Achieving highly anisotropic, whisker-like calcium carbonate (CaCO3) architectures while retaining the thermodynamically stable calcite phase remains a significant challenge. Here, we present a staged additive-assisted carbonation strategy employing Mg, Zn, and SO4 species to produce sub-micrometer calcite nanorods and whiskers. Powder X-ray diffraction identifies the product as calcite without detectable metastable polymorphs, and scanning electron microscopy reveals highly porous, cauliflower-like secondary agglomerates. Transmission electron microscopy directly visualizes the embedded one-dimensional primary nano-units (lengths 393-406 nm; aspect ratios 4-7), and indexed lattice fringes establish their identity as calcite. N2 physisorption further indicates a mesopore-dominated architecture with a specific surface area of 9.58 m[2]/g. On the basis of these multiscale observations and the established crystal-chemical behavior of Mg[2+], Zn[2+], and SO4[2-] at carbonate surfaces, we propose a facet-selective growth model in which synergistic kinetic inhibition by Mg and SO4 suppresses lateral thickening while Zn-mediated surface interactions are inferred to promote anisotropic elongation along the crystallographic c-axis. These findings provide mechanistic insights and a scalable pathway for engineering one-dimensional calcite morphologies for advanced structural and environmental applications.

Infrapatellar fat pad (IPFP) is considered a marker for disease progression in knee osteoarthritis (KOA), but currently no ultrasound parameters effectively quantify abnormal changes in IPFP. To investigate the correlation between clinical symptoms of KOA and semi-quantitative ultrasound scores as well as the echo intensity (EI) of the IPFP, and investigate the correlation between the IPFP EI and knee joint effusion and synovium. This study included 75 patients with primary KOA. Ultrasound semi-quantitative scoring of the knee joint and measurement of IPFP EI were performed. Patients' Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores and Visual Analog Scale (VAS) scores were assessed. Spearman correlation analysis was used to compare the correlations between these two symptom scores and the ultrasound semi-quantitative score and IPFP EI. The correlation between IPFP EI and joint effusion and synovium was also compared. Ordered logistic regression analysis was performed to determine the factors influencing clinical symptoms of KOA. Correlation analysis reveals that VAS scores, WOMAC pain scores, stiffness scores, and functional scores all show a positive correlation with IPFP EI. Synovial thickening also exhibits a positive correlation with IPFP EI. Ordered logistic regression analysis demonstrates that IPFP EI is an independent and significant predictor of KOA symptom severity. In summary, synovial thickening shows a significant correlation with IPFP's EI. The stronger the echo of the IPFP, the more severe the clinical symptoms of KOA. This may offer a new perspective for ultrasound in assessing the severity of KOA patients.

Objective: To analyze the diagnostic and therapeutic characteristics of patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) with predominantly nasal symptoms. Methods: Clinical data of 10 patients (4 males and 6 females, aged 24-73 years) with AAV with predominantly nasal symptoms who were treated in the Second Hospital of Shanxi Medical University from January 2019 to January 2025 were collected and retrospectively analyzed with regard to clinical manifestations, endoscopy, imaging, laboratory examination, pathohistology, treatment and prognosis of the patients. Descriptive statistical methods were used for analysis. Results: Nasal symptoms such as nasal congestion, pus and dry crusts and pulmonary manifestations such as cough and pulmonary nodules were present in all 10 patients; most of them were accompanied by multifocal involvement of the head and neck (9/10) and systemic inflammatory prodromal manifestations such as intermittent fever and polyarticular pain (9/10). Nasal endoscopy showed congestion, erosion, and increased secretion of the nasal mucosa, and in severe cases, perforation of the nasal septum was seen (3/10). Sinus CT showed thickening of nasal and sinus mucosa, bone hyperplasia, and even progressive bone destruction and paranasal sinus granuloma formation (2/10). Laboratory tests showed ANCA positivity in 9 cases and negativity in 1. Six patients were treated with nasal surgery and 5 had postoperative outbreaks. Ten patients were treated with systemic glucocorticoid combined with immunosuppressant or monoclonal antibody after diagnosis, and all of them went into remission. During follow-up, 6 cases relapsed and all 10 cases survived. Conclusions: For patients with refractory nasal symptoms and inflammatory precursor manifestations (combined with other extra-nasal systems), who have poor responses to conventional treatment, AAV should be considered. Early ANCA testing, histopathological examination and multidisciplinary team combined diagnosis and treatment should be performed to improve patient prognosis.

Small cell lung cancer (SCLC), a highly aggressive neuroendocrine malignancy, exhibits poor response to immunotherapy, and the underlying mechanisms remain unclear. Here, we identify a blood-brain barrier-like vascular gate (BVG) in SCLC, distinct from non-SCLC (NSCLC) and other cancers, composed of tightly connected endothelial cells, a thickened basement membrane, and dense pericyte coverage. Functionally, this blood-brain barrier-like vascular gate restricts immune cell infiltration, contributing to SCLC's immunotherapy resistance. Mechanistically, achaete-scute family basic-helix-loop-helix (bHLH) transcription factor 1 (ASCL1), the master transcription factor of SCLC, is essential for BVG formation by regulating insulin-like growth factor-binding protein 5 (IGFBP5), which activates the IGF1 signaling in endothelial cells. IGFBP5 knockout or treatment with the IGF1R inhibitor OSI-906 enhances CD8[+] T cell infiltration and synergizes with anti-PD1 therapy. Furthermore, this ASCL1-IGFBP5-IGF1R axis and the BVG are conserved across multiple neuroendocrine cancers (NECs). Our findings reveal a previously unrecognized vascular gate in NECs and propose novel therapeutic strategies to enhance immunotherapy efficacy in these recalcitrant cancers.

