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Abstract Purpose Lipids increase osteoporosis and fracture risk, yet research on Atherogenic Index of Plasma (AIP), bone mineral density declines (BMD), and trabecular bone score (TBS) is limited. This study examined the relationships between AIP, TBS, and BMD in American adults using the National Health and Nutrition Examination Survey (NHANES) data, including the effect of obesity. Methods Based on data from 3,162 Americans, multivariable logistic regression and a generalized additive model (GAM) were used to analyze AIP, BMD, and TBS. Mediation studies assessed the impact of obesity (BMI) on these relationships. A threshold effect study identified turning points. Results The average participant age was 47.5 ± 17 years. AIP showed no correlation with BMD after BMI adjustment but was significantly associated with lumbar spine and femoral neck BMD without BMI adjustment. AIP negatively correlated with TBS even after adjusting for covariates. The relationship between AIP and TBS was L-shaped, with a turning point at -0.17. BMI mediated the AIP-BMD relationship by 122.01–131.49% (P

Abstract To investigate the effect and safety of percutaneous endovascular angioplasty (PEA) with optional stenting for the treatment of severe stenosis or occlusion of subclavian artery, patients with severe stenosis ≥ 70% or occlusion of subclavian artery treated with PEA were retrospectively enrolled. The clinical data were analyzed. A total of 222 patients were retrospectively enrolled, including 151 males (68.0%) and 71 females (32.0%) aged 48–86 (mean 63.9 ± 9.0) years. Forty-seven (21.2%) patients had comorbidities. Subclavian artery stenosis ≥ 70% was present in 201 (90.5%) patients and complete subclavian occlusion in 21 (9.5%) cases. Angioplasty was successfully performed in all (100%) patients. Balloon-expandable stents were used in 190 (85.6%) cases, and self-expandable stents in 20 (9.0%) cases. Only 12 (5.4%) cases were treated with balloon dilation only. Among 210 patients treated with stent angioplasty, 71 (33.8% or 71/210) cases underwent balloon pre-dilation, 139 (66.2% or 139/210) had direct deployment of balloon-expandable stents, and 2 (1.0% or 2/210) experienced balloon post-dilation. Distal embolization protection devices were used in 5 (2.3% or 5/222) cases. Periprocedural complications occurred in 3 (1.4%) patients, including aortic dissection in 2 (0.9%) cases and right middle cerebral artery embolism in 1 (0.5%). No hemorrhage occurred. Among 182 (82.0%) patients with 6-month follow-up, restenosis > 70% occurred in 1 (0.5%) patient, and among 68 (30.6%) patients with 12-month follow-up, restenosis > 70% took place in 11 (16.2%) patients. Percutaneous endovascular angioplasty can be safely and efficiently performed for the treatment of severe stenosis ≥ 70% or occlusion of subclavian artery.

Abstract To investigate the significance of atherosclerotic plaque location in hybrid surgery comprising both endovascular recanalization approaches and carotid endarterectomy for symptomatic atherosclerotic non-acute long-segment occlusion of the internal carotid artery (ICA), 162 patients were enrolled, including 120 (74.1%) patients in the proximal plaque group and 42 (25.9%) in the distal plaque group. Surgical recanalization was performed in all patients, with successful recanalization in 119 (99.2%) patients in the proximal and 39 (92.9%) in the distal plaque group. The total successful recanalization rate was 97.5% (158/162) with a failure rate of 2.5% (4/162). Periprocedural complications occurred in 5 (4.2% or 5/120) patients in the proximal plaque group, including neck infection in two (1.7%), recurrent nerve injury in 1 (0.8%), and laryngeal edema in 2 (1.7%), and 2 (4.8%) in the distal plaque group, including femoral puncture infection in 2 (4.8%). No severe complications occurred in either group. Univariate analysis showed plaque location was a significant (P = 0.018) risk factor for successful recanalization, and multivariate analysis indicated that the plaque location remained a significant independent risk factor for recanalization success (P = 0.017). In follow-up 6–48 months after the recanalization surgery, reocclusion occurred in two (2.8%) patients in the proximal plaque group and 4 (13.3%) in the distal plaque group. In conclusion, although hybrid surgery achieves similar outcomes in patients with ICA occlusion caused by either proximal or distal atherosclerotic plaques, plaque location may be a significant risk factor for successful recanalization of symptomatic non-acute long-segment ICA occlusion.

