their roles in living cells contributes to understanding the side-effect process induced by cisplatin. Herein, we present a near-infrared fluorescent logic gate for sensing pH/ONOO - , which can accurately discriminate four scenarios (no analyte, analyte H + alone, analyte ONOO - alone, and H + + ONOO - ) and which one comes first. With this probe, the significant roles of pH and ONOO - in cisplatin treatment are disclosed, in which the cell account shows a dramatic reduction accompanied by decreased pH and upregulated ONOO - levels. By artificially recovering the pH, the ONOO - content and cell account can maintain a stable state, possibly due to the protection from acidification and nitration. This work provides an ideal pH/ONOO - logical sensor for revealing their potential roles under cisplatin, which is expected to proffer new insights into more related diseases and drug research.

Organic radicals exhibit great potential in photothermal applications, however, their innate high reactivity with oxygen renders the preparation of stable organic radicals highly challenging. In this work, a series of co-doped radical polymers ares prepared by doping dihydrophenazine derivatives (DPPs) into the epoxy resin matrix. DPPs can form radical species through the electron transfer process, which are further stabilized by the complex 3D network structure of epoxy resin. Experimental results show that the photothermal conversion efficiency is as high as 79.9%, and the temperature can quickly rise to ≈130 °C within 60 s. Due to the excellent visible light transmittance and mechanical properties of co-doped systems, this study further demonstrates their practical applications in energy-saving solar windows and thermoelectric power generation., (© 2024 Wiley‐VCH GmbH.)

Background: While prehabilitation (pre surgical exercise) effectively prevents postoperative pulmonary complications (PPCs), its cost-effectiveness in valve heart disease (VHD) remains unexplored. This study aims to evaluate the cost-effectiveness of a three-day prehabilitation program for reducing PPCs and improving quality adjusted life years (QALYs) in Chinese VHD patients., Methods: A cost-effectiveness analysis was conducted alongside a randomized controlled trial featuring concealed allocation, blinded evaluators, and an intention-to-treat analysis. In total, 165 patients scheduled for elective heart valve surgery at West China Hospital were randomized into intervention and control groups. The intervention group participated in a three-day prehabilitation exercise program supervised by a physiotherapist while the control group received only standard preoperative education. Postoperative hospital costs were audited through the Hospital Information System, and the EuroQol five-dimensional questionnaire was used to provide a 12-month estimation of QALY. Cost and effect differences were calculated through the bootstrapping method, with results presented in cost-effectiveness planes, alongside the associated cost-effectiveness acceptability curve (CEAC). All costs were denominated in Chinese Yuan (CNY) at an average exchange rate of 6.73 CNY per US dollar in 2022., Results: There were no statistically significant differences in postoperative hospital costs (8484 versus 9615 CNY, 95% CI -2403 to 140) or in the estimated QALYs (0.909 versus 0.898, 95% CI -0.013 to 0.034) between the intervention and control groups. However, costs for antibiotics (339 versus 667 CNY, 95% CI -605 to -51), nursing (1021 versus 1200 CNY, 95% CI -330 to -28), and electrocardiograph monitoring (685 versus 929 CNY, 95% CI -421 to -67) were significantly lower in the intervention group than in the control group. The CEAC indicated that the prehabilitation program has a 92.6% and 93% probability of being cost-effective in preventing PPCs and improving QALYs without incurring additional costs., Conclusions: While the three-day prehabilitation program did not significantly improve health-related quality of life, it led to a reduction in postoperative hospital resource utilization. Furthermore, it showed a high probability of being cost-effective in both preventing PPCs and improving QALYs in Chinese patients undergoing valve surgery., Clinical Registration Number: This trial is registered in the Chinese Clinical Trial Registry (URL: https://www.chictr.org.cn/) with the registration identifier ChiCTR2000039671., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2024 The Author(s). Published by IMR Press.)

Purpose: To identify the clinical effect of inspiratory muscle training (IMT) among esophageal cancer patients undergoing esophagectomy based on randomized controlled trials (RCTs)., Methods: Several databases were searched for relevant RCTs up to August 23, 2023. Primary outcomes were respiratory muscle function, including the maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP), and pulmonary function, including the forced expiratory volume in one second % (FEV1%), forced vital capacity% (FVC%), maximal ventilator volume (MVV), FEV1/FVC% and FVC. The secondary outcomes were exercise performance, including the six-minute walk distance test (6MWT) and Borg index; mental function and quality of life, as evaluated by the Hospital Anxiety Depression Scale (HADS) and Nottingham Health Profile (NHP) score; and postoperative complications. All the statistical analyses were performed with REVMAN 5.3 software., Results: Eight RCTs were included in this meta-analysis, with 368 patients receiving IMT and 371 control subjects. The pooled results demonstrated that IMT could significantly enhance respiratory muscle function (MIP: MD = 7.14 cmH2O, P = 0.006; MEP: MD = 8.15 cmH2O, P<0.001) and pulmonary function (FEV1%: MD = 6.15%, P<0.001; FVC%: MD = 4.65%, P<0.001; MVV: MD = 8.66 L, P<0.001; FEV1/FVC%: MD = 5.27%, P = 0.03; FVC: MD = 0.50 L, P<0.001). Furthermore, IMT improved exercise performance (6MWT: MD = 66.99 m, P = 0.02; Borg index: MD = -1.09, P<0.001), mental function and quality of life (HADS anxiety score: MD = -2.26, P<0.001; HADS depression score: MD = -1.34, P<0.001; NHP total score: MD = -48.76, P<0.001). However, IMT did not significantly decrease the incidence of postoperative complications., Conclusion: IMT improves clinical outcomes, such as respiratory muscle function and pulmonary function, in esophageal cancer patients receiving esophagectomy and has potential for broad applications in the clinic., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Su et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Macrocyclic arenes have gained considerable attention for their structural diversity and widespread applications. In this research, a new kind of macrocyclic arenes, namely prism[2]dihydrophenazines (anti-P2P20, syn-P2P20, and P2P22), composed of two dihydrophenazine derivatives subunits bridged by methylene groups, were conveniently synthesized by AlCl 3 -catalyzed one-pot condensation in 1,2-dichloroethane. Both anti-P2P20 and its isomer syn-P2P20 exhibited flexible and convertible conformation with narrow cavity, while P2P22 possessed rigid and rhombic-like skeleton due to the more steric hindrance on subunits. In addition, the selection of electron-deficient guest was found to influence the outside binding behavior of syn-P2P20. Fantastic regular supramolecular tessellation was fabricated by tiling of syn-P2P20 with tetrafluoro-1,4-benzoquinone (TFB) through the exo-wall interactions. Using 1,5-difluoro-2,4-dinitrobenzene (DFN) as a linker, only the regular 2D network superstructure with periodic units in a plane was obtained through cocrystallization. This work not only reports the construction of supramolecular tessellations by using prism[2]dihydrophenazines as building blocks, but also provides a new perspective for the design of macrocyclic arenes and fabrication of 2D supramolecular materials., (© 2024 Wiley-VCH GmbH.)

Developing luminogens with a high emission efficiency in both single-molecule and aggregate states, as well as high mobility, shows promise for advancing the iteration and update of organic optoelectronic materials. However, achieving a delicate balance between the plane configuration of luminophores and the strong exciton interactions of aggregates is a formidable task from the molecular design perspective. This dilemma was overcome by integrating a rigid donor and flexible acceptor to establish donor-acceptor (D-A) type emitters. The π-conjugate-extended donor ensures the substantial planarity of these molecules, allowing strong emission in solution with photoluminescence quantum yield values of 86% and 75%. Furthermore, the restricted molecular motion of the aggregation-induced emission moiety and the formation of J -aggregates reduce the quenching effect, leading to a high emissive efficiency of 85% and 91% in the aggregate state. The mildly distorted D-A geometry builds moderate electrostatic interaction, resulting in high mobility with μ M,h of 7.12 × 10 -5 and 3.27 × 10 -4 cm 2 /V s. Additionally, an improved synthesized procedure for terminal E -configured acrylonitrile with metal-free and concise reaction conditions is presented. The successful application of the synthesized compounds in organic light-emitting diode devices demonstrates the practicability of the molecular design strategy with connecting a rigid donor and flexible acceptor.

