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Yi-Tong Zhang,&ast; Hui-Yao Li,&ast; Xiao-Tong Sun, Xue-Wei Tong, Yong-Yan Shan, Yu-Xin Xu, Sheng-Dan Pu, Xin-Yuan Gao Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xin-Yuan Gao, Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Harbin, 150001, People’s Republic of China, Email 15124768260@163.comBackground: Diabetic retinopathy (DR) is strongly associated with cardiovascular disease, which is a risk factor for sudden cardiac death (SCD). The index of cardiac electrophysiological balance (iCEB) and the frontal QRS-T angle are recommended to predict the risk of ventricular arrhythmias more than other ECG parameters. However, the relationships between these two markers and DR have not yet been explored. The aim of this study was to investigate the variation in the iCEB, corrected iCEB (iCEBc) and frontal QRS-T angle in different stages of DR and determine whether there are associations between these markers and DR.Methods: The sample comprised 665 patients with Type 2 diabetes mellitus (T2DM) who were classified into three groups: no DR (NDR), mild to moderate non-proliferative DR (NPDR), and vision-threatening DR (VTDR). Twelve-lead ECG was performed and the QT, QTc, QRS duration, iCEB, iCEBc and frontal QRS-T angle were recorded and compared across the groups.Results: The VTDR group had a significantly higher iCEBc and frontal QRS-T angle than the NDR and NPDR groups. After controlling for confounding variables, the correlations between the iCEBc (OR=2.217, 95% CI=1.464– 3.358, P< 0.001), frontal QRS-T angle (OR=1.017, 95% CI=1.008– 1.025, P< 0.001) and DR risk remained (P< 0.05). Subjects in the fourth iCEBc quartile (adjusted OR=2.612, 95% CI=1.411– 4.834, p=0.002) had a much higher chance of developing DR compared to those in the first quartile. In comparison to the first frontal QRS-T angle quartile, subjects in the third (adjusted OR=1.998, 95% CI=1.167– 3.422, P=0.012) and fourth (adjusted OR=2.430, 95% CI=1.420– 4.160, P=0.001) frontal QRS-T angle quartiles had significantly greater risks of DR.Conclusion: With the progression of DR, the iCEBc and frontal QRS-T angle increase. An increased iCEBc and frontal QRS-T angle are associated with an increased risk of DR.Keywords: type 2 diabetes mellitus, diabetic retinopathy, index of cardiac electrophysiological balance, iCEB, frontal QRS-T angle, ventricular arrhythmia

Xue-Wei Tong, Yi-Tong Zhang, Zi-Wei Yu, Sheng-Dan Pu, Xin Li, Yu-Xin Xu, Yong-Yan Shan, Xin-Yuan Gao First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of ChinaCorrespondence: Xin-Yuan Gao, Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, Heilongjiang, People’s Republic of China, Tel +86-18846030512, Email m15124768260@163.comBackground: The triglyceride glucose (TyG) index reflects insulin resistance; the latter being associated with mild cognitive impairment (MCI).Objective: To investigate the clinical value of the TyG index to identify MCI in patients living with type 2 diabetes (T2D) using a cross-sectional study.Methods: This cross-sectional study was performed on 517 patients with T2D. The diagnosis of MCI was based on criteria established by the National Institute on Aging-Alzheimer’s Association workgroup, and patients were divided into the MCI group and the normal cognitive function (NCF) group. The logistic regression analysis determines whether the TyG index is related to MCI. Subsequently, we constructed the receiver operating characteristic curve (ROC) and calculated the area under the curve (AUC). The nomogram model of the influence factor was established and verified.Results: Compared to the type 2 diabetes-normal cognitive function (T2D-NCF) group, the MCI subjects were olderand had higher TyG indexes, lower cognitive scores, and lower education levels (p < 0.01). After adjusting for the confounders, the TyG index was associated with MCI (OR = 7.37, 95% CI = 4.72– 11.50, p < 0.01), and TyG-BMI was also associated with MCI (OR = 1.02, 95% CI = 1.01– 1.02, p< 0.01). The TyG index AUC was 0.79 (95% CI = 0.76– 0.83). The consistency index of the nomogram was 0. 83[95% CI (0. 79, 0. 86)].Conclusion: Our results indicate that the TyG index and TyG-BMI are associated with MCI in T2D patients, and the TyG index is an excellent indicator of the risk of MCI in T2D patients. The nomogram incorporating the TyG index is useful to predict MCI risk in patients with T2D.Keywords: triglyceride glucose index, TyG, mild cognitive impairment, MCI, insulin resistance, IR, type 2 diabetes, T2D

