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Abstract Background Pulmonary hypertension (PH) is a long-term disease that impacts approximately 1% of the world’s population. Currently, levosimendan (Lev) is proposed for PH treatment. However, the mechanism of Lev in the treatment of PH is unknown. Methods We used hypoxia-induced pulmonary artery smooth muscle cells (PASMCs) to establish a PH cell model. A number of cell biology methods were performed to assay alterations in cell proliferation, migration and apoptosis after Lev treatment. qRT-PCR and WB were performed to test the levels of circUSP34 and miR-1298, and BMP/Smad protein respectively. In addition, the regulatory relationship between circUSP34 or BMPR2 with miR-1298 was verified through the use of double luciferase as well as RIP assay. In addition, we explored the regulatory effect of Lev on the circUSP34/miR-1298/BMP/Smad axis using a rat PH model. Results Our results demonstrate that Lev inhibited PASMCs cell proliferation, migration and promoted apoptosis exposed to hypoxia. In hypoxia-treated PASMCs, circUSP34 expression got downregulated while miR-1298 upregulated, whereas the addition with Lev resulted in upregulation of circUSP34 expression and downregulation of miR-1298 expression, indicating that circUSP34 can target and regulate miR-1298. In addition, miR-1298 targets and regulates the expression of BMPR2. In a rat PH model induced by hypoxia combined with SU5416, Lev upregulated circUSP34 targeting miR-1298-mediated BMP/Smad axis to alleviate the PH phenotype. Conclusion We have shown that Lev can be used as a therapeutic drug for PH patients, which works through the circUSP34/miR-1298/BMP/Smad axis to alleviate PH symptoms.

This study presents a detailed investigation into the soil arching effects within deep foundation pits (DFPs), focusing on their mechanical behavior and implications for structural design. Through rigorous 3D finite element modeling and parameter sensitivity analyses, the research explores the formation, geometric characteristics, and spatial distribution of soil arching phenomena. The investigation encompasses the influence of key parameters such as elastic modulus, cohesion, and internal friction angle on the soil arching effect. The findings reveal that soil arching within DFPs exhibits distinct spatial characteristics, with the prominent arch axis shifting as excavation depth progresses. Optimal soil arching is observed when the pile spacing approximates three times the pile diameter, enhancing soil retention and minimizing deformation risks. Sensitivity analyses highlight the significant impact of soil parameters on soil arching behavior, underscoring the critical role of cohesive forces and internal friction angles in shaping arching characteristics. By elucidating the interplay between soil parameters and soil arching effects, the research provides insights for optimizing pile spacing and structural stability.

BackgroundPatients with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis often experience severe symptoms. Resting-state functional MRI (rs-fMRI) has revealed widespread impairment of functional networks in patients. However, the changes in information flow remain unclear. This study aims to investigate the intrinsic functional connectivity (FC) both within and between resting-state networks (RSNs), as well as the alterations in effective connectivity (EC) between these networks.MethodsResting-state functional MRI (rs-fMRI) data were collected from 25 patients with anti-NMDAR encephalitis and 30 healthy controls (HCs) matched for age, sex, and educational level. Changes in the intrinsic functional connectivity (FC) within and between RSNs were analyzed using independent component analysis (ICA). The functional interaction between RSNs was identified by granger causality analysis (GCA).ResultsCompared to HCs, patients with anti-NMDAR encephalitis exhibited lower performance on the Wisconsin Card Sorting Test (WCST), both in terms of correct numbers and correct categories. Additionally, these patients demonstrated decreased scores on the Montreal Cognitive Assessment (MoCA). Neuroimaging studies revealed abnormal intra-FC within the default mode network (DMN), increased intra-FC within the visual network (VN) and dorsal attention network (DAN), as well as increased inter-FC between VN and the frontoparietal network (FPN). Furthermore, aberrant effective connectivity (EC) was observed among the DMN, DAN, FPN, VN, and somatomotor network (SMN).ConclusionPatients with anti-NMDAR encephalitis displayed noticeable deficits in both memory and executive function. Notably, these patients exhibited widespread impairments in intra-FC, inter-FC, and EC. These results may help to explain the pathophysiological mechanism of anti-NMDAR encephalitis.

Background: Sepsis, a severe infectious disease, carries a high mortality rate. Early detection and prompt treatment are crucial for reducing mortality and improving prognosis. The aim of this research is to develop a clinical prediction model using machine learning algorithms, leveraging complete blood cell (CBC) parameters, to detect sepsis at an early stage. Methods: The study involved 572 patients admitted to West China Hospital of Sichuan University between July 2020 and September 2021. Among them, 215 were diagnosed with sepsis, while 357 had local infections. Demographic information was collected, and 57 CBC parameters were analyzed to identify potential predictors using techniques such as the Least Absolute Shrinkage and Selection Operator (LASSO), Random Forest (RF), Support Vector Machine (SVM), and eXtreme Gradient Boosting (XGBoost). The prediction model was built using Logistic Regression and evaluated for diagnostic specificity, discrimination, and clinical applicability including metrics such as the area under the curve (AUC), calibration curve, clinical impact curve, and clinical decision curve. Additionally, the model's diagnostic performance was assessed on a separate validation cohort. Shapley's additive explanations (SHAP), and breakdown (BD) profiles were used to explain the contribution of each variable in predicting the outcome. Results: Among all the machine learning methods' prediction models, the LASSO-based model (λ = min) demonstrated the highest diagnostic performance in both the discovery cohort (AUC = 0.9446, P

Distinct brain regions are differentially affected during the various stages of Alzheimer's disease (AD). While the hippocampus and cortex are known to play significant roles, the involvement of the cerebellum has received less attention. Understanding the changes in diverse brain regions is essential to unravel the neuropathological mechanism in early-stage AD. Our research aimed to explore and compare amyloid-β (Aβ) pathology and gene expression profiles across the hippocampus, cortex, and cerebellum in the early stages of the Amyloid Precursor Protein/Presenilin-1 (APP/PS1) mouse model. By 7 months of age, significant Aβ plaque accumulation was observed in the hippocampus and cortex of APP/PS1 mice, while no such deposits were found in the cerebellum. Gene expression analysis revealed predominant effects on immune response pathways in the hippocampus and cortex. Even in the absence of Aβ deposition, notable gene expression changes were observed in the cerebellum of APP/PS1 mice. Intriguingly, Neuronal PAS Domain protein 4 (Npas4) expression was consistently down-regulated across all brain regions, independent of Aβ plaque presence. Our findings reveal distinct transcriptomic alterations and Aβ pathology in select cerebral regions during the initial phase of AD. Notably, the diminished expression of the Npas4 across three brain regions implies that Npas4 could play a pivotal role in the early pathogenesis of AD.

The Well Mitan-1 has achieved a major breakthrough in the exploration of Ordovician subsalt natural gas in the mid-eastern Ordos Basin, demonstrating a high-yield industrial gas flow in fourth member of the Majiagou Formation of Ordovician (O1m4). Despite this success, there are ongoing disputes regarding the origin of the natural gas found in Well Mitan-1. Measured results show that the natural gas in Well Mitan-1 is mainly composed of alkane gas (95.18 %). The gas drying coefficient (C1/C1-5) is measured at 0.947, and the H2S content is 3.49 %, with a small amount of N2 and CO2 in the non-hydrocarbon gas. The carbon isotopic compositions of methane, ethane, and propane in the natural gas are −45.5 ‰, −26.4 ‰, and −24.3 ‰, respectively. Based on the regional geological background, the characteristics of potential source rocks and the geochemical characteristics of natural gas, it is considered that the natural gas in Well Mitan-1 is self-generated and self-accumulated oil-associated gas in Ordovician subsalt carbonate rocks. However, certain geochemical anomalies, such as the lighter methane carbon isotope value (δ13C1) and coal-type gas characteristics in ethane carbon isotope (δ13C2), raise questions. Further insights from thermal simulation experiments on hydrocarbon generation and the analysis of residual gas in rocks suggest a close relationship between the special geochemical characteristics of Well Mitan-1 and the presence of gypsum rocks. The ubiquitous gypsum rock serves a dual purpose: acting as an effective caprock, facilitating the retention of early-generated natural gas, and promoting the generation of heavy hydrocarbon gases (C2+) and H2S. The relatively low H2S content (less than 5 %) and higher C2+ content indicate that thermochemical sulfate reduction (TSR), if present, is not strong enough to significantly impact methane. The δ13C2 is identified as a potentially sensitive parameter for identifying TSR.

