Silver nanoparticle-functionalized melamine-formaldehyde aerogel for online in-tube solid-phase microextraction of polycyclic aromatic hydrocarbons followed by HPLC-DAD analysis.

Based on the π-metal interaction between silver nanoparticles (AgNPs) and aromatic compounds, AgNPs were in-situ grown to melamine-formaldehyde (MF) aerogel for improving the extraction performance to polycyclic aromatic hydrocarbons (PAHs). The AgNPs/MF aerogel was regulated through varing the concentration of reactants, and characterized by scanning electron microscopy, X-ray photoelectron spectroscopy and X-ray powder diffraction. As a new extraction coating, the AgNPs/MF aerogel was coated to stainless-steel wires for in-tube solid-phase microextraction (IT-SPME). The extraction effects of MF aerogels before and after the modification of AgNPs were compared, and the AgNPs greatly improved the extraction ability for PAHs reaching to 166.4 %. Combining IT-SPME with high performance liquid chromatographic detection, an online analytical system was constructed. Furthermore, the sampling volume and rate, concentration of organic solvent, and desorption time were optimized factor by factor. The online analytical method with low detection limits (0.003-0.010 µg L-1) and efficient enrichment factors (1998-3237) for PAHs was established, which fastly detected trace level of PAHs in drinking and environmental water samples. Compared with other methods, the method was comparable or better in the detection limit and linear range, indicating prospective application of the AgNPs/MF aerogel for sample preparation.

Management of type 1 gastric neuroendocrine tumors: an 11-year retrospective single-center study.

BACKGROUND: Type 1 gastric neuroendocrine tumors (NETs) are relatively rare to the extent that some physicians have little experience in diagnosing and treating them. The purpose of this study was to increase the understanding of the disease by analyzing and summarizing the management and prognoses of patients with type 1 gastric NETs at our center. METHODS: The data of 229 patients (59.4% female) with type 1 gastric NETs who were treated at our center during 2011-2022 were retrospectively analyzed. RESULTS: The average patient age was 50.5 ± 10.8 years. Multiple tumors affected 72.5% of the patients; 66.4% of the tumors were < 1 cm, 69.4% were NET G1, and 2.2% were stage III-IV. A total of 76.9% of the patients had received endoscopic management, 60.7% had received traditional Chinese medicine treatment, 10.5% received somatostatin analogues treatment, and 6.6% underwent surgical resection. Seventy patients (41.2%) experienced the first recurrence after a median follow-up of 31 months (range: 2-122 months), and the median recurrence-free time was 43 months. The 1-, 2-, and 3-year cumulative recurrence-free survival rates were 71.8%, 56.8%, and 50.3%, respectively. During a median follow-up of 39 months (range: 2-132 months), one patient had bilateral pulmonary metastasis, and no disease-related deaths were observed. CONCLUSION: Type 1 gastric NETs have a high recurrence rate and a long disease course, underscoring the importance of long-term and comprehensive management.

Correlation between conventional ultrasound features combined with contrast-enhanced ultrasound patterns and pathological prognostic factors in malignant non-mass breast lesions.

OBJECTIVE: To investigate the correlation between ultrasound performance and prognostic factors in malignant non-mass breast lesions (NMLs). MATERIALS AND METHODS: This study included 106 malignant NMLs in 104 patients. Different US features and contrast enhancement patterns were evaluated. Prognostic factors, including histological types and grades, axillary lymph node and peritumoral lymphovascular status, estrogen and progesterone receptor status and the expression of HER-2 and Ki-67 were determined. A chi-square test and logistic regression analysis were used to analyse possible associations. RESULTS: Lesion size (OR: 3.08, p = 0.033) and posterior echo attenuation (OR: 8.38, p < 0.001) were useful in reflecting malignant NMLs containing an invasive carcinoma component. Posterior echo attenuation (OR: 7.51, p = 0.003) and unclear enhancement margin (OR: 6.50, p = 0.018) were often found in tumors with axillary lymph node metastases. Peritumoural lymphovascular invasion mostly exhibited posterior echo attenuation (OR: 3.84, p = 0.049) and unclear enhancement margin (OR: 8.68, p = 0.042) on ultrasound images. Perfusion defect was a comparatively accurate enhancement indicator for negative ER (OR: 2.57, p = 0.041) and PR (OR: 3.04, p = 0.008) expression. Calcifications (OR: 3.03, p = 0.025) and enlarged enhancement area (OR: 5.36, p = 0.033) imply an increased risk of positive HER-2 expression. Similarly, Calcifications (OR: 4.13, p = 0.003) and enlarged enhancement area (OR: 11.05, p < 0.001) were valid predictors of high Ki-67 proliferation index. CONCLUSION: Ultrasound performance is valuable for non-invasive prediction of prognostic factors in malignant NMLs.

