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Qi Kong,1 Ling-ling Qian,1 Lei Zhang,1 Huan-huan Liu,1,2 Fan Yang,1 Xiao-lu Zhang,1 Chao Wang,1 Xiao-xi Zhao,1 Ku-lin Li,1 Ru-xing Wang1,2 1Department of Cardiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, 214023, People’s Republic of China; 2Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, People’s Republic of ChinaCorrespondence: Ru-xing Wang; Ku-lin Li, Department of Cardiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, 214023, People’s Republic of China, Email ruxingw@aliyun.com; liyantong2002@126.comPurpose: The aim of this study was to investigate the effects and mechanisms of SGLT2 inhibitor empagliflozin on diabetic coronary function.Methods: A rat diabetic model was established by injection of streptozotocin. Rats in the treated group were administered empagliflozin by gavage and rat coronary vascular tensions were measured after eight weeks. Large conductance calcium activated K+ channel currents were recorded using a patch clamp technique, while human coronary artery smooth muscle cells were used to explore the underlying mechanisms.Results: After incubation with empagliflozin (10, 30, 100, 300, 1000 μmol/L), the Δ relaxation % of rat coronary arteries were 2.459 ± 1.304, 3.251 ± 1.119, 6.946 ± 3.407, 28.36 ± 11.47, 86.90 ± 3.868, respectively. Without and with empagliflozin in the bath solution, BK channel opening probabilities at a membrane potential of +60 mV were 0.0458 ± 0.0517 and 0.3413 ± 0.2047, respectively (p < 0.05, n = 4 cells). After incubation with iberiotoxin, the Δ tensions of rat coronary arteries in the control (Ctrl), untreated (DM), low empagliflozin (10 mg/kg/d)-treated (DM+L-EMPA) and high empagliflozin (30mg/kg/d)-treated (DM+H-EMPA) group were 103.20 ± 5.85, 40.37 ± 22.12, 99.47 ± 28.51, 78.06 ± 40.98, respectively (p < 0.01 vs Ctrl, n = 3– 7; p < 0.001 vs DM+L-EMPA, n = 5– 7). Empagliflozin restored high glucose-induced downregulation of Sirt1, Nrf2, and BK-β 1, while the effect of empagliflozin disappeared in the presence of EX-527, a Sirt1 selective inhibitor.Conclusion: Empagliflozin has a vasodilation effect on the coronary arteries in a concentration-dependent manner and can activate BK channels via the Sirt1-Nrf2 mechanism.Keywords: diabetes, SGLT2 inhibitor, vasodilatation, large conductance calcium activated potassium channel

Arbuscular mycorrhizal fungi (AMF) play an important role on litter decomposition, which is increasing suffering the negative impact of acid deposition. In this study, we investigated the AMF effects on litter decomposition via suppressing AMF and simulating acid deposition in a subtropical Cinnamomum camphora forest. The results showed that acid deposition and AMF suppression decelerated C. camphora leaf litter decomposition, especially at late decomposition stage; soil water content was the main factor restricting early-stage decomposition. The inhibiting effect of acid deposition was enhanced with acid intensity increase and AMF suppression aggravated the negative effect of acid stress on decomposition. Nitrogen-cycling enzymatic activity was significantly higher in later than in early decomposition stage, and acid deposition and AMF suppression significantly decreased microbial activity. Despite the seasonal effect was overwhelming, we still detected the effects of acid deposition and AMF suppression on litter nutrient release. Without or under low acid deposition, AMF suppression significantly increased organic matter and decreased alkali-hydrolyzable nitrogen content of detritusphere soil. Acid deposition significantly reduced soil organic matter content, while high acid deposition intensity increased alkali-hydrolyzable nitrogen content after 2- and 12-month decomposition, and decreased it at other months. Both acid deposition and AMF suppression decreased available phosphorus content, but did not affect phosphatase activity. AMF effects on invertase and nitrogen-release enzyme activities, and alkali-hydrolyzable nitrogen and available phosphorus contents of detritusphere soil were highly sensitive to acid deposition. Our results revealed that AMF effects on microbial activity and nutrient release during litter decomposition are sensitive to acid deposition.

Fan Yang,1,&ast; Huan-Huan Liu,2,&ast; Lei Zhang,1,&ast; Xiao-Lu Zhang,1 Jie Zhang,1 Feng Li,1 Ning Zhao,2 Zhi-Yuan Zhang,1 Qi Kong,1 Xiao-Yu Liu,1 Ying Wu,1 Zhi-Ming Yu,1 Ling-Ling Qian,1 Ru-Xing Wang1,2 1Department of Cardiology, the Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, 214023, People’s Republic of China; 2Wuxi School of Medicine, Jiangnan University, Wuxi, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ling-Ling Qian; Ru-Xing Wang, Department of Cardiology, the Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, 214023, People’s Republic of China, Tel +0086-510-85351593, Email qianlingling@njmu.edu.cn; ruxingw@aliyun.comPurpose: Diabetes mellitus is an independent risk factor for atrial fibrillation (AF), which may be related to accumulation of advanced glycation end products (AGEs). However, the mechanisms involved are not completely clear. Abnormality of gap junction proteins, especially connexin 43 (Cx43) and connexin 40 (Cx40) in atrial myocytes, is an important cause of increased susceptibility of AF. The aim of our work is to investigate the mechanism of dysregulated Cx43 and Cx40 in atrial myocytes of diabetic rats.Methods: We established a type 1 diabetic rat model by intraperitoneal injection of streptozotocin. HL-1 cells and primary rat atrial myocytes were treated with AGEs in vitro. Using Western blotting, immunofluorescence staining, immunohistochemistry, and lucifer yellow diffusion measurements, we investigated dysregulation of Cx43 and Cx40 and its mechanism in atrial myocytes of diabetic rats.Results: Accumulation of AGEs was found in diabetic rats. The expression of Cx43 and Cx40 was reduced in the atrium of diabetic rats, accompanied by the decrease of phosphorylated Adenosine 5’-monophosphate-activated protein kinase (p-AMPK). Similar results were found in cultured HL-1 cells and primary rat atrial myocytes, suggesting a role of AGEs on gap junction proteins. An AMPK agonist, 5-Aminoimidazole-4-carboxamide ribonucleoside (AICAR), reversed the down-regulated Cx43 expression induced by AGEs stimulation. More importantly, lucifer yellow diffusion assay showed that AGEs significantly affected gap junctional function, and these changes were reversed by AICAR.Conclusion: Thus, we conclude that AGEs cause dysregulation of Cx43 and Cx40 in diabetic atria via the AMPK pathway, thereby leading to gap junction dysfunction, which may contribute to the increased AF susceptibility in diabetes.Keywords: diabetes, atrial fibrillation, advanced glycosylation end products, adenosine 5’-monophosphate-activated protein kinase, connexin

