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Background: Fructose oligosaccharides (FOS) have been shown to reduce soybean antigeninduced hypersensitivity in piglets, but their effects on intestinal epithelial barrier function have not been characterized. Therefore, this study aimed to determine the effects of FOS on intestinal barrier injury induced by soybean antigen in piglets in vitro and in vivo., Methods: We studied the protective effects of FOS against mechanical barrier dysfunction induced using β-conglycinin or glycinin in porcine intestinal epithelial cells (IPEC-J2), and measured the serum concentrations of diamine oxidase (DAO), D-lactic acid, and endotoxin, and the expression of tight junction (TJ) proteins, in piglets., Results: We found that FOS concentration dependently increases cell activity, trans-epithelial electrical resistance, and TJ protein expression (P < 0.05) and reduces alkaline phosphatase (AP) activity (P < 0.05) in vitro. In addition, the serum DAO, D-lactic acid, and endotoxin concentrations were reduced by FOS administration in piglets (P < 0.05). Both in vitro and in vivo, the expression levels of TJ proteins (zona occludens 1 and occludin) were increased significantly by FOS (P < 0.05)., Conclusion: Therefore, FOS protect against intestinal injury induced by soybean antigen in piglets, which may provide a basis for the prevention of allergy., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background and Aims: Gut functions including motility, secretion, and blood flow are largely controlled by the enteric nervous system. Characterizing the different classes of enteric neurons in the human gut is an important step to understand how its circuitry is organized and how it is affected by disease., Methods: Using multiplexed immunohistochemistry, 12 discriminating antisera were applied to distinguish different classes of myenteric neurons in the human colon (2596 neurons, 12 patients) according to their chemical coding. All antisera were applied to every neuron, in multiple layers, separated by elutions., Results: A total of 164 combinations of immunohistochemical markers were present among the 2596 neurons, which could be divided into 20 classes, with statistical validation. Putative functions were ascribed for 4 classes of putative excitatory motor neurons (EMN1-4), 4 inhibitory motor neurons (IMN1-4), 3 ascending interneurons (AIN1-3), 6 descending interneurons (DIN1-6), 2 classes of multiaxonal sensory neurons (SN1-2), and a small, miscellaneous group (1.8% of total). Soma-dendritic morphology was analyzed, revealing 5 common shapes distributed differentially between the 20 classes. Distinctive baskets of axonal varicosities surrounded 45% of myenteric nerve cell bodies and were associated with close appositions, suggesting possible connectivity. Baskets of cholinergic terminals and several other types of baskets selectively targeted ascending interneurons and excitatory motor neurons but were significantly sparser around inhibitory motor neurons., Conclusions: Using a simple immunohistochemical method, human myenteric neurons were shown to comprise multiple classes based on chemical coding and morphology and dense clusters of axonal varicosities were selectively associated with some classes., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Infants with congenital heart disease (CHD) are known to have higher rates of necrotizing enterocolitis (NEC). Although the etiology is recognized as distinct from the premature neonatal population, there is not a universal consensus regarding etiology or specific risk factors. To analyze the clinical features of neonates with CHD who develop NEC., Methods: A retrospective study of neonates with CHD in the cardiac intensive care unit (ICU) between 2015 and 2018 was performed, and modified Bell's criteria were used to diagnose NEC. Patients were divided into 2 groups according to ductal-dependent (DD) lesions, and were further stratified by Risk Adjustment for Congenital Heart Surgery-1 (RACHS-1) score and Aristotle score, to compare the differences., Results: Among 412 patients with CHD, 69 (16%) developed NEC. The incidence of NEC was notably higher among DD patients than among non-DD (nDD) patients (18.7% vs. 11.1%; P=0.04). Patients with RACHS-1 >2 also had a higher rate of NEC than did those with RACHS-1 ≤2 (19.49% vs. 9.29%; P=0.01). nDD patients who developed NEC were younger, had a lower gestational age (36.25±1.88 vs. 38.10±1.28 weeks; P=0.00), a lower weight (2.86±0.85 vs. 3.33±0.55 kg; P=0.01), and a lower birth weight (2.79±0.79 vs. 3.26±0.55; P=0.01) compared to the DD group. All nDD patients developed NEC after congenital heart surgery, while only 38 cases (76%), NEC occurred after heart surgery in the DD group. Four patients needed surgery for NEC in the DD group and RACHS-1 >2 group. Presence of NEC was not associated with an increased risk of mortality in any group., Conclusions: NEC is a common complication in neonates with CHD and can occur both before and after CHD operations. Likely there are varying mechanism for NEC in different forms of CHD. While NEC is more common in patients with DD CHD and those with more complex forms of CHD, there was no significant difference observed in weight-for-age Z-score (WAZ) between the DD group during follow-up., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://atm.amegroups.com/article/view/10.21037/atm-22-3248/coif). The authors have no conflicts of interest to declare., (2022 Annals of Translational Medicine. All rights reserved.)