To address the problem of reduced channel estimation performance in underwater acoustic Orthogonal Frequency Division Multiplexing (OFDM) systems due to impulse noise, a method for impulse noise suppression and underwater acoustic channel estimation based on Temporally Multiple Sparse Bayesian Learning (TMSBL) is proposed. The method exploits the sparse nature of the underwater acoustic channel and impulse noise, which transforms the channel and impulse noise estimation problem into a compressed multi-measurement perception problem. Firstly, the joint estimation of channel and impulse noise is implemented using TMSBL(JCI-TMSBL), which effectively mitigates the impact of impulse noise on the performance of the algorithm. The noise-reduced received pilot matrix is then combined with the estimated time-domain channel impulse response to obtain the a priori information for TMSBL channel estimation, which improves the performance of channel estimation. Finally, the method applies the TMSBL channel estimation technique to achieve the joint estimation of underwater acoustic channels associated with different symbols. Simulation results demonstrate that the proposed method reduces the normalized mean square error of channel estimation by approximately 93.87% and the runtime by approximately 10.67% compared to the TMSBL method. This indicates that the proposed method improves the accuracy of the algorithm and reduces its computational complexity.

The implementation of ridge-furrow with plastic film mulching has the potential to enhance crop yields and water productivity, particularly in black soil regions. However, the synergistic impacts of combining ridge-furrow with plastic mulching alongside with various organic amendments on maize yield and nitrogen fertilizer utilization efficiency remain unclear. Using 15N-labeled tracing technology, we investigated fertilizer-N recovery of maize, distribution, fertilizer-N residual in soil, and nitrogen fertilizer loss across six treatments: non-mulched flat with non-organic amendment (FN), non-mulched flat with straw amendment (FS), non-mulched flat with biochar amendment (FBC), ridge-furrow with plastic mulching without organic amendment (RN), ridge-furrow with plastic mulching with straw amendment (RS), and ridge-furrow with plastic mulching with biochar amendment (RBC). The results revealed that ridge-furrow with plastic mulching in comparison to non-mulched flat, led to a significant increase in maize dry biomass accumulation, yield, and the rate of fertilizer-N recovery in maize (NRE) by 8.57%–12.36%, 10.08%–15.13%, and 2.22%–3.18%, respectively. The rate of fertilizer-N residual in soil (NSR) and fertilizer-N loss (NLS) decreased by 0.5%–2.04% and 0.78%–3.21%, respectively. In addition, the straw and biochar amendments under different planting methods promoted NRE in plants and NSR in soil, reducing NLS. Compared with non-organic amendment treatments, the inclusion of straw and biochar amendments resulted in increased NRE and NRS by 1.64%–6.20% and 0.12%–2.18%, while NLS decreased by 1.76%–7.78%. Biochar amendment treatment exhibited significantly higher nitrogen accumulation and NRE compared to the straw amendment treatment. Overall, ridge-furrow with plastic mulching combined with biochar amendment proved to be an effective method to enhance nitrogen fertilizer utilization of maize in the black soil regions, improving both yield and nitrogen fertilizer utilization efficiency.

Right aortic arch with isolation of left brachiocephalic artery is a rare congenital aortic arch anomaly. Herein, we reported a case of this rare anomaly with ventricular septal defect in a 9-month-old infant. We successfully reconstructed the islolated left brachiocephalic artery and repaired the ventricular septal defect in one stage.

Objective To explore the perioperative blood management in patients with pancreatic pseudocyst combiend with coagulation factor Ⅴ(FⅤ) deficiency. Methods Preoperative: In order to determine the effect of cryoprecipitated antihemophilic factor and fresh frozen plasma (FFP) on the elevation level of factor Ⅴ, we alternately infused cryoprecipitate and FFP in the resting state. TEG, coagulation function and coagulation factor activity were monitored before and 1 h, 24 h and 48 h after infusion, and intraoperative and postoperative blood transfusion strategies were formulated. FFP 600 mL and cryoprecipitate 10 U were supplemented preoperatively. Intraoperative: The operation procedure was performed for 7 hours with an infusion of 600 mL FFP without significant bleeding. Postoperative: FFP was infused. Results Preoperative: The coagulation factor Ⅴ activity on pre-operation was 1.9% and 1.8%. After alternating infusion cryoprecipitate 10 U and FFP 1 200 mL, the FⅤactivity increased to 5.1% and 6.0%, respectively. There was no significant difference in TEG parameters, PT and ATPP results were decreased to varying degrees. Intraoperative: The operation was successful without obvious bleeding. Postoperative: FFP 500 mL was infused 2 h after operation, and FFP 250-500 mL was injected daily from 1 to 7 days after surgery. No significant bleeding was observed in the wound, the results of TEG, PT, APTT and hemoglobin (Hb) did not change significantly compared with those before surgery. The patient was discharged successfully 12 days after surgery. The genetic test results showed that he had inherited coagulation factor Ⅴ deficiency, which was a compound heterozygous variation. Conclusion Perioperative blood management in patients with FⅤ deficiency combined with surgical disease, requiring pre-transfusion evaluation and post-transfusion evaluation in combination with laboratory investigations and clinical manifestations, cryoprecipitate and fresh frozen plasma can be effective in supplementing coagulation factors. The TEG seems to be better than the Seven items of coagulation function in judging the clotting status of patients with FⅤ deficiency.

Abstract Background This article summarizes the treatment experience for congenital complete atrioventricular block (CCAVB) in newborns and infants, and discusses the necessity and feasibility of treating CCAVB with permanent pacemaker implantation in this population. Methods In this study, the clinical data and follow-up results of nine children admitted at our center with CCAVB from January 2005 to March 2023 were retrospectively analyzed. Among them, two children received early implantation of permanent pacemakers (within 1 year of age), two children received non-early implantation (1 year or older), and the remaining five children received no pacemaker implantation. CCAVB diagnosis was confirmed by clinical symptoms and clinical examinations, including electrocardiography and echocardiography before surgery. After surgery, the pacing and sensing functions of the pacemaker were observed using electrocardiography, echocardiography, and pacing threshold monitoring. A comprehensive assessment of the treatment efficacy was conducted, encompassing improvements in clinical symptoms, growth and development, as well as the absence of any additional potential complications. The children who did not receive pacemaker implantation were followed up. Results Among the four children who successfully received pacemaker implantation, one child who received non-early implantation died. For the remaining three children, the threshold level, amplitude, impedance, and minute ventilation sensor function of the pacemaker were good during the follow-up period, with a heart rate at the pacing rate. The growth and development of the aforementioned patients who received pacemaker implantation demonstrated adherence to the percentile curve, and their motor and cognitive development remained unaffected. However, among the children who did not undergo pacemaker implantation, two experienced death, while three were lost to follow-up, thereby limiting the evaluation of their long-term outcomes. Conclusions Early implantation of an epicardial pacemaker at an early stage in newborns and infants diagnosed with CCAVB can significantly improve clinical symptoms without affecting their growth and development. These data are in line with current literature and suggest that early implantation of an epicardial pacemaker in newborns and infants diagnosed with CCAVB but further studies are needed.

