Ulcer Research Articles

Neonatal Riga-Fede disease: A systematic review of 84 cases collected over 120 years

Background: Traumatic ulceration of the tongue due to congenital teeth is known as Riga-Fede disease (RFD). The literature on RFD consists largely of anecdotal case reports, thereby lacking valid clinical recommendations. While managing a newborn with RFD complicated by Ludwig’s angina, this knowledge gap was recognized. Therefore, this systematic review was conducted to gain insight into the optimal management and the possible complications of RFD. Methods: A literature search was conducted using PubMed, Google Scholar, and Science Direct, supplemented with African Journals Online, Indmed, and manual searches. Papers published between 1900 and July 2023 in any language were retrieved. Neonates with natal or neonatal teeth and ulceration of the oral mucosa were included. Papers with incomplete data and review articles were excluded. Results: A total of 84 newborns with RFD from 62 published reports (including the case reported herein) were analyzed. Most of the reports were from the Indian subcontinent, and the frequency of reporting has increased since the year 2000. Tongue ulceration in all cases was due to mandibular incisors. There was no significant difference in the median duration of healing between the tooth extraction group (14 days) and the conservative management group (18 days). There was only a very weak positive correlation between the duration of symptoms and healing time, which was statistically insignificant. Conclusion: Healing of mucosal ulcers in RFD is often protracted and does not appear to be influenced by the duration of symptoms or by the modality of treatment. Extraction of the offending teeth is more common (75% of cases) than conservative management, such as grinding (ameloplasty) or resin capping of teeth. RFD is mostly a benign disorder; however, serious complications such as meningitis, Ludwig’s angina, and soft tissue abscesses can rarely occur with Staphylococcus aureus infections.

Bacillus coagulans restores pathogen-induced intestinal dysfunction via acetate-FFAR2-NF-κB-MLCK-MLC axis in Apostichopus japonicus.

Skin ulceration syndrome (SUS) is currently the main disease threatening Apostichopus japonicus aquaculture due to its higher mortality rate and infectivity, which is caused by Vibrio splendidus. Our previous studies have demonstrated that SUS is accompanied by intestinal microbiota (IM) dysbiosis, alteration of short-chain fatty acids (SCFAs) content and the damage to the intestinal barrier. However, the mediating effect of IM on intestine dysfunction is largely unknown. Herein, we conducted comprehensive intestinal microbiota transplantation (IMT) to explore the link between IM and SUS development. Furthermore, we isolated and identified a Bacillus coagulans strain with an ability to produce acetic acid from both healthy individual and SUS individual with IM from healthy donors. We found that dysbiotic IM and intestinal barrier function in SUS recipients A. japonicus could be restored by IM from healthy donors. The B. coagulans strain could restore IM community and intestinal barrier function. Consistently, acetate supply also restores intestinal homeostasis of SUS-diseased and V. splendidus-infected A. japonicus. Mechanically, acetate was found to specifically bind to its receptor-free fatty acid receptor 2 (FFAR2) to mediate IM structure community and intestinal barrier function. Knockdown of FFAR2 by transfection of specific FFAR2 siRNA could hamper acetate-mediated intestinal homeostasis in vivo. Furthermore, we confirmed that acetate/FFAR2 could inhibit V. splendidus-activated NF-κB-MLCK-MLC signaling pathway to restore intestinal epithelium integrity and upregulated the expression of ZO-1 and Occludin. Our findings provide the first evidence that B. coagulans restores pathogen-induced intestinal barrier dysfunction via acetate/FFAR2-NF-κB-MLCK-MLC axis, which provides new insights into the control and prevention of SUS outbreak from an ecological perspective.IMPORTANCESkin ulceration syndrome (SUS) as a main disease in Apostichopus japonicus aquaculture has severely restricted the developmental A. japonicus aquaculture industry. Intestinal microbiota (IM) has been studied extensively due to its immunomodulatory properties. Short-chain fatty acids (SCFAs) as an essential signal molecule for microbial regulation of host health also have attracted wide attention. Therefore, it is beneficial to explore the link between IM and SUS for prevention and control of SUS. In the study, the contribution of IM to SUS development has been examined. Additionally, our research further validated the restoration of SCFAs on intestinal barrier dysfunction caused by SUS via isolating SCFAs-producing bacteria. Notably, this restoration might be achieved by inhibition of NF-κB-MLCK-MLC signal pathway, which could be activated by V. splendidus. These findings may have important implications for exploration of the role of IM in SUS occurrence and provide insight into the SUS treatment.