This research aimed to determine the relationships between the risk factors for nosocomial multidrug-resistant Acinetobacter baumannii (MDRAB) bacteremia and associated mortality. We analyzed 144 patients treated for A. baumannii bacteremia, including 120 patients with MDRAB bacteremia, from March 2015 to March 2020, in this retrospective study. The overall bacteremia-related mortality rate was 48.6%. The mortality rates were 25.0% and 53.3% for non-MDRAB and MDRAB bacteremia, respectively. Risk factors for the development of MDRAB bacteremia were prior use of cephalosporins [odds ratio (OR): 8.62; P < .001], carbapenems (OR: 15.04; P < .001), or quinolones (OR: 5.02; P = .040); indwelling urinary catheters (OR: 21.38; P < .001); and respiratory tract as the source of bacteremia (OR: 75.33; P < .001). Patients with elective surgeries were inclined to develop non-MDRAB bacteremia (OR: 0.45; P = .029). High scores in the Acute Physiology and Chronic Health Evaluation II (OR: 1.321; P < .001) and Sequential Organ Failure Assessment (OR: 1.326; P < .001) were risk factors for mortality from MDRAB infection. In summary, higher mortality rates occur in patients with MDRAB bacteremia, and risk factors include prior use of cephalosporins, carbapenems, or quinolones. Urinary catheters and the respiratory tract as sources of the infection increase the risk of MDRAB bacteremia., (© The Author(s) 2024. Published by Oxford University Press on behalf of Applied Microbiology International.)

The viscosity distribution of micellar interiors from the very center to the outer surface is dramatically varied, which has been distinguished in theoretical models, yet it remains highly challenging to quantify this issue experimentally. Herein, a series of fluorophore-substituted surfactants DPAC-F n ( n = 3, 5, 7, 9, 11, 13, and 15) are developed by functionalizing the different alkyl-trimethylammonium bromides with the butterfly motion-based viscosity sensor, N , N '-diphenyl-dihydrodibenzo[ a , c ]phenazine ( DPAC ). The immersion depth of DPAC units of DPAC-F n in cetrimonium bromide ( C 16 TAB ) micelles depends on the alkyl chain lengths n . From deep ( n = 15) to shallow ( n = 3), DPAC-F n in C 16 TAB micelles exhibits efficient viscosity-sensitive dynamic multicolor emissions. With external standards for quantification, the viscosity distribution inside a C 16 TAB micelle with the size of ∼4 nm is changed seriously from high viscosity (∼190 Pa s) in the core center to low viscosity (∼1 Pa s) near the outer surface. This work provides a tailored approach for powerful micelle tools to explore the depth-dependent microviscosity of micellar interiors.

Ferroptosis is a new mode of cell death with major morphological changes in mitochondria, including structural shrinkage and increased membrane density, indicating the mitochondrial abnormality during this process. Viscosity, as one of the crucial microenvironmental parameters for characterizing the mitochondrial state, is thought to be highly involved in the ferroptosis. Herein, we present a single fluorescent probe (PPAC-C4) for the dual ratio and ultrahigh-accuracy quantification of mitochondrial viscosity. This probe is constructed by linking a mitochondria-targeting cation fragment on a vibration-based fluorescent scaffold whose fluorescence exhibits the rare triple emission (480, 533, and 628 nm) depending on the viscosity. The intensity ratios of 480 nm/628 nm and 533 nm/628 nm can be used to monitor the viscosity changes in a double self-calibration manner and finally afford an average viscosity value with improved precision. By virtue of this pattern, we reveal that the mitochondrial viscosity will increase from 43.58 to 152.05 cP in A549 cells during the ferroptosis. This dual-ratio probe with triemission not only shows great potential in the study of ferroptosis and ferroptosis-related diseases but also proposes a new concept for ultraprecision quantitative analysis.

Electrochemical synthesis has emerged as a promising approach for the large-scale production of graphene-based two-dimensional (2D) materials. Electrochemical intercalation of ions and molecules between graphite layers plays a key role in the synthesis of graphene with controllable thickness. However, there is still a limited understanding regarding the impact of intercalant molecules. Herein, we investigated a series of anionic species (i.e., ClO 4 - , PF 6 - , BF 4 - , HSO 4 - , CH 3 SO 3 - , and TsO - ) and examined their wedging process between the weakly bonded layered materials driven by electrochemistry. By combining cyclic voltammetry, X-ray diffraction (XRD), and Raman spectroscopy, along with density functional theory (DFT) calculations, we found that stage-2 graphite intercalation compounds (GICs) can be obtained through intercalation of ClO 4 - , PF 6 - , or BF 4 - anions into the adjacent graphene bilayers. The anodic exfoliation step based on ClO 4 - -GIC in (NH 4 ) 2 SO 4 (aq.) resulted in the formation of bilayer-rich (>57%) electrochemically exfoliated graphene oxide (EGO), with a high yield (∼85 wt %). Further, the physicochemical properties of these EGO can be readily customized through electrochemical reduction and modification with different surfactants. This versatility allows for precise tailoring of EGO, making it feasible for energy and electronic applications such as electrodes in electrochemical capacitors and functional composites in wearable electronics., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

A simple dynamic monitoring strategy for chiral self-assembly is achieved by confining the bent-to-planar evolution observed in N , N '-diphenyl-dihydrodibenzo[ a , c ]phenazine derivatives (DPAC-R/S-GLD). Besides, this approach provides a facile pathway to fabricate architectures with circularly polarized luminescence (CPL) properties.

Perovskite quantum dot light-emitting diodes (Pe-QLEDs) have been shown as promising candidates for next-generation displays and lightings due to their unique feature of wide color gamut and high color saturation. Hole-transporting materials (HTMs) play crucial roles in the device performance and stability of Pe-QLEDs. However, small-molecule HTMs have been less studied in Pe-QLEDs due to their poor solvent resistance and low hole mobility. In this work, three novel small-molecule HTMs employing benzimidazole as the center core, named X4 , X5 , and X6 , were designed and synthesized for application in Pe-QLEDs. One of the tailored HTM- X6 exhibits excellent solvent resistant ability to the perovskite quantum dot (QD) inks due to its proper solubility and low surface energy. Our result clearly demonstrated that the synergistic effect of poor solubility and low surface energy facilitates the achievement of good solvent resistance to perovskite QD inks. As a result, a promising maximal external quantum efficiency (EQE) of 14.1% is achieved in X6 -based CsPbBr 3 Pe-QLEDs, which is much higher than that of X4 (9.16%) and X5 (6.60%)-based devices, which is comparable to the PTAA reference (EQE ∼ 15.8%) under the same conditions. To the best of our knowledge, this is the first example that a benzimidazole-based small-molecule HTM demonstrated a good application in Pe-QLEDs. Our work provides new guidance for the rational design of small-molecule HTMs with high solvent resistance for efficient Pe-QLEDs and other photoelectronic devices.

