Virtual reality-based supportive care interventions for patients with cancer: an umbrella review of systematic reviews and meta-analyses.

PURPOSE: This umbrella review aimed to identify, critically appraise, and synthesize current evidence from systematic reviews and meta-analyses on the applications of virtual reality-based supportive care interventions in cancer. METHODS: Three bibliographic databases were searched from inception to February 1, 2024. Two independent reviewers screened the titles and abstracts of 421 records and retrieved 26 full-text systematic reviews. Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) was used for quality assessment. Qualitative syntheses were performed to investigate the effects of virtual reality-based supportive care interventions on quality of life and physical, psychological, cognitive, and functional outcomes. Meta-analysis was performed based on data from the distinct primary studies that were extracted from the included reviews. RESULTS: This umbrella review included 20 systematic reviews that were published between 2018 and 2023; nine of them conducted meta-analyses. A total of 86 distinct primary studies were identified. According to the AMSTAR-2 assessment, two reviews were evaluated as moderate quality, nine as low, and nine as critically low. Meta-analyses of primary studies revealed significant effects of virtual reality on anxiety (p < 0.001), depression (p < 0.001), and pain (p < 0.001), but not fatigue (p = 0.263). Qualitative syntheses revealed positive effects of virtual reality on physical function, cognitive function, and quality of life. Limited evidence was reported regarding outcomes of balance, gait, mobility, and activities of daily living. CONCLUSION: Virtual reality has proven to be a safe and feasible approach to deliver supportive care in cancer. Virtual reality can be implemented in various stages and settings of the cancer care continuum to support patients undergoing painful procedures, during or after chemotherapy, and after surgical interventions. Virtual reality can serve as an effective supportive care intervention to manage anxiety, pain, and depression for patients with cancer.

Pelvic floor muscle training in telerehabilitation: a systematic review and meta-analysis.

PURPOSE: This systematic review aims to identify, critically appraise, and summarize current evidence regarding the feasibility and efficacy of pelvic floor muscle training in telerehabilitation. METHODS: Three bibliographic databases, PubMed, Embase, and Scopus were searched from inception to October 1, 2023. Clinical trials assessing the feasibility and efficacy of pelvic floor muscle training in telerehabilitation were eligible for inclusion. The Physiotherapy Evidence Database scale and National Institutes of Health Study Quality Assessment Tool were used for methodological quality assessment. Study selection, data extraction, and quality assessment were completed by two independent reviewers. Meta-analyses were performed to determine the effects of pelvic floor muscle training in telerehabilitation. RESULTS: Five randomized controlled trials and three single cohort clinical trials were included in this review. Four studies were evaluated as good quality, and four as fair. Pelvic floor telerehabilitation was well tolerated and demonstrated good patient compliance and satisfaction. Pooled analysis indicated significant effects of pelvic floor telerehabilitation on the severity of urinary incontinence with a large effect size, pelvic floor muscle strength with a large effect size, and quality of life with a medium effect size. CONCLUSION: This systematic review demonstrates that pelvic floor muscle training in telerehabilitation is a feasible and effective approach and highlights its efficacy in patients with urinary incontinence. This review supports the application of pelvic floor muscle training in telerehabilitation and informs further clinical and research endeavors to incorporate digital health technologies in managing pelvic floor dysfunction.

MoS2-Thin Film Transistor Based Flexible 2T1C Driving Circuits for Active-Matrix Displays.

Two-dimensional (2D) semiconductors offer great potential as high-performance materials for thin film transistors (TFTs) in displays. Their thin, stable, and flexible nature, along with excellent electrical properties, makes them suitable for flexible displays. However, previous demonstrations lacked clear superiority in pixel resolution and TFT performance. Here we present the flexible 2T1C pixel driving circuit for active-matrix displays based on high-quality large-scale monolayer MoS2. A gate-first fabrication process was developed for flexible MoS2-TFTs, showing a remarkable carrier mobility (average at 52.8 cm2 V-1 s-1), high on/off ratio (average at 1.5 × 108), and negligible hysteresis. The driving current can be modulated by pulsed input voltages and demonstrates a stable and prompt response to both frequency and amplitude. We also demonstrated a 10 × 10 active-matrix with high resolution of 508 pixels per inch, exhibiting 100% yield and high uniformity. The driving circuit works well under bending up to ∼0.91% strain, highlighting its normal functions in flexible displays.

