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Yu Zhang,1 Hong-Hai Li,1 Min-Feng Ye,1 Wei-Wei Li,2 Chu Zhang,3 Hai-Feng Wang1 1Department of Gastrointestinal Surgery, Shaoxing People’s Hospital, Shaoxing, Zhejiang Province, 312000, People’s Republic of China; 2Department of Gastroenterology, Shaoxing People’s Hospital, Shaoxing, Zhejiang Province, 312000, People’s Republic of China; 3Department of Thoracic Surgery, Shaoxing People’s Hospital, Shaoxing, Zhejiang Province, 312000, People’s Republic of ChinaCorrespondence: Hai-Feng Wang, Department of Gastrointestinal Surgery, Shaoxing People’s Hospital, No. 568 Zhongxing North Road, Shaoxing, Zhejiang Province, 312000, People’s Republic of China, Email drwanghaifeng01@163.comBackground: Foreign body-induced cancer is a traditional way of understanding cancer development. The induction of cancers by exogenous foreign bodies has been identified in many organs. However, small bowel adenocarcinoma induced by foreign bodies has not been reported in the literature, although the incidence of small bowel adenocarcinoma is increasing globally.Case Presentation: A 70-year-old man was hospitalized for persistent right-sided abdominal pain for 3 months. Abdominal computed tomography revealed localized thickening and clustering of the small bowel wall in the right abdominal cavity. A comminuted fracture of the right 11th rib protruding into the abdominal cavity was observed, with a bone fragment located within the intestinal mass. Exploratory laparotomy was performed, and extensive adhesions were noted among the greater omentum, small bowel, mesentery, and right abdominal wall. Radical resection and lymph node dissection of the affected small bowel and appendix were performed. We also excised the rib end and repaired the abdominal wall to prevent further irritation. The patient was discharged 12 days post-surgery and follow-up assessments revealed no reported discomfort.Conclusion: We first report a case of small bowel adenocarcinoma induced by self-bone tissue, along with successful radical tumor excision and thorough foreign body removal. This case highlights the significant role of chronic inflammation in carcinogenesis.Keywords: foreign body, small bowel adenocarcinoma, chronic inflammation, rib fracture, case report

Heng-Hui Li,1,* Yan-Ni Su,2,* Xin Huang3 1Department of Ophthalmology, Gaoxin Branch of the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China; 2The First Clinical Medical College, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China; 3Department of Ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, 330006, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xin Huang, Department of Ophthalmology, Jiangxi Provincial People’s Hospital, No. 152, Ai Guo Road, Dong Hu District, Nanchang, 330006, Jiangxi, People’s Republic of China, Tel +86 15879215294, Email 334966891@qq.comBackground: Diabetic retinopathy (DR) is a prevalent ocular manifestation of diabetic microvascular complications and a primary driver of irreversible blindness. Existing studies have illuminated the presence of aberrant brain activity in individuals affected by DR. However, the alterations in the modular segregation of brain networks among DR patients remain inadequately understood. The study aims to explore the modular segregation of brain networks in patients with DR.Methods: We examined the blood oxygen levels dependent (BOLD) signals using resting-state functional magnetic resonance imaging (R-fMRI) in a cohort of 46 DRpatients and 43 age-matched healthy controls (HC). Subsequently, Modular analysis utilizing graph theory method was applied to quantify the degree of brain network segregation by computing the participation coefficient (PC). Deviations from typical PC values were further elucidated through intra- and inter-module connectivity analyses.Results: The DR group demonstrated significantly lower mean PC in the frontoparietal network (FPN), sensorimotor network (SMN), and visual network (VN) compared to the HCgroup. Moreover, increased inter-module connections were observed between the default-mode network (DMN) and SMN, as well as between FPN and VN within the DR group. In terms of nodal analysis, higher PC values were detected in the left thalamus, right frontal lobe, and right precentral gyrus in the DR group compared to the HC group.Conclusion: Patients with DR show impairments in primary sensory networks and higher cognitive networks within their functional brain networks. These changes may provide essential insights into the neurobiological mechanisms of DR by identifying alterations in the brain networks of DR patients and pinpointing sensitive neurobiological markers that could serve as vital imaging references for future treatments of diabetic retinopathy.Keywords: diabetic retinopathy, brain functional networks, functional connectivity, fMRI

Jing-Jing Huang,1,&ast; Lin Jia,2,3,&ast; Qiao-Jun Zhang,4 Hao-Hong Li,5 Da-Li Zheng,2 Ming Zheng3 1Second Department of Dental Implant, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, People’s Republic of China; 2Fujian Key Laboratory of Oral Diseases, Fujian Biological Materials Engineering and Technology Center of Stomatology, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, 350004, People’s Republic of China; 3Department of Prosthodontics, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, People’s Republic of China; 4Zhongshan Hospital Affiliated to Xiamen University, Xiamen, 361000, People’s Republic of China; 5College of Chemistry, Fuzhou University, Fuzhou, Fujian, 350116, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ming Zheng, Department of Prosthodontics, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Middle Road, Fuzhou, 350001, People’s Republic of China, Tel +86-591-83736431, Email zmdentist@163.com Da-Li Zheng, Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 88 Jiaotong Road, Fuzhou, 350004, People’s Republic of China, Tel +86-591-83720599, Email dalizheng@fjmu.edu.cnPurpose: To investigate the inhibition of Streptococcus mutans (S.mutans) and its biofilm by AgBr-nanoparticles (NP) @CTMAB (cetyltrimethyl-ammonium bromide) and evaluate the changes in Polymethyl methacrylate (PMMA)’s surface roughness (Ra), microhardness, and flexural strength during prolonged immersion in AgBr-NP@CTMAB for application in the denture cleaning industry.Patients and Methods: The antibacterial activity of AgBr-NP@CTMAB against S.mutans was measured colony formation assay, OD600 and laser confocal microscopy. Changes in the specimens’ values for surface roughness, microhardness, and flexural strength (MPa) were measured after immersion solutions for 180 or 360 days.Results: The AgBr-NP@CTMAB solution exhibited a robust antibacterial effect on planktonic S. mutans, with a minimum bactericidal concentration of 5 μg/mL. The 10 μg/mL AgBr-NP@CTMAB solution efficiently inhibited S. mutans biofilm formation. (2) No significant difference in surface roughness after immersion in AgBr-NP@CTMAB (10 μg/mL and 20 μg/mL) comparing with distilled water (P > 0.05) and Polident had significantly higher than distilled water (P < 0.05). There was a significant decrease in the surface hardness of the PMMA specimens that were immersed in the Polident compared with those in distilled water (P < 0.05). While, no significant differences in surface hardness after immersion in the AgBr-NP@CTMAB (P > 0.05). The result of flexural strength suggested that there was no statistically significant difference (P < 0.05) between AgBr-NP@CTMAB as well as Polident and water.Conclusion: AgBrNP@CTMAB can efficiently inhibit the growth of plankton S.mutans and biofilm formation, without affecting the flexural strength, microhardness, or surface roughness of PMMA. Therefore, AgBrNP@CTMAB holds promise as a new denture cleaning agent.Keywords: AgBr-NP@CTMAB, S.mutans, polymethyl methacrylate, denture cleanser, biofilm

