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Background: Apolipoprotein E (APOE) is closely related to Alzheimer’s disease and other age-related diseases. In recent years, several studies have shown an interaction of APOE by age on brain volume. However, validation in larger cohorts is required. Objective: We explored the age-related effect of APOE on brain volumes in a community-dwelling cohort. Methods: Inhabitants in Shunyi District in Beijing aged≥35 years were invited to join this study from 2013 to 2016. The baseline assessments, APOE genotyping and brain magnetic resonance imaging were performed. Neuroimaging small vessel disease characteristics and brain volumes (global measures, cerebral lobes, hippocampus, brainstem, and subcortical nuclei) were acquired. The general linear model was used to analyze the interaction of APOE genotypes by age on brain volumes, and the age of 60 years was chosen as a cut-off value for stratification analysis. Results: A total of 1,105 subjects were enrolled in the final analysis with a mean age of 56.18 (9.30) years, and 37.7% were men. APOE ɛ3/ɛ3 carriers account for 71.8%, ɛ2 (+) 14.0%, and ɛ4 (+) 14.2%. Compared with APOE ɛ3/ɛ3, a significant protective effect for APOE ɛ4 (+) on brain parenchyma fraction (β = 0.450, p = 0.048) was observed in subjects aged≤60 years; in participants aged > 60 years, a negative effect for APOE ɛ4 (+) on hippocampus (β = 1.087, p = 0.021) was found. Conclusion: Our study reveals that APOE ɛ4 has differential effects on cerebral structures in different stages of lifespan, suggesting its complicated biological function and underlying antagonistic pleiotropy.

Bingyue Xin, Keyue Xie, Bing Huang, Ming Yao Department of Anesthesiology and Pain Research Center, The First Hospital of Jiaxing or The Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of ChinaCorrespondence: Ming Yao, Department of Anesthesiology and Pain Research Center, The First Hospital of Jiaxing or The Affiliated Hospital of Jiaxing University, No. 1882 South Zhonghuan Road, Nanhu District, Jiaxing, Zhejiang Province, People’s Republic of China, Email jxyaoming666@163.comObjective: To investigate the effectiveness and safety of computed tomography (CT)-guided radiofrequency thermocoagulation (RFTC) of the thoracic sympathetic nerve versus chemical resection (CTS) for the treatment of pain caused by Raynaud’s disease.Methods: Patients who underwent CTS or thoracic sympathetic nerve RFTC between March 2012 and March 2021 were enrolled in this retrospective study. There were 28 cases in the alcohol group (Group A) and 44 in the radiofrequency group (Group R). Visual analog scores (VAS) were collected from patients at different time points, as well as preoperative and postoperative finger end perfusion index (PI) and hand temperature (T). The efficiency, postoperative recurrence rate, complications, and improvement in postoperative quality of life were observed in both groups.Results: Pain scores at different follow-up times after surgery decreased in both groups compared to the preoperative period (P < 0.05). Postoperative T and PI were higher in both groups than preoperatively all (P < 0.05). The recurrence rate was higher in the R group than in the A group. Postoperative complications were observed in 13.6% and 25% of patients in groups R and A, respectively. Meanwhile, the postoperative quality of life improved in both groups, but the radiofrequency (RF) group was better than the alcohol group in terms of improvement in quality of life (P < 0.05).Conclusion: Both CT-guided CTS and RFTC of the thoracic sympathetic nerve provided good treatment outcomes. However, the RF group was superior to the alcohol group in terms of complication rate and quality of life improvement.Keywords: Raynaud’s disease, sympathetic nerve, radiofrequency thermocoagulation, chemical thoracic sympathectomy, CT guidance

The conventional direct torque control (DTC) has high torque and stator flux fluctuation that causes the stator current distortion. This paper presents an efficient control method based on the feedback-linearization direct torque control (FL-DTC) method for an interior permanent magnet synchronous motor (IPMSM) drive by using an improved firefly algorithm. The proposed approach can greatly restrain the poor performance of torque and stator flux. Thus, it is suitable for IPMSM drives in electric vehicles. First, a decoupled linear model is derived to implement the proposed efficient feedback linearization control for the IPMSM. Two phase voltages in d-q axes and two additional control inputs take shape into an isomorphism mapping with the concept of orthogonal transformation. The torque generation is related to the additional control. Second, the Hamiltonian efficient control theory combined with an improved firefly algorithm is applied to obtain an analytical solution. An efficient linearization controller is designed with a cost function considering the maximum voltage of the inverter. Finally, simulation and experiment are carried out to compare the performance of the proposed efficient FL-DTC with the improved firefly algorithm and the conventional direct torque control. The results show that the proposed control method can reduce the torque and flux ripples at a steady state and maintains a good dynamic response with the variations of speed and torque.