Relaxor ferroelectric (RFE) films are promising energy-storage candidates for miniaturizing high-power electronic systems, which is credited to their high energy density ( U e ) and efficiency. However, advancing their U e beyond 200 joules per cubic centimeter is challenging, limiting their potential for next-generation energy-storage devices. We implemented a partitioning polar-slush strategy in RFEs to push the boundary of U e . Guided by phase-field simulations, we designed and fabricated high-performance Bi(Mg 0.5 Ti 0.5 )O 3 -SrTiO 3 -based RFE films with isolated slush-like polar clusters, which were realized through suppression of the nonpolar cubic matrix and introduction of highly insulating networks. The simultaneous enhancement of the reversible polarization and breakdown strength leads to a U e of 202 joules per cubic centimeter with a high efficiency of ~79%. The proposed strategy provides a design freedom for next-generation high-performance dielectrics.

Colorectal cancer is a common malignant tumor with high mortality, for which chemotherapy resistance is one of the main reasons. The high expression of ABCG2 in the cancer cells and expulsion of anticancer drugs directly cause multidrug resistance (MDR). Therefore, the development of new ABCG2 inhibitors that block the active causes of MDR may provide a strategy for the treatment of colorectal cancer. In this study, we find that dorsomorphin (also known as compound C or BML-275) potently inhibits the transporter activity of ABCG2, thereby preserving the chemotherapeutic agents mitoxantrone and doxorubicin to antagonize MDR in ABCG2-overexpressing colorectal cancer cells. Additionally, dorsomorphin does not alter ABCG2 protein expression. The results of molecular docking studies show that dorsomorphin is bound stably to the ABCG2-binding pocket, suggesting that dorsomorphin is a potent ABCG2 inhibitor that attenuates ABCG2-mediated MDR in colorectal cancer., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Li, Cao, Yu, He, Ding, Li, Shan, Su, Yuan and Shi.)

Diabetic retinopathy (DR) is a complication of diabetes with a complex pathophysiology and multiple factors involved. Recently, it has been found that the upregulation of the renin-angiotensin-aldosterone system (RAAS) leads to overexpression of angiotensin II (Ang II), which induces oxidative stress, inflammation, and angiogenesis in the retina. Therefore, RAAS may be a promising therapeutic target in DR. Notably, RAAS inhibitors are often used in the treatment of hypertension. Still, the potential role and mechanism of DR must be further studied. In this review, we discuss and summarize the pathology and potential therapeutic goals of RAAS in DR.

Background: To assess the relationship between novel insulin resistance (IR) indices and the presence and severity of diabetic retinopathy (DR) in patients with type 2 diabetes., Methods: This is a cross-sectional study involving 2211 patients. The study outcomes were DR events. The study exposures were IR indices including estimated glucose disposal rate (eGDR), natural logarithm of glucose disposal rate (lnGDR), metabolic insulin resistance score (METS-IR), triglyceride glucose index-body mass index (TyG-BMI), triglyceride glucose index-waist-to-hip ratio (TyG-WHR), and triglyceride/high-density lipoprotein cholesterol(TG/HDL-c ratio). We used binary and multivariate ordered logistic regression models to estimate the association between different IR indices and the presence and severity of DR. Subject work characteristic curves were used to assess the predictive power of different IR indices for DR., Results: DR was present in 25.4% of participants. After adjusting for all covariates, per standard deviation (SD) increases in eGDR (ratio [OR] 0.38 [95% CI 0.32-0.44]), lnGDR (0.34 [0.27-0.42]) were negatively associated with the presence of DR. In contrast, per SD increases in METS-IR (1.97 [1.70-2.28]), TyG-BMI (1.94 [1.68-2.25]), TyG-WHR (2.34 [2.01-2.72]) and TG/HDL-c ratio (1.21 [1.08-1.36]) were positively associated with the presence of DR. eGDR was strongly associated with severity of DR. Of all variables, eGDR had the strongest diagnostic value for DR (AUC = 0.757)., Conclusions: Of the six IR indices, eGDR was significantly associated with the presence and severity of DR in patients with type 2 diabetes. eGDR has a good predictive value for DR. Thus, eGDR maybe a stronger marker of DR., (© 2023 Royal Australian and New Zealand College of Ophthalmologists.)