Scaling of MoS2 Transistors and Inverters to Sub-10 nm Channel Length with High Performance.

Two-dimensional (2D) semiconductors such as monolayer molybdenum disulfide (MoS2) are promising building blocks for ultrascaled field effect transistors (FETs), benefiting from their atomic thickness, dangling-bond-free flat surface, and excellent gate controllability. However, despite great prospects, the fabrication of 2D ultrashort channel FETs with high performance and uniformity remains a challenge. Here, we report a self-encapsulated heterostructure undercut technique for the fabrication of sub-10 nm channel length MoS2 FETs. The fabricated 9 nm channel MoS2 FETs exhibit superior performances compared with sub-15 nm channel length including the competitive on-state current density of 734/433 µA/µm at VDS = 2/1 V, record-low DIBL of ∼50 mV/V, and superior on/off ratio of 3 × 107 and low subthreshold swing of ∼100 mV/dec. Furthermore, the ultrashort channel MoS2 FETs fabricated by this new technique show excellent homogeneity. Thanks to this, we scale the monolayer inverter down to sub-10 nm channel length.

Zearalenone-Induced Mechanical Damage of Intestinal Barrier via the RhoA/ROCK Signaling Pathway in IPEC-J2 Cells.

Zearalenone (ZEN) is a widespread contaminant of cereals and agricultural products which causes food safety issues. Ingesting food or feed contaminated with ZEN can disrupt the intestinal epithelial barrier function. The RhoA/ROCK signaling pathway plays a key role in regulating the epithelial barrier function, but studies on such roles have rarely focused on the intestine. The aim of this experiment was to investigate the exact mechanism of ZEN-induced intestinal barrier damage and whether the RhoA/ROCK signaling pathway is involved. The results showed that ZEN significantly induced alkaline phosphatase (AP) activity and FITC-dextran (4 kDa) passage across the epithelial barrier, which significantly reduced the transepithelial resistance (TEER). Meanwhile, ZEN could induce the significantly down-regulated mRNA expression of tight junction proteins (occludin, claudin-1, ZO-1, and claudin-3) and redistribution of ZO-1 immunofluorescence. Further studies demonstrated that ZEN exposure activated the RhoA/ROCK signaling pathway, significantly up-regulated the mRNA expression of ROCK1, the main effector of the signaling pathway, the protein expression of phosphorylated myosin light chain (MLC) and myosin light chain kinase (MLCK), and relatively increased the activity of ATP in cells, simultaneously remodeling the cytoskeleton (F-actin). Overall, our study indicated that ZEN induced intestinal barrier dysfunction by activating the RhoA/ROCK signaling pathway.

In Situ Oxygen Doping of Monolayer MoS2 for Novel Electronics.

In 2D semiconductors, doping offers an effective approach to modulate their optical and electronic properties. Here, an in situ doping of oxygen atoms in monolayer molybdenum disulfide (MoS2 ) is reported during the chemical vapor deposition process. Oxygen concentrations up to 20-25% can be reliable achieved in these doped monolayers, MoS2- x Ox . These oxygen dopants are in a form of substitution of sulfur atoms in the MoS2 lattice and can reduce the bandgap of intrinsic MoS2 without introducing in-gap states as confirmed by photoluminescence spectroscopy and scanning tunneling spectroscopy. Field effect transistors made of monolayer MoS2- x Ox show enhanced electrical performances, such as high field-effect mobility (≈100 cm2 V-1 s-1 ) and inverter gain, ultrahigh devices' on/off ratio (>109 ) and small subthreshold swing value (≈80 mV dec-1 ). This in situ oxygen doping technique holds great promise on developing advanced electronics based on 2D semiconductors.

Effects of virtual reality on balance in people with diabetes: a systematic review and meta-analysis.