A picoliter thin-layer chromatography (pTLC) platform was developed for analyzing extremely miniature specimens, such as assay of the contents of a single cell of 1 picoliter volume. The pTLC chip consisted of an array of microscale bands made from highly porous monolithic silica designed to accept picoliter-scale volume samples. pTLC bands were fabricated by combining sol-gel chemistry and microfabrication technology. The width (60-80 μm) and depth (13 μm) of each band is comparable to the size of single cells and acted to reduce the lateral diffusion and confine the movement of compounds along the microbands. Ultrasmall volumes (tens of pL) of model fluorescent compounds were spotted onto the microband by a piezoelectric microdispenser and successfully separated by pTLC. The separation resolution and analyte migration were dependent on the macropore size (ranging from 0.3 to 2.3 μm), which was adjustable by changing the porogen concentration during the sol-gel process. For a 0.3 μm macropore size, attomoles of analyte were detectable by fluorescence using standard microscopy methods. The separation resolution, theoretical plate number, and separation times ranged from 1.3 to 2.1, 4 to 357, and 2 to 8 min, respectively, for the chosen model biological lipids. To demonstrate the capability of pTLC for separating analytes from single mammalian cells, cells loaded with fluorescent lipophilic dyes or sphingosine kinase reporter were spotted on microbands, and the single-cell contents separated by pTLC were detected from their fluorescence. These results demonstrate the potential of pTLC for applications in many areas where miniature specimens and high-throughput parallel analyses are needed.

In this work, Rh metallene (Rhlene) with a high surface area was successfully used to support Pt nanoparticles (Pt/Rhlene). Pt/Rhlene revealed better performance for ethylene glycol oxidation reaction in alkaline solution than Pt black.

Orthogonal integration of holographic and fluorescent dual-mode optical images with facile tunable emission colors has been achieved by precisely controlling the Förster resonance energy transfer and photocleavage reaction of an AIEgen.

Evidence has indicated that lysine methyltransferase 2B (KMT2B), a major H3K4 tri-methyltransferase (H3K4me3), contributes to the development of various cancers; however, its role in cervical cancer (CC) is unclear. In this study, increased KMT2B expression was observed in human CC specimens and significantly associated with poor prognosis. The condition medium of KMT2B-overexpressing cells facilitated angiogenesis

In order to explore the adsorption characteristics of phosphorus from molecules with different molecular structures and varying number of phosphate groups on metal-modified biochar, walnut shell biochar was modified with LaCl

Background: Cognitive impairment is common in the elderly population. Exploring patterns of white matter damage at the microstructural level would give important indications for the underlying mechanisms. Objective: To investigate the spatial patterns of white matter microstructure and structural network alternations in relation to different cognition domains Methods: Participants from the community-based Shunyi Study were included to investigate the association between white matter measurements and cognition cross-sectionally, via both global and local analysis. Cognitive functions were assessed using digit span, trail making test (TMT)-A/B, Fuld object Memory, and 12-Word Philadelphia Verbal Learning Test (PVLT). White matter measurements including fractional anisotropy (FA), mean diffusivity (MD), and structural network parameters were calculated based on diffusion tensor imaging. Results: Of the 943 participants included, the mean (SD) age was 55.8 (9.1) years, and the mean (SD) education level was 6.7 (3.2) years. We found the whole set of cognitive measurements was related to diffused white matter microstructural integrity damage and lower global efficiency. Poor executive functions (TMTA/B complete time) were related to lower FA and higher MD predominantly on the anterior white matter skeleton, while verbal memory loss (PVLT test scores) was related to sub-network dysconnectivity in the midline and the right temporal lobe. Conclusion: The anterior brain is dominantly involved in executive dysfunction, while midline and right temporal brain disconnection are more prominent in verbal memory loss. Global and regional disruption of white matter integrity and network connectivity is the anatomical basis of the cognitive impairment in the aging population.

