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"Li, Xin-Ming"
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Effects of intensive insulin therapy on the retinal microvasculature in patients with type 2 diabetes mellitus: a prospective observational study
Background
We examined the retinal microvascular changes and associated factors in type 2 diabetes mellitus (T2DM) before and after intensive insulin therapy.
Methods
This prospective observational study recruited patients with T2DM and divided them into intensive insulin therapy and oral hypoglycemic agent groups. All patients enrolled in this study had diabetes without retinopathy or non-proliferative diabetic retinopathy. Optical coherence tomography angiography (OCTA) was used in all patients before treatment and at 1, 3, and 6 months after treatment. Vessel density (VD) and thickness changes in the macular and optic disc areas were assessed.
Results
The study included 36 eyes in the intensive insulin therapy group and 36 in the oral hypoglycemic agent group. One month after treatment, VD in the deep capillary plexus (DCP) and peripapillary capillary VD (ppVD) were significantly decreased by intensification (
P
= 0.009, 0.000). At three months after treatment, decreases in VD induced by intensification were found in the superficial capillary plexus (SCP), DCP, foveal density in a 300-μm-wide region around the foveal avascular area (FD-300), and ppVD (
P
= 0.032, 0.000, 0.039, 0.000). Six months after treatment, decreases in VD by intensification were observed in the DCP and ppVD groups (
P
= 0.000, 0.000). Vessel density showed no significant change in the oral hypoglycemic agent group after treatment. The amount of DCP-VD reduction was correlated with macular thickening (
r
= 0.348,
P
= 0.038;
r
= 0.693,
P
= 0.000 and
r
= 0.417,
P
= 0.011, respectively) after intensive insulin therapy.
Conclusions
Insulin-intensive treatment caused a transient reduction in vessel density in the macular and optic disc areas. DCP-VD and ppVD were more susceptible at an earlier stage. Retinal microvasculature monitoring using OCTA is vital for patients with type 2 diabetes receiving intensive insulin therapy.
Journal Article
Functional and Anatomical Connectivity Abnormalities in Cognitive Division of Anterior Cingulate Cortex in Schizophrenia
Current pathophysiological theories of schizophrenia highlight the role of altered brain functional and anatomical connectivity. The cognitive division of anterior cingulate cortex (ACC-cd) is a commonly reported abnormal brain region in schizophrenia for its importance in cognitive control process. The aim of this study was to investigate the functional and anatomical connectivity of ACC-cd and its cognitive and clinical manifestation significance in schizophrenia by using the resting-state functional magnetic resonance imaging (fMRI) and the diffusion tensor imaging (DTI).
Thirty-three medicated schizophrenics and 30 well-matched health controls were recruited. Region-of-interest (ROI)-based resting-state functional connectivity analysis and Tract-Based Spatial Statistics (TBSS) were performed on 30 patients and 30 controls, and 24 patients and 29 controls, respectively. The Pearson correlation was performed between the imaging measures and the Stroop performance and scores of the Positive and Negative Syndrome Scale (PANSS), respectively.
Patients with schizophrenia showed significantly abnormal in the functional connectivity and its hemispheric asymmetry of the ACC-cd with multiple brain areas, e.g., decreased positive connectivity with the bilateral putamen and caudate, increased negative connectivity with the left posterior cingulated cortex (PCC), increased asymmetry of connectivity strength with the contralateral inferior frontal gyrus (IFG). The FA of the right anterior cingulum was significantly decreased in patients group (p=0.014). The abnormal functional and structural connectivity of ACC-cd were correlated with Stroop performance and the severity of the symptoms in patients.
Our results suggested that the abnormal connectivity of the ACC-cd might play a role in the cognitive impairment and clinical symptoms in schizophrenia.
Journal Article
Effects of low-dose esketamine on hypoxemia during gastroscopy in patients with moderate-to-high risk obstructive sleep apnea: protocol for a prospective, randomized, controlled trial
Background
Propofol sedation in patients with Obstructive Sleep Apnea (OSA) frequently induces hypoxemia, posing significant clinical risks. Esketamine, an N-Methyl-D-Aspartate (NMDA) receptor antagonist, may reduce propofol requirements while preserving respiratory stability, but its efficacy in OSA patients remains unproven. At the studied dose (0.25 mg/kg), esketamine’s potential side effects (transient hypertension) are expected to be mild and self-limited. Therefore, we aimed to test whether low-dose esketamine (0.25 mg/kg) can reduce the incidence of hypoxemia in moderate-to-high risk OSA patients during propofol-based painless gastroscopy.