Background: Endometrial thickness is an essential factor affecting female fertility. Clinically, ultrasound imaging is the first choice for the examination of uterine and endometrial-related diseases. However, the boundary of some endometrial is challenging to distinguish due to the effects of image resolution and noise. In addition, the irregular shape of the endometrium makes it more difficult for doctors to measure its thickness. Through the automatic segmentation and extraction of the endometrium, the maximum thickness of the endometrium can be measured automatically and accurately. This provides a quantitative index for doctors to use diagnostically., Methods: In this study, 85 cases of three-dimensional transvaginal ultrasound (3D TVUS) images were collected retrospectively, including 75 cases of endometrial adhesion and 10 cases of non-adhesion. Firstly, the ultrasound images were filtered by block-matching and 3D filtering and speckle reducing anisotropic diffusion (SRAD). These two kinds of filtered images were combined with the original image to construct a three-channel image. Then, the augmented images were sent to 3D U-Net to realize endometrium segmentation. The performance of the segmentation models was evaluated using the Dice similarity coefficient (DSC), Jaccard, sensitivity, and 95th percentile Hausdorff distance (HD95). Finally, the medial axis transform was used to extract the endometrial centerline, based on which the endometrial thickness could be automatically measured., Results: The endometrium segmentation method proposed in this paper achieved 90.83% in Dice, 83.35% in Jaccard, 90.85% in sensitivity, and 12.75 mm in HD95 in the testing set. Taking the doctor's manual measurement as the gold standard, 94.20% of the automatic endometrial thickness measurements based on the segmentation results were within the allowable error range of clinical diagnosis., Conclusions: This paper presents an automatic endometrium segmentation and thickness measurement method for 3D TVUS images. The experimental results show that this method has high segmentation accuracy to recognize endometrial adhesion images. Furthermore, the thickness measurement based on the segmentation results has high reliability and repeatability, and the accuracy can meet clinical diagnosis needs., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-21-1155/coif). The authors report that this work was supported by the National Natural Science Foundation of China (NSFC) under grant number 61873257 and the Guizhou Province Science and Technology Project under grant number Qiankehezhicheng [2019] 2794. The authors have no other conflicts of interest to declare., (2022 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Glioblastoma multiforme (GBM) is the most common type of malignant brain tumor, among which IDH1-wild type GBM has a poor prognosis. Recent studies have shown that ferroptosis-related genes (FRGs) are correlated with the development and progression of cancer. In GBM, the role of FRGs associated with IDH1 status as biological indicators and therapeutic targets remains to be clarified. Ten of FRGs (STEAP3, HSPB1, MAP1LC3A, SOCS1, LOX, CAPG, CP, GDF15, CDKN1A, and CD44) associated with IDH1 status in GBM were identified as key genes through screening by survival analysis and Random Forest using The Cancer Genome Atlas (TCGA) datasets, and the protein expressions of key genes were verified. Transwell and qPCR results showed that ferroptosis promoted the migration of glioblastoma cells and affected the expression of key genes. Our study established the ferroptosis-related prognostic model for GBM patients based on ten key genes by a different modeling method from previous study, the GSVA algorithm. Further, we took the methods of functional enrichment analysis, clinical characteristics, immune cell infiltration, immunomodulator, ESTIMATE and single nucleotide variant (SNV) analysis to study the molecular mechanisms of prognostic model and key genes. The results showed that ten key genes were strongly associated with immune-related factors and were significantly involved in the p53 signaling pathway, senescence and autophagy in cancer, and in the negative regulation of protein kinase activity. Moreover, potential therapeutic drugs were identified by Virtual Screening and Molecular Docking. Our study indicated that the novel ferrotosis-related prognostic model for GBM patients and key genes possessed the prognostic and therapeutic values., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zhang, Jin, Shi, Liu, Li, Liu, Zhong, Liu, Li, Tao, Zhai, Bao, Ren, Wu and Bao.)

Constructing 2D inorganic perovskites and TMDs heterostructures is an effective method to design stable and high-performance perovskites optoelectronic applications. Here, we investigate the optoelectronic properties and interfacial interactions of Cs 2 PbX 4 -MSe 2 (X = Cl, Br, I; M = Mo, W) heterostructures using first-principles calculations. Firstly, six Cs 2 PbX 4 -MSe 2 interfaces remain stable in energy. With the halogen varying from Cl to I, the interlayer distances of Cs 2 PbX 4 -MSe 2 heterostructures increase rapidly. The CBM and VBM of monolayer Cs 2 PbX 4 are all higher than that of monolayer MSe 2 and the charges transfer from Cs 2 PbX 4 interfaces to MSe 2 interfaces when they contact. Both Cs 2 PbX 4 -MSe 2 heterostructures are type-II heterostructures, which can drive the photogenerated electrons and holes to move in opposite directions. What's more, Cs 2 PbCl 4 -MoSe 2 heterostructures exhibit the highest charge transport efficiency among Cs 2 PbX 4 -MoSe 2 heterostructures because Cs 2 PbCl 4 -MoSe 2 heterostructures have the lowest exciton binding energies among Cs 2 PbX 4 -MSe 2 heterostructures. In addition, the optical absorptions of all heterostructures are significantly higher than the corresponding Cs 2 PbX 4 monolayers and MSe 2 monolayers. The construction of Cs 2 PbX 4 -MoSe 2 heterostructures is beneficial for improving the photoelectric performance of two-dimensional perovskite devices. Lastly, we found that the Cs 2 PbI 4 -WSe 2 heterostructure has the largest PCE (18%) among Cs 2 PbX 4 -MSe 2 heterostructures. The Cs 2 PbCl 4 -MoSe 2 heterostructure exhibits great potential application in photodetector devices and the Cs 2 PbI 4 -WSe 2 heterostructure has great potential application in solar cells., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Background: The sympathetic nervous system inhibits human colonic motility largely by effects on enteric neurons. Noradrenergic axons, which branch extensively in the myenteric plexus, are integral to this modulatory role, but whether they contact specific types of enteric neurons is unknown. The purpose of this study was to determine the association of noradrenergic varicosities with types of enteric neurons., Methods: Human colonic tissue from seven patients was fixed and dissected prior to multi-layer immunohistochemistry for human RNA binding proteins C and D (HuC/D) (pan-neuronal cell body labelling), tyrosine hydroxylase (TH, catecholaminergic labelling), Enkephalin (ENK), choline acetyltransferase (ChAT, cholinergic labelling) and/or nitric oxide synthase (NOS, nitrergic labelling) and imaged using confocal microscopy. TH-immunoreactive varicose nerve endings and myenteric cell bodies were reconstructed as three dimensional digital images. Data was exported to a purpose-built software package which quantified the density of varicosities close to the surface of each myenteric cell body., Results: TH-immunoreactive varicosities had a greater mean density within 1 μm of the surface of ChAT +/NOS- nerve cell bodies compared with ChAT-/NOS + cell bodies. Similarly, ENK-immunoreactive varicosities also had a greater mean density close to ChAT +/NOS- cell bodies compared with ChAT-/NOS + cells., Conclusion: A method for quantifying close associations between varicosities and nerve cell bodies was developed. Sympathetic axons in the myenteric plexus preferentially target cholinergic excitatory cells compared to nitrergic neurons (which are largely inhibitory). This connectivity is likely to be involved in inhibitory modulation of human colonic motility by the sympathetic nervous system., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Parker, Wiklendt, Humenick, Chen, Sia, Wattchow, Dinning and Brookes.)