BackgroundAutoimmune nodopathy (AN) has emerged as a novel diagnostic category that is pathologically different from classic chronic inflammatory demyelinating polyneuropathy. Clinical manifestations of AN include sensory or motor neuropathies, sensory ataxia, tremor, and cranial nerve involvement. AN with a serum-positive contactin-1 (CNTN1) antibody usually results in peripheral nerve demyelination. In this study, we reported a rare case of AN with CNTN1 antibodies characterized by the presence of CNTN1 antibodies in both serum and cerebrospinal fluid, which is associated with cerebellar dysarthria.MethodsA 25-year-old man was admitted to our hospital due to progressive dysarthria with limb tremors. The patient was initially diagnosed with peripheral neuropathy at a local hospital. Three years after onset, he was admitted to our hospital due to dysarthria, apparent limb tremor, and limb weakness. At that time, he was diagnosed with spinocerebellar ataxia. Eight years post-onset, during his second admission, his condition had notably deteriorated. His dysarthria had evolved to typical distinctive cerebellar characteristics, such as tremor, loud voice, stress, and interrupted articulation. Additionally, he experienced further progression in limb weakness and developed muscle atrophy in the distal limbs. Magnetic resonance imaging (MRI), nerve conduction studies (NCS), and autoimmune antibody tests were performed.ResultsThe results of the NCS suggested severe demyelination and even axonal damage to the peripheral nerves. MRI scans revealed diffuse thickening of bilateral cervical nerve roots, lumbosacral nerve roots, cauda equina nerve, and multiple intercostal nerve root sheath cysts. Furthermore, anti-CNTN1 antibody titers were 1:10 in the cerebrospinal fluid (CSF) and 1:100 in the serum. After one round of rituximab treatment, the patient showed significant improvement in limb weakness and dysarthria, and the CSF antibodies turned negative.ConclusionApart from peripheral neuropathies, cerebellar dysarthria (central nervous system involvement) should not be ignored in AN patients with CNTN1 antibodies.

ObjectiveMovement disorders (MDs) are common in anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis but are poorly studied. This study aimed to investigate the clinical characteristics of MDs and the clinical differences between patients with and without MDs in anti-NMDAR encephalitis.MethodsA retrospective study was conducted on patients with anti-NMDAR encephalitis who were first diagnosed and treated in the First People’s Hospital of Yunnan Province from January 2017 to September 2022. According to the presence or absence of MDs, all patients were divided into two groups, and the clinical manifestations, auxiliary examinations, and prognosis of the two groups were compared. Patients in the MDs group were further subgrouped by different ages (

ObjectiveExtracorporeal membrane oxygenation (ECMO) is an advanced life support that has been utilized in the neonate for refractory respiratory and circulatory failure. Striving for the best outcomes and understanding optimal surgical techniques continue to be at the forefront of discussion and research. This study presents a single-center experience of cervically cannulated neonatal patients on V-A ECMO, a description of our cannulation/decannulation techniques and our patient outcomes.MethodsSingle center retrospective review of neonates who received neck V-A ECMO support from January 2012 to December 2022. The data and outcomes of the patients were retrospectively analyzed.ResultsA total of 78 neonates received V-A ECMO support. There were 66 patients that received ECMO for respiratory support, the other 12 patients that received ECMO for cardiac support. The median duration of ECMO support was 109 (32–293) hours for all patients. During ECMO support, 20 patients died and 5 patients discontinued treatment due to poor outcome or the cost. A total of 53 (68%) patients were successfully weaned from ECMO, but 3 of them died in the subsequent treatment. Overall 50 (64%) patients survived to hospital discharge. In this study, 48 patients were cannulated using the vessel sparing technique, the other 30 patients were cannulated using the ligation technique. We found no significant difference in the rates of normal cranial MRI at discharge between survivors with and without common carotid artery ligation.ConclusionWe achieved satisfactory outcomes of neonatal ECMO in 11-year experience. This study found no significant difference in early neuroimaging between survivors with and without common carotid artery ligation. The long-term neurological function of ECMO survivors warranted further follow-up and study.

This study investigated the protective effect of vanillin against Parkinson’s disease (PD). 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP; 30 mg/kg) was administered s.c. for 6 consecutive days to induce PD and mice were treated with vanillin (100 and 200 mg/kg, p.o.) for 15 days. Cognitive, motor and non-motor functions were assessed to evaluate the effect of vanillin in PD mice. Levels of dopamine and glutamate and activity of monoamine oxidaseB (MAO-B) were estimated in vanillin-treated PD mice. The effect of vanillin on the level of lipid peroxidation and superoxide dismutase in brain tissue of PD mice was estimated. Data of the study revealed that vanillin reversed the altered cognitive, motor and non-motor function in PD mice. Activity of MAO-B and neurochemical level were attenuated with vanillin in PD mice. Inflammatory cytokines, nuclear factor kappa B (NF-kB) and Toll-like receptor 4 (TLR-4) levels were lower in the vanillin-treated group compared to the PD group of mice. Data of the study suggest that vanillin protects against neuronal injury and recovers the altered behaviour in PD mice by regulating neurochemical balance and the TLR-4/NF-kB pathway.

Abstract Background In the early stages of the coronavirus disease 2019 (COVID-19) outbreak, the most widely recognised symptoms of the disease were fever, cough, shortness of breath, myalgia, and fatigue. However, in addition to these symptoms, COVID-19 can cause systemic symptoms outside the lungs. Older patients with severe COVID-19 often require admission to the intensive care unit (ICU). Acute rectal ulcer bleeding, characterised by painless, profuse haematochezia, caused by solitary or multiple rectal ulcers, is one of the main causes of severe haematochezia in patients with COVID-19 in the ICU. However, recurrent duodenal ulcer bleeding followed by rectal ulcer bleeding has not previously been reported in older patients during ICU treatment for severe COVID-19. Cases presentation Herein, we report the case of an 81-year-old woman admitted to the emergency department due to severe COVID-19 and transferred to the ICU 2 days later for treatment. During treatment in the ICU, the patient developed recurrent duodenal ulcer bleeding and underwent endoscopic electrocoagulation haemostasis and gastroduodenal artery embolisation. However, the night after the final haemostatic operation, due to rectal ulcer bleeding, the patient discharged bloody stools intermittently, which was effectively controlled using endoscopic electrocoagulation, topical medication, blood transfusion, and haemostatic drugs. Conclusions To the best of our knowledge, this is the first report of duodenal ulcer bleeding followed by rectal ulcer bleeding in an older patient with severe COVID-19 infection. This report creates awareness for clinicians about the multiple and complex gastrointestinal symptoms that may occur during COVID-19 treatment.

As a common bulking agent and stabilizer for residents, aluminum-containing food additives have a comprehensive application scenario. However, it is noteworthy that the abuse of aluminum-containing food additives may cause a potential health risk to the public. Taking aluminum-containing food additives as the research object, the paper systematically discusses the basic characteristics of aluminum-containing food additives, detection technology of aluminum-containing food additives, and monitoring of food aluminum content, and summarizes the current problems for each part.

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an antibody-related autoimmune encephalitis. It is characterized by the existence of antibodies against NMDAR, mainly against the GluN1 subunit, in cerebrospinal fluid (CSF). Recent research suggests that anti-NMDAR antibodies may reduce NMDAR levels in this disorder, compromising synaptic activity in the hippocampus. Although anti-NMDAR antibodies are used as diagnostic indicators, the origin of antibodies in the central nervous system (CNS) is unclear. The blood–brain barrier (BBB), which separates the brain from the peripheral circulatory system, is crucial for antibodies and immune cells to enter or exit the CNS. The findings of cytokines in this disorder support the involvement of the BBB. Here, we aim to review the function of NMDARs and the relationship between anti-NMDAR antibodies and anti-NMDAR encephalitis. We summarize the present knowledge of the composition of the BBB, especially by emphasizing the role of BBB components. Finally, we further provide a discussion on the impact of BBB dysfunction in anti-NMDAR encephalitis.

Due to the fact that murals are usually displayed on a large area, it is necessary to develop intelligent algorithms for high-resolution images. In recent years, deep learning has been widely applied in the field of image processing. For the problem of high-resolution image restoration in murals, deep learning technology can also be used to solve it. This article carries out systematic research on deep learning-driven high-resolution image restoration for murals from the perspective of vision sensing. Firstly, principal characteristics of mural paintings such as textures and structures are extracted using conventional vision feature representation. Then, the extracted feature contents are mapped into restorage schemes with the assistance of deep neural network structure, so that digital restoration of mural paintings can be realized. The proposed solution blocks high priority sample blocks, prevents sample blocks with a large number of unknown pixels from being processed, and reduces the continuous accumulation of errors caused by matching errors to achieve digital restoration of murals. The simulation results on real-world image sets show that compared to the baseline method, the recovery accuracy can be improved by more than 20%. This method can restore the main structure and texture details of complex scene images, especially in the case of large-scale information loss.

