The efficacy and safety of fexuprazan in treating erosive esophagitis: a phase III, randomized, double-blind, multicenter study.

BACKGROUND AND AIM: Fexuprazan is a novel potassium-competitive acid blocker (P-CAB). This study aimed to explore the noninferior efficacy and safety of fexuprazan to esomeprazole in treating erosive esophagitis (EE). METHODS: This was a phase III, randomized, double-blind multicenter study. Patients with endoscopically confirmed EE were randomized to receive fexuprazan 40 mg or esomeprazole 40 mg once a daily for 4-8 weeks. The healing rates of EE, symptom response, GERD-health-related quality life (GERD-HRQL), and treatment-emergent adverse events (TEAEs) were compared between fexuprazan group and esomeprazole group. RESULTS: A total of 332 subjects were included in full analysis set (FAS) and 311 in per-protocol set (PPS). The healing rates of fexuprazan and esomeprazole groups at 8 weeks were 88.5% (146/165) and 89.0% (145/163), respectively, in FAS and 97.3% (145/149) and 97.9% (143/146), respectively, in PPS. Noninferiority of fexuprazan compared with esomeprazole according to EE healing rates at 8 weeks was demonstrated in both FAS and PPS analysis. No significant difference was found between groups in EE healing rates at 4 weeks, symptom responses, and changes of GERD-HRQL. The incidence of drug-related AEs was 19.4% (32/165) in fexuprazan arm and 19.6% (32/163) in esomeprazole arm. CONCLUSION: This study demonstrated noninferior efficacy of fexuprazan to esomeprazole in treating EE. The incidence of TEAEs was similar between fexuprazan and esomeprazole. Trial registration number NCT05813561.

Physiological responses and health risks of edible amaranth under simultaneous stresses of lead from soils and atmosphere.

Lead (Pb) is widely distributed in the environment that can impose potential risks to vegetables and humans. In this work, we conducted a pot experiment in Southern China to examine the physiological response and risk of edible amaranth (Amaranthus tricolor L.) under the simultaneous stresses of lead from soil and atmosphere. The results indicate that the lead content of amaranth substantially exceeded China's national standard when Pb concentration from soils and atmosphere was high, and comparing to teenagers and adults, children exposed a higher health risk after consuming the contaminated amaranth. Under the co-stress, the lead in roots of amaranth mainly came from the soil, but the Pb from atmospheric deposition can significantly affect the lead concentration in leaves. While lead from atmospheric deposition is found to promote the growth of amaranth, the stress of lead from the soils shows an inhibitory effect, as indicated by the increase in H2O2 content, the damage in cell membranes, and the limitation in chlorophyll synthesis. The antioxidant system in stems and leaves of amaranth can effectively alleviate the Pb toxicity. However, the stress of high lead concentration from soils can substantially suppress the antioxidant enzyme activity of roots. While it is found that heavy metals in soils can significantly affect the vegetables grown in a multi-source pollution environment, we also call for the attention on the potential health risk imposed by the lead from atmospheric deposition. This study provides an important reference for the prevention and control of crop contamination in multi-source pollution environments.

Overcoming Drug Resistance in Colon Cancer by Aptamer-Mediated Targeted Co-Delivery of Drug and siRNA Using Grapefruit-Derived Nanovectors.

BACKGROUND/AIMS: Multidrug resistance (MDR) is the most common cause of chemotherapy failure. Upregulation of P-glycoprotein (P-gp) is one of the main mechanisms underlying MDR. METHODS: In this study, we developed a targeted drug and small interfering (si)RNA co-delivery system based on specific aptamer-conjugated grapefruit-derived nanovectors (GNVs) that we tested in MDR LoVo colon cancer cells. The internalization of nanovectors in cancer cells was tested by fluorescence microscopy and flow cytometry. The anti-cancer activity in vitro was determined by colony formation and cell apoptosis assays. The biodistribution of nanovectors was analyzed by live imaging and the anti-cancer activity in vivo was observed. RESULTS: GNVs loaded with aptamer increased doxorubicin (Dox) accumulation in MDR LoVo cells, an effect that was abolished by pretreatment with DNase. The LA1 aptamer effectively promoted nanovector internalization into cells at 4°C and increased the targeted delivery of Dox to tumors. Constructs harboring Dox, LA1, and P-gp siRNA more effectively inhibited proliferation and enhanced apoptosis in cultured MDR LoVo cells while exhibiting more potent anti-tumor activity in vivo than free Dox or GNVs loaded with Dox alone or in conjunction with LA1, an effect that was associated with downregulation of P-gp expression. CONCLUSION: This GNV-based system may be an effective strategy for overcoming MDR in clinical settings.

