Development and validation of a preoperative risk nomogram prediction model for gastric gastrointestinal stromal tumors.

BACKGROUND AND STUDY AIMS: Gastrointestinal stromal tumors (GIST) carry a potential risk of malignancy, and the treatment of GIST varies for different risk levels. However, there is no systematic preoperative assessment protocol to predict the malignant potential of GIST. The aim of this study was to develop a reliable and clinically applicable preoperative nomogram prediction model to predict the malignant potential of gastric GIST. PATIENTS AND METHODS: Patients with a pathological diagnosis of gastric GIST from January 2015 to December 2021 were screened retrospectively. Univariate and multivariate logistic analyses were used to identify independent risk factors for gastric GIST with high malignancy potential. Based on these independent risk factors, a nomogram model predicting the malignant potential of gastric GIST was developed and the model was validated in the validation group. RESULTS: A total of 494 gastric GIST patients were included in this study and allocated to a development group (n = 345) and a validation group (n = 149). In the development group, multivariate logistic regression analysis revealed that tumor size, tumor ulceration, CT growth pattern and monocyte-to- lymphocyte ratio (MLR) were independent risk factors for gastric GIST with high malignancy potential. The AUC of the model were 0.932 (95% CI 0.890-0.974) and 0.922 (95% CI 0.868-0.977) in the development and validation groups, respectively. The best cutoff value for the development group was 0.184, and the sensitivity and specificity at this value were 0.895 and 0.875, respectively. The calibration curves indicated good agreement between predicted and actual observed outcomes, while the DCA indicated that the nomogram model had clinical application. CONCLUSIONS: Tumor size, tumor ulceration, CT growth pattern and MLR are independent risk factors for high malignancy potential gastric GIST, and a nomogram model developed based on these factors has a high ability to predict the malignant potential of gastric GIST.

Identification of a Diagnosis and Therapeutic Inflammatory Response-Related Gene Signature Associated with Esophageal Adenocarcinoma.

The purpose of this study is to identify the key regulatory genes related to the inflammatory response of esophageal adenocarcinoma (EAC) and to find new diagnosis and therapeutic options. We downloaded the dataset GSE72874 from the Gene Expression Omnibus database for this study. Weighted gene co-expression network analysis (WGCNA) and differentially expressed genes (DEGs) analysis were used to find common inflammatory response-related genes (IRRGs) in EAC. The relationship between normal and tumor immune infiltration was analyzed using an online database of CIBERSORTx. Finally, 920 DEGs were identified, of which 5 genes were key IRRGs associated with EAC, including three down-regulated genes GNA15, MXD1, and NOD2, and two down-regulated genes PLAUR and TIMP1. Further research found that GNA15, MXD1, and NOD2 were down-regulated, PLAUR and TIMP1 were up-regulated in Barrett's esophagus (BE). In addition, we found that the expression of GNA15 and MXD1 in normal esophageal squamous epithelial cells decreased after ethanol treatment, while the expression of PLAUR and TIMP1 increased after ethanol treatment. Compared with normal esophageal tissue, immune cells infiltrated such as plasma cells, macrophages M0, macrophages M1, macrophages M2, dendritic cells activated, and mast cells activated were significantly increased in EAC, while immune cells infiltrated such as T cells CD4 memory resting, T cells follicular helper, NK cells resting, and dendritic cells resting were significantly reduced. The receiver operating characteristic curve indicated that GNA15, MXD1, NOD2, PLAUR and TIMP1 expression had a performed well in diagnosing EAC from healthy control. GNA15, MXD1, NOD2, PLAUR and TIMP1 were identified and validated as novel potential biomarkers for early diagnosis and may be new molecular targets for treatment of EAC.

Prediction model for lymph node metastasis in superficial colorectal cancer: a better choice than computed tomography.

