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There is insufficient unified research on the effects of propofol and dexmedetomidine on brain functional activity and synchronization. We collected resting-state functional magnetic resonance imaging data from 21 healthy subjects in four different levels of consciousness induced by propofol (awake, mild sedation, deep sedation, and recovery), and other 21 healthy subjects in three different levels of consciousness induced by dexmedetomidine (awake, mild sedation and recovery). The results showed that with the increasing of sedation levels of propofol or dexmedetomidine, fractional amplitude of low-frequency fluctuations and regional homogeneity values decreased in the frontal lobe, while they increased in the superior temporal gyrus and paracentral lobule. Under propofol sedation, functional connectivity (FC) decreased both within and between sensorimotor network and attention network, and within and between the frontoparietal network (FPN) and default mode network (DMN). Simultaneously, a small number of increased connections were observed between the FPN, DMN, and other networks. Under dexmedetomidine sedation, generally decreased FC was observed in the whole brain. This study shows consistent effects on brain functional activity, but distinct impacts on functional synchronization, providing new insights into the understanding of anesthetic mechanisms.

Objectives The Da Vinci robotic surgical system was used for head and neck surgery. This study aimed to investigate the feasibility, safety, and effect of postauricular approach on the resection of lateral neck cysts. Methods Eleven patients with lateral neck cysts were enrolled in this retrospective study and accepted robot‐assisted surgery via a postauricular approach. Data on volume of cervical cysts, length of incision, bleeding volume, mean operating time, and hospitalization time were analyzed. The postoperative esthetic satisfaction of patients was investigated. Results In this case series, the average length of the incision was 6.67 cm. Bleeding volumes ranged from 10 to 20 mL. Average operation time was 55 min. Four patients developed postauricular numbness after the operation, and all recovered over 3 months. No other serious adverse events occurred after the operation. Postoperative cosmetic outcomes were satisfactory. During the follow‐up median period of 38.2 months, there was no evidence of recurrence or long‐term complications. Conclusion Robot‐assisted resection for lateral neck cysts via a postauricular approach is feasible and safe and yields excellent cosmetic outcomes. Key points Robot‐assisted resection of lateral neck cysts by using a postauricular approach could yield excellent cosmesis and comprehensive resection without severe complications. It is technically feasible and could be considered an alternative choice for patients with lateral cervical cysts.

Interferon-stimulated gene 15 (ISG15) is known to be involved in tumor progression. We previously reported that ISG15 expressed on nasopharyngeal carcinoma (NPC) cells and related to poor prognosis of patients with NPC. We further observed that ISG15 can be secreted by NPC cell and expressed on the macrophages in situ. However, the role of ISG15 in tumor-associated macrophages (TAMs) remains poorly understood. In the present study, we found that ISG15 treatment induces macrophages with M2-like phenotype, and the enhancement of NPC cell migration and tumorigenicity. Mechanically, ISG15-induced M2-like phenotype is dependent on the interaction with its receptor, LFA-1, and engagement of SRC family kinase (SFK) signal, and the subsequent secretion of CCL18. Blocking LFA-1, or SRC signal with small molecular inhibitors, or neutralizing with anti-CCL18 antibody can impede the activation of LFA-1-SFK-CCL18 axis in ISG15-treated macrophages. Clinically, ISG15 + CD163 + TAMs related to impaired survival of patients and advanced tumor stage of NPC. Furthermore, we found ISG15 + CD163 + macrophages inhibited antitumor CD8 + cells responses in NPC. Together, our findings suggested tumor cell-secreted ISG15, which acted as a tumor microenvironmental factor, induces M2-like phenotype, promoting tumor progression and suppression of cytotoxic T lymphocyte response.

Objectives Traditional resection of second branchial cleft fistulas (SBCFs) involves a transcervical incision in the neck, which leaves a prominent scar; therefore, endoscope‐assisted excision of SBCFs through the anterior chest approach has been proposed. To introduce endoscope‐assisted excision of SBCFs via the anterior chest approach and to evaluate its feasibility, validity, safety, and clinical results. Methods This was a study of four patients with SBCFs who underwent surgical resection with the assistance of endoscopy via the anterior chest approach between May 2012 and May 2018. Results All procedures were successfully performed with endoscope‐assisted surgery via the anterior chest approach. The volume of blood loss ranged from 5 to 10 mL (median 6 ml). The operating time ranged from 45 to 67 min (median 50 min). No patients presented evidence of long‐term complications or recurrence during the median follow‐up period of 72–144 months (median 99 months). All patients were satisfied with the cosmetic outcomes. Conclusions Endoscope‐assisted resection of SBCFs via the anterior chest approach is feasible, effective, and safe and has better esthetic effects. Therefore, SBCF surgery via the anterior chest approach could be a novel and superior treatment option for patients with SBCFs. Key Points Endoscope‐assisted resection of SBCFs via the anterior chest approach is feasible, effective, and safe had has better esthetic effects. It could be a novel and superior treatment option for patients.