Objective: To analyze the correlation between the histological classification of hepatocellular carcinoma (HCC), especially macrotrabecular-massive (MTM), tumor invasiveness, and prognosis. Methods: The clinical and follow-up data of 246 consecutive HCC cases who met the inclusion criteria from 2015 to 2018 were retrospectively analyzed. They were divided into trabecular/pseudoglandular, trabecular/patchy, and MTM types according to the histological classification. The relationship between each type and related clinicopathological features was analyzed. The Kaplan-Meier method was used to plot tumor-free survival (DFS) and overall survival (OS) curves. Log rank tests, COX univariate, and multivariate regression analyses were conducted to analyze the relationship between clinical features, including histological classification, DFS, and OS. Results: Trabecular/pseudoglandular, trabecular/nodular, and MTM type proportions were 44.7% (110 cases), 32.9% (81 cases), and 22.4% (55 cases), respectively. The results of the clinicopathological features showed that MTM-type HCC was significantly more invasive than the other two types, with alpha-fetoprotein (AFP) ≥400 ng/ml, tumor diameter≥8 cm, no tumor capsule, poor differentiation, and MVI positivity proportions, and the differences were statistically significant (P < 0.05).The proportion of MTM-type HCC patients with American Joint Committee on Cancer TNM Stage III to IV and Chinese Liver Cancer Staging (CNLC) II to II was significantly higher than that of the first two types, and the differences were statistically significant (P < 0.05). In addition, the proportion of MTM subtypes undergoing transcatheter arterial chemoembolization was also raised (P < 0.05). The DFS and OS were significantly lower for MTM-type HCC compared to trabecular/pseudoductal-type HCC at 1-, 3-, and 5-years, and the differences were statistically significant (P < 0.05). Univariate analysis indicated that strongly invasive clinical pathological features such as alpha fetoprotein (AFP) ≥400 ng/ml, tumor diameter ≥ 8 cm, no tumor capsule, poor differentiation, positive microvascular invasion, tumor stage, and MTM staging were all risk factors affecting DFS and OS (P < 0.05). Multivariate COX analysis showed that MTM histological staging, AFP ≥ 400 ng/ml, tumor non-encapsulation, satellite nodules, CNLC stages II~III, and TNM stages III~IV were independent risk factors for DFS (P < 0.05), while AFP ≥ 400 ng/ml, tumor non-encapsulation, and CNLC stage II~III were independent risk factors for OS ( P < 0.05). Conclusion: Histological classification is highly correlated with tumor invasiveness and HCC prognosis. Trabecular/pseudoglandular types have lower malignancy and a better prognosis, while MTM types exhibit strong invasive features and a poor prognosis.

Background: A pseudoaneurysm of the superficial temporal artery is an uncommon clinical entity that has largely been linked with direct traumatic causes. Neurofibromatosis type 1 (NF1)-related vasculopathy is a rare cause of idiopathic arterial bleeding in the craniofacial region., Observations: A 46-year-old male with clinical features of NF1 presented to the hospital with an enlarging and tender right temporal mass without a history of trauma. Computed tomography angiography suggested the development of a pseudoaneurysm, and surgery was performed to resect the mass. Histopathological examinations showed focal interruption of the epithelium layer and elastic lamina, well-demarcated thickening of the smooth muscle layers of the arterial wall, supporting the diagnosis of pseudoaneurysm., Lessons: NF1-associated vasculopathy is likely the predisposing factor for the development of a superficial temporal artery pseudoaneurysm.

Background: A new uric acid (UA) index has recently been proposed, while serum uric acid (SUA), fasting triglyceride, and fasting blood glucose levels in the index are shown to affect cognitive function. This study aims to investigate the clinical value of the UA index for assessing mild cognitive impairment (MCI) in type 2 diabetes (T2D) patients., Methods: This was an observational cross-sectional study with 616 participants. A generalized additive model was used to determine a linear or curvilinear relationship between cognitive performance and the UA index. Logistic regression and random forest models were both developed. A receiver operating characteristic curve (ROC) was delineated and the area under the curve (AUC) was calculated., Results: MCI was diagnosed in 313 participants (50.81%). Compared with the T2D-normal cognitive function group, MCI subjects had higher UA indexes, lower cognitive scores, and lower education levels (p < 0.001). Generalized additive models showed the UA index and the Montreal Cognitive Assessment (MoCA) score to be decreased linearly (p < 0.001). The UA index AUC was 0.751 (95% CI = 0.713-0.789, p < 0.001). The optimal cut-off point for the identification of MCI based on the UA index was 11.26 (sensitivity: 62.3%, specificity: 75.9%). Results for females in the cohort yielded an AUC change of + 2.5%, the less-educated population (AUC change of + 4.7%), and the hypertensive population (AUC change of + 1.1%). The AUCs were 0.791 (95% CI = 0.720-0.863) for the random forest model and 0.804 (95% CI = 0.770-0.837) for the logistic regression model, and no statistical significance was found (p = 0.758)., Conclusion: This study showed that the increased UA index was independently associated with MCI in patients with T2D, especially among female, less-educated, and hypertensive patients. It could be a potential indicator of MCI in T2D patients., (© 2023. The Author(s), under exclusive licence to Hellenic Endocrine Society.)