We demonstrate that a single polycyclic π-scaffold can undergo sequential multistep excited-state structural evolution along the bent, planar, and twisted conformers, which coexist to produce intrinsic multiple fluorescence emissions in room-temperature solution. By installing a methyl or trifluoromethyl group on the ortho-site of N,N'-diphenyl-dihydrodibenzo[a,c]phenazine (DPAC), the enhanced steric effects change the fluorescence emission of DPAC from a dominant red band to well-resolved triple bands. The ultra-broadband triple emissions of ortho-substituted DPACs range from ≈350 to ≈850 nm, which is unprecedented for small fluorophores with molecular weight of <500. Ultrafast spectroscopy and theoretical calculations clearly reveal that the above dramatic changes originate from the influence of steric hindrance on the shape of excited state potential energy surface (S 1 PES). Compared to the steep S 1 PES of parental DPAC, the introduction of ortho-substituent is shown to make the path of structural evolution in S 1 wider and flatter, so the ortho-substituted derivatives exhibit slower structural transformations from bent to planar and then to twisted forms, yielding intrinsic triple emission. The results provide the proof of concept that the bent, planar, and twisted emissive states can coexist in the same S 1 PES, which greatly expand the fundamental understanding of the excited-state structural relaxation., (© 2023 Wiley-VCH GmbH.)

A simple strategy is presented for the bifunctional detection of environmental organic vapor and temperature by utilizing H-bond interactions to trap a butterfly-vibration-based fluorophore (DPAC-OH) in a polyurethane (PU) matrix. The method opens up a new path for large-scale environmental inspections and the design of dual-response luminescent materials.

Depression is considered to be the most common mental disorder and is probed by several studies that chronic mild stress contributes to depression, and fortunately, most antidepressants ameliorate depressive-like behavior accompanied with reversed hippocampal neurogenesis defects. In our present study, we confirmed that different antidepressants repaired the stress-induced neuronal and behavioral deficits by modulating adult hippocampal neurogenesis. Antidepressant treatment restored the adult hippocampal neurodegeneration, which was impaired by chronic unpredicted mild stress displaying decreased proliferation and neuronal differentiation but increased apoptosis of newly formed neurons in dentate gyrus. Notably, sucrose preference ratio significantly correlated with both neuronal differentiation proportion and newborn apoptosis proportion, suggesting a mechanistic relationship between neurogenesis and behavior. Indeed, the neotype TREK-1 potassium channel blocker expressed an earlier and pronounced antidepressant manifestation compared to the traditional selective serotonin-reuptake inhibitors fluoxetine. We therefore conclude that the administration of TREK-1 potassium channel antagonism can reverse the depressive deficits caused by chronic stress quickly via regulation of adult hippocampal neurogenesis.

Our previous study indicated that inhibition of NLRP1-dependent pyroptosis could decrease intracerebroventricular (ICV) injection of a protein kinase A (PKA) agonist- or streptozotocin (STZ)-induced hyperphosphorylated tau. In this study, we used a glycogen synthase kinase-3β (GSK-3β) overactivation rat model to reconfirm our previous results. ICV injection of wortmannin (WT, a PI3K inhibitor) and GF-109203X (GFX, a PKC inhibitor) was used to induce overactivation of GSK-3β in rats. We injected NLRP1 siRNA together with WT/GFX to evaluate the effect of the inhibition of NLRP1-dependent neuronal pyroptosis on hyperphosphorylated tau. Our results indicated that ICV injection of NLRP1 siRNA prevented ICV-WT/GFX-induced neuronal death, further improving the spatial memory of the rats in the Morris water maze test. ICV injection of NLRP1 siRNA downregulated the expression of ASC, caspase-1, and GSDMD and the contents of IL-1β and IL-18 in rat brains. ICV injection of NLRP1 siRNA also decreased hyperphosphorylated tau and the activity of GSK-3β. Thus, these results support our previous study that NLRP1-dependent pyroptosis could enhance hyperphosphorylation of tau protein., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Single-molecule conductance measurements for 9,14-diphenyl-9,14-dihydrodibenzo[ a , c ]phenazine ( DPAC ) may offer unique insight into the bent-to-planar photocycle between the ground and excited states. Herein, we employ DPAC derivative DPAC-SMe as the molecular prototype to fabricate single-molecule junctions using the scanning tunneling microscope break junction technique and explore photoconductance dependence on the excited-state structural/electronic changes. We find up to ∼200% conductance enhancement of DPAC-SMe under continuous 340 nm light irradiation than that without irradiation, while photoconductance disappears in the case where structural evolution of the DPAC-SMe is halted through macrocyclization. The in situ conductance modulation as pulsed 340 nm light irradiation is monitored in the DPAC-SMe -based junctions alone, suggesting that the photoconductance of DPAC-SMe stems from photoinduced intramolecular planarization. Theoretical calculations reveal that the photoinduced structural evolution brings about a significant redistribution of the electron cloud density, which leads to the appearance of Fano resonance, resulting in enhanced conductance through the DPAC-SMe -fabricated junctions. This work provides evidence of bent-to-planar photocycle-induced conductance differences at the single-molecule level, offering a tailored approach for tuning the charge transport characteristics of organic photoelectronic devices.

Objective: More than one-third of chronic pancreatitis patients will eventually develop diabetes, recently classified as post-chronic pancreatitis diabetes mellitus (PPDM-C). This study was aimed to investigate the pancreatic and gut hormone responses to a mixed meal test in PPDM-C patients, compared with non-diabetic chronic pancreatitis (CP), and type 2 diabetes patients or healthy controls., Design and Methods: Sixteen patients with PPDM-C, 12 with non-diabetic CP as well as 10 with type 2 diabetes and healthy controls were recruited. All participants underwent mixed meal tests, and blood samples were collected for measurements of blood glucose, C-peptide, insulin, glucagon, pancreatic polypeptide (PP), ghrelin, peptide YY, glucagon like peptide-1 (GLP-1) and gastric inhibitory peptide (GIP). Indices of insulin sensitivity and secretion were calculated. Repeated measures analysis of variance was performed., Results: Participants with PPDM-C exhibited decreases in both fasting and postprandial responses of C-peptide (P < 0.001), insulin (P < 0.001), ghrelin (P < 0.001) and PYY (P = 0.006) compared to participants with type 2 diabetes and healthy controls. Patients with CP showed blunted glucagon, PP and incretin reactions, while the responses were increased in patients with PPDM-C compared to controls. The level of insulin sensitivity was higher for PPDM-C than type 2 diabetes (P < 0.01), however the indices for early/late-phase and overall insulin secretion (P < 0.01) were lower., Conclusions: Patients with PPDM-C are characterized by decreased C-peptide, insulin, ghrelin and PYY responses, and similar levels of glucagon, PP, GIP and GLP-1 compared to those with type 2 diabetes. The above findings, when confirmed in a larger population, may prove helpful to establish the diagnosis of PPDM-C, and should promote study on underlying pathophysiological mechanisms., Competing Interests: Declaration of Competing Interest No potential conflicts of interest relevant to this article were reported., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

To gain insights into the coupling of conformational and electronic variables, we exploited steric hindrance to modulate a polycyclic skeleton with a bent conformation in the S 0 state and a twisted conformation in the S 1 state under the guidance of photoexcited aromaticity reversals. Polycyclic 5,10-dihydrophenazine ( DHP ) adopted a bent structure in S 0 but involved a bent-to-planar transformation in S 1 due to the excited-state aromaticity of the 8π-electron central ring. The N , N '-locations and 1,4,6,9-sites of the DHP skeleton provided a versatile chemical handle for fine-tuning intramolecular steric hindrance. Specifically, N , N '-diphenyl-5,10-dihydrophenazine ( DPP-00 ) and its derivatives DPP-10 - DPP-22 were synthesized with different numbers of methyl groups on the 1,4,6,9-sites. X-ray crystal analyses suggested that the DHP skeletons of DPP-00 - DPP-22 had more bending configurations along the N···N axis with an increase in the number of methyl groups. Following the bending-promoted interruption of π-conjugation, the absorption spectra of DPP-00 - DPP-22 significantly blue-shifted from 416 to 324 nm. By contrast, the emission bands exhibited a reverse shift to longer wavelengths from 459 to 584 nm as the number of methyl substituents increased. Theoretical calculations revealed that introducing methyl groups caused the planar DHP skeleton in S 1 to further twist along the N···N axis, resulting in a twisted high-strain conformation. The greater Stokes shift of the more steric-hindered structure can be attributed to the release of larger strain and aromatic stabilization energy. This research highlighted the potential promise associated with the interplay of steric effects and aromaticity reversals in a single fluorophore.