BACKGROUND: Risk evaluation of lymph node metastasis (LNM) in superficial colorectal cancer resected by endoscopic surgery is critical for determining subsequent therapeutic strategies, but the role of existing clinical methods, including computed tomography, remains limited. METHODS: Features of the nomogram were determined by logistic regression analysis, and the performance was validated by calibration plots, ROC curves and DCA curves in both the training set and the validation set. RESULTS: A total of 608 consecutive superficial CRC cases were randomly divided into 426 training and 182 validation cases. Univariate and multivariate logistic regression analyses revealed that age < 50, tumour budding, lymphatic invasion and lower HDL levels were risk factors for LNM. Stepwise regression and the Hosmer‒Lemeshow goodness of fit test showed that the nomogram had good performance and discrimination, which was validated by ROC curves and calibration plots. Internal and external validation demonstrated that the nomogram had a higher C-index (training group, 0.749, validation group, 0.693). DCA and clinical impact curves graphically show that the use of the nomogram to predict LNM had remarkable predictive power. Finally, in comparison with CT diagnosis, the nomogram also visually showed higher superiority, as demonstrated by ROC, DCA and clinical impact curves. CONCLUSION: Using common clinicopathologic factors, a noninvasive nomogram for individualized prediction of LNM after endoscopic surgery was conveniently established. Nomograms have great superiority in the risk stratification of LNM compared with traditional CT imaging.

Comparable long-term survival outcomes of endoscopic therapy versus surgical therapy for T1-2N0M0 duodenal neuroendocrine tumors.

BACKGROUND AND STUDY AIMS: The optimal treatment modality for T1-2N0M0 duodenal neuroendocrine tumors (DNETs) is still controversial. In this study, long-term survival outcomes were compared between the endoscopic therapy and surgical therapy for T1-2N0M0 DNETs using the Surveillance, Epidemiology, and End Results (SEER) database. PATIENTS AND METHODS: Patients with DNETs from the SEER database were selected from 2004 to 2015. We used the Kaplan-Meier method and log-rank test to compare long-term survival results between the endoscopic therapy and surgical therapy. An analysis of the multivariable Cox proportional hazards model was performed to identify risk factors for patient prognoses. The 1:1 propensity score matching (PSM) was performed to balance baseline data. RESULTS: A total of 816 patients with DNETs were included, of which 578 patients (70.8%) received endoscopic therapy and 238 patients (29.2%) received surgical therapy. Before the PSM, there was no difference between the two groups of patients with DNETs on long-term survival [5-year OS (86.1% vs. 87.9%, P = 0.45), 10-year OS (72.5% vs. 72.3%, P = 0.45)]. After adjusting covariates, we found endoscopic therapy and surgical therapy groups had comparable risks of overall survival (HR 0.86, 95% CI 0.60-1.23, P = 0.409) and cancer-specific survival (HR 1.68, 95% CI 0.74-3.83, P = 0.214). In the post-PSM analysis, there was no discernible difference between the endoscopic therapy and surgical therapy group. CONCLUSIONS: Our study found that for T1-2N0M0 DNETs patients, whose long-term OS and CSS results were similar for the endoscopic and surgical therapy groups. For these patients, endoscopic resection might be an optimal therapy modality.

Student Learning Behavior Recognition Incorporating Data Augmentation with Learning Feature Representation in Smart Classrooms.

