Development of esophagogastroduodenoscopy in China: results from the national census in 2013 and 2020.

Background: Given the significant burden of upper digestive diseases, there has been a substantial increase in the utilization of esophagogastroduodenoscopy (EGD) in China from 2012 to 2019. The objective of this study is to investigate the development, practice, and factors influencing the widespread use of EGD during this period. Methods: Two national censuses were conducted among all hospitals in mainland China that perform gastrointestinal endoscopy. These censuses aimed to extract information on the infrastructure, volume, and quality of EGD. The analysis of potential factors influencing EGD practice was based on real-world data from open access sources. Results: From 2012 to 2019, the number of hospitals performing EGD in mainland China increased from 1,518 to 2,265 (1.49-fold) in tertiary hospitals and from 3,633 to 4,097 (1.12-fold) in secondary hospitals, respectively. The national utilization rate of EGD also increased from 1,643.53 to 2,018.06 per 100,000 inhabitants, indicating a 1.23-fold increase. Regions with more endoscopists per 100,000 inhabitants (OR 9.61, P<0.001), more tertiary hospitals performing EGD per million inhabitants (OR 2.43, P<0.001), higher incidence of esophageal and gastric cancer (OR 2.09, P=0 016), and higher number of hospitals performing EGD per million inhabitants (OR 1.77, P=0.01) tended to provided more numerous and qualitied EGD. And hospital grading, regional GDP, incidence of esophageal and gastric cancer and the volume of EGD were observed as the significantly relevant factors of malignant dictation rate (MDR) (P<0.05), but not the number and educational background of endoscopists. Conclusion: Over the past seven years, China has made significant progress in EGD. However, challenges persist in terms of quality and inequality.

Development and status quo of digestive endoscopy in China: An analysis based on the national census in 2013 and 2020.

Background and Objectives: Technique and practice of digestive endoscopy are undergoing speedy development all over the world. This study aimed to evaluate its status quo and development in China. Methods: All hospitals performing digestive endoscopy in mainland China participated in the national census in 2013 and 2020. Retrospective data of hospitals, endoscopists, volumes, and qualities were collected via an online structured questionnaire, and its accuracy and rationality were verified by logical tests and manual reviews. Data from other countries were used to compare with that of China. Results: From 2012 to 2019, the number of hospitals performing digestive endoscopy increased from 6,128 to 7,470 (1.22-fold), in which primary healthcare played a minor role. The median hospitals per 100,000 inhabitants per provincial region increased from 0.49 (IQR, 0.39-0.57) to 0.55 (IQR, 0.49-0.63). The endoscopists increased from 26,203 to 39,638 (1.51-fold), but their average workload even expanded. Overall volume increased from 28.8 million to 44.5 million (1.55-fold), and most types of endoscopic procedures recorded a high growth rate. Contrastingly, the specific utilization rates were low and paled in comparison with some developed countries. Nationwide, regional utilization rates showed a significant correlation with GDP per capita (P <0.001). Overall qualities of digestive endoscopy were excellent, but certain results of quality indicators posed a huge challenge, such as the detection rates of adenoma and early cancers. Conclusions: Impressive progress has been made in digestive endoscopy with rapidly expanding economy in China. However, primary healthcare, utilization rates, and income-related inequality of regional services were needed to be improved to promote public health better.

Nebulized Inhalation of Peptide-Modified DNA Origami To Alleviate Acute Lung Injury.

Acute lung injury (ALI) is a severe inflammatory lung disease, with high mortality rates. Early intervention by reactive oxygen species (ROS) scavengers could reduce ROS accumulation, break the inflammation expansion chain in alveolar macrophages (AMs), and avoid irreversible damage to alveolar epithelial and endothelial cells. Here, we reported cell-penetrating R9 peptide-modified triangular DNA origami nanostructures (tDONs-R9) as a novel nebulizable drug that could reach the deep alveolar regions and exhibit an enhanced uptake preference of macrophages. tDONs-R9 suppressed the expression of pro-inflammatory cytokines and drove polarization toward the anti-inflammatory M2 phenotype in macrophages. In the LPS-induced ALI mouse model, treatment with nebulized tDONs-R9 alleviated the overwhelming ROS, pro-inflammatory cytokines, and neutrophil infiltration in the lungs. Our study demonstrates that tDONs-R9 has the potential for ALI treatment, and the programmable DNA origami nanostructures provide a new drug delivery platform for pulmonary disease treatment with high delivery efficiency and biosecurity.

