Feasibility and safety of a self-developed sleeve for the endoscopic removal of refractory foreign body incarceration.

Objective: This study aimed to assess the feasibility and safety of a novel self-designed sleeve for the endoscopic removal of a refractory incarcerated foreign body in the upper gastrointestinal tract (UGIT). Methods: An interventional study was conducted between June and December 2022. A total of 60 patients who underwent an endoscopic removal of a refractory incarcerated foreign body from the UGIT were randomly allocated to the self-developed sleeve and the conventional transparent cap. The study evaluated and compared the operation time, successful removal rate, new injury length at the entrance of the esophagus, new injury length at the impaction site, visual field clarity, and postoperative complications between the two groups. Results: The success rates of the two cohorts in the foreign body removal display no significant discrepancy (100% vs. 93%, P = 0.529). Nevertheless, the methodology of the novel overtube-assisted endoscopic foreign body removal has culminated in a significant reduction in the removal duration [40 (10, 50) min vs. 80 (10, 90) min, P = 0.01], reduction in esophageal entrance traumas [0 (0, 0) mm vs. 4.0 (0, 6) mm, P < 0.001], mitigation of injuries at the location of the foreign body incarceration [0 (0, 2) mm vs. 6.0 (3, 8) mm, P < 0.001], an enhanced visual field (P < 0.001), and a decrement in postoperative mucosal bleeding (23% vs. 67%, P < 0.001). The self-developed sleeve effectively negated the advantages of incarceration exclusion during removal. Conclusion: The study findings support the feasibility and safety of the self-developed sleeve for the endoscopic removal of a refractory incarcerated foreign body in the UGIT, with advantages over the conventional transparent cap.

Potential value of tumor stiffness and sE-cadherin in predicting the response to neoadjuvant therapy in HER2-positive breast cancers.

Background: This prospective study compared the diagnostic value of tumor stiffness and serum soluble E-cadherin (sE-cadherin) expression for predicting response to neoadjuvant therapy in HER2-positive breast cancers. Methods: 112 patients with early or locally advanced HER2-positive breast cancer were enrolled. Maximum stiffness (Emax), mean stiffness (Emean) and their relative changes were assessed at t0 and t2. sE-cadherin levels were analyzed using ELISA. Pathological complete response was defined as no invasive disease in the breast and axilla (ypT0/is, ypN0) after surgery. The ability of tumor stiffness, sE-cadherin and the combination of ΔEmean (the relative change in Emean after the second cycle of neoadjuvant therapy) and sE-cadherin in predicting tumor responses was assessed using receiver operating characteristic curves and the Z-test. Results: Tumor stiffness and sE-cadherin decreased during neoadjuvant therapy. ΔEmean and sE-cadherin revealed the best predictive performance, with areas under the curve (AUCs) of 0.843 and 0.857, respectively. No significant differences in AUCs were reported between ΔEmean and sE-cadherin (p = 0.795). The combined use of ΔEmean and sE-cadherin showed the highest sensitivity and specificity (93.22 and 90.57%, respectively), with an AUC of 0.937. Conclusion: The combination of ΔEmean and sE-cadherin may improve the predictive power of each single factor. Although further verification is required, this study may promote noninvasive prediction of neoadjuvant therapy responses and help personalize the treatment regimen.

HER2 positivity in breast cancer is associated with a poor prognosis and shortened overall survival. For patients with HER2-positive early breast cancer, the standard neoadjuvant treatment consists of trastuzumab and pertuzumab plus docetaxel, and produces high response rates. In spite of the success of neoadjuvant therapy, some patients show no response due to drug resistance. An accurate prediction of the response of early HER2-positive breast cancer to neoadjuvant therapy would allow the modification of treatment with a response-guided strategy, thereby improving overall survival. Shear wave elastography and serum soluble E-cadherin may provide useful data on responsiveness to neoadjuvant therapy in breast cancers. This study was conducted to compare the diagnostic value of tumor stiffness and soluble E-cadherin expression for predicting the response to neoadjuvant therapy in HER2-positive breast cancers. Although these results will require further verification with larger studies, this study may promote noninvasive prediction of neoadjuvant therapy responses and help personalize the treatment regimen.

Controllable Synthesis of Defect-Rich CoMoS Catalysts with Different Morphologies for the Ultradeep Hydrodesulfurization of 4,6-Dimethydibenzothiophene.