The use of biologic agents has become the cornerstone of therapy for moderate to severe IBD. Few studies have investigated the efficacy of vedolizumab (VDZ) induction for ulcerative colitis (UC) in Asian patients in a real practice setting.To evaluate the efficacy and safety of VDZ induction therapy for moderate to severe UC in Taiwan.This was a retrospective and observational study. Selected moderate to severe UC patients received VZD 300 mg i.v. at weeks 0, 2, and 6 as induction therapy. Mayo scores were calculated to evaluate the efficacy.A total of 37 patients with UC who received VDZ and completed the induction therapy at Chang Gung Memorial Hospital (2017/10-2021/5) were included. The mean age was 46.5 year-old and the male to female ratio was 1:1 (19/18). 81.8% of the patients were biologic-naive. At weeks 8-10, a clinical response, clinical remission and endoscopic remission with VDZ induction therapy were achieved in 56.8% (21/37), 32.4% (12/37) and 58.3% (7/12) of the patients, respectively. 54.1% (20/37) were able to taper off at week 8. Overall, only 10.8% (4/37) of the patients were primary non-responders during induction therapy. No obvious VDZ-related severe adverse events were noted. Overall, 58.9% (11/19) of the patients relapsed after stopping VDZ, and the relapse rate after VDZ discontinuation was 42.1% (8/19) within first 6 months and 52.6% (10/19) within the first year.In real-world experience, induction therapy with VDZ showed promising clinical benefits and safety profile for patients with UC.

Cations and anions are indispensable resources for the development of nature and modern industry and agriculture, and exploring more efficient technology to monitor them is urgently needed. A multifunctional fluorescent probe based on 1,8-naphthalimide, N-(2-thiophenhydrazide)acetyl-4-morpholine-1,8-naphthalimide (TMN), was successfully designed and synthesized for the detection of Co2+, F−, and CN−, with N-carboxymethyl-4-morpholine-1,8-naphthalimide and thiophene-2-carbohydrazide as starting materials. TMN displayed superior stability in MeCN with an “on–off” mode towards Co2+, F−, and CN− by the naked eye. The linear response ranges of TMN were 0–3 and 4–19 μM with a detection limit of 0.21 μM for detecting Co2+, 0–5 and 5–22 μM with a detection limit of 0.36 μM for F−, and 0–10 and 10–25 μM with a detection limit of 0.49 μM for CN−. TMN could also recognize Co2+, F−, and CN− in real samples. Finally, the possible sensing mechanisms of TMN for detecting Co2+, F−, and CN− were deeply investigated. These results implied that TMN could be a potential chemosensor for monitoring metal cations and anions sensitively and selectively and could be used in real sample detection.

Backgrounds: Influenza vaccination could decrease the risk of major cardiac events in patients with hypertension. However, the vaccine’s effects on decreasing the risk of chronic kidney disease (CKD) development in such patients remain unclear. Methods: We retrospectively analysed the data of 37,117 patients with hypertension (≥55 years old) from the National Health Insurance Research Database during 1 January 2001 to 31 December 2012. After a 1:1 propensity score matching by the year of diagnosis, we divided the patients into vaccinated (n = 15,961) and unvaccinated groups (n = 21,156). Results: In vaccinated group, significantly higher prevalence of comorbidities such as diabetes, cerebrovascular disease, dyslipidemia, heart and liver disease were observed compared with unvaccinated group. After adjusting age, sex, comorbidities, medications (anti-hypertensive agents, metformin, aspirin and statin), level of urbanization and monthly incomes, significantly lower risk of CKD occurrence was observed among vaccinated patients in influenza season, non-influenza season and all season (Adjusted hazard ratio [aHR]: 0.39, 95% confidence level [C.I.]: 0.33–0.46; 0.38, 95% C.I.: 0.31–0.45; 0.38, 95% C.I.: 0.34–0.44, respectively). The risk of hemodialysis significantly decreased after vaccination (aHR: 0.40, 95% C.I.: 0.30–0.53; 0.42, 95% C.I.: 0.31–0.57; 0.41, 95% C.I.: 0.33–0.51, during influenza season, non-influenza season and all season). In sensitivity analysis, patients with different sex, elder and non-elder age, with or without comorbidities and with or without medications had significant decreased risk of CKD occurrence and underwent hemodialysis after vaccination. Moreover, the potential protective effect appeared to be dose-dependent. Conclusions: Influenza vaccination decreases the risk of CKD among patients with hypertension and also decrease the risk of receiving renal replacement therapy. Its potential protective effects are dose-dependent and persist during both influenza and noninfluenza seasons.