Objective: To investigate the effects of remimazolam versus propofol on postoperative recovery quality in elderly patients undergoing thoracoscopic laparoscopic radical esophagectomy. Methods: A total of 108 elderly patients undergoing thoracoscopic laparoscopic radical esophagectomy under general anesthesia in the Affiliated Cancer Hospital of Zhengzhou University from May to October 2022 were prospectively included. The participants were divided into two groups by the random number table method: remimazolam group (R group, n =54) and propofol group (P group, n =54). There were 54 cases in the R group, with 35males and 19 females, and aged (65.4±3.1) years. Meanwhile, there were 54 cases in the P group, with 33males and 21 females, and aged (64.5±3.0) years. Anesthesia was induced as follows: remimazolam 0.2-0.3 mg/kg and remifentanil 0.5-1.0 μg/kg were intravenously injected in R group, while propofol 1-2 mg/kg and remifentanil 0.5-1.0 μg/kg were intravenously injected in P group. Subsequently, anesthesia was maintained as follows: remimazolam 0.4-1.0 mg·kg -1 ·h -1 and remifentanil 0.05-0.2 μg·kg -1 ·min -1 were intravenously infused in group R, while propofol 4-10 mg·kg -1 ·h -1 and remifentanil 0.05-0.2 μg·kg -1 ·min -1 were intravenously infused in group P. Bispectral index (BIS) was maintained at 45-60 during operation. The main outcome measures were the 15-item quality of recovery (QoR-15) scores 1 day before surgery, 1 day and 3 days after surgery. Secondary outcome measures included mean arterial pressure (MAP), heart rate and pulse oxygen saturation (SpO 2 ) recorded 5 min before anesthesia induction (T 0 ), 1 min after induction (T 1 ), 1 min after endotracheal intubation (T 2 ), immediately after skin incision (T 3 ) and tracheal extubation (T 4 ). The incidence of bradycardia and hypotension and the frequency of application of vasoactive drugs during anesthesia were recorded. Restlessness score (RS) and Ramsay sedation scale during the awakening period were recorded. Emergence time, tracheal extubation time, duration of postanesthesia care unit (PACU) stay and postoperative length of hospital stay were recorded. The incidence of postoperative pulmonary infection and other complications were also recorded. Results: The QoR-15 scale scores [ M ( Q 1 , Q 3 )] of R group 1 day and 3 days after surgery were 114.0 (109.0, 118.3) and 131.0 (127.8, 133.0), which were higher than those of P group [106.0 (101.0, 112.0) and 127.0 (125.0, 129.3)] (both P <0.001). The incidence of bradycardia, hypotension and the frequency of application of vasoactive drugs of R group during anesthesia were 5.6% (3/54), 35.2% (19/54) and 27.8% (15/54), which were lower than those in P group [33.3% (18/54), 63.0% (34/54) and 55.6% (30/54), respectively] (all P <0.05). RS score during the awakening period in R group was 0.9±0.5, which was lower than that of P group (1.1±0.6) ( P =0.046). Emergence time, tracheal extubation time and postoperative length of hospital stay of R group were (15.4±4.9) min, (16.6±4.7) min and (11.6±1.4) d, which were shorter than those of P group [(26.2±6.4) min, (27.8±5.8) min and (12.6±1.3) d] (all P <0.05). There were no statistically significant differences in Ramsay scores during the awakening period, duration of PACU stay and the incidence of postoperative complications (all P >0.05). Conclusions: Both remimazolam and propofol can achieve satisfactory postoperative recovery quality in elderly patients undergoing thoracoscopic laparoscopic radical esophagectomy. Remimazolam has more stable hemodynamics and lower incidence of adverse reactions.