Background: The autophagy pathway within the tumour microenvironment can be regulated to inhibit or promote tumour development. In the fight against tumour growth, immunotherapy induces an anti-tumour immune response, whereas autophagy modulates this immune response. A key protein in the autophagy pathway, microtubule-associated protein 1 light chain 3 (MAP1LC3), has recently become a hotspot for tumour research. As a relatively novel member, the function of MAP1LC3C in tumours still need to be investigated. Therefore, the goal of this study was to look into the possible link between MAP1LC3C and immunotherapy for 33 kinds of human malignancies by using pan-cancer analysis. Methods: High-throughput sequencing data from The Cancer Genome Atlas, Genotype-Tissue Expression Project and Cancer Cell Line Encyclopedia databases, combined with clinical data, were used to analyze the expression of MAP1LC3C in 33 types of cancer, as well as patient prognosis and neoplasm staging. Activity scores were calculated using ssGSEA to assess the MAP1LC3C activity in pan-cancer. Associations between MAP1LC3C and the tumour microenvironment, including immune cell infiltration and immunomodulators, were analyzed. Moreover, tumour tissue ImmuneScores and StromalScores were analyzed using the ESTIMATE algorithm. Additionally, associations between MAP1LC3C and tumour mutational burden/microsatellite instability, were investigated. Finally, based on the expression and structure of MAP1LC3C, the United States Food and Drug Administration (FDA)-approved drugs, were screened by virtual screening, molecular docking and NCI-60 drug sensitivity analysis. Results: Our study found that MAP1LC3C was differentially expressed in tumour and normal tissues in 23 of 33 human cancer types, among which MAP1LC3C had prognostic effects in 12 cancer types, and MAP1LC3C expression was significantly correlated with tumour stage in four cancer types. In addition, MAP1LC3C activity in 14 cancer types was consistent with changes in transcription levels. Moreover, MAP1LC3C strongly correlated with immune infiltration, immune modulators and immune markers. Finally, a number of FDA-approved drugs were identified via virtual screening and drug sensitivity analysis. Conclusion: Our study investigated the prognostic and immunotherapeutic value of MAP1LC3C in 33 types of cancer, and several FDA-approved drugs were identified to be highly related to MAP1LC3C and can be potential cancer therapeutic candidates., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zhang, Li, Zhong, Liu, Liu, Li, Han, Zhai, Bao, Shi and Bao.)

Purpose: Medical imaging examination is the primary method of diagnosis, treatment, and prevention of cancer. However, the amount of medical image data is often not enough to meet deep learning needs. This article aims to expand the small data set in tumor segmentation based on the deep learning method., Methods: This method includes three main parts: image cutting and mirroring augmentation, segmentation of augmented images, and boundary reconstruction. Firstly, the image is divided into four parts horizontally & vertically, and diagonally along the tumor's approximate center. Then each part is mirrored to get a new image and hence a four times data set. Next, the deep learning network trains the augmented data and gets the corresponding segmentation model. Finally, the segmentation boundary of the original tumor is obtained by boundary compensation and reconstruction., Results: Combined with Mask-RCNN and U-Net, this study carried out experiments on a public breast ultrasound data set. The results show that the dice similarity coefficient (DSC) value obtained by horizontal and vertical cutting and mirroring augmentation and boundary reconstruction improved by 9.66% and 12.43% compared with no data augmentation. Moreover, the DSC obtained by diagonal cutting and mirroring augmentation and boundary reconstruction method improved by 9.46% and 13.74% compared with no data augmentation. Compared with data augmentation methods (cropping, rotating, and mirroring), this method's DSC improved by 4.92% and 12.23% on Mask-RCNN and U-Net., Conclusion: Compared with the traditional methods, the proposed data augmentation method has better performance in single tumor segmentation., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zhang, Bao, Sun, Li, Li, Qian and Zhou.)

Purpose: Mammography is an important imaging technique for the detection of early breast cancer. Doctors classify mammograms as Breast Imaging Reporting and Data Systems (BI-RADS). This study aims to provide an intelligent BI-RADS grading prediction method, which can help radiologists and clinicians to distinguish the most challenging 4A, 4B, and 4C cases in mammography., Methods: Firstly, the breast region, the lesion region, and the corresponding region in the contralateral breast were extracted. Four categories of features were extracted from the original images and the images after the wavelet transform. Secondly, an optimized sequential forward floating selection (SFFS) was used for feature selection. Finally, a two-layer classifier integration was employed for fine grading prediction. 45 cases from the hospital and 500 cases from Digital Database for Screening Mammography (DDSM) database were used for evaluation., Results: The classification performance of the support vector machine (SVM), Bayes, and random forest is very close on the 45 testing set, with the area under the receiver operating characteristic curve (AUC) of 0.978, 0.967, and 0.968. On the DDSM set, the AUC achieves 0.931, 0.938, and 0.874. Using the mean probability prediction, the AUC on the two datasets reaches 0.998 and 0.916. However, they are all significantly higher than the doctors' diagnosis, with the AUC of 0.807 and 0.725., Conclusions: A BI-RADS fine grading (2, 3, 4A, 4B, 4C, 5) prediction model was proposed. Through the evaluation from different datasets, the performance is proved higher than that of the doctors, which may provide great help for clinical BI-RADS classification diagnosis. Therefore, our method can produce more effective and reliable results., (© 2021. CARS.)