Association between physical activity and risk of gastroesophageal reflux disease: A systematic review and meta-analysis.

BACKGROUND: Lifestyle plays an important role in preventing and managing gastroesophageal reflux disease (GERD). In response to the conflicting results in previous studies, we performed a systematic review and meta-analysis to investigate this association. METHODS: Relevant studies published until January 2023 were retrieved from 6 databases, and the prevalence of symptomatic gastroesophageal reflux (GER) or GERD was determined from the original studies. A random effects model was employed to meta-analyze the association by computing the pooled relative risk (RR) with 95% confidence intervals (95%CIs). Furthermore, subgroup and dose-response analyses were performed to explore subgroup differences and the association between cumulative physical activity (PA) time and GERD. RESULTS: This meta-analysis included 33 studies comprising 242,850 participants. A significant negative association was observed between PA and the prevalence of symptomatic GER (RR = 0.74, 95%CI: 0.66-0.83; p < 0.01) or GERD (RR = 0.80, 95%CI: 0.76-0.84; p < 0.01), suggesting that engaging in PA might confer a protective benefit against GERD. Subgroup analyses consistently indicated the presence of this association across nearly all subgroups, particularly among the older individuals (RR<40 years:RR≥40 years = 0.85:0.69, p < 0.01) and smokers (RRsmoker:RRnon-smoker = 0.67:0.82, p = 0.03). Furthermore, a dose-response analysis revealed that individuals who engaged in 150 min of PA per week had a 72.09% lower risk of developing GERD. CONCLUSION: Maintaining high levels of PA decreased the risk of GERD, particularly among older adults and smokers. Meeting the recommended PA level of 150 min per week may significantly decrease the prevalence of GERD.

Development, quality, and influencing factors of colonoscopy in China: results from the national census in 2013 and 2020.

Background and Aim: With the increasing burden of colorectal cancer (CRC), the practice of colonoscopy is gaining attention worldwide. However, it exhibits distinct trends between developing and developed countries. This study aims to explore its development and identify influencing factors in China. Methods: The Chinese Digestive Endoscopy Censuses were conducted twice in mainland China under the supervision of health authorities. Information regarding the practice of colonoscopy was collected through a structured online questionnaire. The authenticity of the data was evaluated through logical tests, and a random selection of endoscopic reports underwent manual validation by Quality Control Centers. Potential factors associated with colonoscopy were analyzed using real-world information. Results: From 2012 to 2019, the number of hospitals that performed colonoscopy increased from 3,210 to 6,325 (1.97-fold), and the volume increased from 5.83 to 12.92 million (2.21-fold). The utilization rate rose from 436.0 to 914.8 per 100,000 inhabitants (2.10-fold). However, there was an exacerbation of regional inequality in the adequacy of colonoscopy. Regions with higher incidence of CRC, higher gross domestic product per capita, more average numbers of endoscopists and tertiary hospitals tended to provide more accessible colonoscopy (P<0.001). Nationwide, the cecal intubation rate improved from 83.9% to 94.4% and the unadjusted adenoma detection rate (ADR) improved from 16.3% to 18.1%. Overall, hospital grading, educational background of endoscopists, economic income, and colonoscopy volume were observed as the significantly positive factors affecting ADR (P<0.05), but not the incidence of CRC or the number of endoscopists. Conclusions: Tremendous progress in colonoscopy has been made in China, but some issues needed timely reflection. Our findings provide timely evidence for better colonoscopy strategies and measures, such as quality control and medical education of endoscopists.

Changes in soil fertility under partial organic substitution of chemical fertilizer: a 33-year trial.