To investigate the technological innovation, safety, operational advantages, and clinical application value of direct percutaneous computed tomography (CT)-guided enterostomy.This retrospective study included patients who underwent direct percutaneous CT-guided enterostomy (n = 52), percutaneous endoscopic gastrojejunostomy (PEG-J, n = 39), or laparoscopic jejunostomy (n = 68) at Fujian Provincial Hospital between October 2019 and July 2021. The study indices included stoma surgery success rate, operation time, complication rate, and postoperative pain score. We concurrently analyzed the technological innovation of direct percutaneous CT-guided enterostomy and the changes in body mass index (BMI), serum albumin, prealbumin, and C-reactive protein (CRP) levels and patient-generated subjective global assessment (PG-SGA) scores after patients received 2 months of nutritional support.Direct percutaneous CT-guided enterostomy had a high success rate (100%) and low postoperative complication rate (5.77%). Compared to laparoscopic jejunostomy, direct percutaneous CT-guided enterostomy had a shorter operation time (36.92 ± 10.60) minutes, lower postoperative pain score (4.06 ± 2.02), lower anesthesia risk, and lower operative cost. The anesthetic risk for direct percutaneous CT-guided enterostomy is lower than that for PEG-J and has wider applications. After 2 months of postoperative nutritional support, patients had increased BMI, serum albumin level, and serum prealbumin level and decreased PG-SGA scores and CRP level with statistically significant differences compared to the preoperative state ( p0.05).Direct percutaneous CT-guided enterostomy is an important method of establishing an enteral nutrition therapy pathway, especially when endoscopic jejunostomy is not possible. It has a high safety profile and few complications, has unique advantages, and deserves further promotion of its application in clinical practice.

Andrographolide(ADE) has been demonstrated to inhibit tumor growth through direct cytotoxicity on tumor cells. However, its potential activity on tumor microenvironment (TME) remains unclear. Tumor-associated macrophages (TAMs), composed mainly of M2 macrophages, are the key cells that create an immunosuppressive TME by secretion of cytokines, thus enhancing tumor progression. Re-polarized subpopulations of macrophages may represent vital new therapeutic alternatives. Our previous studies showed that ADE possessed anti-metastasis and anoikis-sensitization effects. Here, we demonstrated that ADE significantly suppressed M2-like polarization and enhanced M1-like polarization of macrophages. Moreover, ADE inhibited the migration of M2 and tube formation in HUVECs under M2 stimulation. In vivo studies showed that ADE restrained the growth of MDA-MB-231 and HCC1806 human breast tumor xenografts and 4T-1 mammary gland tumors through TAMs. Wnt5a/β-catenin pathway and MMPs were particularly associated with ADE's regulatory mechanisms to M2 according to RNA-seq and bioinformatics analysis. Moreover， western blot also verified the expressions of these proteins were declined with ADE exposure. Among the cytokines released by M2, PDGF-AA and CCL2 were reduced. Our current findings for the first time elucidated that ADE could modulate macrophage polarization and function through Wnt5a signaling pathway, thereby playing its role in inhibition of triple-negative breast cancer.

Postherpetic neuralgia (PHN) is a painful condition that persists for 1 month or more after herpes zoster rash has healed. Radiofrequency thermocoagulation (RF-TC) provides analgesia by destroying the dorsal root ganglion and blocking the pain upload pathway; nonetheless, the concomitant neurological-related side effects and recurrence remain a concern.In this study, 228 patients with PHN in the thoracic segment treated with RF-TC of the dorsal root ganglion of the spinal nerve were included, and were followed up regularly after surgery. The numerical rating scale (NRS) scores, time to recurrence, and intraoperative and postoperative adverse events were recorded and analyzed. The Kaplan-Meier method was used to plot survival curves and calculate the cumulative effective rate and recurrence rate. Cox regression analyses were performed to identify factors associated with postoperative recurrence. Predictive models were built to assess the value of applications.The NRS scores decreased in all postoperative periods compared with preoperative ones. At 10-year-follow-up, recurrence was observed in 34.6% (79/228) of patients that underwent PHN. The main postoperative complications were numbness and reduced abdominal muscle strength, which gradually decreased with time, while the abdominal muscle strength gradually recovered. No other adverse events occurred. Interval-censored multivariable Cox regression analysis demonstrated that disease course, complications, pain grade, and type of RF electrode were associated with a significantly higher risk of relapse. The main intraoperative adverse effect was a transient increase in pain during RF-TC.CT-guided RF-TC of the dorsal root ganglion of the spinal nerve for PHN is a relatively safe and effective surgical option. Disease course, type of RF electrode, complications, and pain grade are risk factors for postoperative recurrence and can assist in clinical decision-making before the RF-CT procedure.