Objective: We aimed to investigate the effect of the differing amino acid (AA) release dynamics of two protein sources on the growth performance, nitrogen deposition, plasma biochemical parameters, and muscle synthesis and degradation of piglets when included in their diets at normal and low concentrations., Methods: Forty-eight piglets (Duroc×Landrace×Large White) with initial body weight of 7.45±0.58 kg were assigned to six groups and fed one of 6 diets. The 6 dietary treatments were arranged by 3×2 factorial with 3 protein sources and 2 dietary protein levels. They are NCAS (a normal protein content with casein), NBlend (a normal protein content with blend of casein and corn gluten meal), NCGM (a normal protein content with corn gluten meal), LCAS (a low protein content with casein), LBlend (a low protein content with blend of casein and corn gluten meal), LCGM (a low protein content with corn gluten meal). The release dynamics of AA in these diets were determined by in vitro digestion. The digestibility, utilization and biological value of nitrogen in piglets were determined by micro Kjeldahl method. Plasma insulin was measured by enzyme-linked immunosorbent assay kits. The protein expression of mediators of muscle synthesis and degradation was determined by western blotting., Results: Although the consumption of a low-protein diet supplemented with crystalline AA was associated with greater nitrogen digestion and utilization (p<0.05), the final body weight, growth performance, nitrogen deposition, and phosphorylation of ribosomal protein S6 kinase 1 and eIF4E binding protein 1 in the muscle of pigs in the low-protein diet-fed groups were lower than those of the normal-protein diet-fed groups (p<0.05) because of the absence of non-essential AA. Because of the more balanced release of AA, the casein (CAS) and Blend-fed groups showed superior growth performance, final body weight and nitrogen deposition, and lower expression of muscle ring finger 1 and muscle atrophy F-box than the CGM-fed groups (p<0.05)., Conclusion: We conclude that the balanced release of AA from CAS containing diets and mixed diets could reduce muscle degradation, favor nitrogen retention, % intake and improve growth performance in pigs consuming either a normal- or low-protein diet.

Background: Effective nutrition programs are beneficial for nutritional recovery in infants. Few studies have focused on the effect of early high-energy feeding after open heart surgery. This study sought to assess the effects of early high-energy feeding in infants after congenital heart surgery., Methods: Patients at a tertiary pediatric cardiology center who underwent open heart surgery between July 2016 and July 2018 were recruited and randomly allocated to 1 of the following 2 groups: (I) the intervention group (postoperative early high-energy feeding; n=124); and (II) the control group (no intervention; n=120).The primary endpoints of average energy delivery and growth Z-scores [i.e., weight-for-height Z-score (WHZ), weight-for-age Z-score (WAZ), and height-for-age Z-score (HAZ)] were recorded preoperatively, during the intensive care unit (ICU) stay, at discharge, and at 1 and 3 months postoperatively. The secondary endpoints of malnutrition recovery, ventilator support time, infection rate, and cardiac ICU (CICU) stay were also recorded., Results: A total of 244 infants were included in the study. There were no significant differences in the baseline features between the 2 groups. The intervention group received higher calories on average than the control group (44.5 vs. 34.7; P<0.001). At discharge from the ICU, the WHZ (-2.29 vs. -2.76; P<0.001) and WAZ (-3.08 vs. -3.43; P=0.005) of patients in the intervention group were higher than those of patients in the control group. Ventilator support time (P=0.004), CICU stay (P=0.045), and infection rate (P=0.001) were significantly lower in the intervention group than the control group. At 3 months post-surgery, the intervention group exhibited a higher malnutrition recovery rate than the control group (19.4% vs. 6.5%; P=0.002)., Conclusions: The administration of early high-energy feeding to infants after congenital heart surgery is associated with improved growth, reduced CICU stay, decreased ventilator support time, and reduced postoperative infection rates., Trial Registration: ClinicalTrials NCT04609358., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/tp-21-360). All authors report that this work was supported by the Key Subject Program for Clinical Nutrition from Shanghai Municipal Health Commission for Li HONG [No. 2019ZB0103]. The authors have no other conflicts of interest to declare., (2021 Translational Pediatrics. All rights reserved.)

Objective: The aim of the study was to evaluate the effectiveness of an audio and animated cartoon questionnaire (AACQ) at improving consent process in child for biospecimen donation., Methods: A multi-center randomized and controlled survey was performed at two pediatric hospitals in China from 2019 to 2020. Children aged from 7 to 18 years in the pediatric surgery wards were invited to investigate the participants' willingness and attitudes for donating biospecimens. A total of 264 children, including 119 in the AACQ group and 145 in the TQ group, and 67 parents of children were analyzed. A separate knowledge test was acquired in the questionnaires., Results: Our findings showed that the response rate of the AACQ group (89.85%) was significantly higher than that of the TQ group (68.44%; p < 0.001). AACQ can improve the child's understanding, increase children's engagement in biospecimen donation, reduced the differences in selected characteristics affecting children understanding, and enhanced their risk awareness of donating biospecimens. We also found that increasing pain and privacy disclosure were the most popular concern among children for the refusal to donate biospecimens., Conclusions: AACQ is an effective and standardized tool of content delivery to children from the surgical wards. Children who fully understood of biospecimen donation are suggested to participate in the consent signing., Impact: Using audio and animated cartoon questionnaire is a more effective and standardized tool of content delivery to children. This study expanded the use of an animated cartoon to a children's survey. Audio and animated cartoon questionnaire (AACQ) can improve the child's understanding, increase children's engagement in biospecimen donation compared to text questionnaire (TQ) group, and enhanced their risk awareness of donating biospecimens. More AACQ should be used with children in the future to effectively deliver content to children and improve children's participation in the survey., (© 2020. International Pediatric Research Foundation, Inc.)