A robust and scientifically grounded teaching evaluation system holds significant importance in modern education, serving as a crucial metric that reflects the quality of classroom instruction. However, current methodologies within smart classroom environments have distinct limitations. These include accommodating a substantial student population, grappling with object detection challenges due to obstructions, and encountering accuracy issues in recognition stemming from varying observation angles. To address these limitations, this paper proposes an innovative data augmentation approach designed to detect distinct student behaviors by leveraging focused behavioral attributes. The primary objective is to alleviate the pedagogical workload. The process begins with assembling a concise dataset tailored for discerning student learning behaviors, followed by the application of data augmentation techniques to significantly expand its size. Additionally, the architectural prowess of the Extended-efficient Layer Aggregation Networks (E-ELAN) is harnessed to effectively extract a diverse array of learning behavior features. Of particular note is the integration of the Channel-wise Attention Module (CBAM) focal mechanism into the feature detection network. This integration plays a pivotal role, enhancing the network's ability to detect key cues relevant to student learning behaviors and thereby heightening feature identification precision. The culmination of this methodological journey involves the classification of the extracted features through a dual-pronged conduit: the Feature Pyramid Network (FPN) and the Path Aggregation Network (PAN). Empirical evidence vividly demonstrates the potency of the proposed methodology, yielding a mean average precision (mAP) of 96.7%. This achievement surpasses comparable methodologies by a substantial margin of at least 11.9%, conclusively highlighting the method's superior recognition capabilities. This research has an important impact on the field of teaching evaluation system, which helps to reduce the burden of educators on the one hand, and makes teaching evaluation more objective and accurate on the other hand.

Source Acquisition Device Identification from Recorded Audio Based on Spatiotemporal Representation Learning with Multi-Attention Mechanisms.

Source acquisition device identification from recorded audio aims to identify the source recording device by analyzing the intrinsic characteristics of audio, which is a challenging problem in audio forensics. In this paper, we propose a spatiotemporal representation learning framework with multi-attention mechanisms to tackle this problem. In the deep feature extraction stage of recording devices, a two-branch network based on residual dense temporal convolution networks (RD-TCNs) and convolutional neural networks (CNNs) is constructed. The spatial probability distribution features of audio signals are employed as inputs to the branch of the CNN for spatial representation learning, and the temporal spectral features of audio signals are fed into the branch of the RD-TCN network for temporal representation learning. This achieves simultaneous learning of long-term and short-term features to obtain an accurate representation of device-related information. In the spatiotemporal feature fusion stage, three attention mechanisms-temporal, spatial, and branch attention mechanisms-are designed to capture spatiotemporal weights and achieve effective deep feature fusion. The proposed framework achieves state-of-the-art performance on the benchmark CCNU_Mobile dataset, reaching an accuracy of 97.6% for the identification of 45 recording devices, with a significant reduction in training time compared to other models.

Multi-Channel Representation Learning Enhanced Unfolding Multi-Scale Compressed Sensing Network for High Quality Image Reconstruction.

Deep Unfolding Networks (DUNs) serve as a predominant approach for Compressed Sensing (CS) reconstruction algorithms by harnessing optimization. However, a notable constraint within the DUN framework is the restriction to single-channel inputs and outputs at each stage during gradient descent computations. This constraint compels the feature maps of the proximal mapping module to undergo multi-channel to single-channel dimensionality reduction, resulting in limited feature characterization capabilities. Furthermore, most prevalent reconstruction networks rely on single-scale structures, neglecting the extraction of features from different scales, thereby impeding the overall reconstruction network's performance. To address these limitations, this paper introduces a novel CS reconstruction network termed the Multi-channel and Multi-scale Unfolding Network (MMU-Net). MMU-Net embraces a multi-channel approach, featuring the incorporation of Adap-SKConv with an attention mechanism to facilitate the exchange of information between gradient terms and enhance the feature map's characterization capacity. Moreover, a Multi-scale Block is introduced to extract multi-scale features, bolstering the network's ability to characterize and reconstruct the images. Our study extensively evaluates MMU-Net's performance across multiple benchmark datasets, including Urban100, Set11, BSD68, and the UC Merced Land Use Dataset, encompassing both natural and remote sensing images. The results of our study underscore the superior performance of MMU-Net in comparison to existing state-of-the-art CS methods.

Development and application of specific FISH probes for karyotyping Psathyrostachys huashanica chromosomes.