circANKRD28 inhibits cisplatin resistance in non-small-cell lung cancer through the miR-221-3p/SOCS3 axis.

BACKGROUND: Non-small-cell lung cancer (NSCLC) is a common cancer. Chemotherapeutic drug resistance limits the therapeutic effect of NSCLC and leads to a poor prognosis. As a result, new specific targets may be better identified by studying the mechanism of drug resistance to cisplatin in NSCLC. METHODS: In the present study, we performed a quantitative real-time polymerase chain reaction and western blotting to detect mRNA and protein levels. The proliferation of cells was analyzed by a Cell Counting Kit-8 and colony formation assays. Cell invasion was measured via the Transwell assay. A scratch assay was performed to measure cell migration in cisplatin (DDP)-resistant NSCLC cells. Apoptosis of cells was examined using flow cytometry. RESULTS: We found that circANKRD28 was notably decreased in NSCLC. The results showed that circANKRD28 expression was not affected, and its half-life was more than 12 h. Functional experiments revealed that circANKRD28 overexpression inhibited DDP resistance in NSCLC cells in vitro. Mechanistic findings demonstrated that circANKRD28 regulated tumor cell progression and DDP sensitivity through the miR-221-3p/SOCS3 axis. CONCLUSIONS: The present study revealed the regulatory effects and molecular mechanism of circANKRD28 on the development and cisplatin resistance in NSCLC, which may provide experimental basis and theoretical support to identify new targets for therapy of DDP resistance in NSCLC.

Outcomes and risk factors in patients with crescentic glomerulonephritis: a multicenter cohort study.

BACKGROUND: Patients with crescentic glomerulonephritis have a poor prognosis despite immunosuppressive therapy. This study investigated the clinicopathologic features, outcomes, and risk factors in Chinese patients with crescentic glomerulonephritis. METHODS: The multicenter cohort study included consecutive individuals with crescentic glomerulonephritis and a minimum follow-up of 1 year after biopsy, observed from January 2013 to December 2020. Primary outcome was the occurrence of death or end stage kidney disease (ESKD) for surviving patients. Multivariable adjusted Cox proportional hazards model was applied. RESULTS: Of 109 patients enrolled, 73 (67%) suffered primary outcomes, including 39 deaths, and 34 ESKDs among the 70 surviving patients, with a mean follow-up of 26 months. All 26 patients with over 90% glomeruli with crescents reached a primary outcome. Patients with type III crescentic glomerulonephritis had the worst prognosis for primary outcomes (HR, 95% CI for type I vs. type III: 0.29, 0.14-0.58; type II vs. type III: 0.44, 0.22-0.91) and a significantly faster rate of eGFR decline after adjusting for baseline variables. In patients with 75%-100% glomeruli with crescents, the risk of a primary outcome increased nearly fourfold (HR 3.96; 95% CI 2.17-7.23) compared with patients with 50-75% glomeruli with crescents after adjusting for baseline variables. Type of crescentic glomerulonephritis and percentage of cellular and total glomeruli with crescents were independent risk factors for early primary outcomes (within 6 months). CONCLUSIONS: This study provides new insights into crescentic glomerulonephritis, including a description of the worst outcomes occurring in patients with type III crescentic glomerulonephritis, and suggests that the quantification of the percentage of crescents may be of use for guiding therapeutic decisions, due to their role in identifying the risk of primary outcomes.

Non-mass Breast Lesions: Could Multimodal Ultrasound Imaging Be Helpful for Their Diagnosis?