The development of low-viscosity, high-concentration protein systems is hindered by shear-thickening behavior arising from intermolecular entanglement. We report a cyclical preheating-ultrasonication strategy that reconstitutes cod protein (CPs) into low-adhesion particles. Pre-heating (100 °C, 10 min) partially unfolds CPs to expose hydrophobic nucleation sites, followed by ultrasonication (400 W, 10 min) fragmenting aggregates into metastable subunits via cavitation shear while redistributing surface charges. Force curve analysis validated the adhesion force reduction (62.6%, 3.96 → 1.48 nN) and its direct correlation with significant viscosity reduction at high concentration. The modified CPs exhibit Newtonian fluid behavior at 6% w/v concentration, with the viscosity was reduced to approximately 0.1 Pa·s at a scanning frequency of nearly 1 s[-1]. Small-angle X-ray scattering (SAXS) shows a structural shift from loose aggregates to dense molten spheres. This physical reprocessing approach provides a sustainable pathway to engineer high-density protein colloids for injectable formulations and 3D food printing.

Subretinal delivery of retinal pigment epithelium (RPE) cells is an important treatment for retinal degeneration patients, and the cell suspension method is the most common approach. Injectable hydrogel-mediated cell engraftment is expected to potentially improve cell transplantation outcomes. Here, alginate hydrogels were used to deliver human-induced pluripotent stem cell (hiPSC)-differentiated RPE cells or an RPE cell line (ARPE-19 cells) into the subretinal sites of Royal College of Surgeons (RCS) rats with retinal degeneration. RPE cell-grafted sites were monitored operating a retinal imaging instrument, and the visual functions of RCS rats were assessed via optomotor response (OMR) and electroretinogram (ERG), and retinal structure was analyzed histologically. The OMR results revealed similar spatial vision recovery among the cell transplantation groups injected with and without hydrogels. However, the ERG results revealed superior light perception in RCS rats treated with hydrogel-mediated RPE cell transplantation, particularly compared to hiPSC-derived RPE cell transplantation. This is because OMR evaluates movement of RCS rat eyes, which is difficult to evaluate visual acuity precisely. Optical coherence tomography at four and eight weeks post-transplantation confirmed long-term RPE cell retention and a thickened outer nuclear layer at injection sites after RPE cell engraftment with injectable hydrogels but not without injectable hydrogels; this was supported by the histological results showing retinal outer nuclear layer preservation for 8 weeks. These findings indicate that compared with RPE cell suspensions, alginate hydrogels enhance RPE cell transplantation outcomes and that the structural and functional rescue effects of hiPSC-derived RPE cells with injectable hydrogels are valuable. Hydrogel-mediated delivery represents a promising strategy for improving subretinal cell transplantation efficacy.

Immunoglobulin G4 (IgG4)-related disease is a fibroinflammatory condition that can involve multiple organs. Isolated involvement of the gallbladder is exceptionally uncommon and often radiologically indistinguishable from gallbladder carcinoma, resulting in diagnostic uncertainty before surgery. A 77-year-old man presented with right upper abdominal discomfort lasting 1 month. Cross-sectional imaging revealed irregular gallbladder wall thickening with contrast enhancement, raising suspicion for resectable gallbladder cancer. The patient underwent a radical cholecystectomy with partial hepatectomy. Histopathological analysis demonstrated dense lymphoplasmacytic infiltration, storiform fibrosis, and marked infiltration of IgG4-positive plasma cells exceeding established diagnostic thresholds, consistent with IgG4-related cholecystitis. The postoperative course was uneventful, and no additional treatment was required. IgG4-related cholecystitis should be considered in the differential diagnosis of gallbladder malignancy, particularly in atypical or indeterminate cases. However, when imaging findings strongly suggest carcinoma, radical surgical resection remains an appropriate oncologic approach.

Most cases of primary small intestinal cancer are diagnosed at an advanced stage, and when accompanied by intussusception or obstruction, emergency surgery may be required. Preoperative evaluation of small intestinal cancer is challenging. The patient was a 52-year-old man who was referred to our hospital with abdominal pain and vomiting, and was diagnosed with small intestinal intussusception. Abdominal CT at our hospital revealed bowel wall thickening at the site where the intussusception had resolved, raising suspicion for small intestinal cancer. Based on the patient's clinical history and physical findings, delayed small intestinal perforation was suspected, and emergency surgery was performed. Laparoscopy-assisted surgery was carried out to resect the small intestinal tumor and peritoneal dissemination nodules. Pathological examination revealed moderately differentiated adenocarcinoma. The final diagnosis was pT3, pN1, pM1, and Stage Ⅳ. Laparoscopic surgery for small bowel cancer can be useful both for treatment and intraoperative diagnosis. In this case, the decision to perform non-curative resection based on the Stage Ⅳ diagnosis enabled early discharge and prompt initiation of additional treatments.