Abstract We aimed to study the regulatory roles and mechanism of circular nuclear factor IX (circNFIX) in cancer growth and stemness properties of ovarian cancer (OC). CircNFIX and SH3RF3 levels in OC tissues and cells were tested by quantitative real‐time PCR. RNase R treatment quantified circNFIX RNA stability. Molecular interaction among circNFIX, LIN28B, and SH3RF3 was predicted by bioinformatics software and validated through RNA immunoprecipitation (RIP) assay. The gain‐ or loss‐experiments of circNFIX on capabilities of metastasis and stemness in vitro were assessed using Cell Counting Kit‐8, Transwell, western blot, and sphere‐formation assays. CircNFIX and SH3RF3 were markedly elevated in OC tissues and OC cells. Knocking down circNFIX repressed the proliferation, migration, invasion, and stemness properties of A2780 and SKOV3 cells. The RIP assay verified the direct binding relationship between LIN28B, circNFIX, and SH3RF3. Additionally, overexpression of circNFIX elevated the SH3RF3 expression, while this effect was reversed by LIN28B silence. Rescue experiments demonstrated that the overexpression of SH3RF3 reversed the knockdown of circNFIX on OC cells' proliferation, metastasis, and stemness properties. CircNFIX improved the mRNA stability and translation of SH3RF3 via recruiting LIN28B, thus promoting the proliferation, invasion, and stemness properties of OC cells in vitro.

Abstract Ovarian cancer (OC) is a gynecological cancer with high mortality. OC‐derived exosomal circRNAs can regulate angiogenesis. This study aims to explore the role and mechanism of exosomal circRNA nuclear factor I X (CircNFIX) derived from OC cells in angiogenesis. Quantitative real‐time polymerase chain reaction was employed to evaluate the levels of circNFIX, miR‐518a‐3p, and tripartite motif protein 44 (TRIM44) in OC and adjacent tissues. Exosomes from the ovarian surface epithelial cell (HOSEpiC) and OC cells (SKOV3 or OVCAR3) were isolated by differential centrifugation. Exosomes were cocultured with the human umbilical vein endothelial cells (HUVECs). The angiogenesis capacity was analyzed by Tube formation assay. 3‐(4,5‐dimethyl‐2‐thiazolyl)‐2,5‐diphenyl‐2‐H‐tetrazolium bromide (MTT) and Transwell assays were used to determine the cell viability and migration ability. The dual‐luciferase report, RNA immunoprecipitation (RIP), and RNA pull‐down assays were applied to validate the gene's interaction. CircNFIX and TRIM44 expression were higher and miR‐518a‐3p was lower in OC tissues than in the adjacent tissues. Upregulated circNFIX and TRIM44 were significantly correlated with the tumor size and International Federation of Gynecology and Obstetrics (FIGO) stage of OC patients. HUVECs treated OC‐derived exosomes had higher proliferation, migration, and angiogenesis capacities than the control group. While OC‐derived exosomal circNFIX silencing restrained HUVECs' proliferation, migration, and angiogenesis, compared with the OC‐derived exosomes group. OC‐derived exosomal circNFIX positively regulated TRIM44 expression by targeting miR‐518a‐3p in HUVECs. OC‐derived exosomal circNFIX promoted angiogenesis by regulating the Janus‐activated kinase/signal transducer and activator of transcription 1 (JAK/STAT1) pathway via miR‐518a‐3p/TRIM44 axis in HUVECs.

