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Polyethylene oxide (PEO)-based solid-state batteries hold great promise as the next-generation batteries with high energy density and high safety. However, PEO-based electrolytes encounter certain limitations, including inferior ionic conductivity, low Li+ transference number, and poor mechanical strength. Herein, we aim to simultaneously address these issues by utilizing one-dimensional zwitterionic cellulose nanofiber (ZCNF) as fillers for PEO-based electrolytes using a simple aqueous solution casting method. Multiple characterizations and theoretical calculations demonstrate that the unique zwitterionic structure imparts ZCNF with various functions, such as disrupting PEO crystallization, dissociating lithium salts, anchoring anions through cationic groups, accelerating Li+ migration by anionic groups, as well as its inherent reinforcement effect. As a result, the prepared PL-ZCNF electrolyte exhibits remarkable ionic conductivity (5.37×10-4â S cm-1) and Li+ transference number (0.62) at 60 °C without sacrificing mechanical strength (9.2â MPa), together with high critical current density of 1.1â mA cm-2. Attributed to these merits of PL-ZCNF, the LiFePO4|PL-ZCNF|Li solid-state full-cell delivers exceptional rate capability and cycling performance (900â cycles at 5â C). Notably, the assembled pouch-cell can maintain steady operation over 1000â cycles with an impressive 93.7 % capacity retention at 0.5â C and 60 °C, highlighting the great potential of PL-ZCNF for practical applications.
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Water evaporation-induced electricity generators (WEGs) have drawn widespread attention in the field of hydrovoltaic technology, which can convert atmospheric thermal energy into sustainable electric power. However, it is restricted in the wide application of WEGs due to the low power output, complex fabrication process, and high cost. Herein, we present a simple and effective approach to fabricate TiO2-carbon black film-based WEGs (TC-WEGs). A single TC-WEG device can sustainably output an open-circuit voltage of 1.9 V and a maximum power density of 40.9 µW/cm2. Moreover, it has been shown that TC-WEGs exhibit stable electrical energy output when operating in seawater, which can yield a short-circuit current of 1.2 µA. The superior electricity generation performance can be attributed to the intrinsic characteristics of the TC-WEGs, including hydrophilicity, porous structure, and electrical conductivity. This work provides an important reference for the constant harvesting of clean energy.
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There is growing acknowledgment that the properties of the electrochemical interfaces play an increasingly pivotal role in improving the performance of the hydrogen evolution reaction (HER). Here, we present, for the first time, direct dynamic spectral evidence illustrating the impact of the interaction between interfacial water molecules and adsorbed hydroxyl species (OHad) on the HER properties of Ni(OH)2 using Au/core-Ni(OH)2/shell nanoparticle-enhanced Raman spectroscopy. Notably, our findings highlight that the interaction between OHad and interfacial water molecules promotes the formation of weakly hydrogen-bonded water, fostering an environment conducive to improving the HER performance. Furthermore, the participation of OHad in the reaction is substantiated by the observed deprotonation step of Au@2 nm Ni(OH)2 during the HER process. This phenomenon is corroborated by the phase transition of Ni(OH)2 to NiO, as verified through Raman and X-ray photoelectron spectroscopy. The significant redshift in the OH-stretching frequency of water molecules during the phase transition confirms that surface OHad disrupts the hydrogen-bond network of interfacial water molecules. Through manipulation of the shell thickness of Au@Ni(OH)2, we additionally validate the interaction between OHad and interfacial water molecules. In summary, our insights emphasize the potential of electrochemical interfacial engineering as a potent approach to enhance electrocatalytic performance.
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Electrolyte plays a crucial role in ensuring stable operation of lithium metal batteries (LMBs). Localized high-concentration electrolytes (LHCEs) have the potential to form a robust solid-electrolyte interphase (SEI) and mitigate Li dendrite growth, making them a highly promising electrolyte option. However, the principles governing the selection of diluents, a crucial component in LHCE, have not been clearly determined, hampering the advancement of such a type of electrolyte systems. Herein, the diluents from the perspective of molecular polarity are rationally designed and developed. A moderately fluorinated solvent, 1-(1,1,2,2-tetrafluoroethoxy)propane (TNE), is employed as a diluent to create a novel LHCE. The unique molecular structure of TNE enhances the intrinsic dipole moment, thereby altering solvent interactions and the coordination environment of Li-ions in LHCE. The achieved solvation structure not only enhances the bulk properties of LHCE, but also facilitates the formation of more stable anion-derived SEIs featured with a higher proportion of inorganic species. Consequently, the corresponding full cells of both Li||LiFePO4 and Li||LiNi0.8Co0.1Mn0.1O2 cells utilizing Li thin-film anodes exhibit extended long-term stability with significantly improved average Coulombic efficiency. This work offers new insights into the functions of diluents in LHCEs and provides direction for further optimizing the LHCEs for LMBs.
