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Microtia is a congenital deformity of the ear with an incidence of about 0.8–4.2 per 10,000 births. Total auricular reconstruction is the preferred treatment of microtia at present, and one of the core technologies is the preparation of cartilage scaffolds. Autologous costal cartilage is recognized as the best material source for constructing scaffold platforms. However, costal cartilage harvest can lead to donor-site injuries such as pneumothorax, postoperative pain, chest wall scar and deformity. Therefore, with the need of alternative to autologous cartilage, in vitro and in vivo studies of biomaterial scaffolds and cartilage tissue engineering have gradually become novel research hot points in auricular reconstruction research. Tissue-engineered cartilage possesses obvious advantages including non-rejection, minimally invasive or non-invasive, the potential of large-scale production to ensure sufficient donors and controllable morphology. Exploration and advancements of tissue-engineered cartilaginous framework are also emerging in aspects including three-dimensional biomaterial scaffolds, acquisition of seed cells and chondrocytes, 3D printing techniques, inducing factors for chondrogenesis and so on, which has greatly promoted the research process of biomaterial substitute. This review discussed the development, current application and research progress of cartilage tissue engineering in auricular reconstruction, particularly the usage and creation of biomaterial scaffolds. The development and selection of various types of seed cells and inducing factors to stimulate chondrogenic differentiation in auricular cartilage were also highlighted. There are still confronted challenges before the clinical application becomes widely available for patients, and its long-term effect remains to be evaluated. We hope to provide guidance for future research directions of biomaterials as an alternative to autologous cartilage in ear reconstruction, and finally benefit the transformation and clinical application of cartilage tissue engineering and biomaterials in microtia treatment.

Refractory skin defects such as pressure ulcers, diabetic ulcers, and vascular ulcers represent a challenge for clinicians and researchers in many aspects. The treatment strategies for wound healing have high cost and limited efficacy. To ease the financial and psychological burden on patients, a more effective therapeutic approach is needed to address the chronic wound. MSC-derived exosomes (MSC-exosomes), the main bioactive extracellular vesicles of the paracrine effect of MSCs, have been proposed as a new potential cell-free approach for wound healing and skin regeneration. The benefits of MSC-exosomes include their ability to promote angiogenesis and cell proliferation, increase collagen production, regulate inflammation, and finally improve tissue regenerative capacity. However, poor targeting and easy removability of MSC-exosomes from the wound are major obstacles to their use in clinical therapy. Thus, the concept of bioengineering technology has been introduced to modify exosomes, enabling higher concentrations and construction of particles of greater stability with specific therapeutic capability. The use of biomaterials to load MSC-exosomes may be a promising strategy to concentrate dose, create the desired therapeutic efficacy, and maintain a sustained release effect. The beneficial role of MSC-exosomes in wound healing is been widely accepted; however, the potential of bioengineering-modified MSC-exosomes remains unclear. In this review, we attempt to summarize the therapeutic applications of modified MSC-exosomes in wound healing and skin regeneration. The challenges and prospects of bioengineered MSC-exosomes are also discussed.

ObjectiveTo compare the outcomes of four types of cardioplegia during cardiac surgery: del Nido (DN), blood cardioplegia (BC), histidine-tryptophan-ketoglutarate (HTK) and St. Thomas.MethodsRandomized controlled trials (RCTs) and observational cohort studies from 2005 to 2021 were identified in PubMed, Embase, and Cochrane databases. Data were extracted for the primary endpoint of perioperative mortality as well as the following secondary endpoints: atrial fibrillation, renal failure, stroke, use of an intra-aortic balloon pump, re-exploration, intensive care unit stay and hospital stay. A network meta-analysis comparing all four types of cardioplegia was performed, as well as direct meta-analysis comparing pairs of cardioplegia types.ResultsData were extracted from 18 RCTs and 49 observational cohort studies involving 18,191 adult patients (55 studies) and 1,634 children (12 studies). Among adult patients, risk of mortality was significantly higher for HTK (1.89, 95% CI 1.10, 3.52) and BC (RR 1.73, 95% CI 1.22, 2.79) than for DN. Risk of atrial fibrillation was significantly higher for BC (RR 1.41, 95% CI 1.09, 1.86) and DN (RR 1.51, 95% CI 1.15, 2.03) than for HTK. Among pediatric patients, no significant differences in endpoints were observed among the four types of cardioplegia.ConclusionsThis network meta-analysis suggests that among adult patients undergoing cardiac surgery, DN may be associated with lower perioperative mortality than HTK or BC, while risk of atrial fibrillation may be lower with HTK than with BC or DN.