Effect of GDF11 on proliferation and apoptosis of esophageal cancer cells.

This study was aimed at investigating the effect of growth differentiation factor 11 (GDF11) on the proliferation and apoptosis of esophageal cancer cells. Serum levels of GDF11 in esophageal cancer patients were determined with ELISA kits, and the correlation between serum GDF11 and pathological features of esophageal cancer were determined. The effect of recombinant GDF11 on the growth of esophageal cancer cells was measured by CCK6 method. In order to investigate the effect of recombinant GDF11 on the proliferation and apoptosis of esophageal cancer cells, the expression of apoptosis-promoting protein Bax and proliferative-associated protein Bcl-2 in esophageal cancer cells were determined using western blot. Moreover, GDF11 was used to treat esophageal cancer cells, and its effect on proliferation and apoptosis was determined with MTT assay and flow cytometry, respectively. The serum content of GDF11 was much less in esophageal cancer patients than in the control group. Esophageal GDF II in cancer patients was correlated with cancer differentiation: the higher the degree of differentiation, the higher the content of GDF11. GDF11 inhibits proliferation and apoptosis of esophageal cancer cells.

Systemic transcriptome analysis of hepatocellular carcinoma.

Liver cancer is one of the most common malignant tumors, and most of which is hepatocellular carcinoma (HCC). We aim to study the characteristic changes of numerous genes and their roles in HCC through systematical analysis of the characteristics of expression spectrum of HCC. Firstly, we made systematic clustering of the HCC samples according to the RNAseq data from TCGA (The Cancer Genome Atlas) and newly classified HCC. Then the characteristic genes in different molecular subtypes were found out and further analyzed combing with methylation and SNP 6.0 chip. Finally, these genes were subjected to do functional annotation and abnormal signaling pathways of HCC in various molecular subtypes and were screened out. There were 3843 differential genes screened; among which, 689 genes were enriched into 13 KEGG-related pathways, and the expression of 27 and 924 genes showed positive and negative correlation to methylation level, respectively, while the expression of 43 genes showed positive correlation to variation level of copy number. The methylation degree of ZSCAN18 may be considered as a marker for prognosis evaluation, and ABHD6 could be a potential anti-oncogene.

Overexpression of zinc finger E-box binding homeobox factor 1 promotes tumor invasiveness and confers unfavorable prognosis in esophageal squamous cell carcinoma.

Zinc finger E-box binding homeobox factor 1 (ZEB1), as a crucial mediator of "epithelial-mesenchymal transition," contributes to malignant progression of various epithelial tumors. However, its involvement in human esophageal squamous cell carcinoma (ESCC) remains unclear. In order to investigate the expression pattern of ZEB1 in ESCC tissues and evaluate its associations with tumor progression and patients' prognosis, 100 pairs of formalin-fixed and paraffin-embedded cancerous and adjacent noncancerous tissues from patients with ESCC were used to detect the expression pattern of ZEB1 by immunohistochemistry. Then, the association between ZEB1 expression, clinicopathological parameters, and prognosis of ESCC was examined. We also performed migration and invasion assays of small interfering RNA (siRNA)-targeted ZEB1-transfected cells in vitro. As a result, expression level of ZEB1 was significantly higher in ESCC tissues compared to that in adjacent noncancerous tissues (P < 0.001). High expression of ZEB1 was observed in 55.00 % (55/100) of ESCCs. In addition, high ZEB1 expression was found to be closely correlated with advanced tumor stage (P = 0.001), positive lymph node metastasis (P = 0.001), great tumor depth (P = 0.03), and high histologic grade (P = 0.008). Moreover, multivariate analysis showed that the status of ZEB1 expression was an independent predictor for overall survival in ESCC. Furthermore, knockdown of ZEB1 by transfection of siRNA-ZEB1 abrogated the migration and invasion of ESCC cells in vitro. Taken together, our data offer the convincing evidence that ZEB1 may play a crucial role in promoting aggressive ESCC progression. ZEB1 may serve as an effective prognostic marker and a potential target for therapeutic intervention of ESCC.