Coronavirus disease 2019 (COVID-19) is an emergent infectious pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is highly contagious and pathogenic. COVID-19 has rapidly swept across the world since it was first discovered in December 2019 and has drawn significant attention worldwide. During the early stages of the outbreak in China, traditional Chinese medicines (TCMs) were involved in the whole treatment process. As an indispensable part of TCM, Chinese patent medicines (CPMs) played an irreplaceable role in the prevention and treatment of this epidemic. Their use has achieved remarkable therapeutic efficacy during the period of medical observation and clinical treatment of mild, moderate, severe, and critical cases and during convalescence. In order to better propagate and make full use of the benefits of TCM in the treatment of COVID-19, this review will summarize the potential target of SARS-CoV-2 as well as the theoretical basis and clinical efficacy of recommended 22 CPMs by the National Health Commission and the Administration of TCM and local provinces or cities in the treatment of COVID-19. Additionally, the study will further analyze the drug composition, potential active ingredients, potential targets, regulated signaling pathways, and possible mechanisms for COVID-19 through anti-inflammatory and immunoregulation, antiviral, improve lung injury, antipyretic and organ protection to provide meaningful information about the clinical application of CPMs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Yang, Wang, Ma, Wang, Lin, Yan, Fan, Chen, Ge, Zhu, Wang, Zhang, Sun and Feng.)

Probiotics, including Lactobacillus rhamnosus GG ATCC53103 and Lactobacillus plantarum JL01, can improve growth performance and immunity of piglets, and relieve weaning stress-related immune disorders such as intestinal infections and inflammation. This study aimed to evaluate the ability of co-administration of the probiotics L. rhamnosus GG ATCC53103 and L. plantarum JL01 to stimulate immune responses and improve gut health during the critical weaning period in piglets. Forty-eight weaned piglets were randomly divided into four groups, and fed daily for 28 days either without, or with the two probiotics independently, or in combination. On day 28, we analyzed the cytokine and bacterial changes in intestinal mucosa and the hepatic portal vein blood metabolites of the weaned piglets. Our results showed that combined L. rhamnosus GG ATCC53103 and L. plantarum JL01 significantly increased (p < 0.05) the growth performance and expression of IL-10 and TGF-β1 mRNAs. In contrast, this treatment significantly decreased (p < 0.05) IL-1β mRNA level in the jejunum, ileum, and cecum. Furthermore, the secretion of IL-6 in the cecum, IL-1β in the jejunum, ileum, and cecum, and TNF-α in the jejunum and ileum was significantly decreased (p < 0.05). The relative abundance of Prevotella&#95;9 and Enterococcus in ileum and cecum was significantly increased (p < 0.05). The relative abundance of Ruminococcus&#95;1 and Ruminococcaceae&#95;UCG-005 in cecum was significantly decreased (p < 0.05). Prevotella&#95;9 and Enterococcus may increase the accumulation of (4Z,7Z,10Z,13Z,16Z,19Z)-4,7,10,13,16,19-docosahexaenoic acid (DHA) and tauroursodeoxycholic acid (TCDA) in portal vein blood, while Ruminococcus&#95;1 and Ruminococcaceae&#95;UCG-005 may decrease the accumulation of succinic and palmitic acids. These results indicate that L. rhamnosus GG ATCC53103 and L. plantarum JL01 may regulate cytokine levels by reducing the accumulation of succinic and palmitic acids and increasing the accumulation of TCDA and DHA, thereby enhancing the immunity of weaned piglets., (Copyright © 2021. Published by Elsevier Ltd.)

Soybean agglutinin (SBA) has a toxic effect on most animals. The anti-nutritional mechanisms of SBA are not fully understood, in terms of cell survival activity and metabolism of intestinal cells. This study aims to investigate the effects of SBA on the cell cycle, apoptosis, and to verify the mechanism of SBA anti-nutritional characters based on proteomic-based analysis. The IPEC-J2 cell line was cultured with medium containing 0.0, 0.5, or 2.0 mg/mL SBA. With increasing SBA levels, the percentage of the cells at G0/G1 phase, cell apoptosis rates, expressions of Bax and p21, and the activities of Casp-3 and Casp-9 were increased, while cyclin D1 and Bcl-2 expressions were declined ( p < 0.05). The proteomic analysis showed that the numbers of differentially expressed proteins, induced by SBA, were mainly enriched in different pathways including DNA replication, base excision repair, nucleus excision repair, mismatch repair, amide and peptide biosynthesis, ubiquitin-mediated proteolysis, as well as structures and functions of mitochondria and ribosome. In conclusion, the anti-nutritional mechanism of SBA is a complex cellular process. Such process including DNA related activities; protein synthesis and metabolism; signal-conducting relation; as well as subcellular structure and function. This study provides comprehensive information to understand the toxic mechanism of SBA in monogastrics., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Pan, Liu, Lan, Bao, Zhao, Sun, Qin and Farouk.)

Soybean can cause allergy in both humans and animals. The herein study aims to identify the antigenic determinants (epitopes) of β-conglycinin that lead to allergy in different animal species (swine, bovine, and rats). The epitopes of β-conglycinin were identified through co-immunoprecipitation and mass spectrometry. The binding abilities of seven identified epitope peptides to allergic sera of three animal species were compared by ELISA and dot-blot techniques. Some epitope peptides could be recognized by the three animal allergic sera, while most epitopes showed some differences in binding abilities to the different animal sera. The strongest reaction using swine sera was detected with peptides α2, β2, and β3, but the biggest sensitive regions for bovine and rats were peptides α2, β1, and β4. Most epitopes of β-conglycinin exhibited different binding abilities to the three animal sera, in which the biggest sensitive regions were peptides α2, β2, and β3 for swine, but peptides α2, β1, and β4 were detected for bovine and rats., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Zhao, Naren, Qiang, Qin, Bao and Farouk.)

