Efficacy of real-time artificial intelligence-aid endoscopic ultrasonography diagnostic system in discriminating gastrointestinal stromal tumors and leiomyomas: a multicenter diagnostic study.

Background: Gastrointestinal stromal tumors (GISTs) represent the most prevalent type of subepithelial lesions (SELs) with malignant potential. Current imaging tools struggle to differentiate GISTs from leiomyomas. This study aimed to create and assess a real-time artificial intelligence (AI) system using endoscopic ultrasonography (EUS) images to differentiate between GISTs and leiomyomas. Methods: The AI system underwent development and evaluation using EUS images from 5 endoscopic centers in China between January 2020 and August 2023. EUS images of 1101 participants with SELs were retrospectively collected for AI system development. A cohort of 241 participants with SELs was recruited for external AI system evaluation. Another cohort of 59 participants with SELs was prospectively enrolled to assess the real-time clinical application of the AI system. The AI system's performance was compared to that of endoscopists. This study is registered with Chictr.org.cn, Number ChiCT2000035787. Findings: The AI system displayed an area under the curve (AUC) of 0.948 (95% CI: 0.921-0.969) for discriminating GISTs and leiomyomas. The AI system's accuracy (ACC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) reached 91.7% (95% CI 87.5%-94.6%), 90.3% (95% CI 83.4%-94.5%), 93.0% (95% CI 87.2%-96.3%), 91.9% (95% CI 85.3%-95.7%), and 91.5% (95% CI 85.5%-95.2%), respectively. Moreover, the AI system exhibited excellent performance in diagnosing ≤20 mm SELs (ACC 93.5%, 95% CI 0.900-0.969). In a prospective real-time clinical application trial, the AI system achieved an AUC of 0.865 (95% CI 0.764-0.966) and 0.864 (95% CI 0.762-0.966) for GISTs and leiomyomas diagnosis, respectively, markedly surpassing endoscopists [AUC 0.698 (95% CI 0.562-0.834) for GISTs and AUC 0.695 (95% CI 0.546-0.825) for leiomyomas]. Interpretation: We successfully developed a real-time AI-assisted EUS diagnostic system. The incorporation of the real-time AI system during EUS examinations can assist endoscopists in rapidly and accurately differentiating various types of SELs in clinical practice, facilitating improved diagnostic and therapeutic decision-making. Funding: Science and Technology Commission Foundation of Shanghai Municipality, Science and Technology Commission Foundation of the Xuhui District, the Interdisciplinary Program of Shanghai Jiao Tong University and the Research Funds of Shanghai Sixth people's Hospital.

A Hydrogel-coated Wood Membrane with Intelligent Oil Pollution Detection for Emulsion Separation.

Considering the potential threats posed by oily wastewater to the ecosystem, it is urgently in demand to develop efficient, eco-friendly, and intelligent oil/water separation materials to enhance the safety of the water environment. Herein, an intelligent hydrogel-coated wood (PPT/PPy@DW) membrane with self-healing, self-cleaning, and oil pollution detection performances is fabricated for the controllable separation of oil-in-water (O/W) emulsions and water-in-oil (W/O) emulsions. The PPT/PPy@DW is prepared by loading polypyrrole (PPy) particles on the delignified wood (DW) membranes, further modifying the hydrogel layer as an oil-repellent barrier. The layered porous structure and selective wettability endow PPT/PPy@DW with great separation performance for various O/W emulsions (≥98.69% for separation efficiency and ≈1000 L m-2 h-1 bar-1 for permeance). Notably, the oil pollution degree of PPT/PPy@DW can be monitored in real-time based on the changed voltage generated during O/W emulsion separation, and the oil-polluted PPT/PPy@DW can be self-cleaned by soaking in water to recover its separation performance. The high affinity of PPT/PPy@DW for water makes it effective in trapping water from the mixed surfactant-stabilized W/O emulsions. The prepared eco-friendly and low-cost multifunctional hydrogel wood membrane shows promising potential in on-demand oil/water separation and provides new ideas for the functional improvement of new biomass oil/water separation membrane materials.

ETS translocation variant 5 (ETV5) promotes CD4+ T cell-mediated intestinal inflammation and fibrosis in inflammatory bowel diseases.