BACKGROUND: Psathyrostachys huashanica Keng has long been used as a genetic resource for improving wheat cultivar because of its genes mediating the resistance to various diseases (stripe rust, leaf rust, take-all, and powdery mildew) as well as its desirable agronomic traits. However, a high-resolution fluorescence in situ hybridization (FISH) karyotype of P. huashanica remains unavailable. RESULTS: To develop chromosome-specific FISH markers for P. huashanica, repetitive sequences, including pSc119.2, pTa535, pTa713, pAs1, (AAC)5, (CTT)12, pSc200, pTa71A-2, and Oligo-44 were used for a FISH analysis. The results indicated that the combination of pSc200, pTa71A-2 and Oligo-44 probes can clearly identify all Ns genomic chromosomes in the two P. huashanica germplasms. The homoeologous relationships between individual P. huashanica chromosomes and common wheat chromosomes were clarified by FISH painting. Marker validation analyses revealed that the combination of pSc200, pTa71A-2, and Oligo-44 for a FISH analysis can distinguish the P. huashanica Ns-genome chromosomes from wheat chromosomes, as well as all chromosomes (except 4Ns) from the chromosomes of diploid wheat relatives carrying St, E, V, I, P and R genomes. Additionally, the probes were applicable for discriminating between the P. huashanica Ns-genome chromosomes in all homologous groups and the corresponding chromosomes in Psathyrostachys juncea and most Leymus species containing the Ns genome. Furthermore, six wheat-P. huashanica chromosome addition lines (i.e., 2Ns, 3Ns, 4Ns, 7Ns chromosomes and chromosomal segments) were characterized using the newly developed FISH markers. Thus, these probes can rapidly and precisely detect P. huashanica alien chromosomes in the wheat background. CONCLUSIONS: The FISH karyotype established in this study lays a solid foundation for the efficient identification of P. huashanica chromosomes in wheat genetic improvement programs.

Comparison of some biochemical markers between early-onset and late-onset colorectal precancerous lesions: A single-center retrospective study.

OBJECTIVE: Given that the onset of diseases including colorectal cancer precursors is affecting younger individuals and that obesity is an important risk factor for early-onset, we conducted a study to explore the biochemical profile of differences in serum between early-onset patients and late-onset colorectal precancerous lesions. METHODS: A total of 1447 patients, including 469 early-onset patients and 978 late-onset patients, were enrolled from the First Affiliated Hospital of Nanchang University (FAHNU), of which there were 311 sessile serrated adenoma/polyps (SSA/P) and 1136 normal adenomas. The distribution of the included categorical variables was compared via Pearson's chi-squared test, whereas continuous variables were compared by using the nonparametric Kruskal-Wallis test and ANOVA. RESULTS: Compared with late-onset patients, the levels of total bilirubin and HDL-C were lower (p < 0.05), whereas triglyceride and uric acid levels were higher, in early-onset patients. Interestingly, in the subgroup analysis, triglyceride and uric acid levels remained at higher levels, whereas HDL-C remained at lower levels, in early-onset patients than in late-onset patients. Other characteristics, such as LDL-C, drinking, γ-GT, and the N/L ratio, were similar between the two groups. An additional analysis of the association of tumor size with markers showed that lower levels of HDL-C and higher levels of uric acid were associated with increased tumor size (p < 0.05). CONCLUSIONS: Early-onset CRC precursor cases exhibit higher levels of triglycerides and lower levels of HDL-C than late-onset cases. Additionally, levels of HDL-C are negatively associated with tumor size, whereas uric acid was positively correlated with tumor size.

Activation of Aquaporin 5 by carcinogenic Helicobacter pylori infection promotes epithelial-mesenchymal transition via the MEK/ERK pathway.