Hsin-Hua Li,1,&ast; Hanoch Livneh,2,&ast; Hua-Lung Huang,3 Yu-Han Wang,4,&ast; Ming-Chi Lu,5,6 Wei-Jen Chen,1,4,7,8 Tzung-Yi Tsai9– 11 1Department of Chinese Medicine, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Chiayi, 62247, Taiwan; 2Rehabilitation Counseling Program, Portland State University, Portland, OR, 97207-0751, USA; 3Department of Rehabilitation, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan; 4Center of Sports Medicine, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Chiayi, 62247, Taiwan; 5Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Chiayi, 62247, Taiwan; 6School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan; 7School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, 97004, Taiwan; 8Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, 33301, Taiwan; 9Department of Medical Research, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Chiayi, 62247, Taiwan; 10Department of Nursing, Tzu Chi University of Science and Technology, Hualien, 97004, Taiwan; 11Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, 70428, Taiwan&ast;These authors contributed equally to this workCorrespondence: Wei-Jen Chen; Tzung-Yi Tsai, Tel +886-5-2648000-5003 ; +886-5-2648000-3209, Fax +886-5-2648006, Email tough2915@hotmail.com; dm732024@tzuchi.com.twObjective: Sarcopenia is a frequently observed comorbidity of rheumatoid arthritis (RA) due to the chronic activation of the innate immune system. Accumulating evidence has indicated that Chinese herbal medicine (CHM) safely suppresses proinflammatory pathways and controls inflammation-associated disease, but its effect in reducing the risk of developing sarcopenia among RA subjects has not been established. We conducted a population-level cohort study to compare the sarcopenia risk in patients with RA who use or do not use CHM.Methods: Using claims from a nationwide insurance database, we recruited patients with newly diagnosed RA and without sarcopenia between 2002 and 2010. Propensity score matching was applied to randomly select sets of CHM users and non-CHM users to compare the sarcopenia risk until the end of 2013. The risk of new-onset sarcopenia was assessed using the Cox proportional hazards model.Results: As compared to non-CHM users, those receiving CHM treatment had a lower incidence of sarcopenia (7.69 vs 9.83 per 1000 person-years). CHM was correlated with a decreased chance of sarcopenia after controlling for potential covariates. Notably, use of CHM for more than two years may diminish the risk of getting sarcopenia by about 47% when taken as prescribed. Prescriptions of several herbal formulae may benefit the reduction of sarcopenia risk, such as Yan-Hu-Suo, Bei-Mu, Da-Huang, Huang Qin, Ping-Wei-San (PWS), Shu-Jing-Huo-Xue-Tang (SJHXT) and Chuan-Xiong-Cha-Tiao-San (CXCTS).Conclusion: This study produced new evidence as it is the first to show that the longer duration of CHM use was correlated to reduced risk of sarcopenia in a dose-dependent manner, implying that CHM treatment could be embraced as a routine care strategy for preventing sarcopenia.Keywords: sarcopenia, rheumatoid arthritis, Chinese herbal medicine, cohort study

Wei-Jen Chen,1– 4,&ast; Hanoch Livneh,5 Hsin-Hua Li,1 Yu-Han Wang,4,&ast; Ming-Chi Lu,6,7 Tzung-Yi Tsai,8– 10 Kuei-Yu Chien2 1Department of Chinese Medicine, Dalin Tzu chi Hospital, The Buddhist Tzu chi Medical Foundation, Chiayi, 62247, Taiwan; 2Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, 33301, Taiwan; 3School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, 97004, Taiwan; 4Center of Sports Medicine, Dalin Tzu chi Hospital, The Buddhist Tzu chi Medical Foundation, Chiayi, 62247, Taiwan; 5Rehabilitation Counseling Program, Portland State University, Portland, OR, 97207-0751, USA; 6Division of Allergy, Immunology and Rheumatology, Dalin Tzu chi Hospital, The Buddhist Tzu chi Medical Foundation, Chiayi, 62247, Taiwan; 7School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan; 8Department of Medical Research, Dalin Tzu chi Hospital, The Buddhist Tzu chi Medical Foundation, Chiayi, 62247, Taiwan; 9Department of Nursing, Tzu Chi University of Science and Technology, Hualien, 97004, Taiwan; 10Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, 70428, Taiwan&ast;These authors contributed equally to this workCorrespondence: Kuei-Yu Chien; Tzung-Yi Tsai, Tel +886-3-3283201-2421 ; +886-5-2648000-3209, Fax +886-3-3280592 ; +886-5-2648006, Email chienkueiyu@gmail.com; dm732024@tzuchi.com.twIntroduction: With population aging, sarcopenia and its accompanying risk of osteoporotic fracture has drawn increased attention. Nowadays, while Chinese herbal medicine (CHM) is often used as complementary therapy for many medical conditions, its effect against likelihood of osteoporotic fracture among sarcopenia subjects was not fully elucidated yet. We therefore conducted a population-level study to compare osteoporotic fracture risk for sarcopenia persons with or without CHM use.Methods: Using the patient record from a nationwide insurance database, we recruited persons with newly diagnosed sarcopenia and simultaneously free of osteoporotic fracture between 2000 and 2010. Propensity score matching was then applied to randomly select sets of CHM users and non-CHM users. All of them were tracked until end of 2013 to measure the incidence and adjusted hazard ratios (HRs) for new new-onset fracture in multivariable Cox proportional hazards model.Results: Compared to non-CHM users, the CHM users indeed had a lower incidence of osteoporotic fracture (121.22 vs 156.61 per 1000 person-years). Use of CHM correlated significantly with a lower fracture likelihood after adjusting for potential covariates, and those receiving CHM treatment for more than two years experienced a remarkably lower risk by 73%. Uses of several herbal formulae were correlated to reduced risk of osteoporotic fracture, such as Caulis Spatholobi, Xuduan, Duzhong, Danshen, Shu-Jing-Huo-Xue-Tang, Du-Huo-Ji-Sheng-Tang, Shao-Yao-Gan-Cao-Tang, and Shen-Tong-Zhu-Yu -Tang.Conclusion: Our study depicted that cumulative CHM exposure was inversely associated with osteoporotic fracture risk in a duration-dependent manner, implying that CHM treatment may be embraced as routine care in preventing incident osteoporotic fracture.Keywords: sarcopenia, osteoporotic fracture, risk, Chinese herbal medicines, cohort study

