Silver film is commonly used to examine the structure and composition of molecules due to its surface-enhanced Raman scattering (SERS) effect. A simple method for preparing SERS silver films is proposed in this paper by electrodeposition in an amide-based liquid mixture (urea-acetamide-LiBr). The electrochemical behavior of silver in urea-acetamide-LiBr mixture was studied by cyclic voltammetry (CV) and chronoamperometry. It was found that the nucleation mechanism of silver shifts to instantaneous nucleation under diffusion control with increasing overpotential and temperature. The energy dispersive spectroscopy (EDS) and X-ray diffraction (XRD) investigations confirmed that the obtained deposits are pure silver. Scanning electron microscopy (SEM) analysis showed that the morphology of the silver deposits depends on the deposition potential and temperature. Rhodamine 6G was used as probe molecules for SERS experiments, showing that these new active substrates have high sensitivity to SERS response with high enhancement factors, of approximately 107, and enable Raman scattering even for diluted solutions. surfaceenhanced surface enhanced (SERS effect amidebased amide based ureaacetamideLiBr. ureaacetamideLiBr urea acetamide LiBr . (urea-acetamide-LiBr) CV (CV chronoamperometry temperature EDS (EDS Xray X ray XRD (XRD SEM (SEM G experiments factors 107 solutions (urea-acetamide-LiBr 10 1

Two novel alkyl thiophene-modified pyrene derivatives (1)-(2) were created and synthesized using palladium-catalyzed Stille coupling processes and Friedel-Crafts reaction of pyrene. The polycyclic aromatic groups of the thiophene-modified pyrene were oxidized with Ag[Al(OC(CF3)3)4] to provide the insensitive radical cations 1•+-2•+ based on the alkyl thiophene-modified pyrene derivatives. Nuclear magnetic resonance (NMR), electron paramagnetic resonance (EPR), UV-Vis spectroscopy, and density functional theory (DFT) calculations, were used to investigate their structures and properties. The pyrene moieties were the primary location of the electron spin distribution, with a little overflow onto the outer thiophene moieties. Due to the different substituent groups, free radicals 1•+ 2•+ exhibit some different properties. Compound 1•+ is the most extensive thiophene-modified pyrene radical cation that has been reported. These species are anticipated to have wide-ranging potential in the areas of optoelectronic materials and semiconductors. thiophenemodified modified 12 1 2 (1)-(2 palladiumcatalyzed palladium catalyzed FriedelCrafts Friedel Crafts AgAlOCCF334 AgAlOCCF Ag Al OC CF3 3 4 CF Ag[Al(OC(CF3)3)4 1•+2•+ 1•+-2• NMR, NMR , (NMR) EPR, EPR (EPR) UVVis UV Vis spectroscopy DFT (DFT calculations properties distribution 1• 2• reported wideranging wide ranging semiconductors (1)-( AgAlOCCF33 Ag[Al(OC(CF3)3) 1•+2• 1•+-2 (NMR (EPR (1)- AgAlOCCF3 Ag[Al(OC(CF3)3 1•+2 1•+- (1) Ag[Al(OC(CF3) (1 Ag[Al(OC(CF3 ( Ag[Al(OC(CF

The recycle and utilization of expired drugs is a challenge for many countries at present. The employment of expired drugs as green corrosion inhibitors is expected to address both drug recycling and corrosion prevention issues, with significant economic and environmental value. Herein, the individually and combination corrosion inhibition performance of expired amoxicillin (AMC) and penicillin V potassium tablets (PVP) for lowcarbon steel in 20% acetic acid solution containing 600 mg L-1 chloride ion are evaluated by electrochemistry and weight loss method. Both the AMC and PVP present the mixed-type corrosion inhibitors mainly affect the cathode process when used individually. The optimum inhibition efficiency is 61.22% (AMC) and 79.21% (PVP), which all appear in 5.0 × 10-3 mol L-1. The AMC and PVP are adsorbed on the steel surface by mixed physisorption and chemisorption, which are consistent with the Langmuir adsorption isotherm. The corrosion inhibition rate drops sharply when AMC and PVP are combined use with a close mole ratio. But a small amount of PVP significantly enhance the corrosion inhibition effect of AMC, the corrosion inhibition rate from 61.22 to 79.72%. The corrosion inhibition rate of AMC and PVP combination inhibitor decreased with the increase of temperature. issues value Herein (AMC (PVP 20 60 L1 L 1 L- method mixedtype type 6122 61 22 7921 79 21 79.21 PVP, , 50 5 0 5. 103 10 3 10- L1. 1. chemisorption isotherm ratio 61.2 7972 72 79.72% temperature 2 6 612 792 7 79.2 61. 797 79.72 79. 79.7