Computed Tomography Finding of Crusty Thrombosed Arteries: An Appearance of Lower Extremity Vascular Pythiosis.

Vascular pythiosis is a dreadful vascular infection that presents as a chronic leg ulcer. To distinguish this infectious disease from atherosclerotic occlusion of the lower limb, we investigated the imaging appearance and presence of thick and irregular arterial wall enhancement, named crusty thrombosed arterial sign, on computed tomography images in cases with vascular pythiosis infection of lower extremities. In this study, 13 cases of vascular pythiosis of lower extremities with available images from 2016 to 2022 were reviewed and the presence of crusty thrombosed arterial signs, segments of vascular involvement, and radiological findings of hematologic disease, including hepatosplenomegaly and bone changes were recorded. Crusty arterial sign with long segmental arterial involvement was found in all cases. All cases had hepatomegaly and abnormal spleen, either splenomegaly or splenectomy, found in 12 cases (92.3%). Six cases (46.1%) had thalassemic bone changes. We proposed the pathognomonic radiologic sign of vascular pythiosis: the crusty thrombosed arterial sign, which manifested as diffusely thick and irregular arterial wall enhancement along long arterial thrombosis without skip lesions. Other associated findings included splenomegaly, splenectomy, and thalassemic bone changes. These radiologic findings facilitated the diagnosis of vascular pythiosis, particularly in cases of atypical presentation or unreliable clinical context.

A Double-Blind Study on the Effectiveness of Polarized Light Therapy in the Treatment of Venous leg Ulcers-Pilot Study.

Vein diseases are one of the most common civilization diseases. The most advanced form chronic venous insufficiency are venous leg ulcers. The study included 40 patients, 20 male (50%) and 20 female (50%) in age between 52 and 88 years (mean age: 68.00 ± 8.55 years) with venous leg ulcers lasting 12.50 ± 5.45 months. Patients were distributed randomly in a double-blind study into two equal groups including 20 patients each (group 1-polarized light therapy and group 2-sham exposure). Patients from both groups received routine pharmacological treatment, specialistic medical dressings and compression therapy. In addition, patients were exposed to a cycle of polarized light therapy procedures or to sham exposures (30 procedures performed in two series of 15 procedures). Wound surface area was evaluated by computerized planimetry and pain intensity was assessed with the use of Visual Analog Scale (VAS) before and after therapy (2.5 months). The analysis showed a statistically significant reduction of surface ulcers area between groups 1 and 2. The median (IQR) size of wounds in group 1 was 2.4 (1.95-2.9) cm2, in group 2; 2.8 (2.6-3.1) cm2 (p = 0.038). The level of pain (VAS) after treatment was assessed in group 1, median (IQR): 2 (2-3) points, in group 2 4.5 (4-5) points; and the observed difference was also statistically significant (p < 0.001). In group 1, after treatment, the area of ulcers decreased-median (IQR): 33.05 (28.7-41.48) %, in group 2 by 18.99 (15-24.4) % (p < 0.001). In group 1, the pain intensity measured using the VAS scale decreased with a median (IQR): 71.42 (61.25-71.42) %, in group 2: 37.5 (28.57-50) % (p < 0.001). Complex therapy with polarized light therapy added to standard care was more effective than standard care alone in reducing of ulcers surface area and intensity of pain ailments in patients with chronic venous leg ulcers.

Immunizing Mice with Influenza Virus-like Particles Expressing the Leishmania amazonensis Promastigote Surface Antigen Alleviates Inflammation in Footpad.