Pancreaticogastrostomy versus pancreaticojejunostomy.

BACKGROUND: It has long been debated whether pancreaticogastrostomy (PG) or pancreaticojejunostomy (PJ) is the better choice for reconstruction after pancreaticoduodenectomy. The purpose of this study is to evaluate the two techniques. METHODS: Randomized controlled trials (RCTs) comparing PG with PJ published from January 1995 to January 2014 were searched electronically using PubMed, Medline, and Cochrane Library. Published data of these RCTs were analyzed using either fixed-effects model or random-effects model. RESULTS: Seven RCTs were included in this meta-analysis, with a total of 1121 patients (562 in PG, 559 in PJ). The incidence of postoperative pancreatic fistula and intra-abdominal fluid collection were significantly lower in PG than in PJ (respectively: odds ratio = 0.53 [0.37, 0.74], P < 0.001; odds ratio = 0.48 [0.30, 0.76], P < 0.01), no significant difference could be found for delayed gastric emptying, hemorrhage, morbidity, reoperation rate, and mortality. CONCLUSIONS: The evidence from RCTs suggests that PG technique is associated with a lower rate of postoperative pancreatic fistula and intra-abdominal fluid collection than PJ.

Noxa inhibits oncogenesis through ZNF519 in gastric cancer and is suppressed by hsa-miR-200b-3p.

While Phorbol-12-myristate-13-acetate-induced protein 1 (Noxa/PMAIP1) assumes a pivotal role in numerous tumors, its clinical implications and underlying mechanisms of gastric cancer (GC) are yet enigmatic. In this investigation, our primary objective was to scrutinize the clinical relevance and potential mechanisms of Noxa in gastric cancer. Immunohistochemical analysis was conducted on tissue microarrays comprising samples from a meticulously characterized cohort of 84 gastric cancer patients, accompanied by follow-up data, to assess the expression of Noxa. Additionally, Noxa expression levels in gastric cancer clinical samples and cell lines were measured through quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot analysis. The effect of Noxa expression on the prognosis of patients with gastric cancer was evaluated using Kaplan-Meier survival. Further insight into the role of Noxa in driving gastric cancer progression was gained through an array of experimental techniques, including cell viability assays (CCK8), plate cloning assays, transwell assays, scratch assays, and real-time cell analysis (RTCA). Potential upstream microRNAs (miRNAs) that might modulate Noxa were identified through rigorous bioinformatics analysis, substantiated by luciferase reporter assays and Western blot experiments. Additionally, we utilized RNA sequencing, qRT-PCR, and Western blot to identify proteins binding to Noxa and potential downstream target. Finally, we utilized BALB/c nude mice to explore the role of Noxa in vivo. Our investigation unveiled a marked downregulation of Noxa expression in gastric cancer and underscored its significance as a pivotal prognostic factor influencing overall survival (OS). Noxa overexpression exerted a substantial inhibitory effect on the proliferation, migration and invasion of GC cells. Bioinformatic analysis and dual luciferase reporter assays unveiled the capacity of hsa-miR-200b-3p to interact with the 3'-UTR of Noxa mRNA, thereby orchestrating a downregulation of Noxa expression in vitro, consequently promoting tumor progression in GC. Our transcriptome analysis, coupled with mechanistic validation, elucidated a role for Noxa in modulating the expression of ZNF519 in the Mitophagy-animal pathway. The depletion of ZNF519 effectively reversed the oncogenic attributes induced by Noxa. Upregulation of Noxa expression suppressed the tumorigenesis of GC in vivo. The current investigation sheds light on the pivotal role of the hsa-miR-200b-3p/Noxa/ZNF519 axis in elucidating the pathogenesis of gastric cancer, offering a promising avenue for targeted therapeutic interventions in the management of this challenging malignancy.

Physiological evaluation and transcriptomic and proteomic analyses to reveal the anti-aging and reproduction-promoting mechanisms of glycitein in Caenorhabditis elegans.

