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Abstract Oral submucous fibrosis (OSF) is a precancerous condition that poses substantial health risks. OSF is mainly caused by betel nut chewing behavior, but its pathogenesis is still unclear and there is no effective treatment strategy. The transformation of fibroblasts to myofibroblast is the key pathological change in the development of OSF. We isolated fibroblasts from human oral mucosa and induced them into myofibroblasts by arecoline, during which autophagy was significantly activated. Here, we found that adipose-derived stem cell exosomes (ADSCs-EXO) could inhibit autophagy to regulate myofibroblast phenotype, and transcriptome sequencing analysis suggested that this process is closely related to the TGF-β pathway. The interplay between autophagy and TGF-β pathway was examined through modulation the two with autophagy activators and inhibitors, TGF-β receptor activators and inhibitors. Results showed that in vitro, the TGF-β/Smad2 pathway augmented autophagy and promoted myofibroblast transformation. The transcriptome information of ADSCs-EXO showed that it contains a large number of miRNAs. Among them, miR-125a-5p could target Smad2. In vivo, injection of ADSCs-EXO alleviated OSF in mice, during which TGF-β and autophagy signals were inhibited. We suggested that ADSCs-EXO could inhibit myofibroblast transformation via inhibiting autophagy through TGF-β/Smad2 axis in OSF, providing new insights for autophagy-based intervention strategies.

The long-term stability of the cast-in-place footings in permafrost regions has received much attention due to its climate sensitivity. The current research lacks long-term data validation, especially in the context of climate change. Based on the 13-year (2011–2023) temperature and deformation monitoring data from the Qinghai‒Tibet Power Transmission Line, this study investigates the characteristics of permafrost variation and its impact on the stability of tower footings under the cooling effect from thermosyphons. The results reveal that the thermosyphons effectively reduce the ground temperature around the footings. After the first freeze‒thaw cycle, the soil around the tower footings completed refreezing and maintained a frozen state. In the following 13 years, the ground temperature continued to decrease due to the cooling effect of thermosyphons. The duration notably exceeded the previously predicted 5 years. The temperature reduction at the base of the footings corresponded well with the frost jacking of the tower footings and could be divided into three distinct phases. In phase 1, the ground temperature around the footings rapidly reduced, approaching that of the natural field, while the footings experienced pronounced deformation. In phase 2, the ground temperature decreased at a faster rate, and the deformation rate of the footings slowed down. In phase 3, the frost jacking of the footings gradually retarded with the decrease in base temperature. Additionally, the ground temperature differences of over 1 °C were observed among different tower footings, which may lead to the differential deformation among the tower footings. The ground temperature differentiation is attributed to the difference in solar radiation intensity, which is shaded by the tower structure from different directions. This study provides theoretical support and empirical accumulation for the construction and maintenance of tower footings in permafrost regions.

Tracking the genome diversity and evolution of virus like severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was the hotspot of current researches, which were essential for the developing of prevention strategies and therapeutic vaccines. In the current study, a total of 206073 oral or nasopharyngeal swab specimens were collected in 2022 from entry populations originated from Hong Kong, among which 141 whole genome sequences were obtained through next-generation sequencing and analyzed. Two major Omicron sub-lineages were identified: BA.2.2 (70.21%, 99/141) and BA.5 (24.11% 34/141). An average of 53.22 mutations was emerged in the genome, with S protein and ORF1a harboring the highest number of mutations among structure proteins and non-structure proteins (p

Background: Bronchobiliary fistulas (BBFs), primarily stemming from choledocholithiasis, present considerable diagnostic and treatment challenges. Their prolonged nature can lead to life-threatening situations without timely management, often complicated by lung abscesses. Case presentation: A 64-year-old man, presenting with fever, chills, and a cough initially misdiagnosed as a common cold, developed severe respiratory distress and delirium upon admission. Urgent intensive care unit (ICU) admission was prompted by a computed tomography (CT) scan revealing a right lung abscess. Enhanced CT scans and elevated bilirubin levels confirmed the biliary origin of the BBFs. Comprehensive treatment included laparoscopic partial hepatectomy, choledochojejunostomy, stone extraction, choledochoscopy, T-tube drainage, and BBFs closure. The patient was discharged with a T-tube. Follow-up CT after two months showed no recurrence. Conclusions: Managing BBFs, especially with concurrent lung abscesses in choledocholithiasis patients, remains challenging but feasible. Early diagnosis and intervention are crucial to improving survival rates and quality of life, highlighting the need for vigilance. This case underscores the importance of early detection and comprehensive treatment for successful outcomes in such complex conditions.