Aims: The early distinction of pancreatic cancer associated diabetes (PaCDM) in patients with elderly diabetes is critical. However, PaCDM and type 2 diabetes mellitus (T2DM) remain indistinguishable. We aim to address the differences between the pancreatic and gut endocrine hormones of patients with PaCDM and T2DM., Methods: A total of 44 participants underwent mixed meal tolerance test (MMTT). Fasting and postprandial concentrations of insulin, C-peptide, glucagon, pancreatic polypeptide (PP), glucagon-like peptide-1 (GLP-1), and gastric inhibitory peptide (GIP) were measured. Insulin sensitivity and secretion indices were calculated. One-way ANOVA with post-hoc analysis was used for statistical analysis., Results: Insulin and C-peptide responses to MMTT were blunted in PaCDM patients compared with T2DM. Baseline concentrations and AUCs differed. PaCDM patients showed lower insulin secretion capacity but better insulin sensitivity than T2DM patients. The peak concentration and AUC of PP in T2DM group were higher than healthy controls, but in accordance with PaCDM. PaCDM patients presented lower baseline GLP-1 concentration than T2DM patients. No between-group differences were found for glucagon and GIP., Conclusions: PaCDM patients had a lower baseline and postprandial insulin and C-peptide secretion than T2DM patients. Reduced insulin secretion and improved peripheral sensitivity were found in PaCDM patients compared with T2DM., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Purpose: To evaluate whether postoperative exercise training is effective in improving clinical outcomes such as the quality of life (QoL), exercise capacity and respiratory function of patients receiving pulmonary resection., Data Sources: The PubMed, EMBASE, Web of Science and PEDro electronic databases were comprehensively searched to identify eligible randomized controlled trials (RCTs)., Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. The primary outcome was postoperative QoL and secondary outcomes were exercise capacity and respiratory function., Results: A total of eight studies involving 691 participants were enrolled in this systematic review and meta-analysis. For the postoperative QoL measured by 36-Item Short Form Health Survey (SF-36), the pooled results demonstrated that postoperative exercise training could significantly improve the SF-36 physical domain score [weighted mean difference (WMD) = 5.87, 95% confidence interval (CI): 3.96 to 7.78, P＜0.001] and SF-36 mental domain score (WMD = 8.15, 95% CI: 0.13 to 16.16, P = 0.05). The results of further analysis for the eight dimensions of SF-36 were similar to the overall results. However, for secondary outcomes, no significant effects of postoperative exercise training on exercise capacity and respiratory function were observed., Conclusion: Postoperative exercise training could significantly improve the QoL of patients undergoing lung surgery. However, more RCTs with large samples are still needed to verify the effects of postoperative exercise rehabilitation on clinical outcomes of patients who receive pulmonary resection., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Microglia are immune cells of the central nervous system that mediate neuroinflammation. It is widely known that microglia-mediated inflammation in the brain contribute to the widespread tissue damage and neurological deficits in traumatic brain injury (TBI). However, the mechanisms responsible for this inflammatory response remain elusive. Here, we investigated the role of astrocyte-derived chemokine (C-C motif) ligand 7 (CCL7) in microglial-controlled inflammation following TBI. Our results demonstrated that astrocyte-derived CCL7 induced microglial activation and the release of proinflammatory mediators in the cortex and serum of rats that underwent experimental TBI. Furthermore, CCL7 knockout improved microglia-controlled inflammation, brain morphology and neurological dysfunction following TBI. In vitro, CCL7-siRNA attenuated the LPS-induced expression of pro-inflammatory markers in the co-culture of microglia and astrocytes. Collectively, our findings uncover an important role for astrocyte-derived CCL7 in promoting microglia-mediated inflammation after TBI and suggests CCL7 could serve as a potential therapeutic strategy for attenuating TBI by inhibiting microglial activation., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Parkinson's disease (PD) is a common neurological disorder worldwide, characterized by loss of dopaminergic neurons and decrease of dopamine content. Mitochondria plays an important role in the development of PD. Adenosine 5'-monophosphate-activated protein kinase (AMPK), glycogen synthase kinase 3 (GSK-3β) and protein phosphatase 2A (PP2A) are all key proteins that regulate mitochondrial metabolism and apoptosis, and they are involved in a variety of neurodegenerative diseases. Here, we aimed to explore the involvement of mitochondrial dysfunction and apoptosis in 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine hydrochloride (MPTP)-induced PD mice and MPP + iodide-induced PC12 cells. MPTP-induced mice were subjected to behavioral testing to assess PD-like behaviors. Various molecular biological techniques including ELISA, Western blot, TUNEL assay, flow cytometry, and the important instruments Seahorse XF24 Extracellular and high performance liquid chromatography (HPLC), were used to identify the underlying molecular events of mitochondria. Treatment with the AMPK activator GSK621 dramatically ameliorated PD by increasing the levels of dopamine and rescuing the loss of dopaminergic neurons, which is dependent on the mitochondrial pathway. Moreover, regulation of AMPK/GSK-3β/PP2A pathway-related proteins by GSK621 was partially inhibited the development of PD, suggesting a negative feedback loop exists between AMPK action and mitochondrial dysfunction-mediated apoptosis. Our data preliminarily indicated that mitochondrial dysfunction and apoptosis in the pathogenesis of PD might be mediated by AMPK/GSK-3β/PP2A pathway action, which might be a promising new option for future therapy of PD., (Copyright © 2021. Published by Elsevier B.V.)

As an alternative mesenchymal stem cell- (MSC-) based therapy, MSC-derived extracellular vesicles (EVs) have shown promise in the field of regenerative medicine. We previously found that human umbilical cord mesenchymal stem cell-derived EVs (hUCMSC-EVs) improved functional recovery and nerve regeneration in a rat model of sciatic nerve transection. However, the underlying mechanisms are poorly understood. Here, we demonstrated for the first time that hUCMSC-EVs promoted the proliferation of Schwann cells by activating the PI3K/AKT signaling pathway. Furthermore, we showed that hUCMSC-EVs mediated Schwann cell proliferation via transfer of miR-21. Our findings highlight a novel mechanism of hUCMSC-EVs in treating peripheral nerve injury and suggest that hUCMSC-EVs may be an attractive option for clinical application in the treatment of peripheral nerve injury., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2021 Yongbin Ma et al.)

Herein, a molecular pixel system for full-color luminescence reproduction is achieved by adjusting the colorless mixtures of two matching fluorophores, i.e., polarity-insensitive 9,14-diphenyl-9,14-dihydrodibenzo[ a , c ]phenazine ( DPAC ) as the fixed red primary color and polarity-sensitive dansylamide ( DSA ) as dynamic blue to green primary colors. DPAC and DSA possess independent emission properties free from electron and energy transfer crosstalk between them because of their close frontier molecular orbitals as well as similar absorptions below 400 nm. According to the additive color theory, under diverse mixing ratios and various polarities, a smooth emission color change is realized in the triangle surrounded by the luminophores in the chromaticity diagram with accurate prediction and expedient reproduction. The principle of this system may open an innovative route for the development of powerful full-color luminescent materials, for example, ratiometric fluorescent polarity sensors and invisible fluorescent crayons.

