Artificial Intelligence-Assisted Colonoscopy for Colorectal Cancer Screening: A Multicenter Randomized Controlled Trial.

BACKGROUND AND AIMS: Artificial intelligence (AI)-assisted colonoscopy improves polyp detection and characterization in colonoscopy. However, data from large-scale multicenter randomized controlled trials (RCT) in an asymptomatic population are lacking. METHODS: This multicenter RCT aimed to compare AI-assisted colonoscopy with conventional colonoscopy for adenoma detection in an asymptomatic population. Asymptomatic subjects 45-75 years of age undergoing colorectal cancer screening by direct colonoscopy or fecal immunochemical test were recruited in 6 referral centers in Hong Kong, Jilin, Inner Mongolia, Xiamen, and Beijing. In the AI-assisted colonoscopy, an AI polyp detection system (Eagle-Eye) with real-time notification on the same monitor of the endoscopy system was used. The primary outcome was overall adenoma detection rate (ADR). Secondary outcomes were mean number of adenomas per colonoscopy, ADR according to endoscopist's experience, and colonoscopy withdrawal time. This study received Institutional Review Board approval (CRE-2019.393). RESULTS: From November 2019 to August 2021, 3059 subjects were randomized to AI-assisted colonoscopy (n = 1519) and conventional colonoscopy (n = 1540). Baseline characteristics and bowel preparation quality between the 2 groups were similar. The overall ADR (39.9% vs 32.4%; P < .001), advanced ADR (6.6% vs 4.9%; P = .041), ADR of expert (42.3% vs 32.8%; P < .001) and nonexpert endoscopists (37.5% vs 32.1%; P = .023), and adenomas per colonoscopy (0.59 ± 0.97 vs 0.45 ± 0.81; P < .001) were all significantly higher in the AI-assisted colonoscopy. The median withdrawal time (8.3 minutes vs 7.8 minutes; P = .004) was slightly longer in the AI-assisted colonoscopy group. CONCLUSIONS: In this multicenter RCT in asymptomatic patients, AI-assisted colonoscopy improved overall ADR, advanced ADR, and ADR of both expert and nonexpert attending endoscopists. (ClinicalTrials.gov, Number: NCT04422548).

Association between CASC16 rs4784227 polymorphism and breast cancer susceptibility: A meta-analysis.

OBJECTIVE: To explore whether rs4784227 polymorphism of CASC16 is correlated with risk of breast cancer. METHODS: Relevant studies up to December 24, 2020 were searched in PubMed, Embase, Web of Science, CNKI, VIP, and WANFANG databases. Data were analyzed by using Stata 12.0. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated, and country-based subgroup analyses were conducted. Sensitivity analysis was conducted to assess the stability of the results. Publication bias was assessed by using the Egger regression asymmetry test and visualization of funnel plots. RESULTS: Seven case-control studies enrolling 4055 breast cancer cases and 4229 controls were included. rs4784227 was found significantly associated with increased risk of breast cancer in a dominant (OR = 1.301, 95% CI = 1.190-1.423, P < .001), a recessive (OR = 1.431, 95% CI = 1.216-1.685, P < .001), and an allele model (OR = 1.257, 95% CI = 1.172-1.348, P < .001), while an over-dominant model showed that rs4784227 was correlated with decreased breast cancer risk (OR = 0.852, 95% CI = 0.778-0.933, P = .001). CONCLUSION: The rs4784227 polymorphism of CASC16 gene is correlated with breast cancer susceptibility.

RNF135 Promoter Methylation Is Associated With Immune Infiltration and Prognosis in Hepatocellular Carcinoma.

RING finger protein 135 has an important role in the occurrence of many cancers; however its regulation and function of RNF135 in hepatocellular carcinoma remains unknown. The promoter methylation status and mRNA expression of RNF135 was evaluated by methylation-specific PCR, semi-quantitative RT-PCR, and real-time quantitative PCR in HCC tissues and cell lines, and further analyzed from The Cancer Genome Atlas database. Wound healing assay, transwell migration, cell viability, and colony formation assay were performed to investigate the function of RNF135. GSEA analysis, TIMER database, and ESTIMATE algorithm were used to decipher the associated pathway and immune infiltration. The survival analysis was applied to assess the prognostic value of RNF135. RNF135 expression was downregulated in HCC tissues and 5 of 8 HCC cell lines, and was negatively correlated with its promoter hypermethylation. Demethylating regent decitabine restored RNF135 expression on the cellular level. Knockdown of RNF135 expression enhanced the migration of HCC cells, while RNF135 overexpression and decitabine treatment repressed cell migration. Bioinformatics analysis and immunohistochemistry revealed a positive relationship between RNF135 expression and six immune cell infiltrates (B cells, CD4+ T cells, CD8+ T cells, neutrophils, macrophages, and dendritic cells). Survival analysis disclosed that RNF135 hypermethylation is independently associated with poor clinical outcomes in HCC. Decreased RNF135 expression driven by promoter hypermethylation frequently occurred in HCC and associated with prognosis of HCC. RNF135 functions as a tumor suppressor and is involved in tumor immune microenvironment in HCC.