CoMoS catalysts with controllable morphology are prepared by a single-source precursor hydrothermal method using sodium diethyldithiocarbamate trihydrate (DDTC) as the ligand and the sulfur source. The effects of the single-source precursor, the pH of the hydrothermal solution, and the surfactant with respect to the morphology, nanostructure, and hydrodesulfurization (HDS) activity of the CoMoS catalyst are investigated. It is revealed that the coordination between the metal atom and DDTC can effectively control the in-plane and out-of-plane crystal growth of MoS2 and promote the formation of the CoMoS active phase. The lower pH value of the hydrothermal solution facilitates the synthesis of CoMoS catalysts with improved purity, lower crystallinity, and smaller nanocrystallites, and the different surfactants would significantly change the morphologies. For HDS activity, the conversion efficiency of 4,6-DMDBT is increased from 71 to 99% by the CoMoS catalysts that have fewer stacking layers of MoS2 slabs. While the high HDS activity is maintained, a notable improvement in selectivity for the direct desulfurization (DDS) pathway is observed for the CoMoS-CTAB catalyst, where the average slab length of MoS2 is the longest.

A systematic review and meta-analysis examining the benefits of quantitative exercise intervention on effective bowel preparation prior to colonoscopy.

BACKGROUND: This study systematically evaluated and analyzed the efficacy of quantitative exercise intervention on colonoscopy intestinal preparation. METHODS: A systematic search was performed using the Cochrane Library, the JBI evidence-based database, Embase, Web of Science, CINAHL, Medline, CNKI, the China Biomedical Literature Database (CBM), and the Wanfang database to identify literature relating to the efficacy of exercise intervention on bowel preparation for colonoscopy. Randomized controlled trials (RCTs) and clinical controlled trials (CCTs) published from the establishment of the database to July 2021 were included. After screening the literatures, relevant data was extracted and evaluated for quality. The RevMan 5.3 software was used for meta-analysis. RESULTS: A total of 8 studies with 1,486 patients, including 747 in the intervention group and 739 in the control group, were included in this meta-analysis. The results of 4 studies showed that the use of quantitative exercise intervention programs did significantly improve the quality of the patient's bowel preparations [mean difference (MD) =2.15, 95% confidence interval (CI): 0.04 to 4.26; P=0.046]. The results of 6 studies demonstrated that the use of quantitative exercise intervention programs can effectively improve the patient's bowel preparation adequacy rate [relative risk (RR) =1.25, 95% CI: 1.05 to 1.49; P=0.012]. Meta-analysis of 5 studies showed that the use of quantitative exercise intervention programs can reduce the incidence of nausea in patients (RR =0.52; 95% CI: 0.37 to 0.74; P=0.000). Analysis of 4 studies revealed that quantitative exercise intervention can reduce the incidence of vomiting in patients (RR =0.36; 95% CI: 0.23 to 0.56; P=0.000). Furthermore, evaluation of 4 studies demonstrated that quantitative exercise intervention reduced the incidence of abdominal pain in patients (RR =0.50; 95% CI: 0.28 to 0.89; P=0.019), and reduced the incidence of abdominal distension (RR =0.60; 95% CI: 0.36 to 0.99; P=0.047). DISCUSSION: Quantitative exercise intervention can effectively improve the quality of intestinal preparation before colonoscopy and reduce the incidence of adverse reactions.

Relationship between the structure and catalytic performance of MoS2 with different surfactant-assisted syntheses in the hydrodesulfurization reaction of 4,6-DMDBT.

Surfactants are important factors in the hydrothermal synthesis of MoS2 with different morphologies. Herein, we report the synthesis of MoS2 via the hydrothermal method combined with a single-source precursor with the assistance of different surfactants (CTAB/SDS/SDBS). The synthesis mechanisms of MoS2 with different morphologies and their effects on 4,6-DMDBT in hydrodesulfurization (HDS) have been systematically studied. MoS2-CTAB was prepared by the adsorption of molybdate radicals, nucleation and formation. MoS2-SDS and MoS2-SDBS were synthesized via four steps, namely, adsorption, insertion, exfoliation and assembly, and the relationship between the morphology-structure-performance of MoS2 in the hydrodesulfurization of 4,6-DMDBT was investigated. It was established that the desulfurization rate of MoS2, HYD ratio and selectivity of the MoS2 increased in the order: MoS2-SDBS > MoS2-CTAB > MoS2-SDS, which exhibited a positive correlation with the average number of layers and dispersion, and a negative correlation with the average slab length and the ratio of the Mo edge/corner sites of MoS2. Among all the MoS2, MoS2-SDBS exhibited the best HDS performance.