Abstract Background Extracorporeal membrane oxygenation (ECMO) can be used as salvage therapy for multitrauma patients with acute respiratory distress syndrome (ARDS) when conventional treatment fails to maintain oxygenation. However, controversy exists between ECMO application and the risk of bleeding due to systemic anticoagulation during the treatment. Non-heparin introduction seems to be a possible solution for this dilemma, owing to technical improvements in the device and management methods of ECMO. Case presentation A 58-year-old woman suffered from blunt thoracic, pelvic, and right lower limb fractures due to a falling accident, which resulted in acute respiratory distress syndrome (ARDS). Although the patient received intubation and mechanical ventilation (MV), respiratory failure was not alleviated. Venous-venous (V-V) ECMO was used as a salvage therapy. With the support of V-V ECMO, we safely cleared blood clots in the bronchus and avoided secondary lung injury caused by pressure trauma and oxygen poisoning of the MV. We introduced heparin-free ECMO management as a solution to reduce the risk of bleeding associated with pulmonary contusion and other organ injuries. To prevent thrombosis, we set the blood rate of ECMO to 4.0 L/min, which is much higher than the usual parameter. During ECMO, coagulation factors, such as prothrombin time, activated partial thromboplastin time, and D-dimer, were examined. ECMO was maintained for 5 days without any complications; MV was stopped on the 13th day, extubated on the 24th day, and discharged from ICU on the 28th day. Conclusion ECMO with non-heparin could be an optimal treatment for multitrauma patients with ARDS when traditional treatment cannot sustain oxygenation. High blood flow rate could prevent thrombosis through ongoing ECMO therapy without systemic anticoagulation. In addition, monitoring D-dimer value change (Δ D-dimer) may be better than D-dimer value in predicting clot formation in the membrane oxygenator.

Molecular and stable carbon isotopic compositions of 32 crude oils from the Kekeya area of the Southwest Depression, Tarim Basin, were analyzed comprehensively to clarify oil groups and trace oil sources. The results indicate that lacustrine shale sequences within the Upper-Middle Permian Pusige Formation (P3–2p) are the major effective oil sources; the thermal maturation effects exert the crucial impact on geochemical compositions of crude oils. In the Kekeya structural belt, crude oils produced from the Lower-Neogene, Middle-Paleogene and Middle-Cretaceous sandstone reservoirs were generated mainly from deeply buried P3–2p at the late-to-high maturity stage. These condensates are depleted in terpanes, steranes and triaromatic steranes and enriched in adamantanes and diamantanes. The evaluated thermal maturity levels of crude oils by terpanoids and steranes are generally lower than that of diamondoids, implying at least two phases of oil charging. In the Fusha structural belt, oils produced from the Lower-Jurassic reservoirs (J1s) of Well FS8 were generated from the local P3–2p at the middle to late mature stage. On the contrary, these oils are relatively rich in molecular biomarkers such as terpanes and steranes and depleted in diamondoids with only adamantanes detectable. The P3–2p-associated oils can migrate laterally from the Kekeya to Fusha structural belt, but not to the location of Well FS8. The Middle-Lower Jurassic (J1–2) lacustrine shales as the major oil sources are limited to the area around Well KS101 in the Kekeya structural belt. Crude oils originated from J1–2 and P3–2p can mix together within the Cretaceous reservoirs of Well KS101 by presenting the concurrence of high concentrations of terpane and sterane biomarkers and diamondoids as well as 2–4% 13C-enriched n-alkanes than those of P3–2p derived oils. This study provides a better understanding of hydrocarbon sources and accumulation mechanisms and hence petroleum exploration in this region.

To solve problems in dissimilarly light metal joints, refilled friction stir spot welding (RFSSW) is proposed instead of resistance spot welding. However, rotation speed, dwell time, plunge depth, and the diameter of welding tools all have a great influence on joints, which brings great challenges in optimizing welding parameters to ensure their mechanical properties. In this study, the 1.5 mm thick 2A12Al and 2 mm thick 7B04Al lap joints were prepared by Taguchi orthogonal experiment design and RFSSW. The welding tool (shoulder) diameters were 5 mm and 7 mm, respectively. The macro/microstructures of the cross-section, the geometrical characteristics of the effective welding depth (EWD), the stir zone area (SZA), and the stir zone volume (SZV) were characterized. The shear strength and failure mode of the lap joint were analyzed using an optical microscope. It was found that EWD, SZA, and SZV had a good correlation with tensile–shear force. The optimal welding parameters of 5 mm diameter joints are 1500 rpm of rotation speed, 2.5 mm of plunge depth, and 0 s of dwell time, which for 7 mm joints are 1200 rpm, 1.5 mm, and 2 s. The tensile–shear force of 5 mm and 7 mm joints welded with these optical parameters was 4965 N and 5920 N, respectively. At the same time, the 5 mm diameter joints had better strength and strength stability.

BackgroundCongenital heart diseases (CHDs) are conditions that involve structural problems to the heart's structure existing at birth, with an incidence of approximately 8 per 1,000 live births globally. CHD is one of the leading causes of maternal, fetal, and neonatal morbidity and mortality worldwide. The present study sought to examine the clinical profiles of CHD patients and provide important implications for therapeutic interventions.MethodsThis was a retrospective, observational, cohort study. The medical records of all CHDs patients aged between 0 and 18 years were collected from July 1, 2021 to June 30, 2022. Clinical profiles and demographic data were collected from cardiology and pediatric department registers for analysis.ResultsOf the 265 children with CHDs, 201 were diagnosed with acyanotic CHD (ACHD), while 64 children had cyanotic CHD (CCHD). Based on the eleventh revision of the International Classification of Diseases (ICD-11), “congenital anomaly of a ventricle or the ventricular septum” was the most common CHD. The most common symptom was failure to thrive, accounting for 18.5% of all CHD cases. The most frequent symptom in ACHD was murmur (93.53%) and sweating (80.60%), whereas the most common symptom in CCHD was sweating (95.31%) and cyanosis (84.38%).ConclusionsThis study retrospectively analyzed CHD clinical characteristics from children receiving care at the seventh center, which forms a proper basis for appropriate clinical treatments and further studies.

The amyloid-β (Aβ) hypothesis was once believed to represent the pathogenic process of Alzheimer’s disease (AD). However, with the failure of clinical drug development and the increasing understanding of the disease, the Aβ hypothesis has been challenged. Numerous recent investigations have demonstrated that the vascular system plays a significant role in the course of AD, with vascular damage occurring prior to the deposition of Aβ and neurofibrillary tangles (NFTs). The question of how Aβ relates to neurovascular function and which is the trigger for AD has recently come into sharp focus. In this review, we outline the various vascular dysfunctions associated with AD, including changes in vascular hemodynamics, vascular cell function, vascular coverage, and blood–brain barrier (BBB) permeability. We reviewed the most recent findings about the complicated Aβ-neurovascular unit (NVU) interaction and highlighted its vital importance to understanding disease pathophysiology. Vascular defects may lead to Aβ deposition, neurotoxicity, glial cell activation, and metabolic dysfunction; In contrast, Aβ and oxidative stress can aggravate vascular damage, forming a vicious cycle loop.

Abstract This paper reported a wine-derived lactic acid bacterium, Lactiplantibacillus plantarum XJ25, which exhibited higher cell viability under acid stress upon methionine supplementation. Cellular morphology and the composition of the cytomembrane phospholipids revealed a more solid membrane architecture presented in the acid-stressed cells treated with methionine supplementation. Transcriptional analysis showed L. plantarum XJ25 reduced methionine transport and homocysteine biosynthesis under acid stress. Subsequent overexpression assays proved that methionine supplementation could alleviate the cell toxicity from homocysteine accumulation under acid stress. Finally, L. plantarum XJ25 employed energy allocation strategy to response environmental changes by balancing the uptake methionine and adjusting saturated fatty acids (SFAs) in membrane. These data support a novel mechanism of acid resistance involving methionine utilization and cellular energy distribution in LAB and provide crucial theoretical clues for the mechanisms of acid resistance in other bacteria.

Abstract Foggy weather can cause such problems as blurred image information and the loss of image details, which may pose great challenges to road traffic target detection based on images and videos. In this study, we propose a domain‐adaptive road vehicle target detection method to implement domain adaptation for the real foggy scene. We firstly constructed a highway vehicle detection dataset with foggy images (HVFD), which contains normal weather images and foggy images and provides a complete data support for vehicle detection based on computer vision. Secondly, by improving CycleGAN we designed an improved generative confrontation network (CPGAN), which realised the style transfer between foggy images and normal weather images. Finally, we formulated a YOLOv4 target detection framework according to the domain adaptation based on the pre‐trained YOLOv4 fog vehicle detection model. The experimental results show that the method we put forward can effectively improve vehicle detection performance and reduce the work of manually labelling a large number of foggy image tags, which has a strong generalisation ability for computer vision‐based applications in low‐visibility weather.