Purpose: This systematic review aims to identify, critically appraise, and synthesize the effects of virtual reality on balance in people with diabetes. Methods: Five biomedical databases were searched from inception to December 15, 2023. Clinical trials investigating the effects of virtual reality on performance-based or patient-reported outcome measures related to balance function among people with diabetes were included. Two independent reviewers conducted study selection, data extraction, and quality assessment. Cochrane risk-of-bias tool-2 were used to assess included studies. Meta-analysis was performed to examine the effects of the intervention. Results: Six studies with a total of 257 participants were identified. Two studies had high risk of bias, and four studies had some concerns regarding risk of bias. No adverse events related to virtual reality were reported. Meta-analysis revealed significant improvements in the Berg Balance Scale (SMD = 1.56, 95% CI 0.71 to 2.40, p < 0.001), Timed Up and Go test (SMD = -0.74, 95% CI -1.21 to -0.28, p = 0.002), and falls efficacy (SMD = 0.99, 95% CI 0.43 to 1.54, p < 0.001) following virtual reality intervention. No significant differences were found for postural sway and single leg stance measures. Conclusion: Virtual reality-based rehabilitation demonstrates promising effects for improving balance in people with diabetes. Further studies with high methodological quality and large sample sizes are warranted. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-024-01413-7.

Mirror therapy for patients with breast cancer: A systematic review and meta-analysis.

BACKGROUND: Pain and dysfunction of the shoulder and arm are prevalent among patients with breast cancer. This review aimed to evaluate current evidence regarding the effects of mirror therapy on pain, function, and quality of life in patients with breast cancer. METHODS: Five bibliographic databases in English and Chinese, PubMed, Embase, Scopus, CNKI, and Wanfang were searched from inception to May 15, 2024. Randomized controlled trials comparing the effects of mirror therapy to conventional treatment were eligible for inclusion. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Meta-analyses were performed to determine the effects of mirror therapy. RESULTS: Four randomized controlled trials were included, with a total of 311 patients with breast cancer. All included studies were scored six to seven on the PEDro scale, indicating good quality. No adverse events related to mirror therapy were reported. Compared to conventional treatment, mirror therapy demonstrated significantly reduced pain (SMD: - 1.17, 95% CI: - 1.64 to - 0.70, p < 0.001), improved upper extremity function (SMD: 1.03, 95% CI: 0.05-2.02, p = 0.04), and enhanced quality of life (SMD: 0.43, 95% CI: 0.07-0.79, p = 0.02). CONCLUSIONS: Mirror therapy is feasible and effective for upper extremity pain and dysfunction following breast cancer surgery. Clinicians may consider mirror therapy as an adjunctive intervention for breast cancer postoperative rehabilitation to advance the quality of care.

Prenatal diagnosis and clinical management of cardiac rhabdomyoma: a single-center study.

Objective: The study aims to assess the ultrasonic features of fetal cardiac rhabdomyoma (CR), track the perinatal outcome and postnatal disease progression, investigate the clinical utility of ultrasound, MRI and tuberous sclerosis complex (TSC) gene analysis in CR evaluation, and offer evidence for determing of fetal CR prognosis. Methods: We conducted a retrospective analysis of prenatal ultrasound-diagnosed fetal CR cases in our hospital from June 2011 to June 2022, tracked the perinatal outcomes, regularly followed live infants to analyze cardiac lesion changes and disease progression, and compared the sensitivities of ultrasound, MRI and their combination in the detecting of intracranial sclerosing nodules. Results: Our study included 54 fetuses with CR: 32 pregnancies were terminated, 22 were delivered, 35 were diagnosed with TSC, 13 had simple CR without TSC, and in 6 cases, remained unclear whether TSC accompanied the CR due to insufficient evidence. 45 fetuses (83.3%) had multiple lesions, while 9 fetuses (16.7%) presented with a single lesion. Twelve cases had intracardiac complications, all associated with multiple lesions, and these cases exhibited larger maximum tumor diameters than the non-complicated group. Multiple intracardiac lesions were more prevalent in the TSC group than in the simple CR group. However, there was no significant difference in maximum tumor diameter between the two groups. Among 30 fetuses who underwent fetal brain MRI, 23 were eventually diagnosed with TSC, with 11 fetuses showing intracranial sclerosis nodules by ultrasound and 15 by MRI, and the diagnostic consistency was moderate (k = 0.60). Twenty-two fetuses were born and followed up for 6-36 months. CR lesions diminished or disappeared in 18 infants (81.8%), while they remained unchanged in 4 infants (18.2%). Ten out of 12 (83.3%) surviving children diagnosed with TSC developed epilepsy, and 7 (58.3%) had neurodevelopmental dysfunction. Conclusions: The majority of CR cases involve multiple lesions, which are a primary risk factor for TSC. Through prenatal ultrasound examination is crucial for assessing fetal CR prognosis. Although ultrasound combined with MRI can detect intracranial sclerosis nodules in TSC fetuses, its sensitivity is limited. TSC gene sequencing is an essential diagnostic method. Simple CR cases without TSC generally have a favorable prognosis.

