9-[(2-Methoxybenzyl)amino]-5-(3,4,5-trimethoxyphenyl)-5,5a,8a,9-tetrahydrofuro[3′,4′:6,7]naphtho[2,3-d][1,3]dioxol-6(8H)-one

In the title compound, C30H31NO8, the tetrahydrofuran ring and the six-membered ring fused to it both display envelope conformations, both having the same C atom as the flap. The dihedral angles between the benzene ring of the benzo[d][1,3]dioxole ring system and the other two benzene rings are 53.73 (3) and 83.30 (2)°. An intramolecular N—H...O hydrogen bond is present. In the crystal, weak intermolecular C—H...O hydrogen bonds link the molecules into chains parallel to the c axis

Deployment of Artificial Intelligence in Real-World Practice: Opportunity and Challenge

Artificial intelligence has rapidly evolved from the experimental phase to the implementation phase in many image-driven clinical disciplines, including ophthalmology. A combination of the increasing availability of large datasets and computing power with revolutionary progress in deep learning has created unprecedented opportunities for major breakthrough improvements in the performance and accuracy of automated diagnoses that primarily focus on image recognition and feature detection. Such an automated disease classification would significantly improve the accessibility, efficiency, and cost-effectiveness of eye care systems where it is less dependent on human input, potentially enabling diagnosis to be cheaper, quicker, and more consistent. Although this technology will have a profound impact on clinical flow and practice patterns sooner or later, translating such a technology into clinical practice is challenging and requires similar levels of accountability and effectiveness as any new medication or medical device due to the potential problems of bias, and ethical, medical, and legal issues that might arise. The objective of this review is to summarize the opportunities and challenges of this transition and to facilitate the integration of artificial intelligence (AI) into routine clinical practice based on our best understanding and experience in this area

XuefuZhuyu decoction protected cardiomyocytes against hypoxia/reoxygenation injury by inhibiting autophagy

Abstract Background XuefuZhuyu decoction (XFZY) is a well-known traditional Chinese herbal medicine for the treatment of various cardiovascular diseases, such as unstable angina pectoris and myocardial ischemia-reperfusion injury. However, the mechanism by which XFZY contributes to the amelioration of cardiac injury remains unclear. Methods H9C2 cells were cultured under the hypoxic condition for 10 h and reoxygenated for 2 h. In the presence of various concentrations of XFZY for 12 h, the cell viability was measured by MTT assay. The protective effect of XFZY in hypoxia/reoxygenation (H/R) cell model was confirmed by measuring the amount of LDH released into the extracellular fluid. Cell apoptosis was measured by western blotting. The autophagy level of H9C2 cells and the correlative pathway were determined by transmission electron microscopy, Cyto-ID® Autophagy Detection Kit, and western blotting. Results In this study, we investigated the effects of XFZY on H/R induced cardiac injury. The results showed that treatment with XFZY significantly inhibited autophagy induced by H/R, with decreased formation of autophagosomes as well as the expression of LC3-II/LC3-I ratio and Beclin 1 after H/R. Importantly, inhibition of autophagy by XFZY resulted in enhanced cell viability and decreased apoptosis. XFZY also inhibited the activation of AMPK and upregulated the phosphorylation of mammalian target of Rapamycin (mTOR). Conclusions The cardioprotective effects of XFZY during H/R were mediated by inhibiting autophagy via regulating AMPK-mTOR signaling pathways

Folate-targeted PTEN/AKT/P53 signaling pathway promotes apoptosis in breast cancer cells

Objective Folate deficiency is closely related to the occurrence of human tumors and plays an important role in cell growth, differentiation, repair, and host defense. We studied the effects of folic acid on the apoptosis of breast cancer cells (MDA-MB-231) and on the activity of the PTEN/AKT/P53 signaling pathway in breast cancer cells

Clinical Outcomes of “U” Route Transforaminal Percutaneous Endoscopic Lumbar Discectomy in Chronic Pain Patients with Lumbar Spinal Stenosis Combined with Disc Herniation

Introduction. “U” route transforaminal percutaneous endoscopic lumbar discectomy (PELD) was introduced for lumbar spinal stenosis (LSS) combined with disc herniation (DH) treatment. This study aims to explore the efficacy and safety of “U” route PELD on chronic pain patients with LSS combined with DH. Methods. Degenerative LSS combined with DH patients who underwent “U” route PELD were reexamined, and 80 patients were recruited and followed up for 2 years. The other 80 healthy individuals who were age- and sex-matched to the patients without chronic pain were enrolled as healthy controls. Minimum dura sac cross-sectional area (mDCSA) by MRI, Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and modified MacNab outcomes were assessed. Emotional evaluation of pain catastrophizing and depression was documented with Pain Catastrophizing Scale (PCS) and Beck Depression Inventory (BDI), respectively, for patients before and after surgery and healthy individuals. Results . All patients were of the age range from 47 to 85 years, with an average of 59.5 ± 9.76 years. Symptoms duration was 114.6 ± 22.77 months, operation time was 87.7 ± 25.20 minutes, and the average hospital stay was 5.8 ± 2.81 days. Four patients quit, and hence, a total of 76 patients completed the follow-up. The results indicated that mDCSA was improved significantly after operation (p0.05). Conclusions. The “U” route PELD seems an alternative to LSS combined with DH treatment, which might reach a better decompression and effectively improve chronic pain conditions. Still, the complications were potential and required further consideration