Aims: We explored the relationship between the mutation at the p.G245S site in TP53 and the short-term recurrence of hepatocellular carcinoma (HCC). Materials and Methods: 101 HCC patients were included in this study. The TP53 p.G245S mutation frequency spectrum was examined by direct sequencing of genomic DNA from tissue specimens of HCC patients. Univariate and multivariate Cox regression analyses were performed to evaluate the independent prognostic factors of tumor recurrence. ROC curve analysis was applied to determine the cut-off value for the p.G245S mutation frequency and to verify the predictive ability of the Cox model compared with single risk factor indices. Results: A multivariate Cox regression analysis showed that TP53 p.G245S mutation frequency ( HR  = 1.231, 95% CI: 1.006-1.505, p  = 0.043), AFP ( HR  = 2.432, 95% CI: 1.297-4.561, p  = 0.006), MTM ( HR  = 2.656, 95% CI: 0.930-7.583, p  = 0.068), and PVTT ( HR  = 14.297, 95% CI: 3.085-66.243, p  = 0.001) were independent prognostic factors for short-term recurrence. The cut-off value for the TP53 p.G245S mutation frequency (18.5%) was determined by ROC analysis. A predictive model integrating the TP53 p.G245S mutation frequency with PVTT, MTM, and AFP values appears to an excellent predictive indicator of short-term recurrence in HCC patients (AUC = 0.849, 95% CI = 0.748-0.950, p  = 0.000001). Survival analysis indicated that the probability of short-term recurrence-free survival was significantly different among different TP53 p.G245S mutation frequency, MTM, PVTT, and AFP risk groups ( p  < 0.05). Conclusion: The mutation frequency of the p.G245S site is a novel prognostic risk factor for the short-term recurrence of HCC.

Gut microbiota are involved in many physiological functions such as metabolism, brain development, and neurodegenerative diseases. Many microbes in the digestive tract do not maintain a constant level of their relative abundance but show daily oscillations under normal conditions. Recent evidence indicates that chronic jetlag, constant darkness, or deletion of the circadian core gene can alter the composition of gut microbiota and dampen the daily oscillation of gut microbes. However, the neuronal circuit responsible for modulating gut microbiota remained unclear. Using genetic mouse models and 16s rRNA metagenomic analysis, we find that light-dark cycle information transmitted by the intrinsically photosensitive retinal ganglion cells (ipRGCs) is essential for daily oscillations of gut microbes under temporal restricted high-fat diet conditions. Furthermore, aberrant light exposure such as dim light at night (dLAN) can alter the composition, relative abundance, and daily oscillations of gut microbiota. Together, our results indicate that external light-dark cycle information can modulate gut microbiota in the direction from the brain to the gut via the sensory system., (© 2022 The Authors.)

Exosomes are discoid vesicles with a diameter of 40-160 nm. They are mainly derived from the multivesicular body formed by the invagination of lysosomal particles in the cell, which are released into the extracellular matrix after the fusion of the outer membrane. Exosomes are widespread and distributed in various body fluids, they are rich in nucleic acids (microRNA, lncRNA, circRNA, mRNA, tRNA, etc.), proteins, lipids, etc. As an important mediator of cellular communication, exosomes carry and transmit important signaling molecules and are widely involved in intercellular material transport and information transfer, they regulate cellular physiological activities and are closely related to the occurrence and course of various diseases. In recent years, with the deepening of exosome-related research, we discovered that exosomal non-coding RNAs are associated with diabetic complications such as diabetic retinopathy, diabetic nephropathy, diabetic foot ulcer. This article reviews the new findings of exosomal non-coding RNAs (mainly microRNAs, lncRNAs, circRNAs) in diabetic complications, and analyzes the potential of exosomal ncRNA as new biomarkers and new cell-free therapies in the diagnosis and treatment of diabetic complications, hoping to provide new ideas for the prevention, diagnosis, and treatment of diabetic complications., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The strength and plasticity balance of F/B dual-phase X80 pipeline steels strongly depends on deformation compatibility between the soft phase of ferrite and the hard phase of bainite; thus, the tensile strength of ferrite and bainite, as non-negligible factors affecting the deformation compatibility, should be considered first. In this purely theoretical paper, an abstract representative volume elements (RVE) model was developed, based on the mesostructure of an F/B dual-phase X80 pipeline steel. The effect of the yield strength difference between bainite and ferrite on tensile properties and the strain hardening behaviors of the mesostructure was studied. The results show that deformation first occurs in ferrite, and strain and stress localize in ferrite prior to bainite. In the modified Crussard-Jaoul (C-J) analysis, as the yield strength ratio of bainite to ferrite (σy,B/σy,F) increases, the transition strain associated with the deformation transformation from ferrite soft phase deformation to uniform deformation of ferrite and bainite increases. Meanwhile, as the uncoordinated deformation of ferrite and bainite is enhanced, the strain localization factor (SLF) increases, especially the local strain concentration. Consequently, the yield, tensile strength, and yield ratio (yield strength/tensile strength) increase with the increase in σy,B/σy,F. Inversely, the strain hardening exponent and uniform elongation decrease.