Methods
This single-center, double-blind, randomized controlled superiority trial will enroll 294 patients (STOP-Bang score ≥ 3, 18–90 years, STOP-Bang = Snoring, Tiredness, Observed apnea, Pressure [blood], Body Mass Index [BMI], Age, Neck size, Gender.) undergoing gastroscopy. Participants will be randomized 1:1 to receive either esketamine (0.25 mg/kg) plus propofol or saline placebo plus propofol, stratified by age (18–65 vs. > 65 years) and OSA severity (STOP-Bang 5–6 vs. ≥ 7). The primary outcome is the incidence of hypoxemia (Peripheral Oxygen Saturation [SpO
2
] < 90% for > 10 s). Secondary outcomes include severe hypoxemia (SpO
2
≤ 75% or ≤ 90% for ≥ 60 s), duration of hypoxemia, emergency airway management, propofol consumption, hemodynamic stability, involuntary body movements, procedure/recovery times, and clinician satisfaction (measured via 10-cm Visual Analog Scale [VAS]).
Discussion
This protocol rigorously evaluates esketamine’s potential to improve sedation safety in OSA patients, addressing a critical gap in peri-procedural care.
Trial registration
Chinese Clinical Trial Registry (ChiCTR2500099420). Registered on March 24, 2025 (Supplementary File 2). Si-Qi Hao is a co-first author with the same contribution as the first author. The corresponding author is Li-Xin An.
Journal Article
Optimization of a VIGS System Suitable for the Functional Study of Resistance Genes of Chinese Cabbage Against Clubroot Disease
Clubroot disease caused by Plasmodiophora brassicae has greatly affected the quality and yield of Chinese cabbage. Excavating the key resistance genes and verifying their function is important for clarifying disease resistance mechanisms. Virus-induced gene silencing (VIGS) technology has been widely used in gene function research. However, the VIGS system specifically designed for the functional analysis of clubroot resistance genes is currently unavailable. In this study, it was found that the vacuum infiltration VIGS method is more effective for gene silencing than the seed soaking method. When seedlings were VIGS-treated using vacuum infiltration for 10 min, genes were effectively silenced on the 6th-35th days (d) after treatment, ensuring high seedling survival rate and plant transformation rate. To investigate the optimal inoculation time with P. brassicae, plants were inoculated 3, 6, 9, and 15 d after VIGS treatment. Results showed that the difference of clubroot resistance between gene-silenced and control plants was most significant when plants were inoculated 6 d after VIGS treatment. This result suggests that, when the target gene began to silence (6 d after VIGS), immediate inoculation with P. brassicae should be suitable for the functional study of clubroot-resistance genes.
Journal Article
Pyrimidin-2-amine derivative-grafted cellulose ratiometric fluorescent probe for pH detection in extremely acidic media
A novel cellulose-based ratiometric fluorescent probe DAC-CPA was rationally developed and synthesized by grafting camphor-derived pyrimidine-2-amine (CPA) onto dialdehyde cellulose (DAC). The probe DAC-CPA was capable of monitoring extremely acidic conditions with a pKa of 1.57. The pH titration experiments demonstrated that the probe DAC-CPA displayed a distinct red-shifted fluorescent emission from 416 to 486 nm along with decreasing pH values from 6.86 to 1.04. This probe responds linearly to the acidic pH region within the range of 1.04–2.35. The probe DAC-CPA also displayed high selectivity, good repeatability, prominent stability and rapid response toward H+. Moreover, the portable DAC-CPA hydrogel was fabricated that benefited from its excellent formability and could be conveniently and effectively applied to sensing acidic pH conditions (1.0–5.0). Furthermore, this proposed probe could be utilized as a solid-state device for selective and sensitive visualization of acidic pH circumstances. More importantly, the probe DAC-CPA was successfully applied to determine the pH values of some real vinegar samples.Graphic abstract
Journal Article
Micro-mechanical properties of Song Dynasty tilestones based on nanoindentation tests and homogenization approach
Song Dynasty tilestones are one type of ancient Chinese building materials. Studying their mechanical properties is of great significance for the design and development of restoration materials. It is a challenge to sample and perform traditional tests (ϕ50mm × 100mm) for the tilestone cultural relics. In this work, a combination of nanoindentation techniques and the homogenization calculation method based on the Mori–Tanaka model were used to determine the mechanical parameters of Song Dynasty tilestones. The study process involved several steps: (1) Using X-ray diffraction and scanning electron microscopy to examine the surface morphology and mineral composition of the tilestones. (2) Determining the mechanical parameters (i.e., the elastic modulus, hardness and fracture toughness) through nanoindentation tests. (3) Upgrading mechanical parameters from micro to meso-scale using the Mori–Tanaka model and comparing these with uniaxial compression test results. The result shows that the red tilestones and green tilestone are mainly composed of quartz, feldspar and mica. The average elastic modulus of the red tilestones and the green tilestones are 29.47 GPa and 30.21 GPa, respectively. Compared with the parameter result obtained by upscaling, the deviation rates of the red tilestones and green tilestones are 10.3% and 9.6%, respectively, which proves that the test method is reliable. The nanoindentation test and homogenization approach in this work provide the robust theoretical and practical basis for evaluating the mechanical strength of Song Dynasty tilestones.