Objective: To develop a prediction model for discriminating malignant from benign breast non-mass-like lesions (NMLs) using conventional ultrasound (US), strain elastography (SE) of US elastography and contrast-enhanced ultrasound (CEUS). Methods: A total of 101 NMLs from 100 patients detected by conventional US were enrolled in this retrospective study. The characteristics of NMLs in conventional US, SE and CEUS were compared between malignant and benign NMLs. Histopathological results were used as the reference standard. Binary logistic regression analysis was performed to identify the independent risk factors. A multimodal method to evaluate NMLs based on logistic regression was developed. The diagnostic performance of conventional US, US + SE, US + CEUS and the combination of these modalities was evaluated and compared. Results: Among the 101 lesions, 50 (49.5%) were benign and 51 (50.5%) were malignant. Age ≥45 y, microcalcifications in the lesion, elasticity score >3, earlier enhancement time and hyper-enhancement were independent diagnostic indicators included to establish the multimodal prediction method. The area under the receiver operating characteristic curve (AUC) of US + SE + CEUS was significantly higher than that of US (p < 0.0001) and US + SE (p < 0.0001), but there was no significant difference between the AUC of US + SE + CEUS and the AUC of US + CEUS (p = 0.216). Conclusion: US + SE + CEUS and US + CEUS could significantly improve the diagnostic efficiency and accuracy of conventional US in the diagnosis of NMLs.

Acteoside alleviates dextran sulphate sodium­induced ulcerative colitis via regulation of the HO­1/HMGB1 signaling pathway.

Ulcerative colitis (UC) is a significant burden on human health, and the elucidation of the mechanism by which it develops has potential for the prevention and treatment of UC. It has been reported that acteoside (ACT) exhibits strong anti­inflammatory activity. In the present study, it was hypothesized that ACT may exert a protective effect against UC. The effects of ACT on inflammation, oxidative stress and apoptosis were evaluated using dextran sulphate sodium (DSS)­treated mice and DSS­treated human colorectal adenocarcinoma Caco­2 cells, which have an epithelial morphology. The results demonstrated that the ACT­treated mice with DSS­induced UC exhibited significantly reduced colon inflammation, as demonstrated by a reversal in body weight loss, colon shortening, disease activity index score, inflammation, oxidative stress and colonic barrier dysfunction. Further in vivo experiments demonstrated that ACT inhibited DSS­induced apoptosis in colon tissues, as demonstrated by the results of the TUNEL assay and the altered protein expression levels of Bax, cleaved caspase­3 and Bcl­2. Furthermore, DSS significantly stimulated the protein expression levels of high mobility group box 1 protein (HMGB1), which serves a central role in the initiation and progression of UC, an effect which was markedly inhibited by ACT. Finally, DSS significantly decreased the protein expression levels of heme oxygenase­1 (HO­1) in colon tissues and the effect of ACT on GSH, apoptotic proteins and HMGB1 was markedly attenuated in the presence of the HO­1 inhibitor tin protoporphyrin. In conclusion, ACT ameliorated colon inflammation through HMGB1 inhibition in a HO­1­dependent manner.

High expression of HIV-1 matrix protein p17 in both lymphoma and lymph node tissues of AIDS patients.

BACKGROUND: HIV-1 matrix protein p17 was found to be associated with lymphoma development in vitro. This study aimed to elucidate the pathogenetic roles of HIV-1 p17 in AIDS-related lymphoma. METHODS: Expression of HIV-1 proteins p17, p24, nef and tat were evaluated in tumor tissue samples from 60 lymphoma patients and lymph node samples from 23 non-lymphoma patients with HIV-1 infection by immunohistochemistry. Microvascular density (MVD) determined by CD34 were also assessed in tumor tissues. Clinicopathological data of AIDS patients with lymphoma were collected retrospectively. RESULTS: The subtypes of lymphoma among sixty AIDS patients were diffuse large B-cell lymphoma (32 cases), Burkitt lymphoma (23 cases), Hodgkin's lymphoma (4 cases), and plasmablastic lymphoma (1 case). The expression rate of HIV-1 p17 in lymphoma and non-lymphoma group was 63 % (38/60) and 61 % (14/29) respectively, with no significant difference (p = 0.835). The positive expression rate of p17 in both groups was significantly higher than that of p24, nef and tat (p < 0.05). The expression of p17 was associated with a higher MVD in the lymphoma group (p < 0.05). There were no significant differences in the 2-years overall survival between p17 positive and negative group (61 % vs. 50 %, p = 0.525). CONCLUSION: The common expression of HIV-1 matrix protein p17 in both lymphoma and lymph node tissues of AIDS patients and the association between p17 expression and the higher MVD suggest that the accumulation and persistence of p17 in tissues may play a role in lymphoma development.

