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Significance: Near-infrared autofluorescence (NIRAF) utilizes the natural autofluorescence of parathyroid glands (PGs) to improve their identification during thyroid surgeries, reducing the risk of inadvertent removal and subsequent complications such as hypoparathyroidism. This study evaluates NIRAF's effectiveness in real-world surgical settings, highlighting its potential to enhance surgical outcomes and patient safety. Aim: We evaluate the effectiveness of NIRAF in detecting PGs during thyroidectomy and central neck dissection and investigate autofluorescence characteristics in both fresh and paraffin-embedded tissues. Approach: We included 101 patients diagnosed with papillary thyroid cancer who underwent surgeries in 2022 and 2023. We assessed NIRAF's ability to locate PGs, confirmed via parathyroid hormone assays, and involved both junior and senior surgeons. We measured the accuracy, speed, and agreement levels of each method and analyzed autofluorescence persistence and variation over 10 years, alongside the expression of calcium-sensing receptor (CaSR) and vitamin D. Results: NIRAF demonstrated a sensitivity of 89.5% and a negative predictive value of 89.1%. However, its specificity and positive predictive value (PPV) were 61.2% and 62.3%, respectively, which are considered lower. The kappa statistic indicated moderate to substantial agreement (kappa = 0.478; P < 0.001 ). Senior surgeons achieved high specificity (86.2%) and PPV (85.3%), with substantial agreement (kappa = 0.847; P < 0.001 ). In contrast, junior surgeons displayed the lowest kappa statistic among the groups, indicating minimal agreement (kappa = 0.381; P < 0.001 ). Common errors in NIRAF included interference from brown fat and eschar. In addition, paraffin-embedded samples retained stable autofluorescence over 10 years, showing no significant correlation with CaSR and vitamin D levels. Conclusions: NIRAF is useful for PG identification in thyroid and neck surgeries, enhancing efficiency and reducing inadvertent PG removals. The stability of autofluorescence in paraffin samples suggests its long-term viability, with false positives providing insights for further improvements in NIRAF technology.
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Imagen Óptica , Glándulas Paratiroides , Espectroscopía Infrarroja Corta , Tiroidectomía , Humanos , Glándulas Paratiroides/cirugía , Glándulas Paratiroides/metabolismo , Masculino , Femenino , Persona de Mediana Edad , Imagen Óptica/métodos , Adulto , Espectroscopía Infrarroja Corta/métodos , Adhesión en Parafina/métodos , Anciano , Cáncer Papilar Tiroideo/cirugía , Cáncer Papilar Tiroideo/patología , Cáncer Papilar Tiroideo/metabolismo , Receptores Sensibles al Calcio/metabolismo , Receptores Sensibles al Calcio/análisisRESUMEN
Control of N-nitrosodimethylamine (NDMA) in drinking water could be achieved by removing its precursors as one practical way. Herein, superfine powdered activated carbons with a diameter of about 1 µm (SPACs) were successfully prepared by grinding powdered activated carbon (PAC, D50=24.3 µm) and applied to remove model NDMA precursors, i.e. ranitidine (RAN) and nizatidine (NIZ). Results from grain diameter experiments demonstrated that the absorption velocity increased dramatically with decreasing particle size, and the maximum increase in k2 was 26.8-folds for RAN and 33.4-folds for NIZ. Moreover, kinetic experiments explained that rapid absorption could be attributed to the acceleration of intraparticle diffusion due to the shortening of the diffusion path. Furthermore, performance comparison experiments suggested that the removal of RAN and NIZ (C0=0.5 mg/L) could reach 61.3% and 60%, respectively, within 5 min, when the dosage of SAPC-1.1 (D50=1.1 µm) was merely 5 mg/L, while PAC-24.3 could only eliminate 17.5% and 18.6%. The adsorption isotherm was well defined by Langmuir isotherm model, indicating that the adsorption of RAN/NIZ was a monolayer coverage process. The adsorption of RAN or NIZ by SAPC-1.1 and PAC-24.3 was strongly pH dependent, and high adsorption capacity could be observed under the condition of pH > pka+1. The coexistence of humic acid (HA) had no significant effect on the adsorption performance because RAN/NIZ may be coupled with HA and removed simultaneously. The coexistence of anions had little effect on the adsorption also. This study is expected to provide an alternative strategy for drinking water safety triggered by NDMA.