To systematically evaluate the clinical efficacy and safety of Danhong Injection combined with conventional therapy in improving diabetes mellitus complicated with coronary heart disease. Based on the online literature database(CNKI, Wanfang, VIP, PubMed, Web of Science, Cochran Library), the Chinese and English papers about the randomized controlled trial(RCT) of Danhong Injection in the treatment of diabetes mellitus complicated with coronary heart disease were searched comprehensively from the establishment of the databases to January 1, 2020. The papers were screened strictly according to the inclusion and exclusion criteria. Based on Jadad scale, the risk assessment of literature was carried out, and Meta-analysis was performed by STATA 12.0 software. Seventeen RCTs were included, involving 1 453 patients. The results of Meta-analysis showed that the combination of Danhong Injection and conventio-nal treatment could improve the clinical comprehensive effective rate(RR=1.47, 95%CI[1.38, 1.58], P&lt;0.000 1), electrocardiogram(ECG) efficiency(RR=1.30, 95%CI[1.16, 1.46], P&lt;0.000 1), efficiency of the angina pectoris(RR=1.41, 95%CI[1.25, 1.58], P&lt;0.000 1), cholesterol level(SMD=-1.05, 95%CI[-1.95,-0.16], P=0.02), low-density lipoprotein(LDL) level(SMD=-0.50, 95%CI[-0.79,-0.21], P&lt;0.000 1), coronary angina attack frequency(SMD=-3.71, 95%CI[-4.05,-3.36], P&lt;0.000 1) and duration of angina pectoris(SMD=-2.96, 95%CI[-3.25,-2.66], P&lt;0.000 1), with statistically significant differences. But the differences in fasting plasma glucose(FPG)(SMD=-0.19, 95%CI[-0.45, 0.08], P=0.16), plasma glucose of two hours after meal(2 hPG)(SMD=0.19, 95%CI[-0.11, 0.49], P=0.22), and high-density lipoprotein(HDL) level(SMD=0.10, 95%CI[-0.30, 0.49], P=0.62) after treatment were not statistically significant. Compared with the control group, there was no significant difference in adverse reactions(SMD=-2.96, 95%CI[-3.25,-2.66], P=0.75). The existing evidence shows that the combination of Western medicine and Danhong Injection can improve the clinical effect for diabetes mellitus complicated with coronary heart disease and has no obvious adverse reactions. However, due to the low level of overall literature evidence, high risk and some kind of publication bias, it still needs more high-quality randomized controlled trials and low-bias studies for further verification.

Pressure overload is one of the pathophysiological conditions commonly associated with right-sided congenital heart disease (CHD). Patients suffer from this condition right after birth. However, little is known about how neonatal heart reacts to it. We have previously established a pulmonary artery banding (PAB) model in neonatal rat. Here we show that PAB accelerated transition of mononuclear cardiomyocytes into multinucleated cells to promote hypertrophic growth in neonatal heart. The elevated afterload significantly increased the mitotic activities of neonatal cardiomyocytes. Consistent with the proliferative potential, the elevated pressure overload also increased cytokinetic marker counts of cardiomyocytes. Using cardiomyocyte-specific lineage tracing, we noticed a clonal expansion of rare unlabeled cardiomyocytes in the PAB group, revealing a subgroup of cardiomyocytes with a strong capability of proliferation. In addition, PAB hearts at post-banding day 7 didn't have the accumulation of macrophages, which is an immune response essential for neonatal heart regeneration in injury models. Transcriptomic analyses revealed that neonatal PAB induced an expression profile featuring both cardiomyocyte hypertrophy, such as highly activated translation, oxidative phosphorylation, and mitochondrial biogenesis programs etc., and immature cardiomyocyte, such as enhanced cell cycle activities and glycolytic metabolism, down-regulated cytoskeleton and ion channel gene expression, and maintenance of fetal-specific sarcomeric isoforms etc. It indicates that pressure overload has differential impacts on various cardiomyocyte maturation (CM) programs that may contribute to the concurrent cardiomyocyte hypertrophy and hyperplasia. The bivalent status of transcriptional profile highlights the plasticity of neonatal cardiomyocytes that can be exploited to adapt the postnatal environment., (Copyright © 2020 Ding, Wang, Wang, Yang, Bao, Liu and Zhang.)

Background: Parents are active participants in the referral process of children with non-life-threatening surgical pathologies. Nonetheless, there is scarce literature about the influence of parent's level of income and perception of their children's conditions on their decision process. Our study aims at expanding our knowledge about this parameter. We focused our research on parents of children spina bifida occulta (SBO), a condition that with a broad clinical impact and that often requires timely referral., Methods: Questionnaires in Mandarin were administered to parents of patients presenting to the neurosurgery clinic of a children's hospital in Shanghai. Participants were grouped according to the level of income, above and below 50,000 Yuan. The SBO was classified into two groups, with and without evident subcutaneous mass., Results: One hundred and forty-five participants completed the questionnaire. Regardless of the type of lesion, families with lower income attributed their concerns for seeking care to their local physicians and the lack of health resources. Families with higher income exhibited fear of treatment. The lower income cohort presented for treatment at an older age than a higher income group. Patients with subcutaneous mass presented for treatment at a younger age than those that did not exhibit mass., Conclusion: Parental social economic background and visual presentation of SBO have to be factored when analyzing their decision-making process when seeking care for their children. Parental factors can be barriers to surgical care. Healthcare providers must bring parents to the forefront of the treatment process., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Surgical Neurology International.)

Background: The study aimed to investigate the risk factors of malnutrition in children with congenital heart defect (CHD) in China., Methods: This cohort study was performed at the biggest pediatric heart center in China; 3252 patients with CHD who underwent cardiac surgeries in 2013 were included. Anthropometric measurements included weight for age Z score (WAZ), weight for height Z score (WHZ), and height for age Z score (HAZ). The patients were classified as normal nutritional status and malnutrition, based on a cut-off Z score of <- 2. Factors associated with malnutrition were determined using logistic regression analysis., Results: The prevalence of preoperative WAZ < -2 (underweight), HAZ < -2 (stunting), and WHZ < -2 (wasting) was 23.3, 23.3, and 14.3%, respectively. The multivariable analysis of preoperative malnutrition showed that hospitalization, age at surgery, risk adjustment for congenital heart surgery-1 > 3, mechanical ventilation, pulmonary hypertension, and acyanotic heart disease were associated with underweight. Parents' height, single ventricle, and cyanotic heart disease were associated with stunting. Hospitalization and pulmonary hypertension were associated with wasting. After surgery, the patients presented a significant improvement in growth within the first year in all three parameters and grew to the normal range of WAZ (- 0.3 ± 0.9, P < 0.001), HAZ (0.2 ± 0.8, P = 0.001), and WHZ (0.03 ± 0.6, P < 0.001) at 2 years after surgery. The prevalence of underweight, stunted, and wasting declined to 3.2, 2.7, and 1.9% 3 years after surgery. Malnutrition after surgery was associated with cardiac residual cardiac abnormalities (OR = 35.3, p < 0.0001), high Ross classification of heart function (OR = 27.1, p < 0.0001), and long-term taking oral diuretics (OR = 20.5, P = 0.001)., Conclusions: Malnutrition is still a problem in children with CHD in China, especially before the surgery. There is need to strengthen the nutrition support for children with CHD before surgery. Hemodynamic factors were found to be the risk factors associated with malnutrition after operation.