Cutaneous leishmaniasis (CL) is a tropical disease endemic in many parts of the world. Characteristic clinical manifestations of CL include the formation of ulcerative skin lesions that can inflict life-long disability if left untreated. Although drugs are available, they are unaffordable and out of reach for individuals who need them the most. Developing a highly cost-efficient CL vaccine could address this problem but such a vaccine remains unavailable. Here, we developed a chimeric influenza virus-like particle expressing the Leishmania amazonensis promastigote surface antigen (LaPSA-VLP). LaPSA-VLPs were self-assembled in Spodoptera frugiperda insect cell lines using the baculovirus expression system. After characterizing the vaccines and confirming successful VLP assembly, BALB/c mice were immunized with these vaccines for efficacy assessment. Sera acquired from mice upon subcutaneous immunization with the LaPSA-VLP specifically interacted with the L. amazonensis soluble total antigens. LaPSA-VLP-immunized mice elicited significantly greater quantities of parasite-specific IgG from the spleens, popliteal lymph nodes, and footpads than unimmunized mice. LaPSA-VLP immunization also enhanced the proliferation of B cell populations in the spleens of mice and significantly lessened the CL symptoms, notably the footpad swelling and IFN-γ-mediated inflammatory response. Overall, immunizing mice with the LaPSA-VLPs prevented mice from developing severe CL symptoms, signifying their developmental potential.

The Dynamic Donning Technique of Prosthetic Liners

ABSTRACT Introduction Prosthetic liners are widely used for a variety of indications such as improving prosthetic socket fit and suspension. However, these are associated with complications affecting the skin, including skin rubs, breakdown, and ulceration. Methods and Discussion We outline the splinting effect of prosthetic liners as a possible contributing factor that results in increased shear during joint motion and propose a simple liner donning technique to minimize these shear forces by spreading liner/skin tension over the whole range of motion of the proximal joint. Clinical Relevance The proposed dynamic donning technique would minimize the risk of skin ulcerations and improve joint range of motion in prosthetic limb users.

Assessment of potential genetic markers for diabetic foot ulcer among Moscow residents.

Diabetic foot ulcer (DFU) is one of the most severe complications of type 2 diabetes, which is manifested in chronic skin ulcers of lower extremities. DFU treatment remains complex and expensive despite the availability of well-established protocols. Early prediction of potential DFU development at the onset of type 2 diabetes can greatly improve the aftermath of this complication. To assess potential genetic markers for DFU, a group of diabetic patients from Moscow region with and without DFU was genotyped for a number of SNPs previously reported to be associated with the DFU. Obtained results did not confirm previously claimed association of rs1024611, rs3918242, rs2073618, rs1800629, rs4986790, rs179998, rs1963645 and rs11549465 (respectively, in MCP1, MMP9, TNFRSF11B, TNFα, TLR4, eNOS, NOS1AP and HIF1α genes) with the DFU. Surprisingly, the t allele of rs7903146 in the TCF7l2 gene known as one of the most prominent risk factors for type 2 diabetes has shown a protective effect on DFU with OR(95%) = 0.68(0.48-0.96). Non-replication of previously published SNP associations with DFU suggests that the role of genetic factors in the DFU onset is either highly variable in different populations or is not as significant as the role of non-genetic factors.

Comparison of vonoprazan bismuth-containing triple therapy with quadruple therapy in Helicobacter pylori-infected treatment-naive patients: a prospective multicenter randomized controlled trial.

Helicobacter pylori infection is linked to various gastrointestinal conditions, such as chronic active gastritis, peptic ulcers, and gastric cancer. Traditional treatment options encounter difficulties due to antibiotic resistance and adverse effects. Therefore, the aim of this study was to explore the effectiveness of a new treatment plan that combines vonoprazan (VPZ), amoxicillin, and bismuth for the eradication of H. pylori. A total of 600 patients infected with H. pylori were recruited for this multicenter randomized controlled trial. Patients treated for H. pylori elimination were randomly assigned at a 1:1 ratio to receive 14days of vonoprazan-based triple therapy (vonoprazan + amoxicillin + bismuth, group A) or standard quadruple therapy (esomeprazole + clarithromycin + amoxicillin + bismuth, group B). Compliance and adverse effects were tracked through daily medication and side effect records. All patients underwent a 13C/14C-urea breath test 4weeks after treatment completion. Intention-to-treat (ITT) and per-protocol (PP) analyses revealed no substantial differences in H. pylori eradication rates between groups A and B (ITT: 83.7% vs 83.2%; PP: 90.9% vs 89.7%). However, significant differences were observed in the assessment of side effects (13.7% vs 28.6%, P<0.001). Specifically, group A had significantly fewer "bitter mouths" than group B did (3.7% vs 16.2%, P<0.001). Triple therapy comprising vonoprazan (20mg), amoxicillin (750mg), and bismuth potassium citrate (220mg) achieved a PP eradication rate ≥90%, paralleling standard quadruple therapy, and had fewer adverse events and lower costs (¥306.8 vs ¥645.8) for treatment-naive patients.