Flexible piezoelectric thin films are raising interest in energy harvesting and wearable electronics, although their direct fabrication is challenging in the selection of substrates and thermal processing. In this work, we developed direct fabrication of flexible lead-free (K, Na)NbO 3 (KNN)-based piezoelectric films on commercially available metallic foils by sol-gel processing. Stainless steel and platinum foils are selected as flexible substrates because of their good thermal stability, robust flexibility, and cost-efficiency. The sol-gel-processed KNN-based thin films on both of the metallic foils show good flexibility, with the bending radii reaching ±3 mm. The flexible thin films grown on stainless steel and platinum foils present high breakdown electric fields that reach 1760 and 2530 kV/cm, respectively, resulting from the fine-grained dense structure, limited leakage current density, and suppressed mobility of charged carriers. Improved effective piezoelectric coefficient d 33, eff * (75.4 pm/V) with a slight decrease after bending was obtained in the flexible thin films on Pt when compared to their rigid counterparts. The flexible lead-free piezoelectric thin films with combined high breakdown electric fields and piezoelectric and energy storage properties may pave the way for integrating KNN-based multifunctional thin films into flexible electronics.

Aim: Bacteriocins with antimicrobial activity are considered as potential natural bio-preservatives to control the growth of food spoilage bacteria. The aim of this work was to characterize a novel bacteriocin BM1029 discovered from Lactobacillus crustorum MN047 and evaluate its antibacterial mechanism., Methods and Results: Bacteriocin BM1029 was purified by cation-exchange chromatography and reversed-phase chromatography. Antibacterial activity assay showed that BM1029 is antagonistic against both Gram-positive and Gram-negative bacteria. Furthermore, it was found that BM1029 showed low haemolysis with high stability to the pretreatment with different temperatures, pH and surfactants. Moreover electron microscopy and flow cytometry suggested that BM1029 inhibit indicator strains by damaging the cell envelope integrity. Cell cycle assay suggested that BM1029 arrested cell cycle in R-phase., Conclusion: The novel bacteriocin BM1029 showed high bactericidal activity against Escherichia coli and Staphylococcus aureus through a cell envelope-associated mechanism., Significance and Impact of the Study: Application of BM1029 inhibited the growth of indicator strains on beef meat storage at 4°C suggesting that this bacteriocin is promising to be used as a novel preservative in food processing and preservation., (© 2020 The Society for Applied Microbiology.)

Objective: To evaluate the feasibility and efficacy of total hilar en bloc resection and reconstruction(THERR) and portal vein resection and reconstruction(PVRR) in treatment of perihilar cholangiocarcinoma(PHC). Methods: Data of a total of 101 consecutive patients with PHC who underwent bile duct resection with various types of hepatectomies from June 2013 to December 2019 at Department of Hepatopancreatobiliary,Lihuili Hospital were retrospectively analyzed. Patients who underwent PHC resection combined with THERR or PVRR were identified and grouped accordingly. Fourteen patients(6 males, 8 females, aged (64.3±9.7)years old) underwent hepatectomy combined with THERR, 19 patients(11 males, 8 females, aged (63.8±8.6)years old) underwent hepatectomy combined with PVRR. Indications and surgical procedures of THERR and PVRR were reported. The clinicopathological characteristics and operation data, as well as the short and long-term outcomes of patients of the two groups were compared by Student's t -test and the χ 2 test or Fisher exact test, respectively. The actual survivals rates were calculated by using the Kaplan-Meier method, and compared using the Log-rank test. Results: There were no statistically significant differences between the two groups in respect to age,sex and whether they had preoperative biliary drainage or not. The types of combined hepatectomy carried out predominately between the two groups were statistically different with the left side being predominant in the THERR group(10/14, P =0.010) and right side in PVRR group(12/19, P =0.001). There were no significant differences between the two groups in respect to whether they received preoperative portal vein embolization,intraoperative blood loss,curative degree,number of lymph node dissections, and whether there was lymphatic metastasis or not. However, both the times of operation and continuous Pringle maneuver were statistically longer in the THERR group((586±158)minutes and (32.5±7.3)minutes)than those in the PVRR group((453±88)minutes and (12.4±3.8)minutes),respectively( t =3.087, P =0.004; t =10.325, P <0.01). One patient in the THERR group died of liver failure 9 days postoperative, the cumulative 1-, 3- and 5-year survival rates were 84.9%, 57.1% and 37.0% for the THERR group and 81.9%, 37.8% and 30.2% for the PVRR group, respectively. There was no statistically significant differences between the two groups(χ²=0.150, P =0.698). Conclusions: Compared to the role of PVRR in the treatment of PHC, THERR is a novel and technically demanding procedure that is feasible in selected patients for the treatment of advanced PHC with invasion of both the hepatic artery and portal vein. However,due to the small size of this primary study,the value of THERR needs further evaluation.