Hai-Liang Yuan,1 Xian Zhang,2 Dong-Zhu Peng,1 Guan-Bin Lin,1 Hui-Hui Li,1 Fang-Xian Li,1 Jing-Jing Lu,1 Wei-Wei Chu1 1Department of Gastroenterology, Beilun Branch of the First Affiliated Hospital of Zhejiang University, Ningbo, Zhejiang, People’s Republic of China; 2Department of Endocrinology, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of ChinaCorrespondence: Wei-Wei Chu, Department of Gastroenterology, Beilun Branch of the First Affiliated Hospital of Zhejiang University, No. 1288, Lushan East Road, Beilun District, Ningbo, Zhejiang Province, People’s Republic of China, Tel +86-134 56123811, Fax +86- 574 86100266, Email chuweiwei920@163.comPurpose: Constipation is a common complication of diabetic patients, which has a negative impact on their own health. This study aims to establish and internally validate the risk nomogram of constipation in patients with type 2 diabetes mellitus (T2DM) and to test its predictive ability.Patients and Methods: This retrospective study included 746 patients with T2DM at two medical centers. Among the 746 patients with T2DM, 382 and 163 patients in the Beilun branch of the First Affiliated Hospital of Zhejiang University were enrolled in the training cohort and the validation cohort, respectively. A total of 201 patients in the First Affiliated Hospital of Nanchang University were enrolled in external validation cohorts. The nomogram was established by optimizing the predictive factors through univariate and multivariable logistic regression analysis. The prediction performance of the nomogram was measured by the area under the receiver operating characteristic curve (AUROC), the calibration curve, and the decision curve analysis (DCA). Furthermore, its applicability was internally and independently validated.Results: Among the 16 clinicopathological features, five variables were selected to develop the prediction nomogram, including age, glycated hemoglobin (HbA1c), calcium, anxiety, and regular exercise. The nomogram revealed good discrimination with an area under the receiver operating characteristic curve (AUROC) of 0.908 (95% CI = 0.865– 0.950) in the training cohort, and 0.867 (95% CI = 0.790– 0.944) and 0.816 (95% CI = 0.751– 0.881) in the internal and external validation cohorts, respectively. The calibration curve presented a good agreement between the prediction by the nomogram and the actual observation. The DCA revealed that the nomogram had a high clinical application value.Conclusion: In this study, the nomogram for pretreatment risk management of constipation in patients with T2DM was developed which could help in making timely personalized clinical decisions for different risk populations.Keywords: constipation, type 2 diabetes mellitus, model, nomogram, prediction

Liang-Wen Shi,1,&ast; Quan-Quan Zhuang,2,&ast; Tai-Qin Wang,1 Xian-Dong Jiang,3 Yue Liu,4 Jing-Wen Deng,1 Huan-Huan Sun,5 Yi Li,4 Hao-Hong Li,4 Ting-Bo Liu,6 Jian-Zhi Liu1 1Department of Otorhinolaryngology, Fujian Medical University Union Hospital, Fuzhou, Fujian, People’s Republic of China; 2Department of Pharmacy, Affiliated Quanzhou First Hospital of Fujian Medical University, Quanzhou, Fujian, People’s Republic of China; 3Department of laboratory medicine, the School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China; 4College of Chemistry, Fuzhou University, Fuzhou, Fujian, People’s Republic of China; 5Department of Otolaryngology, Changji Region Hospital of Traditional Chinese Medicine, Changji, Xinjiang, People’s Republic of China; 6Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, Fujian, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jian-Zhi Liu, Department of Otorhinolaryngology, Fujian Medical University Union Hospital, Fuzhou, Fujian, People’s Republic of China, Tel/Fax +86-591 83346181, Email liujianzhient@163.com Ting-Bo Liu, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, Fujian, People’s Republic of China, Tel/Fax +86-591 83357896, Email liutingboblood@163.comBackground: Drug-resistant microbes pose a global health concern, requiring the urgent development of effective antibacterial agents and strategies in clinical practice. Therefore, there is an urgent need to explore novel antibacterial materials to effectively eliminate bacteria. The synthesis of quaternary phosphonium salt in haloargentate systems, wherein the phosphorus atom is represented in a cationic form, is a possible strategy for the development of antibacterial materials.Methods: Using (triphenyl)phosphonium-based quaternary phosphorus salts with different spacer lengths (n=2, 4, 6) as a template, we designed three kinds of quaternary phosphorus salts as effective antibacterial agents against drug-resistant bacteria.Results: The synthesized quaternary phosphorus salt of (1,4-DBTPP)Br2 effectively prevented the formation of the bacterial biofilms, and degraded bacterial membranes and cell walls by promoting the production of reactive oxygen species, which exhibited effective therapeutic effects in a rat model of a superficial wound infected with methicillin-resistant Staphylococcus aureus.Conclusion: The quaternary phosphorus salt (1,4-DBTPP)Br2 demonstrated hemocompatibility and low toxicity, revealing its potential in the treatment of clinical infections.Graphical Abstract: Keywords: quaternary phosphorus salts, reactive oxygen species, antibacterial, biocompatible, wound infection therapy

BackgroundLanadelumab demonstrated efficacy in preventing hereditary angioedema (HAE) attacks in the phase 3 HELP Study.ObjectiveTo assess time to onset of effect and long-term efficacy of lanadelumab, based on exploratory findings from the HELP Study.MethodsEligible patients with HAE type I/II received lanadelumab 150 mg every 4 weeks (q4wks), 300 mg q4wks, 300 mg q2wks, or placebo. Ad hoc analyses evaluated day 0-69 findings using a Poisson regression model accounting for overdispersion. Least-squares mean monthly HAE attack rate for lanadelumab was compared with placebo. Intrapatient comparisons for days 0-69 versus steady state (days 70-182) used a paired t test for continuous endpoints or Kappa statistics for categorical endpoints.ResultsOne hundred twenty-five patients were randomized and treated. During days 0-69, mean monthly attack rate was significantly lower with lanadelumab (0.41-0.76) vs placebo (2.04), including attacks requiring acute treatment (0.33-0.61 vs 1.66) and moderate/severe attacks (0.31-0.48 vs 1.33, all P ≤ .001). More patients receiving lanadelumab vs placebo were attack free (37.9%-48.1% vs 7.3%) and responders (85.7%-100% vs 26.8%). During steady state, the efficacy of lanadelumab vs placebo was similar or improved vs days 0-69. Intrapatient differences were significant with lanadelumab 300 mg q4wks for select outcomes. Lanadelumab efficacy was durable-HAE attack rate was consistently lower vs placebo, from the first 2 weeks of treatment through study end. Treatment emergent adverse events were comparable during days 0-69 and 70-182.ConclusionProtection with lanadelumab started from the first dose and continued throughout the entire study period.

Qiao-Jun Zhang,1,2,* Yue Liu,3,* Wen-Ting Zhang,3 Jing-Jing Huang,2 Hao-Hong Li,3 You-Guang Lu,1 Ming Zheng,2 Da-Li Zheng1 1Fujian Key Laboratory of Oral Diseases, Fujian Biological Materials Engineering and Technology Center of Stomatology, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, 350004, People’s Republic of China; 2Department of Prosthodontics, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, People’s Republic of China; 3College of Chemistry, Fuzhou University, Fuzhou, Fujian, 350116, People’s Republic of China*These authors contributed equally to this workCorrespondence: Da-Li ZhengFujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 88 Jiaotong Road, Fuzhou, 350004, People’s Republic of ChinaTel +86-591-83720599Email dalizheng@fjmu.edu.cnMing ZhengDepartment of Prosthodontics, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Middle Road, Fuzhou, 350001, People’s Republic of ChinaTel +86-591-83736431Email zmdentist@163.comObjective: To synthesize and determine the antifungal activity of AgBr-nanoparticles (NP) @CTMAB (cetyltrimethyl-ammonium bromide) against Candida albicans (C. albicans) for use in the field of denture cleaning.Methods: The morphology and structure of AgBr-NP@CTMAB were characterized by IR, UV-Vis, XRD and SEM. The antifungal potential of AgBr-NP@CTMAB against C. albicans was determined by colony formation assay and growth curve analysis. PMMA containing AgBr-NP@CTMAB was prepared, and the long-term antifungal efficacy was analyzed. The effect against C. albicans biofilm was analyzed by SEM and OD600 , and the color changes of the specimens were observed by stereomicroscopy after 1 week of incubation. Cytotoxicity to human oral gingival fibroblasts and oral mucosal epithelial cells was detected by Cell Counting Kit-8 (CCK-8) in vitro.Results: The compound showed a good crystalline phase, the presence of AgBr nanoparticles and the hybridization of CTMAB+ with AgBr-NPs. AgBr-NP@CTMAB showed significant antifungal activity against C. albicans at concentrations of 10 μg/mL and 20 μg/mL. PMMA specimens containing AgBr-NP@CTMAB showed no long-term antifungal effect against C. albicans biofilm. The clearance rate of C. albicans attached to PMMA was 44.73% after soaking in 10 μg/mL AgBr-NP@CTMAB solution for 30 min and 91.35% for 8 h. There was no significant residual cytotoxicity or visual color change after soaking.Significance: AgBr-NP@CTMAB showed promising potential treatment for denture cleaners.Keywords: C. albicans, AgBr-NP@CTMAB, polymethyl methacrylate, cytotoxicity, biofilm