Herein, we introduce the cyclic 8π-electron (C8π) molecule N,N'-diaryl-dihydrodibenzo[a,c]phenazine (DPAC) as a dual-functional donor to establish a series of new donor-linker-acceptor (D-L-A) dyads DLA1-DLA5. The excited-state bent-to-planar dynamics of DPAC regulate the energy gap of the donor, while the acceptors A1-A5 are endowed with different energy gaps and HOMO/LUMO levels. As a result, the rate and efficiency of the excited-state electron transfer vs. energy transfer can be finely harnessed, which is verified via steady-state spectroscopy and time-resolved emission measurements. This comprehensive approach demonstrates, for the first time, the manifold of excited-state properties governed by bifunctional donor-based D-L-A dyads, including bent-to-planar, photoinduced electron transfer (PET) from excited donor to acceptor (oxidative-PET), fluorescence resonance energy transfer (FRET), bent-to-planar followed by electron transfer (PFET), and PET from donor to excited acceptor (reductive-PET)., (© 2020 Wiley-VCH GmbH.)

Organic chromophores with large Stokes shifts and dual emissions are fascinating because of their fundamental and applied interest. Vibration-induced emission (VIE) refers to a tunable multiple fluorescence exhibited by saddle-shaped N , N '-disubstituted-dihydribenzo[ a , c ]phenazines (DHPs), which involves photo-induced configuration vibrations from bent to planar form along the N-N axis. VIE-active molecules show intrinsic long-wavelength emissions in the unconstrained state (planar state) but bright short-wavelength emissions in the constrained state (bent state). The emission response for VIE-active luminogens is highly sensitive to steric hindrance encountered during the planarization process such that a tiny structural variation can induce an evident change in fluorescence. This can often be achieved by tuning the intensity ratio of short- and long-wavelength bands. In some special cases, the alterations in the emission wavelength of VIE fluorophores can be achieved step by step by harnessing the degree of bending angle motion in the excited state. In this perspective, we summarize the latest progress in the field of VIE research. New bent heterocyclic structures, as novel types of VIE molecules, are being developed, and the general features of the chemical structures are also being proposed. Technologically, novel emission color-tuning approaches and VIE-based probes for visualizing biological activity are presented to demonstrate how the dynamic VIE effect can be exploited for cutting-edge applications., (This journal is © The Royal Society of Chemistry 2020.)

A novel electron-transporting unit, imidazo [1,2- b ]pyridazine (IP), was first reported for developing host materials. The IP moiety possesses excellent electron-transporting ability and great thermal stability. Using carbazole as p-type units and IP as n-type units, several bipolar host materials, namely, IP6Cz, IP68Cz, IP36Cz, and IP368Cz, were developed through altering the substitution site of the IP core. Among these four materials, 6-site-substituted IP6Cz and 6,8-site-substituted IP68Cz exhibit the best electroluminescence (EL) performance. IP6Cz- and IP68Cz-based red phosphorescent organic light-emitting diodes using Ir(pq) 2 acac as the emitter exhibit extremely high EL efficiency with the maximum external quantum efficiency (η ext,max ) of 26.9 and 25.2% and an insignificant efficiency roll-off. Moreover, IP6Cz- and IP68Cz-based deep-red devices doped by Ir(piq) 2 acac also show satisfactory EL performance with a η ext,max of 20.5 and 19.9%, respectively. The influence of different substitution sites of the IP core on the photophysical and electrochemical properties was systematically investigated. This study demonstrates that IP could be a first-rate electron-transporting unit for bipolar materials for red-emitting devices.

The development of color-tunable white-light-emitting systems is significant for artificial smart materials. Recently, a set of conformational dependent fluorophores N , N '-diaryl-dihydrodibenzo[ a , c ]phenazines ( DPAC s) have been developed with unique photoluminescence mechanism vibration-induced emission (VIE). DPAC s can emit intrinsical blue emission at a bent excited state and abnormal orange-red emission at a planar excited state, which are due to the varied π-conjugation via excited-state configuration transformation along the N - N ' axis from bent to planar form. Herein, a novel VIE-active compound DPAC-[B15C5] 2 is designed and synthesized with two wings of benzo-15-crown-5. The excited-state vibration of the DPAC moiety can be modulated by tuning the supramolecular assembly and disassembly via chelation competition of K + between 15-crown-5 and 18-crown-6, and hence, a wide-color-tuning emission is achieved from blue to orange-red including white. Dynamic light scattering and transmission electron microscopy experiments were conducted to exhibit the supramolecular assembling process. Additionally, the moisture detection in organic solvents is realized since the water could dissociate the supramolecular assembly.

Herein, we report a modular synthetic approach of (C-10 to C-13)-substituted 9,14-diaryl-9,14-dihydrodibenzo[a,c]phenazine derivatives. This synthetic route enables the aromatic substitution in a predictable and programmed manner to obtain products in synthetically useful isolated yield.

With the aim of generalizing the structure-properties relationship of bending heterocyclic molecules that undergo prominent photoinduced structural planarization (PISP), a series of new dihydrodibenzo[ac]phenazine derivatives in which one nitrogen atom is replaced by oxygen (PNO), sulfur (PNS), selenium (PNSe), or dimethylmethanediyl (PNC) was strategically designed and synthesized. Compounds PNO, PNS, and PNSe have significantly nonplanar geometries in the ground state, which undergo PISP to give a planarlike conformer and hence a large emission Stokes shift. A combination of femtosecond early relaxation dynamics and computational approaches established an R*→I* (intermediate)→P* sequential kinetic pattern for PNS and PNSe, whereas PNO undergoes R*→P* one-step kinetics. The polarization ability of the substituted heteroatoms, which is in the order O

Polyurethanes (PUs) are a very attractive type of segmented polymer with unique mechanical properties derived from thermodynamic incompatibility between flexible soft segments and hard segments. The performance of PUs is closely related to their microphase separation structures, in which the hard domains serve as physical cross-linking points in the soft matrix. Studying the microphase separation of PUs in a facile manner is thus of great significance but challenging due to the complexity of the internal structures of PUs. N , N '-disubstituted-dihydrophenazine (DPAC) derivatives, the typical molecules featured with vibration-induced emission (VIE) attribute, can emit fluorescence varying with surrounding environment. In this proof-of-concept work, a series of DPAC derivatives were employed as built-in ratiometric "fluorescent rulers" to measure the degree of microphase separation in PUs modulated by temperature variation. The fluorescence of selected DPAC-doped PU films is dependent on the temperature, providing a theoretical basis for this concept. The feasibility of these fluorescent rulers was further validated by the small-angle X-ray scattering (SAXS) analysis. The SAXS curves show significant change in q range of 0.02 to 0.15 Å -1 with the variation in temperature, showing the changes in the internal microstructure. The polydisperse hard sphere model analysis of the scattering data revealed that the volume fraction of hard spheres has a defined relationship with the fluorescence intensity ratio of orange-red light and blue light, thereby demonstrating a novel fluorimetry method for measuring and monitoring the microphase separation of polyurethanes.