Qingyan Kong, Mengshi Yi, Fei Teng, Hang Li, Zheyu Chen Division of Hepatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People’s Republic of ChinaCorrespondence: Zheyu Chen, Division of Hepatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People’s Republic of China, Email kqydoctor@163.comBackground: Recent research has suggested that sarcopenia may have an impact on postoperative outcomes. The number of hepatocellular carcinoma (HCC) patients with metabolic dysfunction-associated fatty liver disease (MAFLD) has increased significantly over time. The main objective of this study was to investigate the impact of sarcopenia on the prognosis of HCC patients with MAFLD after hepatectomy.Methods: A multivariate Cox proportional hazards model and a propensity score matching (PSM) analysis were conducted to ensure that the baseline characteristics were similar. Kaplan‒Meier survival curves were used to compare the prognosis of the two groups.Results: This study involved 112 HCC patients with MAFLD undergoing hepatectomy. Sarcopenia was indicated as a risk factor for both recurrence-free survival (RFS) and overall survival (OS) in HCC patients with MAFLD after multivariate analysis (p=0.002 and 0.022, respectively). After conducting PSM analysis, Kaplan‒Meier survival curve analysis revealed significant differences in both the RFS and OS between the two groups (p=0.0002 and p=0.0047, respectively). All results showed that sarcopenia had a poor prognosis for HCC patients with MAFLD undergoing hepatectomy.Conclusion: In summary, our study suggests that sarcopenia might be a risk factor for OS and RFS in HCC patients with MAFLD who underwent hepatectomy through multivariate analysis and PSM analysis. Sarcopenia imperils postoperative survival rates and this finding can guide clinical decision-making. For postoperative patients, preventing or treating sarcopenia can potentially improve survival outcomes for patients with HCC and MAFLD.Keywords: sarcopenia, metabolic dysfunction-associated fatty liver disease, hepatocellular carcinoma, hepatectomy

YiFan Wu,1,&ast; Yun Hui,2,&ast; Fang Liu,2 Huan Chen,2 KeHan Liu,1 QiYing Chen,2 YiFan He,1 Nan Hong,2 WenLiang Yan,2 QingTao Kong,2 Hong Sang1,2 1Nanjing Medical University, Nanjing, 210002, People’s Republic of China; 2Department of Dermatology, Jinling Hospital, Nanjing University, Nanjing, 210002, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: QingTao Kong; Hong Sang, Jinling Hospital, Nanjing, Jiangsu, People’s Republic of China, Tel +86 025-80860092, Email kongqingtao2008@163.com; sanghong@nju.edu.cnBackground: The frequent coexistence of obesity and metabolic syndrome in patients with Androgenetic alopecia (AGA), may indicate a common pathogenetic pathway with adipokines being a possible implicating cytokine.Objective: This study was conducted to investigate the changes in serum levels of adipokines, insulin resistance, vitamin D status and their relationship with AGA, and the relationship between serum levels of adipokines and insulin resistance.Methods: 80 male patients with AGA were selected as the experimental group and 60 healthy males served as the control group. Both the AGA group and healthy control group were divided into 2 groups according to the presence or absence of insulin resistance (IR): the IR group and the NIR group. Serum levels of leptin, adiponectin, resistin, visfatin, insulin and 25(OH)D were evaluated in all subjects.Results: Compared with the control group, AGA patients showed higher serum levels of leptin and lower adiponectin/leptin (Adpn/Lep) ratio (P< 0.05), and both were positively correlated with the severity of the disease. Compared with the AGA NIR group, serum leptin levels were increased in the AGA IR group (P< 0.05). AGA IR group and AGA NIR group possessed lower Adpn/Lep ratio when compared with the healthy IR group and healthy NIR group respectively (P< 0.05). The multi-factor logistic regression analysis results showed decreased Adpn/Lep level and increased leptin level as risk factors for AGA. AGA Patients had lower vitamin D levels than healthy controls (P< 0.05).Conclusion: Patients with AGA show an imbalance between pro- and anti-inflammatory adipokines, and probably be involved in AGA pathogenesis. Insulin resistance may influence levels of adipokines, but the present findings cannot indicate insulin resistance plays a role in the onset of AGA. The insufficiency and deficiency of vitamin D are common health concern in our subjects and may be involved in the dysfunction of adipocytes and the development of AGA.Keywords: androgenetic alopecia, adipokines, leptin, vitamin D

