Case report: Unusual cause of refractory hypoxemia after pacemaker lead extraction

A 59-year-old woman with a history of a pacemaker implanted for III-degree atrioventricular block was admitted due to pocket infection. The atrial and ventricular leads were removed via the right femoral vein using a needle's eye snare. Hypoxemia was observed immediately after the removal of the lead. It was refractory to oxygen therapy. The pulse oxygen saturation (SpO2) showed 89% in the supine position and 77% in the upright position. However, the CTPA and pulmonary perfusion SPECT/CT imaging did not reveal any signs of pulmonary embolism. Pulmonary function tests and chest CT showed normal results. Transthoracic contrast echocardiography revealed a patent foramen ovale (PFO) and a right-to-left intracardiac shunt, no significant tricuspid regurgitation, without any signs of elevated right heart pressure or pulmonary hypertension. Hypoxemia was considered to be associated with the right-to-left shunt through PFO. The condition was relieved by percutaneous closure of the PFO. Refractory hypoxemia resulting from an intracardiac right-to-left shunt following pacemaker lead extraction is a rare but serious complication. Transthoracic contrast echocardiography helps in diagnosis. If the right-to-left intracardiac shunt through PFO persists irreversibly and the associated hypoxemic symptoms are significant, closure of the PFO is necessary. Transesophageal echocardiography also revealed the presence of a left-to-right shunt through PFO during cardiac systole. The closure of the PFO is also necessary to avoid long-term complications, such as chronic pulmonary hypertension and right heart failure

Fusobacterium nucleatum-triggered neutrophil extracellular traps facilitate colorectal carcinoma progression

Abstract Background Fusobacterium nucleatum (Fn) acts as a procarcinogenic bacterium in colorectal carcinoma (CRC) by regulating the inflammatory tumor microenvironment (TME). Neutrophil extracellular traps (NETs), which can be generated by persistent inflammation, have been recently considered to be significant contributors in promoting cancer progression. However, whether NETs are implicated in Fn-related carcinogenesis is still poorly characterized. Here, we explored the role of NETs in Fn-related CRC as well as their potential clinical significance. Methods Fn was measured in tissue specimens and feces samples from CRC patients. The expression of NET markers were also detected in tissue specimens, freshly isolated neutrophils and blood serum from CRC patients, and the correlation of circulating NETs levels with Fn was evaluated. Cell-based experiments were conducted to investigate the mechanism by which Fn modulates NETs formation. In addition, we clarified the functional mechanism of Fn-induced NETs on the growth and metastasis of CRC in vitro and in vivo experiments. Results Tissue and blood samples from CRC patients, particularly those from Fn-infected CRC patients, exhibited greater neutrophil infiltration and higher NETs levels. Fn infection induced abundant NETs production in in vitro studies. Subsequently, we demonstrated that Fn-induced NETs indirectly accelerated malignant tumor growth through angiopoiesis, and facilitated tumor metastasis, as manifested by epithelial-mesenchymal transition (EMT)-related cell migration, matrix metalloproteinase (MMP)-mediated basement membrane protein degradation, and trapping of CRC cells. Mechanistically, the Toll-like receptor (TLR4)-reactive oxygen species (ROS) signaling pathway and NOD-like receptor (NOD1/2)-dependent signaling were responsible for Fn-stimulated NETs formation. More importantly, circulating NETs combined with carcinoembryonic antigen (CEA) could predict CRC occurrence and metastasis, with areas under the ROC curves (AUCs) of 0.92 and 0.85, respectively. Conclusions Our findings indicated that Fn-induced NETs abundance by activating TLR4-ROS and NOD1/2 signalings in neutrophils facilitated CRC progression. The combination of circulating NETs and CEA was identified as a novel screening strategy for predicting CRC occurrence and metastasis

Conserved Function of ACYL–ACYL CARRIER PROTEIN DESATURASE 5 on Seed Oil and Oleic Acid Biosynthesis between Arabidopsis thaliana and Brassica napus

Previous studies have shown that several ACYL–ACYL CARRIER PROTEIN DESATURASE (AtAAD) members in Arabidopsis thaliana are responsible for oleic acid (C18:1) biosynthesis. Limited research has been conducted on another member, AtAAD5, and its paralog BnAAD5 in the closely related and commercially important plant, Brassica napus. Here, we found that AtAAD5 was predominantly and exclusively expressed in developing embryos at the whole seed developmental stages. The aad5 mutation caused a significant decrease in the amounts of oil and C18:1, and a considerable increase in the content of stearic acid (C18:0) in mature seeds, suggesting that AtAAD5 functioned as an important facilitator of seed oil biosynthesis. We also cloned the full-length coding sequence of BnAAD5-1 from the A3 subgenome of the B. napus inbred line L111. We showed that ectopic expression of BnAAD5-1 in the A. thaliana aad5-2 mutant fully complemented the phenotypes of the mutant, such as lower oil content and altered contents of C18:0 and C18:1. These results help us to better understand the functions of AAD members in A. thaliana and B. napus and provide a promising target for genetic manipulation of B. napus

Pd Nanoparticles Decorated N‑Doped Graphene Quantum Dots@N-Doped Carbon Hollow Nanospheres with High Electrochemical Sensing Performance in Cancer Detection

The development of carbon based hollow-structured nanospheres (HNSs) materials has stimulated growing interest due to their controllable structure, high specific surface area, large void space, enhanced mass transport, and good biocompatibility. The incorporation of functional nanomaterials into their core and/or shell opens new horizons in designing functionalized HNSs for a wider spectrum of promising applications. In this work, we report a new type of functionalized HNSs based on Pd nanoparticles (NPs) decorated double shell structured N-doped graphene quantum dots (NGQDs)@N-doped carbon (NC) HNSs, with ultrafine Pd NPs and “nanozyme” NGQDs as dual signal-amplifying nanoprobes, and explore their promising application as a highly efficient electrocatalyst in electrochemical sensing of a newly emerging biomarker, i.e., hydrogen peroxide (H₂O₂), for cancer detection. Due to the synergistic effect of the robust and conductive HNS supports and catalytically active Pd NPs and NGQD in facilitating electron transfer, the NGQD@NC@Pd HNS hybrid material exhibits high electrocatalytic activity toward the direct reduction of H₂O₂ and can promote the electrochemical reduction reaction of H₂O₂ at a favorable potential of 0 V, which effectively restrains the redox of most electroactive species in physiological samples and eliminates interference signals. The resultant electrochemical H₂O₂ biosensor based hybrid HNSs materials demonstrates attractive performance, including low detection limit down to nanomole level, short response time within 2 s, as well as high sensitivity, reproducibility, selectivity, and stability, and have been used in real-time tracking of trace amounts of H₂O₂ secreted from different living cancer cells in a normal state and treated with chemotherapy and radiotherapy