BACKGROUND: Helicobacter pylori (H. pylori) is a major risk factor for gastric cancer. The water channel protein Aquaporin 5 (AQP5) is involved in the tumorigenesis and progression of various cancers. In this study, we aimed to explore the role of AQP5 in H. pylori-induced gastric carcinogenesis. MATERIALS AND METHODS: We collected 160 samples which inculded CNAG, IM, Dys and gastric cancer from patients who underwent endoscopy and detected the expression of AQP5. In vivo and vitro H. pylori infection models, we explored the relationship between AQP5 and H. pylori. Plasmid, siRNA and inhibitors were used to investigated the relationship between AQP5 and EMT and the role of AQP5 in H. pylori-induced gastric carcinogenesis. RESULT: AQP5 expression was gradually increased in human gastric tissues with the progression of chronic nonatrophic gastritis to gastric cancer and associated with the H. pylori infection status. In vivo and in vitro studies showed that H. pylori infection induced AQP5 expression in gastric epithelial cells in a CagA-dependent manner. Knockdown of AQP5 reversed H. pylori-induced cell proliferation and invasion, and -suppressed cell apoptosis. Additionally, knockdown of AQP5 suppressed H. pylori-induced Epithelial-mesenchymal transition (EMT) phenotypes by regulating transcriptional factors, mesenchymal markers, and epithelial markers. CONCLUSIONS: We explored the underlying mechanism and our results indicated that knockdown of AQP5 significantly suppressed H. pylori infection-induced phosphorylation of ERK1/2, MEK and the expression levels of downstream genes. Treatment with an ERK inhibitor suppressed the EMT induced by H. pylori infection. Taken together, this study suggest that pathogenic H. pylori infection promotes AQP5 expression to induce the EMT via the MEK/ERK signaling pathway.

Barrier performance and biodegradability of antibacterial poly(butylene adipate-co-terephthalate) nanocomposites reinforced with a new MWCNT-ZnO nanomaterial.

A new nanomaterial or nano-filler in the form of multiwalled carbon nanotube-zinc oxide (MWCNT-ZnO) was synthesized for the purpose of modifying poly(butylene adipate-co-terephthalate) (PBAT) and its derivative (modified PBAT or MPBAT) through a melt-blending method (MPBAT was obtained by introducing maleic anhydride groups into PBAT). The effect of the new nano-filler on the properties of resultant nanocomposites was determined from the characterization of mechanical properties, morphology, crystallinity, thermal stability, barrier properties, hydrophilicity, conductivity, antibacterial property, and biodegradability. The results showed that MPBAT nanocomposites had stronger mechanical properties, better barrier properties, and higher electrical conductivity than PBAT nanocomposites. Scanning electron microscopy illustrated that MWCNT-ZnO had better compatibility with MPBAT than with PBAT. At 0.2% MWCNT-ZnO, the MPBAT/MWCNT-ZnO nanocomposite film exhibited the greatest mechanical properties (17.74% increase in tensile strength, 22.17% in yield strength, and 14.29% in elongation at break). When the MWCNT-ZnO content was 0.4%, the nanocomposite film demonstrated the best water vapor barrier ability (an increase of 30.4%). The MPBAT/MWCNT-ZnO film with 0.6% MWCNT-ZnO turned out to have the best oxygen barrier performance (an increase of 130% relative to pure PBAT). It was shown from the results of antibacterial evaluation that the new nanomaterial could impart PBAT and MPBAT with antibacterial activity. The biodegradability tests indicated that an MWCNT-ZnO content of 0.2% could slightly reduce the biodegradability, and when the content was higher than 0.2%, the weight loss rate would increase.

Nomograms that predict the survival of patients with adenocarcinoma in villous adenoma of the colorectum: a SEER-based study.