Panicle development and grain production in crop species are essential breeding characteristics affected by the synthesis of auxin, which is influenced by flavin monooxygenase-encoding genes such as YUC (YUCCA) family members. In this trial, fourteen YUCs were identified and named uniformly in foxtail millet, an ancient crop species cultivated across the world. The phylogenetic analysis revealed that the SiYUCs were clustered into four subgroups; protein motif and gene structure analyses suggested that the closely clustered SiYUC genes were relatively conserved within each subgroup; while genome mapping analysis indicated that the SiYUC genes were unevenly distributed on foxtail millet chromosomes and colinear with other grass species. Transcription analysis revealed that the SiYUC genes differed greatly in expression pattern in different tissues and contained hormonal/light/stress-responding cis-elements. The haplotype characterization of SiYUC genes indicated many superior haplotypes of SiYUCs correlated with higher panicle and grain weight could be favorably selected by breeding. These results will be useful for the further study of the functional characteristics of SiYUC genes, particularly with regard to the marker-assisted pyramiding of beneficial haplotypes in foxtail millet breeding programs.

The hydrocarbon source rocks of the marine carbonates of the Ordovician Majiagou Formation in the Ordos Basin are generally in the high-overmature stage and are, therefore, not suitable for hydrocarbon thermal simulation experiments. Their hydrocarbon generation potential and hydrocarbon generation characteristics are not clearly understood. Meanwhile, Nordic Cambrian carbonates are similar in lithology, parent material type, and sedimentary age, and are in the low evolution stage, which is suitable for hydrocarbon thermal simulation experiments. Therefore, in this study, we selected the Nordic carbonates for the gold tube thermal simulation experiment to analyze the content and geochemical characteristics of the thermal simulation products. The experimental results are also compared and analyzed with the characteristics of thermal simulation products of Pingliang Formation mud shale (contemporaneous with the Majiagou Formation) and Shanxi Formation coal (in the upper part of the Majiagou Formation), which are similar to the Majiagou Formation in the Ordos Basin. The results showed that the Nordic carbonate has different hydrocarbon production characteristics from the mud shale of the Pingliang Formation of the same parent material type, and although the hydrocarbon production yields of the two are not very different, the carbonate still produces methane at 600 °C. The hydrocarbon production yield of the Nordic carbonates is almost equivalent to that of type-II2 kerogen, indicating that the hydrocarbon production yield is not related to lithology and only to the organic matter type; however, the Nordic carbonate can produce a large amount of H2S. The alkane carbon isotope changes are mainly controlled by the degree of thermal evolution, showing gradual heaviness with increasing temperature. No carbon isotope sequence reversal occurred during the thermal simulation, and its distribution range is roughly the same as that of the alkane carbon isotope composition of the mud shale of the Pingliang Formation. The ethane carbon isotope composition is as heavy as −21.2‰ at the high-temperature stage, showing similar coal-type gas characteristics. The addition of calcium sulphate (CaSO4) causes the TSR reaction to occur, which has a significant impact on the methane content under high maturity conditions, reducing its content by more than 50% at 600 °C. However, the addition of CaSO4 increases the yield of heavy hydrocarbon gases, such as ethane, and promotes the production of C6-14 hydrocarbons and C14+ hydrocarbons at high-temperature stages, and the addition of CaSO4 substantially increases the yield of H2, CO2, and H2S. The thermal simulation results have implications for the hydrocarbon formation mechanism of the early Paleozoic marine carbonate formation system in the stacked basins of the Ordos Basin and the Tarim Basin in China.

CYP46A1 is a brain-specific enzyme responsible for cholesterol homeostasis. Inhibition of CYP46A1 activity serves as a therapeutic target for excitatory neurotoxicity. Sesame is a common medicine and food resource; its component lignans possess various pharmacological activities. In this study, the inhibitory effects of sesame lignans on CYP46A1 activity were investigated. Inhibition kinetics analyses revealed that sesamin and sesamolin produce mixed partial competitive inhibition of CYP46A1, while sesamol produces non-competitive inhibition. Notably, molecular simulations revealed that the sesame lignans have excellent orientations within the active cavity of CYP46A1. Importantly, the sesame lignans had high permeability coefficients and low efflux ratios. Furthermore, sesamin significantly reduced the levels of 24S-hydroxycholesterol in rat plasma and brain tissues, and down-regulated the protein expressions of CYP46A1, NMDAR2A, NMDAR2B, and HMGCR. Collectively, sesame lignans exhibit significant inhibitory effects on CYP46A1 activity, highlighting their potential therapeutic role in treating excitatory neurotoxicity.

Abstract Clock genes not only regulate the circadian rhythm of physiological activities but also participate in the pathogenesis of many diseases. Previous studies have documented the abnormal expression of clock genes in epilepsy. However, the molecular mechanism of brain and muscle Arnt-like protein 1 (Bmal1), one of the core clock genes, in the epileptogenesis and seizures of temporal lobe epilepsy (TLE) remain unclear. We first investigated the levels of Bmal1 and other clock proteins in the hippocampus of subjects with epilepsy to define the function of Bmal1. The levels of Bmal1 were decreased during the latent and chronic phases in the experimental group compared with those in the control group. Knockout of Bmal1 in hippocampal dentate gyrus (DG) neurons of Bmal1flox/flox mice by Synapsin 1 (Syn1) promoter AAV (adeno-associated virus) lowered the threshold of seizures induced by pilocarpine administration. High-throughput sequencing analysis showed that PCDH19 (protocadherin 19), a gene associated with epilepsy, was regulated by Bmal1. PCDH19 expression was also decreased in the hippocampus of epileptic mice. Furthermore, the higher levels of Bmal1 and PCDH19 were detected in patients with no hippocampal sclerosis (no HS) than in patients with HS International League Against Epilepsy (ILAE) type I and III. Altogether, these data suggest that decreased expression of clock gene Bmal1 may participate in epileptogenesis and seizures via PCDH19 in TLE.

ObjectiveTo report a case of autoimmune nodopathy (AN) with concurrent serum and CSF immunoglobulin (Ig)G4 anti-neurofascin 155 (NF155) and anti-GD1b antibodies.MethodsA 20-year-old male presented distal weakness of the 4 limbs, hypoesthesia, absent tendon reflexes and sensory ataxia. Nerve conduction studies (NCS), MRI, and autoantibody tests were performed.ResultsNCS revealed a diffuse demyelinating neuropathy in the peripheral nerve with motor and sensory involvement. MRI of the cervical and lumbar plexus showed diffuse enlargement. IgG4 anti-NF155 antibodies in both serum and CSF and IgG anti-GD1b antibodies in serum were positive. After treatment with IVIg, rituximab, and plasma exchange, the titer of the patient’s anti-NF155 antibodies decreased, but symptoms did not significantly improve.DiscussionThis patient presented a typical clinical feature of AN with serum and CSF anti-NF155 antibodies and serum anti-GD1b antibodies coexistent but poor response to IVIg, rituximab and plasma exchange. Early detection of antibodies may be helpful in both diagnosis and therapy of the disease. And prospective studies are necessary to demonstrate the potential role of anti-NF155 antibodies in CSF and help further understand this complex and heterogeneous disease.