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Carbón Orgánico , Dimetilnitrosamina , Tamaño de la Partícula , Contaminantes Químicos del Agua , Purificación del Agua , Adsorción , Carbón Orgánico/química , Contaminantes Químicos del Agua/química , Purificación del Agua/métodos , Dimetilnitrosamina/química , Cinética , Modelos QuímicosRESUMEN
Perineural invasion (PNI) is a notorious feature of salivary adenoid cystic carcinoma (SACC) and other neurotropic tumors. The pathogenesis of PNI that involves the molecular communication between the tumor and the suffered nerve is elusive. The in vitro co-culture assays of SACC cells with dorsal root ganglia (DRG) or neural cells showed that nerve-derived CCL2 activated CCR2 expression in SACC cells, promoting the proliferation, adhesion, migration, and invasion of SACC cells via the ERK1/2/ITGß5 pathway. Meanwhile, SACC-derived exosomes delivered ITGß5 to promote the neurite outgrowth of neural cells or DRG. Blocking of CCL2/CCR2 axis or ITGß5 inhibited the PNI of SACC cells in models in vitro by 3D co-culture of DRG with SACC cells and in vivo by xenografting SACC cells onto the murine sciatic nerve. High levels of ITGß5 in tissues or plasma exosomes were significantly correlated with CCL2 and CCR2 expression in the tissues and associated with PNI and poor prognosis of SACC cases. Our findings revealed a novel reciprocal loop between neural and tumor cells driven by the CCL2/CCR2 axis and exosomal ITGß5 during PNI of SACC. The present study may provide a prospective diagnostic and anti-PNI treatment strategy for SACC patients via targeting the nerve-tumor interactions.
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Infectious, inflammatory and autoimmune conditions present differently in males and females. SARS-CoV-2 infection in naive males is associated with increased risk of death, whereas females are at increased risk of long COVID1, similar to observations in other infections2. Females respond more strongly to vaccines, and adverse reactions are more frequent3, like most autoimmune diseases4. Immunological sex differences stem from genetic, hormonal and behavioural factors5 but their relative importance is only partially understood6-8. In individuals assigned female sex at birth and undergoing gender-affirming testosterone therapy (trans men), hormone concentrations change markedly but the immunological consequences are poorly understood. Here we performed longitudinal systems-level analyses in 23 trans men and found that testosterone modulates a cross-regulated axis between type-I interferon and tumour necrosis factor. This is mediated by functional attenuation of type-I interferon responses in both plasmacytoid dendritic cells and monocytes. Conversely, testosterone potentiates monocyte responses leading to increased tumour necrosis factor, interleukin-6 and interleukin-15 production and downstream activation of nuclear factor kappa B-regulated genes and potentiation of interferon-γ responses, primarily in natural killer cells. These findings in trans men are corroborated by sex-divergent responses in public datasets and illustrate the dynamic regulation of human immunity by sex hormones, with implications for the health of individuals undergoing hormone therapy and our understanding of sex-divergent immune responses in cisgender individuals.
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Testosterona , Personas Transgénero , Adulto , Femenino , Humanos , Masculino , Conjuntos de Datos como Asunto , Células Dendríticas/inmunología , Células Dendríticas/metabolismo , Células Dendríticas/efectos de los fármacos , Sistema Inmunológico/efectos de los fármacos , Sistema Inmunológico/metabolismo , Interferón Tipo I/inmunología , Interferón Tipo I/metabolismo , Interferón gamma/inmunología , Interferón gamma/metabolismo , Interleucina-15/inmunología , Interleucina-15/metabolismo , Células Asesinas Naturales/inmunología , Células Asesinas Naturales/efectos de los fármacos , Monocitos/inmunología , Monocitos/efectos de los fármacos , Monocitos/metabolismo , FN-kappa B/metabolismo , Caracteres Sexuales , Testosterona/efectos adversos , Testosterona/inmunología , Testosterona/farmacología , Testosterona/uso terapéutico , Factor de Necrosis Tumoral alfa/metabolismoRESUMEN
Learning using privileged information (LUPI) has shown its effectiveness to improve the B-mode ultrasound (BUS) based computer-aided diagnosis (CAD) by transferring knowledge from the elasticity ultrasound (EUS). However, LUPI only performs transfer learning between the paired data with shared labels, and cannot handle the scenario of modality imbalance. In order to conduct the supervised transfer learning between the paired ultrasound data together with the additional single-modal BUS images, a novel multi-view LUPI algorithm with Dual-Level Modality Completion, named DLMC-LUPI, is proposed to improve the performance of BUS-based CAD. The DLMC-LUPI implements both image-level and feature-level (dual-level) completions of missing EUS modality, and then performs multi-view LUPI for knowledge transfer. Specifically, in the dual-level modality completion stage, a variational autoencoder (VAE) model for feature generation and a novel generative adversarial network (VAE-based GAN) model for image generation are sequentially trained. The proposed VAE-based GAN can improve the synthesis quality of EUS images by adopting the features generated by VAE from the BUS images as the model constrain to make the features generated from the synthesized EUS images more similar to them. In the multi-view LUPI stage, two feature vectors are generated from the real or pseudo images as two source domains, and then fed them to the multi-view support vector machine plus classifier for model training. The experiments on two ultrasound datasets indicate that the DLMC-LUPI outperforms all the compared algorithms, and it can effectively improve the performance of single-modal BUS-based CAD.