BACKGROUND: Considering that the knowledge of adenocarcinoma in villous adenoma of the colorectum is limited to several case reports, we designed a study to investigate independent prognostic factors and developed nomograms for predicting the survival of patients. METHODS: Univariate and multivariate Cox regression analyses were used to evaluate prognostic factors. A nomogram predicting cancer-specific survival (CSS) was performed; internally and externally validated; evaluated by receiver operating characteristic (ROC) curve, C-index, and decision curve analyses; and compared to the 7th TNM stage. RESULTS: Patients with adenocarcinoma in villous adenoma of the colorectum had a 1-year overall survival (OS) rate of 88.3% (95% CI: 87.1-89.5%), a 3-year OS rate of 75.1% (95% CI: 73.3-77%) and a 5-year OS rate of 64.5% (95% CI: 62-67.1%). Nomograms for 1-, 3- and 5-year CSS predictions were constructed and performed better with a higher C-index than the 7th TNM staging (internal: 0.716 vs 0.663; P < 0.001; external: 0.713 vs 0.647; P < 0.001). Additionally, the nomogram showed good agreement between internal and external validation. According to DCA analysis, compared to the 7th TNM stage, the nomogram showed a greater benefit across the period of follow-up regardless of the internal cohort or external cohort. CONCLUSION: Age, race, T stage, pathologic grade, N stage, tumor size and M stage were prognostic factors for both OS and CSS. The constructed nomograms were more effective and accurate for predicting the 1-, 3- and 5-year CSS of patients with adenocarcinoma in villous adenoma than 7th TNM staging.

Retrospective analysis of LNM risk factors and the effect of chemotherapy in early colorectal cancer: A Chinese multicenter study.

BACKGROUND: Estimating the risk of lymph node metastasis (LNM) is crucial for determining subsequent treatments following curative resection of early colorectal cancer (ECC). This multicenter study analyzed the risk factors of LNM and the effectiveness of postoperative chemotherapy in patients with ECC. METHODS: We retrospectively analyzed the data of 473 patients with ECC who underwent general surgery in five hospitals between January 2007 and October 2018. The correlations between LNM and sex, age, tumor size, tumor location, endoscopic morphology, pathology, depth of invasion and tumor budding (TB) were directly estimated based on postoperative pathological analysis. We also observed the overall survival (OS) and recurrence in ECC patients with and without LNM after matching according to baseline measures. RESULTS: In total, 473 ECC patients were observed, 288 patients were enrolled, and 17 patients had LNM (5.90%). The univariate analysis revealed that tumor size, pathology, and lymphovascular invasion were associated with LNM in ECC (P = 0.026, 0.000, and 0.000, respectively), and the multivariate logistic regression confirmed that tumor size, pathology, and lymphovascular invasion were risk factors for LNM (P = 0.021, 0.023, and 0.001, respectively). There were no significant differences in OS and recurrence between the ECC patients with and without LNM after matching based on baseline measures (P = 0.158 and 0.346, respectively), and no significant difference was observed between chemotherapy and no chemotherapy in ECC patients without LNM after surgery (P = 0.729 and 0.052). CONCLUSION: Tumor size, pathology, and lymphovascular invasion are risk factors for predicting LNM in ECC patients. Adjuvant chemotherapy could improve OS and recurrence in patients with LNM but not always in ECC patients without LNM.

Analysis of embCAB mutations associated with ethambutol resistance in multidrug-resistant mycobacterium tuberculosis isolates from China.

Ethambutol (EMB) plays a pivotal role in the chemotherapy of drug-resistant tuberculosis (TB), including multidrug-resistant tuberculosis (MDR-TB). Resistance to EMB is considered to be caused by mutations in the embCAB operon (embC, embA, and embB). In this study, we analyzed the embCAB mutations among 139 MDR-TB isolates from China and found a possible association between embCAB operon mutation and EMB resistance. Our data indicate that 56.8% of MDR-TB isolates are resistant to EMB, and 82.2% of EMB-resistant isolates belong to the Beijing family. Overall, 110 (79.1%) MDR-TB isolates had at least one mutation in the embCAB operon. The majority of mutations were present in the embB gene and the embA upstream region, which also displayed significant correlations with EMB resistance. The most common mutations occurred at codon 306 in embB (embB306), followed by embB406, embA(-16), and embB497. Mutations at embB306 were associated with EMB resistance. DNA sequencing of embB306-497 was the best strategy for detecting EMB resistance, with 89.9% sensitivity, 58.3% specificity, and 76.3% accuracy. Additionally, embB306 had limited value as a candidate predictor for EMB resistance among MDR-TB infections in China.

Single-channel endoscopic closure of large endoscopy-related perforations.