Objective: To investigate the factors which effect the compliance of treatment for chronic rhinosinusitis(CRS) patients. Method: Offering disease education to 386 patients who suffered from CRS, then find out the reason why some of them refuse to accept surgery through a half-year follow-up by phone and analysis the clinical information. Result: One hundred and ninety-seven accepted surgery while.Not among 386 patients the compliance rate was 51.04%，we found out that the factors affecting compliance were educational level and VAS scale using χ² test and logistic regression. Conclusion: Patients with higher educational level, lower VAS score,turned to be less compliable; and we should still work on how to improve the patients' compliance., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To investigate the dynamic changes in the frequencies of Th17 (CD3 + CD8-IL-17 + ) and regulatory T cells (Treg, CD4 + CD25 + CD127 low ) and Th17/Treg ratio in the peripheral blood in patients with acute hepatitis B (AHB), as well as their association with the outcome of AHB. Methods: A total of 10 AHB patients were enrolled as observation group, and according to the outcome of AHB, these patients were further divided into acute stage group, early recovery group, and full recovery group. Another 10 healthy subjects who underwent physical examination were enrolled as control group. Flow cytometry was used to measure the frequencies of Th17 and Treg in peripheral blood, and the Th17/Treg ratio was calculated. An automatic biochemical analyzer was used to measure liver function parameters, and RT-PCR was used to measure HBV DNA. An one-way analysis of variance was used for comparison between groups, and the t-test was used for comparison between any two groups. Results: Compared with the control group, the acute stage group showed significant increases in the frequencies of Th17 and Treg (18.22%±4.13%/6.46%±2.46% vs 0.68%±0.29%/1.62%±0.18%, P < 0.01) and the Th17/Treg ratio (3.37±1.73 vs 0.42±0.20, P < 0.01). Compared with the acute stage group, the early recovery group showed a significant reduction in the frequency of Th17 (3.14%±1.90%, P < 0.01), a significant increase in the frequency of Treg (11.73%±1.76%, P < 0.01), and a significant reduction in the Th17/Treg ratio (0.27±0.19, P < 0.01). Compared with the early recovery group, the full recovery group showed a slight increase in the frequency of Th17 (3.31±0.95, P = 0.888), a significant reduction in the frequency of Treg (6.83%±1.85%, P < 0.01), but which was significantly higher than that in the control group ( P < 0.01), and a slight increase in the Th17/Treg ratio (0.52±0.21, P < 0.05), which showed no significant difference between this group and the control group ( P = 0.286). In the acute stage of AHB, HBsAg and HBeAg levels were positively correlated with Th17/Treg ratio ( r = 0.639, P < 0.05; r = 0.633, P < 0.05). Conclusion: The dynamic changes in the frequencies of Th17 and Treg and the Th17/Treg ratio may be associated with the outcome of AHB.

An ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) was developed and validated for the determination and pharmacokinetic investigation of songorine in rat plasma. Sample preparation was accomplished through a simple one-step deproteinization procedure with 0.2mL of acetonitrile to a 0.1mL plasma sample. Plasma samples were separated by UPLC on an Acquity UPLC BEH C18 column using a mobile phase consisting of acetonitrile-0.1% formic acid in water with gradient elution. The total run time was 3.0min and the elution of songorine was at 1.68min. The detection was performed on a triple quadrupole tandem mass spectrometer equipped with positive-ion electrospray ionization (ESI) by multiple reaction monitoring (MRM) of the transitions at m/z 358.3→340.3 for songorine and m/z 237.2→194.3 for carbamazepine (internal standard). The calibration curve was linear over the range of 1-1000ng/mL with a lower limit of quantitation (LLOQ) of 1.0 ng/mL. Mean recovery of songorine in plasma was in the range of 75.2-87.5%. The intra- and inter-day precision (RSD) was between 3.1-8.5% and 4.3-9.6% and the intra- and inter-day accuracy (RE) ranged from -4.0 to 8.9% and -9.0 to 6.7%. This method was successfully applied in pharmacokinetic study after intravenous administration of 5.0mg/kg songorine in rats., (Copyright © 2015 Elsevier B.V. All rights reserved.)