Abstract Background Aneurysm is a severe and fatal disease. This study aims to comprehensively identify the highly conservative co-expression modules and hub genes in the abdominal aortic aneurysm (AAA), thoracic aortic aneurysm (TAA) and intracranial aneurysm (ICA) and facilitate the discovery of pathogenesis for aneurysm. Methods GSE57691, GSE122897, and GSE5180 microarray datasets were downloaded from the Gene Expression Omnibus database. We selected highly conservative modules using weighted gene co‑expression network analysis before performing the Gene Ontology, Kyoto Encyclopedia of Genes and Genomes pathway and Reactome enrichment analysis. The protein–protein interaction (PPI) network and the miRNA-hub genes network were constructed. Furtherly, we validated the preservation of hub genes in three other datasets. Results Two modules with 193 genes and 159 genes were identified as well preserved in AAA, TAA, and ICA. The enrichment analysis identified that these genes were involved in several biological processes such as positive regulation of cytosolic calcium ion concentration, hemostasis, and regulation of secretion by cells. Ten highly connected PPI networks were constructed, and 55 hub genes were identified. In the miRNA-hub genes network, CCR7 was the most connected gene, followed by TNF and CXCR4. The most connected miRNAs were hsa-mir-26b-5p and hsa-mir-335-5p. The hub gene module was proved to be preserved in all three datasets. Conclusions Our study highlighted and validated two highly conservative co-expression modules and miRNA-hub genes network in three kinds of aneurysms, which may promote understanding of the aneurysm and provide potential therapeutic targets and biomarkers of aneurysm.

Abstract Background Kimura’s disease is a rare, benign chronic inflammatory disease of unknown etiology that mostly affects Asians. The disease typically presents as subcutaneous masses in the head or neck region that are predominantly found in the preauricular and submandibular areas. Case presentation A 7-year-old boy presenting with paralysis of both lower extremities and a thoracic spine dumbbell mass was initially diagnosed with a neurogenic tumor, but the pathological and laboratory examinations confirmed the diagnosis of Kimura’s disease. The paralysis symptom disappeared rapidly, but the patient had developed a recurrent mass in the cervical vertebral canal at the 9-month follow-up. Conclusion To our knowledge, no prior published literature has revealed Kimura’s disease cases that mimic dumbbell neurogenic tumors. Here, we report such a case of Kimura’s disease for the first time and provide a brief review of the literature.

Background: Present researches exploring the prognostic value of calcium concentration are undermined by sample size and study design. Our study investigated the association of both total calcium (tCa) and ionized Ca (iCa) to short- and long-term mortality and other outcomes in post-cardiovascular surgery (PCS) patients admitted to intensive care unit (ICU) from two large public data sets.Methods: The Medical Information Mart for Intensive Care III (MIMIC-III) database and the eICU Collaborative Research Database (eICU) were inspected to identify PCS patients. The primary outcome was 28-day mortality. Multivariate regression was used to elucidate the relationship between calcium concentration and outcomes. The propensity score estimation was performed to validate our findings.Results: A total of 6122 and 914 patients were included from the MIMIC III and eICU data sets, respectively. The groups with the most patients were the mild hypo-iCa and hypo-tCa groups. The mild hypo-iCa group showed significant association with worse short-term and long-term prognosis, less use of ventilation, longer ICU and hospital stay, and more incidence of 7-day acute kidney injury.Conclusions: The mild hypo-iCa (0.9–1.15 mmol/L) within the first day of admission to the ICU could serve as an independent prognosis factor for PCS patients.

Background: This study was aimed to investigate the relationship between first 24-h mean body temperature and clinical outcomes of post cardiac surgery patients admitted to intensive care unit (ICU) in a large public clinical database.Methods: This is a retrospectively observational research of MIMIC III dataset, a total of 6,122 patients included. Patients were divided into 3 groups according to the distribution of body temperature. Multivariate cox analysis and logistic regression analysis were used to investigate the association between abnormal temperature, and clinical outcomes.Results: Hypothermia (38°C). Hyperthermia was related to the extended length of ICU stay (p < 0.001), and hospital stay (p < 0.001).Conclusion: Hypothermia within 24h after ICU admission was associated with the increased mortality of post cardiac surgery patients. Enhanced monitoring of body temperature within 24h after cardiac surgery should be taken into account for improving clinical outcomes.