The application of virtual reality to home-based rehabilitation for children and adolescents with cerebral palsy: A systematic review and meta-analysis.

BACKGROUND: Home-based rehabilitation enables children and families to participate in therapeutic activities built into their daily routines without the barriers of arrangement and transportation to facilities. Virtual reality is an emerging technology which has shown promising outcomes in rehabilitation. PURPOSE: This systematic review aims to examine the feasibility and effects of virtual reality-enhanced home rehabilitation on Body functions and structures, Activity, and Participation outcomes in children and adolescents with cerebral palsy. METHODS: Interventional studies were searched across five biomedical databases on November 26, 2022. Two independent reviewers conducted study selection, data extraction, and quality assessment. The Physiotherapy Evidence Database scale and National Institutes of Health Study Quality Assessment Tools were used to evaluate the quality of included studies. Meta-analysis was performed to examine the effects of the intervention. RESULTS: Eighteen studies were included in this review. Home-based virtual reality rehabilitation appears feasible with effects on upper extremity and gross motor function, strength, bone density, cognition, balance, walking, daily activity performance, and participation. Meta-analyses revealed significant improvements in hand function (SMD = 0.41, p= .003), gross motor function (SMD = 0.56, p= .0002), and walking capacity (SMD = 0.44, p= .01) following home-based virtual reality intervention. CONCLUSION: Home-based virtual reality may serve as an adjunct to conventional facility-based therapy to promote participation in therapeutic exercises and maximize rehabilitation outcomes. Further properly designed randomized controlled trials using valid and reliable outcome measures with adequately powered sample sizes are warranted to enhance the current body of evidence using home-based virtual reality in cerebral palsy rehabilitation.

Four-section approach of fetal congenital heart disease at 11-13+6 weeks.

Objective: The objective of the study is to explore the value of the four-section approach in detecting fetal heart defects in the first trimester (11-13+6 weeks), analyze the reasons for the inconsistency between the results of ultrasound examination in the first trimester and subsequent verification, and describe the most common abnormal flow patterns of four sections. Materials and methods: Between June 2019 and June 2021, a prenatal four-section approach (upper abdominal transverse section, four-chamber section, three vessel-trachea section, and bilateral subclavian artery section) with verification results in early pregnancy was analyzed. Results: In total, 9,533 fetuses were included. Finally, 176 fetuses with congenital heart disease (CHD), containing 34 types, were identified. The total detection rate of cardiac abnormalities was 1.85%. 102 cases were accurately diagnosed by ultrasonography during early pregnancy. A total of 74 fetuses who had inconsistent results between fetal cardiac ultrasound and verification in early pregnancy were reported, of which the cases of 22 fetuses were inconsistent due to disease evolution and progression and the cases of 52 fetuses were inconsistent due to missed diagnosis and misdiagnosis. The sensitivity, specificity, positive predictive value, and negative predictive value of the four-section approach were 67.05%, 99.96%, 96.58%, and 99.33%, respectively. In this study, a total of 30 abnormal ultrasonic imaging patterns in four sections were summarized. Conclusion: We confirmed that the four-section approach in early pregnancy has a good diagnostic efficacy for fetal CHD. Intrauterine evolution of the fetal heart, missed diagnosis, and misdiagnosis are the reasons for the inconsistency between the results of early pregnancy ultrasound and subsequent verification. This study also presents the abnormal imaging patterns of four scan sections of CHD in early pregnancy, which are instructive for the rapid identification and diagnosis of CHD in the first trimester.

Anomalous origin of the fetal pulmonary artery.

