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Background: Coronary heart disease is considered an epidemic problem with the increasing number of people affected. Coronary artery bypass grafting (CABG) has been the gold standard treatment for revascularization in complex multivessel coronary artery disease. The pre-rehabilitation of CABG aims to improve the functional capacity of patients in the preoperative stage, optimize the physiological reserve to withstand the stress of surgery, and improve the functional status of patients after surgery. Since there are still relatively few studies on preoperative pre-rehabilitation with elective CABG, the main goal of this study is to evaluate whether pre-rehabilitation programs during phase I in-hospital rehabilitation can improve exercise tolerance among patients who undergo elective CABG. Furthermore, this study aims to investigate the effects of pre-rehabilitation program during phase I in-hospital rehabilitation on the inspiratory muscle strength, cardiac function, the conditions of anxiety and depression, health-related quality of life, the rate of pulmonary complication after CABG and the length of inpatient stay. Methods: This study will be a prospective, single-centre, two parallel groups, randomized controlled clinical trial with blinded evaluators. There are 4 measurement time points: T0= admission, T1 = 1 day before surgery, T2 = 1 day before discharge, T3 = 12- week follow-up. A total of 84 patients who will undergo elective CABG will be included. Interventions include oral education and preoperative pre-rehabilitation delivered by physiotherapists. The primary outcome is exercise tolerance measured by 6minute walking test. Secondary outcomes include inspiratory muscle strength, cardiac function, the conditions of anxiety and depression, health-related quality of life, exercise load, the rate of pulmonary complication after CABG and the length of inpatient stay. Final data collection is expected to be completed by May 2024. Discussion: This study may provide valuable insights into the effectiveness and safety of preoperative pre-rehabilitation for CABG to improve functional recovery after surgery and provide evidence for standardized preoperative pre-rehabilitation guidelines for CABG. Trial registration: The trial has been registered with the Chinese Clinical Trial Registry on March 6, 2023 under the registration number: ChiCTR2300069045

Radiation-induced pulmonary fibrosis (RIPF) is a common consequence of radiation for thoracic tumors, and is accompanied by gradual and irreversible organ failure. This severely reduces the survival rate of cancer patients, due to the serious side effects and lack of clinically effective drugs and methods. Radiation-induced pulmonary fibrosis is a dynamic process involving many complicated and varied mechanisms, of which alveolar type II epithelial (AT2) cells are one of the primary target cells, and the epithelial–mesenchymal transition (EMT) of AT2 cells is very relevant in the clinical search for effective targets. Therefore, this review summarizes several important signaling pathways that can induce EMT in AT2 cells, and searches for molecular targets with potential effects on RIPF among them, in order to provide effective therapeutic tools for the clinical prevention and treatment of RIPF.

Poly(styrene-co-maleic anhydride)s (SMAs) with different compositions and molecular weight were synthesized through the reversible addition–fragmentation chain transfer polymerization technique. SMAs were converted to poly(styrene-co-octadecyl maleimide)s (SNODMIs) by amidation with octadecyl amine and subsequent imidization. SNODMIs with octadecyl branches were evaluated as flow improvers in the model crude oil with a high content of asphaltenes. The effects of molecular structures, including molecular weight, branch content, and imidization degree, on the effectiveness of SNODMI in reducing the viscosity and yield stress and improving the morphologies of asphaltene particles were thoroughly investigated using a rotational rheometer with parallel plate geometry and a polarizing microscope with a hot stage, respectively. It has been found that efficacy of SNODMI in reducing the viscosity and yield stress of the model crude oil increases with an increasing branch content of SNODMI. (alt)SNODMI with the highest branch content, approximately 45 mol %, achieved the best performance. Too high or too low molecular weight is not beneficial for SNODMI to improve the flow ability of the model crude oil. The appropriate molecular weight (Mₙ = 3500 Da) is required to achieve the optimal effectiveness. The optimal imidization degree of SNODMI is 100% and is independent of the branch content. The addition of SNODMI in a real crude oil has reduced the viscosity and yield stress by more than 90%.

PurposeTo construct a dynamic prediction model for BK polyomavirus (BKV) reactivation during the early period after renal transplantation and to provide a statistical basis for the identification of and intervention for high-risk populations.MethodsA retrospective study of 312 first renal allograft recipients was conducted between January 2015 and March 2022. The covariates were screened using univariable time-dependent Cox regression, and those with PResultsWe constructed a dynamic prediction model with 18 covariates that could predict the probability of BKV reactivation from 2.5 to 8.5 months after renal transplantation. Elder age, basiliximab combined with cyclophosphamide for immune induction, acute graft rejection, higher body mass index, estimated glomerular filtration rate, urinary protein level, urinary leukocyte level, and blood neutrophil count were positively correlated with BKV reactivation, whereas male sex, higher serum albumin level, and platelet count served as protective factors. The AUC value and Brier score of the static model were 0.64 and 0.14, respectively, whereas those of the dynamic model were 0.79 ± 0.05 and 0.08 ± 0.01, respectively. In the cross-validation, the AUC values of the static and dynamic models decreased to 0.63 and 0.70 ± 0.03, respectively, whereas the Brier score changed to 0.11 and 0.09 ± 0.01, respectively.ConclusionDynamic Cox regression based on the landmarking method is effective in the assessment of the risk of BKV reactivation in the early period after renal transplantation and serves as a guide for clinical intervention.