Outpatient regenerative therapy of a chronic diabetic foot ulcer with exposed bone surface

BACKGROUND: Treatment of deep chronic wounds with the bone tissue involvement against the background of lower limb atherosclerosis and diabetic foot syndrome does not fit any reasonable hospital stay duration and at the same time has no effective outpatient methods. Therapy with conditioned medium derived from human mesenchymal stem cells (CM-MSC) may be a solution for this problem. CLINICAL CASE DESCRIPTION: Patient F., 77-year-old, arrived for an outpatient treatment of local necrosis in the area of the 1st toe of the left foot in April, 2022. The main diagnosis: Peripheral arterial disease of the lower extremities. Multifocal atherosclerosis. Occlusion of the superficial femoral and popliteal arteries, diffuse lesions of the lower leg arteries on the left. Chronic arterial insufficiency of the 4th degree. Attempts of revascularisation of the left lower limb. Limited gangrene (Wagner IV) of the 1st toe of the left foot. Associated diseases: insulin-dependent type 2 diabetes mellitus (for more than 30 years). Diabetic polyneuropathy. Diabetic foot syndrome, neurotrophic form. Local treatment was performed by the microsurgical debridement of the affected surface in combination with the method of multilayered dressings, according to the previously patented technology. The microsurgical treatment of the bone surface in the wound area was carried out with the use of CM-MSC. Positive dynamics in the form of a partial closure of the bone fragment with soft tissue was observed on the sixth month of therapy. The complete closure of the open bone fragment was observed in 12 months from the beginning of the outpatient treatment. CONCLUSION: The developed method of treatment using CM-MSC can be effective for chronic wounds with open bone surfaces.

Association of Tryptophan/Kynurenine Metabolites with Healing in Chronic Venous Leg Ulcers.

Objective: Chronic wound healing is a complex process that is still not well understood. The tryptophan (TRP)-l-kynurenine (KYN) pathway has recently been under increased scrutiny with regard to wound healing. The study applied metabolomics to elucidate the TRP-l-KYN pathway associated with wound healing in chronic venous leg ulcers (CVLUs). Approach: This study used a longitudinal comparative design of 60 serum samples collected from 30 older adult patients with CVLUs, receiving weekly sharp debridement at a wound clinic. The serum samples were collected at baseline and week 4 (healed wounds) or week 8 (nonhealed wounds). Liquid chromatography-mass spectrometry (LC-MS) metabolomics was used to analyze targeted metabolites. A Bayesian approach was used to examine robust correlations between changes in metabolite values and linear healing slope and to compare by group. Results: The mean age was 71.13 (±9.46 years). Half of the sample were female and the minority (17%) were Black. The mean values of evaluated metabolites for the nonhealed group were consistently lower than those for the healed group. The healed group (n = 12) had higher KYN values. Those on a healing trajectory (n = 23) had lower KYN levels and higher TRP levels at baseline and over time. There was moderate support (Bayes factor = 3.70) for a negative association between change in kynurenic acid and linear healing slope (r = -0.35, credibility intervals [CrI] = -0.62, -0.04; probability of direction [PD] = 98%). Results suggest that KYN and TRP may be markers for healing in individuals with CVLUs. Innovation and Conclusion: Gaining a better understanding of the associations between the TRP-l-KYN pathway and the healing of CVLUs may help to clarify the links of inflammation with the rate and success of wound healing. Biomarker development focused on the TRP-l-KYN pathway could be pursued, if the associations are further supported by focused research studies.

Carcinoma Cuniculatum Masquerading as Eumycetoma: An Unacquainted Entity Posing a Diagnostic Dilemma.

Carcinoma cuniculatum (CC) is a rare and distinct clinicopathological variant of well-differentiated squamous cell carcinoma. It is a rare and slow-growing tumor with a peculiar infiltrative growth pattern resembling rabbit burrows (cuniculi). It usually occurs over the plantar aspect of the foot but can also occur at other sites like the oral cavity and genitals. The pathogenesis is unknown, with various hypotheses of trauma as proposed by different authors. It is essential to be aware of this entity as it commonly mimics benign and other low-grade squamous cell carcinoma (SCC). Diagnosis of CC can be challenging and requires repeated histological evaluation and clinical correlation. Herein, we present a case report of CC of the plantar and dorsal aspect of the foot in a 60-year-old male with a history of multiple chronic non-healing ulcers, which was clinically suspected as eumycetoma and remained inconclusive on numerous biopsies.