The clinical value of conventional ultrasound combined with contrast-enhanced ultrasound in the evaluation of BI-RADS 4 lesions detected by magnetic resonance imaging.

OBJECTIVE: To determine the value of conventional ultrasound combined with contrast-enhanced ultrasound (CEUS) in Breast Imaging Reporting and Data System (BI-RADS) Category 4 lesions as detected by MRI. METHODS: A total of 176 breast lesions from 171 patients were detected by MRI and categorised as BI-RADS 4. All patients also underwent ultrasound and CEUS scans. The combination of ultrasound-BI-RADS and CEUS 5-point scoring system created the Rerated BI-RADS (referred to as CEUS-BI-RADS). The diagnostic performances of ultrasound and CEUS-BI-RADS were then compared. A χ2 test was used to compare the CEUS features of mass-like and non-mass-like enhancement types of MRI-BI-RADS 4 lesions. RESULTS: There were 167 (167/176) breast lesions detected by ultrasound, with a detection rate of 94.89%, while all were subsequently detected by "second-look" ultrasound combined with CEUS, with a detection rate of 100%. The areas under the receiver operating characteristic curves for ultrasound and CEUS-BI-RADS were 0.810 and 0.940, respectively. The diagnostic efficiency of CEUS-BI-RADS was significantly higher than that of ultrasound alone (z = 3.264, p = 0.001). For both mass-like and non-mass-like enhancement types of MRI-BI-RADS 4 lesions, CEUS-BI-RADS demonstrated satisfactory sensitivity and accuracy. Moreover, 29 (29/176) category 4 lesions were downgraded to 3 by CEUS-BI-RADS. CONCLUSION: Ultrasound combined with CEUS can allow reclassification, reduce biopsy rates, and facilitate pre-surgical localisation for biopsy or surgery for MRI-BI-RADS 4 lesions. ADVANCES IN KNOWLEDGE: For MRI-BI-RADS Category 4 lesions with a wide range of malignancies, ultrasound combined with CEUS is a promising diagnostic approach with high clinical utility.

Intraoperative thromboelastography-guided transfusion in a patient with factor XI deficiency: A case report.

BACKGROUND: Factor XI (FXI) deficiency, also known as hemophilia C, is a rare bleeding disorder of unpredictable severity that correlates poorly with FXI coagulation activity. This often poses great challenges in perioperative hemostatic management. Thromboelastography (TEG) is a method for testing blood coagulation using a viscoelastic hemostatic assay of whole blood to assess the overall coagulation status. Here, we present the successful application of intraoperative TEG monitoring in an FXI-deficient patient as an individualized blood transfusion strategy. CASE SUMMARY: A 21-year-old male patient with FXI deficiency was scheduled to undergo reconstructive surgery for macrodactyly of the left foot under general anesthesia. To minimize his bleeding risk, he was scheduled to receive fresh frozen plasma (FFP) as an empirical prophylactic FXI replacement at a dose of 15-20 mL/kg body weight (900-1200 mL) before surgery. Subsequent FFP transfusion was to be adjusted according to surgical need. Instead, TEG assessment was used at the beginning and toward the end of his surgery. According to intraoperative TEG results, the normalization of coagulation function was achieved with an infusion of only 800 mL FFP, and blood loss was minimal. The patient showed an uneventful postoperative course and was discharged on postoperative day 8. CONCLUSION: TEG can be readily applied in the intraoperative period to individualize transfusion needs in patients with rare inherited coagulopathy.

Vascular Risk Factors, Imaging, and Outcomes in Transient Ischemic Attack/Ischemic Stroke Patients with Neuroimaging Evidence of Probable/Possible Cerebral Amyloid Angiopathy.