Alzheimer’s disease (AD) is a most common form of dementia and results in memory loss, disorientation, impaired thinking and changes in personality as well as mood. The dementia cases mostly turn into the Alzheimer’s disease (AD). Another disease, the Parkinson’s disease (PD), mainly affects dopaminergic neurons in substantia nigra. A series of previously synthesized quinolone-triazole hybrids were investigated and evaluated for their anti-acetyl cholinesterase and against monoamine oxidase reactive properties through in silico characterization. The ground state electronic properties were determined by electron density of the compounds through DFTs (density functional theory) calculation. The geometries of all compounds were optimized using Becke-3-parameter-Lee-Yang-Parr (B3LYP) method and 6-311g basis set. Docking studies were conducted using the AutoDock and Molecular Operating Environment (MOE) software and the results of the potent derivatives found to be encouraging. The data confirmed that all the compounds have drug-like properties and was further confirmed by ADMET (absorption, distribution, metabolism, excretion and toxicity) properties. Alzheimers Alzheimer s AD (AD loss disorientation mood AD. . Parkinsons Parkinson PD, PD , (PD) nigra quinolonetriazole quinolone triazole antiacetyl anti acetyl characterization theory calculation Becke3parameterLeeYangParr BeckeparameterLeeYangParr Becke 3 parameter Lee Yang Parr B3LYP BLYP B LYP (B3LYP 6311g g 6 311g set MOE (MOE encouraging druglike drug like absorption, absorption (absorption distribution metabolism toxicity (PD parameterLeeYangParr

We created a fast and effective thin-layer chromatography method to detect homoisoflavones in Polygonatum odoratum (Mill.) Druce (POD), demonstrating high sensitivity, specificity, and stability. Utilizing this method, we assessed the quality of 20 commercial batches of POD. Our results indicated that homoisoflavones (III, IV, and V) were present in 8 samples, absent in 7, and detected in 5. This method facilitates the effective evaluation of POD germplasm resources, laying a strong foundation for enhancing quality standards. This advancement aids in the standardization and quality control of POD, ensuring the consistency of its active ingredients and thereby supporting its therapeutic applications. thinlayer thin layer Mill. Mill (Mill. , (POD) sensitivity specificity stability 2 III, III (III IV V samples 7 5 resources standards applications (Mill (POD

Abstract Accounting for fluid-solid coupling in saturated underwater soils, the scattering problem of underwater tunnel under plane SV-wave incidence is investigated by using the Fourier-Bessel series expansion method of wave function. Numerical examples analyze the effects of incident wave angle, frequency, tunnel burial depth, and porosity on displacement at the water-soil interface and dynamic stress concentration on the tunnel surface. When η=0.5, increasing the incident angle reduces horizontal displacement by up to 39.3%, increases vertical displacement by up to 96.2%, and raises the Dynamic Stress Concentration Factor (DSCF) on the tunnel surface by 65.6%. Porosity shows minimal impact on stress and displacement. As porosity increases, horizontal displacement decreases by up to 2.1%, vertical displacement increases by approximately 1.23%, and DSCF decreases by 1.2%. As incident frequency increases, displacement and stress distributions become more complex, with more pronounced peaks, and troughs. Maximum horizontal displacement increases by 86.4%, and vertical displacement by 91.2%. Displacement and stress concentration are most pronounced above the tunnel under shallow burial conditions. fluidsolid fluid solid soils SVwave SV FourierBessel Fourier Bessel function depth watersoil water soil η05 η 0 5 η=0.5 393 39 3 39.3% 962 96 2 96.2% (DSCF 656 65 6 65.6% 21 1 2.1% 123 23 1.23% 12 1.2% complex peaks troughs 864 86 4 86.4% 912 91 91.2% conditions η0 η=0. 39.3 9 96.2 65.6 2.1 1.23 1.2 8 86.4 91.2 η=0 39. 96. 65. 2. 1. 86. 91. η=

ABSTRACT Over the last two decades, coastal conservation has transitioned from traditional engineering methods to more comprehensive, nature-based solutions, marking a pivotal era in coastal protection from 2000 to 2023. This literature review delves into the evolution of coastal protection technologies by analyzing 99 articles selected from extensive database searches covering the period up to December 2023. It highlights the significant technologies linked to stakeholder involvement, forthcoming challenges, and emerging trends in coastal defense. The insights gained underscore the importance of collaborative efforts among stakeholders to enhance coastal protection practices, fostering a sustainable coastal economy. Ultimately, effective coastal defense is crucial for the immediate safety of coastal communities and the enduring health of coastal ecosystems and economies. decades comprehensive naturebased nature based solutions 200 2023 9 involvement challenges practices economy Ultimately economies 20 202 2