Journal Article
SOX2-mediated inhibition of miR-223 contributes to STIM1 activation in phenylephrine-induced hypertrophic cardiomyocytes
Stromal interaction molecule 1 (STIM1) is the key molecule responsible for store-operated Ca
2+
entry (SOCE). Numerous studies have demonstrated that STIM1 levels appeared to be enhanced during cardiac hypertrophy. However, the mechanism underlining this process remains to be clarified. In this study, phenylephrine (PE) was employed to establish a model of hypertrophic neonatal rat cardiomyocytes (HNRCs) in vitro, and low expression of primary and mature miR-223 was detected in PE-induced HNRCs. Our results have revealed that downregulation of miR-223 by PE contributed to the increase of STIM1, which in turn induced cardiac hypertrophy. As expected, overexpression of miR-223 could prevent the increase in cell surface and reduce the mRNA levels of ANF and BNP in cardiomyocytes. To address the mechanism triggering downregulation of miR-223 under PE, we demonstrated that PE-induced inhibition of GSK-3β activity led to the activation of β-catenin, which initiates the transcription of SOX2. Increased expression of SOX2 occupied the promoter region of primary miR-223 and suppressed its transcription. Therefore, miR-223 appears to be a promising candidate for inhibiting cardiomyocyte hypertrophy, and miR-223/STIM1 axis might be one of interesting targets for the clinical treatment of hypertrophy.
Journal Article
Phase‐Pure 2D Interfacial Perovskite Passivation for Stable and Efficient Photovoltaics
Phase‐pure two‐dimensional (2D) interfacial passivation has emerged as an effective strategy for addressing the intrinsic instability and interfacial defects of three‐dimensional (3D) perovskite absorbers. However, conventionally formed 2D layers often suffer from mixed‐ n phases, heterogeneous quantum‐well distributions, and disordered orientation, which impede charge transport, distort energy‐level alignment, and accelerate structural degradation. In this review, we elucidate the thermodynamic and kinetic origins of mixed‐phase formation and discuss how dimensional heterogeneity adversely impacts carrier dynamics and device stability. We then summarize recent advances in achieving phase‐pure 2D perovskite interlayers that enable precise n ‐value control, favorable crystal orientation, and optimized interfacial energetics. These strategies yield highly ordered 2D/3D heterostructures that effectively suppress ion migration, mitigate non‐radiative recombination, and significantly enhance long‐term operational stability. Finally, we outline the remaining challenges and emerging opportunities for scalable, phase‐pure engineering toward high‐efficiency and stable perovskite photovoltaic technologies. Overall, this review provides a unified framework linking phase purity, interfacial ordering, and device stability, offering guidance for the development of next‐generation robust perovskite photovoltaics.
Journal Article
Clinical analysis of percutaneous computed tomography–guided injection of cyanoacrylate for localization of 115 small pulmonary lesions in 113 asymptomatic patients
Objective
This study was performed to assess the clinical feasibility, safety, and effectiveness of a computed tomography (CT)–guided cyanoacrylate injection system and investigate the relationship between clinical features and pathologic characteristics of diminutive pulmonary lesions.
Methods
In total, 115 pulmonary nodules from 113 patients (63 female, 50 male) with a diameter of <20 mm were percutaneously localized with a CT-guided cyanoacrylate injection system and then resected.
Results
Of the pure ground-glass opacities (GGOs), 16.0% were atypical adenomatous hyperplasia (AAH), 18.7% were adenocarcinoma in situ (AIS), 49.3% were lung adenocarcinoma (ADC), and 16.0% were benign inflammatory fibrosis/fibrotic scars. Of the mixed GGOs, 18.2% were AAH, 22.7% were AIS, 22.7% were ADC, and 36.4% were benign lesions. Lesions of >10 mm and those located in relation to vessels were significantly more likely to be malignant. The success rate of both the cyanoacrylate injection system and video-assisted thoracoscopic surgery was 100% with no severe complications.
Conclusions
Preoperative localization of small pulmonary nodules using a cyanoacrylate injection system is a safe, simple, and useful technique.
Journal Article