Soy isoflavones from soy sauce residues have important biological activities. However, the anti-aging and reproduction-promoting effects of glycitein are still rarely reported. Here, we systematically evaluated and explored the anti-aging and reproduction-promoting effects of glycitein in Caenorhabditis elegans (C. elegans). Firstly, we analyzed the effects of glycitein on the lifespan under normal and heat stress, reproduction, locomotion, and reactive oxygen species (ROS) levels of C. elegans. The results showed that 100 µmol L-1 glycitein increased the anti-stress ability of nematodes and activated the antioxidant defense system. Secondly, transcriptomic and proteomic technologies were further used to explore in-depth the anti-aging and reproduction-promoting mechanisms of glycitein in C. elegans. The results showed that both differentially expressed proteins (DEPs) including PDE-2 and MSRA-1 and differentially expressed genes (DEGs) including skpo-2 and cytochrome P450 (cyp-35A3, cyp-35A5, cyp-35C1, cyp-35D1) were associated with the extension of the lifespan and the exertion of antioxidant capacity. VIT-1, plx-2, and Y73F8A.35 were related to promoting reproduction. ASP-1, DNJ-10, and abu-1 were related to the anti-stress ability of glycitein. Pathway analysis revealed that the longevity regulation pathway and FOXO signaling pathway were regulated by the changes in genes and proteins to improve the lifespan of the nematode. Moreover, hydrogenase regulation, longevity regulation, and lipid metabolism were regulated by the changes in genes and proteins to promote the reproduction of nematodes. This study not only demonstrates a viable strategy for utilizing soy sauce residues, but also provides a theoretical foundation and developmental insights for the future application of glycitein.

Correction: Physiological evaluation and transcriptomic and proteomic analyses to reveal the anti-aging and reproduction-promoting mechanisms of glycitein in Caenorhabditis elegans.

Correction for 'Physiological evaluation and transcriptomic and proteomic analyses to reveal the anti-aging and reproduction-promoting mechanisms of glycitein in Caenorhabditis elegans' by Jianping Lei et al., Food Funct., 2024, https://doi.org/10.1039/D4FO02271H.

Variation of sulfate reducing bacteria communities in ionic rare earth tailings and the potential of a single cadmium resistant strain in bioremediation.

Heap leaching ionic rare earth tailings might be prone to nourish sulfate reducing bacteria (SRB), but the SRB community in terrestrial ecosystems, such as tailings, has never been studied. This work was conducted to investigate the SRB communities in revegetated and bare tailings in Dingnan county, Jiangxi province, China, incorporating with indoor experiments to isolate SRB strain in bioremediation of Cd contamination. Significant increases in richness, accompanied by reductions in evenness and diversity, were found in the SRB community in revegetated tailings compared to bare tailings. At genus taxonomic level, two distinct dominant SRB were observed in samples from bare and revegetated tailings, with Desulfovibrio dominating in the former and Streptomyces dominating in the latter, respectively. A single SRB strain was screened out from the bare tailings (REO-01). The cell of REO-01 was rod-shaped and belonged to family Desulfuricans and genus Desulfovibrio. The Cd resistance of the strain was further examined, no changes in cell morphology were observed at 0.05 mM Cd, additionally, the atomic ratios of S, Cd, and Fe changed with the increase in Cd dosages, indicating FeS and CdS were produced simultaneously, XRD results further confirmed the production changed gradually from FeS to CdS with increasing Cd dosages from 0.05 to 0.2 mM. FT-IR analysis showed that functional groups containing amide, polysaccharide glycosidic linkage, hydroxyl, carboxy, methyl, phosphodiesters and sulfhydryl groups in extracellular polymeric substances (EPS) of REO-01 might have affinity with Cd. This study demonstrated the potential of a single SRB strain isolated from ionic rare earth tailings in bioremediation of Cd contamination.

The geochemical stability of typical arsenic-bearing sinter in the Tibetan plateau: Implications from quantitative mineralogy.