E26 transformation-specific translocation variant 5 (ETV5) has been implicated in the pathogenesis of inflammatory bowel diseases (IBD). However, the exact roles of ETV5 in regulating CD4+ T cell-mediated intestinal inflammation and fibrosis formation remain unclear. Here, we reveal that ETV5 overexpression induced interleukin (IL)-9 and its transcription factor IRF4 expression in IBD CD4+ T cells under T helper type 9 (Th9) cells-polarizing conditions. The silencing of IRF4 inhibited ETV5-induced IL-9 expression. CD4+ T cell-specific ETV5 deletion ameliorated intestinal inflammation and fibrosis in trinitrobenzene sulfonic acid (TNBS)-induced experimental colitis and CD4+ T cell-transferred recombination-activating gene-1 knockout (Rag1-/-) colitis mice, characterized by less CD4+ T cell infiltration and lower fibroblast activation and collagen deposition in the colonic tissues. Furthermore, IL-9 treatment aggressive TNBS-induced intestinal fibrosis in CD4+ T cell-specific ETV5 deletion and wild-type control mice. In vitro, human intestinal fibroblasts cocultured with ETV5 overexpressed-Th9 cells expressed higher levels of collagen I and III, whereas an inclusion of anti-IL-9 antibody could reverse this effect. Ribonucleic acid sequencing analysis demonstrated that IL-9 upregulated TAF1 expression in human intestinal fibroblasts. Clinical data showed that number of α-smooth muscle actin+TAF1+ fibroblasts are higher in inflamed mucosa of patients with IBD. Importantly, TAF1 small interfering ribonucleic acid treatment suppressed IL-9-mediated profibrotic effect in vitro. These findings reveal that CD4+ T cell-derived ETV5 promotes intestinal inflammation and fibrosis through upregulating IL-9-mediated intestinal inflammatory and fibrotic response in IBD. Thus, the ETV5/IL-9 signal pathway in T cells might represent a novel therapeutic target for intestinal inflammation and fibrosis in IBD.

Joule Heating-Assisted Crude Oil Purification by a Poly(pyrrole)-Modified Microfibril Cellulose Membrane.

Using membrane materials to purify viscous watery oil from industrial production processes and accidental oil spills is of great importance but still challenging. Based on the excellent electrical conductivity and electric-thermal conversion of poly(pyrrole) (PPy), a hydrophobic PPy-modified micro-fibrillated cellulose membrane (P-CP) was successfully prepared. The size of the P-CP membrane can be customized to meet specific requirements. In this research, the membrane diameter is capable of reaching 24 cm. By applying a voltage ranging from 0 to 12 V, the surface temperature of the P-CP membrane can be elevated to roughly 120 °C. After 10 cycles of heating and cooling under 12 V voltage, the electric-thermal curves, surface hydrophobicity, and pore structure of P-CP membrane can remain stable, which suggests remarkable electric-thermal stability and reliability despite prolonged operation. The P-CP membrane shows good linearity between voltage and current (R2 = 0.997) and easy temperature control from room temperature to ∼120 °C at low supply voltage (0-12 V). Under the condition of 12 V power supply and self-gravity, the separation flux of the P-CP membrane for water-in-oil (W/O) emulsions (kerosene, diesel) is 2-3 times higher than that at room temperature, and the separation efficiency is also improved. Importantly, the P-CP membrane shows excellent separation performance for high viscosity water-in-crude oil emulsions, with a separation flux of 40 L m-2 h-1 by gravity. Compared to the situation without electricity, the separation flux of water-in-crude oil emulsion has increased four-fold. The joule heating of the P-CP membrane expands its service time and application scenarios, demonstrating its great application prospects in actual viscous oil-water emulsion separation.

Memory Th17 cell-mediated protection against lethal secondary pneumococcal pneumonia following influenza infection.