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Phthalate esters (PAEs), as emerging pollutants, pose a serious threat to human health and have become a major concern in the fields of environmental protection and food safety. Selective adsorption using molecularly imprinted polymer (MIP) is feasible, but most MIPs use the potentially toxic methacrylic acid (MAA) as a functional monomer, along with other crosslinking agents. In this study, MIP adsorbent was prepared using only ethylene glycol dimethacrylate (EGDMA) as both the functional monomer and crosslinking agent, without the inclusion of MAA. The adsorbent was utilized for the adsorption of PAEs from an ethanol aqueous solution. The results showed that EGDMA-based MIP (EMIP) achieved better adsorption performance of PAEs than MAA-based MIP (MMIP) due to more interactions of EGDMA with PAEs than MAA with them. For the adsorption of dibutyl phthalate (DBP) using EMIP, 95% of the equilibrium adsorption capacity was achieved within the first 15 min. In the isotherm analysis, the theoretical maximum adsorption capacity of EMIP was obtained as high as 159.24 mg/g at 20 °C in an ethanol (10 v%) aqueous solution. Furthermore, the adsorption of EMIP was not affected by the pH of the solution. The adsorption process of EMIP followed the pseudo-second-order kinetic and Freundlich isotherm model. Ethanol had a significant impact on the adsorption of DBP, and the results of molecular simulation could validate this. In addition, the regeneration experiments indicated that EMIP could be recycled 5 times without significant performance change and had a high recovery efficiency of 94.55%.
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The abundance of uranium (U(VI)) reserves in seawater makes it crucial to develop economically efficient methods for uranium extraction from seawater. In this work, an enhanced polyamidoxime porous membrane (PAOM) was fabricated by pre-in situ amidoxime modification combined with nonsolvent-induced phase separation (NIPS). The strategy of in situ modification of the polyacrylonitrile (PAN) solution served to enhance the homogeneity of the reaction and avoid the destruction of the membrane matrix and pore structure. Compared with the control sample (AOPM), PAOM possessed better mechanical strength and hydrophilicity. The introduction of polyvinylpyrrolidone (PVP) formed a porous structure in PAOM, improving spatial accessibility and facilitating the diffusion transport and capture of UO22+ inside the membrane. The more uniform and abundant distribution of amidoxime groups in PAOM gave it ultrahigh adsorption capacity and selectivity. The equilibrium adsorption capacity and Kd value of PAOM were 1.72 and 5.51 times higher than those of AOPM. Meanwhile, PAOM also demonstrated good recyclability, with only a 6.15% decrease in adsorption capacity after seven cycles. Additionally, PAOM exhibited excellent dynamic adsorption performance, and after 14 days of continuous filtration and adsorption, PAOM could extract 2.03 mg·g-1 U(VI) from natural seawater.