Dihydrochalcones from the leaves of Lithocarpus litseifolius.

Three new phlorizin derivatives, 6"-O-vanilloylphlorizin (1), 6"-O-(4-hydroxybenzoyl)phlorizin (2), 6"-O-feruloylphlorizin (3), along with four known dihydrochalcones, phlorizin (4), 3-hydroxyphlorizin, trilobatin, and 6"-O-acetylphlorizin were isolated from the leaves of Lithocarpus litseifolius. Their structures were established by analysis of extensive spectroscopic data. The new compounds were shown to be non-cytotoxic when tested against A549, HeLa, HepG2, and MCF-7 cell lines.

Analysis of volumetric mass transfer coefficient (k L a) in small- (250 mL) to large-scale (2500 L) orbitally shaken bioreactors.

In this study, the combination of dimensional analysis (DA) and analysis of variance (ANOVA) was used to predict the volumetric mass transfer coefficient (k L a) values under different operating conditions for orbitally shaken bioreactors (OSRs) with different filling volumes. It was found that Reynolds number and the interaction between Froude number and geometric number have the largest impact on k L a with impact indexes of 7.41 and 7.50, respectively. Moreover, the volume number has the largest negative impact on k L a, with an impact index of - 5.34. Thus, an effective way to increase the oxygen supply is by increasing the shaking speed and shaking diameter or decreasing the vessel diameter. However, cell cultivation with a higher filling volume will have an increased risk of oxygen scarcity. Therefore, with the help of the k L a prediction model, a suitable operating condition can be determined effectively and easily.

Fabrication of Micro Ultrasonic Powder Molding Polypropylene Part with Hydrophobic Patterned Surface.

Constructing regular micro-structures with certain geometric characteristics on the surface of the polymer part can obtain some specific functions. Micro ultrasonic powder molding (micro-UPM) is an efficient processing technique for the fabrication of well-filled micro-structured Polypropylene (PP) parts. The micro-structure array on the surface of the core insert was obtained by low speed wire electrical discharge machining (WEDM-LS). PP polymer surfaces with micro-structured patterns were successfully replicated from the core insert surface after micro-UPM. By studying the detailed topography characterizations of micro-structured PP parts, the effects of processing parameters (ultrasonic energy, welding pressure and holding time) on the micro-structured filling show that when PP polymer was formed under the conditions of 1000 J, 115 kPa and 8 s during micro-UPM, well-filled micro-structured parts can be obtained. Besides, without low surface energy coating modification, the water contact angles (WCAs) of micro-structured PP parts increased from 85.3° to 146.8°, indicating that the wettability of the surface can be changed by replicating the micro-structure on PP parts after micro-UPM.

Androgen Receptor Promotes Gastric Carcinogenesis via Upregulating Cell Cycle-Related Kinase Expression.

Gastric cancer (GC) is a leading global health problem as it is the fifth most common cancer type and the third most common cause of cancer-related deaths worldwide. In most areas of the world, the incidence rate of GC is 1.5- to 3-fold higher in males than in females. The androgen receptor (AR) is an independent adverse prognostic factor in patients with GC. However, the mechanism by which AR regulates the progression of GC remains unclear. In this study, we found that AR expression was upregulated in 6/8 GC cell lines, and this expression was higher than that in immortalized gastric cells. AR expression was also higher in GC tissues than in adjacent tissues. Moreover, the ectopic expression of AR promoted the colony formation ability, migration and invasion of GC cells. In contrast, AR knockdown had the opposite effects on GC cell lines. Remarkably, we found that AR regulated cell cycle-related kinase (CCRK) expression through transcriptional mechanisms. The AR-CCRK axis promoted GC development through the phosphorylation of GSK3ß and ß-catenin. Furthermore, TCGA data revealed that high expression of AR or CCRK was related to poor prognosis in GC patients. The prognosis was significantly worse in patients with concurrent high AR and CCRK expression than in patients with low AR and CCRK expression. In conclusion, our study demonstrated that AR and CCRK acted as oncogenes in GC progression. However, their clinical roles require further exploration.