Background: Autosomal dominant polycystic kidney disease (ADPKD) is mainly caused by PKD1 and PKD2 mutations. However, only a few studies have investigated the genotype and phenotype characteristics of Asian patients with ADPKD. This study aimed to investigate the relationship between the natural course of ADPKD genotype and phenotype.Methods: Genetic studies of PKD1/2 genes of Chinese patients with ADPKD in a single center were performed using targeted exome sequencing and next-generation sequencing on peripheral blood DNA.Results: Among the 140 patients analyzed, 80.00% (n = 112) harbored PKD1 mutations, 11.43% (n = 16) harbored PKD2 mutations, and 8.57% (n = 12) harbored neither PKD1 nor PKD2 mutations. The average age at dialysis was 52.60 ± 11.36, 60.67 ± 5.64, and 52.11 ± 14.63 years, respectively. The renal survival rate of ADPKD patients with PKD1 mutations (77/112) was significantly lower than that of those with PKD2 mutations (9/16), leading to an earlier onset of end-stage renal disease (ESRD). Renal prognosis was poor for those with nonsense mutations, and they required earlier renal replacement therapy.Conclusions: The genotype and phenotype characteristics of ADPKD patients potentially vary across ethnic groups. Our findings supplement the genetic profiles of Chinese ADPKD patients, could serve as a guide for therapy monitoring and prognosis assessment of ADPKD, and may improve the clinical diagnosis.

In recent years, flows of many rivers and lakes have become reduced in arid and semi-arid regions around the world. The most typical examples of this phenomenon occur in Central Asia, and the reduction of the Aral Sea area is closely related to agricultural water use. However, due to a lack of continuous data in Central Asia spanning many years, “virtual water” is used to evaluate changes in agricultural water use. Based on virtual water theory, 325 kinds of agricultural products in eight categories are selected as the research object, and changes in virtual water are calculated for Central Asia from 1992 to 2016. Results indicate that: (1) The average annual net export of agricultural virtual water (TVWNE) in Central Asia is about 9 billion m3, concentrated in Kazakhstan, whose annual TVWNE reaches 8.1 billion m3. (2) Since 2007, the TVWNE in Central Asia has dropped significantly, with a drop rate of 86%, while the total volume of agricultural virtual water has gradually increased since 1998. (3) The upstream and downstream countries in Central Asia have different characteristics in the change of virtual water quantity.

A series of poly(styrene-co-octadecyl maleimide) (SNODMI) with various molecular structures were prepared through RAFT polymerization and subsequent modification with amine. The obtained SNODMIs we...

Fine-needle aspiration biopsy (FNAB) is a safe and effective thyroid examination method with rare complications. Herein, we report a rare case of acute transient thyroid swelling that occurred after ultrasound-guided FNAB. The patient experienced acute pain with rapid thyroid swelling. Ultrasound imaging revealed a nodule with a linear, hypoechoic, and "patch-like" appearance, indicating edema without hemorrhage. After receiving anti-anaphylaxis and detumescence therapy for 1 day, the swelling regressed. Acute transient thyroid swelling is an extremely rare event that occurs shortly after FNAB and may frighten patients; therefore, clinicians should be aware of this complication in this context.

Background Ionizing radiation (IR) can induce pulmonary fibrosis by causing epithelial mesenchymal transition (EMT), but the exact mechanism has not been elucidated. To investigate the molecular mechanism of how radiation induces pulmonary fibrosis by altering miR-486-3p content and thus inducing EMT. Methods The changes of miR-486-3p in cells after irradiation were detected by RT-qPCR. Western blot was used to detect the changes of cellular epithelial marker protein E-cadherin, mesenchymal marker N-cadherin, Vimentin and other proteins. The target gene of miR-486-3p was predicted by bioinformatics method and the binding site was verified by dual luciferase reporter system. In vivo experiments, adeno-associated virus (AAV) was used to carry miR-486-3p mimic to lung. Radiation-induced pulmonary fibrosis (RIPF) model was constructed by 25Gy60Co γ-rays. The structural changes of mouse lung were observed by HE and Masson staining. The expression of relevant proteins in mice was detected by immunohistochemistry. Results IR could decrease the miR-486-3p levels in vitro and in vivo, and that effect was closely correlated to the occurrence of RIPF. The expression of Snail, which induces EMT, was shown to be restrained by miR-486-3p. Therefore, knockdown of Snail blocked the EMT process induced by radiation or knockdown of miR-486-3p. In addition, the molecular mechanism underlying the IR-induced miRNA level reduction was explored. The increased in BCL6 could inhibit the formation of pri-miR-486-3p, thereby reducing the levels of miR-486-3p in the alveolar epithelial cells, which would otherwise promote EMT and contribute to RIPF by targeting Snail. Conclusion IR can exacerbate RIPF in mice by activating the transcription factor BCL6, which inhibits the transcription of miR-486-3p and decreases its content, which in turn increases the content of the target gene slug and triggers EMT.