Jing-Bo Liu,1 Qiao-Jun Zhang,2 Jian-Zhi Liu,1 Wen-Ting Zhang,3 Yi Li,3 Hao-Hong Li,3 Zhi-Rong Chen,3 Da-Li Zheng2 1Department of Otorhinolaryngology, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, People’s Republic of China; 2Fujian Key Laboratory of Oral Diseases, Fujian Biological Materials Engineering and Technology Center of Stomatology, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian 350004, People’s Republic of China; 3College of Chemistry, Fuzhou University, Fuzhou, Fujian 350116, People’s Republic of ChinaCorrespondence: Da-Li ZhengFujian Key Laboratory of Oral Diseases, Fujian Biological Materials Engineering and Technology Center of Stomatology, School and Hospital of Stomatology, Fujian Medical University, 88 Jiaotong Road, Fuzhou 350004, People’s Republic of ChinaTel +86-591-83720599Email dalizheng@fjmu.edu.cnJian-Zhi LiuDepartment of Otorhinolaryngology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou 350001, People’s Republic of ChinaTel +86-591- 83357896Email liujianzhi@aliyun.comBackground: The realization of multifunction in one bulk material is fascinating for developing a new generation of devices. Quaternary phosphorus salts were seldom utilized as templates in haloargentate systems, and the hybridization of alkyl(triphenyl)phosphonium with halometallate will be a good strategy for the development of multifunctional material, especially for biological material.Methods: Under the template of (triphenyl)phosphonium-based quaternary phosphorus salts with different spacer lengths (n=2, 3, 4), three bromoargentate hybrids were constructed via the solution method, ie, (1,2-DBTPP)(Ag2Br4) ( 1), {(1,3-DBTPP)2(Ag7Br11)]∙CH3CN∙H2O}n ( 2), and {[(1,4-DBTPP)(Ag5Br7)](CH3CN)2∙H2O}n ( 3) (1,2-DBTPP2+=ethane-1,2-diylbis (triphenyl)phosphonium, 1,3-DBTPP2+=propane-1,3-diylbis (triphenyl)phosphonium, 1,4-DBTPP2+=butane-1,4-diylbis (triphenyl)phosphonium)).Results: The (Ag7Br11)n4n- chain in 2 is a new type of 1-D bromoargentate chain constructed from cubane-like Ag4Br4 nodes, AgBr4 tetrahedrons and AgBr3 triangles. Interestingly, by elongating spacer n from 2 to 4, argentophilicity interactions are weakened, and the hydrogen bonds are strengthened. Consequently, their water stabilities and photocurrents are improved, in which the Ag-4d/Br-4p to π* anti-bonding orbital of the quaternary phosphorus transfer is facilitated. Furthermore, the greenish blue emissions can be detected. Finally, high inhabitation rates against Streptococcus mutans and Candida albicans can be observed in 2 and 3.Conclusion: In all experiments, by elongating the spacer lengths of quaternary phosphorus salts, multifunctions were integrated in the quaternary phosphorus/bromoargentate hybrids, including greenish blue luminescence, repeatable photocurrent responses and durable antimicrobial activities with enhanced water stability. This work could provide a theoretical guide for the design of new biologically multifunctional materials.Keywords: quaternary phosphorus, bromoargentates, nanoparticles, luminescence, antimicrobial

BackgroundHereditary angioedema (HAE) due to C1 inhibitor deficiency manifests as recurrent swelling attacks that can be disabling and sometimes fatal. Long-term prophylaxis with twice-weekly intravenous injections of plasma-derived C1-inhibitor (pdC1-INH) has been established as an effective treatment. Subcutaneous (SC) administration of pdC1-INH has not been studied in patients with HAE.MethodsThis open-label, dose-ranging, crossover study (COMPACT Phase II) was conducted in 18 patients with type I or II HAE who received two of twice-weekly 1500, 3000, or 6000 IU SC doses of highly concentrated volume-reduced CSL830 for 4 weeks each. The mean trough plasma levels of C1-INH functional activity, C1-INH and C4 antigen levels during Week 4, and overall safety and tolerability were evaluated. The primary outcome was model-derived steady-state trough C1-INH functional activity.ResultsAfter SC CSL830 administration, a dose-dependent increase in trough functional C1-INH activity was observed. C1-INH and C4 levels both increased. The two highest dose groups (3000 and 6000 IU) achieved constant C1-INH activity levels above 40% values, a threshold that was assumed to provide clinical protection against angioedema attacks. Compared with intravenous injection, pdC1-INH SC injection with CSL830 showed a lower peak-to-trough ratio and more consistent exposures. All doses were well tolerated. Mild-to-moderate local site reactions were noted with pain and swelling being the most common adverse event.ConclusionsSubcutaneous volume-reduced CSL830 was well tolerated and led to a dose-dependent increase in physiologically relevant functional C1-INH plasma levels. A clinical outcome study of SC CSL830 in patients with HAE warrants further investigation.

Hong-Hua Li,1 Jun-Yan Feng,1 Bing Wang,1 Yu Zhang,1 Cheng-Xin Wang,1 Fei-Yong Jia1,2 1Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, Jilin 130021, People’s Republic of China; 2Neurological Research Center of the First Hospital of Jilin University, Changchun, People’s Republic of ChinaCorrespondence: Fei-Yong JiaDepartment of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, Jilin 130021, People’s Republic of ChinaTel +86-0431-88783846Email erkekangfujia@163.comBackground: The newly revised Children Neuropsychological and Behavior Scale (CNBS-R2016) is a diagnostic assessment tool widely used in China to assess the developmental level of children aged 0 to 6 years. The purpose of this study was to determine whether the effectiveness of developmental assessment in children with autism spectrum disorder (ASD) by the CNBS-R2016 was consistent with that of the Griffiths Mental Development Scales for China (GDS-C).Methods: In total, 139 children with ASD were recruited in this study. The Autism Behavior Checklist (ABC) and the Childhood Autism Rating Scale (CARS) were used to measure ASD severity. All subjects were evaluated with both the CNBS-R2016 and GDS-C. To determine the consistency between the CNBS-R2016 and GDS-C, Pearson correlation coefficients and Bland-Altman plots were computed. The GDS-C was used as a reference assessment, and the performance of the CNBS-R2016 was analyzed with receiver operating curves.Results: No significant difference was found between the proportions of developmental delays detected by the CNBS-R2016 subscales and the corresponding GDS-C subscales. The CNBS-R2016 Communication Warning Behavior subscale quotients and the total ABC and CARS scores were significantly and positively correlated. The general and subscale quotients of the CNBS-R2016 and the corresponding quotient of the GDS-C were also significantly and positively correlated. The area under all the curves of the CNBS-R2016 was above 0.8 according to the results of the GDS-C (general or subscale quotient