The role of acetaminophen in managing critically ill patients with acute ischemic stroke (AIS) is debated. While it is commonly used for fever and pain, its direct impact on mortality in the intensive care unit (ICU) setting is unclear. This study aims to estimate the causal effect of early acetaminophen administration on mortality in critically ill adults with AIS. This study employed a target trial using retrospective data from the MIMIC-IV database (2008–2019, 1779 patients) and an external validation cohort in the eICU database (1182 patients). We compared acetaminophen (ACE) use within 48 h of ICU admission with non-ACE use within 48 h and used clone-censor-weight methods for the main analysis. The primary outcomes were 30-day and 90-day all-cause mortality. Furthermore, the findings were substantiated by sensitivity analyses, competing risk models, and subgroup analyses. In the primary CCW-weighted analysis, early acetaminophen administration was associated with a statistically significant reduction in 90-day all-cause mortality (HR, 0.70; 95% CI 0.58–0.84; P  < 0.001). Similarly, the 30-day mortality risk was significantly lower in the ACE group (HR, 0.66; 95% CI 0.54–0.81). Early acetaminophen administration was associated with reduced mortality in critically ill AIS patients, particularly those without diabetes. Despite the variability in external validation, these findings suggest a phenotype-specific survival benefit warranting confirmation in precision-based randomized trials.

The compensatory angiogenesis that occurs after cerebral ischemia increases blood flow to the injured area and limits extension of the ischemic penumbra. In this way, it improves the local blood supply. Fostering compensatory angiogenesis is an effective treatment for ischemic cerebrovascular disease. However, angiogenesis in the adult organism is a complex, multi-step process, and the mechanisms underlying the regulation of angiogenesis are not well understood. Although Notch signaling reportedly regulates the vascularization process that occurs in ischemic tissues, little is known about the role of Notch signaling in the regulation of ischemia-induced angiogenesis after ischemic stroke. Recent research has indicated that miR-210, a hypoxia-induced microRNA, plays a crucial role in regulating the biological processes that occur in blood vessel endothelial cells under hypoxic conditions. This study was undertaken to investigate the role of miR-210 in regulating angiogenesis in response to brain ischemia injury and the role of the Notch pathway in the body’s response. We found miR-210 to be significantly up-regulated in adult rat ischemic brain cortexes in which the expression of Notch1 signaling molecules was also increased. Hypoxic models of human umbilical vein endothelial cells (HUVE-12) were used to assess changes in miR-210 and Notch1 expression in endothelial cells. Results were consistent with in vivo findings. To determine the molecular mechanisms behind these phenomena, we transfected HUVE-12 cells with miR-210 recombinant lentiviral vectors. We found that miR-210 overexpression caused up-regulation of Notch1 signaling molecules and induced endothelial cells to migrate and form capillary-like structures on Matrigel. These data suggest that miR-210 is involved in the regulation of angiogenesis in response to ischemic injury to the brain. Up-regulation of miR-210 can activate the Notch signaling pathway, which may contribute to angiogenesis after cerebral ischemia.

Fully understanding traditional Chinese medicines (TCMs) is still challenging because of the extreme complexity of their chemical components and mechanisms of action. The TCM Plant Genome Project aimed to obtain genetic information, determine gene functions, discover regulatory networks of herbal species, and elucidate the molecular mechanisms involved in the disease prevention and treatment, thereby accelerating the modernization of TCMs. A comprehensive database that contains TCM‐related information will provide a vital resource. Here, we present an integrative genome database of TCM plants (IGTCM) that contains 14,711,220 records of 83 annotated TCM‐related herb genomes, including 3,610,350 genes, 3,534,314 proteins and corresponding coding sequences, and 4,032,242 RNAs, as well as 1033 non‐redundant component records for 68 herbs, downloaded and integrated from the GenBank and RefSeq databases. For minimal interconnectivity, each gene, protein, and component was annotated using the eggNOG‐mapper tool and Kyoto Encyclopedia of Genes and Genomes database to acquire pathway information and enzyme classifications. These features can be linked across several species and different components. The IGTCM database also provides visualization and sequence similarity search tools for data analyses. These annotated herb genome sequences in IGTCM database are a necessary resource for systematically exploring genes related to the biosynthesis of compounds that have significant medicinal activities and excellent agronomic traits that can be used to improve TCM‐related varieties through molecular breeding. It also provides valuable data and tools for future research on drug discovery and the protection and rational use of TCM plant resources. The IGTCM database is freely available at http://yeyn.group:96/. Core Ideas It helps researchers to explore potential mechanisms of action of a gene with ingredients in an herb. It would help to identify new candidate compounds for drug developers. It provides a theory and platform for the breeding, cultivation, and molecular identification of traditional Chinese medicine (TCM) species. It provides a tool for the molecular identity of herb species and the discovery of active ingredients in TCM plants.