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Interfacial water molecules are the most important participants in the hydrogen evolution reaction (HER). Hence, understanding the behavior and role that interfacial water plays will ultimately reveal the HER mechanism. Unfortunately, investigating interfacial water is extremely challenging owing to the interference caused by bulk water molecules and complexity of the interfacial environment. Here, the behaviors of interfacial water in different cationic electrolytes on Pd surfaces were investigated by the electrochemistry, in situ core-shell nanostructure enhanced Raman spectroscopy and theoretical simulation techniques. Direct spectral evidence reveals a red shift in the frequency and a decrease in the intensity of interfacial water as the potential is shifted in the positively direction. When comparing the different cation electrolyte systems at a given potential, the frequency of the interfacial water peak increases in the specified order: Li+ < Na+ < K+ < Ca2+ < Sr2+. The structure of interfacial water was optimized by adjusting the radius, valence, and concentration of cation to form the two-H down structure. This unique interfacial water structure will improve the charge transfer efficiency between the water and electrode further enhancing the HER performance. Therefore, local cation tuning strategies can be used to improve the HER performance by optimizing the interfacial water structure.
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Malignant melanoma (MM) frequently occurs in the skin or mucosa, whereas malignant melanoma of unknown primary (MUP) is diagnosed in patients with lymph nodes or visceral organs as the site of origin, where it is challenging to detect the primary lesion by comprehensive examination. MUP is possibly related to the spontaneous regression of the primary lesion. In addition, primary hepatic melanoma (PHM) usually refers to the primary MM occurring in the liver, with no typical primary lesions and no manifestations of tumor metastasis. A 61-year-old male patient with liver as the site of origin was diagnosed with MM by Melan-A, HMB-45, and S-100 immunohistochemistry staining of liver biopsy tissue. Based on a comprehensive examination, no basis was found for melanoma in sites such as the skin, mucosa, five sense organs, brain, digestive tract, respiratory tract, or genitalia, and the patient was subsequently diagnosed with MUP. MMs require a comprehensive inspection, beginning with the liver, to search for the primary lesion; if the primary lesion is not found, the possibility of PHM or MUP should be considered.
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OBJECTIVE: The role E3 ubiquitin ligase membrane-associated RING-CH 8 (MARCH8) has not been studied in pancreatic cancer. METHOD: Pancreatic cancer cell lines and the normal pancreatic cells were tested in vitro studies and male athymic nude mice were tested in vivo studies. Measuring cell viability by Cell Counting Kit-8 assay (CCK8), 5-ethynyl-2'- deoxyuridine (Edu) staining, and colony formation assay. Wound healing assay was implemented for cell migration and Transwell assay was performed for cell invasion to evaluate the histological status by hematoxylin and eosin staining and to detect the protein ubiquitination by ubiquitination assay. The protein expression was determined by immunohistochemistry staining and western blotting, and mRNA expression was measured by quantitative reverse transcription polymerase chain reaction. RESULT: The expression of MARCH8 was increased whereas PTPN4 was decreased in pancreatic cancer cells. Overexpression of MARCH8 promoted the growth, migration, and invasion of cells, and knockdown of PTPN4 had the similar effects both in vitro and in vivo. MARCH8 promoted PTPN4 protein degradation through ubiquitination. Moreover, PTPN4 suppressed the transcription activities of STAT3 by impairing the level of pSTAT3 (705), while inhibition of PTPN4 activated phosphorylation of STAT3. CONCLUSIONS: MARCH8 promoted pancreatic cancer growth and invasion through mediating the degradation of PTPN4 and activated the phosphorylation of STAT3.