BACKGROUND: This study examined the changes in soil fertility in a maize cropping area when chemical fertilizer was partially replaced with straw or livestock manure over a 33-year period. Four treatments were included: (i) CK (no fertilizer application); (ii) NPK (only chemical fertilizer application); (iii) NPKM (chemical fertilizer partly replaced with livestock manure); (iv) NPKS (chemical fertilizer partly replaced with straw). RESULTS: Soil organic carbon increased by 41.7% and 95.5% in the NPKS and NPKM treatments, respectively, over the 33-year trial compared with the initial concentration. However, soil organic carbon in NPK was significantly reduced by 9.8%. Soil total N, P and K increased in both NPKM and NPKS treatments compared to the original soil. Soil pH was significantly acidified from 7.6 to 5.97 in the NPK treatment during the experimental period. The NPKM and NPKS treatments buffered the acidification compared to NPK. Meta-analysis results showed that, compared with NPK, NPKM significantly raised soil bacteria and fungi populations by 38.7% and 58.6%; enhanced microbial biomass carbon and nitrogen by 66.3% and 63%, respectively; and increased sucrase, urease and catalase activities by 34.2%, 48.2% and 21.5%. NPKS significantly increased soil fungi and actinomycetes populations by 24.3% and 41.2%, respectively; enhanced microbial biomass carbon and nitrogen by 27.1% and 45%; and strengthened sucrase and urease activities by 36% and 20.3%, respectively. CONCLUSION: Long-term chemical fertilizer application led to the deterioration of soil fertility and environment. Partial replacement of chemical fertilizers with organic materials could significantly amend and buffer such negative effects. © 2023 Society of Chemical Industry.

Exfoliated 2D Layered and Nonlayered Metal Phosphorous Trichalcogenides Nanosheets as Promising Electrocatalysts for CO2 Reduction.

Two-dimensional (2D) materials catalysts provide an atomic-scale view on a fascinating arena for understanding the mechanism of electrocatalytic carbon dioxide reduction (CO2 ECR). Here, we successfully exfoliated both layered and nonlayered ultra-thin metal phosphorous trichalcogenides (MPCh3 ) nanosheets via wet grinding exfoliation (WGE), and systematically investigated the mechanism of MPCh3 as catalysts for CO2 ECR. Unlike the layered CoPS3 and NiPS3 nanosheets, the active Sn atoms tend to be exposed on the surfaces of nonlayered SnPS3 nanosheets. Correspondingly, the nonlayered SnPS3 nanosheets exhibit clearly improved catalytic activity, showing formic acid selectivity up to 31.6 % with -7.51 mA cm-2 at -0.65 V vs. RHE. The enhanced catalytic performance can be attributed to the formation of HCOO* via the first proton-electron pair addition on the SnPS3 surface. These results provide a new avenue to understand the novel CO2 ECR mechanism of Sn-based and MPCh3 -based catalysts.

Radiation-induced Cell Death and Its Mechanisms.

ABSTRACT: With rapid technical advances, ionizing radiation has been put into wider application in ordinary living, with the worst cytological effect on the human body being cell death. Moreover, according to the Nomenclature Committee on Cell Death, the method of radiation-induced cell death, usually classified as interphase and proliferative death, undergoes more detailed classifications oriented by its molecular mechanism. Elaborating its mode and molecular mechanism is crucial for the protection and treatment of radiation injury, as well as the radiotherapy and recovery of tumors. Varying with the changes of the radiation dose and the environment, the diverse targets and pathways of ionizing radiation result in various cell deaths. This review focuses on classifications of radiation-induced cell death and its molecular mechanism. We also examine the main characteristics of ionizing radiation-induced cell death. The modes of radiation-induced cell death can be classified as apoptosis, necrosis, autophagy-dependent cell death, pyroptosis, ferroptosis, immunogenic cell death, and non-lethal processes. Once the dose is high enough, radiation effects mostly appear as destructiveness ("destructiveness" is used to describe a situation in which cells do not have the opportunity to undergo a routine death process, in which case high-dose radiation works like a physical attack). This breaks up or even shatters cells, making it difficult to find responses of the cell itself. Due to diversities concerning cell phenotypes, phases of cell cycle, radiation dose, and even cellular subregions, various methods of cell death occur, which are difficult to identify and classify. Additionally, the existence of common initial activation and signaling molecules among all kinds of cell deaths, as well as sophisticated crossways in cellular molecules, makes it more laborious to distinguish and classify various cell deaths.