The Effect of Indole-3-Lactic Acid from <i>Lactiplantibacillus plantarum</i> ZJ316 on Human Intestinal Microbiota In Vitro

Microbiota-derived tryptophan metabolites are essential signals for maintaining gut homeostasis, yet the potential contribution to modulating gut microbiota has been rarely investigated. In this study, Lactiplantibacillus plantarum ZJ316 (CCTCC No. M 208077) with a high production (43.14 μg/mL) of indole-3-lactic acid (ILA) was screened. ILA with 99.00% purity was prepared by macroporous resin, Sephadex G–25 and reversed-phase high-performance liquid chromatography. Purified ILA can effectively inhibit foodborne pathogens such as Salmonella spp., Staphylococcus spp., Escherichia coli and Listeria monocytogenes. In an in vitro model of the human gut microbiota, a medium-dose ILA (172 mg/L) intervention increased the average relative abundance of phyla Firmicutes and Bacteroidota by 9.27% and 15.38%, respectively, while Proteobacteria decreased by 14.36% after 24 h fermentation. At the genus level, the relative abundance of Bifidobacterium and Faecalibacterium significantly increased to 5.36 ± 2.31% and 2.19 ± 0.77% (p Escherichia and Phascolarctobacterium decreased to 16.41 ± 4.81% (p p p Oscillospira and Collinsella. Overall, ILA has the potential to regulate the gut microbiota, and an in-depth understanding of the relationship between tryptophan metabolites and gut microbiota is needed in the future

Dynamics of nitrogen and phosphorus accumulation and their stoichiometry along a chronosequence of forest primary succession in the Hailuogou Glacier retreat area, eastern Tibetan Plateau.

As the two limiting nutrients for plants in most terrestrial ecosystems, nitrogen (N) and phosphorus (P) are essential for the development of succession forests. Vegetation N:P stoichiometry is a useful tool for detecting nutrient limitation. In the present work, chronosequence analysis was employed to research N and P accumulation dynamics and their stoichiometry during forest primary succession in a glacier retreat area on the Tibetan Plateau. Our results showed that: (1) total ecosystem N and P pools increased from 97 kg hm-2 to 7186 kg hm-2 and 25 kg hm-2 to 487 kg hm-2, respectively, with increasing glacier retreat year; (2) the proportion of the organic soil N pool to total ecosystem N sharply increased with increasing glacier retreat year, but the proportion of the organic soil and the vegetation P pools to the total ecosystem P was equivalent after 125 y of recession; (3) the N:P ratio for tree leaves ranged from 10.1 to 14.3, whereas the N:P ratio for total vegetation decreased form 13.3 to 8.4 and remained constant after 35 y of recession, and the N:P ratio for organic soil increased from 0.2 to 23.1 with increasing glacier retreat. These results suggested that organic soil N increased with increasing years of glacier retreat, which may be the main sink for atmospheric N, whereas increased P accumulation in vegetation after 125 y of recession suggested that much of the soil P was transformed into the biomass P pool. As the N:P ratio for vegetation maintained a low level for 35-125 y of recession, we suggested that N might be the main limiting element for plant growth in the development of this ecosystem

Laparoscopic total extraperitoneal (TEP) inguinal hernia repair with preperitoneal closed-suction drainage reduced postoperative complications

Abstract Background Although laparoscopic total extraperitoneal (TEP) inguinal hernia repair has the advantages of less bleeding, less trauma, less pain, and fast recovery, there are several issues that need to be addressed. This study aims to evaluate the effectiveness of preperitoneal closed‑suction drainage on reducing postoperative complications in TEP inguinal hernia repair. Methods A retrospective analysis of 122 patients who underwent TEP inguinal hernia repair between June 2018 and June 2021 was performed. The patients were divided into the drainage group and the non-drainage group according to whether the drainage tube was placed or not. Clinical data, surgical procedures and outcome of these patients were collected and analyzed to assess the effectiveness of drainage. Results A total of 122 patients undergoing TEP surgery were screened, of which 22 were excluded. Most of the patients were male with right indirect inguinal hernia. There was no difference in the mean length of hospital stay between the two groups. Postoperative pain was alleviated by preperitoneal closed‑suction drainage 24 h after operation (p = 0.03). The rate of complications such as scrotal edema, seroma and urinary retention in the drainage group was significantly lower than that in the non-drainage group (p  10 cm3 might receive more clinical benefits by placing drainage tube. Conclusion In TEP inguinal hernia repair, placing drainage tube is a simple and feasible traditional surgical treatment, which can promote postoperative recovery without increasing the risk of infection, especially in patients with large hernia sac volume