Background: Spinal cord injury without radiographic abnormality (SCIWORA) is defined as having "clinical symptoms of traumatic myelopathy with no radiographic or computed tomographic features of spinal fracture or instability". The mechanism of pediatric SCIWORA following minor trauma is still unclear. Tight filum terminale (TFT) has been studied in the literature, but the information regarding the predisposing factor for SCIWORA is still being defined., Case Presentation: We report three cases of thoracic and lumber SCIWORA with TFT. The trauma was potentially mild in all cases but resulted in catastrophic damage of the cord. All patients had no signs or symptoms of tethered cord syndrome prior to the minor trauma. TFT was found during operation., Conclusions: We suggest that TFT might be a predisposing factor for SCIWORA and chronic spinal cord traction play an important role in the mechanism of pediatric thoracic and lumber SCIWORA following minor trauma. Patients who never undergo treatment for TFT likely have an elevated risk of developing SCIWORA following minor trauma.

The authors made a profound review on the development and the recent status of craniomaxillofacial surgery in China during past three decades. The emphases were placed on the following aspects: the modifications of the reconstructive procedure and minimal invasive mode, the researches on molecular genetic characteristics of the congenital craniofacial malformations, the clinical applications of three-dimensional digital computer-aided techniques (including three-dimensional printing and prefabricated template for precious osteotomies), the craniomaxillofacial defects reconstructing by using the distraction osteogenesis and osseous integrated titanium implant and prothesis, etc . Finally, the authors outlooked prospectively the future trends of the craniomaxillofacial surgery.

Background: The People's Republic of China (PRC) has the highest incidence of neural tube defects (NTDs) in the world. NTDs remain a significant contributor to the global burden of disease amendable to surgical care; however, no studies to date have evaluated the patients' perspective regarding perceived barriers to care., Methods: The study was conducted at the Shanghai Children's Medical Center (SCMC) between 6/11/2014 and 7/17/2014. Surveys were administered to families presenting to the clinic of the SCMC director for Pediatric Neurosurgery. Additionally, orphaned patients under the care of the Baobei Foundation were surveyed for comparison. Participants were allowed to mark as many barriers on the survey as they deemed relevant to their experience., Results: A total of 69 patients were surveyed. The most frequently chosen barrier to care, with a P value < 10 -5 , was that the referring physician did not know enough about the child's condition. As compared to the Baobei Foundation orphans, surveyed patients presented at an older age for initial treatment (7 months versus 1 month, P value = 0.001), and visited more hospitals before reaching SCMC (3.14 versus 1.0, P value < 10 -5 )., Conclusions: The results of this study highlight the referring physician as a primary barrier to care. The younger age at time of treatment for Baobei orphans born with NTDs supports this finding, as they essentially bypassed the referral process. An elaboration on reasons for this real or perceived barrier may provide insight into a means for expedited diagnosis and treatment of NTDs within the PRC., Competing Interests: There are no conflicts of interest.

Objective: To investigate infection prevention by antibiotic-impregnated shunts (AIS) relative to conventional ones after pediatric hydrocephalus treatment., Methods: This single center, retrospective analysis comprised 807 consecutive pediatric cases of hydrocephalus shunting performed by the same neurosurgeon between January 2001 and February 2013. Conventional and AIS catheters were used in 303 and 504 cases, respectively. Study outcomes were infection rates at 6 months (primary), and at 1 month and between 1 and 6 months (secondary). An infant (<1year) subgroup was also analyzed., Results: The AIS relative to the conventional catheter group had significantly lower infection rates at 6 months (1.98% [10/504] vs. 5.95% [18/303], two-tailed p=0.0046; central nervous system: 60% and 55.56%; abdominal: 20% and 27.77%; wound: 20% and 16.67%, respectively) and 1 month (0.19% [1/504] vs. 2.65% [8/303], p=0.0023, respectively), but statistically similar rates between 1 and 6 months (1.79% [9/504] vs. 3.30% [10/303], p=0.2296, respectively). In the infant subgroup, AIS application was also associated with reduction in shunt infection (1.49% [7/470] vs. 3.76% [10/266], p=0.0489, respectively)., Conclusion: AIS as compared to conventional catheter use appears to lower infection risk at 6 months, mainly during the first month, after hydrocephalus therapy in children., (Copyright © 2016 Elsevier B.V. All rights reserved.)

In this article, a novel route for the synthesis of graphene/TiO 2 continuous fibers (GTF) using force-spinning combined with water vapor annealing method is reported for the first time. The morphology, structure and optical properties of the composite were fully characterized. With a single step of heat treatment process using steam at ambient conditions, we were able to initiate a series of chemical reactions, such as reduction of graphene oxide (GO), crystallization of TiO 2 , formation of C-Ti bond, and introduction of oxygen vacancies into TiO 2 . The incorporation of graphene in TiO 2 fibers facilitated bandgap narrowing and improved photo-induced charge separation in the photocatalyst. As a result of synergistic effects, TiO 2 fibers-2 wt% graphene (2%GTF) showed the highest photocatalytic activities in the degradation of X-3B under UV irradiation, superior to the benchmark photocatalyst P25. Under visible light irradiation, the same catalyst was about 4 times more efficient compared to pure TiO 2 fibers (PTF). A detailed study of involved active species (in particular, ·, h + and ·OH) unraveled the mechanism regarding photocatalysis.