DNA-based enzymatic systems and their applications.

DNA strands with unique secondary structures can catalyze various chemical reactions and mimic natural enzymes with the assistance of cofactors, which have attracted much research attention. At the same time, the emerging DNA nanotechnology provides an efficient platform to organize functional components of the enzymatic systems and regulate their catalytic performances. In this review, we summarize the recent progress of DNA-based enzymatic systems. First, DNAzymes (Dzs) are introduced, and their versatile utilities are summarized. Then, G-quadruplex/hemin (G4/hemin) Dzs with unique oxidase/peroxidase-mimicking activities and representative examples where these Dzs served as biosensors are explicitly elaborated. Next, the DNA-based enzymatic cascade systems fabricated by the structural DNA nanotechnology are depicted. In addition, the applications of catalytic DNA nanostructures in biosensing and biomedicine are included. At last, the challenges and the perspectives of the DNA-based enzymatic systems for practical applications are also discussed.

Hierarchical Assembly of Super-DNA Origami Based on a Flexible and Covalent-Bound Branched DNA Structure.

DNA origami technique provides a programmable way to construct nanostructures with arbitrary shapes. The dimension of assembled DNA origami, however, is usually limited by the length of the scaffold strand. Herein, we report a general strategy to efficiently organize multiple DNA origami tiles to form super-DNA origami using a flexible and covalent-bound branched DNA structure. In our design, the branched DNA structures (Bn: with a certain number of 2-6 branches) are synthesized by a copper-free click reaction. Equilateral triangular DNA origamis with different numbers of capture strands (Tn: T1, T2, and T3) are constructed as the coassembly tiles. After hybridization with the branched DNA structures, the super-DNA origami (up to 13 tiles) can be efficiently ordered in the predesigned patterns. Compared with traditional DNA junctions (Jn: J2-J6, as control groups) assembled by base pairing between several DNA strands, a higher yield and more compact structures are obtained using our strategy. The highly ordered and discrete DNA origamis can further precisely organize gold nanoparticles into different patterns. This rationally developed DNA origami ordering strategy based on the flexible and covalent-bound branched DNA structure presents a new avenue for the construction of sophisticated DNA architectures with larger molecular weights.

DNA-based plasmonic nanostructures and their optical and biomedical applications.

In the past few decades, DNA nanotechnology has been developed a lot due to their appealing features such as structural programmability and easy functionalization. In the emerging field of DNA nanotechnology, DNA molecules are regarded not only as biological information carriers but also as building blocks in the assembly of various two-dimensional and three-dimensional nanostructures, serving as outstanding templates for the bottom-up fabrication of plasmonic nanostructures. By arranging nanoparticles with different components and morphologies on the predesigned DNA templates, various static and dynamic plasmonic nanostructures with tailored optical properties have been obtained. In this review, we summarized recent advances in the design and construction of static and dynamic DNA-based plasmonic nanostructures. In addition, we addressed their emerging applications in the fields of optics and biosensors. At the end of this review, the open questions and future directions of DNA-based plasmonic nanostructure are also discussed.

Tungsten disulfide nanosheets-based colorimetric assay for glucose sensing.

We have developed a glucose oxidase (GOx)-mediated strategy for glucose detection, which is based on the intrinsic peroxidase-like activity of WS2 as a catalyst for the 3,3',5,5'-tetramethylbenzidine­hydrogen peroxide (TMB-H2O2) reaction. The colorimetric assay involves two parts: generation of H2O2 from the oxidation of glucose catalyzed by GOx, and WS2 nanosheets that catalyze the reaction between TMB and H2O2. In this colorimetric assay, the enhancement of colorimetric signals depends directly on the increased H2O2 concentration, which, in turn, relies on the glucose concentration. The results show that the concentrations of the glucose were directly proportional to absorbance of the TMB solutions over a range of 1 nM-500 µM with a limit of detection of 0.1445 nM. In addition, this new colorimetric assay has been utilized for glucose detection in human serum with a satisfactory result.

Colorimetric detection of L-histidine based on the target-triggered self-cleavage of swing-structured DNA duplex-induced aggregation of gold nanoparticles.