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Neoplasias Pancreáticas , Ubiquitina-Proteína Ligasas , Animales , Masculino , Ratones , Línea Celular Tumoral , Proliferación Celular , Regulación Neoplásica de la Expresión Génica , Proteínas de la Membrana/genética , Ratones Desnudos , Neoplasias Pancreáticas/genética , Neoplasias Pancreáticas/metabolismo , Ubiquitina-Proteína Ligasas/metabolismo , Ubiquitinación , Humanos , Factor de Transcripción STAT3/metabolismo , Proteína Tirosina Fosfatasa no Receptora Tipo 4/metabolismoRESUMEN
Realizing the dual emission of fluorescence-phosphorescence in a single system is an extremely important topic in the fields of biological imaging, sensing, and information encryption. However, the phosphorescence process is usually in an inherently "dark state" at room temperature due to the involvement of spin-forbidden transition and the rapid non-radiative decay rate of the triplet state. In this work, we achieved luminescent harvesting of the dark phosphorescence processes by coupling singlet-triplet molecular emitters with a rationally designed plasmonic cavity. The achieved Purcell enhancement effect of over 1000-fold allows for overcoming the triplet forbidden transitions, enabling radiation enhancement with selectable emission wavelengths. Spectral results and theoretical simulations indicate that the fluorescence-phosphorescence peak position can be intelligently tailored in a broad range of wavelengths, from visible to near-infrared. Our study sheds new light on plasmonic tailoring of molecular emission behavior, which is crucial for advancing research on plasmon-tailored fluorescence-phosphorescence spectroscopy in optoelectronics and biomedicine.
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Ruthenium exhibits comparable or even better alkaline hydrogen evolution reaction activity than platinum, however, the mechanistic aspects are yet to be settled, which are elucidated by combining in situ Raman spectroscopy and theoretical calculations herein. We simultaneously capture dynamic spectral evidence of Ru surfaces, interfacial water, *H and *OH intermediates. Ru surfaces exist in different valence states in the reaction potential range, dissociating interfacial water differently and generating two distinct *H, resulting in different activities. The local cation tuning effect of hydrated Na+ ion water and the large work function of high-valence Ru(n+) surfaces promote interfacial water dissociation. Moreover, compared to low-valence Ru(0) surfaces, high-valence Ru(n+) surfaces have more moderate adsorption energies for interfacial water, *H, and *OH. They, therefore, facilitate the activity. Our findings demonstrate the regulation of valence state on interfacial water, intermediates, and finally the catalytic activity, which provide guidelines for the rational design of high-efficiency catalysts.
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Introduction: Multimode thermal therapy (MTT) is an innovative interventional therapy developed for the treatment of liver malignancies. When compared to the conventional radiofrequency ablation (RFA), MTT typically offers improved prognosis for patients. However, the effect of MTT on the peripheral immune environment and the mechanisms underlying the enhanced prognosis have yet to be explored. The aim of this study was to further investigate the mechanisms responsible for the difference in prognosis between the two therapies. Methods: In this study, peripheral blood samples were collected from four patients treated with MTT and two patients treated with RFA for liver malignancies at different time points before and after the treatment. Single cell sequencing was performed on the blood samples to compare and analyze the activation pathways of peripheral immune cells following the MTT and RFA treatment. Results: There was no significant effect of either therapy on the composition of immune cells in peripheral blood. However, the differential gene expression and pathway enrichment analysis demonstrated enhanced activation of T cells in the MTT group compared to the RFA group. In particular, there was a remarkable increase in TNF-α signaling via NF-κB, as well as the expression of IFN-α and IFN-γ in the CD8+ effector T (CD8+ Teff) cells subpopulation, when compared to the RFA group. This may be related to the upregulation of PI3KR1 expression after MTT, which promotes the activation of PI3K-AKT-mTOR pathway. Conclusion: This study confirmed that MTT could more effectively activate peripheral CD8+ Teff cells in patients compared with RFA and promote the effector function, thus resulting in a better prognosis. These results provide a theoretical basis for the clinical application of MTT therapy.