Radioresistance is one of the key obstacles that may lead to the failure of cancer treatment. The underlying mechanisms of radioresistance remain largely unknown; however, increasing evidence has shown that long noncoding RNAs (lncRNAs) are involved in radiotherapy resistance of several cancers. In the present study, we demonstrated that radiation-elevated transcript (RET), a newly identified lnRNA, was highly expressed in cancer cells. Knockdown of RET significantly inhibited the proliferation and colony formation of cancer cells and markedly inhibited apoptosis. Furthermore, downregulation of RET in cancer cells significantly inhibited cell growth, decreased colony survival fractions, and promoted apoptosis in response to radiation treatment, indicating a role in radiation resistance. Moreover, RET knockdown significantly increased the expression of γ-H2AX, an indicator of DNA double strand damage, and reversed radiation-induced EMT, both of which contributed to its radiation resistance. In addition, a negative correlation was found between the expression of RET and PTEN. Rescue assays confirmed RET knockdown enhanced radiosensitivity of cancer cells by upregulating the expression of PTEN. Mechanistically, RET positively regulated Slug, a repressor of PTEN transcription, by acting as a molecular sponge of miR-3179. Our present study showed that RET conferred radioresistance by regulating miR-3179/Slug/PTEN axis, indicating that RET may be a potential target for the clinical application in cancer patients with radioresistance.

Understanding miRNAs regulatory roles in epithelial-mesenchymal transition (EMT) would help establish new avenues for further uncovering the mechanisms underlying radiation-induced pulmonary fibrosis (RIPF) and identifying preventative and therapeutic targets. Here, we demonstrated that miR-541-5p repression by Myeloid Zinc Finger 1 (MZF1) promotes radiation-induced EMT and RIPF. Irradiation could decrease miR-541-5p expression in vitro and in vivo and inversely correlated to RIPF development. Ectopic miR-541-5p expression suppressed radiation-induced-EMT in vitro and in vivo. Knockdown of Slug, the functional target of miR-541-5p, inhibited EMT induction by irradiation. The upregulation of transcription factor MZF1 upon irradiation inhibited the expression of endogenous miR-541-5p and its primary precursor (pri-miR-541-5p), which regulated the effect of the Slug on the EMT process. Our finding showed that ectopic miR-541-5p expression mitigated RIPF in mice by targeting Slug. Thus, irradiation activates MZF1 to downregulate miR-541-5p in alveolar epithelial cells, promoting EMT and contributing to RIPF by targeting Slug. Our observation provides further understanding of the development of RIPF and determines potential preventative and therapeutic targets.

Radiation-induced pulmonary fibrosis (RIPF) is a major lung complication in using radiotherapy to treat thoracic diseases. MicroRNAs (miRNAs) are reported to be the therapeutic targets for many diseases. However, the miRNAs involved in the pathogenesis of RIPF are rarely studied as potential therapeutic targets. Alveolar epithelial cells participate in RIPF formation by undergoing epithelial-mesenchymal transition (EMT). Here we demonstrated the critical role of miR-155-5p in radiation-induced EMT and RIPF. Using the previously established EMT cell model, we found that miR-155-5p was significantly down-regulated through high-throughput sequencing. Irradiation could decrease the expression of miR-155-5p in intro and in vivo, and it was inversely correlated to RIPF formation. Ectopic miR-155-5p expression inhibited radiation-induced-EMT in vitro and in vivo. Knockdown of glycogen synthase kinase-3β (GSK-3β), the functional target of miR-155-5p, reversed the induction of EMT and enhanced the phosphorylation of p65, a subunit of NF-κB, which were mediated by the down-regulation of miR-155-5p. Moreover, our finding demonstrated that ectopic miR-155-5p expression alleviated RIPF in mice by the GSK-3β/NF-κB pathway. Thus, radiation downregulates miR-155-5p in alveolar epithelial cells that induces EMT, which contributes to RIPF using GSK-3β/NF-κB pathway. Our observation provides further understanding on the regulation of RIPF and identifies potential therapeutic targets.