The purpose of this investigation was to describe the effect of antibacterial stewardship and evaluate the trends and correlation of antibacterial resistance and usage from 2009 to 2013 in a tertiary-care teaching hospital in northwest China. Antibacterial usage was expressed as defined daily doses per 100 patients per day (DDDs/100 PDs). Hospital-wide population-level data and time series analysis were used to evaluate the trends and determine associations between antibacterial exposure and acquisition of resistance. Yearly consumption of overall antibacterials significantly decreased from 66.54 to 28.08 DDDs/100 PDs (β = -10.504, p < 0.01). The resistant rates of the five most frequently isolated species (including Escherichia coli, Acinetobacter baumannii, Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae) significantly decreased or remained stable, and none of them showed a statistically significant upward trend. The medical quality indicators got better or remained stable. Autoregressive integrated moving average (ARIMA) models demonstrated that the monthly resistance rate of P. aeruginosa to imipenem was strongly correlated with antipseudomonal carbapenems usage (β = 34.94, p < 0.001), as did the correlation of P. aeruginosa to meropenem with antipseudomonal third-generation cephalosporins usage (β = 32.76, p < 0.01) and K. pneumoniae to amikacin with aminoglycosides usage (β = 22.01, p < 0.001). The decreased antibacterial use paralleled the improved bacterial resistance without deteriorating medical quality indicators during antimicrobial stewardship. It also suggests that optimum antibiotic use is necessary to alleviate the threat posed by resistant microorganisms at the hospital level.

A practical synthesis of 2,3-diarylated 2H-benzo[e][1,2]thiazine 1,1-dioxides and their 3,4-dihydro derivatives was developed. ortho-Methyl lithiation of N-aryl-o-toluenesulfonamide followed by reaction with aryl aldehydes gave carbinol sulfonamides, which were either converted directly, or first oxidized to their ketones and converted, to 2,3-diarylated six-membered benzosultams via a TMSCl-NaI-MeCN mediated cyclization. A library of benzosultams was synthesized and evaluated for inhibitory activity against MCF-7 cells. Compound 3 in the 3,4-dihydro (saturated) series and compound 8 in the unsaturated series exhibited the highest potencies with growth inhibition (GI50) values of 0.8 and 18.0 μM, respectively. Molecular modeling studies suggest that these compounds can associate with the colchicine binding site on microtubules. However, experimental assessments of that and other mechanistic possibilities are still ongoing.

Mullite (2SiO(2).3Al(2)O(3)) nanoribbons, millimetres in length and with a high width-to-thickness ratio, were synthesized at temperatures as low as 1150 degrees C. This high ratio made it easy to fabricate a single nanoribbon sensor. The I-V relation of the sensor versus concentration of glucose was recorded with a pico-ammeter. The sensor shows good reproducibility and long-term stability. This single nanoribbon sensor may be used as an in situ monitor. The nanoribbons were also characterized by x-ray diffraction, scanning electron microscopy, transmission electron microscopy and x-ray photoemission spectroscopy.

Nanocantilever arrays were formed on the edges of the +/- (0001) planes of pre-synthesized ZnS nanoribbons via catalyst-assisted post-annealing treatment on Si substrate at 600 degrees C. Similar nanostructures could also be generated when ZnS nanoribbons were annealed by mixing with Si or SiO powder. The formation of nanocantilever arrays is associated with orientation-dependent chemical etching of the +/- (0001) polar surfaces of ZnS nanoribbons. The ability of increasing structural complexity beyond the one-step "thermal evaporation and condensation" synthesis provides a new dimension to the rational design of building blocks for nanodevices.

Zn x Cd 1 - x S single-crystal nanoribbons of controlled composition (where 0 ≤ x ≤ 1) can be synthesized by combining laser ablation with thermal evaporation. The nanoribbons exhibit lasing emission that can be continuously tuned within the ranges of 340-390 nm and 485-515 nm. These results suggest that Zn x Cd 1- x S nanoribbon lasers of pre-selected "tunable" wavelengths between 340 and 515 nm may be achievable by tailoring the value of x., (Copyright © 2005 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)