Abstract Objective To identify CT features and establish a nomogram, compared with a machine learning-based model for distinguishing gastrointestinal heterotopic pancreas (HP) from gastrointestinal stromal tumor (GIST). Materials and methods This retrospective study included 148 patients with pathologically confirmed HP (n = 48) and GIST (n = 100) in the stomach or small intestine that were less than 3 cm in size. Clinical information and CT characteristics were collected. A nomogram on account of lasso regression and multivariate logistic regression, and a RandomForest (RF) model based on significant variables in univariate analyses were established. Receiver operating characteristic (ROC) curve, mean area under the curve (AUC), calibration curve and decision curve analysis (DCA) were carried out to evaluate and compare the diagnostic ability of models. Results The nomogram identified five CT features as independent predictors of HP diagnosis: age, location, LD/SD ratio, duct-like structure, and HU lesion/pancreas A. Five features were included in RF model and ranked according to their relevance to the differential diagnosis: LD/SD ratio, HU lesion/pancreas A, location, peritumoral hypodensity line and age. The nomogram and RF model yielded AUC of 0.951 (95% CI: 0.842–0.993) and 0.894 (95% CI: 0.766–0.966), respectively. The DeLong test found no statistically significant difference in diagnostic performance (p > 0.05), but DCA revealed that the nomogram surpassed the RF model in clinical usefulness. Conclusion Two diagnostic prediction models based on a nomogram as well as RF method were reliable and easy-to-use for distinguishing between HP and GIST, which might also assist treatment planning.

PurposeThis study aims to evaluate the efficacy of immune checkpoint inhibitors (ICIs) combined with concurrent chemoradiotherapy (CCRT) versus CCRT alone in patients with locally advanced esophageal squamous cell carcinoma.Materials and methodsThis retrospective cohort study included patients diagnosed with locally advanced esophageal squamous cell carcinoma who received either CCRT alone or CCRT combined with ICIs from April 2019 to February 2023. The primary endpoint was progression-free survival (PFS), and the secondary endpoint was overall survival (OS).ResultsA total of 101 patients were enrolled, with 58 undergoing CCRT alone and 43 receiving CCRT+ICI. The CCRT+ICI group demonstrated a higher complete response rate compared to the CCRT alone group (11.6% vs. 1.7%, P = 0.037). However, no significant difference was observed in 1-year PFS (58.9% vs. 55.2%; hazard ratio [HR] = 1.26, 95% confidence interval [CI]: 0.70-2.26; P = 0.445) or 1-year OS (70.8% vs. 75.9%; HR = 1.21, 95% CI: 0.58-2.53; P = 0.613) between CCRT+ICI and CCRT alone groups. The CCRT alone group experienced a higher incidence of leukopenia of any grade (93.1% vs. 76.7%, P = 0.039) but a lower incidence of pneumonitis of any grade (36.2% vs. 65.1%, P = 0.008).ConclusionCCRT+ICI may not lead to improved survival outcomes compared to CCRT alone in patients with locally advanced esophageal squamous cell carcinoma. These findings indicate the need for further investigation into this treatment approach.

Dianthus barbatus linn. is widely used in gardens, mainly as flower beds and flower borders. The effects of different gradients of P on the growth and root morphology of Dianthus barbatus were studied to explore its morphological and physiological responses and adaptive strategies. Hence, this study provides a theoretical basis and practical guidance for D. barbatus production. Two soil substrates, namely loess and vegetable soil, and five phosphorus concentration gradients were set; no phosphorus application was used as the control. The morphology and physiology of D. barbatus were also investigated. Low-to-medium- and low-phosphorus treatments promoted the growth of D. barbatus in the above and underground parts of the plants grown on both substrates. Chlorophyll content, flower quantity, and acid phosphatase activity in the rhizosphere soil were significantly increased in the H1 and H2 treatments of loess and in the C4 treatment of vegetable soil. Thus, D. barbatus seems to reduce the damage caused by phosphorus stress by increasing chlorophyll content and root acid phosphatase activity. The latter was significantly higher in vegetable soil than in loess. Vegetable soil was more conducive to D. barbatus growth than loess.