Jing Zhao, Qianqian Kong, Minghuan Wang, Hao Huang, Xirui Zhou, Yinping Guo, Yi Zhang, Lingshan Wu, Zhiyuan Yu, Xiang Luo Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of ChinaCorrespondence: Xiang Luo, Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China, Tel +86 27-83663337, Email flydottjh@163.comPurpose: Excessive daytime sleepiness (EDS) and cerebral small vessel disease (CSVD) are common problems among older adults; however, their association is not clear. The present study aimed to investigate the frequency of EDS in CSVD patients and the relationship between EDS and neuroimaging markers of CSVD.Patients and Methods: We conducted a cross-sectional study among 1076 community-dwelling older adults aged 55– 85 years. EDS was measured using the Epworth Sleepiness Scale (ESS), and EDS was defined as an ESS score greater than 10. Binary logistic regression was performed to assess the association between EDS and neuroimaging markers of CSVD.Results: Of the 1076 participants (mean age: 65.58 ± 6.46 years, 60.5% female), the prevalence of EDS was 10.0%. EDS was more frequent in participants with CSVD than in the total sample (20.0% vs 10.0%, p < 0.001). In fully adjusted models, EDS was significantly correlated with CSVD burden (OR = 1.39, 95% CI 1.16 to 1.68, p < 0.001), the severity of white matter hyperintensities (WMH) (OR = 1.33, 95% CI 1.14 to 1.54, p < 0.001), and presence of lacunes (OR = 2.47, 95% CI 1.53 to 4.00, p < 0.001) but not with the presence of cerebral microbleeds (CMBs) (OR=1.54, 95% CI 0.92 to 2.56, p = 0.099) or severity of enlarged perivascular spaces (EPVS) in basal ganglia (OR = 1.16, 95% CI 0.70 to 1.92, p = 0.564).Conclusion: We found a high frequency of EDS symptoms in CSVD individuals. Further, EDS was significantly associated with WMH, lacunes, and CSVD burden. Our findings further suggest patients with CSVD may exhibit abnormal sleep-wake patterns.Keywords: cerebral small vessel disease, daytime sleepiness, sleep disorders, white matter hyperintensities, lacunes

Qingxin Fan,1,&ast; Hao Wu,1,2,&ast; Qingquan Kong1 1Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 2Department of Orthopedics, The Second Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qingquan Kong, Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China, Email kqqspine@126.comBackground: The frequent occurrence of failed back surgery syndrome (FBSS) seriously affects the quality of life of postoperative lumbar patients. Epidural adhesion is the major factor in FBSS.Purpose: A safe and effective antiadhesion material is urgently needed.Methods: A superhydrophilic PLGA-g-PVP/PC nanofiber membrane (NFm) was prepared by electrospinning. FTIR was performed to identify its successful synthesis. Scanning electron microscopy, thermogravimetric analysis, differential scanning calorimetry, and water contact angle measurement were performed. CCK-8 assays were performed in primary rabbit fibroblasts (PRFs) and RAW264.7 cells to explore the cytotoxicity of PLGA-g-PVP/PC NFm. Calcein-AM/PI staining was used to measure the adhesion status in PRFs. ELISA was performed to measure the concentrations of TNF-α and IL-10 in RAW264.7 cells. In addition, the anti-epidural adhesion efficacy of the PLGA-g-PVP/PC NFm was determined in a rabbit model of lumbar laminectomy.Results: The PLGA-g-PVP/PC NFm exhibited ultrastrong hydrophilicity and an appropriate degradation rate. Based on the results of the CCK-8 assays, PLGA-g-PVP/PC NFm had no cytotoxicity to PRFs and RAW264.7 cells. Calcein-AM/PI staining showed that PLGA-g-PVP/PC NFm could inhibit PRF adhesion. ELISAs showed that PLGA-g-PVP/PC NFm could attenuate lipopolysaccharide-induced macrophage activation. In vivo experiments further confirmed the favorable anti-epidural adhesion effect of PLGA-g-PVP/PC NFm and the lack of a strong inflammatory response.Conclusion: In this study, PLGA-g-PVP/PC NFm was developed successfully to provide a safe and effective physical barrier for preventing epidural adhesion. PLGA-g-PVP/PC NFm provides a promising strategy for preventing postoperative adhesion and has potential for clinical translation.Keywords: superhydrophilic membrane, irradiation graft, postoperative adhesion, failed back surgery syndrome, electrospinning