RESUMEN En las últimas dos décadas, la conservación costera ha pasado de métodos tradicionales de ingeniería a soluciones más integrales y basadas en la naturaleza, marcando una era crucial en la protección costera desde 2000 hasta 2023. Esta revisión profundiza en la evolución de las tecnologías de protección costera a través del análisis de 99 artículos seleccionados de extensas búsquedas en bases de datos, cubriendo el período hasta diciembre de 2023. Destaca las tecnologías significativas relacionadas con la participación de los interesados, los desafíos futuros y las tendencias emergentes en la defensa costera. Las percepciones obtenidas subrayan la importancia de los esfuerzos colaborativos entre los interesados para mejorar las prácticas de protección costera, fomentando una economía costera sostenible. En última instancia, una defensa costera efectiva es crucial no solo para la seguridad inmediata de las comunidades costeras, sino también para la salud a largo plazo de los ecosistemas y economías costeras. décadas naturaleza 200 2023 9 datos sostenible instancia costeras 20 202 2

RESUMO Nas últimas duas décadas, a conservação costeira passou de métodos tradicionais de engenharia para soluções mais abrangentes e baseadas na natureza, marcando uma era crucial na proteção costeira de 2000 a 2023. Esta revisão aprofunda-se na evolução das tecnologias de proteção costeira por meio de uma análise de 99 artigos selecionados a partir de extensas pesquisas em bases de dados, cobrindo o período até dezembro de 2023. Destaca as tecnologias significativas relacionadas ao envolvimento dos interessados, aos desafios futuros e às tendências emergentes na defesa costeira. As percepções obtidas sublinham a importância dos esforços colaborativos entre os interessados para melhorar as práticas de proteção costeira, fomentando uma economia costeira sustentável. Em última análise, uma defesa costeira eficaz é crucial não só para a segurança imediata das comunidades costeiras, mas também para a saúde duradoura dos ecossistemas e economias costeiras. décadas natureza 200 2023 aprofundase aprofunda se 9 dados sustentável costeiras 20 202 2

ABSTRACT Introduction: We aim to compare the safety and effectiveness of the KangDuo (KD)-Surgical Robot-01 (KD-SR-01) system and the da Vinci (DV) system for robot-assisted radical nephroureterectomy (RARNU). Materials and Methods: This multicenter prospective randomized controlled trial was conducted between March 2022 and September 2023. Group 1 included 29 patients undergoing KD-RARNU. Group 2 included 29 patients undergoing DV-RARNU. Patient demographic and clinical characteristics, perioperative data, and follow-up outcomes were collected prospectively and compared between the two groups. Results: There were no significant differences in patient baseline demographic and preoperative characteristics between the two groups. The success rates in both groups were 100% without conversion to open or laparoscopic surgery or positive surgical margins. No significant difference was observed in docking time [242 (120-951) s vs 253 (62-498) s, P = 0.780], console time [137 (55-290) min vs 105 (62-220) min, P = 0.114], operative time [207 (121-460) min vs 185 (96-305) min, P = 0.091], EBL [50 (10-600) mL vs 50 (10-700) mL, P = 0.507], National Aeronautics and Space Administration Task Load Index scores, and postoperative serum creatinine levels between the two groups. None of the patients showed evidence of distant metastasis, local recurrence, or equipment-related adverse events during the four-week follow-up. One (3.4%) patient in Group 2 experienced postoperative enterovaginal and enterovesical fistulas (Clavien-Dindo grade III). Conclusions: The KD-SR-01 system is safe and effective for RARNU compared to the DV Si or Xi system. Further randomized controlled studies with larger sample sizes and longer durations are required. Introduction KDSurgical KD Surgical Robot01 Robot 01 Robot-0 KDSR01 KDSR SR (KD-SR-01 (DV robotassisted robot assisted RARNU. . (RARNU) Methods 202 2023 KDRARNU. KDRARNU KD-RARNU DVRARNU. DVRARNU DV-RARNU data followup follow up Results 100 margins 242 [24 120951 120 951 (120-951 25 62498 62 498 (62-498 0.780, 0780 0.780 , 0 780 0.780] 137 [13 55290 55 290 (55-290 10 62220 220 (62-220 0.114, 0114 0.114 114 0.114] 207 [20 121460 121 460 (121-460 18 96305 96 305 (96-305 0.091, 0091 0.091 091 0.091] [5 10600 600 (10-600 5 10700 700 (10-700 0.507, 0507 0.507 507 0.507] scores metastasis recurrence equipmentrelated equipment related fourweek four week followup. up. 3.4% 34 3 4 (3.4% ClavienDindo Clavien Dindo III. III III) Conclusions KD-SR-0 required Robot0 Robot- KDSR0 (KD-SR-0 (RARNU 20 24 [2 12095 12 95 (120-95 6249 6 49 (62-49 078 0.78 78 13 [1 5529 (55-29 6222 22 (62-22 011 0.11 11 12146 46 (121-46 9630 9 30 (96-30 009 0.09 09 [ 1060 60 (10-60 1070 70 (10-70 050 0.50 3.4 (3.4 KD-SR- (KD-SR- 1209 (120-9 624 (62-4 07 0.7 7 552 (55-2 622 (62-2 0.1 1214 (121-4 963 (96-3 00 0.0 106 (10-6 107 (10-7 05 0.5 3. (3. KD-SR (KD-SR (120- (62- 0. (55- (121- (96- (10- (3 (120 (62 (55 (121 (96 (10 ( (12 (6 (5 (9 (1