BACKGROUND: In TIA/ischemic stroke patients, the clinical significance of lobar microbleeds potentially indicating cerebral amyloid angiopathy (CAA) is unknown. We assessed vascular risk factors and outcomes, including cognition, in TIA/ischemic stroke patients with neuroimaging evidence of probable/possible CAA. METHODS: This prospective cohort was conducted from August 2015 and January 2018 at 40 centers. 2625 participants were collected. Eligible participants were aged at least 55 years. Montreal Cognitive Assessment (MoCA) score is less than or equal to 26. A total of 1620 patients were included. 1604 (99.0%) and 1582 (97.7%) participants are followed up at 3 and 12 months. The primary outcomes were death or disability (mRS score, 3-6) and Montreal Cognitive Assessment (MoCA) at 3 months and 12 months. Demographic and vascular risk factors were measured at baseline (smoking, alcohol, diabetes, atrial fibrillation, hypertension, hypercholesterolemia, coronary artery disease, ischemic stroke, and transient ischemic attack). Blood samples were collected within 24 hours of admission. MRI was recommended for all patients. MoCA score was evaluated at baseline and follow-up. RESULTS: In total, 291/1620 patients with ischemic stroke/TIA (32.7% female and mean age, 67.8 years) had neuroimaging evidence of probable/possible CAA. Higher age, history of hypertension, atrial fibrillation, ischemic stroke, alcohol, and high glucose at the admission were more common in the patients. Mean MoCA changed from 21.4 at 3 months (SD 5.2) to 22.3 at 12 months (SD 4.7), difference 0.3 (SD 3.8). At the 3-month and 12-month follow-up, there were significant differences in age, education level, and sex among different cognitive groups. Higher age, lower education (less than high school), and female sex were the predictors of changing in MoCA score from 3 months to 12 months. Moreover, age (more than 66 years) and education (less than high school) are strongly associated with MoCA at 3- and 12-month follow-up. 30 of 286 (10.5%) and 37 of 281 (13.2%) patients had poor outcome of death or disability (modified Rankin Scale score, 3-6) at follow-up 3 and 12 months. Cortical superficial siderosis (cSS) was associated with higher mRS at follow-up. cSS status, cSS count 1-2, cSS strictly lobar, and strictly deep might be the risks of outcomes in adjusted analyses. CONCLUSION: This study suggested that an increasing number of vascular risk factors and imaging markers were significantly associated with outcomes of TIA/ischemic stroke patients with CAA pattern. Male, young patients with high education should get better cognitive recovery.

Case report: histopathology and molecular pathology analysis on enteric tissue of a COVID-19 patient.

AIMS: Patients with COVID-19 can also have enteric symptoms. Here we analyzed the histopathology of intestinal detachment tissue from a patient with COVID-19. METHODS: The enteric tissue was examined by hematoxylin & eosin stain, PAS (Periodic acid-Schiff) staining, Gram staining, Ziehl-Neelsen stain and Grocott's Methenamine Silver (GMS) Stain. The distribution of CD3, CD4, CK20 and CD68, cytomegalovirus (CMV) and Herpes Simplex Virus (HSV) antigen were determined by immunohistochemistry. In situ hybridization (ISH) of SARS-CoV-2 and Epstein-Barr virus-encoded small RNA (EBER) were also performed. RESULTS: We observed mucosal epithelium shedding, intestinal mucosal erosion, focal inflammatory necrosis with hemorrhage, massive neutrophil infiltration, macrophage proliferation accompanied by minor lymphocyte infiltration. Fungal spores and gram positive cocci but not mycobacteria tuberculosis were identified. Immunohistochemistry staining showed abundant CD68+ macrophages but few lymphocytes infiltration. HSV, CMV and EBV were negative. ISH of SARS-CoV-2 RNA showed positive signal which mostly overlapped with CD68 positivity. CONCLUSIONS: The in situ detection of SARS-CoV-2 RNA in intestinal macrophages implicates a possible route for gastrointestinal infection. Further study is needed to further characterize the susceptibility of enteric cells to SARS-CoV-2 infection.

Using Lumbar X-Ray to Facilitate Modified Taylor's Approach of Spinal Anesthesia in an Elderly Patient With Scoliosis.