Zubai Cao,1 Chengcheng Yue,1 Qinxiang Kong,2 Yanyan Liu,1,3,4 Jiabin Li1,3,4 1Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China; 2Department of Infectious Diseases, The Chaohu Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China; 3Anhui Center for Surveillance of Bacterial Resistance, Anhui Medical University, Hefei, Anhui, People’s Republic of China; 4Institute of Bacterial Resistance, Anhui Medical University, Hefei, Anhui, People’s Republic of ChinaCorrespondence: Jiabin Li Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Jixi road 218, Hefei, Anhui, 230022, People’s Republic of China Tel +86-551-62922713 Fax +86-551-62922281 Email lijiabin@ahmu.edu.cnPurpose: This study aimed to describe trends in Klebsiella pneumoniae (KP) resistance in bloodstream infections (BSI) and to identify risk factors for a hospital-acquired carbapenem-resistant Klebsiella pneumoniae (CRKP) BSI and 28-day mortality from a hospital-acquired KP BSI.Patients and Methods: We recorded the results of antimicrobial susceptibility testing of 396 KP-positive blood cultures from January 2016 to December 2020. A total of 277 patients with a KP BSI were included in this study, of which 171 had a hospital-acquired infection and 84 had a hospital-acquired CRKP BSI. Multivariate logistic regression analysis was used to identify risk factors for a hospital-acquired CRKP BSI and 28-day mortality from a hospital-acquired KP BSI.Results: The proportion of hospital-acquired infections among KP BSI patients increased from 53.1% in 2016 to 72.8% in 2020. The detection rate of CRKP among KP BSI patients increased from 18.8% in 2016 to 37.7% in 2020. Multivariate logistic regression showed that β-lactam/β-lactamase inhibitor combinations (BLBLIs) exposure (P = 0.022, OR 2.863), carbapenems exposure (P = 0.007, OR 3.831) and solid organ transplantation (P < 0.001, OR 19.454) were independent risk factors for a hospital-acquired CRKP BSI. Risk factors for a 28-day mortality from hospital-acquired KP BSI were CRKP BSI (P =0.009, OR 5.562), septic shock (P =0.002, OR 4.862), mechanical ventilation> 96 hours (P =0.020, OR 8.765), and platelet counts < 100× 109/L (P =0.003, OR 4.464).Conclusion: The incidence of hospital-acquired KP BSI continues to rise and the proportion of CRKP BSI is also increasing. We believe that the use of the BLBLIs needs to be carefully evaluated in hospital-acquired infection. Hospital-acquired KP BSI Patients with CRKP BSI, septic shock, mechanical ventilation and deficiency of platelets are more likely to have a poor prognosis.Keywords: Klebsiella pneumoniae, bloodstream infection, carbapenem resistance, hospital-acquired infection, risk factors

Yudan Liang,1,2,&ast; Qinghuo Kong,1,&ast; Huiwen Luo,1 Jinhua Tan,1 Huizheng Zhu3 1Department of Acupuncture and Rehabilitation, The Affiliated Jiangmen Traditional Chinese Medicine Hospital of Jinan University, Jiangmen, Guangdong, People’s Republic of China; 2Integrated Chinese and Western Medicine Postdoctoral Research Station, Jinan University, Guangzhou, Guangdong, People’s Republic of China; 3Department of Traditional Chinese Medicine, The 2nd Clinical Medical College (Shenzhen People’s Hospital) of Jinan University, Shenzhen, Guangdong, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Huizheng ZhuDepartment of Traditional Chinese Medicine, The 2nd Clinical Medical College (Shenzhen People’s Hospital) of Jinan University, No. 1017, Dongmen North Road, Luohu District, Shenzhen, Guangdong, 518020, People’s Republic of ChinaEmail zhuhuizheng@jnu.edu.cnPurpose: Chronic spontaneous urticaria (CSU) pathogenesis involves mast cell degranulation induced by the inositol 1,4,5-trisphosphate/diacylglycerol (IP3/DAG) pathway, but the condition lacks specific biomarkers. This study was performed to investigate long non-coding RNA (lncRNA) expression profiles, identify those associated with IP3/DAG pathway, and assess their diagnostic and prognostic value for CSU.Methods: Ten samples were selected from CSU and control groups, and microarray was performed to screen differentially expressed (DE) lncRNAs and mRNAs. Bioinformatic and co-expression network analyses were used to identify lncRNAs associated with IP3/DAG pathway. Quantitative real-time polymerase chain reaction was used to validate lncRNA expression levels. Combined with disease characteristics and serum indices detected with enzyme-linked immunosorbent assays, Spearman analysis and logistic regression were applied to analyze lncRNA-associated disease risk. Receiver operating characteristic (ROC) curves and 2-year follow-up data were applied to evaluate lncRNA diagnostic and prognostic value.Results: A total of 678 up- and 573 downregulated DE lncRNAs and 609 up- and 176 downregulated DE mRNAs were identified. Seven lncRNAs (upregulated T264761, T280622, ENST00000587970, T224062, ENST00000562459, and his-1_RNA_dna; downregulated ENST00000417930) were associated with the IP3/DAG pathway. D-dimer and histamine levels were significantly different between the two groups. Correlation analysis showed that his-1_RNA_dna positively correlated with the frequency of symptom appearance, while his-1_RNA_dna, ENST00000417930, T264761, and T280622 negatively correlated with the maximum wheal diameter. Regression analysis showed T264761 was associated with CSU risk. ROC analysis showed that the specificity of T264761 was 90%, with an area under the curve of 0.666. In follow-up, the rate of well-controlled disease in the low T264761 expression group was 82.61%.Conclusion: This study established lncRNA and mRNA expression profiles in CSU and identified lncRNAs associated with IP3/DAG pathway, which is mechanistically involved in this disease. T264761 may be a novel biomarker for CSU, but further study is needed to confirm its specific mechanism.Keywords: lncRNA, biomarker, urticaria, mRNA, microarray