Effect of Yinxieling decoction on PASI, TNF-α and IL-8 in patients with psoriasis vulgaris.

OBJECTIVE: To study the effect of Yinxieling decoction on PASI, TNF-α and IL-8 in patients with psoriasis vulgaris. METHODS: A total of 120 cases of psoriasis vulgaris were divided into 4 groups according to syndrome differentiation of TCM and randomized controlled method: wind heat syndrome group (group A), blood stasis syndrome group (group B), blood dryness syndrome group (group C) and control group (group D) (n=30 per group). Patients in observation groups were treated with Yinxieling decoction, while patients in control group were treated by placebo for 8 weeks. Levels of TNF-α and IL-8 were determined before treatment, 4 and 8 weeks after treatment. psoriasis area and severity index score was also performed before and after treatment. RESULTS: psoriasis area and severity index score and serum level of TNF-α, IL-8 were significantly decreased in all groups. The decrease in three observation groups was more significant (P<0.05 or P<0.01), and the decrease in wind heat syndrome group was the most significant (P<0.01). psoriasis area and severity index was positively correlated with TNF-α and IL-8, respectively (P<0.05). CONCLUSIONS: Yinxieling decoction has therapeutical effect on psoriasis vulgaris via regulating TNF-α and IL-8.

Relationship between high density of peritumoral lymphatic vessels and biological behavior of cervical cancer.

OBJECTIVE: To investigate the relationship between lymphangiogenesis and lymphatic metastasis in cervical squamous carcinoma. METHODS: Eighty cases of invasive cervical squamous cancer were selected as objects of our study. Double immunohistochemical staining with antibodies against lymphatic vessel endothelial hyaluronan receptor 1 and Ki-67 was used to label the lymphatic vessels and mark the proliferative lymphatic vessels in cervical squamous cancer. The peritumoral lymphatic vessel density and intratumoral lymphatic vessel density was assessed. The lymphatic vessels proliferation index was evaluated by calculating Ki-67 proliferation index (PI) to reflect the lymphangiogenesis of cervical squamous cancer. Then the correlation between lymphangiogenesis and clinicopathologic features of cervical squamous cancer was analyzed. RESULTS: The LVD of cervical cancer (15.23 ± 3.6) was clearly higher than that of the adjacent normal cervical subepithelial tissues (9.9 ± 2.5, P < 0.001). The peritumoral lymphatic vessel density of cervical cancer (18.75 ± 4.3) was significantly higher than the intratumoral lymphatic vessel density of cervical cancer (11.71 ± 4.9, P < 0.001). Lymphatic PI (LPI) of cervical cancer (0.258 ± 0.07) was higher than that of the adjacent normal cervical subepithelial tissues (0.068 ± 0.08, P < 0.001). The peritumoral lymphatic vessel PI of cervical cancer (0.324 ± 0.06) was notably higher than the intratumoral lymphatic vessel PI of cervical cancer (0.232 ± 0.06, P < 0.001). Peritumoral lymphatic vessel density and peritumoral lymphatic vessel were clearly associated with the lymph node metastasis (P = 0.001 and P = 0.002, respectively) and lymphovascular space invasion (P = 0.024 and P = 0.01, respectively). CONCLUSIONS: The high density of peritumoral lymphatic vessels is a potential predictor of more aggressive phenotype of cervical squamous cancer.

[Update of research on minimally invasive treatment of lumbar disc herniation].

There has been rapid progress in endoscopy-and imaging technology-based minimally invasive surgery for the treatment of lumbar disc herniation (LDH). It is advategeous over conventional surgery in that it not only reduces surgical trauma but relieves sufferings of patients. However, endoscopy-and imaging technology-based minimally invasive surgery cannot completely replace traditional surgery at present because of its limited indications. How to expand the indications and solve the practical problem of lumbar reconstruction remains to be the direction of future breakthrough. This article is a summary of the progress and current situation of minimally invasive percutaneous and endoscopic techniques for the treatment of LDH.

[Expression of Oct-4 transcription factor in squamous cell skin carcinoma and seborrheic keratosis].