In geriatric patients scheduled for hip or knee surgery, neuraxial anesthesia is a safe and effective anesthesia method and may be a better option than general anesthesia. Unfortunately, establishing neuraxial anesthesia is not always easy in this group of patients. Anatomical abnormalities, such as spinal stenosis, scoliosis, and narrowed interspaces, contribute to the difficulties that anesthesiologists face while performing these procedures. The classic Taylor's approach targets the widest interspace, L5-S1, as the needle insertion site and accordingly has an increased success rate in difficult neuraxial anesthesia. As this technique historically relies solely on palpation, it might be difficult in patients with less prominent or distorted anatomic landmarks. Ultrasonography or fluoroscopy guidance may help to better target the epidural or subarachnoid space, but both have limitations due to equipment availability or provider expertise. The modified Taylor's approach we propose in this case report is based on preoperative lumbar x-ray interpretation when point-of-care image guidance cannot be performed. By measuring on the patient's preoperative lumbar x-ray, we successfully performed a modified Taylor's approach of spinal anesthesia on an elderly patient with severe scoliosis. She underwent open reduction and internal fixation (ORIF) of the left femur with satisfactory pain control and no complications.

A dual-modal colorimetric and photothermal assay for glutathione based on MnO2 nanosheets synthesized with eco-friendly materials.

We developed a dual-modal colorimetric and photothermal assay for glutathione (GSH) using MnO2 nanosheets prepared with environmentally friendly materials. The nanosheets were synthesized by using ascorbic acid present abundantly in lemon and orange juices to reduce KMnO4. The as-prepared MnO2 nanosheets display oxidase-like activity and can catalyze the oxidation reaction of 3,3',5,5'-tetramethylbenzidine (TMB), yielding a blue oxidative product (oxTMB) that exhibits a UV-Vis absorption peak at 652 nm. In the presence of GSH, the MnO2 nanosheets are reduced and decomposed, resulting in a decrease in the peak intensity. The colorimetric assay offers a wide dynamic range (0.1-100 µM) and a detection limit of 100 nM. The MnO2 nanosheets are also efficient in converting photoenergy to thermal energy, with a photothermal conversion efficiency of 23.3%. The temperature change, after near-infrared (NIR) irradiation at 808 nm, can be easily measured by an inexpensive pen-type thermometer. This effect can also be used for GSH quantification and expands the GSH concentration detection to the range from 6.0 to 200 µM. The viability of our dual-modal assay for clinical applications was demonstrated with successful analyses of GSH in human serum samples. Graphical abstract.

MiR-328-3p inhibits cell proliferation and metastasis in colorectal cancer by targeting Girdin and inhibiting the PI3K/Akt signaling pathway.

MiR-328-3p has been reported to be downregulated and serve as a tumor suppressor in several cancers. Previous studies only have reported the downregulation of miR-328-3p in CRC. However, the roles of miR-328-3p in CRC growth and metastasis were unknown. In this study, we demonstrated that miR-328-3p overexpression inhibited cell proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT). The PI3K/Akt signaling pathway was also inactivated by miR-328-3p overexpression. MiR-328-3p knockdown showed the opposite effects. In addition, we confirmed that miR-328-3p directly bound to 3'UTR of Girdin and negatively regulated its expression. Girdin knockdown or treatment with PI3K inhibitor LY294002 blocked the effects of miR-328-3p inhibitor on cell proliferation, metastasis, and the PI3K/Akt signaling pathway. Moreover, pre-miR-328 decreased numbers of liver metastatic nodules, and reduced the levels of p-Akt, p-Girdin, and Girdin in metastatic tissues in liver. In conclusion, miR-328-3p may inhibit proliferation and metastasis of CRC cells by targeting Girdin and inactivating the PI3K/Akt signaling pathway. MiR-328-3p may be a novel target in cancer therapy.

Biodegradable Self-Assembled Nanoparticles of Galactose-Containing Amphiphilic Triblock Copolymers for Targeted Delivery of Paclitaxel to HepG2 Cells.