ABSTRACT Purpose: Ureteroplasty using buccal or lingual mucosa graft Is feasible for complex proximal ureteral stricture (1, 2). Ileal ureter replacement is considered as the last resort for ureteral reconstruction. Totally intracorporeal robot-assisted ileal ureter replacement can be performed safely and effectively (3). In China, the KangDuo Surgical Robot 2000 Plus (KD-SR-2000 Plus) has been developed featuring two surgeon consoles and five robotic arms. This study aims to share our experience with totally intracorporeal robot-assisted bilateral ileal ureter replacement using KD-SR-2000 Plus. Materials and Methods: A 59-year-old female patient underwent a complete intracorporeal robot-assisted bilateral ileal ureter replacement for the treatment of ureteral strictures using KD-SR-2000 Plus. The surgical procedure involved dissecting the proximal ends of the bilateral ureteral strictures, harvesting the ileal ureter, restoring intestinal continuity, and performing an anastomosis between the ileum and the ureteral end as well as the bladder. The data were prospectively collected and analyzed. Results: The surgery was successfully completed with single docking without open conversion. The length of the harvested ileal ureter was 25 cm. The docking time, operation time and console time were 3.4 min., 271 min and 231 min respectively. The estimated blood loss was 50 mL. The postoperative hospitalization was 6 days. No perioperative complications occurred. Conclusions: It is technically feasible to perform totally intracorporeal robot-assisted bilateral ileal ureter replacement for the treatment of ureteral strictures using KD-SR-2000 Plus. A longer follow-up and a larger sample size are required to evaluate its safety and effectiveness. Purpose 1, 1 (1 2. 2 . 2) reconstruction robotassisted robot assisted 3. 3 (3) China 200 KDSR2000 KDSR KD SR (KD-SR-200 arms KD-SR-200 Methods 59yearold yearold 59 year old continuity bladder analyzed Results conversion cm 34 4 min. 27 23 respectively 5 mL days occurred Conclusions followup follow up effectiveness ( (3 20 KDSR200 (KD-SR-20 KD-SR-20 KDSR20 (KD-SR-2 KD-SR-2 KDSR2 (KD-SR- KD-SR- (KD-SR KD-SR

SUMMARY: In current study, we used Nissl staining to examine the histological structure of the juvenile Chinese alligator brain, and immunohistochemistry (IHC) staining to detail the serotonin (5-hydroxytryptamine, 5-HT) localization and morphology of neurons belonging to the serotonergic system. Nissl staining revealed that the Chinese alligator brain was divided into four regions (telencephalon, diencephalon, brainstem, and cerebellum) and a connected ventricular system (containing the pair of lateral ventricles, third ventricle, fourth ventricle and the aqueduct). According to the IHC results, 5-HT immunoreactive (5-HT-IR) neurons were primarily observed in the cerebral cortex, the hypothalamic paraventricular nucleus (PH), tectum and tegmentum of the optic lobes, the medial longitudinal fasciculus (Flm) of medulla oblongata and the cerebellar cortex. 5-HT-IR fibers were mostly located lateral to the hypothalamic paraventricular nucleus (PH), in the medial vestibular nucleus (MVe) of the medulla oblongata, and in the choroid plexus (CP) of the lateral ventricles. Additionally, our findings paralleled those results of other reptiles; nevertheless, some distinctions in terms of both histological architecture and function were identified. The layering of the cerebral cortex and tectum, as well as the arrangement of Purkinje cells, differed between reptile brains. The distribution of 5-HT-IR neurons varied in the layer of cerebral and cerebellar cortex when compared to other reptiles. Within the diencephalon, 5-HT-IR neurons formed distinct nuclei in the hypothalamic paraventricular nucleus (PH), but few in the infundibular recess.