Objective: To compare these managements focusing on the efficacy and safety to treat overactive bladder (OAB) in children through network meta-analysis (NMA). Methods: We searched PubMed, Embase, the Cochrane Library Central Register of Controlled Trials (CENTRAL) and the reference lists up to May 1st, 2017. Data from eligible randomized controlled trails (RCT) studies including three different treatment options were extracted. The primary outcome was maximal voiding volume (MVV). We performed pairwise meta-analyses by random effects model and NMA by Bayesian model. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework to assess the quality of evidence contributing to each network estimate. Results: Six RCTs (462 patients) comparing three different interventions fulfilled the inclusion criteria. A low risk of bias was shown for the majority of the study items. The results of NMA showed that compared with antimuscarinic drugs, Parasacral transcutaneous electrical nerve stimulation was associated with significant improvement in the MVV (mean difference [MD] = 58.50, 95% confidential interval [CI]: 45.95–69.52), followed by urotherapy group (MD = 21.03, 95% CI: 11.85–29.97). When it comes to the constipation, antimuscarinic drugs exerted significant benefit than PTENS (odds ratio [OR]: 0.22, 95% CI: 0.01–0.46). No significant difference was found between other treatments. Conclusion: Compared with antimuscarinic drugs, PTENS was associated with significant better efficacy considering MVV, but more constipation events in de novo OAB children. Antimuscarinic drugs showed remarkably better efficacy considering MVV and comparable safety profile compared with urotherapy. Clinicians should take all known safety and compliance of patients into account when choosing an optimal strategy. Keywords: Overactive bladder, Meta-analysis, Anticholinergics, Parasacral transcutaneous electrical nerve stimulation

IntroductionCutaneous angiosarcoma (cAS) is an aggressive vascular tumor that originates from vascular or lymphatic epithelial cells. To date, the cAS literature has been limited in a small number with single-center experiences or reports due to its rarity and the optimal treatment strategy is still in dispute. This study aimed to conduct a systematic review and compare the effect of available treatments retrieved from observational studies and Surveillance, Epidemiology, and End Results (SEER) program.MethodsThe authors performed a systematic review in the PubMed, Embase and MEDLINE database identifying the researches assessing the treatment for cAS patients. Clinical and treatment information of patients who had been diagnosed with a primary cAS were also obtained from the SEER program.ResultsThirty-two studies were eligible but only 5 of which with 276 patients were included in meta-analysis since the unclear or unavailable information. The risk ratio of 5-year death for surgery, surgery with radiotherapy and surgery with chemotherapy were 0.84, 0.96, and 0.69. Meanwhile, in SEER database, there are 291 metastatic and 437 localized patients with cAS. The localized patients receiving surgery showed a significantly worse overall survival result when compared with the surgery combined with RT: hazard ratio: 1.6, 95% confidential interval: 1.05, 2.42, P = 0.03.ConclusionIn conclusion, our study provided a detailed picture of the effectiveness of present treatments for localized and metastatic cAS patients. The CT could be inappropriate in localized patients. For metastatic patients, the surgery combined RT was recommended compared with surgery alone since its enhanced OS prognosis. Yet, more novel-designed clinical trials with specific targeted populations and rigorous conducting are needed for a solid conclusion on which would be a better treatment strategy.

Due to a strong retardation effect of o-nitrobenzyl ester on polymerization, it is still a great challenge to prepare amphiphilic block copolymers for polymersomes with a o-nitrobenzyl ester-based hydrophobic block. Herein, we present one such solution to prepare amphiphilic block copolymers with pure poly (o-nitrobenzyl acrylate) (PNBA) as the hydrophobic block and poly (N,N’-dimethylacrylamide) (PDMA) as the hydrophilic block using bulk reversible addition-fragmentation chain transfer (RAFT) polymerization of o-nitrobenzyl acrylate using a PDMA macro-RAFT agent. The developed amphiphilic block copolymers have a suitable hydrophobic/hydrophilic ratio and can self-assemble into photoresponsive polymersomes for co-loading hydrophobic and hydrophilic cargos into hydrophobic membranes and aqueous compartments of the polymersomes. The polymersomes demonstrate a clear photo-responsive characteristic. Exposure to light irradiation at 365 nm can trigger a photocleavage reaction of o-nitrobenzyl groups, which results in dissociation of the polymersomes with simultaneous co-release of hydrophilic and hydrophobic cargoes on demand. Therefore, these polymersomes have great potential as a smart drug delivery nanocarrier for controllable loading and releasing of hydrophilic and hydrophobic drug molecules. Moreover, taking advantage of the conditional releasing of hydrophilic and hydrophobic drugs, the drug delivery system has potential use in medical applications such as cancer therapy.