Hong-Hua Li,1 Zhi-Da Xu,1,2 Bing Wang,1 Jun-Yan Feng,1 Han-Yu Dong,1 Fei-Yong Jia1,31Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, Jilin 130021, People’s Republic of China; 2Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands; 3Neurological Research Center of the First Hospital of Jilin University, Changchun, People’s Republic of ChinaCorrespondence: Fei-Yong JiaDepartment of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, Jilin 130021, People’s Republic of ChinaTel +86 04 318 878 3846Email erkekangfujia@163.comPurpose: Vitamin D deficiency has been found in children with chronic tic disorders (CTDs). Our previous data showed that serum 25-hydroxyvitamin D [25(OH)D] level in children with CTDs was lower than that of the healthy controls and lower serum 25(OH)D level was associated with increased severity of the tic disorder. Thus, we intend to further verify this phenomenon and examine the effect of vitamin D3 on CTDs.Patients and methods: In total, 120 children with CTDs and 140 normal controls were enrolled in this study, with 36/120 of those in the CTD group receiving vitamin D3 treatment for 3 months. The Yale Global Tic Severity Scale (YGTSS) and Clinical Global Impression of Severity of Illness (CGI-SI) were, respectively, used to evaluate the tic severity. High-performance liquid chromatography and tandem mass spectrometry were used to measure serum 25(OH)D level.Results: Those children with CTDs exhibited significantly lower 25(OH)D levels than did healthy controls, and these reduced 25(OH)D levels were linked to increasing severity of tic symptoms. After treatment with supplemental vitamin D3, serum 25(OH)D level and scores of YGTSS total, motor tics, phonic tics, total tic, impairment, and CGI-SI improved significantly in children with CTDs without any adverse reactions.Conclusion: Supplementation vitamin D3, given its low cost and excellent safety, may be an effective means of improving symptoms in certain children with CTDs.Keywords: vitamin D, chronic tic disorders, 25(OH)D, dopamine, child

The branching fraction of the ψ(2S) decay into τ+τ - has been measured for the first time using the BES detector at the Beijing Electron-Positron Collider. The result is Bττ=(2.710. 43±0.55)× 10-3, where the first error is statistical and the second is systematic. This value, along with those for the branching fractions into e+e- and μ+ μ- of this resonance, satisfy well the relation predicted by the sequential lepton hypothesis. Combining all these values with the leptonic width of the resonance, the total width of the ψ(25) is determined to be (252±37) keV. ©2002 The American Physical Society.

Huamin Henry Li Institute for Asthma and Allergy, Chevy Chase, MD, USA Abstract: Hereditary angioedema (HAE) is a rare genetic disease characterized by episodic subcutaneous or submucosal swelling. The primary cause for the most common form of HAE is a deficiency in functional C1 esterase inhibitor (C1-INH). The swelling caused by HAE can be painful, disfiguring, and life-threatening. It reduces daily function and compromises the quality of life of affected individuals and their caregivers. Among different treatment strategies, replacement with C1-INH concentrates is employed for on-demand treatment of acute attacks and long-term prophylaxis. Three human plasma-derived C1-INH preparations are approved for HAE treatment in the US, the European Union, or both regions: Cinryze®, Berinert®, and Cetor®; however, only Cinryze is approved for long-term prophylaxis. Postmarketing studies have shown that home therapy (self-administered or administered by a caregiver) is a convenient and safe option preferred by many HAE patients. In this review, we summarize the role of self-administered plasma-derived C1-INH concentrate therapy with Cinryze at home in the prophylaxis of HAE. Keywords: C1-INH concentrate, hereditary angioedema, disease management, first line, prophylaxis, self-administration

BACKGROUND: Recent advances have indicated a complex interplay between the autonomic nervous system and the innate immune system. Targeting neural networks for the treatment of sepsis is being developed as a therapeutic strategy. Because electroacupuncture at select acupoints can modulate activities of the autonomic nervous system, we tested the hypothesis that electroacupuncture at specific acupoints could modulate systemic inflammatory responses and improve survival via its impact on the autonomic nervous system in a rat model of sepsis. METHODS: Sprague-Dawley male rats received electroacupuncture for 45 min before and at 1, 2, or 4 h after a lethal dose of intraperitoneal lipopolysaccharide injection (6 mg/kg). Outcomes included survival and systemic cytokine responses. Also, the possible roles of neural circuitry, including the hypothalamic-pituitary-adrenal axis and the autonomic nervous system, were evaluated. RESULTS: Electroacupuncture pretreatment at the Hegu acupoints significantly attenuate systemic inflammatory responses and improve survival rate from 20% to 80% in rats with lethal endotoxemia. Such a site-specific effect requires the activation of muscarinic receptors in the central nervous system, but not increasing central sympathetic tone. In the periphery synergistic, rather than independent, action of the sympathetic and parasympathetic systems is also necessary. CONCLUSIONS: Electroacupuncture pretreatment has a dramatic survival-enhancing effect in rats with lethal endotoxemia, which involves the activation of efferent neural circuits of the autonomic nervous system (e.g., cholinergic antiinflammatory pathway). This approach could be developed as a prophylactic treatment for sepsis or perioperative conditions related to excessive inflammation. [ABSTRACT FROM AUTHOR]

CHANG Y.H., LI H.-H., WU C.M. & WANG P.C. (2010) The influence of personality traits on nurses' job satisfaction in Taiwan. International Nursing Review The purpose of this study was to empirically investigate a set of personality traits based on core self-evaluations in relation to job satisfaction among nurses in Taiwan, and to identity important personality characteristics in contributing to nurses' satisfactory attitudes towards work. A cross-sectional survey research was conducted with self-reported questionnaires. The participants were 314 nurses (89% response rate) in two regional hospitals in Taiwan. Among them, 99% were female ( n = 311), 54.5% ( n = 171) ranging between 21 and 30 years old, 37.9% ( n = 119) ranging between 31 and 40 years old, 44.6% ( n = 140) are registered nurse, 29.3% ( n = 92) are licensed vocational nurse and 52.9% were married ( n = 166). In addition, ethical research requirements for conducting research on human subjects were fulfilled for all of the participants in the study. Data were analysed using SPSS version 14.0 software (SPSS Inc., Chicago, IL, USA). A number of data analysis procedures were conducted including descriptive statistics, Pearson product-moment correlation and multiple regression analysis. The selection of the predictor variables was performed with the level of significance P < 0.05 and the adjusted explained variance was used to examine statistical explanatory power. Personality traits of optimism, self-esteem, proactive personality, self-efficacy and negative affectivity significantly contributed to job satisfaction. The findings of this study confirmed the importance of taking personality variables into consideration during the process of evaluating job satisfaction. Job satisfaction should not only be related to extrinsic factors but also associated with individual differences of dispositional tendency. Nurses with positive evaluation and expectation towards self and others tend to report higher job satisfaction. The results of this study are consistent with previous studies. The implications for nursing managements are discussed. [ABSTRACT FROM AUTHOR]