ObjectiveWe previously identified the independent predictors of recurrent relapse in neuromyelitis optica spectrum disorder (NMOSD) with anti-aquaporin-4 antibody (AQP4-ab) and designed a nomogram to estimate the 1- and 2-year relapse-free probability, using the Cox proportional hazard (Cox-PH) model, assuming that the risk of relapse had a linear correlation with clinical variables. However, whether the linear assumption fits real disease tragedy is unknown. We aimed to employ deep learning and machine learning to develop a novel prediction model of relapse in patients with NMOSD and compare the performance with the conventional Cox-PH model.MethodsThis retrospective cohort study included patients with NMOSD with AQP4-ab in 10 study centers. In this study, 1,135 treatment episodes from 358 patients in Huashan Hospital were employed as the training set while 213 treatment episodes from 92 patients in nine other research centers as the validation set. We compared five models with added variables of gender, AQP4-ab titer, previous attack under the same therapy, EDSS score at treatment initiation, maintenance therapy, age at treatment initiation, disease duration, the phenotype of the most recent attack, and annualized relapse rate (ARR) of the most recent year by concordance index (C-index): conventional Cox-PH, random survival forest (RSF), LogisticHazard, DeepHit, and DeepSurv.ResultsWhen including all variables, RSF outperformed the C-index in the training set (0.739), followed by DeepHit (0.737), LogisticHazard (0.722), DeepSurv (0.698), and Cox-PH (0.679) models. As for the validation set, the C-index of LogisticHazard outperformed the other models (0.718), followed by DeepHit (0.704), DeepSurv (0.698), RSF (0.685), and Cox-PH (0.651) models. Maintenance therapy was calculated to be the most important variable for relapse prediction.ConclusionThis study confirmed the superiority of deep learning to design a prediction model of relapse in patients with AQP4-ab-positive NMOSD, with the LogisticHazard model showing the best predictive power in validation.

Cancer patients generally has a high risk of thrombotic diseases. However, anticoagulant therapy always aggravates bleeding risks. Rivaroxaban is one of the most widely used direct oral anticoagulants, which is used as anticoagulant treatment or prophylaxis in clinical practice. The present study aimed to systemically estimate the combination safety of rivaroxaban with tyrosine kinase inhibitors (TKIs) based on human cytochrome P450 (CYPs) and efflux transporters and to explore the drug–drug interaction (DDI) mechanisms in vivo and in vitro. In vivo pharmacokinetic experiments and in vitro enzyme incubation assays and bidirectional transport studies were conducted. Imatinib significantly increased the rivaroxaban Cmax value by 90.43% (p < 0.05) and the area under the curve value by 119.96% (p < 0.01) by inhibiting CYP2J2- and CYP3A4-mediated metabolism and breast cancer resistance protein (BCRP)- and P-glycoprotein (P-gp)-mediated efflux transportation in the absorption phase. In contrast, the combination of sunitinib with rivaroxaban reduced the exposure in vivo by 62.32% (p < 0.05) and the Cmax value by 72.56% (p < 0.05). In addition, gefitinib potently inhibited CYP2J2- and CYP3A4-mediated rivaroxaban metabolism with Ki values of 2.99 μΜ and 4.91 μΜ, respectively; however, it almost did not affect the pharmacokinetics of rivaroxaban in vivo. Taken together, clinically significant DDIs were observed in the combinations of rivaroxaban with imatinib and sunitinib. Imatinib increased the bleeding risks of rivaroxaban, while sunitinib had a risk of reducing therapy efficiency. Therefore, more attention should be paid to aviod harmful DDIs in the combinations of rivaroxaban with TKIs.

N6-methyladenosine (m6A) is an epigenetic modification that widely exists in long noncoding RNAs (lncRNAs) and is involved in the regulation of oncogenes or tumor suppressor genes that form complex enzymes to affect the occurrence of tumors. The abnormal modification of m6A methylation can alter the overall m6A level and thus contribute to the malignant biological behaviors of hepatocellular carcinoma (HCC). LncRNAs related to m6A methylation are involved in lipogenesis, the proliferation, migration and invasion of HCC cells, the stemness of tumor cells and sorafenib resistance. In this review, we systematically elaborated the occurrence mechanism of lncRNA and m6A methylation modification in HCC and the effect of m6A methylation modification of lncRNA on the occurrence of HCC, suggesting that the combination of m6A methylation modification and lncRNA will be more meaningful as molecular markers or prognostic markers. It is helpful to provide further ideas for exploring the pathogenesis of HCC and identifying new targets for HCC treatment and diagnosis and achieve precise individual treatment of liver cancer.

In human–computer interaction (HCI) systems for Mandarin learning, tone recognition is of great importance. A brand-new tone recognition method based on random forest (RF) and feature fusion is proposed in this study. Firstly, three fusion feature sets (FFSs) were created by using different fusion methods on sound source features linked to Mandarin syllable tone. Following the construction of the CART decision trees using the three FFSs, modeling and optimization of the corresponding RF tone classifiers were performed. The method was tested and evaluated on the Syllable Corpus of Standard Chinese (SCSC), which is a speaker-independent Mandarin monosyllable corpus. Additionally, the effects were also assessed on small sample sets. The results show that the tone recognition algorithm can achieve high tone recognition accuracy and has good generalization capability and classification ability with unbalanced data. This indicates that the proposed approach is highly efficient and robust and is appropriate for mobile HCI learning systems.

Imipenem (IMP) possesses a broad spectrum of antibacterial activity; however, nephrotoxicity limits its clinical application in patients with renal insufficiency. In our previous studies, a dipeptide, JBP485, a dipeptide with the chemical structure cyclo-trans-4-L-hydroxyprolyl-L-serine, was found to attenuate drug-induced kidney injury. The current study aimed to explore whether JBP485 could relieve IMP-induced kidney injury and clarify the potential molecular pharmacokinetic mechanism. The effects of JBP485 on IMP nephrotoxicity were evaluated in rabbits and human kidney 2 (HK-2) cells. Drug-drug interactions (DDIs) mediated by organic anion transporters (OATs) and dehydropeptidase-I (DHP-I) were explored through pharmacokinetic studies in rats, metabolism assays in the kidney, and uptake studies in OAT-over-expressing cells. The results revealed that JBP485 significantly ameliorated IMP-induced nephrotoxicity in rabbits. Further, incubation of HK-2 cells with JBP485 or cilastatin markedly improved the cell survival rate, inhibited apoptosis and attenuated mitochondrial damage by improving the stability of IMP and reducing its intracellular accumulation. This suggests that DHP-I and OATs might be involved in the protective effect of JBP485. Furthermore, coadministration with JBP485 significantly increased the IMP’s plasma concentration as well as the area under the plasma concentration-time curve (AUC), while decreasing IMP renal clearance and cumulative urinary excretion. Moreover, JBP485 reduced IMP uptake in kidney slices and OAT1/3-human embryonic kidney 293 (HEK293) cells. At the same time, the metabolism of IMP by DHP-I was inhibited by JBP485 with an IC50 value of 12.15 ± 1.22 μM. Finally, the molecular docking assay revealed a direct interaction between JBP485 and OAT1/3 or DHP-I. In conclusion, JBP485 protected against IMP nephrotoxicity in rabbits and HK-2 cells by improving IMP stability and reducing its intracellular accumulation via simultaneous inhibition of renal OATs and DHP-I. JBP485 is a promising renoprotective agent and could serve as an effective supplement to reduce IMP-induced adverse renal reactions in the clinical setting.

Background: Primary localized mediastinal mesothelioma is a rare tumour which accounts for about 0.7% of all mesotheliomas. The mesothelial cells lining of the pericardium are suggested as the most probable cells of origin. Mediastinal pleural mesothelioma are distinctly uncommon, which has only been reported in a single case. Case presentation: We report a case of a 57 years old man with primary mediastinal pleural mesothelioma involving middle and posterior upper mediastinum, one months following surgery, the patient is alive with good performance status. Chest plain scan and contrast-enhanced computer tomography（CT）scan showed a 43 mm×36 mm×36 mm tumor，with a CT value of about 41.5 HU, an arterial phase CT value of about 59.8HU and a venous phase CT value of about 77.5HU during the contrast-contrast-enhanced scan.Patients underwent thoracotomy.The pathological diagnosis was derived from malignant pleural mesothelioma(MPM) growing from the chest wall into the mediastinum. Conclusions Imaging manifestations of tumors have rarely been described in the literature. A short review of literature on MPM is given and summarize the imaging characteristics.