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BACKGROUND: Little is known about the underlying factors contributing to unfavourable clinical outcomes in patients with diabetes mellitus (DM) complicated by new-onset acute myocardial infarction (AMI). The aim of this study was to investigate the impact of DM on the pathophysiologic features and prognosis of patients with new-onset AMI following successful revascularization by utilizing cardiac magnetic resonance (CMR). METHODS: Consecutive patients diagnosed with new-onset AMI between June 2022 and January 2024 were included. All patients underwent culprit vessel revascularization upon admission and CMR imaging 3-7 days later. The primary clinical endpoint of this study was the occurrence of major adverse cardiac and cerebrovascular events (MACCEs), for which the average follow-up was 10 months. RESULTS: A total of 72 patients were divided into a DM group (n = 23) and a non-DM group (n = 49). Multivariate logistic regression analysis revealed that DM was an independent risk factor for the occurrence of microvascular obstruction. Multivariate linear regression analysis found that DM was the influencing factor of global radial strain (B = -4.107, t = -2.328, p = 0.023), while fasting blood glucose influenced infarct segment myocardial radial strain (B = -0.622, t = -2.032, p = 0.046). DM independently contributed to the risk of MACCEs following successful revascularization in patients with AMI (p < 0.05). CONCLUSION: Comprehensive phenotypic characterization of myocardial injury and microcirculatory status could enable reliable identification of high-risk MACCEs in DM patients with new-onset AMI following successful revascularization.
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Infarto del Miocardio , Humanos , Masculino , Femenino , Persona de Mediana Edad , Estudios Prospectivos , Infarto del Miocardio/diagnóstico por imagen , Infarto del Miocardio/fisiopatología , Pronóstico , Anciano , Diabetes Mellitus/epidemiología , Diabetes Mellitus/fisiopatología , Revascularización Miocárdica/estadística & datos numéricos , Factores de Riesgo , Imagen por Resonancia Magnética , Imagen por Resonancia Cinemagnética/métodosRESUMEN
The change and mechanism of soil and soil bacterial diversity during the change of herbaceous litter thickness in desert areas is crucial to understand. In the study, the dominant herbaceous litter mixture in Baijitan National Nature Reserve was selected as the research material, and an experiment was established by adjusting the litter depth. The results showed that the measured values of soil physicochemical factors (total nitrogen, total protein, total potassium, available phosphorus, available potassium, pH, and soil water content) increased with the increase of herbaceous litter mixture thickness in 0-5 cm soil layer. Actinobacteria, Proteobacteria, Acidobacteria, Chloroflexi, and Gemmatimonadetes were the dominant bacterial phyla under different thicknesses of herbaceous litter in 0-5 and 5-10 cm soil layers. Balneimonas, Rubrobacter, and Geodermatophilus were the dominant bacterial genera under different thicknesses of herbaceous litter in 0-5 and 5-10 cm soil layers. There was no obvious change in the α-diversity index of bacterial community the same soil layer, but the α-diversity index in the 0-5 cm soil layer was lower compared to the 5-10 cm soil layer. The results of this study revealed that the change of herbaceous litter thickness had no significant effect on soil bacterial community structure in desert areas.
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As a novel pollutant, microplastic pollution has become a global environmental concern. Melatonin (MT) has a protective effect on the damage caused by pollutants. However, there is still a lack of research on the transgenerational toxicity of microplastics and the alleviation of microplastics toxicity by MT. In this study, the adult zebrafish was exposed to (0, 0.1 and 1 mg/L) polystyrene nanoplastics (PSNP) with or without (1 µM) MT for 14 days, and embryos (F1) were used for experiments. Our study found that long-term exposure of parents to 1 mg/L PSNP reduced fertilization rate and survival rate of offspring, increased the deformity rate and induced embryos to hatch in advance. The growth inhibition of offspring was related to the gene transcription of the growth hormone/insulin-like growth factor axis. Moreover, PSNP caused oxidative stress in offspring, damaged immune system, reduced antioxidant capacity and induced apoptosis. MT supplementation could effectively alleviate the developmental toxicity and oxidative damage of offspring, but the negative effects brought by PSNP could not be completely eliminated. Our research provided a new reference for the protective effect of MT on transgenerational toxicity induced by PSNP.
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Low voltage electrostatic field (LVEF), a novel non-thermal processing technology, shows promise for food preservation. However, the absence of clear definition and quantification of the core concept "low voltage" obstructs the effective application of LVEF. This study assessed the efficiency of various LVEF intensities (100, 200, 300 V) on cherry tomato preservation, revealing significant differences in preservation efficiency. Compared to the control, samples treated with different intensities showed varied reductions in weight loss (6.26-25.45 %), firmness changes (5.17-28.91 %), and decay incidence (47.91-70.89 %). Quantitative analysis elucidated that the differential preservation efficiency may arise from a dose-response relationship between electric field strength and hydrogen peroxide (H2O2) contentï¼ identifying an optimal H2O2 content range of 21.18-27.01 mmol kg-1 for the effective preservation of cherry tomatoes under LVEF. These findings highlight the importance of precise LVEF intensity control for effective food preservation and offer insights for developing optimal LVEF treatment intensities for diverse produce.
