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Selenium nanoparticles (SeNPs) can be absorbed by plants, thereby affecting plant physiological activity, regulating gene expression, and altering metabolite content. However, the molecular mechanisms by which exogenous selenium affects Polygonatum kingianum coll.et Hemsl plant secondary metabolites remain unclear. In this study, we exposed P. kingianum plants to SeNPs at 0, 10, 25, and 50 mg/L concentrations. Joint physiological, metabolomic, and transcriptomic analyses were performed to reveal the response mechanisms of major secondary metabolites of P. kingianum to SeNPs. Our data shows that under the treatment of 25 mg/L, the photosynthetic electron transfer rate of plants significantly increases and the carbon-nitrogen ratio significantly decreases. In parallel, the main active components, polysaccharides and saponins, showed a significant increase in content, while flavonoid content decreased. SeNPs affect polysaccharide accumulation mainly through up-regulation of SPS, UGPase, AGPase, UTP, and SUS genes in starch and sucrose metabolic pathways. The accumulation of saponins was affected by upregulating genes in the sesquiterpenoid and triterpenoid biosynthesis pathways, including PAD, ADH, PK, and GS. The accumulation of flavonoids was mainly regulated by metabolic pathways such as flavonoid biosynthesis, isoflavonoid biosynthesis, and the biosynthesis of phenylpropanoids. In summary, this study reveals the key metabolic pathways affected by SeNPs in the main secondary metabolic products of P. kingianum .

The eighth edition of the American Joint Committee on Cancer (AJCC) staging system incorporated pathologic depth of invasion (pDOI) and pathologic extranodal extension (pENE) for prognostic stratification in oral squamous cell carcinoma (OSCC). However, the extent of stage migration and the consistency of survival discrimination across populations remained controversial. This study aimed to evaluate stage migration associated with the AJCC 8th edition, assess its prognostic performance relative to the AJCC 7th edition, and explore potential refinements to the pT classification. Patient data from the Hospital of Stomatology, Sun Yat-sen University (2014-2021), and the SEER database (2018-2019) were used. Overall survival (OS) and disease-specific survival (DSS) were estimated using the Kaplan-Meier method to compare the prognostic outcomes of the AJCC 7th and 8th editions. An exploratory refinement of the AJCC 8th pT classification was then developed using the SYSU-OSCC cohort. Multivariable Cox regression was used to assess the prognostic value of different cutoff thresholds, and a refined pT classification was proposed. Model performance was evaluated according to the established Groome criteria. In the SYSU-OSCC cohort, upstaging was observed in 31.3% of patients for pT classification, 10.9% for pN classification, and 31.4% for overall pathologic stage. Compared with the AJCC 7th edition, the AJCC 8th showed clearer prognostic separation between pT3 and pT4a in the SYSU-OSCC cohort (5-year OS rates: 69.2% vs. 51.7%, p = 0.012; 5-year DSS rates: 76.6% vs. 62.0%, p = 0.014) and improved survival discrimination, particularly at intermediate and advanced-stage disease. However, prognostic overlap persisted between pT1 and pT2 categories (5-year OS rates: 82.4% vs. 76.9%, p = 0.14; 5-year DSS rates: 87.0% vs. 83.9%, p = 0.45). In the SEER-OSCC cohort, however, risk separation between pT3 and pT4a remained limited (3-year OS rates: 58.1% vs. 54.3%, p = 0.16; 3-year DSS rates: 64.5% vs. 63.4%, p = 0.41). Based on the SYSU-OSCC cohort, tumors with pDOI > 5 mm and ≤ 10 mm and a tumor size ≤ 2 cm were proposed for reclassification into the pT1 category. In the SYSU-OSCC training and internal validation cohorts, the exploratory refined classification showed improved prognostic performance compared with the original AJCC 8th edition. The AJCC 8th edition improved prognostic stratification in OSCC, particularly for intermediate and advanced-stage disease. However, residual prognostic overlap remained between specific pT categories. The exploratory refinement of selected pT thresholds may modestly improve prognostic accuracy. However, rigorous validation in larger independent external cohorts is required before its clinical applicability can be determined.

Immunosuppressive therapy (IST) with antithymocyte globulin (ATG) and cyclosporine (CsA) is the standard treatment for children with severe aplastic anemia (SAA) with no human leukocyte antigen-matched siblings. Due to the unavailability of horse ATG in China, porcine antilymphocyte globulin (p-ALG), which is less expensive and more effective than rabbit ATG, is widely used. We sought to evaluate the efficacy and safety profile of modified IST with p-ALG plus delayed CsA at day 21 in 50 SAA children. Eighteen SAA patients who progressed from nonsevere aplastic anemia (NSAA) were classified as SAA-II; the other 32 patients were classified as SAA-I. Overall response (OR) rates at 3, 6 and 12 months were 56, 64 and 62%, respectively. The 10-year overall survival (OS) rate and disease-free survival (DFS) rate were 80 and 56%. The OR, OS and DFS rates in the SAA-I group were clearly better than those in the SAA-II group. Death rate from infection within 30 days was 4%. Modified IST with p-ALG plus delayed CsA is a reliable and well-tolerated treatment for children with SAA, and reduces early death due to infection. Modified IST is more suitable for children with SAA-I.