This descriptive cross-sectional study examines cathexis, or satisfaction, with the body and the orofacial region in relationship to eight major demographic and health status variables in a nonprobability sample of 34 male and 47 female edentulous subjects aged 36 to 77 years. Kiyak's 27-item Body Cathexis Scale (BCS), including an innovative five-item Orofacial Cathexis Scale (OFCS), was shown to be reliable for use in elderly clients at least to age 77 (Cronbach's alpha = .95). More research is needed to validate the OFCS. Overall scores were in the neutral range, with teeth being the most negatively cathected body part. Longer periods of edentulism were associated with more dissatisfaction with the teeth. Body and orofacial cathexis were highly positively correlated. Chronic illness, education level, race, and religion were not significantly related to cathexis. Edentulism, especially recent edentulism in the elderly, female gender, and divorced marital status could be important indicators for body image disturbance. [ABSTRACT FROM AUTHOR]

Background: Over-expression of cyclooxygenase-2 (COX-2) enzyme has been reported in nasopharyngeal carcinoma (NPC). However, the prognostic significance of this has yet to be conclusively determined. Thus, from our randomized trial of radiation versus concurrent chemoradiation in endemic NPC, we analyzed a cohort of tumour samples collected from participants from one referral hospital.Methods: 58 out of 88 patients from this institution had samples available for analysis. COX-2 expression levels were stratified by immunohistochemistry, into negligible, weak, moderate and strong, and correlated with overall and disease specific survivals.Results: 58% had negligible or weak COX-2 expression, while 14% and 28% had moderate and strong expression respectively. Weak COX-2 expression conferred a poorer median overall survival, 1.3 years for weak versus 6.3 years for negligible, 7.8 years, strong and not reached for moderate. There was a similar trend for disease specific survival.Conclusion: Contrary to literature published on other malignancies, our findings seemed to indicate that over-expression of COX-2 confer a better prognosis in patients with endemic NPC. Larger studies are required to conclusively determine the significance of COX-2 expression in these patients. [ABSTRACT FROM AUTHOR]

Alkyl phosphonates are important motifs in medicinal chemistry, yet their efficient synthesis by direct C(sp3)-H functionalization remains a challenge. Here, we report straightforward access to benzylic phosphonates by direct C(sp3)-H functionalization in a cross-dehydrogenative-coupling reaction between non-specialized alkylarenes and unfunctionalized phosphites. Notably, the C-H substrates are used as the limiting reagents. The scope of benzylic C-H substrates is broad, and the mild reaction conditions allow for good functional group tolerance. Mechanistic studies indicate that the reaction proceeds via a radical pathway rather than the cationic pathway followed for specialized benzylic C-H substrates in previous methods., (© 2024 Wiley‐VCH GmbH.)

Herein, we disclose a simple copper-catalyzed method for enantioselective allylic C(sp 3 )-H oxidation of unsymmetrical acyclic alkenes, specifically 1-aryl-2-alkyl alkenes. The C-H substrates are used in limiting amounts, and the products are obtained with high enantioselectivity, E/Z-selectivity, and regioselectivity. The method exhibits broad functional group tolerance, and E/Z-alkene mixtures are suitable C-H substrates. The transformation is enabled by light irradiation, which sustains the enantioselective copper catalysis by photoinduced oxidant homolysis., (© 2024 The Author(s). Angewandte Chemie International Edition published by Wiley-VCH GmbH.)

Background: In addressing elderly healthcare issues, cognitive impairment can cause significant disruptions in daily life and may potentially develop into dementia. Thus, finding ways to delay the progression of cognitive impairment is a critical issue., Methods: This study aims to develop an adaptive artificial intelligence (AI) mechanism that creates enjoyable and beneficial content to help delay cognitive impairment in the elderly. Utilising virtual reality (VR) and a fishing game, the design enhances reaction time and attention through interactive fishing activities. The AI personalises content based on individual performance to improve cognitive function., Results: Experimental results showed that adaptive AI increased participant satisfaction from 86.84 to 91.05 points and future willingness from 75.26 to 85.68 points. The number of fish caught rose from 98 to 120, with the average per participant increasing from 2.64 to 2.85., Conclusions: This is undoubtedly the trend of the future. VR allows the elderly to have a more impactful and memorable first experience, while AI dynamically adjusts the game's difficulty based on the elderly's performance, addressing the issue of reduced willingness to continue due to inappropriate game difficulty. The VR game developed in this study is designed to be relaxing and incorporates mechanisms to promote the elderly's health. It is not restricted by location or time and, more importantly, meets the health promotion needs of the elderly., (© 2024 Japanese Psychogeriatric Society.)

The mitochondrial dynamic imbalance is an important cause of myocardial ischaemia/reperfusion (I/R) injury and dysfunction. Psmb8, as one of the immunoproteasome catalytic subunits, is a key regulator of protein homoeostasis, inflammation and some cardiac diseases. Here, we found that the expression level and activity of Psmb8 were significantly reduced in the heart of I/R mice and in subjects with myocardial infarction (MI). Cardiomyocyte-specific Psmb8 overexpression in mice markedly ameliorated I/R-mediated cardiac injury and dysfunction, which was accompanied by reduced mitochondrial division via the downregulation of dynamin-related protein-1 (Drp1). However, Psmb8 knockout (KO) mice exhibited the opposite changes. The effects of Psmb8 on mitochondrial fission and apoptosis was confirmed in primary cardiomyocytes with overexpression or knockdown of Psmb8 in vitro. Mechanistically, Psmb8 was directly associated with Drp1 and enhanced its degradation, which subsequently suppressed I/R-mediated mitochondrial fission and cardiac injury. Conversely, knockdown of Drp1 in Psmb8-KO mice restored I/R-induced cardiac dysfunction and mitochondrial dynamic imbalance. Our study identified a new cardioprotective role of Psmb8 in cardiac I/R damage through targeting Drp1, and highlight that increasing Psmb8 activity may constitute a promising therapy for ischaemic heart disease., (© 2024. The Author(s).)

Abstract: BACKGROUND: The objective of this study is to investigate the clinical effectiveness of the combination of multimodal exercise (MME) with supportive music and imagery in the management of poststroke mood disorders (PSMD). METHODS: A total of 200 PSMD patients treated in the neurology department of a tertiary hospital in Jiangsu Province were enrolled. They were assigned to either a control group or the observation group using a random number table at a 1:1 ratio, with 100 patients in each group. The control group received conventional nursing care, and the observation group received both MME and music and imagery in addition to the conventional nursing interventions. The scores of the 10-item Kessler Psychological Distress Scale (K10), Hospital Anxiety and Depression Scale (HADS), and Well-being Index Scale (WBIS) were recorded before and 3, 6, and 9 months after the interventions and compared between the 2 groups. RESULTS: Changes in K10, HADS, and WBIS scores significantly differed between the 2 groups after interventions (all P < .05) and among different time points (all P < .05). There were interactions between the time points of the K10, HADS, and WBIS assessments and the intervention methods in both groups (P < .05). The improvements in anxiety or depression and psychological distress in the observation group were significantly superior to those in the control group. CONCLUSION: MME combined with music and imagery can effectively improve anxiety and depression, reduce symptoms of psychological distress, and improve well-being in PSMD patients., Competing Interests: Competing interests: The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc.)