Purpose This study aimed to describe the initial experience with robot‐assisted transaxillary parathyroidectomy (RATP) and to investigate its safety and efficacy as a surgical approach for the treatment of primary hyperparathyroidism (PHPT). With the advent of robotic head and neck surgery, there is growing interest in the application of robotic technology to improve cosmetic outcomes and surgical precision. Method A retrospective analysis was conducted on 20 patients who underwent parathyroidectomy from June 2020 to January 2024. Patients were divided into two groups based on surgical approach: the robotic group (n = 8), who underwent robot‐assisted axillary approach parathyroidectomy, and the open group (n = 12), who underwent conventional open parathyroidectomy. Surgical outcomes, biochemical parameters, cosmetic results, and complications were compared between the two groups. Results Both groups demonstrated comparable levels of intraoperative blood loss and postoperative reductions in parathyroid hormone (PTH) and calcium levels. While the robotic group had a significantly longer operative time ([109.3 ± 30.1] vs. [76.2 ± 32.9] min, p = 0.037), there were no significant differences in postoperative complications, recovery trajectories, or biochemical marker normalization. The robotic group exhibited significantly lower postoperative Scar Cosmesis Assessment and Rating (SCAR) scores (2.25 ± 0.5 vs. 3.2 ± 0.8, p = 0.011), indicating improved cosmetic outcomes and patient satisfaction. Conclusion RATP is a safe and cosmetically surgical option for the treatment of PHPT, offering superior cosmetic outcomes compared to the conventional open approach. Although the operative duration was longer in the robotic group, this did not translate into differences in postoperative complications, recovery, or biochemical marker normalization. Therefore, RATP can be considered a new and promising alternative to parathyroid surgery.

Pancreatic ductal adenocarcinoma (PDAC) is distinguished by its aggressive malignancy, limited treatment avenues and a tendency towards chemotherapy resistance, underscoring the critical need for advanced research to uncover new therapeutic approaches. Stress granules (SGs) that is implicated in cellular self-protection mechanism, along with its associated family molecules have shown pro-cancer effects and are closely related to tumor chemotherapy resistance. In this study we investigated the relationship between Ras GTPase-activating protein-binding proteins 2 (G3BP2), a core component of SGs, and the malignancy of PDAC as well as its resistance to the chemotherapy drug gemcitabine. Analyzing TCGA dataset revealed that the expression of G3BP1 and G3BP2 was significantly upregulated in PDAC compared with adjacent normal pancreatic tissues, and the high expression of G3BP2 rather than G3BP1 was significantly associated with poorer overall survival (OS) in PDAC patients. We demonstrated that knockdown of G3BP2 inhibited the proliferation and invasion of PANC‐1 and CFPAC-1 cells in vitro and in vivo. By analyzing the differentially expressed genes in G3BP2 knockdown and overexpressed PANC‐1 cells, we identified DKC1 that was associated with RNA stability and regulation as the target of G3BP2. We demonstrated that G3BP2 bound to PDIA3 mRNA and recruited them into SGs, increasing the stability of PDIA3 mRNA and attenuating its translation efficiency, thereby promoting DKC1 expression. Furthermore, DKC1 could bind to hENT mRNA and inhibited its expression, which enhanced gemcitabine resistance of PDAC. Therefore, we propose a novel mechanism wherein G3BP2 facilitates PDAC’s resistance to chemotherapy by modulating PDIA3-DKC1-hENT in a SGs-dependent way, suggesting G3BP2 SGs a protentional therapeutic target for the treatment in PDAC.

Four new meroterpenoids, guignardones P–S (1–4), and three known analogues (5–7) were isolated from the endophytic fungal strain Guignardia mangiferae A348. Their structures were elucidated on the basis of spectroscopic analysis and single crystal X-ray diffraction. All the isolated compounds were evaluated for their inhibitory effects on SF-268, MCF-7, and NCI-H460 human cancer cell lines. Compounds 2 and 4 exhibited weak inhibitions of cell proliferation against MCF-7 cell line.