Context The effect of kaempferol, a regulator of oestrogen receptors, on atherosclerosis (AS) and the underlying mechanism is elusive. Objective To explore the effect and mechanism of kaempferol on AS. Methods and materials In vivo, C57BL/6 and apolipoprotein E (APOE)–/– mice were randomly categorized into six groups (C57BL/6: control, ovariectomy (OVX), high-fat diet (HFD); APOE–/–: OVX-HFD, OVX-HFD + kaempferol (50 mg/kg) and OVX-HFD + kaempferol (100 mg/kg) and administered with kaempferol for 16 weeks, intragastrically. Oil-Red and haematoxylin–eosin (HE) staining were employed to examine the effect of kaempferol. In vitro, human aortic endothelial cells (HAECs) were pre-treated with or without kaempferol (5, 10 or 20 μM), followed by administration with kaempferol and oxidized low-density lipoprotein (ox-LDL) (200 μg/mL). The effect of kaempferol was evaluated using flow cytometry, and TdT-mediated dUTP Nick-End Labelling (TUNEL). Results In vivo, kaempferol (50 and 100 mg/kg) normalized the morphology of blood vessels and lipid levels and suppressed inflammation and apoptosis. It also activated the G protein-coupled oestrogen receptor (GPER) and PI3K/AKT/nuclear factor-erythroid 2-related factor 2 (Nrf2) pathways. In vitro, ox-LDL (200 μg/mL) reduced the cell viability to 50% (IC50). Kaempferol (5, 10 or 20 μM) induced-GPER activation increased cell viability to nearly 10%, 19.8%, 30%, and the decreased cellular reactive oxygen species (ROS) generation (16.7%, 25.6%, 31.1%), respectively, consequently attenuating postmenopausal AS. However, the protective effects of kaempferol were blocked through co-treatment with si-GPER. Conclusions The beneficial effects of kaempferol against postmenopausal AS are associated with the PI3K/AKT/Nrf2 pathways, mediated by the activation of GPER.

2198 aluminum–lithium alloy was friction stir-welded with a KUKA Robot integrated with a compact friction stir-welding head with a rotation speed of 800 rpm at different welding speeds. The real-time tool force in the three directions of Fx, Fy and Fz was measured with a load sensor. Mechanical properties and microstructure evolution were investigated systematically. The results showed that Fz force increased from 3.2 kN to 8.5 kN as welding speed increased from 50 mm/min to 500 mm/min. Ultimate tensile strength of 383 MPa, 88% of base metal, was obtained when the welding speed was 100 mm/min. The nugget zone consisted of refined grains with an average size of 4 μm. TEM investigation demonstrates that T1 precipitation predominated in the base metal and disappeared in the nugget zone, as a small amount of δ’ was retained. The W-shape hardness profile in all weldments and higher welding speed lead to a higher hardness value.

Friction stir lap welding (FSLW) was employed to weld dissimilar joints of zirconium and stainless steel for the first time. The microstructure, evolution mechanism of intermetallic compounds (IMCs) and mechanical properties of joint were investigated. Discontinuous dynamic recrystallization (DDRX) and continuous dynamic recrystallization (CDRX) occurred in zirconium, while DDRX occurred in stainless steel during FSLW. The formation sequence of IMCs at the interface was FeZr3, FeZr2, Fe2Zr, and Fe23Zr6. The crack nucleated at the hook zone on the advancing side (HookAS), and IMCs in the Zr/SS mixed zone accelerated crack propagation. The fracture surface exhibited ductile-brittle mixed fracture characteristic.

BackgroundRecognizing the predictors of disease relapses in patients with anti-aquaporin-4 antibody (AQP4-ab)-positive neuromyelitis optica spectrum disorder (NMOSD) is essential for individualized treatment strategy. We aimed to identify the factors that predicted relapses among patients with AQP4-ab-positive NMOSD, develop outcome prediction models, and validate them in a multicenter validation cohort.MethodsBetween January 2015 and December 2020, 820 patients with NMOSD were registered at Huashan Hospital. We retrospectively reviewed their medical records, and included 358 AQP4-ab-positive patients with 1135 treatment episodes. Univariate and multivariate analyses were used to explore the predictors of relapse, severe visual or motor disability during follow-up. A model predicting the 1- and 2-year relapse-free probability was developed and validated in an external validation cohort of 92 patients with 213 treatment episodes.ResultsLower serum AQP4-ab titer (< 1:100), higher Expanded Disability Status Scale (EDSS) score at onset (≥ 2.5), and use of intravenous methylprednisolone (IVMP) at the first attack predicted an overall lower annualized relapse rate. Older age (> 48 years), optic neuritis at onset, and higher onset EDSS score (≥ 2.5) significantly increased the risk for blindness, while IVMP at the first attack and maintenance therapy reduced the risk for blindness. Myelitis at onset increased the possibility of motor disability (EDSS ≥ 6.0), severe motor disability or death (EDSS ≥ 8.0), while maintenance therapy reduced these possibilities. Anderson and Gill model identified that the risk factors predicting recurrent relapses under certain treatment status were female gender, high AQP4-ab titer (≥ 1:100), previous attack under same therapy, lower EDSS score at treatment initiation (< 2.5), and no maintenance therapy or oral prednisone lasting less than 6 months. A nomogram using the above factors showed good discrimination and calibration abilities. The concordance indexes in the primary and validation cohort were 0.66 and 0.65, respectively.ConclusionThis study reports the demographic, clinical and therapeutic predictors of relapse, and severe visual or motor disability in NMOSD. Early identification of patients at risk of unfavorable outcomes is of paramount importance to inform treatment decisions.

This study aimed to clarify that organic anion transporters (OATs) mediate the drug–drug interaction (DDI) between imipenem and cilastatin. After co-administration with imipenem, the plasma concentrations and the plasma concentration-time curve (AUC) of cilastatin were significantly increased, while renal clearance and cumulative urinary excretion of cilastatin were decreased. At the same time, imipenem significantly inhibited the uptake of cilastatin in rat kidney slices and in human OAT1 (hOAT1)-HEK293 and human OAT3 (hOAT3)-HEK293 cells. Probenecid, p-aminohippurate, and benzylpenicillin inhibited the uptake of imipenem and cilastatin in rat kidney slices and in hOAT1- and hOAT3-HEK 293 cells, respectively. The uptakes of imipenem and cilastatin in hOAT1- and hOAT3-HEK 293 cells were significantly higher than that in mock-HEK-293 cells. Moreover, the Km values of cilastatin were increased in the presence of imipenem with unchanged Vmax, indicating that imipenem inhibited the uptake of cilastatin in a competitive manner. When imipenem and cilastatin were co-administered, the level of imipenem was higher compared with imipenem alone both in vivo and in vitro. But, cilastatin significantly inhibited the uptake of imipenem when dehydropeptidase-1 (DPEP1) was silenced by RNAi technology in hOAT1- and hOAT3-HEK 293 cells. In conclusion, imipenem and cilastatin are the substrates of OAT1 and OAT3. OAT1 and OAT3 mediate the DDI between imipenem and cilastatin. Meanwhile, cilastatin also reduces the hydrolysis of imipenem by inhibiting the uptake of imipenem mediated by OAT1 and OAT3 in the kidney as a complement. Keywords: Imipenem/cilastatin, Renal dipeptidase, Organic anion transporters, Drug–drug interaction

Pharmacokinetics (PK) is the study of the absorption, distribution, metabolism, and excretion (ADME) processes of a drug. Understanding PK properties is essential for drug development and precision medication. In this review we provided an overview of recent research on PK with focus on the following aspects: (1) an update on drug-metabolizing enzymes and transporters in the determination of PK, as well as advances in xenobiotic receptors and noncoding RNAs (ncRNAs) in the modulation of PK, providing new understanding of the transcriptional and posttranscriptional regulatory mechanisms that result in inter-individual variations in pharmacotherapy; (2) current status and trends in assessing drug–drug interactions, especially interactions between drugs and herbs, between drugs and therapeutic biologics, and microbiota-mediated interactions; (3) advances in understanding the effects of diseases on PK, particularly changes in metabolizing enzymes and transporters with disease progression; (4) trends in mathematical modeling including physiologically-based PK modeling and novel animal models such as CRISPR/Cas9-based animal models for DMPK studies; (5) emerging non-classical xenobiotic metabolic pathways and the involvement of novel metabolic enzymes, especially non-P450s. Existing challenges and perspectives on future directions are discussed, and may stimulate the development of new research models, technologies, and strategies towards the development of better drugs and improved clinical practice. KEY WORDS: Pharmacokinetics, Drug metabolism, Drug–drug interactions, Modeling, Metabolizing enzymes, Transporters, Nuclear receptors, Noncoding RNAs