Objectives: This study aims to investigate the efficacy of prenatal ultrasonography in diagnosing the anomalous origin of the fetal pulmonary artery (AOFPA). Methods: A total of 26 AOFPA cases were retrospectively analyzed from January 2014 to January 2023. The features of the AOFPA were characterized by comparing the prenatal ultrasonic data with the results of anatomical casting after pregnancy termination or postnatal imaging and surgical intervention. Missed diagnoses and misdiagnoses were expounded. Results: Of the 26 AOFPA cases, there were 13 cases of pulmonary artery sling, 8 cases of anomalous origin of the unilateral pulmonary artery, and five cases of unilateral absence of the pulmonary artery; 17 cases received pathological anatomy and casting after pregnancy termination, and nine cases were confirmed by postnatal imaging and surgery. Nineteen cases were accurately prenatally diagnosed (19/26, 73.1%), and seven cases were missed or misdiagnosed (7/26, 26.9%). Conclusions: Prenatal ultrasonography has a favorable diagnostic efficacy for anomalous origin of the fetal pulmonary artery. The absence of either the left or right pulmonary artery from the image of pulmonary artery bifurcation may indicate origin abnormalities of the pulmonary artery in fetuses, which signifies the necessity to detect the abnormal origin of the pulmonary artery on the affected side and other potential intracardiac malformation complications.

Characterization of ultrasound and postnatal pathology in fetuses with heterotaxy syndrome.

Background: To explore the diagnostic clues and abnormality spectrum of heterotaxy syndrome by prenatal ultrasonography and postnatal verification. Methods: The prenatal ultrasonic data of 88 heterotaxy syndrome fetuses were analyzed retrospectively as left isomerism (LI) and right isomerism (RI). Prenatal ultrasound compared with the anatomical casting of the fetal body after labor induction, and the confirmatory postnatal diagnosis after delivery. Results: Fetal LI showed typical malformations of gastric vesicles on different sides from the heart, absence of hepatic segment of the inferior vena cava (IVC), abdominal aorta (AO) parallel with the azygos vein (AV), bilateral left bronchus, bilateral left atrial appendages, and polysplenia; intracardiac malformations of AV septal defects (AVSD), single atrium (SA), left ventricular outflow tract obstruction (LVOTO), and double-outlet right ventricle (DORV); and cardiac conduction abnormalities of sinus bradycardia and AV blockage. Fetal RI reported typical malformations of gastric vesicles on different sides from the heart, juxtaposition of the IVC with AO, anomalous pulmonary venous connection (APVC), asplenia, and bilateral right atrial appendages; intracardiac malformations of AVSD, SA, single ventricle, pulmonary atresia and stenosis, and DORV. The postnatal verification revealed 3 malformations misdiagnoses and 4 malformations missed diagnoses in LI fetuses and 10 misdiagnoses and 8 missed diagnoses in RI fetuses. Conclusions: The proposed five-step prenatal ultrasonography has an important diagnostic value for the identification and classification of heterotaxy syndrome. The different sides of gastric vesicles and cardiac apex are important diagnostic clues for heterotaxy syndrome, featuring disconnected or hypoplastic IVC, typical complex cardiac malformation, and atrioventricular block in fetal LI, and shown APVC, juxtaposition of IVC and AO, and intracardiac malformations such as AVSD, DORV, and LVOTO in fetal RI.

Prenatal diagnosis and postnatal verification in fetuses with total anomalous pulmonary venous connection.