RESUMEN: Utilizamos la tinción de Nissl para examinar la estructura histológica del cerebro juvenil del caimán chino y la tinción inmunohistoquímica (IHC) para detallar la localización y morfología de la serotonina (5-hidroxitriptamina, 5-HT) de las neuronas que pertenecen al sistema serotoninérgico. La tinción de Nissl reveló que el cerebro del caimán chino estaba dividido en cuatro regiones (telencéfalo, diencéfalo, tronco encefálico y cerebelo) y un sistema ventricular conectado (que contiene el par de ventrículos laterales, el tercer ventrículo, el cuarto ventrículo y el acueducto). Según los resultados de IHC, las neuronas inmunorreactivas 5-HT (5-HT-IR) se observaron principalmente en la corteza cerebral, el núcleo paraventricular (PH) hipotalámico, el tectum y tegmento de los lóbulos ópticos, el fascículo longitudinal medial (Flm) de médula oblonga y la corteza cerebelosa. Las fibras 5-HT-IR se ubicaron principalmente lateral al núcleo paraventricular (PH) hipotalámico, en el núcleo vestibular medial (MVe) de la médula oblonga y en el plexo coroideo (CP) de los ventrículos laterales. Además, nuestros hallazgos fueron semejantes a los resultados obtenidos de otros reptiles; sin embargo, se identificaron algunas distinciones en términos tanto de arquitectura histológica como de función. Las capas de la corteza cerebral y el tectum, así como la disposición de las neuronas purkinjenses, diferían entre los cerebros de los reptiles. La distribución de las neuronas 5-HT-IR varió en la capa de la corteza cerebral y cerebelosa en comparación con otros reptiles. Dentro del diencéfalo, las neuronas 5-HT-IR formaron núcleos distintos en el núcleo paraventricular (PH) hipotalámico, pero pocos en el receso infundibular.

SUMMARY: The objective of this study was to investigate the effects of different oral root canal filling materials on the expression of inflammatory factors and protease related molecules in gingival crevicular fluid (GCF). A total of 90 patients with posterior tooth defects who underwent root canal therapy in our hospital were selected. They were divided into an observation group (group A) and a control group (group B) based on different root canal filling materials, with 45 teeth in each group. The group A patients were repaired with fiber post, composite resin combined with zirconia ceramic crown, while the group B patients were repaired with metal post core combined with metal ceramic crown. The clinical effect, periodontal index, restoration success rate, mastication efficiency, periodontal index, restoration effect, and the levels of GCF and Alkaline phosphatase (ALP) before and after restoration were compared between the two groups. The clinical efficacy of the group A was better than that of the group B patients. The success rate of repair and chewing efficiency in the group A were higher than those in the group B. The completeness rate, color matching rate, edge fit rate, edge coloring qualification rate, and gingival qualification rate of the group A patients were higher than those of the group B patients. After repair, the levels of GCF and ALP in both groups of patients were higher than before repair, and the group B was raised than the group A. The PLI, GI, and SBI indices of the group A patients were reduced than those of the group B patients. The application of fiber post, composite resin combined with zirconia porcelain crown restoration in patients with posterior tooth defects after root canal treatment can improve the success rate, chewing efficiency, and restoration effect, with little impact on changes in GCF and ALP levels in the body.

RESUMEN: El objetivo de este estudio fue investigar los efectos de diferentes materiales de obturación del canal radicular sobre la expresión de factores inflamatorios y moléculas relacionadas con proteasas en el fluido crevicular gingival (GCF). Se seleccionaron un total de 90 pacientes con defectos de los dientes posteriores que se sometieron a tratamiento de canal en nuestro hospital. Se dividieron en un grupo de observación (grupo A) y un grupo control (grupo B) basado en diferentes materiales de obturación del canal radicular, con 45 dientes en cada grupo. Los dientes de los pacientes del grupo A fueron reparados con poste de fibra, resina compuesta combinada con corona de cerámica de circonio, mientras que los dientes de los pacientes del grupo B fueron reparados con núcleo de poste de metal combinado con corona de cerámica de metal. Se compararon en los dos grupos el efecto clínico, el índice periodontal, la tasa de éxito de la restauración, la eficiencia de la masticación, el índice periodontal, el efecto de la restauración y los niveles de GCF y fosfatasa alcalina (ALP) antes y después de la restauración. La eficacia clínica del grupo A fue mejor que la de los pacientes del grupo B. La tasa de éxito de la reparación y la eficiencia de la masticación en el grupo A fueron mayores que las del grupo B. La tasa de integridad, la tasa de coincidencia de colores, la tasa de ajuste de los bordes, la tasa de calificación de la coloración de los bordes y la tasa de calificación gingival de los pacientes del grupo A fueron mayores que las de los pacientes del grupo B. Después de la reparación, los niveles de GCF y ALP en ambos grupos de pacientes fueron más altos que antes de la reparación, y el grupo B aumentó más que el grupo A. Los índices PLI, GI y SBI de los pacientes del grupo A fueron más reducidos que los pacientes del grupo B. La aplicación de poste de fibra, resina compuesta combinada con restauración de corona de porcelana de circonio en pacientes con defectos de dientes posteriores después del tratamiento de canal puede mejorar la tasa de éxito, la eficiencia de la masticación y el efecto de la restauración, con poco impacto en los cambios en los niveles de GCF y ALP en el cuerpo.