BACKGROUND AND STUDY AIMS: Gastrointestinal endoscopy procedures, such as endoscopic retrograde cholangiopancreatography (ERCP), endoscopic submucosal dissection (ESD), and colonoscopy are widely used for the diagnosis or treatment of digestive diseases. Perforation is a rare but potentially lethal complication. Large perforations usually require immediate endoscopic or surgical repair. Endoscopic closure using a nylon loop pouch suture is usually performed with a double-channel endoscope. This paper describes the endoscopic closure of large procedure-related perforations using a single-channel endoscope. PATIENTS AND METHODS: A total of 10 patients with large perforations (2.5 - 4.0 cm), which occurred during ERCP, ESD, or colonoscopy, were treated using the single-channel endoscope technique. RESULTS: All perforations were successfully closed using a nylon loop pouch suture through the single-channel endoscope. No surgery or further endoscopic intervention was required. CONCLUSIONS: Nylon loop pouch suture through a single-channel endoscope was easy to perform and was feasible for the closure of large gastrointestinal perforations.

Expression of TßR-2, Smad3 and Smad7 in the vaginal anterior wall of postpartum rats with stress urinary incontinence.

PURPOSE: The objective of this study is to quantify and evaluate the expression of several important proteins in TGF-ß1/Smad pathway in the anterior vaginal wall in postpartum rats with stress urinary incontinence (SUI). METHODS: Forty 8-week-old Sprague-Dawley (SD) female rats were randomized into three groups: blank group (n = 10), control group (n = 10) and SUI group (n = 20). Rats in blank group were non-pregnant, while rats in the control and SUI groups underwent normal parturition and normal parturition plus immediate postpartum vaginal balloon dilation, respectively. 1 week after dilation, a sneezing experiment and pad test were performed and the anterior vaginal wall was collected. The histological changes of the anterior vaginal wall were assessed by hematoxylin-eosin (HE) staining, and the expression of TßR-2, Smad3 and Smad7 in the anterior vaginal wall was detected by immunohistochemical staining and Western blotting. RESULTS: HE staining showed that collagen was more fragmented, sparse and disorganized in the SUI group compared with the control and blank groups. Compared with the blank group, the expression of TßR-2 and Smad7 protein was significantly increased in the vaginal anterior wall in the control and SUI groups (P < 0.05), while their levels in the SUI group were significantly higher than those in the control group (P < 0.05). Expression of Smad3 protein in the anterior vaginal wall of SUI rats was significantly decreased compared with the blank and control groups (P < 0.05). CONCLUSION: Dysregulation of the TGF-ß1/Smad signaling pathway may involve in the pathogenesis of SUI.

[Effect of pelvic floor muscle training with biofeedback on stress urinary incontinence in postpartum and post-menopausal women].

OBJECTIVE: To investigate the short-term effect of pelvic floor muscle training (PFM) with biofeedback on stress urinary incontinence (SUI) in postpartum and post-menopausal women. METHODS: According to the different period that the SUI occurs, 107 women with SUI were divided into two groups: the group of SUI in postpartum with 60 women, and the group of SUI in post- menopausal with 47 women. PFM with biofeedback was performed on all patients for 8 weeks. One hour pad- weighing test, voiding diary, transperineal three- dimensional ultrasound and female pelvic floor muscle assessment were recorded before and after treatment. RESULTS: There was statistically significant difference in 1 hour pad-weighing test between pre- treatment and post-treatment for the group of SUI in postpartum (the negative, mild, moderate, and severe cases of post-treatment: 21, 24, 14, 1, of pre-treatment: 0, 30, 28, 2; P < 0.05), and the group of SUI in post-menopausal (the negative, mild, moderate, and severe cases of post-treatment: 7, 22, 11, 7, of pre-treatment: 0, 14, 25, 8; P < 0.05). The strength of the pelvic floor muscles of type I and type II in two groups after treatment were significantly different from those in pre-treatment (P < 0.01). The efficient rate of improvement in symptoms after treatment in the group of SUI in postpartum was 88% (53/60) and the cure rate was 38% (23/60). While the efficient rate in the group of SUI in post-menopausal women was 64% (30/47) and the cure rate was 15% (7/47). There was statistically significant difference in the development of symptoms in two groups after treatment (P = 0.003). CONCLUSION: PFM with biofeedback is an effective treatment for SUI in postpartum and post-menopausal women, especially for postpartum ones.