High­arsenic (As) sinter deposited from geothermal water is a potentially overlooked hazardous matrix and there remain substantial gaps in our comprehension of the stability of As sequestered within it. In this study, qualitative and quantitative analysis of the mineralogy of As-bearing sinter was conducted by Mineral Liberation Analyzer (MLA) in geothermal areas of the Tibetan Plateau to reveal the geochemical stability of As. Our results indicated that the contents of As in sinter were 3 orders of magnitude higher than the local soil. The dominant host minerals of As were calcite (40.9 %), thenardite (22.5 %), calcium silicate (13.0 %), and halite (8.1 %). Additionally, it was found that a relatively higher As bioavailability was extracted by ethylene diamine tetraacetic acid (EDTA), with a leaching rate of 41.2 %. Notably, the X-ray diffraction (XRD) showed that the thenardite and halite were decomposed after the leaching. The combination of mineralogy and geochemistry data suggested that calcite and calcium silicate were a crucial mechanism for As retention in sinter, while the dissolution of saline minerals (e.g., thenardite, halite, and calcium chloride) served as the primary sources for As release. This finding unveils the potential risks and mechanisms associated with high-As sinter, providing scientific guidance for risk management of sinter.

Denitrifying bacteria agent together with composite materials enhanced soil chemical properties and denitrifying functions in rare earth tailings: A field study.

The exploitation of ionic rare earth ore using ammonium sulfate extractant in China caused serious soil degradation and nitrogen compounds pollution in surrounding water. It was critical to improve soil properties and eliminate the nitrogen compounds and prevent their diffusion from the rare earth tailings. Here, we addressed this issue by conducting a field experiment for six months through four different treatments including control (CK), denitrifying bacteria agent mainly consisted of Bacillus (DBA), composite materials (CM) and denitrifying bacteria agent together with composite materials (DBA+CM). Besides, the treatments except CK were also amended with basic soil conditioners. DBA+CM could significantly increase soil pH from 5.01 to 6.84 (p ≤ 0.05). Cation exchange capacity in DBA+CM increased from below detection limit to 2.79 cmol+/kg. DBA+CM possessed the highest removal rate of soil NH4+ (95.14 %) and soil NO3- (66.46 %). Compared to CK, DBA+CM significantly increased the absolute abundance of nirS genes and relative abundance of denitrification, nitrate respiration, and nitrite respiration the most (p ≤ 0.05). Denitrification, nitrate respiration and nirS genes were negatively correlated with soil NO3- (p ≤ 0.05). This study demonstrates denitrifying bacteria agent together with composite materials can be a promising approach to control the pollution of nitrogen compounds in ionic rare earth tailings.

The nutritional and functional properties of 1-oleoyl-2-palmitoyl-3-linoleoylglycerol-rich oil: promoting early-life growth and intestinal health with alterations in the intestinal microbiota of Micropterus salmoides.

1-Oleoyl-2-palmitoyl-3-linoleoylglycerol (OPL), a key structural lipid in the breast milk fat, plays a critical role in providing nutrients and energy for infants. OPL is more abundant in Chinese breast milk fat and might be better for Chinese infants' growth. However, few studies have investigated the effect of OPL on the growth and intestinal health of the organism in early life. OPL-rich oil with 45.77% OPL was prepared by immobilized lipase-catalyzed synthesis and purification. The effects of OPL on the nutritional properties and the regulation of intestinal microbiota in early life were further investigated in vivo (Micropterus salmoides). Dietary OPL-rich oil significantly increased the juvenile fish weight gain rate, protein content, and muscular polyunsaturated fatty acids, which in turn markedly altered the muscle texture in springiness and cohesiveness. Dietary OPL-rich oil could also protect intestinal tissues by significantly increasing fish intestinal fold height, mucosal thickness, and intestinal wall thickness. Furthermore, dietary OPL-rich oil regulated intestinal microbiota. Particularly, OPL significantly increased the probiotics (Cetobacterium_sp014250685, Streptomyces_mutabilis, Saccharopolyspora_spinosa, and Nocardiopsis_kunsanensis) and reduced the potential pathogens (Staphylococcus_nepalensis, Salmonella_enterica, the Candidatus_berkiella). The structured OPL significantly promoted fish growth and improved nutritional composition due to its higher bioavailability relative to tripalmitate (PPP). Moreover, OPL significantly improved the growth, cholesterol metabolism, and intestinal health than the mixed oil (MO), which was attributed to the higher palmitic acid content in the sn-2 position. Overall, the structure of triacylglycerols and its distribution of fatty acids affected early growth and intestinal health, and OPL was more effective in the improvement of juvenile growth and intestinal health.