SUMMARY: To explore morphological evidence for neuronal circuits between adenosine A2A receptor (A2AR) neurons in the nucleus accumbens (NAc) and orexin neurons. The utilized adeno-associated virus (AAV) encoding humanized Renilla green fluorescent protein (hrGFP) as a tracer to visualize the expression of the A2AR neurons in the NAc and their axon distributions in orexin neurons. The Cre-dependent AAV was injected into the NAc in adenosine A2AR-Cre mice. Immunohistochemistry was then used to visualize hrGFP and their projections in orexin neurons. The data revealed that NAc A2AR neurons, mainly expressed in γ-aminobutyric acidergic (GABAergic) projection neurons, projected to the hypothalamus, with apparent contacts of hrGFP containing boutons onto orexin-immunoreactive (IR) soma and dendrites. We also observed strong staining of orexin-IR varicose terminals in the NAc, with apparent contacts of orexin-IR terminals onto A2AR neurons. Furthermore, in the NAc, orexin-IR varicosities contained vesicular glutamate transporter 2 (VGluT2) and synaptophysin (Syp). These data provide morphological evidence for exploring the function between NAc A2AR neurons and orexin neuron in the hypothalamus, particularly in regulating sleep processes.

RESUMEN: El objetivo de este trabajo fue explorar la evidencia morfológica de los circuitos neuronales entre las neuronas del receptor de adenosina A2A (A2AR) en el núcleo accumbens (NAc) y las neuronas de orexina. El virus adenoasociado (AAV) que codifica la proteína fluorescente verde Renilla humanizada (hrGFP) se utilizó como trazador para visualizar la expresión de las neuronas A2AR en la NAc y sus distribuciones de axones en las neuronas de orexina. El AAV dependiente de Cre se inyectó en la NAc en ratones adenosina A2AR-Cre. Luego se utilizó inmunohistoquímica para visualizar hrGFP y sus proyecciones en las neuronas de orexina. Los datos revelaron que las neuronas NAc A2AR, expresadas principalmente en neuronas de proyección acidérgicas γ-aminobutíricas (GABAérgicas), se proyectaban hacia el hipotálamo, con contactos aparentes de botones que contenían hrGFP en el soma y las dendritas inmunorreactivas con orexina (IR). También observamos una fuerte tinción de las terminales varicosas de orexina-IR en la NAc, con contactos aparentes de las terminales de orexina-IR en las neuronas A2AR. Además, en la NAc, las varicosidades de orexina-IR contenían transportador vesicular de glutamato 2 (VGluT2) y sinaptofisina (Syp). Estos datos proporcionan evidencia morfológica para explorar la función entre las neuronas NAc A2AR y la neurona orexina en el hipotálamo, particularmente en la regulación de los procesos del sueño.

Abstract Objective Monitoring the disease status of Epstein-Barr virus (EBV)-related hemophagocytic lymphohistiocytosis (HLH) patients is crucial. This study aimed to investigate the different strategies and outcomes of patients with EBV-HLH and re-elevated EBV-DNA. Method A retrospective analysis was conducted on 20 patients diagnosed with EBV-HLH. Clinical features, laboratory tests, treatments, plasma EBV-DNA levels, and outcomes were assessed. Three cases were highlighted for detailed analysis. Results Nine of the 20 patients had a re-elevation of EBV-DNA during treatment, and 55.5 % (5/9) experienced relapses. Patients with persistently positive plasma EBV-DNA (n = 4) and those with re-elevated EBV-DNA after conversion (n = 9) showed a significantly higher relapse rate compared to those with persistently negative EBV-HLH (n = 7) (p < 0.05). Among the highlighted cases, Case 1 exhibited plasma EBV-DNA re-elevation after four weeks of treatment without relapse, maintaining stability with the original treatment regimen, and eventually, his plasma EBV-DNA turned negative. In Case 2, plasma EBV-DNA was elevated again with a recurrence of HLH after L-DEP. Consequently, she underwent allogeneic hematopoietic stem cell transplantation and eventually achieved complete remission (CR) with negative plasma EBV-DNA. Case 3 experienced plasma EBV-DNA re-elevation after L-DEP but remained in CR, discontinuing chemotherapy without relapse. Conclusion The re-elevation of plasma EBV-DNA during EBV-HLH treatment poses challenges in determining disease status and treatment strategies. Optimal management decisions require a combination of the level of elevated EBV-DNA, the intensity of hyperinflammation, and the patient's immune function. EpsteinBarr Epstein Barr EBVrelated EBV related (HLH crucial EBVHLH reelevated re EBVDNA. EBVDNA DNA. DNA 2 EBVHLH. HLH. features tests treatments levels assessed reelevation elevation 555 55 5 55. 5/9 59 9 (5/9 relapses n 4 7 p 0.05. 005 0.05 . 0 05 0.05) regimen LDEP. LDEP L DEP. DEP Consequently CR (CR EBVDNA, DNA, hyperinflammation patient s function 5/ (5/ 00 0.0 (5 0. (