胸痛為臨床常見主述，在排除心因性問題後，常因病人合併胃灼熱感，診斷為胃食道逆流。然而本案例為一位36歲女性，因反覆進食後胸痛、胃灼熱及逆流等症狀，依醫囑斷續服用氫離子幫浦抑制劑（Proton Pump Inhibitor, PPI）治療胃食道逆流約一年仍未改善，直至夜間逆流咳嗽加劇，轉至本院消化內科求治，問診後發現合併有吞嚥困難及體重減輕情形，安排上消化道內視鏡排除食道腫瘤後，經食道攝影檢查確診為食道弛緩不能症（achalasia）。個案接受經口內視鏡肌層切開術治療、營養重建及心理諮商後，胸痛、逆流及吞嚥困難等症狀大幅改善，體重也從44 kg回復至50 kg，焦慮程度亦漸緩解。針對反覆出現與胃食道逆流相似症狀，或經藥物治療無效者，應進一步評估有無吞嚥困難，與胃食道逆流作鑑別診斷，避免病人因進食困難，造成營養不良併發症，以及長期睡眠困擾導致負向情緒感受，嚴重影響生活品質。 Chest pain as a relatively common clinical symptom especially when excluding ischemic heart dis­ease, patients are often diagnosed with gastroesophageal reflux disease due to acid regurgitation and a sensation of heartburn. A 36-year-old woman had had been intermittently treated with an oral proton pump inhibitor (PPI) under the impression of gastroesophageal reflux disease for approximately one year due to recurrent chest pain, heartburn, and a sensation of regurgitation. However, the symptoms deteriorated with exacerbation at night, which was an indication of poor response to the oral medi­cation. Thus, she was transferred to the Department of Gastroenterology for further examination and treatment. After detailed inquiry, the patient also suffered from progressive dysphagia with body weight loss, chest pain and regurgitation sensation. Therefore, an upper gastrointestinal panendoscopy was performed to exclude the presence of esophageal tumors. A diagnosis of esophageal achalasia was confirmed after an upper gastrointestinal examination series was conducted. After informing the patient, per-oral-endoscopic myotomy was performed. Nutritional supplementation and psychological consultation were also provided. The patient’s symptoms (e.g., chest pain, regurgitation, and dyspha­gia) improved significantly. Body weight increased from 44 kg to 50 kg, and her anxiety level was gradually reduced. For those who diagnosed with recurrent gastroesophageal reflux disease along with a poor response to oral medications, a detailed inquiry and a specific examination should be conduct­ed for other differential diagnoses, (e.g., achalasia) that may have long-term negative impact on the patient’s nutritional status, sleep disturbance, negative emotions, and quality of life &nbsp

Heart failure (HF) and cancer have similar risk factors. HMG-CoA reductase inhibitors, also known as statins, are chemoprotective agents against carcinogenesis. We aimed to evaluate the chemoprotective effects of statins against liver cancer in patients with HF. This cohort study enrolled patients with HF aged ≥20 years between 1 January 2001 and 31 December 2012 from the National Health Insurance Research Database in Taiwan. Each patient was followed to assess liver cancer risk. A total of 25,853 patients with HF were followed for a 12-year period; 7364 patients used statins and 18,489 did not. The liver cancer risk decreased in statin users versus non-users (adjusted hazard ratio (aHR) = 0.26, 95% confidence interval (CI): 0.20–0.33) in the entire cohort in the multivariate regression analysis. In addition, both lipophilic and hydrophilic statins reduced the liver cancer risk in patients with HF (aHR 0.34, 95% CI: 0.26–0.44 and aHR 0.42, 95% CI: 0.28–0.54, respectively). In the sensitivity analysis, statin users in all dose-stratified subgroups had a reduced liver cancer risk regardless of age, sex, comorbidity, or other concomitant drug use. In conclusion, statins may decrease liver cancer risk in patients with HF.