Abstract Background Polyhydroxyalkanoates (PHAs) are optimal potential materials for industrial and medical uses, characterized by exceptional sustainability, biodegradability, and biocompatibility. These are primarily from various bacteria and archaea. Bacterial strains with effective PHA formation capabilities and minimal production cost form the foundation for PHA production. Detailed genomic analysis of these PHA-generating bacteria is vital to understand their PHA production pathways and enhance their synthesis capability. Results ZZQ-149, a halophilic, PHA-producing bacterium, was isolated from the sediment of China’s Qinghai Lake. Here, we decoded the full genome of ZZQ-149 using Single Molecule Real Time (SMRT) technology based on PacBio RS II platform, coupled with Illumina sequencing platforms. Physiological, chemotaxonomic traits, and phylogenetic analysis based on 16 S rRNA gene and single copy core genes of ninety-nine Halomonas type strains identified ZZQ-149 as the type strain of Halomonas qinghailakensis. Furthermore, a low average nucleotide identity (ANI,

The synthesis of zirconium, hafnium, and tantalum amide silyl complexes are described. The novel reactions of silyl ligands, gamma-hydrogen abstraction to give metallaheterocyclic moiety were investigated.

The theoretical study on magnetostructural correlation in unsymmetrical Cu(II) binuclear complexes bridged by [C2O2(NH)2](super 2-) was performed using the broken symmetry approach within the framework of density functional theory (DFT). The calculated results show that the magnetic coupling interaction decreases with the changes of the coordination environment around the Cu atom from a planar structure.

Lungs are easily damaged by the inflammatory responses induced after extensive burns. The aim here was to investigate the protective role of epigallocatechin gallate (EGCG) in mitochondrial DNA (mtDNA)-mediated inflammatory responses and acute respiratory distress syndrome (ARDS) in a rat model of thermal injury. Male Sprague-Dawley rats were randomly assigned to five groups. In the first experiment, a full-thickness thermal injury or control procedure, covering 30% of the TBSA, was inflicted on three groups designated as the thermal injury, EGCG, and sham control groups. In the second experiment, another two groups were established by transfusion with either mtDNA (mtDNA group) or phosphate-buffered saline (phosphate-buffered saline group). Blood samples and lung tissue from all five groups were collected and the plasma concentrations of mtDNA and inflammatory mediators were measured. Bronchoalveolar lavage fluid was collected and histological analysis of the lung tissue was performed to evaluate the severity of ARDS. Significant increases in mtDNA and inflammatory mediator plasma concentrations were seen in the thermal injury and EGCG groups when compared with controls (P < .05). The plasma concentrations of mtDNA and inflammatory mediators were significantly decreased after the administration of EGCG (P < .05). EGCG also significantly reduced the severity of acute lung injury (P < .05). Intravenous administration of mtDNA significantly increased concentrations of inflammatory mediators and caused severe ARDS (P < .05). Our results suggest that mtDNA is important for thermal injury-induced inflammation and associated ARDS. EGCG possesses anti-inflammatory and lung-protective properties, and might act by limiting mtDNA release after thermal injury. [ABSTRACT FROM AUTHOR]

The reaction mechanisms of the (NHC)Ni(0)-catalyzed aldehyde-alkyne reductive couplings with silanes as reducing agent have been theoretically investigated with the aid of DFT calculations. The impacts of N-heterocyclic carbene (NHC) ligands and silanes on the reversal of regioselectivity and the rate-limiting step alteration were rationalized. It is found that the steric effects play a dominant role. The reversal of the regioselectivity is found to be related to the switching of the steric effect, from the aldehyde phenyl hindrance with the adjacent alkyne substituent to the NHC ligand hindrance with the adjacent alkyne substituent, when the NHC ligand employed is changed from small to large. The rate-limiting step alteration caused by using bulkier silanes is due to the generated strong steric effect, which makes the σ-bond metathesis transition state relatively high in enthalpic energy, thus with the entropy penalty making the metathesis step rate-limiting instead of the oxidative cyclization step. [ABSTRACT FROM AUTHOR]