FTY720 is a sphingosine 1 phosphate (S1P) receptor agonist approved for the treatment of multiple sclerosis, which is a chronic inflammatory autoimmune disorder. Sepsis is a complex syndrome associated with progressive endotoxemic developments, which finally leads to damage of multiple organs, including the heart. In critical patients, cardiovascular dysfunction due to sepsis is a major cause of death. Previous studies have shown an association between S1P and cardioprotection in the situation of ischemia reperfusion and myocardial infarction. Therefore, we will study the role of S1P towards endotoxic cardiomyocytes. Different doses of FTY720 were applied or not to endotoxic cardiomyocytes. The concentration of inflammatory cytokines, including tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and IL-10 was measured by enzyme-linked immuno sorbent assay. Western blotting was used to analyze the downstream signaling pathways. We discovered that FTY720 reduced the levels of TNF-α and IL-6 through the NF-ΚB pathway, inhibited the expression of caspase-3, and activated both protein kinase B and extracellular signal-regulated kinase 1/2. Additionally, the activation of protein kinase B and extracellular signal-regulated kinase 1/2 could be inhibited by the S1P1 and S1P3 receptor antagonist vulcanized polyethylene23019. Therefore, we infer that S1P exerts a protective effect towards endotoxic cardiomyocytes by decreasing the levels of TNF-α and IL-6, regulating apoptotic and survival signaling pathway. The S1P1 and S1P3 receptors are involved in the prosurvival signal activation.

We report here the fluorescent sensing of both aromatic and linear saturated dicarboxylate anions ( DC 2- ) (as their tetrabutylammonium salts) with different lengths and shapes in acetonitrile using a single fluorescent probe, i.e., the bis-calix[4]pyrrole-appended 9,14-diphenyl-9,14-dihydrodibenzo[ a , c ]phenazine ( DPAC-bisC4P ) incorporating a vibration-induced emission (VIE) phenazine core. Fluorescence titration studies revealed that treating DPAC-bisC4P with dicarboxylate guests capable of forming pseudomacrocyclic host-guest complexes via multiple hydrogen-bonding interactions between the dicarboxylates and calix[4]pyrrole moieties led to a blue-shift in the emission of the phenazine core. The binding-based fluorescence-tuning features of DPAC-bisC4P allow the underlying binding events and inferred structural changes to be monitored in the form of different chromaticity outputs. The analyte-induced differences in the fluorescence response to DC 2- cover a wide range within the chromaticity diagram and can be visualized readily. The present system thus functions as a rudimentary dicarboxylate anion sensor. It highlights the potential benefits associated with combining a tunable VIE core with noncovalent binding interactions and thus sets the stage for the development of new fluorescent chemosensors where a single chemical entity responds to different analytes with a high level of tunability.

Phenothiazine derivatives based on the 10-phenyl-10H-phenothiazine (NAS) chromophore, namely 7-phenyl-7H-benzo[c]phenothiazine (NAS-1) and 12-phenyl-12H-benzo[a]phenothiazine (NAS-2), were designed and synthesized. NAS-1 and NAS-2 are constitutional isomers with different steric strains imposed on the phenothiazine core moiety. In solution, the more-strained NAS-2 possesses a bent structure and undergoes photoinduced structural planarization (PISP). In the crystal, despite the absence of PISP, bent NAS-2 exhibits prominent excimer emission as well as emission mechanochromism, which is not observed in the planar-like NAS and NAS-1. This unconventional observation results from the bent core structure facilitating π-π stacking of the peripheral naphthalene moieties. Two-photon-coupled depth-dependent emission shows spectral differences between the surface and kernel of the NAS-2 crystal, and is believed to be a general phenomenon, at least in part, for materials exhibiting emission mechanochromism., (© 2019 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Peripheral nerve injury results in limited nerve regeneration and severe functional impairment. Mesenchymal stem cells (MSCs) are a remarkable tool for peripheral nerve regeneration. The involvement of human umbilical cord MSC-derived extracellular vesicles (hUCMSC-EVs) in peripheral nerve regeneration, however, remains unknown. In this study, we evaluated functional recovery and nerve regeneration in rats that received hUCMSC-EV treatment after nerve transection. We observed that hUCMSC-EV treatment promoted the recovery of motor function and the regeneration of axons; increased the sciatic functional index; resulted in the generation of numerous axons and of several Schwann cells that surrounded individual axons; and attenuated the atrophy of the gastrocnemius muscle. hUCMSC-EVs aggregated to rat nerve defects, down-regulated interleukin (IL)-6 and IL-1β, up-regulated IL-10 and modulated inflammation in the injured nerve. These effects likely contributed to the promotion of nerve regeneration. Our findings indicate that hUCMSC-EVs can improve functional recovery and nerve regeneration by providing a favourable microenvironment for nerve regeneration. Thus, hUCMSC-EVs have considerable potential for application in the treatment of peripheral nerve injury., (© 2019 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.)

Single-molecular white-light emissions with CIE coordinates of (0.33, 0.37) and (0.33, 0.31) were achieved with DPAC-p-TPE in viscous solution and with DPAC-Tri(o1,2) in the aggregation state through the combination of vibration-induced emission (VIE) and aggregation-induced emission (AIE) mechanisms.

Background: Oscillatory positive expiratory pressure (OPEP) training is a kind of breathing exercise with Acapella. The clinical value of OPEP has been widely discussed in chronic obstructive pulmonary disease, bronchiectasis as well as pulmonary cyst. However, few studies have explored the application of OPEP in surgery lung cancer patients underwent lobectomy. Thus, the aim of this study is to explore the impact of the application of OPEP device (acapella) in lung cancer patients undergoing video-assisted thorascopic surgery (VATS)., Methods: Sixty-nine patients receiving VATS lobectomy in Department of Thoracic Surgery, West China Hospital, Sichuan University from September 15, 2017 to January 15, 2018 were randomly divided into the acapella group (AG) or the control group (CG). The patients in the AG received oscillating positive expiratory pressure training and the CG underwent standard perioperative treatment. The differences of morbidity, pulmonary function, quality of life were compared between the two groups., Results: Thirty-five patients were assigned to the AG and thirty-four patients were assigned to the CG. The incidences of postoperative pulmonary complications (PPCs) and atelectasis (2.9%, 0.0%) in the AG were significantly lower than that in the CG (20.6%, 14.7%)(P=0.03, P=0.03). The duration of total hospital stay and postoperative hospital stay in the AG (10.86±5.64, 5.09±4.55) d were significantly shorter than that in the CG (10.86±5.64, 5.09±4.55) d (P=0.01, P=0.01). The drug cost in the AG (4,413.60±1,772.35) ¥ were significantly lower than that in the CG (6,490.35±3,367.66) ¥ (P=0.01). The patients in the AG had better forced expiratory volume in the first second and peak expiratory flow [(1.50±0.32) L,(252.06±75.27) L/min] compared with the CG [(1.34±0.19) L, (216.94±49.72) L/min] (P=0.03, P=0.03) at discharge., Conclusions: The application of OPEP device during the perioperative period was valuable in decreasing PPCs and enhancing recovery for lung cancer patients receiving VATS lobectomy.

Background: A decrease in serum albumin is commonly observed after lung cancer surgery, however, whether it is associated with postoperative outcomes is unknown. The objective of this study was to evaluate whether the reduction of serum albumin (ΔALB) on postoperative day one could serve as a predictor of postoperative pulmonary complications (PPCs) after thoracoscopic anatomical resection in lung cancer patients., Methods: Patients characteristics were compared between groups of whether they experienced PPCs or not. The cutoff value of ΔALB was examined by receiver operating characteristic curve to find out the threshold value of ΔALB in predicting PPCs. Logistic regression analysis was conducted to identify potential risk factors for PPCs., Results: Totally 533 patients were included into analysis, and among them, 52 experienced PPCs. The ΔALB was significant in the PPCs group than in the non-PPCs group (P<0.001), and ΔALB was observed an independent risk factor for PPCs (OR =2.268, 95% CI: 1.153-4.460). The cutoff value of ΔALB in predicting PPCs was 14.97%. Patients with ΔALB ≥14.97% were more likely to have PPCs (P<0.001)., Conclusions: A reduction of serum albumin with a cut-off value of 14.97% can be served as a predictor to identify patients at high risk of developing PPCs following thoracosopic anatomical lung cancer surgery., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.