Biological functions of circRNA in regulating the hallmarks of gastrointestinal cancer (Review).

Circular RNA (circRNA) was first observed in the cytoplasm of eukaryotic cells in 1979, but it was not characterized in detail until 2012, when high­throughput sequencing technology was more advanced and available. Consequently, the mechanism of circRNA formation and its biological function have been progressively elucidated by researchers. circRNA is abundant in eukaryotic cells and exhibits a certain degree of organization, timing and disease­specificity. Additionally, it is poorly degradable, meeting the characteristics of an ideal clinical biomarker. In the present review, the recent research progress of circRNAs in digestive tract malignant tumors was primarily discussed. This included the roles, biological functions and clinical significance of circRNA, providing references for its research value and clinical potential in gastrointestinal cancer.

Causal effects of circulating glutamine on colitis, IBD, and digestive system cancers: a Mendelian randomisation study.

Backgrounds: There is growing evidence linking glutamine levels to the risk of gastrointestinal diseases, yet the presence of a causal relationship remains uncertain. In this study, we employed a Mendelian randomization (MR) approach to investigate potential causal associations between glutamine and colitis, inflammatory bowel disease (IBD), and digestive tumors. Methods: Genetic instrumental variables for glutamine exposure were identified from a genome-wide association study (GWAS) involving 114,751 participants. We pooled statistics from GWAS of gastrointestinal diseases in European populations, encompassing colitis (cases=1193, controls=461,740), IBD (cases=31,665, controls=33,977), Crohn's disease (cases=17,897, controls=33,977), ulcerative colitis (cases=1,239, controls=990), oesophageal cancer (cases=740, controls=372,016), gastric cancer (cases=6,563, controls=195,745), liver cell carcinoma (cases=168, controls=372,016), hepatic bile duct cancer (cases=418, controls=159,201), pancreatic cancer (cases=1,196, controls=475,049), and colon cancer (cases=1,494, controls=461,439). To ensure the validity of our findings, we utilized several analytical approaches including inverse variance weighted, weighted median, weighted mode, MR-Egger, and simple mode method. Results: Using the IVW method, we found that glutamine levels were inversely associated with colon cancer (OR = 0.998; 95% CI: 0.997-1.000; P = 0.027), colitis (OR = 0.998; 95% CI: 0.997-1.000; P = 0.020), and IBD (OR = 0.551; 95% CI: 0.343-0.886; P = 0.014). Subgroup analysis revealed a negative association between glutamine and Crohn's disease (OR = 0.375; 95% CI: 0.253-0.557; P = 1.11E-06), but not with ulcerative colitis (OR = 0.508; 95% CI: 0.163-1.586; P = 0.244). Glutamine levels showed no significant correlation with oesophageal cancer (OR = 1.000; 95% CI: 0.999-1.001; P = 0.566), gastric cancer (OR = 0.966; 95% CI: 0.832-1.121; P = 0.648), liver cell carcinoma (OR = 1.000; 95% CI: 0.999-1.000; P = 0.397), hepatic bile duct cancer (OR = 0.819; 95% CI: 0.499-1.344; P = 0.430), and pancreatic cancer (OR = 1.130; 95% CI: 0.897-1.423; P = 0.301). Sensitivity analyses also supports this finding, affirming the reliability and robustness of our study. Conclusions: This study suggests that blood glutamine levels in European populations may lower the risk of colon cancer, colitis, and IBD, particularly Crohn's disease. Nevertheless, additional research involving a diverse range of ancestries is imperative to corroborate this causal relationship.