Effectiveness and potential mechanism of Jiawei-Xiaoyao-San for hyperthyroidism: a systematic review

Objectives: To evaluate the effectiveness and potential mechanism of traditional Chinese medicine Jiawei-Xiaoyao-San (JWXYS) as an adjunct or mono- therapy for antithyroid drugs (ATDs) in the treatment of hyperthyroidism. Methods: Eight databases and three trial registries were searched from inception until May 2023. Randomized controlled trials (RCTs) were included and meta-analysis was conducted using RevMan 5.4 and Stata 14.0. The Cochrane risk of bias (ROB) tool 1.0 and GRADE tool was used for quality appraisal. The findings from case reports using mono-JWXYS and pharmacological studies were summarized in tables. Results: Thirteen RCTs with 979 participants were included. The majority of the included studies were assessed as high risk of bias in one ROB domain. Compared with ATDs, JWXYS plus ATDs resulted in lower free triiodothyronine (FT3) (MD = -1.31 pmol/L, 95% CI [-1.85, -0.76]; low-certainty), lower free thyroxine (MD = -3.24 pmol/L, 95% CI [-5.06, -1.42]; low-certainty), higher thyroid stimulating hormone (MD = 0.42 mIU/L, 95% CI [0.26, 0.59]; low-certainty), higher effectiveness rate of traditional Chinese medicine syndrome (RR = 1.28, 95% CI [1.08, 1.52]; low-certainty), lower goiter score (MD = -0.66, 95% CI [-1.04, -0.29]; very low-certainty), lower thyrotrophin receptor antibody (SMD = -0.44, 95% CI [-0.73, -0.16]; low-certainty) and fewer adverse events (AEs) (RR = 0.34, 95% CI [0.18, 0.67]; moderate-certainty). Compared with regular dosage of ATDs, JWXYS plus half-dose ATDs resulted in fewer AEs (RR = 0.24, 95% CI [0.10, 0.59]; low-certainty). Compared with ATDs in 1 trial, JWXYS resulted in higher FT3, lower goiter score and fewer AEs. Three case reports showed that the reasons patients sought TCM-only treatment include severe AEs and multiple relapses. Three pharmacological studies demonstrated that JWXYS restored Th17/Treg balance, lowered deiodinases activity, regulated thyroid cell proliferation and apoptosis, and alleviated liver oxidative stress in mouse or rat models. Conclusion: JWXYS may enhance the effectiveness of ATDs for hyperthyroidism, particularly in relieving symptoms and reducing AEs. Mono-JWXYS is not recommended except in patients intolerant to ATDs. The findings should be interpreted with caution due to overall high risk of bias. Further pharmacological studies with more reliable models are needed

Experimental investigation of kinetic instabilities driven by runaway electrons in the EXL-50 spherical torus

In this study, the first observation of high-frequency instabilities driven by runaway electrons has been reported in the EXL-50 spherical torus using a high-frequency magnetic pickup coil. The central frequency of these instabilities is found to be exponentially dependent on the plasma density, similar to the dispersion relation of the whistler wave. The instability frequency displays chirping characteristics consistent with the Berk-Breizman model of beam instability. Theoretically, the excitation threshold of the instability driven by runaway electrons is related to the ratio of the runaway electron density to the background plasma density, and such a relationship is first demonstrated experimentally in this study. The instability can be stabilized by increasing the plasma density, consistent with the wave-particle resonance mechanism. This investigation demonstrates the controlled excitation of chirping instabilities in a tokamak plasma and reveals new features of these instabilities, thereby advancing the understanding of the mechanisms for controlling and mitigating runaway electrons

Observation of whistler wave instability driven by temperature anisotropy of energetic electrons on EXL-50 spherical torus

Electromagnetic modes in the frequency range of 30-120MHz were observed in electron cyclotron wave (ECW) steady state plasmas on the ENN XuanLong-50 (EXL-50) spherical torus. These modes were found to have multiple bands of frequencies proportional to the Alfv\'en velocity. This indicates that the observed mode frequencies satisfy the dispersion relation of whistler waves. In addition, suppression of the whistler waves by the synergistic effect of Lower Hybrid Wave (LHW) and ECW was also observed. This suggests that the whistler waves were driven by temperature anisotropy of energetic electrons. These are the first such observations (not runaway discharge) made in magnetically confined toroidal plasmas and may have important implications for studying wave-particle interactions, RF wave current driver, and runaway electron control in future fusion devices

The genetic architecture of the human cerebral cortex

The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder

Anomalous Growth Rate of Ag Nanocrystals Revealed by in situ STEM.

In situ microscopy of colloidal nanocrystal growth offers a unique opportunity to acquire direct and straightforward data for assessing classical growth models. Here, we observe the growth trajectories of individual Ag nanoparticles in solution using in situ scanning transmission electron microscopy. For the first time, we provide experimental evidence of growth rates of Ag nanoparticles in the presence of Pt in solution that are significantly faster than predicted by Lifshitz-Slyozov-Wagner theory. We attribute these observed anomalous growth rates to the synergistic effects of the catalytic properties of Pt and the electron beam itself. Transiently reduced Pt atoms serve as active sites for Ag ions to grow, thereby playing a key role in controlling the growth kinetics. Electron beam illumination greatly increases the local concentration of free radicals, thereby strongly influencing particle growth rate and the resulting particle morphology. Through a systematic investigation, we demonstrate the feasibility of utilizing these synergistic effects for controlling the growth rates and particle morphologies at the nanoscale. Our findings not only expand the current scope of crystal growth theory, but may also lead to a broader scientific application of nanocrystal synthesis