To assess the mechanism of the pharmacokinetic interaction between piperacillin and tazobactam, renal excretion and pharmacokinetic studies of piperacillin/tazobactam were investigated in normal and bacteremia rats. A bacteremia model was established to investigate the pharmacokinetic properties of piperacillin and tazobactam under different conditions. Renal slices were taken to examine the uptake of piperacillin and tazobactam. Pharmacokinetic studies of β-lactamase in rats were performed to study the contribution of rOat1/3 to the inhibition of tazobactam on β-lactamase. The AUC (from 2.93 ± 0.58 to 6.52 ± 1.44 mg·min/ml) and the plasma clearance (CLP) (from 2.41 ± 1.20 to 0.961 ± 0.212 ml/min/kg) of tazobactam were both altered after the intravenous coadministration of piperacillin and tazobactam in the bacteremia rats. The renal clearance (CLR) of tazobactam decreased from 1.30 ± 0.50 to 0.361 ± 0.043 ml/min/kg. In summary, there was a beneficial interaction between piperacillin and tazobactam mediated by rOat1 and rOat3. Piperacillin enhances the inhibitory effect of tazobactam on β-lactamase through the inhibition of rOat1 and rOat3 in rats. The contribution rate of rOat1/3 for the synergistic effect was 20% when the two drugs were coadministered. Keywords: Organic anion transporter, Piperacillin, Tazobactam, Drug-drug interaction

Purpose: To report complications after epilepsy surgery, grade the severity of complications, investigate risk factors, and develop a nomogram for risk prediction of complications.Methods: Patients with epilepsy surgery performed by a single surgeon at a single center between October 1, 2003 and April 30, 2019 were retrospectively analyzed. Study outcomes included severity grading of complications occurring during the 3-month period after surgery, risk factors, and a prediction model of these complications. Multivariable logistic regression analysis was used to calculate odds ratio and 95% confidence interval to identify risk factors.Results: In total, 2,026 surgical procedures were eligible. There were 380 patients with mild complications, 23 with moderate complications, and 82 with severe complications. Being male (odds ratio 1.29, 95% confidence interval 1.02–1.64), age at surgery (>40 years: 2.58, 1.55–4.31; ≤ 40: 2.25, 1.39–3.65; ≤ 30: 1.83, 1.18–2.84; ≤ 20: 1.71, 1.11–2.63), intracranial hemorrhage in infancy (2.28, 1.14–4.57), serial number of surgery ( ≤ 1,000: 1.41, 1.01–1.97; ≤ 1,500: 1.63, 1.18–2.25), type of surgical procedure (extratemporal resections: 2.04, 1.55–2.70; extratemporal plus temporal resections: 2.56, 1.80–3.65), surgery duration (>6 h: 1.94, 1.25–3.00; ≤ 6: 1.92, 1.39–2.65), and acute postoperative seizure (1.44, 1.06–1.97) were independent risk factors of complications. A nomogram including age at surgery, type of surgical procedure, and surgery duration was developed to predict the probability of complications.Conclusions: Although epilepsy surgery has a potential adverse effect on the patients, most complications are mild and severe complications are few. Risk factors should be considered during the perioperative period. Patients with the above risk factors should be closely monitored to identify and treat complications timely. The prediction model is very useful for surgeons to improve postoperative management.

Interleukin-18 (IL-18) can effectively activate natural killer (NK) cells and induce large concentrations of interferon-γ (IFN-γ). In healthy humans, IL-18 binding protein (IL-18BP) can inhibit the binding of IL-18 to IL-18R and counteract the biological action of IL-18 due to its high concentration and high affinity, thus preventing the production of IFN-γ and inhibiting NK-cell activation. Through previous studies and the phenomena observed by our group in pig–non-human primates (NHPs) liver transplantation experiments, we proposed that the imbalance in IL-18/IL-18BP expression upon transplantation encourages the activation, proliferation, and cytotoxic effects of NK cells, ultimately causing acute vascular rejection of the graft. In this research, we used Lewis–Brown Norway rat orthotopic liver transplantation (OLTx) as a model of acute vascular rejection. AAV8-Il18bp viral vectors as gene delivery vehicles were constructed for gene therapy to overexpress IL-18BP and alleviate NK-cell rejection of the graft after transplantation. The results showed that livers overexpressing IL-18BP had reduced damage and could function longer after transplantation, effectively improving the survival time of the recipients.

The stability of food web is a hot issue and a research frontier in ecology which has attracted widespread interests. In this research, a new investigation is conducted on the stability of food web. We take Somme Bay as a study case and employ a dynamic model to analyze food web characteristics, with the model parameters determined by energy flow balance. Based on the model, the food web of Somme Bay is studied via the changing growth rates of producers and the observation of dynamical complexity, species extinction and food web structure. Comparing with former works, a few interesting results are obtained: (1) living dependence, species extinction cascade, competition, “couple” phenomenon between taxonomic groups are clarified; (2) complex dynamics may emerge from the dynamic model and the occurrence of chaos predicts the coming of species extinction; (3) eight degraded food web structures are found, which reflects the possible regime shifts. With the analyses of the food web characteristics in response to the change of key parameters, this research may provide a new way to study the stability and regime shifts.

Imipenem is a carbapenem antibiotic. However, Imipenem could not be marketed owing to its instability and nephrotoxicity until cilastatin, an inhibitor of renal dehydropeptidase-I (DHP-I), was developed. In present study, the potential roles of renal organic anion transporters (OATs) in alleviating the nephrotoxicity of imipenem by cilastatin were investigated in vitro and in rabbits. Our results indicated that imipenem and cilastatin were substrates of hOAT1 and hOAT3. Cilastatin inhibited hOAT1/3-mediated transport of imipenem with IC50 values comparable to the clinical concentration, suggesting the potential to cause a clinical drug–drug interaction (DDI). Moreover, imipenem exhibited hOAT1/3-dependent cytotoxicity, which was alleviated by cilastatin and probenecid. Furthermore, cilastatin and probenecid ameliorated imipenem-induced rabbit acute kidney injury, and reduced the renal secretion of imipenem. Cilastatin and probenecid inhibited intracellular accumulation of imipenem and sequentially decreased the nephrocyte toxicity in rabbit primary proximal tubule cells. Renal OATs, besides DHP-I, was also the target of interaction between imipenem and cilastatin, and contributed to the nephrotoxicity of imipenem. This therefore gives in part the explanation about the mechanism by which cilastatin protected against imipenem-induced nephrotoxicity. Thus, OATs can potentially be used as a therapeutic target to avoid the renal adverse reaction of imipenem in clinic. KEY WORDS: Imipenem, Cilastatin, Probenecid, OATs, hOAT1, hOAT3, Nephrotoxicity

Circular RNAs (circRNAs) are a novel category of non-coding RNAs, and they have been identified to participate in glioma tumorigenesis. Here we investigated the functions of circRNA circSCAF11 in glioma genesis, and we unveiled its molecular mechanism in the pathophysiological process. Expression levels of circSCAF11, miR-421, and SP1 mRNA were measured using RT-PCR. Proteins were measured using western blotting. The tumor phenotypes of glioma cells were detected using flow cytometry and Cell Counting Kit-8 (CCK-8), transwell, and xenograft mouse assays. The combination within circSCAF11, miR-421, and SP1 was validated using luciferase reporter assay or RNA pull-down assay. The binding of transcription factor SP1 with vascular endothelial cell growth factor A (VEGFA) promoter was inspected using chromatin immunoprecipitation (ChIP). circSCAF11 expression was found to be significantly upregulated in the glioma tissue specimens and cell lines. The ectopic overexpression of circSCAF11 was closely correlated with the poor clinical outcome of glioma patients. Functionally, knockdown of circSCAF11 inhibited the proliferation, invasion, and tumor growth and induced the G0/G1 phase arrest. Mechanically, circSCAF11 positively regulated the SP1 expression through sponging miR-421. Moreover, transcription factor SP1 activated the transcription of VEGFA, constructing the circSCAF11/miR-421/SP1/VEGFA axis in the glioma genesis. The findings in this research illustrate that circSCAF11 accelerates glioma tumorigenesis through the miR-421/SP1/VEGFA axis, providing a potential target for circRNA and glioma treatment. Keywords: glioma, circular RNA, circSCAF11, miR-421, SP1, VEGFA