Streptococcus pneumoniae (Sp) frequently causes secondary pneumonia after influenza A virus (IAV) infection, leading to high morbidity and mortality worldwide. Concomitant pneumococcal and influenza vaccination improves protection against coinfection but does not always yield complete protection. Impaired innate and adaptive immune responses have been associated with attenuated bacterial clearance in influenza virus-infected hosts. In this study, we showed that preceding low-dose IAV infection caused persistent Sp infection and suppression of bacteria-specific T-helper type 17 (Th17) responses in mice. Prior Sp infection protected against subsequent IAV/Sp coinfection by improving bacterial clearance and rescuing bacteria-specific Th17 responses in the lungs. Furthermore, blockade of IL-17A by anti-IL-17A antibodies abrogated the protective effect of Sp preinfection. Importantly, memory Th17 responses induced by Sp preinfection overcame viral-driven Th17 inhibition and provided cross-protection against different Sp serotypes following coinfection with IAV. These results indicate that bacteria-specific Th17 memory cells play a key role in providing protection against IAV/Sp coinfection in a serotype-independent manner and suggest that a Th17-based vaccine would have excellent potential to mitigate disease caused by coinfection. IMPORTANCE Streptococcus pneumoniae (Sp) frequently causes secondary bacterial pneumonia after influenza A virus (IAV) infection, leading to increased morbidity and mortality worldwide. Current pneumococcal vaccines induce highly strain-specific antibody responses and provide limited protection against IAV/Sp coinfection. Th17 responses are broadly protective against Sp single infection, but whether the Th17 response, which is dramatically impaired by IAV infection in naïve mice, might be effective in immunization-induced protection against pneumonia caused by coinfection is not known. In this study, we have revealed that Sp-specific memory Th17 cells rescue IAV-driven inhibition and provide cross-protection against subsequent lethal coinfection with IAV and different Sp serotypes. These results indicate that a Th17-based vaccine would have excellent potential to mitigate disease caused by IAV/Sp coinfection.

The Wet Suction Technique Enhances the Diagnostic Efficacy and Aspirate Quality of EUS-FNA for Solid Lesions: A Multicenter Retrospective Study in China.

GOALS: To comprehensively compare the wet suction technique with the conventional dry suction technique for endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in solid lesions. BACKGROUND: Optimal suction techniques for EUS-FNA remain uncertain when approaching solid lesions. STUDY: We performed a retrospective study of EUS-FNA at 3 medical centers in China. A total of 203 patients were enrolled who received 2 passes of EUS-FNA with 22-G needles. If the first pass underwent dry suction, the second pass was wet suction. Otherwise, the order of suction technique is opposite. Diagnostic accuracy, sample quality (including cellularity and blood contamination), and sample quantity (including specimen adequacy, the maximum intact specimen length, and the total specimen length) were compared between wet-suction and dry-suction techniques. RESULTS: The patients included 143 pancreatic lesions and 60 nonpancreatic lesions. Compared with the dry suction technique, the wet suction technique yielded a significantly higher diagnostic accuracy (85.22% vs. 72.41%, P =0.002), better specimen adequacy score and cellularity score ( P <0.0001), and lower blood contamination score ( P <0.0001). In the subgroup analysis, wet suction provided significantly higher diagnostic accuracy in pancreatic cancer without chronic pancreatitis ( P <0.05), and better cellularity score and specimen adequacy score, lower blood contamination score, and longer maximum intact specimen length and total specimen length in various lesions than that in dry suction. CONCLUSIONS: The wet suction technique resulted in significantly higher diagnostic accuracy in pancreatic cancer without chronic pancreatitis, and better cellularity and histologic specimen in most of solid lesions.

The early stage of COVID-19 pandemic: Gastrointestinal manifestations and liver injury in COVID-19 patients in Wuhan, China.

There are few and inconsistent data focusing on gastrointestinal (GI) manifestations and liver injury in China's early stage of COVID-19 pandemic. In this study, we research the prevalence and role of GI symptoms and liver injury in COVID-19 patients in Wuhan during the disease's first outbreak. We conducted a cross-sectional observational study in a non-ICU unit in Wuhan, China. COVID-19 patients were consecutively admitted from 23 February 2020 to 5 April 2020. Demographic and clinical data were retrieved and analyzed throughout the disease course. A total of 93 patients were enrolled, including 45.2% moderate, 54.8% severe, and 2.2% critical type patients. 69.9% of patients had at least one GI symptom; if excluding hyporexia/anorexia, 49.5% of patients showed at least one GI symptom. The incidence rate of hyporexia/anorexia, diarrhea, nausea/vomiting, abdominal discomfort/pain, and elevated liver enzymes were 67.7, 29.0, 28.0, 21.5, and 23.7%, respectively. Patients with GI symptoms or elevated liver enzymes have a higher risk of severe type disease than patients without GI symptoms or elevated liver enzymes (67.7 vs. 25.0%, p < 0.001; 77.3 vs. 47.9%, p = 0.016, respectively), and experienced longer disease duration. In multivariate analysis, hyporexia/anorexia was confirmed as an independent predictive factor of severe type disease (odds ratio: 5.912; 95% confidence interval: 2.247-15.559; p < 0.001). In conclusion, in the early stage of the COVID-19 pandemic, GI symptoms and elevated liver enzymes are common throughout the disease course, and associated with severer disease and longer disease duration.