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Ablación por Catéter , Neoplasias Hepáticas , Ablación por Radiofrecuencia , Humanos , Fosfatidilinositol 3-Quinasas , Transcriptoma , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/terapia , Ablación por Radiofrecuencia/métodos , Linfocitos T CD8-positivosRESUMEN
Transition metal oxide (TMO) anodes show inferior sodium ion storage performance compared with that of lithium ion storage owing to the larger radium size and heavier elemental mass of Na+ than Li+. Effective strategies are highly desired to improve the Na+ storage performance of TMOs for applications. In this work, using ZnFe2O4@xC nanocomposites as model materials for investigation, we found that by manipulating the particle sizes of the inner TMOs core and the features of outer carbon coating, the Na+ storage performance can be significantly improved. The ZnFe2O4@1C with a diameter of the inner ZnFe2O4 core of around 200 nm coated by a thin carbon layer of around 3 nm shows a specific capacity of only 120 mA h g-1. The ZnFe2O4@6.5C with a diameter of the inner ZnFe2O4 core of around 110 nm embedding in a porous interconnected carbon matrix displays a significantly improved specific capacity of 420 mA h g-1 at the same specific current. Furthermore, the latter shows an excellent cycling stability of 1000 cycles with a capacity retention of 90% of the initial 220 mA h g-1 specific capacity at 1.0 A g-1. TEM, electrochemical impedance spectroscopy, and kinetic analysis show that the inner ZnFe2O4 core with reduced particle size and the outer thicker and interconnected carbon matrix synergistically improve the active reaction sites, integrity, electric conductivity, and pseudocapacitive-controlled contribution of ZnFe2O4@xC nanocomposites, thus leading to an overall enhanced Na+ storage performance. Our findings create a universal, facile, and effective method to enhance the Na+ storage performance of the TMO@C nanomaterials.
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Photoelectrocatalytic water splitting using metal sulfides is a promising method for green hydrogen production. However, in situ probing of the hydrogen evolution reaction (HER) on sulfides with excellent performance remains a challenge. Here, we construct Au@CdS core-shell nanoparticles to study the HER on CdS, a typical HER catalyst, by surface-enhanced Raman spectroscopy (SERS) using a "borrowing" strategy. We directly capture the spectroscopic evidence of S-H intermediate under HER condition, further verified by isotopic experiments. Moreover, the population of S-H intermediates is improved by injecting charge carriers through light illumination and the S-H bond is weakened by introducing Pt to form a Au@Pt@CdS structure to change the interfacial electronic structure, both of them resulting in significant HER performance improvement. These findings can deepen the understanding of the HER mechanism and offer strategies for designing of cost-effective HER catalyst with high performance.
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The dynamics and chemistry of interfacial water are essential components of electrocatalysis because the decomposition and formation of water molecules could dictate the protonation and deprotonation processes on the catalyst surface. However, it is notoriously difficult to probe interfacial water owing to its location between two condensed phases, as well as the presence of external bias potentials and electrochemically induced reaction intermediates. An atomically flat single-crystal surface could offer an attractive platform to resolve the internal structure of interfacial water if advanced characterization tools are developed. To this end, here we report a protocol based on the combination of in situ Raman spectroscopy and ab initio molecular dynamics (AIMD) simulations to unravel the directional molecular features of interfacial water. We present the procedures to prepare single-crystal electrodes, construct a Raman enhancement mode with shell-isolated nanoparticle, remove impurities, eliminate the perturbation from bulk water and dislodge the hydrogen bubbles during in situ electrochemical Raman experiments. The combination of the spectroscopic measurements with AIMD simulation results provides a roadmap to decipher the potential-dependent molecular orientation of water at the interface. We have prepared a detailed guideline for the application of combined in situ Raman and AIMD techniques; this procedure may take a few minutes to several days to generate results and is applicable to a variety of disciplines ranging from surface science to energy storage to biology.
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Simulación de Dinámica Molecular , Espectrometría Raman , Agua/química , Electrodos , HidrógenoRESUMEN
The disaster and devastation from abuse of Methamphetamine (MAMP) have a serious impact on people's mental and physical health. Developing a rapid and accurate method to screen drug suspects and thus control MAMP abuse is essential to social security. Hair analysis for MAMP detection is considered to be one of the most potential methods for monitoring drug abuse due to its convenient sample collection, easy for storage and long traceability period. However, the current accurate detection of MAMP in hair primarily utilizes hyphenated mass spectrometry (MS) techniques, but it is not suitable for field-based detection due to the bulky instrument. Hence, developing alternative portable detection techniques for rapid on-site detection of MAMP in hair is an urgent problem to be solved. Here, the high-performance Au nanocakes (Au NCs) were constructed as surface-enhanced Raman spectroscopy (SERS) substrates to detect MAMP in hair, realizing 5 min ultrafast and ultrasensitive detection utilizing a portable Raman spectrometer. Experiments and finite-difference time-domain (FDTD) simulations show that Au NCs have stronger enhancement than Au nanospheres (Au NPs), and 0.5 ppb (3.35 × 10-9 M) MAMP standard is stably detected by Au NCs as an enhanced substrate. A strategy of liquid-liquid microextraction was exploited to eliminate the interference of complex matrices in hair. This method exhibited excellent reproducibility and temporal stability across different drug addicts (relative standard deviation was 5.14% within 160 s). Our approach shows great promise in public safety, providing a rapid and accurate method to detect in hair by SERS.