Hui Zhang,1 Yunzhu Zhu,1 Ning Yang,1 Qinxiang Kong,2 Yahong Zheng,1 Na Lv,1 Haoran Chen,1 Chengcheng Yue,1 Yanyan Liu,1,3,4 Jiabin Li,1– 4 Ying Ye1 1Department of Infectious Disease, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China; 2Department of Infectious Diseases, The Chaohu Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China; 3Anhui Center for Surveillance of Bacterial Resistance, Hefei, Anhui, People’s Republic of China; 4Institute of Bacterial Resistance, Anhui Medical University, Hefei, Anhui, People’s Republic of ChinaCorrespondence: Ying Ye; Jiabin LiDepartment of Infectious Disease, The First Affiliated Hospital of Anhui Medical University, Jixi Road no. 218, Hefei, Anhui, People’s Republic of ChinaTel +86-551-62922713Fax +86-551-62922281Email yeying2@139.com; lijiabin@ahmu.edu.cnPurpose: To study the in vitro and in vivo antibacterial activities of polymyxin B (PB) and other five antimicrobial agents, including imipenem (IMP), meropenem (MEM), tigecycline (TGC), sulbactam (SUL), and rifampicin (RIF), alone or in combination against carbapenem-resistant Acinetobacter baumannii (CRAB).Methods: Microbroth dilution method was used to determine the minimum inhibitory concentration (MIC) of ten strains of CRAB against six antibacterial drugs, and the checkerboard method was used to determine the fractional inhibitory concentration index (FICI). A mouse pneumonia model was established by intranasal instillation of Ab5075 to evaluate the antibacterial activity in vivo.Results: The resistance rate of ten CRAB strains to IMP, MEM, and SUL was 100%, that to PB and TGC was 0%, and that to RIF was 20%. When PB was used in combination with the other five antibiotics in vitro, it mainly showed synergistic and additive effects on CRAB. The synergistic effect of PB and RIF was maximal, followed by MEM and IMP but was weak with SUL and TGC. In vivo, compared to the model group (untreated with antibiotics), treatment group (six antibiotics alone and PB combined with the other five antibiotics) reduced the bacterial load in the lung tissue and the serum inflammatory factors (IL-1β, IL-6, and TNF-α). The bacterial load and the inflammatory factors of the combined group decreased significantly than that of the single group (P< 0.05). The IL-6 and TNF-α values of the PB combined with the RIF group were significantly lower than the two drugs used individually.Conclusion: The combination of PB and IMP, MEM, and RIF exerted robust in vitro synergistic effects on CRAB isolates. The combination of PB and the other five antimicrobial agents had a better effect in the mouse pneumonia model than single agent, while the combination of PB and RIF had the best effect.Keywords: Acinetobacter baumannii, carbapenem-resistant, pneumonia infection model, polymyxin B, combination treatment

Qingling Kong,1 Qing Fan,2 Xianbin Ma,3 Jian Li,4 Rong Ma5 1Office of Hospital Infection Control, People’s Hospital of Rizhao, Rizhao 276826, People’s Republic of China; 2Department of Hemodialysis, People’s Hospital of Rizhao, Rizhao 276826, People’s Republic of China; 3Department of Clinical Laboratory, People’s Hospital of Rizhao, Rizhao 276826, People’s Republic of China; 4Department of Interventional Radiology, People’s Hospital of Rizhao, Rizhao 276826, People’s Republic of China; 5Department of General Medicine, People’s Hospital of Rizhao, Rizhao 276826, People’s Republic of ChinaCorrespondence: Rong Ma Email rz3366978@163.comBackground: Hepatocellular carcinoma (HCC) is a common malignant tumor in the world. Circular RNA hsa_circ_0008274 (circUGGT2) is reported to be upregulated in HCC tissues. Notwithstanding, the role and regulatory mechanism of circUGGT2 in HCC are indistinct.Methods: Quantitative real-time polymerase chain reaction (qRT-PCR) was implemented to examine the levels of circUGGT2, microRNA (miR)-526b-5p, and ras-related protein Rab-1A (RAB1A) mRNA in HCC tissues and cells. Cell proliferation and colony formation were assessed with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide (MTT) or colony formation assays. The levels of cyclin D1, proliferating cell nuclear antigen (PCNA), and RAB1A were detected with Western blotting. Cell cycle progression, migration, and invasion were evaluated by using flow cytometry or transwell assays. The relationship between circUGGT2 or RAB1A and miR-526b-5p was verified via dual-luciferase reporter and/or RNA pull-down assays. Xenograft assay was executed to confirm the role of circUGGT2 in vivo.Results: We observed that circUGGT2 and RAB1A were upregulated while miR-526b-5p was downregulated in HCC tissues and cells. CircUGGT2 silencing suppressed tumor growth in vivo and curbed proliferation, colony formation, cell cycle progression, migration, and invasion of HCC cells in vitro. Mechanically, circUGGT2 regulated RAB1A expression via competitively binding to miR-526b-5p. Also, the inhibitory influence of circUGGT2 silencing on the malignancy of HCC cells was overturned by miR-526b-5p inhibitor. Furthermore, RAB1A overexpression reversed the suppressive influence of miR-526b-5p mimic on the malignancy of HCC cells.Conclusion: CircUGGT2 silencing inhibited HCC development via modulating the miR-526b-5p/RAB1A axis, providing a possible target for HCC treatment.Keywords: HCC, circUGGT2, miR-526b-5p, RAB1A