Understanding excited-state dynamics is critical for improving the photoluminescence (PL) efficiency of exciplexes. A series of exciplexes based on conventional hole-transporting materials as donor and newly developed phenylpyridinato boron derivatives as acceptor were investigated. High PL efficiencies were achieved in only some combinations, and a large difference in performance among combinations provided insight into nonradiative processes in exciplex systems. Furthermore, the triplet local excited states ( 3 LE) of each donor and acceptor were found play an important role in triplet exciplex harvesting. Significant contributions from triplets were clearly observed when the charge-transfer excited states ( 1 CT and 3 CT) and 3 LE were ideally aligned. We also demonstrated fine control of relative energy alignment via the concentration to improve the PL efficiency., (© 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

ortho-Methyl effects are exploited to tune steric hindrance between side-chain N,N'-diaryls and polycyclic dihydrodibenzo[a,c]phenazine, and in turn control the conformations of N,N'-diphenyl-dihydrodibenzo[a,c]phenazine (DPAC) and its ortho-methyl derivatives Mx-My (x=0, 1 or 2, y=1 or 2, x and y correlate with the number of methyl groups in the ortho-positiond of N,N'-diphenyl). The magnitude of steric hindrance increases as x and y increase, and the V-shaped dihydrodibenzo[a,c]phenazine skeleton is gradually tuned from a bent (DPAC) to planar (M2-M2) structure in the ground state. As a result, the relaxation of the excited-state structure of DPAC and its numerous analogues could be mimicked by model structures Mx-My, demonstrating for the first time the the conformation change from bent-to-planar and hence a large range of energy-gap tuning of polycyclic conjugated structures controlled by the steric hindrance., (© 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Herein, a series of universal bipolar host materials, 9,9'-([1,2,4]triazolo[1,5- a]pyridine-2,6-diylbis(4,1-phenylene))bis(9 H-carbazole) (TP26Cz1), 3-(2-(4-(9 H-carbazol-9-yl)phenyl)-[1,2,4]triazolo[1,5- a] pyridine-6-yl)-9-phenyl-9 H-carbazole (TP26Cz2), 9,9'-([1,2,4]triazolo[1,5- a]pyridine-2,7-diylbis(4,1-phenylene))bis(9 H-carbazole) (TP27Cz1), and 3-(2-(4-(9 H-carbazol-9-yl)phenyl)-[1,2,4]triazolo[1,5- a]pyridin-7-yl)-9-phenyl-9 H-carbazole (TP27Cz2), using [1,2,4]triazolo[1,5- a]pyridine (TP) as electron-transporting moiety and carbazole as hole-transporting moiety, were designed and synthesized. All four compounds possess remarkable carrier-transporting properties and excellent thermal stability with high glass-transition temperature ( T g ) in the range of 136-144 °C. The hole- and electron-transporting abilities could be regulated by adjusting the linkage mode between the carbazole and TP units, and balanced charge-transporting properties were realized in TP26Cz2 and TP27Cz2. The phosphorescent and thermally activated delayed-fluorescence (TADF) organic light-emitting diodes (OLEDs) based on these host materials exhibit superior performance with high efficiency and low roll-off. For example, TP26Cz2-hosted phosphorescent OLED (PhOLED) exhibits the maximum external quantum efficiency (η ext ) of 25.6%, and at the high luminance of 5000 cd m -2 , the η ext still remained at 25.2%. TP27Cz1-hosted TADF device exhibits the maximum η ext of 15.5% and only dropped to 15.4% at the luminance of 1000 cd m -2 . Moreover, the influence of linking mode of carbazole unit and TP units in these hosts on their photophysical and carrier-transporting properties as well as the electroluminescence (EL) performance of devices was discussed.

Monitoring specific processes such as gelation in a ratiometric and visual manner is of scientific value and has practical implications but remains challenging. Herein, an innovative fluorescent low-molecular-weight gelator (DPAC-CHOL) capable of revealing and self-revealing the gelation processes in situ and in real time via the ratiometric fluorescence change from orange-red to blue has been developed. By virtue of its vibration-induced emission attribute, the gelation point, critical gelation concentration, and the internal stiffness of the gel networks of DPAC-CHOL and other gelation systems could be facilely evaluated in a ratiometric and naked-eye-observable fashion. Noteworthily, the DPAC-CHOL-doped gelation system Ph-CHOL can quantitatively identify the environmental temperature in a daily-concerned range (i.e., 20-55 °C). This work not only provides a versatile advanced material but also opens up a new avenue for the investigation of gelation systems.

The electron-accepting [1,2,4]triazolo[1,5-a]pyridine (TP) moiety was introduced to build bipolar host materials for the first time, and two host materials based on this TP acceptor and carbazole donor, namely, 9,9'-(2-([1,2,4]triazolo[1,5-a]pyridin-2-yl)-1,3-phenylene)bis(9H-carbazole) (o-CzTP) and 9,9'-(5-([1,2,4]triazolo[1,5-a]pyridin-2-yl)-1,3-phenylene)bis(9H-carbazole) (m-CzTP), were designed and synthesized. These two TP-based host materials possess a high triplet energy (>2.9 eV) and appropriate highest occupied molecular orbital/lowest unoccupied molecular orbital levels as well as the bipolar transporting feature, which permits their applicability as universal host materials in multicolor phosphorescent organic light-emitting devices (PhOLEDs). Blue, green, and red PhOLEDs based on o-CzTP and m-CzTP with the same device configuration all show high efficiencies and low efficiency roll-off. The devices hosted by o-CzTP exhibit maximum external quantum efficiencies (η ext ) of 27.1, 25.0, and 15.8% for blue, green, and red light emitting, respectively, which are comparable with the best electroluminescene performance reported for FIrpic-based blue, Ir(ppy) 3 -based green, and Ir(pq) 2 (acac)-based red PhOLEDs equipped with a single-component host. The white PhOLEDs based on the o-CzTP host and three lumophors containing red, green, and blue emitting layers were fabricated with the same device structure, which exhibit a maximum current efficiency and η c of 40.4 cd/A and 17.8%, respectively, with the color rendering index value of 75.