PurposeThis study aims to investigate the effect and feasibility of intra-aortic catheter looping via transradial access in angioplasty for symptomatic intracranial severe (>70%) atherosclerotic stenosis or occlusion of large arteries (SISOLAs).Materials and methodsPatients with SISOLAs who underwent transradial endovascular angioplasty using the catheter looping technique in the ascending aorta were retrospectively enrolled. The clinical data and treatment outcomes were analyzed.ResultsFifteen patients aged 48–71 years were enrolled in this study. Left vertebrobasilar artery occlusion was present in 1 (6.7%) patient, severe left middle cerebral artery stenosis in 7 (46.7%) patients, severe left internal carotid artery (ICA) stenosis of the ophthalmic segment in 4 (26.7%) patients, severe left ICA stenosis of the cavernous segment in 2 (13.3%) patients, and severe right middle cerebral artery stenosis in 2 (13.3%) patients. The arterial stenosis ranged from 70 to 92% (mean 86%) before stenting. The looping of a guiding catheter in the ascending aorta via transradial access for angioplasty was successful in all patients (100%). The vertebral artery intracranial segment occlusion was successfully recanalized, while severe stenosis in the remaining 14 patients was successfully eliminated. After endovascular recanalization, the residual stenosis was reduced by 12–26% (median 18%). No puncture-related complications or surgical-related neurological complications occurred in these patients. In the follow-up angiography conducted on 10 (66.7%) patients after 6–25 months, no in-stent restenosis was detected.ConclusionIntra-aortic guiding catheter looping via transradial access for endovascular angioplasty of SISOLAs is technically safe, feasible, and effective, especially when the transfemoral artery approach is difficult or impossible to undertake.

PurposeThe study aimed to investigate the feasibility and effect of transradial access with intra-aortic catheter looping for the treatment of intracranial aneurysms.Materials and methodsThis retrospective one-center study was performed on patients with intracranial aneurysms which were embolized through transradial access with intra-aortic catheter looping because of the difficulty of transfemoral access or transradial access without intra-aortic catheter looping. The imaging and clinical data were analyzed.ResultsA total of 11 patients were enrolled, including seven (63.6%) male patients. Most patients were associated with one or two risk factors of atherosclerosis. There were nine aneurysms in the left internal carotid artery system and two aneurysms in the right internal carotid artery system. All 11 patients had complications with different anatomic variations or vascular diseases, which made endovascular operation via the transfemoral artery difficult or a failure. The right transradial artery approach was adopted in all patients, and the success rate of intra-aortic catheter looping was 100%. Embolization of intracranial aneurysms was successfully completed in all patients. No instability of the guide catheter was encountered. No puncture site complications or surgical-related neurological complications occurred.ConclusionTransradial access with intra-aortic catheter looping for embolization of intracranial aneurysms is technically feasible, safe, and efficient as an important supplementary approach to the routine transfemoral access or transradial access without intra-aortic catheter looping.

Abstract Background Ovarian sex cord stromal tumours (OSCSTs) are rare ovarian tumours and include different histopathologic subtypes. This study aimed to analyse the clinical and sonographic characteristics of different histopathologic OSCST subtypes. Methods A total of 63 patients with surgically proven OSCSTs were enrolled in this retrospective study to analyse their clinical and sonographic features. Ultrasound examinations and predictive models were performed before surgery. The clinical and sonographic findings were compared according to the type of OSCST based on the histopathological diagnosis. Results The mean age of 63 patients was 52.17 years (range: 17–78 years). Eighteen patients experienced irregular vaginal bleeding (28.57% 18/63), 7 patients exhibited abnormal body hair (11.11%). 2 patients (3.17%) showed an increased level of CA125, and 25 patients (39.68%, 25/63) showed an increased level of testosterone. Forty-two patients had ovarian thecoma-fibroma groups (OTFGs). Six patients had Sertoli-Leydig cell tumours (S-LCTs), 4 patients had Leydig cell tumours (LCTs), 8 patients had ovarian granulosa cell tumours (OGCTs), 2 patients had ovarian steroid cell tumours, not otherwise specified (OSCTs-NOS), and one patient had sclerosing stromal tumours (SSTs). The mean diameter of the tumour was 47.9 mm (range: 10–258 mm). Forty-seven masses were hypoechoic (74.60%). Twenty-eight masses had posterior echo attenuation, 22 masses exhibited abundant Doppler flow signals (34.92%), and one patient had ascites (1.59%). The diagnostic accuracy of the Simple Rules (SR) and the Assessment of Different NEoplasias in the adneXa (ADNEX) model in distinguishing benign and malignant OSCSTs was 44% (30/63) and 84% (53/63), respectively. The diagnostic accuracy of the SR for OTFGs, S-LCTs & LCTs & OSCTs-NOS, OGCTs, and SSTs was 47.6% (20/42), 16.67% (2/12), 100% (8/8), and 0% (0/1), respectively. The diagnostic accuracy of the ADNEX model for OTFGs, S-LCTs & LCTs & OSCTs-NOS, OGCTs, and SSTs was 93% (31/42), 58.33% (7/12), 75% (6/8), and 100% (1/1), respectively. Conclusions OSCSTs generally appear as a solid mass on ultrasound. Posterior echo attenuation indicates an OTFG. A solid mass with abundant Doppler flow signals indicates an S-LCT, LCT, OSCT-NOS or OGCT. Current predictive models are not very effective, but symptoms, sonographic features and serum hormones are helpful for diagnosis.