Objective: To systematically verify the accuracy of a four-step prenatal ultrasonography in diagnosing fetal total anomalous pulmonary venous connection (TAPVC). Methods: A total of 62 TAPVC fetuses received prenatal ultrasonography and were confirmed by postnatal echocardiography, surgery, or postabortion autopsy. The suspected TAPVC fetuses were further screened by a four-step prenatal ultrasonography for TAPVC classification, pulmonary venous obstruction, and the associated malformations, and followed postpartum. The sonographic features, clinical data, and prognosis of the TAPVC fetuses were retrospectively analyzed. Results: Of the 62 TAPVC fetuses, supracardiac TAPVC was found in 20 cases, intracardiac TAPVC in 12, infracardiac TAPVC in 21, and mixed TAPVC in 9. A total of 30 cases with right atrium isomerism were correctly diagnosed. Of the 11 cases with other intracardiac and extracardiac malformations, 1 case was missed to be diagnosed. Of the 21 isolated TAPVC cases, 6 were missed prenatally and 1 case was prenatally diagnosed as intracardiac and postnatally proved to be mixed (intracardiac type + supracardiac type) by echocardiography. Of the 13 TAPVC live births, 4 infants died in the neonatal period without operation. Of the nine infants undergoing the operation, five recuperated and survived; one survived but had complications with superior vena cava obstruction and collateral circulation formation, and three died postoperatively. Conclusion: The four-step prenatal ultrasound procedure can comprehensively and systematically evaluate fetal TAPVC, detailing the classification, potential obstruction, and associated malformations. It provides substantial support for subsequent prenatal counseling and neonatal assessment. The retrospective analysis also reveals that isolated TAPVC is more prone to be missed in diagnosis.

2D Semiconductor Based Flexible Photoresponsive Ring Oscillators for Artificial Vision Pixels.

Artificial retina implantation provides an effective and feasible attempt for vision recovery in addition to retinal transplantation. The most advanced artificial retinas ever developed based on silicon technology are rigid and thus less compatible with the biosystem. Here we demonstrate flexible photoresponsive ring oscillators (PROs) based on the 2D semiconductor MoS2 for artificial retinas. Under natural light illuminations, arrayed PROs on flexible substrates serving as vision pixels can efficiently output light-intensity-dependent electrical pulses that are processable and transmittable in the human visual nerve system. Such PROs can work under low supply voltages below 1 V with a record-low power consumption, e.g. only 12.4 nW at a light intensity of 10 mW/cm2, decreased by ∼500 times compared with that of the state-of-the-art silicon devices. Such flexible artificial retinas with a simple device structure, high light-to-signal conversion efficiency, ultralow power consumption, and high tunability provide an alternative prosthesis for further clinical trials.

Low power flexible monolayer MoS2 integrated circuits.

Monolayer molybdenum disulfide (ML-MoS2) is an emergent two-dimensional (2D) semiconductor holding potential for flexible integrated circuits (ICs). The most important demands for the application of such ML-MoS2 ICs are low power consumption and high performance. However, these are currently challenging to satisfy due to limitations in the material quality and device fabrication technology. In this work, we develop an ultra-thin high-κ dielectric/metal gate fabrication technique for the realization of thin film transistors based on high-quality wafer scale ML-MoS2 on both rigid and flexible substrates. The rigid devices can be operated in the deep-subthreshold regime with low power consumption and show negligible hysteresis, sharp subthreshold slope, high current density, and ultra-low leakage currents. Moreover, we realize fully functional large-scale flexible ICs operating at voltages below 1 V. Our process could represent a key step towards using energy-efficient flexible ML-MoS2 ICs in portable, wearable, and implantable electronics.

Gastric and gastroesophageal junction cancer: Risk factors and prophylactic treatments for prevention of peritoneal recurrence after curative intent surgery.

Aim: Relapse after curative treatment for advanced gastric cancer, and especially peritoneal recurrence, is very common and has a dismal prognosis. The aim of this review is to summarize existing evidence regarding risk factors and prophylactic treatments intending to prevent peritoneal recurrence. Methods: A structured search of relevant studies was conducted in MEDLINE, Embase, and the Cochrane Library. Results: The main risk factors identified are advanced pathological T-stage (pT ≥ 3), regional lymph node involvement, diffuse/poorly cohesive type tumor, poorly differentiated cancer, and positive peritoneal wash cytology. Systemic chemotherapy in the perioperative or adjuvant setting improves survival for the patients but despite this peritoneal recurrence remains a common and yet an unsolved clinical problem. Different approaches of intraperitoneal chemotherapy such as hyperthermic intraperitoneal chemotherapy and early postoperative intraperitoneal chemotherapy have shown promising results as prophylactic treatments aiming to prevent peritoneal recurrence. Conclusion: Future studies are warranted to find safe and effective treatments to prevent peritoneal recurrence.

Platelet Membrane Biomimetic Nanoparticles Combined With UTMD to Improve the Stability of Atherosclerotic Plaques.