The mechanistic study on the insertion of ethylene into the Zr–H bond of Cp2ZrH2 to give Cp2Zr(H)(CH2CH3) is performed with the aid of density functional theory calculations. Two possible insertion pathways are proposed. One is the side-insertion and the other is the central-insertion. The rate-determining step is the ethylene insertion in the former path and formation of the adduct in the latter path. Our results of calculations predicted that the central-insertion path is preferred kinetically over the side-insertion path. Two types of Zr⋯H–C agostic interactions having different stabilities are described. [ABSTRACT FROM AUTHOR]

The 18e Cp-containing silene tungsten complex, Cp2W(η2-Me2Si＝CH2), can break H–H bond to afford the product, Cp2WH(SiMe3). The mechanisms on reaction of Cp2W(η2-Me2Si＝CH2) with H2 are investigated in this paper by using density functional theory (DFT). On the basis of the features of the reaction and experimental proposal for the reaction mechanisms, three possible pathways are proposed, which are related to the migration of silicon group, Cp ring slippage, and σ-bond metathesis, respectively. Our results of calculations indicate that the pathway involving migration of silicon group is the most favored, supporting the experimental observations. The other two paths are quite unfavorable kinetically. [Copyright &y& Elsevier]

New transition metal silyl amide complexes (Me2N)3Ta[N(SiMe3)2](SiPh2-But) (1) and (Me2N)M[N(SiMe33)]2(SiPh2- But) (M = Zr, 2a, and Hf, 2b) were found to undergo γ-H abstraction by the silyl ligands to give metaJlaheterocyclic complexes (Me2N)3Ta(NSiMe2SiMe2CH2) (3) and {(Me2N)[(Me3Si)2N](Me2N)[(Me3Si)2N]M(NSiMe3CH2)}2 (M = Zr, 4a, and Hf, 4b), respectively. The conversion of 1 to 3 follows first-order kinetics with ΔH‡ = 23.6(1.6) kcal/mol and ΔS‡ = 3(5) eu between 288 and 313 K. The formation of 4a from (Me2N)Zr[N(SiMe3)2]2Cl (5a) and Li(THF)2SiPh2 involves the formation of the intermediate 2a, followed by γ-H abstraction. Kinetic studies of these consecutive reactions, a second-order reaction to give 2a and then a first-order γ-H abstraction to give 4a, were conducted by an analytical method and a numerical method. At 278 K, the rate constants k1 and k2 for the two consecutive reactions are 2.17(0.03) × 10-3 M-1 s-1 and 5.80(0.15) × 10-5 s-1 by the analytical method. The current work is a rare kinetic study of the A + B → C → D (+ E) consecutive reactions. Kinetic studies of the formation of a metallaheterocyclic moiety M(NSiMe3SiMe2CH2) have, to our knowledge, not been reported. In addition, γ-H abstraction by a silyl ligand to give such a metallaheterocyclic moiety is new. Theoretical investigations of the γ-H abstraction by silyl ligands have been conducted by density functional theory calculations at the Becke3LYP (B3LYP) level, and they revealed that the formation of the metallacyclic complexes through γ-H abstraction is entropically driven. X-ray crystal structures of (Me2N)3Ta[N(SiMe3)2](SiPh2Bt)(1), (Me2N)Zr[N(SiMe3)2]2Cl (5a), and {(Me2N)[(Me3-Si)2N]M(NSiMe3SiMe2CH2)}2 (M = Zr, 4a, and Hf, 4b) are also reported. [ABSTRACT FROM AUTHOR]

A case study of a 74-year-old female patient with chest tightness is presented; and out-patient transthoracic echocardiography (TTE) revealed a hyper-echogenic mass at the aortic root and mild tricuspid valve regurgitation; and diagnosis of cardiac calcified amorphous tumor.

This work initiated a systematic study on the thermal treatment for In(OH)3 photocatalysts and its impact on their microstructures and photocatalytic properties. The phase transformation process from In(OH)3 to In2O3 was investigated by XRD, TG, DRS and ion etching XPS technologies. The results demonstrated that the formation of In2O3 phase occurred from surface to inside of bulk In(OH)3 and a heterojunction structure between In2O3 and In(OH)3 was formed. The variation of textural properties and the formation of heterojunction structure were crucial for the enhanced UV-light photocatalytic activities for RhB degradation, while the visible-light photocatalytic activity was mainly associated with the enhancement of the visible light absorbance capacity deriving from surfaced In2O3. The results may be extended to comprehend the structure-property correlations of hydroxide-containing photocatalysts and help to explore highly efficient photocatalysts towards thermal decomposition.