In order to solve the problems of three-dimensional active optical network, such as long path configuration time, high insertion loss of optical router and high network hardware overhead, this paper designs adaptive routing algorithm and nonblocking, low-loss optical router. The adaptive routing algorithm uses theXYZdetermines the routing algorithm to make the first judgment of the port. Then it make a second judgment according to the blocking condition, and finally choose the nonblocking and short distance port as the node output port. Optical routers with 6 ports in the layer and 3 ports in the layer are designed to replace optical routers with 7 ports for three-dimensional communication. The experimental results show that when the adaptive routing algorithm is used for routing calculation, the delay of path establishment is small and the blocking is low. The number of waveguides and micro-ring resonators required by optical routers is small, and the insertion loss is small. The average insertion loss is only 0.88 dB and the optical network hardware has low overhead.

BackgroundAtezolizumab plus chemotherapy has been recommended as a first-line treatment option for patients with advanced non-small cell lung carcinoma (NSCLC) irrespective of programmed cell death-ligand 1 (PD-L1) expression. Currently, little is known about the efficacy and treatment-related adverse effects (TRAEs) of subtracting chemotherapy from the combination for patients with high PD-L1 expression. Thus, we performed an indirect comparison between atezolizumab plus chemotherapy and atezolizumab alone.MethodsA total of five eligible randomized controlled trials (RCTs) were identified from PubMed, EMBASE, and Cochrane Central controlled trial registries, using keywords including atezolizumab, PD-1, PD-L1, NSCLC, and RCT. The clinical outcomes of objective response rate (ORR), progression-free survival (PFS), OS, and TRAEs were extracted and evaluated. Using indirect analysis, the efficacy and TRAEs were compared between arm A (atezolizumab plus chemotherapy) and arm C (atezolizumab), linked by arm B (chemotherapy).ResultsDirect comparison revealed that both atezolizumab plus chemotherapy (HR 0.65, P = 0.003) and atezolizumab alone (HR 0.59, P = 0.010) significantly improved OS compared with chemotherapy. More importantly, the indirect comparison showed that atezolizumab plus chemotherapy was not superior to atezolizumab regarding OS (RR 1.10, P =0.695) and ORR (RR 1.11, P = 0.645). However, patients who received atezolizumab combined with chemotherapy experienced more ≥ grade 3 TRAEs (RR 4.23, P

In this paper, the main work was to study the theoretical self-assembly process of thermosensitive molecularly imprinted polymers (MIPs) for α-lipoic acid and to investigate thermosensitive functional monomers through density functional theory calculations (DFT) and intermolecular weak interaction analysis. The M06-2X/6-311+G (d, p) level was used to study the structural parameters, bonding sites, natural population analysis, binding energies (ΔE), atom in molecules (AIM), independent gradient model (IGM), and imprinted molar ratio. The results revealed that α-lipoic acid mainly interacted with N-vinyl caprolactam (NVCL) by weak hydrogen bonds, and the best conditions for MIP synthesis were an optimum molar ratio of 1 : 4 (α-lipoic acid/NVCL). The thermosensitive properties showed that the highest adsorption was at 40°C and the lowest adsorption was at 20°C; also, the MIPs released the intercepted α-lipoic acid inside polymers, and the lower critical solution temperatures (LCST) of MIPs and nonimprinted polymers (NIPs) are 25.7°C and 19.4°C, respectively. In this study, the thermosensitive MIPs displayed a different adsorption capacity towards NVCL, which could be applied for controlled separation and release of α-lipoic acid in different temperatures in a complex matrix.