Background: Hereditary angioedema (HAE) is a complex disorder with a wide array of treatment options. Shared decision-making (SDM) should be used to ensure that patients are choosing their best treatment option. The goal was to develop and psychometrically test a brief instrument for assessing the patient's perspective of the SDM process during his or her clinical encounters with an HAE specialist/allergist. Method: We hypothesized that SDM could be used effectively to help patients in their choice of therapy for HAE. Ten HAE treating physicians from the United States with a total of 50 patients with HAE used SDM to help patients choose the best prophylactic therapies (oral kallikrein inhibitor, androgens, subcutaneous C1 inhibitor replacement therapy, intravenous C1 inhibitor replacement therapy, monoclonal antibody kallikrein inhibitor) for their HAE and then completed surveys to analyze the effectiveness of the implementation of SDM as a quality indicator in health services assessment. Results: The congruence of answers between the physicians and the patients was then analyzed; 90% of the patient-physician pairs agreed that the advantages and disadvantages of the treatment options were precisely explained; 92% of the patient-physician pairs agreed that the physician helped them understand all the information and that the physician asked them which treatment option they preferred; 88% of the pairs agreed that the different treatment options were thoroughly weighed and 92% of the pairs felt that they selected a treatment option together. Conclusion: In summary, SDM is being implemented by treating physicians to determine the best management options for their patients with HAE.

Background: Alzheimer's disease (AD) can be optimally managed from a healthcare point of view if detected at a prodromal stage. Amnestic mild cognitive impairment (MCI) is known as prodromal AD, has attracted extensive attention and research., Objective: To identify the differences in cognitive function and structural magnetic resonance imaging (MRI) features between men and women with MCI on the basis of A/T/N classification system ("A" means amyloid-β biomarker, "T" means tau biomarker, and "N" means neurodegeneration biomarker as determined by clinical imaging (e.g., positron emission tomography, magnetic resonance imaging (MRI)) or by the measurement of total tau protein (T-tau) in the cerebrospinal fluid (CSF)) and to further explore the correlation between them., Methods: 406 MCI subjects were selected from the Alzheimer's Disease Neuroimaging Initiative database and divided into male and female MCI groups. Differences in demographic characteristics, biomarkers, cognitive assessment performance, and regions of interest (ROIs) of structural MRI were compared between the two groups. The correlations between brain structural changes quantified by MRI and cognitive abilities were investigated through linear regression models., Results: Compared with male MCI subjects, females had significantly higher T-tau concentration in CSF. There were significant differences in ROIs between the sex groups. In the male MCI group, the average cortical thicknesses of the right posterior cingulate, right anterior cingulate and right supramarginal gyrus were more closely correlated with cognitive function. In the female MCI group, the volume of the right rostral anterior cingulate, and the surface area and average cortical thickness of the right isthmus of the cingulate gyrus were more closely correlated with cognitive function., Conclusions: Based on A/T/N classification system, the structural MRI data analysis was closely correlated with the difference of cognitive function from patients with prodromal AD in a sex-dependent manner., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Cardiac ischaemia/reperfusion (I/R) impairs mitochondrial function, resulting in excessive oxidative stress and cardiomyocyte ferroptosis and death. Nuclear factor E2-related factor 2 (Nrf2) is a key regulator of redox homeostasis and has cardioprotective effects against various stresses. Here, we tested whether CBR-470-1, a noncovalent Nrf2 activator, can protect against cardiomyocyte death caused by I/R stress. Compared with vehicle treatment, the administration of CBR-470-1 (2 mg/kg) to mice significantly increased Nrf2 protein levels and ameliorated the infarct size, the I/R-induced decrease in cardiac contractile performance, and the I/R-induced increases in cell apoptosis, ROS levels, and inflammation. Consistently, the beneficial effects of CBR-470-1 on cardiomyocytes were verified in a hypoxia/reoxygenation (H/R) model in vitro, but this cardioprotection was dramatically attenuated by the GPX4 inhibitor RSL3. Mechanistically, CBR-470-1 upregulated Nrf2 expression, which increased the expression levels of antioxidant enzymes (NQO1, SOD1, Prdx1, and Gclc) and antiferroptotic proteins (SLC7A11 and GPX4) and downregulated the protein expression of p53 and Nlrp3, leading to the inhibition of ROS production and inflammation and subsequent cardiomyocyte death (apoptosis, ferroptosis and pyroptosis). In summary, CBR-470-1 prevented I/R-mediated cardiac injury possibly through inhibiting cardiomyocyte apoptosis, ferroptosis and pyroptosis via Nrf2-mediated inhibition of p53 and Nlrp3 and activation of the SLC7A11/GPX4 pathway. Our data also highlight that CBR-470-1 may serve as a valuable agent for treating ischaemic heart disease., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Neuroinflammation and oxidative stress contribute to the progression of sepsis-associated encephalopathy (SAE). Angiotensin-converting enzyme 2 (ACE2) is considered to be a neuroprotective factor due to its anti-inflammatory and antioxidant properties. However, the role of ACE2 on myeloid cells in regulating SAE and the underlying mechanism warrants further exploration. SAE was induced in ACE2 transgenic (TG), knockout (KO), and bone marrow (BM) chimeric mice by cecal ligation and puncture (CLP). The expression levels of apoptosis-, oxidation- and neuroinflammation-associated mediators and morphological changes were monitored by quantitative real-time PCR analyses and histological examinations in the cortex of septic mice. The contents of angiotensin (Ang) II and Ang-(1-7) along with the activity of ACE2 were examined with commercial kits. The expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and Sestrin2 was detected by immunoblotting analysis. Our results indicated that the expression of cortical ACE2 was significantly reduced in the early phase of CLP-induced sepsis. Moreover, ACE2 overexpression in TG mice conferred neuroprotection against sepsis, as evidenced by alleviated neuronal apoptosis, oxidative stress, and proinflammatory M1-like microglial polarization, accompanied by upregulation of the Ang-(1-7), Nrf2, and Sestrin2 protein levels. Conversely, ACE2 deficiency in KO mice exacerbated SAE. The neuroprotective effects of ACE2 were further confirmed in wild-type mice transplanted with ACE2-TG and KO BM cells. Therefore, our data suggest that myeloid ACE2 exerts a protective role in the pathogenesis of SAE, potentially by activating Ang-(1-7)-Nrf2/sestrin2 signaling pathway, and highlight that upregulating ACE2 expression and activity may represent a promising approach for the treatment of SAE in patients with sepsis., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

In this study, Phylloporia fontanesiae polysaccharide was successfully isolated through a sequential water extraction and alcohol precipitation process. Utilizing the Box-Behnken design, the extraction process was optimized based on single-factor experiments, considering variables such as the material-to-liquid ratio, extraction temperature, extraction time, and the number of extractions. The polysaccharide composition of P. fontanesiae is predominantly composed of mannose, glucuronic acid, glucose, and galactose, with a molar mass ratio of 4.31:4.10:36.83:1, along with minor amounts of aminoglucose and fucose. The polysaccharide fraction of P. fontanesiae comprises two distinct components, possessing relative molecular masses of 8.85 kDa and 134.03 kDa. Notably, the polysaccharide exhibited significant antioxidant activity. After undergoing simulated gastrointestinal digestion, no significant changes were observed in its antioxidant activity, molecular weight, or monosaccharide composition. This study not only enhanced the extraction efficiency of P. fontanesiae polysaccharide but also provided valuable insights into its composition, structure, and digestion characteristics. PRACTICAL APPLICATION: The optimum extraction process, stability, and antioxidant activity of Phylloporia fontanesiae polysaccharide during simulated digestion of gastrointestinal tract were studied. The results provide a theoretical basis for the development and application of this polysaccharide in the field of food and health products., (© 2024 Institute of Food Technologists.)