A rapid, highly sensitive and selective colorimetric assay is presented for visually detecting L-histidine. It is based on L-histidine-triggered self-cleavage of DNA duplex-induced gold nanoparticle (AuNP) aggregation. The citrate-capped AuNPs easily aggregate in a high concentration of salt environment. However, in the presence of L-histidine aptamers (DNA1 and DNA2), the partial strands of DNA1 and DNA2 hybridize to form a DNA duplex with a swing structure. The swing-like DNA duplexes are adsorbed on the surface of AuNPs to improve the stability of AuNPs, and the AuNPs also are better dispersed in high-salt media. When L-histidine is added to the solutions, it catalyzes the self-cleavage of DNA1 to form many single-stranded DNA (ssDNA) fragments. These ssDNA segments are adsorbed on the AuNPs and weaken the stability of AuNPs. Hence, the AuNPs aggregate in high-salt environment, and this results in a red-to-blue color change. Under the optimized conditions, L-histidine can be determined with a limit of detection of 3.6 nM. In addition, the sensor was successfully applied to the determination of L-histidine in spiked serum samples. Graphical abstract Schematic of a rapid and homogeneous colorimetric L-histidine assay. It combines L-histidine-triggered self-cleavage of the swing-like DNA duplexes and self-cleavage of DNA-induced AuNP aggregation.

The aptamer-thrombin-aptamer sandwich complex-bridged gold nanoparticle oligomers for high-precision profiling of thrombin by dark field microscopy.

We present a simple and efficient colorimetric assay strategy for ultrasensitive visual detection of human α-thrombin, which is essentially based on the formation of the DNA1-thrombin-DNA2 sandwich complex-bridged gold nanoparticle (Au NP) oligomers. Unlike the traditional colorimetric sensing strategies which induced the nanoparticle aggregates with uncontrolled aggregate size. In this work, the DNA1with rich G bases was firstly conjugated on the surfaces of Au NPs fixed on the hexadecyl trimethylammonium bromide (CTAB)-coated glass slide, and thrombin was captured by the DNA1. Then, the other DNA2 with rich G bases interacted with the former DNA1-thrombin complex and formed a DNA1-thrombin-DNA2 sandwich complex. The subsequently added Au NPs can be bound to the Au NP-DNA1-thrombin-DNA2 via Au-S bond to trigger the formation of Au NP oligomers, an apparent color change of the single Au NPs from green to yellow and red was observed under dark field microscopy. By measuring the intensity change of the yellow and red Au NPs, the concentration of target thrombin could be accurately quantified. As a proof of concept experiment, the formation of Au NP oligomers resulted in significantly improved sensitivity (10 fM of limit of detection and 20 fM of limit of quantity) and wider linear dynamic range of thrombin detection (20 fM-20 nM), the relative standard deviation (RSD) was less than 5.73% (n = 5). In addition, in order to validate the potential application in clinical diagnosis, the content of thrombin in a human serum samples was also quantified.

Colorimetric aggregation based cadmium(II) assay by using triangular silver nanoplates functionalized with 1-amino-2-naphthol-4-sulfonate.

A colorimetric method is described for sensitive and low-cost detection of Cd(II). It is based on the use of triangular silver nanoplates (tri-AgNPs) modified with 1-amino-2-naphthol-4-sulfonate (ANS) acting as a colorimetric probe. ANS is first linked to the tri-AgNPs via electrostatic interaction of the sulfo groups. In the absence of analyte, ANS on the surface of tri-AgNPs protects them from aggregation. In the presence of Cd(II), the tri-AgNPs aggregate due to the interaction between ANS and Cd(II). This results in a distinct color change from blue (absorption peak at 710 nm) to green (peak at 770 nm). UV-vis spectrometry and image analyses demonstrate that this method exhibits selective and sensitive colorimetric response to Cd(II). The color change can be easily detected with bare eyes. Response is linear in the 30 to 70 µM concentration range, and the detection limit is 30 nM. Graphical abstract A colorimetric method for sensitive, and low-cost detection of Cd(II) based on the use of tri-AgNPs modified with ANS acting as a colorimetric probe was presented.