OBJECTIVE: To detect the expression of stem cell transcription factor Oct-4 in squamous cell carcinoma (SCC) and seborrheic keratosis (SK) and its association with cancer stem cells. METHODS: Immunohistochemistry was used to detect Oct-4 expression in 35 SCC cases, 21 SK cases and 15 normal control skin tissues. RESULTS: Oct-4 expression was negative in normal skin and showed a significant difference between SCC and SK tissues (P<0.05). CONCLUSION: The Oct-4-positive cells in SCC and SK are probably tumor stem cells. Oct-4 expression may provide an important evidence for isolation and identification of human SCC and SK stem cells.

Effect of hesperidin on expression of inducible nitric oxide synthase in cultured rabbit retinal pigment epithelial cells.

OBJECTIVE: To study the effect of hesperidin on expression of inducible nitric oxide synthase (iNOS) in cultured rabbit retinal pigment epithelial (RPE) cells under the condition of high glucose in vitro. METHOD: Hesperidin was extracted from Pericarpium Citri Reticulatae by ultrasound and ethanol precipitation and was detected qualitatively by high performance liquid chromatogram. The third to fifth primary cultured rabbit RPE were selected. The cells were divided into 6 groups including the control group cultured in DMEM, the model group cultured in DMEM containing 33 mmol/L glucose without any drug and four experimental groups which were exposed to hesperidin at the concentration of 10, 20, 40 and 80 mg/L at 37 degrees C under 5% CO(2) for 2 h and then cultured in DMEM containing 33 mmol/L glucose. The proliferation of RPE was measured by the MTT assay. The levels of NO produced were measured by spectrophotometry. The changes of iNOS expressed in RPE cells were determined with immunohistochemistry. RESULTS: The growth rate of RPE cells was associated with the concentration of hesperidin. NO production induced by high glucose was significantly inhibited by hesperidin. iNOS expression in hesperidin-treated group was decreased compared with the control group (p <0.001). CONCLUSION: Hesperidin can increase the proliferation of rabbit RPE cells, and inhibit the level of NO and iNOS expression, so hesperidin can protect rabbit RPE cells.

[Function magnetic resonance imaging and diffusion tensor tractography in patients with brain gliomas involving motor areas: clinical application and outcome].

OBJECTIVE: To explore the role of preoperative blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) and diffusion tensor tractography (DTT) to identify the relationship between motor cortical area, pyramidal tracts with brain gliomas in neurosurgical treatment of intraoperative electrical stimulation for gliomas involving motor areas at 3T. METHODS: Twenty-eight patients with brain gliomas involving motor areas were included. They underwent MRI examination, which included conventional T1WI, T2WI, BOLD-fMRI of bilateral hands movement paradigm and diffusion tensor imaging (DTI). The data of BOLD-fMRI and DTI were transferred to the workstation (Leonardo syngo 2003A, Siemens) and analyzed. Activation mapping of hands movement, fractional Anisotropy (FA) Color and three dimensional pyramidal tracts were produced. The relationship between motor cortical area, pyramidal tracts and brain gliomas was demonstrated, which was used to optimize the pre-surgical planning. With guidance of the result of BOLD-fMRI and DTT, all patients received microsurgery under anaesthesia retaining consciousness using intraoperative motor functional brain mapping with the method of direct electrical stimulations. The brain lesions were removed as far as possible in the case of eloquent areas and sub-cortical important white matters preservation. The preoperative and postoperative KPS of all patients were operated to evaluate the state of patients. RESULTS: BOLD-fMRI, DTI were performed successfully in 28 patients. The relationship between the primary motor cortex, premotor area, supplementary motor area, pyramidal tracts and brain gliomas localized by preoperative fMRI and DTI. Under anaesthesia retaining consciousness, the primary motor area was monitored by the method of direct electrical stimulations with the guidance of preoperative BOLD-fMRI. There was good correlation between preoperative fMRI and intraoperative cortical stimulation. Furthermore, the preoperative mappings and DTT could make up for the un-monitored motor areas and pyramidal tracts during operative cortical stimulation. Comparing the preoperative KPS, the postoperative KPS was advanced. CONCLUSIONS: BOLD-fMRI and DTT could non-invasively localize the relationship between brain motor cortex, pyramidal tracts and brain gliomas in vivo to optimize the surgical planning, guide the microsurgery under anaesthesia retaining consciousness using intraoperative motor functional brain mapping with the method of direct electrical stimulations and remove brain tumors as far as possible in the case of eloquent areas and sub-cortical important white matters preservation.