Biodegradable self-assembled polymeric nanoparticles (NPs) composed of poly(6-O-methacryloyl-D-galactopyranose)-b-poly(L-lactide)-b-poly(6-O-methacryloyl-D-galactopyranose) (PMAGP-b-PLA-b-PMAGP) are prepared as carriers for the hydrophobic anticancer drug paclitaxel (PTX), to achieve target delivery to hepatoma cells. PTX can be encapsulated by the NPs with various molar ratios of L-lactide (LA) and 6-O-methacryloyl-D-galactopyranose (MAGP) during the process of self-assembly, and the resulting NPs exhibit high drug loading efficacy and substantial stability in aqueous solution. The size, size distribution, and morphology of the NPs are characterized using a Zetasizer Nano ZS and transmission electron microscopy. The hemolysis assay and cell cytotoxicity assay indicate that the polymeric NPs are biocompatible and non-toxic. The cellular uptake assay demonstrates that the galactose-containing NPs can be selectively recognized and subsequently accumulate in HepG2 cells. All of these results demonstrate that galactose-containing polymeric NPs are potential carriers for hepatoma-targeted drug delivery and liver cancer therapy in clinical medicine.

Comparison of McGrath Series 3 and Macintosh Laryngoscopes for Tracheal Intubation in Patients With Normal Airway by Inexperienced Anesthetists: A Randomized Study.

Difficult and failed intubations account for the major causes of morbidity and mortality in current anesthetic practice. Several devices including McGrath Series 3 videolaryngoscope are available which may facilitate tracheal intubation by improving view of the larynx compared with Macintosh blade laryngoscopy. But no studies demonstrate whether McGrath Series 3 performs better than Macintosh laryngoscope in normal airway intubations by inexperienced anesthetists so far. We therefore designed this randomized controlled study to compare McGrath with Macintosh in routine tracheal intubation performed by inexperienced anesthetists.In total, 180 adult patients with normal-appearing airways requiring orotracheal intubation for elective surgery were randomly allocated to be intubated by 9 inexperienced anesthetists with McGrath or Macintosh. The primary outcome was time to intubation. Ease of intubation was assessed by a 5-point ordinal scale. Intubation attempts/failures, best laryngoscopy view using the Cormack-Lehane grade, associated complications and hemodynamic changes during intubation were recorded.We found that there was no significant difference between McGrath and Macintosh in the median time to intubation (P = 0.46); the Cormack-Lehane views attained using McGrath were superior (P < 0.001); the difference of ease of intubation was statistically significant (P = 0.01). No serious trauma occurred in both groups. And there was statistically significant difference in the systolic blood pressure changes between 2 groups (P < 0.05).We demonstrated that in orotracheal intubation in patients with normal airway by inexperienced anesthetists, McGrath compared with the Macintosh allows superior glottis views, greater ease of intubation, less complications, and hemodynamic changes with noninferior intubation time. And it remained a potential selection for inexperienced anesthetists in uncomplicated intubation.

Comparison of combined general-epidural anesthesia with general anesthesia effects on survival and cancer recurrence: a meta-analysis of retrospective and prospective studies.

OBJECTIVE: Animals underwent combined general-epidural anesthesia (EGA) is reported to have better long-time outcome than general anesthesia (GA). This study aimed to make overall evaluation of the association between these two anesthetic techniques and prognosis of cancer patients undergoing surgery. METHODS: Related databases such as PubMed and EMbase were searched for eligible studies that evaluated the influence of EGA and GA on the prognosis of cancer patients undergoing surgery. Selected studies were evaluated according to the inclusion criteria by two reviewers respectively, followed by data extraction and quality assessment. The odds ratio (OR) with their 95% confidence intervals (CIs) were calculated to assess the influence strength of EGA and GA on prognosis of cancer patients. RESULTS: A total of ten studies involving 3254 patients were included. The overall results demonstrated that there was no significant difference between EGA and GA group (OR = 0.88, 95% CI 0.73 to 1.06, P = 0.187) concerning postoperative recurrence and metastasis rate. In regard to the following two factors: cancer category and time of follow-up, subgroup analysis identified significant differences between EGA and GA in the group of patients with prostate cancer and the group with follow-up less than or equal to two years (OR = 0.66, 95% CI 0.46 to 0.95, P = 0.027; OR = 0.70, 95% CI 0.51 to 0.98, P = 0.035; respectively) concerning postoperative recurrence and metastasis rate. However, no significant difference was found in the group of patients with colorectal cancer (OR = 1.06, 95% CI 0.84-1.33, P = 0.62). CONCLUSIONS: This meta-analysis showed that EGA might be associated with improvement in prognosis of patients with operable prostate cancer and the cancer patients with follow-up less than or equal to two years. However, no obvious relationship between the improvement in prognosis of colorectal cancer and EGA were detected, comparing to GA. Furthermore, all the results should be interpreted cautiously, as heterogeneous data were used for analyzing.