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BACKGROUND: Regenerative endodontic procedures (REPs) is effective for treating young permanent teeth with pulp necrosis. However, its efficacy on delayed replanted avulsed teeth is unclear. AIM: This retrospective study aimed to assess the efficacy of REPs in treating delayed replanted immature permanent teeth with apical periodontitis. DESIGN: Avulsed teeth receiving REPs were systematically screened based on predetermined criteria. This study assessed the REP outcomes, postoperative periodontal healing, and overall treatment efficacy. Samples were grouped by REP outcomes and root development stage, with Fisher's exact tests used to compare outcomes among different groups. RESULTS: Among the included 17 teeth, 47.1% exhibited successful REPs and periodontal healing. Another 47.1%, due to replacement resorption or REP failure, were categorized as tooth survival. Healing of periapical lesions was observed in 88.2% of the cases, but only 41.2% demonstrated continued root development. Although differences were not significant (p = 0.05), teeth with continued root development had a higher rate of functional healing (85.7%) compared to those without (30%). CONCLUSION: Within the limitations of this study, REPs presented reliable outcomes for treating delayed replanted immature permanent teeth with apical periodontitis mainly in periapical lesion healing. Teeth with continued root development after REPs exhibited a higher rate of functional healing. Further investigation is required to explore potential synergies between REP outcomes and periodontal healing.
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Optical metasurfaces with pronounced spectral characteristics are promising for sensor applications. Currently, deep learning (DL) offers a rapid manner to design various metasurfaces. However, conventional DL models are usually assumed as black boxes, which is difficult to explain how a DL model learns physical features, and they usually predict optical responses of metasurfaces in a fuzzy way. This makes them incapable of capturing critical spectral features precisely, such as high quality (Q) resonances, and hinders their use in designing metasurface sensors. Here, a transformer-based explainable DL model named Metaformer for the high-intelligence design, which adopts a spectrum-splitting scheme to elevate 99% prediction accuracy through reducing 99% training parameters, is established. Based on the Metaformer, all-dielectric metasurfaces based on quasi-bound states in the continuum (Q-BIC) for high-performance metasensing are designed, and fabrication experiments are guided potently. The explainable learning relies on spectral position encoding and multi-head attention of meta-optics features, which overwhelms traditional black-box models dramatically. The meta-attention mechanism provides deep physics insights on metasurface sensors, and will inspire more powerful DL design applications on other optical devices.
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Soil microorganisms play a crucial role as a link between vegetation and soil nutrient cycling. However, it is unclear how vegetation and soil influence microbial community during the ecological restoration process of the Mu Us Desert. Using phospholipid fatty acid (PLFA) markers and integrating shrub, herbaceous plants, and soil factors, we explored the characteristics and regulations of soil microbial community changes. In this study, we used and took the soil after 10, 30, 50, and 70 years of Caragana korshinskii sand-fixing forest restoration, with moving dunes as a control (0 year). The results showed that the ecological restoration effect index increased significantly with the increase of recovery years. The total PLFA contents in 0, 10, 30, 50, and 70 years were 47.75, 55.89, 63.53, 67.23, and 82.29 nmol·g-1, respectively. With the increases of ecological restoration index, the biomass of fungi and bacteria, as well as the ratio of Gram-positive to Gram-negative bacteria, all showed significant increase, while the biomass of Gram-positive and Gram-negative bacterial communities, and the ratio of fungi to bacteria, demonstrated significant decrease. Shrub, herbaceous plants, and soil factors could explain 72.4% of the vari-ation of soil microbial community composition, with higher contribution of soil factors than vegetation factors. The total content of phospholipid fatty acids of soil microbial community in Mu Us Desert increased with the increases of restoration years. Soil water content, pH, total nitrogen, and soil organic carbon were the main driving factors affecting the characteristics of soil microbial community. With the increases of restoration years of C. korshinskii sand-fixation forests in the Mu Us Desert, there were significant changes in the structure of soil microbial communities, which were primarily driven by soil factors.