Resumo Historicamente, são necessários, em média, 17 anos para que novos tratamentos passem da evidência clínica para a prática diária. Considerando os tratamentos altamente eficazes disponíveis atualmente para prevenir ou retardar o início e a progressão da doença renal, esse período é demasiadamente longo. Agora é o momento de reduzir a lacuna entre o que sabemos e aquilo que fazemos. Existem diretrizes claras para a prevenção e o manejo dos fatores de risco comuns para doenças renais, como hipertensão e diabetes, mas apenas uma fração das pessoas com essas condições é diagnosticada mundialmente, e um número ainda menor recebe tratamento adequado. Da mesma forma, a grande maioria das pessoas que sofrem de doença renal não têm conhecimento de sua condição, pois ela costuma ser silenciosa nos estágios iniciais. Mesmo entre pacientes que foram diagnosticados, muitos não recebem tratamento adequado para a doença renal. Levando em consideração as graves consequências da progressão da doença renal, insuficiência renal ou óbito, é imperativo que os tratamentos sejam iniciados precocemente e de maneira adequada. As oportunidades para diagnosticar e tratar precocemente a doença renal devem ser maximizadas, começando no nível da atenção primária. Existem muitas barreiras sistemáticas, que vão desde o paciente até o médico, passando pelos sistemas de saúde e por fatores sociais. Para preservar e melhorar a saúde renal para todos em qualquer lugar, cada uma dessas barreiras deve ser reconhecida para que soluções sustentáveis sejam desenvolvidas e implementadas sem mais demora. Historicamente necessários média 1 diária longo fazemos renais diabetes mundialmente forma condição iniciais diagnosticados óbito adequada maximizadas primária sistemáticas médico sociais lugar demora

Abstract Historically, it takes an average of 17 years for new treatments to move from clinical evidence to daily practice. Given the highly effective treatments now available to prevent or delay kidney disease onset and progression, this is far too long. Now is the time to narrow the gap between what we know and what we do. Clear guidelines exist for the prevention and management of common risk factors for kidney disease, such as hypertension and diabetes, but only a fraction of people with these conditions are diagnosed worldwide, and even fewer are treated to target. Similarly, the vast majority of people living with kidney disease are unaware of their condition, because it is often silent in the early stages. Even among patients who have been diagnosed, many do not receive appropriate treatment for kidney disease. Considering the serious consequences of kidney disease progression, kidney failure, or death, it is imperative that treatments are initiated early and appropriately. Opportunities to diagnose and treat kidney disease early must be maximized beginning at the primary care level. Many systematic barriers exist, ranging from the patient to the clinician to the health systems to societal factors. To preserve and improve kidney health for everyone everywhere, each of these barriers must be acknowledged so that sustainable solutions are developed and implemented without further delay. Historically 1 practice progression long diabetes worldwide target Similarly condition stages failure death appropriately level everywhere