Clinical Presentation of Sudanese Patients with Breast Cancer

Background: Breast cancer with advanced stages at a young age is a significant new challenge in Sudan. The purpose of this study was to determine the most common presentations of breast cancer patients in western Sudan. Methodology: For this retrospective descriptive investigation, materials for 183 breast cancer patients were obtained from two histopathology centers (Kordofan histopathology center and El-Obeid International Hospital). A full coverage sample was collected, spanning from January 2019 to May 2024. All data pertaining to the patient's essential identifying, clinical, and histological data were gathered. Results: This study looked at 183 breast cancer patients (177 (96.7%) women and 6 (3.3%) men). Their ages ranged from 20 to 90, with a mean ± standard deviation of 50.78 ± 13.6 years. The majority of participants were aged 41-50 years, followed by ≥61 and 51-60 years, with 50/183 (27%), 43 (23%), and 35 (19%), respectively. For clinical appearance, the most common skin change was unremarkable, followed by ulcerated skin change, which accounted for 127/183 (69%) and 48 (26%) respectively. Conclusion: Breast cancer with advanced stages upon presentation is common in Sudan. The majority of patients presented at a younger age and had distinct initial manifestations.

Naltrexone accelerated oral traumatic ulcer healing and downregulated TLR-4/NF-kB pathway in Wistar rats

ObjectiveTo assess the effect of naltrexone on oral mucosal healing using a traumatic ulcer model DesignWistar rats (n = 112) received distilled water (control) or naltrexone (0.5, 10, or 50 mg/kg/day). Ulcers were induced on the buccal mucosa using a round skin biopsy punch (diameter 6 mm). Euthanasia was performed on days 1, 3, 7, and 14. Healing was assessed by ulcer area, histological scores, histomorphometric analysis (number of polymorphonuclears, mononuclears, and fibroblasts), and collagen percentage. Immunohistochemistry for TLR-2, TLR-4, NF-kB, and CD31 was evaluated. Nociceptive threshold was measured daily. ResultsThe 50 mg/kg group showed reduced ulcer area on days 1 (p < 0.001), 3 (p < 0.05), and 14 (p < 0.01). In this group, there was, on day 14, an increase in the percentage of reepithelization (p = 0.043) and collagen (p < 0.05), an increase in connective tissue maturation (p = 0.016), and on day 7 an increase in fibroblasts (p < 0.001). The 10 mg/kg dose reduced the ulcer area on day 1 (p < 0.001). The 50 mg/kg group showed lower expression of TLR-4 (p < 0.001) on day 1, NF-kB on days 1 (p < 0.05) and 14 (p < 0.05), and CD31 on day 14 (p < 0.05). The 0.5 and 10 mg/kg doses reduced TLR-4 expression on day 1 (p < 0.05; p < 0.01, respectively). Nociceptive threshold increased in the 50 mg/kg group (p < 0.01). ConclusionNaltrexone enhanced traumatic oral ulcer healing by reducing TLR-4/NF-kB signaling and promoting fibroblast proliferation and collagen deposition. Additionally, naltrexone reduced pain in rats.

Harnessing the Synergy of ZIF‐67 Derived Nanohybrid‐Based Immunosensing for sensitive Detection of Helicobacter pylori

AbstractDetection of Helicobacter pylori (H. pylori) infection, a significant risk factor for chronic gastritis, peptic ulcers, and gastric adenocarcinoma, poses a formidable challenge due to the lack of sensitive and selective sensing platforms. Herein, we report the synthesis of a zeolitic imidazolate framework‐67 (ZIF‐67) derived Co/Co3O4/C (CoNH) porous nanostructure, optimized for the electrochemical immunosensing of H. pylori‐specific antigen VacA. By calcining ZIF‐67 at elevated temperatures, we obtained CoNH with enhanced electroactivity and conductivity, crucial for signal enhancement. The synthesized CoNH was thoroughly characterized using SEM, TEM, XPS, Raman, and FT‐IR techniques. Further signal amplification was achieved by introducing gold nanoparticles (AuNPs) onto CoNH‐modified screen‐printed carbon electrodes. Systematic investigation at each modification stage led to an optimized immunosensing platform with high sensitivity and selectivity for VacA detection. The developed immunosensor demonstrated the capability to detect low concentrations of VacA (0.1 ng/ml) within a wide linear range (0.1–50 ng/ml) with long‐term stability. This highly sensitive and selective biosensor holds promise for early‐stage diagnosis of H. pylori infection and gastric cancer.