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Nanopartículas del Metal , Metanfetamina , Humanos , Metanfetamina/análisis , Espectrometría Raman/métodos , Reproducibilidad de los Resultados , Cabello/química , Espectrometría de Masas , Oro/química , Nanopartículas del Metal/químicaRESUMEN
Background: Mucosa-associated lymphoid tissue (MALT) lymphoma is an indolent B cell lymphoma. Its occurrence in the pleura is rare, with atypical clinical manifestations. MALT of the pleura is easily misdiagnosed. This is the first case report of pleural MALT lymphoma in China. Case Description: We report the case of a 54-year-old Chinese man with no notable medical history who complained of cough, sputum, and shortness of breath for 3 months. He had a positive purified protein derivative (PPD) test. An initial misdiagnosis of pleural tuberculosis was corrected, after 3 thoracoscopic biopsies and tests, to primary pleural MALT lymphoma. He received treatments of R-CHOP (rituximab, cyclophosphamide, epirubicin, vindesine and prednisolone) and traditional Chinese medicine. The patient was followed for 3 years until June 2022, with no obvious respiratory symptoms. Pleural MALT lymphoma is extremely rare, with only a few cases reported. This article describes our case, and includes an overview of 15 previously reported cases to summarize the characteristics, treatments, and prognosis of primary pleural MALT lymphoma. Conclusions: Pleural MALT lymphoma is rare, and a correct diagnosis depends on tissue biopsy, immunohistochemical staining, and detection of gene rearrangement. Thoracoscopy is important to diagnose this disease. Multiple thoracoscopic biopsies may be necessary.
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OBJECTIVE: Apolipoprotein E (APOE) loci, including rs429358 (Æ4) and rs7412 (Æ2), are involved in cardiovascular (CV) health. However, their effect on the CV-protective effect of aspirin remains unknown. METHODS: A total of 515 aspirin-treated individuals with existing CV diseases were recruited, and their APOE genotypes, platelet functions and other routine laboratory parameters were assessed when they enrolled. The first major CV events (myocardial infarction, stroke, revascularisation and CV death) and all CV events (major CV events plus unstable angina and transient ischaemic attack) during a mean 5.2-year follow-up period were recorded. RESULTS: After adjusting for age, gender, BMI, lifestyle, lipid profiles and other CV drugs and comorbidities, Æ2 carriers were found to exhibit ~80% lower risk of major CV and 60% lower risk of all CV (HR = 0.186, CI: 0.048-0.715, P = 0.014; HR = 0.435, CI: 0.234-0.812, P = 0.009, respectively) than Æ2 noncarriers. Furthermore, high incidence of high platelet reactivity assessed by arachidonic acid-induced light transmission aggregometry (23.4 vs. 13.7%, P = 0.038), triglyceride and haemoglobin and low low-density lipoprotein were observed. Æ4 carriers had slightly increased cholesterol and hypercholesterolemia incidence relative to Æ4 noncarriers. CONCLUSIONS: Our results demonstrated that APOE*Æ2 carriers can derive additional CV benefit from long-term aspirin treatment. Moreover, it was observed that APOE2 interacts with cyclooxygenase-1 (COX-1) and upregulates its activity. The CV-protective effect of aspirin in Æ2 carriers is likely attributed to APOE2 upregulating vascular COX-1-mediated CV protective pathway, together with aspirin partially inhibiting platelet COX-1-mediated platelet aggregation.