Periostin deficiency reduces diethylnitrosamine-induced liver cancer in mice by decreasing hepatic stellate cell activation and cancer cell proliferation.

Periostin is a critical extracellular regulator in the pathogenesis of liver disorders such as hepatosteatosis, non-alcoholic steatohepatitis, inflammation, and fibrosis. Periostin is also involved in the progression of hepatocellular carcinoma (HCC). However, the molecular mechanisms of periostin in hepatic stellate cell (HSC) activation and tumor cell proliferation in the pathogenesis of HCC remain largely unknown. We demonstrate that periostin is markedly upregulated in diethylnitrosamine (DEN)-induced mouse HCC tissues and that periostin knockout impairs DEN-induced HCC development. Periostin is predominantly derived from activated HSCs and periostin deficiency in HSCs impairs HSC activation and inhibits HSC-promoted HCC cell proliferation in vitro and tumor growth in vivo. Mechanistically, periostin promotes HSC activation through the integrin-FAK-STAT3-periostin pathway and augments HCC cell proliferation by activating ERK. There are positive correlations between periostin and HSC activation and cell proliferation in HCC clinical samples. Collectively, our findings demonstrate that HSC-derived periostin promotes HCC development by enhancing HSC activation through an autocrine periostin-integrin-FAK-STAT3-periostin circuit and by augmenting HCC cell proliferation via the ERK pathway in a paracrine manner. Thus, periostin is a multifaceted extracellular regulator in the development of HCC. © 2021 The Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Efficient removal of various coexisting organic pollutants in water based on ß-cyclodextrin polymer modified flower-like Fe3O4 particles.

HYPOTHESIS: The construction of porous ß-cyclodextrin polymer (ß-CDP) modified flower-like Fe3O4 particles (CDP@Fe3O4) is expected to remove various organic pollutants from water, based on the larger specific surface area of flower-like Fe3O4 particles and the active sites provided by ß-CDP. With the help of various noncovalent interactions, the removal ability of CDP@Fe3O4 for various water-soluble and water-insoluble organic pollutants were systematically studied. EXPERIMENTS: CDP@Fe3O4 were successfully synthesized and applied for the simultaneous removal of various organic pollutants with different electrical properties, structure and hydrophobicity. Adsorption efficiency, adsorption process, adsorption mechanism and the reusability of CDP@Fe3O4 for single pollutant and mixed pollutants were comprehensively investigated. FINDINGS: CDP@Fe3O4 exhibited excellent adsorption capabilities for various pollutants. Importantly, when these pollutants were coexisting, CDP@Fe3O4 still maintained a comparable removal ability for various pollutants. Efficient removal of organic pollutants was attributed to varieties of noncovalent interactions between organic pollutants and CDP@Fe3O4, including hydrophobic interactions, hydrogen bonds, π-π and electrostatic interactions. These results revealed that the excellent adsorption ability and convenient regeneration make CDP@Fe3O4 being a potential candidate in various complex organic wastewater purification.

Periostin Promotes Colorectal Tumorigenesis through Integrin-FAK-Src Pathway-Mediated YAP/TAZ Activation.

Periostin is a multifunctional extracellular matrix protein involved in various inflammatory diseases and tumor metastasis; however, evidence regarding whether and how periostin actively contributes to inflammation-associated tumorigenesis remains elusive. Here, we demonstrate that periostin deficiency significantly inhibits the occurrence of colorectal cancer in azoxymethane/dextran sulfate sodium-treated mice and in ApcMin/+ mice. Moreover, periostin deficiency attenuates the severity of colitis and reduces the proliferation of tumor cells. Mechanistically, stromal fibroblast-derived periostin activates FAK-Src kinases through integrin-mediated outside-in signaling, which results in the activation of YAP/TAZ and, subsequently, IL-6 expression in tumor cells. Conversely, IL-6 induces periostin expression in fibroblasts by activating STAT3, which ultimately facilitates colorectal tumor development. These findings provide the evidence that periostin promotes colorectal tumorigenesis, and identify periostin- and IL-6-mediated tumor-stroma interaction as a promising target for treating colitis-associated colorectal cancer.