Less Invasive Off-loading Surgery of Chronic Plantar Diabetic Forefoot Ulcers: A Narrative Review

Less Invasive Off-loading Surgery of Chronic Plantar Diabetic Forefoot Ulcers: A Narrative Review

Study the Effect of Adding Rebamipide on the Eradication Therapy for Helicobacter pylori Infection

Abstract Background H. pylori infection is a leading etiological factor for various gastroduodenal diseases, including chronic gastritis, peptic ulcers and duodenal ulcers, as well as adenocarcinoma and MALT lymphoma of the stomach. In the last decad, there has been a negative trend in the effectiveness of classic eradication therapy regimens of H.pylori, which has largely been determined by the emergence and spread of antibiotic resistance. Aim of the Work Study the effect of adding Rebamipide on the eradication therapy for helicobacter pylori infection in Egyptian patients. Patients and Methods This study included 100 patients with H.Pylori infection who had been confirmed by tissue histopathology. Results Regarding the outcome, there was a statistically significant difference between the two groups (p = 0.027) as in Rebamipide group, there was 12% cases had positive results and 88% cases had negative results while in control group, there was 30% cases had positive results and 70% cases had negative results. Regarding side effects, there was no statistically significant difference between the two groups (p = 0.360). one case in Rebamipide group experienced mild skin rash at 1st day of treatment because of allergy to rebamipide and patient was completely free of symptoms after two days without stopping treatment. Conclusion This study demonstrated that the addition of rebamipide to H. pylori eradication regimens significantly increases the effectiveness of treatment. Based on our findings, abdominal discomfort was observed significantly higher in control group, there was a statistically significant difference between the two groups (more to rebamipide group) regarding outcome and there was no statistically significant difference between the two studied groups regarding side effects.

A new nomogram based on ultrasound and clinical features for distinguishing epididymal tuberculosis and nontuberculous epididymitis

Using ultrasound findings and clinical characteristics, we constructed and validated a new nomogram for distinguishing epididymal tuberculosis from nontuberculous epididymitis, both of which share similar symptoms. We retrospectively examined data of patients with epididymal tuberculosis and nontuberculous epididymitis hospitalized between January 1, 2013, and March 31, 2023. Eligible patients were randomly assigned to derivation and validation cohorts (ratio, 7:3). We drew a nomogram to construct a diagnostic model through multivariate logistic regression and visualize the model. We used concordance index, calibration plots, and decision curve analysis to assess the discrimination, calibration, and clinical usefulness of the nomogram, respectively. In this study, 136 participants had epididymal tuberculosis and 79 had nontuberculous epididymitis. Five variables—C-reactive protein level, elevated scrotal skin temperature, nodular lesion, chronic infection, and scrotal skin ulceration—were significant and used to construct the nomogram. Concordance indices of the derivation and validation cohorts were 0.95 and 0.96, respectively (95% confidence intervals, 0.91–0.98 and 0.92–1.00, respectively). Decision curve analysis of this nomogram revealed that it helped differentiate epididymal tuberculosis from nontuberculous epididymitis. This nomogram may help clinicians distinguish between epididymal tuberculosis and nontuberculous epididymitis, thereby increasing diagnosis accuracy.

Deletion of the Mitochondrial Membrane Protein Fam210b Is Associated with the Development of Systemic Lupus Erythematosus.