Background To date, it is not clarified whether patients with gastric polyps without any alarming symptoms for colorectal neoplasia need colonoscopy screening. The objective of this study is to prospectively determine the association between gastric polyps and colorectal neoplasia. Methods A multicenter prospective cross-sectional study was performed from July 2012 to December 2014. We compared patients with and without gastric polyps for prevalence of colorectal adenomas. The odds ratios (OR) were computed by logistic regression analysis after multivariable adjustments. Results Totally 1546 patients were included, with 770 patients in the gastric polyp group and 776 in the age- and sex- matched control group. Patients with gastric polyps had greater odds of having any colorectal adenoma (adjusted OR=2.34, 95% confidence interval [CI]: 1.79 to 3.06, p< 0.001) and advanced colorectal adenomas (adjusted OR=2.71, 95% CI: 1.74 to 4.23, p< 0.001) than those without. The positive association between gastric polyps and colorectal adenomas remained significant in both women (OR=2.34, 95% CI: 1.66 to 3.29, p< 0.001) and men (OR=1.87, 95% CI: 1.31 to 2.66, p=0.001). Patients over the age of 40 with gastric polyps had a higher prevalence of colorectal adenomas than those without (40-49yr: OR=1.81, 95% CI=1.02-3.21, p=0.04; 50-59yr: OR=1.88, 95% CI=1.26-2.81, p< 0.001; 60-74yr: OR=2.62, 95% CI=1.73-3.98, p< 0.001). Conclusions The presence of gastric polyps is significantly associated with a higher prevalence of colorectal adenomas, especially advanced colorectal adenomas. Colonoscopy might be considered in patients with gastric polyps, of any gender, and over the age of 40.

The application of porous hydroxyapatite–collagen (HAp-Collagen) as a bone tissue engineering scaffold is hindered by two main problems: its high cost and low initial strength. As a native 3-dimenssional collagen framework, purified porcine acellular dermal matrix (PADM) has been successfully used as a skin tissue engineering scaffold. Here we report its application as a matrix for the preparation of HAp to produce a bone tissue scaffold through a biomimetic chemical process. The HAp-PADM scaffold has two-level pore structure, with large channels (∼100 μm in diameter) inherited from the purified PADM microstructure and small pores (<100 nm in diameter) formed by self-assembled HAp on the channel surfaces. The obtained HAp-PADM scaffold (S15D) has a compressive elastic modulus as high as 600 kPa. The presence of HAp in sample S15D reduces the degradation rate of PADM in collagenase solution at 37°C. After 7 day culture of MC3T3-E1 pre-osteroblasts, MTT data show no statistically significant difference on pure PADM framework and HAp-PADM scaffold (p > 0.05). Because of its high strength and nontoxicity, its simple preparation method, and designable and tailorable properties, the HAp-PADM scaffold is expected to have great potential applications in medical treatment of bone defects.

We report the case of a 59-year-old Chinese man who showed an asymptomatic coagulation factor V deficiency pattern after second intravenous treatment with ceftazidime. Normal pooled plasma failed to correct the abnormalities in a mixing test, and the presence of factor V inhibitor was confirmed by the Bethesda method. The coagulopathy was not corrected by transfusion of fresh frozen plasma and prothrombin complex concentrate, but rather by treatment with prednisone and withdrawal of dubious drugs. The findings reported here should prompt clinicians to watch for drug-induced coagulation factor deficiency.

Lyotropic liquid crystals (LLC), as adjustable structural templates, are useful tools for the synthesis of nanomaterials. In this study, a series of LLC templates have been prepared at very low surfactant concentrations (down to 0.00663–11.0 wt %). The LLC phases have been identified using a stereomicroscope. LLC appears sphere or vesicle shape when the hydrochloric acid is present in the system. In contrast, LLC appears lamellar or rod-like when ethanol is present in the system. The origin of the different geometries or shapes of the LLC phase has been qualitatively clarified using the molecular packing parameter of the surfactant.

To investigate the clinical characteristics of seronegative hepatitis-associated aplastic anemia (AA) (SNHAA) and hepatitis B virus (HBV) infection complicating AA (HBVAA), and thereby compare the efficacy of immunosuppressive therapy (IST). An analysis was conducted on the clinical data of ten patients with SNHAA out of 332 cases of AA from our center at AA diagnosis, and on the efficacy of IST. This was compared to 22 cases of HBVAA at AA onset as well as the associated IST outcomes. Nine patients with SNHAA developed severe aplastic anemia, with a median age of 18 years. After IST, six (60%) of the SNHAA patients achieved complete remission and two achieved partial remission. The patients with HBVAA had a total response rate of 82.3%. The disease recurred in two HBVAA patients. No statistically significant differences were observed in response rate, mortality, and recurrence rate between both groups. As compared with HBVAA, patients with SNHAA had a shorter interval from the acute episode of hepatitis to AA onset (4 months versus 92 months, P=0.00), a quicker response to IST (2.5 months versus 4.5 months, P=0.018), a lower proportion of bone marrow hematopoietic tissues (20.6% versus 23.6%, P=0.03), and lower white blood cell and absolute neutrophil count (0.8 × 10(9)/L versus 1.23 × 10(9)/L and 0.26 × 10(9)/L versus 0.58 × 10(9)/L, P=0.026 and P=0.0009, respectively). No significant liver damage or hepatitis B fulminant infection was observed in either group during the follow-up. The prevalence of SNHAA is 3.01%. SNHAA often presents as severe AA and responds to IST quickly. Neither hepatitis prior to AA nor AA complicating HBV infection have been shown to influence the early efficacy of IST and adverse events, and HBV may not be the causative agent of AA.