Dual-functional Ag3PO4@palygorskite composite for efficient photodegradation of alkane by in situ forming Pickering emulsion photocatalytic system.

Removal of oil from water is highly imperative, because of the worldwide oil-contaminated water caused by industrial development and oil spill accidents. As a solution to meet the demand for clean energy technology, photocatalysis has drawn great attention recently. However, a major problem encountered in photodegrading oil is the difficult availability of oil by photocatalyst. To overcome this problem, a novel concept of integrating Pickering emulsification of palygorskite (PAL) clay particles with photocatalytic activity of Ag3PO4 is proposed in this work. By a simple co-precipitation method, Ag3PO4@PAL composite was prepared and used for the simultaneous emulsification and decomposition of tetradecane. Via a simple Pickering emulsion-based photocatalytic system, Ag3PO4 could contact with tetradecane directly, which effectively overcomes the agglomeration and settlement of Ag3PO4 in aqueous phase. This in situ photocatalytic system shows a higher efficiency for photodegradation of tetradecane, comparing with traditional solution-dispersed photocatalytic system. Under visible-light irradiation, the removal efficiency of tetradecane is 4.9 times higher than Ag3PO4 alone. Direct contact of Ag3PO4 with oil pollutes and sufficiently large active surface area greatly improve the efficiency of photodegrading oil. This study provides a new and simple strategy for oil photodegradation via an in situ Pickering emulsion system.

Insights into the effect of different levels of crude oil on hydrolyzed polyacrylamide biotransformation in aerobic and anoxic biosystems: Bioresource production, enzymatic activity, and microbial function.

The differences of crude oil recovery ratio resulted in different levels of crude oil in actual hydrolyzed polyacrylamide (HPAM)-containing wastewater. The effect of crude oil on HPAM biotransformation was explored from bioresource production, enzymatic activity and microbial function. In aerobic biosystems, the highest polyhydroxyalkanoate (PHA) yield (19.6%-40.2%) and dehydrogenase (DH) activity (4.06-8.32 mg·g-1 VSS) occurred in the 48th hour, and increased with crude oil concentration (0-400 mg·L-1). In anoxic biosystems, the highest PHA yield (24.5%-50.5%) and DH activity (3.24-6.69 mg·g-1 VSS) occurred in the 72nd hour, and increased with crude oil concentration. The higher substrate removal (38.5%-65.7%) occurred in aerobic biosystems, while the higher PHA accumulation occurred in anoxic biosystems. PHA yield, DH activity and HPAM removal were related. Microbial function related to HPAM biodegradation and PHA synthesis was discussed. The main function of Pseudomonas and Bacillus in aerobic biosystems was to degrade HPAM, and in anoxic biosystems was to synthesize PHA.

Prior Appendectomy and the Onset and Course of Crohn's Disease in Chinese Patients.

BACKGROUND AND AIM: The relationship between prior appendectomy and Crohn's disease (CD) has previously revealed conflicting findings. The present study investigates the relationship between prior appendectomy and CD development in Chinese patients. METHODS: A retrospective case-control study was performed to compare prior appendectomy rate between CD patients and age- and gender-matched controls at two Chinese hospitals. The clinical course of CD was determined in patients who underwent and did not undergo appendectomies before CD diagnosis. RESULTS: A total of 617 CD patients and 617 controls were included. The appendectomy rate before CD diagnosis in patients was higher, when compared to controls (6.65% versus 3.73%, P = 0.033). Appendectomy was a risk factor for the onset of CD independent of smoking in the multivariate analysis (OR: 1.878; 95% CI: 1.111-3.174; P = 0.019). Appendectomies were performed closer to the date of CD diagnosis in the trend test (P = 0.039). The rate of appendectomy within one year or 1-5 years before CD diagnosis was higher in patients when compared to that in controls (0.97% versus 0%, P = 0.031; 1.13% versus 0.32%, P = 0.180). However, the rate of appendectomy over five years before CD diagnosis was close to controls (4.54% versus 3.40%, P = 0.392). No significant differences in disease location, behavior, medication, and intestinal resection between appendectomy and nonappendectomy CD patients were found, even in the subgroup analysis by age of appendectomy. CONCLUSION: Prior appendectomy is a risk factor for the onset of CD. However, the appendectomy rate only increased for a short duration before CD diagnosis, likely reflecting a diagnostic bias. Prior appendectomy did not influence the features or course of CD.