Qingfang Kong, Li Yan Department of Infection Prevention and Control, Zhongda Hospital Affiliated to Southeast University, Nanjing 210009, People’s Republic of ChinaCorrespondence: Qingfang KongZhongda Hospital Affiliated to Southeast University, No. 87 Dingjiaqiao, Nanjing, People’s Republic of ChinaEmail njkqf@163.comBackground: Coronavirus disease-2019 (COVID-19) is a new infectious disease. The COVID-19 outbreak has quickly spread globally and now is having remarkable effects on public health and national economies.Purpose: Effective measures for prevention and control of nosocomial infection are urgently needed to control COVID-19 infection among medical staff.Methods: Herein, we described COVID-19 prevention and control strategies that have been implemented in a tertiary hospital in the middle east of China. Hospital layout was adjusted to prevent and control transmission. Other procedures were then implemented to prevent the spread of the virus, including specialized training and evaluation of medical staff, pre-testing and triage, measures to promote early identification of patients, environmental cleaning and disinfection, new medical waste processing procedures, new patient management procedures, timely disinfection of potential sources of nosocomial infection, and strict protective measures.Results: Since the new measures were implemented, to date there have only been three new confirmed cases of COVID-19 infection, no cases of medical staff infection, and no COVID-19-related deaths at the hospital.Conclusion: The current report provides a protocol that could be implemented in medical departments in similar cities worldwide.Keywords: COVID-19, health-associated infection, infection management, SARS-CoV-2

Xuan Zhu,1– 3 Qingquan Kong,2 Xing Niu,4 Lijie Chen,4 Chunlin Ge1 1Department of General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, People’s Republic of China; 2Institute of Translational Medicine, China Medical University, Shenyang, Liaoning 110122, People’s Republic of China; 3Anshan Hospital, The First Affiliated Hospital of China Medical University, Anshan, Liaoning 114011, People’s Republic of China; 4Department of Second Clinical College, Shengjing Hospital Affiliated to China Medical University, Shenyang 110004, Liaoning, People’s Republic of ChinaCorrespondence: Chunlin Ge Email gechunlin126@126.comObjective: To comprehensively analyze the global scientific outputs of nanoparticles in pancreatic cancer research.Methods: Publications regarding the nanoparticles in pancreatic cancer research published from 1986 to 2019 were retrieved from the Web of Science Core Collection (WoSCC). Highly frequent keywords, publication years, journals, cited papers, cited journals and cited authors were identified using BICOMB software, and then a binary matrix and a co-word matrix were constructed. gCLUTO was used for double clustering of highly frequent journals. Co-citation analysis was performed using CiteSpace V software, including keywords, references, journals author or institution cooperation network.Results: A total of 1171 publications were included in this study. Publications mainly came from 10 countries, led by the US (n=470) and China (n=349). Among the top 20 journals ranked by the number of citations, nanoscience nanotechnology was the leader with 300. Cluster analysis of citation network identified 12 co-citation clusters, headed by “stromal barrier” and “emerging inorganic nanomaterial”.Conclusion: Our findings reveal the research performance and intellectual structure of the nanoparticles in pancreatic cancer research, which may help researchers understand the research trends and hotspots in this field.Keywords: Web of Science, CiteSpace, pancreatic cancer, nanoparticles, co-citation analysis, co-word analysis

Hui Zhang,1 Yayun Zhao,1 Yahong Zheng,1 Qinxiang Kong,1,2 Na Lv,1 Yanyan Liu,1,3,4 Dongmei Zhao,5 Jiabin Li,1– 4 Ying Ye1 1Department of Infectious Disease, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China; 2Department of Infectious Diseases, The Chaohu Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China; 3Anhui Center for Surveillance of Bacterial Resistance, Hefei, Anhui, People’s Republic of China; 4Institute of Bacterial Resistance, Anhui Medical University, Hefei, Anhui, People’s Republic of China; 5Department of Infectious Disease, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of ChinaCorrespondence: Ying Ye; Jiabin Li Tel +86-551-62922713Fax +86-551-62922281Email yeying2@139.com; lijiabin@ahmu.edu.cnPurpose: This study aimed to develop and validate a personalized prediction model of death risk in patients with Acinetobacter baumannii (A. baumannii) infection and thus guide clinical research and support clinical decision-making.Patients and Methods: The development group is comprised of 350 patients with A. baumannii infection admitted between January 2013 and December 2015 in The First Affiliated Hospital of Anhui Medical University. Further, 272 patients in the validation group were admitted between January 2016 and December 2018. The univariate and multivariate logistic regression analyses were used to determine the independent risk factors for death with A. baumannii infection. The nomogram prediction model was established based on the regression coefficients. The discrimination of the proposed prediction model was evaluated using the area under the curve (AUC) of the receiver operating characteristic (ROC) curves and decision curve analysis (DCA). The calibration diagram was used to evaluate the calibration degree of this model.Results: The infectious source, carbapenem-resistant A. baumannii (CRAB), hypoalbuminemia, Charlson comorbidity index (CCI), and mechanical ventilation (MV) were independent risk factors for death. The AUC of the ROC curve of the two groups was 0.768 and 0.792, respectively. The net income was higher when the probability was between 30% and 80%, showing a strong discrimination capacity of the proposed model. The calibration curve swung around the 45° oblique line, indicating a high degree of calibration.Conclusion: The proposed model helped predict the risk of death from A. baumannii infection, improve the early identification of patients with a higher risk of death, and guide clinical treatment.Keywords: Acinetobacter baumannii, carbapenem resistance, prediction model, risk factors