RESUMEN: El objetivo de este estudio fue comparar y analizar la eficacia clínica de diferentes abordajes de clavo intramedular con tornillos de bloqueo para las fracturas de tibia proximal. Se incluyeron en el estudio 100 casos de fracturas de tibia proximal tratados en el departamento de ortopedia desde abril de 2021 hasta septiembre de 2023 y se dividieron en grupos de control y de tratamiento mediante una tabla de números aleatorios. Un grupo control (n=50) tratado con clavo intramedular infrapatelar con tornillos de bloqueo, y un grupo tratamiento (n=50) tratado con clavo intramedular suprapatelar con tornillos de bloqueo. Observamos excelentes y buenas tasas en ambos grupos, comparamos varios indicadores perioperatorios, cambios en el rango de movimiento articular (ROM), puntuaciones de dolor en la escala visual analógica (EVA), puntuaciones de función Lysholm de la articulación de la rodilla , cambios en factores inflamatorios y varios marcadores óseos, antes y después del tratamiento, y se analizaron las complicaciones postoperatorias. No hubo diferencias significativas en los datos iniciales como edad, sexo, índice de masa corporal, sitio de fractura, fracturas de fíbula concomitantes, tiempo desde la fractura hasta la cirugía, mecanismo de lesión y clasificación de fractura AO/OTA entre los dos grupos (P>0,05). La tasa de excelente y buena en el grupo con tratamiento después del tratamiento fue del 90,00 % (45/50), significativamente mayor que el 72,00 % (36/50) en el grupo control (P<0,05). No hubo diferencias significativas en la pérdida de sangre intraoperatoria y el tiempo de curación de las fracturas entre los dos grupos (P>0,05). Sin embargo, el grupo con tratamiento tuvo tiempos quirúrgicos más cortos y menos tiempos de fluoroscopía que el grupo control (P <0,05). Después del tratamiento, ambos grupos mostraron un aumento de las puntuaciones de ROM y Lysholm, así como una disminución de las puntuaciones de VAS. Además, en comparación con el grupo control, el grupo con tratamiento tuvo puntuaciones ROM y Lysholm más altas y puntuaciones EVA más bajas (P <0,05). Los factores inflamatorios que incluyen interleucina-1β (IL-1β), proteína C reactiva (CRP), factor de necrosis tumoral-α (TNF-α), osteocalcina (BGP) y calcitonina (CT) aumentaron en ambos grupos después del tratamiento, mientras que el total disminuyó el propéptido n-terminal del procolágeno tipo I (Total-PINP) y el telopéptido β-C-terminal del colágeno tipo I (β-CTX). En comparación con el grupo control, el grupo con tratamiento mostró mayores aumentos en los factores inflamatorios y niveles más bajos de Total-PINP y β-CTX, pero niveles más altos de BGP y CT (P <0,05). La incidencia de complicaciones postoperatorias fue del 8 % (4/50) en el grupo de tratamiento y del 24 % (12/50) en el grupo control, con diferencias estadísticamente significativas (P=4,762, X2=0,029). En el tratamiento de las fracturas de tibia proximal, el clavo intramedular con tornillos de bloqueo mediante el abordaje suprapatelar logra una eficacia clínica significativa. Reduce el tiempo quirúrgico, minimiza la exposición a la radiación de los trabajadores de la salud y los pacientes, mejora el rango de movimiento y la función de la articulación de la rodilla, disminuye el dolor postoperatorio y las tasas de complicaciones, suprime las reacciones inflamatorias y promueve la mejora de los marcadores óseos relacionados con la curación de las fracturas.

SUMMARY: The objective of this study was to compare and analyze the clinical efficacy of different approaches of intramedullary nailing with blocking screws for proximal tibial fractures. One hundred cases of proximal tibial fractures treated in the orthopedic department from April 2021 to September 2023 were included in the study and divided into control and treatment groups using a random number table. A control group (n=50) treated with infrapatellar intramedullary nailing with blocking screws, and a treatment group (n=50) treated with suprapatellar intramedullary nailing with blocking screws. We observed the excellent and good rates in both groups, compared various perioperative indicators, changes in joint range of motion (ROM), Visual Analog Scale (VAS) pain scores, Lysholm knee joint function scores, changes in inflammatory factors, and various bone markers before and after treatment, and analyzed postoperative complications. There were no significant differences in baseline data such as age, sex, body mass index, fracture site, concomitant fibular fractures, time from fracture to surgery, injury mechanism, and AO/OTA fracture classification between the two groups (P>0.05). The excellent and good rate in the treatment group after treatment was 90.00 % (45/50), significantly higher than 72.00 % (36/50) in the control group (P<0.05). There were no significant differences in intraoperative blood loss and fracture healing time between the two groups (P>0.05). However, the treatment group had shorter surgical times and fewer fluoroscopy times than the control group (P<0.05). After treatment, both groups showed increased ROM and Lysholm scores, as well as decreased VAS scores. Moreover, compared to the control group, the treatment group had higher ROM and Lysholm scores and lower VAS scores (P<0.05). Inflammatory factors including interleukin-1β (IL-1β), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), osteocalcin (BGP), and calcitonin (CT) increased in both groups after treatment, while total n- terminal propeptide of type I procollagen (Total-PINP) and b-C-terminal telopeptide of type I collagen (β-CTX) decreased. Compared to the control group, the treatment group exhibited greater increases in inflammatory factors and lower levels of Total-PINP and β-CTX, but higher BGP and CT levels (P<0.05). The incidence of postoperative complications was 8.00 % (4/50) in the treatment group and 24.00 % (12/50) in the control group, with statistically significant differences (P=4.762, X2=0.029). In the treatment of proximal tibial fractures, intramedullary nailing with blocking screws using the suprapatellar approach achieves significant clinical efficacy. It reduces surgical time, minimizes radiation exposure to healthcare workers and patients, improves knee joint range of motion and function, decreases postoperative pain and complication rates, suppresses inflammatory reactions, and promotes the improvement of bone markers related to fracture healing.