Amphiphilic Janus particles for efficient dispersion of oil contaminants in seawater.

Application of dispersants is one of the widely used oil spill response strategies. With the growing concern for particulate emulsifiers, applying amphiphilic Janus particles to emulsify oil in seawater has been examined in this paper. Amphiphilic Janus particles with a combination of colloidal particles and amphiphilic characteristic are found to show a highly effective emulsification for various oils in seawater and overcome several drawbacks of conventional chemical dispersants. We report the synthesis of amphiphilic Janus silica particles (JSPs) as a novel oil spill dispersant and confirm their amphiphilicity by various techniques. The oil-in-seawater emulsion stabilized by JSPs presents small and stable oil droplets in one month, even at a higher volume ratio of oil to seawater and a wide temperature range. It is believed that the small size and high stability of droplets are very important to oil dispersion and eventual biodegradation. Through confocal laser scanning microscopy and scanning electron microscope observations, JSPs were found to anchor tightly at droplet surface and form a dense interfacial particle film to prevent droplets coalescence. The appropriate wettability of JSPs and the reduced interfacial tension contribute to the high interfacial adsorption energy of JSPs. Additionally, JSPs show weak inhibitory effect on oil-degrading bacteria, which is confirmed by bacterial growth curve, resazurin test and oil biodegradation experiment. This study reveals that amphiphilic Janus silica particles hold an impressive capability for environmentally friendly treatment of oil spills.

Biosurfactant-modified palygorskite clay as solid-stabilizers for effective oil spill dispersion.

An effective and conventional remediation technique in marine oil spills is to apply chemical dispersants to emulsify oil slicks into small oil droplets. Still, the potential hazards of chemical dispersants onto the marine ecosystem have motivated the research for environmentally friendly alternative while keeping exceptional dispersion ability. Here, we showed that the mixture of palygorskite (PAL) and rhamnolipid (Rha) formed a biocompatible alternative to synthetic surfactants used for oil spill dispersion. The oil droplets dispersed by R-PAL presented a small average size and long-term stability, which illustrated the synergistic interactions between Rha and PAL acting as an efficient dispersant in artificial sea water (ASW). Due to the strong flocculation caused by high salinity, PAL alone was not effective emulsifiers in ASW. A small amount of Rha could played a major role in modifying the surface characteristics of PAL and decreasing oil-water interfacial tension. Therefore, PAL particles irreversibly adsorbed onto the oil-ASW interface and formed a rigid interfacial film around oil droplets in the presence of Rha, which offered an efficient barrier to droplet coalescence. The synergistic interactions between PAL and Rha could enable the dispersion of tetradecane in ASW. Such a functionality was further tested in dispersing crude oil in ASW. The study presents a new strategy of using a mixture of PAL and Rha for oil dispersion, thus providing an ecofriendly alternative to conventional dispersants.

Effects of Appendectomy on the Onset and Course of Ulcerative Colitis in Chinese Patients.

BACKGROUND: Previous epidemiological studies have suggested that appendectomy may be a protective factor against the development of ulcerative colitis (UC). However, the results of these studies were inconsistent, with rare studies in Chinese populations. AIM: This study examined the associations between appendectomy performed before UC diagnosis and the occurrence and clinical course of UC in Chinese patients. METHODS: A case control study was conducted to compare the rate of appendectomy between UC patients and controls matched for age and sex at two Chinese hospitals. Clinical course of UC was compared between UC patients who underwent appendectomies before UC diagnosis and who did not. RESULTS: 402 UC patients and 402 controls were included. The percentage of appendectomy performed before UC diagnosis in UC patients did not differ significantly from controls (2.74% vs 3.98%, P = 0.442). Subgroup analysis on the basis of localization of UC patients did not find significant difference from controls. The extent of disease involvement in UC patients who underwent appendectomy was smaller than patients who did not (P = 0.009). Appendectomy was found to be significantly related to the location of the disease independent of smoking status in multivariate analysis (P < 0.001). Appendectomy did not influence severity of disease and need for immunosuppressive treatment or colectomy. CONCLUSION: We did not find a significant negative association between appendectomy and the UC occurrence in Chinese patients. Appendectomy performed before UC diagnosis may reduce the extent of UC involvement.