Shao-Hong Huang,1,* Qing-Lei Kong,2,* Xue-Xia Chen,3 Jin-Yuan He,1 Jie Qin,4 Zhuang-Gui Chen5,6 1Department of Cardiothoracic Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; 2Department of Emergency, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; 3Department of Nursing, Eastern Hospital of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; 4Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; 5Department of Pediatrics, Pediatric Intensive Care Unit, The Third Affiliated Hospital of Sun Yat-sen University, 6Institution of Respiratory Disease of Sun Yat-sen University, Guangzhou, China *These authors contributed equally to this work Background and purpose: Several case reports and studies have suggested that there is an increased survival rate for patients who undergo resection of solitary adrenal metastasis from non-small cell lung cancer (NSCLC). This study aimed to investigate whether NSCLC patients with solitary adrenal metastasis could gain a higher survival rate after adrenalectomy (ADX) when compared with those patients undergoing nonsurgical treatment, and to investigate the potential prognostic factors.Patients and methods: A total of 1,302 NSCLC inpatients’ data from 2001 to 2015 were retrospectively reviewed to identify those with solitary adrenal metastasis. Overall survival for those who underwent both primary resection and ADX was compared to those patients with conservative treatment using the log-rank test. Potential prognostic variables were evaluated with univariate and multivariate analyses including clinical, therapeutic, pathologic, primary and metastatic data.Results: A total of 22 NSCLC patients with solitary adrenal metastasis were identified, with an overall median survival of 11 months (95% confidence interval: 9.4–12.6 months) and a 1-year survival rate of 51.4% (95% confidence interval: 29.6%–73.2%). All of the patients had died by 30 months. There was no significant survival difference between patients who underwent primary and metastasis resection (n=10) and those treated conservatively (n=12), (P=0.209). Univariate analysis identified Eastern Cooperative Oncology Group performance status (ECOG PS) as the significant predictor of survival (P=0.024). Age (

Keping Cheng, Jiawei Li, Qingfang Kong, Changxian Wang, Nanyuan Ye, Guohua Xia Department of Infection Control, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu Province, People’s Republic of China Background: The purpose of this study was to identify risk factors for surgical site infection (SSI) in a teaching hospital.Methods: A prospective study was initiated to investigate risk factors for SSI at a university-affiliated tertiary care center from July 2013 to December 2014. The chi-square test for categorical variables was used to determine the significance of association, whereas the multivariate logistic regression model was used to examine independent risk factors for SSI.Results: A total of 1,138 patients met the inclusion criteria, in whom 36 cases of infection occurred during the hospitalization period and two cases occurred after discharge. Univariate analysis showed that SSI was associated with the type of operation, wound classification, volume of blood loss, blood transfusion, American Society of Anesthesiology score before surgery, risk index, duration of surgery, diabetes, cancer, gastrointestinal catheter, urinary catheter, postoperative drainage, and preprocedural white blood cell count. Multivariate analysis identified six independent parameters correlating with the occurrence of SSI: diabetes (odds ratio [OR] 6.400; 95% confidence interval [CI] 2.582–15.866; P=0.000); cancer (OR 2.427; 95% CI 1.028–5.732; P=0.043); preprocedural white blood cell count more than 10×109/L (OR 6.988; CI 3.165–15.425; P=0.000); wound classification (clean contaminated [OR: 7.893; CI: 2.244–27.762; P=0.001]; contaminated [OR: 7.031; CI: 1.652–29.922; P=0.008]; dirty [OR: 48.778; CI: 5.418–439.164; P=0.001]); operative duration more than 120 minutes (OR 4.289; CI 1.773–10.378; P=0.001); and postoperative drainage (OR 3.957; CI 1.422–11.008; P=0.008).Conclusion: Our data suggest that all these risk factors could be regarded as potential indicators of SSI and that relevant preventive measures should be taken to reduce SSI and improve patient outcomes. Keywords: wound classification, surgical site infection, nosocomial infection, risk factors

A remarkable ion energy increase is demonstrated for post acceleration by a laser-plasma booster. An intense short-pulse laser generates a strong current by high-energy electrons accelerated, when this intense short-pulse laser illuminates a plasma target. The strong electric current creates a strong magnetic field along the high-energy electron current in plasma. During the increase phase in the magnetic field, a longitudinal inductive electric field is induced for the forward ion acceleration by the Faraday law. Our 2.5-dimensional particle-in-cell simulations demonstrate a remarkable increase in ion energy by several tens of MeV.

A remarkable improvement is presented on the energy conversion efficiency from laser to protons in a laser-foil interaction by particle simulations. The total laser-proton energy conversion efficiency from laser to protons becomes 16.7%, though a conventional plane foil target serves a rather low efficiency. In our 2.5-dimensional particle-in-cell simulations the Al multihole structure is also employed, and the laser absorption ratio reaches 71.2%. The main physical reason for the enhancement of the conversion efficiency is a reduction of the laser reflection at the target surface area;

A platinum-based nanoframe is a hollow frame with superior catalytic behavior, and a metal-organic framework (MOF) is another porous frame with multifunctionalities. Here, we present the combination of these two components into an individually encapsulated frame-in-frame structure. Via the surface functionalization with hexadecyltrimethylammonium bromide (CTAB) as the bridging layer, the Pt-Ni nanoframe is encased in a special MOF, zeolitic imidazolate framework-8 (ZIF-8), to achieve a single core-shell structure, as evidenced by the three-dimensional tomography. The growth trajectory of such frame-in-frame nanocomposite is also tracked, revealing that ZIF-8 first nucleates in the solution, then attaches to the surface of the nanoframe, and finally grows to capture the entire nanoframe, accomplishing the one-in-one encapsulation. Following the same concept, by utilizing ZIF-67 as the sacrificial layer, the Pt-Ni nanoframe is further solely embedded in ZIF-8 to form the single yolk-shell structure, which has a cavity between the core and the shell. This work provides a new method to build frame-in-frame structures, consisting of different frameworks, and to explore their synergistic properties.