Bacterial community succession and the enrichment of antibiotic resistance genes on microplastics in an oyster farm.

Microplastics can be colonized by microorganisms and form plastisphere. However, knowledge of bacterial community succession and the enrichment of antibiotic resistance genes (ARGs) and pathogens on microplastics in aquaculture environments is limited. Here, we conducted a 30-day continuous exposure experiment at an oyster farm. Results showed that the alpha-diversity of communities on most microplastics continuously increased and was higher than in planktonic communities after 14 days. Microplastics could selectively enrich certain bacteria from water which can live a sessile lifestyle and promote colonization by other bacteria. The composition and function of plastisphere communities were distinct from those in the surrounding water and influenced by polymer type and exposure time. Microplastics can enrich ARGs (sul1, qnrS and blaTEM) and harbor potential pathogens (e.g., Pseudomonas aeruginosa). Therefore, microplastic pollution may pose a critical threat to aquaculture ecosystems and human health. Our study provides further insight into the ecological risks of microplastics.

Gut microbiota alterations in children and their relationship with primary immune thrombocytopenia.

Introduction: Gut microbiota reportedly play a critical role in some autoimmune diseases by maintaining immune homeostasis. Only a few studies have examined the correlation between gut microbiota and the onset of primary immune thrombocytopenia (ITP), especially in children. The purpose of this study was to investigate changes in the composition and diversity of the fecal microbiota of children with ITP, as well as the correlation between such microbiota and the onset of ITP. Methods: Twenty-five children newly diagnosed with ITP and 16 healthy volunteers (controls) were selected for the study. Fresh stool samples were collected to identify changes in the composition and diversity of gut microbiota as well as for potential correlation analysis. Results: In ITP patients, the phyla that were most frequently encountered were Firmicutes (54.3%), followed by Actinobacteria (19.79%), Bacteriodetes (16.06%), and Proteobacteria (8.75%). The phyla that were predominantly found in the controls were, Firmicutes (45.84%), Actinobacteria (40.15%), Bacteriodetes (3.42%), and Proteobacteria (10.23%). Compared with those of the controls, the proportions of Firmicutes and Bacteriodetes in the gut microbiota of ITP patients were increased while the proportions of Actinobacteria and Proteobacteria were decreased. Furthermore, gut microbiota in ITP patients varied by age group, showed specific changes in diversity, and were correlated with antiplatelet antibodies. IgG levels were significantly positively correlated with Bacteroides (P<0.01). Conclusions: The gut microbiota of children with ITP are imbalanced, as shown by the increase in Bacteroidetes, which was positively correlated with IgG. Thus gut microbiota may contribute to ITP pathogenesis via IgG. Clinical Trial Registration: The clinical trial were registered and approved by the Institutional Review Committee of The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University. Ethics number KY-2023-106-01.

Exploring the alteration of gut microbiota and brain function in gender-specific Parkinson's disease based on metagenomic sequencing.

Background: The role of the microbiota-gut-brain axis in Parkinson's disease (PD) has received increasing attention. Although gender differences are known to an essential role in the epidemiology and clinical course of PD, there are no studies on the sex specificity of the microbiota-gut-brain axis in the development and progression of PD. Methods: Fresh fecal samples from 24 PD patients (13 males, 11 females) were collected for metagenomic sequencing. The composition and function of the gut microbiota were analyzed by resting-state functional magnetic resonance imaging (fMRI). Gender-dependent differences in brain ALFF values and their correlation with microbiota were further analyzed. Results: The relative abundance of Propionivibrio, Thermosediminibacter, and Flavobacteriaceae_noname was increased in male PD patients. LEfse analysis showed that Verrucomicrobial, Akkermansiaceae, and Akkermansia were dominant in the males. In female patients, the relative abundance of Propionicicella was decreased and Escherichia, Escherichia_coli, and Lachnospiraceae were predominant. The expression of the sesquiterpenoid and triterpenoid biosynthesis pathways was increased in male PD patients and was statistically different from females. Compared to the Male PD patients, female patients showed decreased ALFF values in the left inferior parietal regions, and the relative abundance of Propionivibrio was positively correlated with the regional ALFF values. Conclusion: Our study provides novel clinical evidence of the gender-specific relationship between gut microbiota alterations and brain function in PD patients, highlighting the critical role of the microbiota-gut-brain axis in gender differences in PD.