Prevalence of hepatitis B and C and factors for infection and nonimmune in inflammatory bowel disease patients in China.

OBJECTIVE: The aims of this study were to investigate the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in inflammatory bowel disease (IBD) patients and the risk factors related to the infection and nonimmune status. METHODS: A retrospective study was carried out at two clinical centers. The prevalence of viral markers and risk factors related to HBV and HCV infection and nonimmune status were analyzed in IBD patients. Age-matched and sex-matched healthy individuals were recruited as the controls. RESULTS: A total of 980 IBD patients were included in this study. Present and past HBV infection was detected in 41.21% of the IBD group, which was higher than that in the general population (P=0.003). Age older than 30 years (P=0.000), ulcerative colitis (P=0.002), and previous surgery (P=0.039) were found to be significant risk factors for HBV infection in the multivariate analysis. 36.43% of the patients in the IBD group had nonimmune status against HBV, and age less than 40 years (P=0.011) and Crohn's disease (P=0.002) were identified as independent risk factors in the multivariate analysis. The prevalence of HCV infection was low and similar to that of the general population. CONCLUSION: The prevalence of HBV infection in IBD patients in China was higher than that in Europe, USA, and the general population in China, but the prevalence of HCV infection in IBD patients was similar to that in the general population in this study. The frequency of nonimmune status against HBV was high, especially in young Crohn's disease patients, and HBV vaccination should be intensified and have a targeted coverage.

Novel Silicone-Coated 125I Seeds for the Treatment of Extrahepatic Cholangiocarcinoma.

125I seeds coated with titanium are considered a safe and effective interstitial brachytherapy for tumors, while the cost of 125I seeds is a major problem for the patients implanting lots of seeds. The aim of this paper was to develop a novel silicone coating for 125I seeds with a lower cost. In order to show the radionuclide utilization ratio, the silicone was coated onto the seeds using the electro-spinning method and the radioactivity was evaluated, then the anti-tumor efficacy of silicone 125I seeds was compared with titanium 125I seeds. The seeds were divided into four groups: A (control), B (pure silicone), C (silicone 125I), D (titanium 125I) at 2 Gy or 4 Gy. Their anti-tumour activity and mechanism were assessed in vitro and in vivo using a human extrahepatic cholangiocarcinoma cell line FRH-0201 and tumor-bearing BALB/c nude mice. The silicone 125I seeds showed higher radioactivity; the rate of cell apoptosis in vitro and the histopathology in vivo demonstrated that the silicone 125I seeds shared similar anti-tumor efficacy with the titanium 125I seeds for the treatment of extrahepatic cholangiocarcinoma, while they have a much lower cost.

miR-139 and miR-200c regulate pancreatic cancer endothelial cell migration and angiogenesis.

Pancreatic cancer remains the fourth deathliest cancer worldwide with a 5-year survival rate of only 4%. The present study tested the hypothesis that dysregulated microRNA (miRNA) expression by pancreatic cancer endothelial cells (CECs) may regulate angiogenesis. Primary EC cultures were established from the pancreatic tumor and adjacent normal tissues of three pancreatic cancer patients. A miRNA microarray was used to identify miRNAs that were differentially expressed. The expression patterns of four highly expressed miRNAs in CECs were confirmed by qPCR analysis. The effects of dysregulated miRNA expression on CEC proliferation, migration and tube formation were determined after transfection with specific miRNA inhibitors. The expression of 14 miRNAs was increased by >20-fold in the the CECs of all three pancreatic patients; the increased expression of miR-200c and miR-139 in CECs was confirmed. miR-1, mir-139 and miR-200c inhibitors significantly reduced CEC migration (all P<0.05), yet not proliferation. The average tube length and total loop number were also significantly decreased upon miR-139 and miR-200c inhibition in all three CEC cultures (all P<0.05). Upregulation of miR-139 and miR-200c expression may increase CEC migration and tube formation, which suggests that these miRNAs may regulate pancreatic tumor angiogenesis.