Objective: To systematically evaluate the efficacy and safety of Duhuo Jisheng decoction combined with manipulation in the treatment of lumbar disc herniation. Method:We systematically searched 8 databases at home and abroad. Literature quality of the included studies was evaluated by the bias risk assessment tool of Cochrane collaboration network, and the Meta-analysis was performed by RevMan 5.3 software. Result: A total of 427 related literature were retrieved, and 12 studies were eventually included, involving 1153 patients. All studies were in Chinese. Meta-analysis results showed that the total effective rate of Duhuo Jisheng decoction combined with manipulation in the treatment of LDH was better than that of the control group(RR= 1.23,95% CI [1.17,1.29],P < 0.00001). Subgroup analysis showed that Duhuo Jisheng decoction combined with manipulation had a more significant effect than conventional treatment(RR=1.34,95% CI [1.20,1.50],P< 0.00001), nonsteroidal anti-inflammatory drugs(RR=1.24,95% CI [1.12,1.37],P< 0.0001), and Yaotongning capsules(RR=1.19,95% CI [1.10,1.29],P< 0.0001). It has obvious advantages in improving VAS scores (MD= -1.19,95%CI -1.19 [-1.87,-0.51],P = 0. 0006), but it has no obvious advantages in improving JOA scores(MD= 2.65 95%CI [0.06,5.24]),P=0.05). In terms of safety, Duhuo Jisheng decoction combined with manipulation treatment reported fewer adverse events. Conclusion: The Duhuo Jisheng decoction combined with manipulation treatment can effectively relieve the clinical symptoms of patients with lumbar disc herniation, with obvious clinical efficacy, and fewer adverse events. But in view of the limitations of clinical studies, there are some limitations in this study, and more studies with high quality of evidence are needed to further confirm its efficacy and safety. [ABSTRACT FROM AUTHOR]

To investigate the kinetics of the degradation of bisphenol A (BPA) by aerobic composting of sewage sludge (SS) and the effects of the major controlling factors, six pilot-scale (5 L) and 10 bench-scale (0.5 L) trials were conducted using sawdust as the amendment. For BPA with initial concentrations of 0.349-0.551 mg kg-1 in pilot-scale trials, half the BPA was removed within the first 2.5-7.5 d of the 14-d composting process. Fitting the pilot-scale BPA reduction data to first-order kinetic models indicated that degradation rate constants and half-lives for BPA ranged from 0.095 to 0.175 d-1 and from 4.0 to 7.3 d, respectively. Kinetic parameters were obtained from bench-scale trials under various controlling factors such as initial concentration of BPA, aeration, moisture content and temperature. The results showed that thermophilic aerobic biodegradation was the main mechanism for BPA removal during the aerobic stabilization phase of SS composting. The optimum conditions for BPA degradation were 0.3-30 mg kg-1 initial concentration, 0.050-0.100 L min-1 kg-1 aeration rate, 60%-70% moisture content and 60°C-70°C temperature. Our findings could be used to further the enhancement of BPA biodegradation in SS or other solid wastes. [ABSTRACT FROM AUTHOR]

Bisphenol A (BPA), as one typical endocrine disrupting compound, has been ubiquitously detected in the aquatic environment, soil and sediment, and wastewater treatment plants (WWTP) are the main pollution sources. In this study, an optimized analytical method, which included the following procedures: microwave-assisted extraction (MAE), solid phase extraction (SPE), derivatization, and analysis by gas chromatography-mass spectrometry (GC-MS), was developed to detect BPA in wastewater and sludge collected from five WWTPs in Guilin. The concentrations of BPA were in the range of: 407-1363 ng L-1 for influent, 72-395 ng L-1 for effluent, and 182-413 ng g-1 for excess sludge. Except plant E, the other four plants could obtain good removal efficiency (77-88%), and a large proportion (89.2%) of residual BPA entered into the environment via the effluent. The total annual amounts of BPA, released and discharged into the environment through the effluent and excess sludge, were estimated to be about 20104.2 and 2441.85 g of one year in Guilin. Further research was needed to focus on the environmental behavior and potential health risks of BPA in the receiving water and the sludge. [ABSTRACT FROM AUTHOR]