Deep Learning-Based Ultrasound Combined with Gastroscope for the Diagnosis and Nursing of Upper Gastrointestinal Submucous Lesions.

The study focused on the diagnostic value of deep learning-based ultrasound combined with gastroscope examination for upper gastrointestinal submucous lesions and nursing. A total of 104 patients with upper gastrointestinal submucous lesions diagnosed in hospital were selected as the research subjects. In this study, the feed forward denoising convulsive neural network (DnCNN) was improved, and the n-DnCNN model was designed and applied to ultrasonic image processing. The peak signal-to-noise ratio (PSNR) and structural similarity (SSIM) of Gaussian filtering, NL-means, and DnCNN were then compared with n-DnCNN. Subsequently, the distribution and types of submucosal lesions in different parts of the upper digestive tract were analyzed by ultrasound combined with gastroscope and gastroscope examination alone, and the diagnostic performance of this method was evaluated. The results showed that the average PSNR and SSIM of the n-DnCNN model were 33.01 dB and 0.87, respectively, which were significantly higher than GF, NL-means, and DnCNN algorithms, and the difference was statistically significant (P < 0.05). Of the 116 lesions detected, 49 were located in the esophagus (42.24%), 52 in the stomach (44.83%), and 15 in the duodenum (12.93%). Of the 49 esophageal submucosal lesions, 6.12% were located in the upper esophagus, 55.1% in the middle esophagus, and 38.79% in the lower esophagus, and the difference was statistically significant (P < 0.05). Of the gastric submucosal lesions, the lesions in the gastric cardia were significantly less than in other parts, and the difference was statistically significant (P < 0.05). The accuracy of ultrasound combined with gastroscope in the diagnosis of upper gastrointestinal submucous episodes was 82.32%, higher than that of gastroscope examination, and the difference was statistically significant (P < 0.05). In conclusion, the n-DnCNN model has a good noise reduction effect, and the obtained image is of high quality. Ultrasound combined with gastroscope examination can effectively improve the accuracy of diagnosis of upper gastrointestinal submucous lesions.

Establishment of prognostic risk model and drug sensitivity based on prognostic related genes of esophageal cancer.

At present, the treatment of esophageal cancer (EC) is mainly surgical and drug treatment. However, due to drug resistance, these therapies can not effectively improve the prognosis of patients with the EC. Therefore, a multigene prognostic risk scoring system was constructed by bioinformatics analysis method to provide a theoretical basis for the prognosis and treatment decision of EC. The gene expression profiles and clinical data of esophageal cancer patients were gathered from the Cancer Genome Atlas TCGA database, and the differentially expressed genes (DEGs) were screened by R software. Genes with prognostic value were screened by Kaplan Meier analysis, followed by functional enrichment analysis. A cox regression model was used to construct the prognostic risk score model of DEGs. ROC curve and survival curve were utilized to evaluate the performance of the model. Univariate and multivariate Cox regression analysis was used to evaluate whether the model has an independent prognostic value. Network tool mirdip was used to find miRNAs that may regulate risk genes, and Cytoscape software was used to construct gene miRNA regulatory network. GSCA platform is used to analyze the relationship between gene expression and drug sensitivity. 41 DEGs related to prognosis were pre-liminarily screened by survival analysis. A prognostic risk scoring model composed of 8 DEGs (APOA2, COX6A2, CLCNKB, BHLHA15, HIST1H1E, FABP3, UBE2C and ERO1B) was built by Cox regression analysis. In this model, the prognosis of the high-risk score group was poor (P < 0.001). The ROC curve showed that (AUC = 0.862) the model had a good performance in predicting prognosis. In Cox regression analysis, the comprehensive risk score can be employed as an independent prognostic factor of the EC. HIST1H1E, UBE2C and ERO1B interacted with differentially expressed miRNAs. High expression of HIST1H1E was resistant to trametinib, selumetinib, RDEA119, docetaxel and 17-AAG, High expression of UBE2C was resistant to masitinib, and Low expression of ERO1B made the EC more sensitive to FK866. We constructed an EC risk score model composed of 8 DEGs and gene resistance analysis, which can provide reference for prognosis prediction, diagnosis and treatment of the EC patients.