Background: Enhanced recovery after surgery (ERAS) program is an effective evidence-based multidisciplinary protocol of perioperative care, but its roles in thoracic surgery remain unclear. This systematic review of randomized controlled trials (RCTs) aims to investigate the efficacy and safety of the ERAS programs for lung cancer surgery., Materials and Methods: We searched the PubMed and EMBASE databases to identify the RCTs that implemented an ERAS program encompassing more than four care elements within at least two phases of perioperative care in lung cancer surgery. The heterogeneity levels between studies were estimated by the Cochrane Collaborations. A qualitative review was performed if considerable heterogeneity was revealed. Relative risk (RR) and weighted mean difference served as the summarized statistics for the meta-analyses. Additional analyses were also performed to perceive potential bias risks., Results: A total of seven RCTs enrolling 486 patients were included. The meta-analysis indicated that the ERAS group patients had significantly lower morbidity rates (RR=0.64; p <0.001), especially the rates of pulmonary (RR=0.43; p <0.001) and surgical complications (RR=0.46; p =0.010), than those of control group patients. No significant reduction was found in the in-hospital mortality (RR=0.70; p =0.58) or cardiovascular complications (RR=1.46; p =0.25). In the qualitative review, most of the evidence reported significantly shortened length of hospital and intensive care unit stay and decreased hospitalization costs in the ERAS-treated patients. No significant publication bias was detected in the meta-analyses., Conclusion: Our review demonstrates that the implementation of an ERAS program for lung cancer surgery can effectively accelerate postoperative recovery and save hospitalization costs without compromising patients' safety. A worldwide consensus guideline is urgently required to standardize the ERAS protocols for elective lung resections in the future., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Background: This study was conducted to develop a preoperative in-hospital short-term rehabilitation program for surgical lung cancer patients, and investigate its feasibility, potential cost benefit and effectiveness on outcome measures including reduction of postoperative pulmonary complications (PPCs) and postoperative length of stay., Methods: A 7-day inpatient-based high-intensive rehabilitation regimen was performed between March 01, 2014 and June 30, 2015. It was combined with inspiratory muscles training (IMT) and aerobic endurance training and was tested in an enriched cohort study with 939 lung cancer patients undergoing lobectomy in a regional thoracic unit., Results: Finally, 939 patients were divided into pulmonary rehabilitation (PR) group (n=197) and non-PR (NPR) group (n=742), according to whether they received the 7-day preoperative in-hospital systematic rehabilitation. The PR group had a shorter total length of stay (14.7±4.0 vs. 16.7±6.2 days, P<0.001) as well as postoperative length of stay (6.2±3.3 vs. 8.3±5.6 days, P<0.001) than the NPR group. Lower incidences of total PPCs (18.3%, 36/197 vs. 26.1%, 194/742, P=0.022), pneumonia (11.2%, 22/197 vs. 17.3%, 128/742, P=0.024) and atelectasis (6.6%, 13/197 vs. 12.3%, 91/742, P=0.038) were found in the PR group compared with NPR group. Meanwhile, a multivariable analysis of risk to PPCs, atelectasis and pneumonia, revealed that the PR intervention was the independent risk factor of the occurrence of the PPCs (OR =0.57, 95% CI: 0.47 to 0.93, P=0.033) and atelectasis (OR =0.49, 95% CI: 0.26 to 0.91, P=0.024)., Conclusions: The study showed the effectiveness of this systematic and high-intensive PR combining IMT and aerobic exercise in reductions of the length of stay and occurrence of PPCs without increase in in-hospital cost, suggesting the potential of this rehabilitation pattern as a practicable strategy performed preoperatively in surgical lung cancer patients., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.

Objective To investigate the isolation and identification of extracellular vesicles (EVs) from rat bone marrow mesenchymal stem cells (BMSCs) and the effect of -80DegreesCelsius cryopreservation on the structural integrity of the EVs' membrane. Methods EVs were isolated and purified from the culture supernatant of bone marrow mesenchymal stem cells (BMSC-CS) by ultrahigh velocity centrifugation. The size and morphology of EVs were observed by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Western blotting was performed to detect the expression of CD63 protein. The integrity of the EVs' membrane structure was observed by TEM at different time after storage at -80DegreesCelsius. Results SEM showed that a large number of EVs with membrane structures, round or oval and ranged in size from 50 to 1000 nm were attached onto BMSC surface. Under TEM, BMSC-EVs were similar in morphology and size to them under SEM. Western blotting revealed that BMSC-EV expressed the marker protein CD63. BMSC-EVs had a complete membrane structure at the first month and the third month, whereas BMSC-EV's membrane structure ruptured at the sixth month after storage at -80DegreesCelsius. Conclusion BMSC-EVs is successfully extracted, and the membrane structure integrity get worse with the prolongation of cryopreservation time.

Background: Postoperative pulmonary complications (PPCs), especially postoperative pneumonia (POP), directly affect the rapid recovery of lung cancer patients after surgery. Peak expiratory flow (PEF) can reflect airway patency and cough efficiency. Moreover, cough impairment may lead to accumulation of pulmonary secretions which can increase the risk of PPCs. The aim of this study is to investigate the effect of preoperative PEF on PPCs in patients with lung cancer., Methods: Retrospective research was conducted on 433 lung cancer patients who underwent lobectomy at the West China Hospital of Sichuan University from January 2014 to December 2015. The associations between preoperative PEF and PPCs were analyzed based on patients' basic characteristics and clinical data in hospital., Results: Preoperative PEF value in PPCs group (280.93±88.99) L/min was significantly lower than that in non-PPCs group (358.38±93.69) L/min (P<0.001). According to the binary logistics regression analysis, PEF and operative time were independent risk factors for PPCs. Further, ROC curve showed that PEF=320 L/min was the cut-off value for predicting the occurrence of PPCs (AUC=0.706, 95%CI: 0.661-0.749). The incidence of PPCs in PEF≤320 L/min group (26.6%) was significantly higher than that in PEF>320 L/min group (9.4%)(P<0.001)., Conclusions: Preoperative PEF and PPCs are correlated, and PEF may be used as a predictor of PPCs.

Several studies have demonstrated extracellular vesicles (EVs) derived from mesenchymal stem cells (MSCs) could promote neural regeneration following central nervous system injury. However, the therapeutic effects of MSC-EVs in peripheral nerve regeneration remain poorly understood. This study was aimed to investigate the therapeutic effects of local application of rat bone marrow mesenchymal stem cell (BMSCs) derived EVs in rat sciatic nerve crush injury model. EVs were isolated from the culture supernatants of BMSCs under serum-free conditioned medium, and identified by transmission electron microscopy (TEM) and scanning electron microscope (SEM). Then, the crush-injured segment of rat was treated by BMSC-EVs or PBS, and assessed the nerve regeneration. Results showed that BMSC-EVs size ranged from 40 to 300 nm and had a typical membrane structure under TEM and SEM. BMSC-EVs treatment promote the function recovery by sciatic function Index, improve the histomorphometric repair in nerve regeneration, and increase the expression of GAP-43, a marker for axon regeneration. The present study demonstrated that BMSC-EVs could promote the functional recovery and nerve regeneration of crush-injured sciatic nerves in rat. BMSC-EVs provide a novel cell-free therapeutic approach to peripheral nerve therapy., Competing Interests: None., (IJCEP Copyright © 2017.)

Objectives: The goal of this study was to assess the impact of a preoperative 1-week, systematic, high-intensity inpatient exercise regimen on patients with lung cancer who had risk factors for postoperative pulmonary complications (PPCs)., Methods: We conducted a randomized controlled trial with 101 subjects of a preoperative, 7-day systematic, integrated, high-intensity pulmonary exercise regimen. The control group received standard preoperative care. We analysed the occurrence of PPCs in both groups as the primary outcome; other outcomes included changes in blood gas, quality of life, peak expiratory flow rate, the 6-min walk distance and others., Results: The 6-min walk distance showed an increase of 22.9 ± 25.9 m in the intervention group compared with 4.2 ± 9.2 m in the control group, giving a between-group difference of 18.7 m (95% confidence interval: 8.8-28.6; P < 0.001); the peak expiratory flow increased by 25.2 ± 24.6 l/min, compared with 4.2 ± 7.7 l/min (between-group difference: 21.0 m, 95% confidence interval: 7.2-34.8; P = 0.003). The intervention group had a shorter average total (15.6 ± 3.6 vs 17.7 ± 5.3 days, P = 0.023) and postoperative length of stay (6.1 ± 3.0 vs 8.7 ± 4.6 days, P = 0.001) than the control group; the incidence of PPCs (9.8%, 5/51 vs 28.0%, 14/50, P = 0.019) was significantly lower. A multivariable analysis of the risk of PPCs identified short-term rehabilitation intervention to be an independent risk factor (odds ratio = 0.156, 95% confidence interval: 0.037-0.649, P = 0.011)., Conclusions: The study results suggested that a systematic, high-intensity pulmonary exercise programme was a practical strategy when performed preoperatively in patients with lung cancer with risk factors for PPCs., Clinical Trial Registration: ChiCTR-IOR-16008109., (© The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)