Although research on the treatment of atherosclerosis has progressed recently, challenges remain in developing more effective, safer and transformative strategies for the treatment of atherosclerosis. Nanomaterials have recently played a unique role in many fields, including atherosclerosis treatment. Platelets are common component in the blood. Due to their inherent properties, platelets can target and adhere to atherosclerotic plaques. Ultrasound-targeted microbubble destruction (UTMD) shows great prospects in promoting the efficiency of drug delivery in treating solid tumors. In this study, we explored the possibility that UTMD assists platelet biomimetic rapamycin (RAP)-loaded poly (lactic-co-glycolic acid) (PLGA) nanoparticles (RAP@PLT NPs) in the treatment of atherosclerosis. The biomimetic nano-formulations exhibit better targeting ability to plaques when administered in vivo. Targeted destruction of Sonovue™ in the aortic area further improved the efficiency of targeting plaques. Moreover, the progression of atherosclerotic plaques was inhibited, and the stability of plaques was improved. Together, our study established a novel strategy for targeted delivery of nanoparticles in atherosclerotic plaques, by combining the advantages of the ultrasonic cavitation effect and biomimicking nanoparticles in drug delivery.

Partial stomach-partitioning gastrojejunostomy for gastric outlet obstruction: A cohort study based on consecutive case series from a single center.

BACKGROUND/OBJECTIVE: Gastric outlet obstruction can have a large impact on quality of life for patients with upper gastrointestinal cancer or benign obstruction. Partial stomach-partitioning gastrojejunostomy has previously shown promising outcomes compared to conventional gastrojejunostomy in terms of reduced delayed gastric emptying. The objective of the current study was to present outcomes of partial stomach-partitioning gastrojejunostomy in a single high-volume center for upper gastrointestinal cancer. METHODS: A retrospective cohort study including all consecutive patients who underwent partial stomach-partitioning gastrojejunostomy from 2013 to 2020. The primary outcome was oral intake tolerance. A subgroup analysis was performed in all patients with manifest gastric outlet obstruction comparing partial stomach-partitioning gastrojejunostomy to conventional gastrojejunostomy. RESULTS: Partial stomach-partitioning gastrojejunostomy was performed in 32 patients and laparoscopic technique was used in 19 patients (59%). The procedure improved oral intake tolerance defined by gastric outlet obstruction scoring system by 0.63 points on average (P = 0.041). No postoperative complications related to the procedure were observed. Recurrence of gastric outlet obstruction developed in six patients (19%), four patients (13%) required endoscopic reintervention but no patient required surgical reintervention. A comparison between partial stomach-partitioning gastrojejunostomy and conventional gastrojejunostomy showed no statistically significant differences regarding postoperative nutritional status, length of hospital stay, recurrence or reintervention. CONCLUSION: The results of the study show that partial stomach-partitioning gastrojejunostomy can be an effective surgical treatment for patients suffering from gastric outlet obstruction and that the procedure can be safely performed with laparoscopic technique.

Role of Radiology in the Preoperative Detection of Arterial Calcification and Celiac Trunk Stenosis and Its Association with Anastomotic Leakage Post Esophagectomy, an Up-to-Date Review of the Literature.

Surgical resection of the esophagus remains a critical component of the multimodal treatment of esophageal cancer. Anastomotic leakage (AL) is the most significant complication following esophagectomy, in terms of clinical implications. Identifying risk factors for AL is important for modifying patient management and improving surgical outcomes. This review aims to examine the role of radiological risk factors for AL after esophagectomy, and in particular, arterial calcification and celiac trunk stenosis. Eligible publications prior to 25 August 2021 were retrieved from Medline and Google Scholar using a predefined search algorithm. A total of 68 publications were identified, of which 9 original studies remained for in-depth analysis. The majority of these studies found correlations between calcifications in the aorta, celiac trunk, and right post-celiac arteries and AL following esophagectomy. Some studies suggest celiac trunk stenosis as a more appropriate surrogate. Our up-to-date review highlights the need for automated quantification of aortic calcifications, as well as the degree of celiac trunk stenosis in preoperative computed tomography in patients undergoing esophagectomy, to obtain robust and reproducible measurements that can be used for a definite correlation.