Preparation of low carbon olefins on a core-shell K-Fe5C2@ZSM-5 catalyst by Fischer-Tropsch synthesis.

In this study, a core-shell catalyst based on Fe5C2@ZSM-5 (ZSM-5 capped Fe5C2 as active phase) is prepared by the coating-carbonization method for Fischer-Tropsch synthesis (FTS). Further, the designed ZSM-5 zeolites are utilized to screen the low carbon hydrocarbons from the products generated on the iron carbide active centre, and for catalytic disassembly of the long-chain hydrocarbons into low carbon olefins. Prior to utilization, the physical-chemical properties of the prepared catalysts are systematically characterized by various techniques of X-ray diffraction (XRD), Brunauer-Emmett-Teller (BET), Fourier transform infrared (FT-IR), and scanning electron microscopy (SEM) as well as transmission electron microscopy (TEM) observations, in addition to the effects of coating-carbonization, molecular sieve coating amount, and K-doping on core-shell iron-based catalysts. Next, the performance of Fischer-Tropsch synthesis is investigated in a micro-fixed bed reactor. The results manifest that, comparing with Fe5C2 and a supported Fe/ZSM-5 catalyst prepared by the traditional impregnation method, the core-shell Fe5C2@ZSM-5 catalysts show higher CO conversion rate, reaction activity and selectivity to low-carbon olefins. Comparatively, the Fe5C2@ZSM-5C catalyst prepared by carbonization after the coating method exhibited more surface area, smaller average pore size, and more reactive active sites, resulting in the improvement of screening of high carbon hydrocarbons and the enhancement of selectivity to low carbon olefins, in comparison to those prepared by the carbonization-coating method. In conclusion, the K-doping catalyst had significantly improved the reactive activity of the core-shell Fe5C2@ZSM-5 catalyst and the selectivity to low carbon olefins, while the CO conversion on K-Fe5C2@ZSM-20C still remained good.

Multi-parameter ultrasound based on the logistic regression model in the differential diagnosis of hepatocellular adenoma and focal nodular hyperplasia.

BACKGROUND: Focal nodular hyperplasia (FNH) has very low potential risk, and a tendency to spontaneously resolve. Hepatocellular adenoma (HCA) has a certain malignant tendency, and its prognosis is significantly different from FNH. Accurate identification of HCA and FNH is critical for clinical treatment. AIM: To analyze the value of multi-parameter ultrasound index based on logistic regression for the differential diagnosis of HCA and FNH. METHODS: Thirty-one patients with HCA were included in the HCA group. Fifty patients with FNH were included in the FNH group. The clinical data were collected and recorded in the two groups. Conventional ultrasound, shear wave elastography, and contrast-enhanced ultrasound were performed, and the lesion location, lesion echo, Young's modulus (YM) value, YM ratio, and changes of time intense curve (TIC) were recorded. Multivariate logistic regression analysis was used to screen the indicators that can be used for the differential diagnosis of HCA and FNH. A ROC curve was established for the potential indicators to analyze the accuracy of the differential diagnosis of HCA and FNH. The value of the combined indicators for distinguishing HCA and FNH were explored. RESULTS: Multivariate logistic regression analysis showed that lesion echo (P = 0.000), YM value (P = 0.000) and TIC decreasing slope (P = 0.000) were the potential indicators identifying HCA and FNH. In the ROC curve analysis, the accuracy of the YM value distinguishing HCA and FNH was the highest (AUC = 0.891), which was significantly higher than the AUC of the lesion echo and the TIC decreasing slope (P < 0.05). The accuracy of the combined diagnosis was the highest (AUC = 0.938), which was significantly higher than the AUC of the indicators diagnosing HCA individually (P < 0.05). This sensitivity was 91.23%, and the specificity was 83.33%. CONCLUSION: The combination of lesion echo, YM value and TIC decreasing slope can accurately differentiate between HCA and FNH.