Nitrogen-doped TiO2 nanopowders have been successfully synthesized by a one-step hydrothennal route under soft-chemistry conditions (150 degrees, 8 h) without high-temperature calcination using seven different types of nitrogen dopants: methylamine, ethylamine, diethylamine, ethylenediamine, triethylamine, triethanolamine and ammonia. X-ray diffraction, transmission electron microscopy, ultraviolet-visible spectroscopy, X-ray photoelectron spectroscopy, N2 adsorption-desorption isothenns and Fourier transform infrared spectroscopy were used to analyse the as-synthesized TiO2 powders. The results indicated that nitrogen was doped effectively and the structure and morphology of the titania samples were strongly influenced by the nitrogen sources. Among the investigated nitrogen sources, the diethylamine system was clearly superior to the other small-molecule amine or ammonia systems due to the broad-spectrum response (between 400 and 700 nm) of the interstitial nitrogen-doped TiO2 nanopowders. The diethylamine N-doped TiO2 had the largest pore volume (0.39 ml x g(-1)) and showed a well-aligned anatase phase. The visible-light photocatalytic degradation of liquid X-3B used as a probe reaction demonstrated that the removal rate over the diethylamine material reached 99.7% in 90 min.

Objective: To describe the pathological changes of lipomas of the conus medullaris and the appropriate surgical treatment for removing such lipomas for optimal reconstruction of the normal spinal cord anatomy., Methods: Data were collected on 73 patients, aged 1.5 months to 18 years, who underwent surgical removal of a lipoma of the conus medullaris at Shanghai Children's Medical Center from January 2005 to December 2008. Neurological symptoms included pain, urine and stool incontinence, and bilateral lower limb dysfunction. The surgical procedures consisted of excision of subcutaneous and intradural extramedullary lipoma, partial excision of intramedullary lipoma, detachment of the spinal cord from the dural membrane, relief of tethered spinal cord, and excision of the affected filum terminale., Results: The main pathological changes in patients with lipoma of the conus medullaris were ventral deviation of the spinal cord caused by compression from a dorsal lipoma, traction on the spinal cord from attachment of intradural lipoma and subcutaneous lipoma, increased tight fit between the spinal cord and the dural membrane on both sides, and degeneration of the filum terminale. A total of 67 patients were followed up for 6 months to 4 years. Improvement after surgery varied among the symptomatic patients. A total of 5 patients had transient deterioration of symptoms after surgery. All asymptomatic patients remained asymptomatic., Conclusion: Only through thorough understanding of the pathology of the lipoma of the conus medullaris, we could optimally excise the lipoma, untether the spinal cord, reconstruct the normal anatomy of the spinal cord, and rehabilitate neurological function., (Georg Thieme Verlag KG Stuttgart · New York.)

Interfacial interactions involved in reverse osmosis (RO) membrane fouling by humic acid were quantitatively evaluated using the XDLVO (extended Derjaguin-Landau-Verwey-Overbeek) approach. The role of each individual interfacial interaction during membrane fouling was elucidated with special emphasis devoted into the influence of Ca2+ under different solution pHs. The results showed that, regardless of the presence of Ca2+, van der Waals interaction favoring fouling contributed the most to the interfacial interactions at pH 3, whereas the polar interaction inhibiting fouling played a dominant role at pH 7 and pH 10. Electrostatic double layer interaction appeared to be the weakest in all cases, thus contributing the least to membrane fouling. It was the changing of polar interaction that gave rise to the influence of Ca2+ on membrane fouling, which turned out to be more significant at lower pH. Ca2+ would accelerate humic acid RO membrane fouling at most cases. Correlation analysis between interfacial free energy and fouling extent revealed that XDLVO approach could reasonably predict humic acid RO membrane fouling behaviors under different solution conditions.

Desmoplastic infantile astrocytoma is a rare low-grade malignant brain tumor found in infants. Its pathological diagnosis can be made on the basis of its histological characteristics and immunohistochemical staining. A case of desmoplastic infantile astrocytoma, including its clinical manifestations, pathological characteristics, differential diagnosis, treatment, and prognosis, is reported. Presurgical percutaneous decompression and subsequent resection resulted in a satisfactory therapeutic outcome.

Objective: To study the effects of ganglioside 1 (GM1) and nerve growth factor (NGF) on neural stem cells (NSCs) proliferation in vitro., Methods: NSCs were isolated and cultured in vitro. NSCs were cultured in the medium containing epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF) or without the two agents. Different concentrations of GM1 and NGF were added into the two different medium. MTT and cell ball counting methods were used to ascertain the proliferation of NSCs. Immunohistochemical technology was used to observe the effect of GM1 and NGF on the proliferation of NSCs., Results: High concentrations of GM1 (100 ng/L and 200 ng/L) promoted significantly the proliferation of NSCs in the medium containing EGF and bFGF (p<0.05). In the differentiation medium containing serum but no EGF and bFGF, NSCs proliferation increased with increasing concentration of GM1; the proportion of neurons and gliacytes increased with increasing concentration of NGF., Conclusions: High concentration of GM1 can promote NSCs proliferation and NGF can promote NSCs differentiation.

Soybean allergy represents a health threat to human and animals. Glycinin and beta-conglycinin, the main storage proteins in soybean, have been identified as major food/ feed allergens. The present study was conducted to investigate the disappearance of immunoreactive glycinin and beta-conglycinin in the digestive processes of piglets. Twelve crossbred piglets, weaned at 21 days of age, were allocated to three dietary treatments in a complete block design, each treatment with four replicates (female/male = 1:1). From day 22-28, the control group was fed diets without leguminous products, while the two treatment groups received diets containing 2.2% purified glycinin or beta-conglycinin. All piglets were slaughtered at 29 days of age and digesta was sampled from stomach, middle jejunum, caecum and colon. Results indicated that immunoreactive glycinin and beta-conglycinin decreased as the digesta descended down the digestive tract to 0.12% and 0.47%, respectively. Little immunoreactive glycinin was found in the digesta of caecum and colon, while immunoreactive beta-conglycinin was detected in the colon. Along the whole digestive tract the disappearance of immunoreactive glycinin was significantly higher than beta-conglycinin (p < 0.05).