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Caragana , Clima Desértico , Microbiota , Microbiología del Suelo , Caragana/crecimiento & desarrollo , China , Bosques , Fosfolípidos/análisis , Restauración y Remediación Ambiental/métodos , Suelo/química , Arena , Ácidos Grasos/análisis , Conservación de los Recursos NaturalesRESUMEN
Effective microorganisms (EM) might alleviate deterioration of soil environmental quality and yield decline of pepper (Capsicum annuum) caused by continuous replanting and imbalanced fertilizer application in Xinjiang. We investigated the effects of applying EM microbial agent on the growth of pepper plants, yield, soil nutrient content, soil enzyme activity, and rhizosphere eukaryotic community. The results showed that the application of EM microbial agent increased plant height, stem diameter, leaf length, leaf width and root length by 22.6%, 35.3%, 33.3%, 29.7% and 15.1%, respectively. It also increased fruit width, individual fruit weight, and yield by 5.3%, 42.9%, and 74.7%, respectively. After the application of EM microbial agent, the levels of soil available nitrogen increased by 10.2% and 5.8% during the flowering and maturity stages, respectively. Similarly, available phosphorus increased by 10.4% and 13.4%, respectively. The soil sucrase activity was increased by 40.7%, 14.6%, and 9.3% during the seedling, flowering, and maturity stages, respectively. Urease activity was also increased by 7.9%, 10.2%, and 11.5%, respectively. Furthermore, the application of EM microbial agent increased soil peroxidase activity by 16.8% and 44.6% at flowering and maturity stages, respectively. The application of microbial agent significantly altered the ß-diversity of the rhizosphere eukaryotic community in pepper plants. Specifically, microbial agent increased the relative abundances of populations belonging to Enchytraeus and Sminthurides genera, which could contribute to soil improvement and nutrient cycling. Compared to the CK, the relative abundance of pathogenic microorganisms including Olpidium and Aplanochytrium genera decreased by 98.0% and 89.3%, and the relative abundance of the Verticillium decreased to 0. These results demonstrated that EM microbial agent could increase soil nutrient content, enhance soil enzyme activity, and reduce soil pathogenic fungi in the pepper cultivation areas of Xinjiang, thus achieving beneficial effects on pepper growth and fruit yield.
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Capsicum , Rizosfera , Microbiología del Suelo , Capsicum/crecimiento & desarrollo , Capsicum/microbiología , China , Suelo/química , Raíces de Plantas/crecimiento & desarrollo , Raíces de Plantas/microbiología , Raíces de Plantas/metabolismoRESUMEN
BACKGROUND: Natural emulsifiers are increasingly preferred by the food industry to meet consumers' demand for 'clean-label' emulsion products. In the present study, 10 short-term retrograded starches with unique molecular structures were explored to examine the relationships between starch structures and their ability to form stable oil-in-water emulsions. RESULTS: Waxy maize starch showed the largest value of contact angle and conductivity of emulsion, whereas potato and lentil starch showed the lowest value of contact angle and conductivity of emulsion, respectively. Emulsion prepared by rice starch showed the lowest, whereas that of sweet potato starch showed the highest value of viscosity. Consequentially, the emulsion stabilized with waxy maize and tapioca starch showed the smallest and less polydisperse droplets, resulting in a much higher emulsifying index. On the other hand, emulsion prepared with potato starch showed the highest stability compared to other starches. Correlation analysis suggested that starches with larger molecular size, a lower amylose content and shorter amylopectin short chains had a higher emulsification ability, whereas the amount of starch molecular interactions formed during short-term retrogradation revealed no obvious linking to emulsion performances. CONCLUSION: These findings provided food industry with exciting opportunities to develop 'clean-label' emulsions with desirable properties. © 2024 Society of Chemical Industry.