The acute effects of a new type of implantable gastric electrical stimulators featuring varied pulse widths on beagle dogs' food intake and gastric accommodation.

BACKGROUND: To improve the therapeutic effects of gastric electrical stimulation (GES) for obesity, an animal experiment was conducted using a new type of stimulators. Proper parameters of GES were selected, and the impacts of GES on the food intake and gastric accommodation of canines were observed. METHODS: Eight beagle dogs were operated on, and GES was performed on them. Firstly, GES was performed to determine the right parameters according to symptoms. Secondly, the so selected parameters were used in a 3-day GES procedure, during which process food intake, body weight, and symptoms were recorded. Thirdly, the gastric capacities before and after GES with different pulse widths were measured by means of a barostat. RESULTS: The selected parameters varied for each dog, with the pulse widths ranging from 0.3 to 6 ms. The food consumption after GES dropped significantly as compared with the amount observed in the sham stimulation. Tolerance to stimulation could be observed during GES. The post-GES gastric fundus capacity increased evidently in comparison with the capacity before GES, suggesting significant distention as compared with sham stimulation. Given an increment of 2 ms in the pulse width twice, the gastric capacity continued to distend each time. CONCLUSIONS: GES featuring pulse trains with wider and individualized pulse widths could inhibit food consumption of dogs. The stimulation parameters should be selected individually and adjusted periodically. GES of this mode could also increase the fasting gastric capacity with certain dose-related effects. The new type of stimulators may be more suitable for the treatment of human obesity than traditional stimulators.

[Expression of Bcl-w protein in human small intestinal adenocarcinoma and effect of Bcl-w siRNA on apoptosis in intestinal adenocarcinoma HuTu-80 cells].

OBJECTIVE: To investigate the expression of apoptosis-related protein Bcl-w in adenocarcinoma of the small intestine, and the apoptotic effect of Bcl-w siRNA on small intestinal adenocarcinoma cells HuTu-80. METHODS: Forty-two tissue samples were examined in our study, including 7 cases from human small intestinal adenocarcinoma, and 35 cases from normal small intestine served as control. The expression of Bcl-w was detected by immunohistochemistry (IHC). Western blot analysis was performed to confirm whether Bcl-w siRNA could effectively down-regulate Bcl-w protein after HuTu-80 cells were transfected with Bcl-w siRNA. The cells were treated with chemotherapeutic agent 5-Fu to observe whether Bcl-w protein-silecing affects the pro-apoptotic effect of 5-Fu. Flow cytometry analysis was used for assessment of apoptotic rate of HuTu-80 cells cultured with Bcl-w siRNA alone, with 5-Fu alone, and with combination of Bcl-w siRNA and 5-Fu, using untreated HuTu-80 cells as control. RESULTS: The positive rate of Bcl-w expression was significantly higher in small intestinal adenocarcinoma than that in normal tissue (85.7% vs. 25.7%, P=0.005). Compared with the control group, Bcl-w siRNA transfection effectively down-regulated the expression of Bcl-w protein (P<0.05). The apoptosis in HuTu-80 cells was not increased significantly in Bcl-w-/-cells compared with that of control group (12.4±2.2)% vs. (8.6±1.7)% (P>0.05). However, compared with the 5-Fu group, the apoptosis in HuTu-80 cells was effectively enhanced after combination treatment with Bcl-w siRNA and 5-Fu (45.7±2.1)% vs. (71.6±3.2)% (P<0.05). CONCLUSIONS: Bcl-w protein plays a significant role in the carcinogenesis of human small intestinal adenocarcinoma. Down-regulation of Bcl-w protein in small intestine adenocarcinoma HuTu-80 cells leads them susceptible to 5-Fu.