Mitochondrial dysfunction has been increasingly recognized as a trigger for systemic lupus erythematosus (SLE). Recent bioinformatics studies have suggested Fam210b as a significant candidate for the classification and therapeutic targeting of SLE. To experimentally prove the role of Fam210b in SLE, we constructed Fam210b knockout (Fam210b-/-) mice using the CRISPR-Cas9 method. We found that approximately 15.68% of Fam210b-/- mice spontaneously developed lupus-like autoimmunity, which was characterized by skin ulcerations, splenomegaly, and an increase in anti-double-stranded DNA (anti-dsDNA) IgG antibodies and anti-nuclear antibodies(ANA). Single-cell sequencing showed that Fam210b was mainly expressed in erythroid cells. Critically, the knockout of Fam210b resulted in abnormal erythrocyte differentiation and development in the spleens of mice. Concurrently, the spleens exhibited an increased number of CD71+ erythroid cells, along with elevated levels of reactive oxygen species (ROS) in the erythrocytes. The co-culture of CD71+ erythroid cells and lymphocytes resulted in lymphocyte activation and promoted dsDNA and IgG production. In summary, Fam210b knockout leads to a low probability of lupus-like symptoms in mice through the overproduction of ROS in CD71+ erythroid cells. Thus, Fam210b reduction may serve as a novel key marker that triggers the development of SLE.

Advances in adsorption technologies for hexavalent chromium removal: Mechanisms, materials, and optimization strategies

In the realm of environmental engineering and water treatment, significant attention has been devoted to the removal of hexavalent chromium Cr (VI) from wastewater. Delving into the mechanisms of adsorption reveals a complex interplay of ion exchange, surface complexation, and electrostatic interactions dictating the binding of Cr (VI) to various adsorption materials. Utilizing diverse adsorbents like 2-D materials, metal oxides, and bio-based substances is driven by their exceptional absorptive capacity and specificity. Key parameters such as pH, temperature, initial concentration, and dosage are scrutinized to optimize the efficiency of adsorbent removal and ascertain the absorptive nature of the adsorbate. Beyond natural sources, human activities have exacerbated chromium contamination across ecosystems, posing a threat to food chains due to chromium's non-biodegradable nature and persistence. Chromium affects a wide range of life forms, including humans, aquatic organisms, and terrestrial species, through the accumulation and repercussions of chromium discharge. The leaching of chromium into ground and surface water triggers various health issues such as dermatitis, allergic reactions, skin ulcerations, bronchial carcinoma, asthma, and gastroenteritis. This review intended to list different treatment technologies for chromium removal along with their mechanism. Different types of sensors used for chromium detection have also been explored.

Intensity Modulated Carbon Ion Radiation Therapy Using Pencil Beam Scanning Technology for Patients With Unresectable Sacrococcygeal Chordoma

ObjectivesTo investigate the safety and efficacy of intensity modulated carbon ion radiotherapy (IM-CIRT) using pencil beam scanning technology for patients with unresectable sacrococcygeal chordoma (SC). Methods and MaterialsA total of 35 unresectable SC patients were retrospectively analyzed, including 54.3% (19/35) recurrent cases. 68.6% (24/35) cases’ tumor located in S2 or above, and all cases were treated with hypofractionated IM-CIRT. The median dose was 70.4 (range 69 - 80) Gy (RBE) in 16 (range 16 - 23) fractions, typically delivered over 5 fractions per week. ResultsThe 3-year OS, CSS, PFS, LRFS and DMFS rates with a median follow-up time of 42 (12∼91) months for the entire cohort were 93.2%, 96.3%, 61.8%, 80% and 77.3%, respectively. Multivariate analysis revealed that GTV volume (HR, 3.807; 95% CI: 1.044 - 13.887, p = 0.043) was the only significant prognostic factor for PFS and the dose for the GTV ≥ 70.4 Gy (RBE) was relevant with significantly better LRFS (HR, 0.190; 95% CI: 0.038 – 0.940, p = 0.042). No significant prognostic factor for OS, CSS and DMFS and no severe (i.e., grade ≥ 3) acute toxicity were identified. Severe late toxicities occurred in 3 patients (8.57 %): pain (1 patient), motor neuropathy (1 patient) and skin ulcer (1 patient). Furthermore, no severe toxicity related to urinary function or defecation was observed following IM-CIRT. Pain grades improved or remained unchanged in 85.7% of patients. ConclusionIM-CIRT produced acceptable 3-year outcomes without substantial late adverse effects, especially urinary and anorectal complications for SC, and did not appear to increase pain. IM-CIRT at high doses using hypofractionated RT may improve outcomes for local control and seems to be feasible even for postoperative recurrent SC.