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Apolipoproteína E2 , Aspirina , Enfermedades Cardiovasculares , Apolipoproteína E2/genética , Aspirina/uso terapéutico , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/genética , Enfermedades Cardiovasculares/prevención & control , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Factores de RiesgoRESUMEN
In situ monitoring of the evolution of intermediates and catalysts during hydrogen oxidation reaction (HOR) processes and elucidating the reaction mechanism are crucial in catalysis and energy science. However, spectroscopic information on trace intermediates on catalyst surfaces is challenging to obtain due to the complexity of interfacial environments and lack of in situ techniques. Herein, core-shell nanoparticle-enhanced Raman spectroscopy was employed to probe alkaline HOR processes on representative PtRu surfaces. Direct spectroscopic evidence of an OHad intermediate and RuOx (Ru(+3)/Ru(+4)) surface oxides is simultaneously obtained, verifying that Ru doping onto Pt promotes OHad adsorption on the RuOx surface to react with Had adsorption on the Pt surface to form H2O. In situ Raman, XPS, and DFT results reveal that RuOx coverage tunes the electronic structure of PtRuOx to optimize the adsorption energy of OHad on catalyst surfaces, leading to an improvement in HOR activity. Our findings provide mechanistic guidelines for the rational design of HOR catalysts with high activity.
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BACKGROUND: Colorectal mucosa-associated lymphoid tissue lymphoma (MALToma), a rare kind of nongastric MALToma, lacks consensus on its endoscopic features and standard therapies. According to previous studies on the clinical characteristics and outcomes of colorectal MALToma, endoscopic resection remains a good therapeutic strategy. CASE SUMMARY: A 71-year-old woman suffered intermittent hematochezia for 1 mo, accompanied with abdominal pains but without weight loss, fever, chills or fatigue. Colonoscopy showed a massive hemispheric mass with rough and hyperemic mucosa in the lower rectum. Narrow-band imaging magnifying endoscopy detected some branching abnormal blood vessels and disappearance of glandular structure, which was similar with the tree-like appearance sign in gastric MALToma. Endoscopic ultrasonography revealed the lesion to be hypoechoic, boundary-defined, and echo uniform inside, originating from the muscularis propria. Abdominal enhanced computed tomography (CT) demonstrated a soft tissue mass with defined boundary. No enlarged superficial lymph nodes were detected by B-mode ultrasound. C13-urea breath test and serum Helicobacter pylori antibody were both negative. The patient underwent endoscopic full-thickness resection. Postoperative pathological analysis indicated colorectal MALToma. The patient remained asymptomatic after discharge, and follow-up positron emission tomography-CT and colonoscopy showed no residual lesion, remnants or lymph node metastasis. CONCLUSION: This case provides new information on the specific endoscopic features of colorectal MALToma and an alternative treatment for patients.
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Neoplasias del Colon , Resección Endoscópica de la Mucosa , Linfoma de Células B de la Zona Marginal , Neoplasias Gástricas , Anciano , Femenino , Humanos , Linfoma de Células B de la Zona Marginal/diagnóstico por imagen , Linfoma de Células B de la Zona Marginal/cirugía , Recto/patología , Neoplasias Gástricas/patologíaRESUMEN
Background: Due to ongoing research on digestive endoscopy, early gastric cancer has become a popular topic. Based on macro-research on morphology using the Paris endoscopic classification system and micro-explorations of histopathology under endoscopy, several researchers have organically combined endoscopy with pathology and surgery. This multidisciplinary combination of digestive endoscopy could improve the diagnosis rate and cure rate of early gastric cancer. Case Description: A 45-year-old female patient underwent gastroscopy for the treatment of intermittent upper abdominal pain, which she had been experiencing for a year. A diagnosis of a submucosal tumor (SMT) was made after several preoperative examinations. An endoscopic submucosal dissection (ESD) was performed to remove the lesion, and the specimens were then fixed to conduct the pathologic examination. The results led to the diagnosis of undifferentiated gastric adenocarcinoma with the following general classification: type 0-IIa, a lesion of 2.7 cm × 2.0 cm × 0.5 cm, and no vascular tumor thrombus or nerve invasion. The surrounding mucosa showed mild chronic non-atrophic gastritis. The tumor tissue reached the vertical cutting edge, and no residual cancer tissue was found at the horizontal cutting edge. The immunohistochemistry results showed poorly differentiated adenocarcinoma. Based on the results, the patient underwent distal gastrectomy and abdominal lymph node dissection. Our combined multidisciplinary diagnostic processes and treatments can now be used as a reference for endoscopists. Conclusions: ESD plays an essential role in the diagnosis and treatment of undifferentiated gastric cancer, and provides a reference for endoscopists.