Bioelectrochemical CO2-reducing rate at high potential was limited by poor bacteria-nanowire interface resulting from an inhospitable alkaline local environment. Tuning the bulk electrolyte pH and increasing its buffering capacity mitigated this issue and supported the formation of a close-packed nanowire-bacteria cathode. The resulting close-packed biohybrid operated with a CO2-reducing current density of 0.65 ± 0.11 mA cm−2 at ∼−1.2 V versus standard hydrogen electrode and enabled solar-powered CO2 fixation with solar-to-acetate efficiency of ∼3.6% over 1 week.

There are well-known inequalities among the eigenvalues of Sturm–Liouville problems with periodic, semi-periodic, Dirichlet and Neumann boundary conditions. In this paper, for an arbitrary coupled self-adjoint boundary condition, we identify two separated boundary conditions corresponding to the Dirichlet and Neumann conditions in the classical case, and establish analogous inequalities. It is also well-known that the lowest periodic eigenvalue is simple; here we prove a similar result for the general case. Moreover, we show that the algebraic and geometric multiplicities of the eigenvalues of self-adjoint regular Sturm–Liouville problems with coupled boundary conditions are the same. An important step in our approach is to obtain a representation of the fundamental solutions for sufficiently negative values of the spectral parameter. Our approach yields the existence and boundedness from below of the eigenvalues of arbitrary self-adjoint regular Sturm–Liouville problems without using operator theory.

Halide perovskites are of great interest because of their large potential for a broad range of applications, such as photovoltaics, light-emitting diodes, and photodetectors. However, currently the state-of-the-art highly emissive halide perovskite materials contain toxic lead ions, and the synthesis of color-stable efficient blue-emissive perovskite analogs remains challenging. The discovery of lead-free, non-toxic halide materials with efficient blue light emission is promising for practical light-emitting applications. Here, we have discovered a series of highly blue-emissive all-inorganic Cu(I)-containing rare-earth halide compounds in the solid state at room temperature. The Cu(I) ions in the compounds show a 3-coordination geometry with the halide ions and connect Sc-Cl octahedra to form clusters in alternating layers, which play a crucial role in the regulation of the electronic structure and emission properties of this series of rare-earth halide cluster compounds.

This study focuses on the psychological characteristics and empirically tests of the factors influencing distracted driving behaviours. This information is used as a reference for an intervention on dangerous driving behaviours. First, a distracted driving scale is constructed based on the theory of planned behaviour (TPB). The questionnaires are distributed in Chongqing, China, and 321 completed questionnaires are obtained. Data are analyzed using mean-variance analysis, one-way ANOVA, T-test, and multivariate test by SPSS 26.0 to determine the significance of distracted behaviours and demographic variables. We use a structural equation model to determine the path coefficients of each latent variable. Finally, we select the drivers with high tendency of distraction from the results of the questionnaires, conduct a four-stage rational emotional behaviour therapy (REBT) experiment, and use a repeated measures ANOVA analysis to test the validity and persistence of the intervention method. Results show that subjective norm is the most influential psychological factor. There are significant differences between the experimental group (2.38, SD=0.41) and the control group (2.89, SD=0.40) in the scores of distractions. This indicates that the distracted behaviour intervention achieves adequate validity and consistency. Educational research on distracted driving behaviour can help identify and correct drivers with high distraction tendency., Author(s): L. Zhang [1]; J. S. Peng (corresponding author) [1]; Z. Song [1]; Z. B. Fan [1]; X. H. Yang [1]; Q. W. Kong [1]; L. Zhou [1] 1. Introduction [...]

Cesium lead iodide (CsPbI3), in its black perovskite phase, has a suitable bandgap and high quantum efficiency for photovoltaic applications. However, CsPbI3 tends to crystalize into a yellow non-perovskite phase, which has poor optoelectronic properties, at room temperature. Therefore, controlling the phase transition in CsPbI3 is critical for practical application of this material. Here we report a systematic study of the phase transition of one-dimensional CsPbI3 nanowires and their corresponding structural, optical, and electrical properties. We show the formation of perovskite black phase CsPbI3 nanowires from the non-perovskite yellow phase through rapid thermal quenching. Post-transformed black phase CsPbI3 nanowires exhibit increased photoluminescence emission intensity with a shrinking of the bandgap from 2.78 to 1.76 eV. The perovskite nanowires were photoconductive and showed a fast photoresponse and excellent stability at room temperature. These promising optical and electrical properties make the perovskite CsPbI3 nanowires attractive for a variety of nanoscale optoelectronic devices. [Figure not available: see fulltext.]

A novel plasma mirror is proposed for realizing all-optical Compton scattering, and its performance is compared with that of planar and concave plasma mirrors. Compared to a planar mirror, a concave mirror augments the radiation energy, but it decreases the collimation of the emitted photon beam. With the aid of the increased pulse length of the reflected laser, our proposed plasma mirror boosts the radiation energy and simultaneously improving the collimation of the emitted radiation. The pulse length and radius of the reflected laser can be controlled by adjusting the parameters of the proposed plasma mirror. The dependences of the pulse length and radius on the mirror parameters have been demonstrated. The impact of non-ideal conditions encountered in real experiments on the proposed mechanism has been discussed, which precisely demonstrates the robustness of the proposed mechanism. Additionally, the required gas density for a wakefield accelerator is derived to achieve optimal scattering under the given plasma mirror configurations. [ABSTRACT FROM AUTHOR]