PANoptosis is a newly discovered type of cell death characterized by pyroptosis, apoptosis and/or necroptosis and has been implicated in the inflammatory response. Piezo1 is a mechanosensitive ion channel that plays important roles in physiological development and various diseases. However, whether cardiomyocytes undergo PANoptosis during myocardial ischaemia/reperfusion (I/R) injury and the role of Piezo1 in this process remain largely unexplored. In this study, our results revealed that the expression levels of the main components of the PANoptosome, including caspase-8, caspase-3, NLRP3, caspase-1, GSDMD, RIPK1, RIPK3 and MLKL, were significantly upregulated in I/R heart tissues over time, indicating the occurrence of PANoptosis in I/R hearts. Accordingly, Piezo1 expression was significantly upregulated in I/R-injured hearts and hypoxia/reoxygenation (H/R)-treated cardiomyocytes. In contrast, pharmacological inhibition of Piezo1 by the inhibitor GsMTx4 in mice markedly attenuated the I/R-mediated decline in cardiac contractile function and increases in infarct size, apoptosis, oxidative stress and inflammation accompanied by the inhibition of PANoptosis-related mediators in I/R hearts. Consistently, the effects of Piezo1 on calcium influx and PANoptosis were further verified by GsMTx4 and Piezo1 activator Yoda1 in H/R-treated cardiomyocytes in vitro. Moreover, caspase-8 rather than calcium influx was required for H/R-induced PANoptosis in vitro. Mechanistically, Piezo1 interacts with caspase-8, a key initial activator of the PANoptosome complex, which subsequently activates cardiomyocyte PANoptosis, leading to cardiac dysfunction. In summary, these data suggest that Piezo1 is a new cardiac mechanosensor that promotes cardiac I/R injury possibly through the caspase-8-mediated activation of cardiomyocyte PANoptosis and highlight that Piezo1 may represent a new target for treating ischaemic heart disease., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Angiotensin-converting enzyme 2 (ACE2), a crucial element of the renin-angiotensin system (RAS), metabolizes angiotensin II into Ang (1-7), which then combines with the Mas receptor (MasR) to fulfill its protective role in various diseases. Nevertheless, the involvement of ACE2 in sepsis-induced cardiomyopathy (SIC) is still unexplored. In this study, our results revealed that CLP surgery dramatically impaired cardiac function accompanied with disruption of the balance between ACE2-Ang (1-7) and ACE-Ang II axis in septic heart tissues. Moreover, ACE2 knockin markedly alleviated sepsis induced RAS disorder, cardiac dysfunction and improved survival rate in mice, while ACE2 knockout significantly exacerbates these outcomes. Adoptive transfer of bone marrow cells and in vitro experiments showed the positive role of myeloid ACE2 by mitigating oxidative stress, inflammatory response, macrophage polarization and cardiomyocyte apoptosis by blocking NF-κB and STAT1 signals. However, the beneficial impacts were nullified by MasR antagonist A779. Collectively, these findings showed that ACE2 alleviated SIC by inhibiting M1 macrophage via activating the Ang (1-7)-MasR axis, highlight that ACE2 might be a promising target for the management of sepsis and SIC patients., (© 2024. The Author(s).)

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) serves as a bridging intervention for subsequent definitive haemorrhagic control. This study compared the clinical outcomes of REBOA and resuscitative thoracotomy (RT) in patients with bleeding below the diaphragm., Materials and Methods: This retrospective cohort study included adult trauma patients who presented to the Trauma Quality Improvement Program between 2020 and 2021 and who underwent either REBOA or RT in the emergency department (ED). Patients with severe head and chest injuries, characterised by an Abbreviated Injury Scale (AIS) score greater than 3, were excluded. The clinical data of patients treated with REBOA and those treated with RT were compared, and multivariable logistic regression (MLR) was employed to identify prognostic factors associated with mortality., Results: A total of 346 patients were enrolled: 138 (39.9 %) received REBOA, and 208 (60.1 %) received RT at the ED. Patients in the RT group underwent ED cardiopulmonary resuscitation (CPR) more frequently (58.2 % vs. 23.2 %; p < 0.001) and had a higher mortality rate (87.0 % vs. 45.7 %; p < 0.001). Patients who died had lower Glasgow Coma Scale scores (6 [4.5] vs. 11 [4.9]; p < 0.001), underwent more ED CPR (58.6 % vs. 9.8 %; p < 0.001), and received RT more frequently (74.2 % vs. 26.5 %, p < 0.001). The MLR revealed that the major prognostic factors for mortality were systolic blood pressure (odds ratio [OR] 0.988, 95 % confidence interval [CI] 0.978-0.998; p = 0.014), ED CPR (OR 11.111, 95 % CI 4.667-26.452; p < 0.001), abdominal injuries with an AIS score ≥ 4 (OR 4.694, 95 % CI 1.921-11.467; p = 0.001) and RT (OR 5.693, 95 % CI 2.690-12.050; p < 0.001)., Conclusions: In cases of blunt trauma, prompt identification of the bleeding source is crucial. For patients with bleeding below the diaphragm, REBOA led to higher survival rates than did RT. However, it is important to consider the limitations of the database and the necessary exclusions from our analysis., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The prevalence of frailty is increasing, and it is associated with increased risk of diseases and adverse outcomes. Although substantial research has focused on post-stroke frailty, understanding of pre-stroke frailty remains limited. Our aim was to synthesize literature on pre-stroke frailty and stroke risk to explore their relationship and impact on prognosis. A systematic search of multiple databases was conducted to identify cohort studies published until October 28, 2023. Meta-analysis was conducted using a random effects model. Heterogeneity was assessed with the I² statistic, and publication bias was evaluated using Begg's test. Finally, we included 11 studies (n = 1,660,328 participants). The pooled hazard ratios (HRs) for stroke risk associated with pre-stroke frailty compared to non-frail individuals was 1.72 (95% confidence interval, CI: 1.46-2.02, p = 0.002, I 2  = 69.2%, Begg's test: p = 0.536). The pooled HRs for mortality and the pooled relative risk (RRs) modified Rankin Scale (mRs) associated with pre-stroke frailty were 1.68 (95% CI: 1.10-2.56, p = 0.136, I 2  = 49.9%, Begg's test: p = 0.296) and 3.11 (95% CI: 1.77-5.46, p = 0.192, I 2  = 39.4%, Begg's test: p = 1.000), respectively. In conclusion, pre-stroke frailty is strongly associated with stroke risk and impacts its prognosis, irrespective of the measurement method. Future research should focus on prospective studies to assess the effects of early intervention for frailty. This has significant implications for primary healthcare services and frailty management., (© 2024. The Author(s).)