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INTRODUCTION: Through methodological quality assessment, this paper summarized the report quality and evidence level of systematic reviews (SRs)/meta-analyses (MAs) of acupuncture and its related treatment of female urinary incontinence (UI). EVIDENCE ACQUISITION: We conducted a comprehensive search in four internationally recognized databases (PubMed, Embase, Web of Science, Cochrane Library) for SRs/MAs pertaining to the treatment of female UI using acupuncture and its related therapies. We evaluated the methodological quality of the SRs/MAs using the "Assessing the Methodological Quality of Systematic Reviews 2" (AMSTAR-2) tool, assessed the quality of evidence using the "Grading of Recommendations, Assessment, Development, and Evaluation" (GRADE) system, and evaluated the reporting quality of the SRs/MAs using the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020" (PRISMA-2020) guidelines. This overview is registered with PROSPERO, CRD42024557600. EVIDENCE SYNTHESIS: In the final selection of 7 SRs/MAs, a consistent finding of the superiority of acupuncture and related therapies in the treatment of female UI was observed. Methodological quality was classified according to AMSTAR-2, with three rated as "high," two as "moderate," and two as "low." The main sources of downgrading included the absence of funding sources, failure to provide a reasonable explanation for heterogeneity, and not reporting potential conflicts of interest. According to the GRADE system, the quality of evidence ranged from moderate to very low. The most common reason for downgrading the evidence quality was the repeated utilization of the same original randomized controlled trials. Some results were also downgraded due to inconsistency, imprecision, and potential publication bias. According to the PRISMA-2020 statement, most SR/MAs clearly presented their title information, and almost all of them correctly used meta-analysis methods. However, some of them lacked comprehensive analysis and discussion of bias risk and consistency of results and were deficient in terms of protocol registration and documentation. CONCLUSIONS: Acupuncture and related therapies demonstrate superiority in terms of efficacy and safety for the treatment of female urinary incontinence (UI). The overall quality of the SRs/MAs seems to be satisfactory, particularly when compared to studies of acupuncture for the treatment of other conditions. However, attention should still be given to the proper use of methods and ensuring completeness in reporting.
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Whether the dynamic development of peripheral inflammation aggravates brain injury and leads to poor outcome in stroke patients receiving intravenous thrombolysis (IVT), remains unclear and warrants further study. In this study, total of 1034 patients with acute ischemic stroke who underwent IVT were enrolled. Serum leukocyte variation (whether increase from baseline to 24 h after IVT), National Institutes of Health Stroke Scale (NIHSS), infarct volume, early neurologic deterioration (END), the unfavorable outcome at 3-month (modified Rankin Scale [mRS] score ≥3) and mortality were recorded. Serum brain injury biomarkers, including Glial fibrillary acidic protein (GFAP), ubiquitin c-terminal hydrolase L1 (UCH-L1), S100ß, neuron-specific enolase (NSE), were measured to reflect the extent of brain injury. We found that patients with increased serum leukocytes had elevated brain injury biomarkers (GFAP, UCH-L1, and S100ß), larger infarct volume, higher 24 h NIHSS, higher proportion of END, unfavorable outcome and mortality. Furthermore, an increase in serum leukocytes was independently associated with infarct volume, 24 h NIHSS, END, and unfavorable outcome at 3 months, and serum UCH-L1, S100ß, and NSE levels. These results suggest that an increase in serum leukocytes indicates severe brain injury and may be used to predict the outcome of patients with ischemic stroke who undergo IVT.
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Background: Cancer-associated fibroblasts (CAFs) are the key components of the immune barrier in liver cancer. Therefore, gaining a deeper understanding of the heterogeneity and intercellular communication of CAFs holds utmost importance in boosting immunotherapy effectiveness and improving clinical outcomes. Methods: A comprehensive analysis by combing single-cell, bulk, and spatial transcriptome profiling with multiplexed immunofluorescence was conducted to unravel the complexities of CAFs in liver cancer. Results: Through an integrated approach involving 235 liver cancer scRNA-seq samples encompassing over 1.2 million cells, we found that CAFs were particularly increased in hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). FAP + fibroblasts were identified as the dominant subtype of CAFs, and which were mainly involved in extracellular matrix organization and angiogenesis. These CAFs were enriched in the tumor boundary of HCC, but diffusely scattered within ICC. The DAB2 + and SPP1 + tumor-associated macrophages (TAMs) reinforce the function of FAP + CAFs through signals such as TGF-ß, PDGF, and ADM. Notably, the interaction between DAB2 + TAMs and FAP + CAFs promoted the formation of immune barrier and correlated with poorer patient survival, non-response to immunotherapy in HCC. High FAP and DAB2 immunohistochemical scores predicted shorter survival and higher serum AFP concentration in a local clinical cohort of 90 HCC patients. Furthermore, this communication pattern might be applicable to other solid malignancies as well. Conclusions: The interaction between DAB2 + TAMs and FAP + CAFs appears crucial in shaping the immune barrier. Strategies aimed at disrupting this communication or inhibiting the functions of FAP + CAFs could potentially enhance immunotherapy effectiveness and improve clinical outcomes.