The occurrence and development mechanisms of esophageal stricture: state of the art review.

BACKGROUND: Esophageal strictures significantly impair patient quality of life and present a therapeutic challenge, particularly due to the high recurrence post-ESD/EMR. Current treatments manage symptoms rather than addressing the disease's etiology. This review concentrates on the mechanisms of esophageal stricture formation and recurrence, seeking to highlight areas for potential therapeutic intervention. METHODS: A literature search was conducted through PUBMED using search terms: esophageal stricture, mucosal resection, submucosal dissection. Relevant articles were identified through manual review with reference lists reviewed for additional articles. RESULTS: Preclinical studies and data from animal studies suggest that the mechanisms that may lead to esophageal stricture include overdifferentiation of fibroblasts, inflammatory response that is not healed in time, impaired epithelial barrier function, and multimethod factors leading to it. Dysfunction of the epithelial barrier may be the initiating mechanism for esophageal stricture. Achieving perfect in-epithelialization by tissue-engineered fabrication of cell patches has been shown to be effective in the treatment and prevention of esophageal strictures. CONCLUSION: The development of esophageal stricture involves three stages: structural damage to the esophageal epithelial barrier (EEB), chronic inflammation, and severe fibrosis, in which dysfunction or damage to the EEB is the initiating mechanism leading to esophageal stricture. Re-epithelialization is essential for the treatment and prevention of esophageal stricture. This information will help clinicians or scientists to develop effective techniques to treat esophageal stricture in the future.

Anti-inflammatory and Neuroprotective α-Pyrones from a Marine-Derived Strain of the Fungus Arthrinium arundinis and Their Heterologous Expression.

Fungal linear polyketides, such as α-pyrones with a 6-alkenyl chain, have been a rich source of biologically active compounds. Two new (1 and 2) and four known (3-6) 6-alkenylpyrone polyketides were isolated from a marine-derived strain of the fungus Arthrinium arundinis. Their structures were determined based on extensive spectroscopic analysis. The biosynthetic gene cluster (alt) for alternapyrones was identified from A. arundinis ZSDS-F3 and validated by heterologous expression in Aspergillus nidulans A1145 ΔSTΔEM, which revealed that the cytochrome P450 monooxygenase Alt2' could convert the methyl group 26-CH3 to a carboxyl group to produce 4 from 3. Another cytochrome P450 monooxygenase, Alt3', catalyzed successive hydroxylation, epoxidation, and oxidation steps to produce 1, 2, 5, and 6 from 4. Alternapyrone G (1) not only suppressed M1 polarization in lipopolysaccharide (LPS)-stimulated BV2 microglia but also stimulated dendrite regeneration and neuronal survival after Aß treatment, suggesting alternapyrone G may be utilized as a privileged scaffold for Alzheimer's disease drug discovery.

Tanzawaic Acid Derivatives from the Marine-Derived Penicillium steckii as Inhibitors of RANKL-Induced Osteoclastogenesis.

Seven new tanzawaic acid derivatives, steckwaic acids E-K (1-7), and one new benzene derivate (8), together with seven known tanzawaic acid analogues (9-16) were isolated from the marine algicolous fungus Penicillium steckii SCSIO 41040. The structures and absolute configurations of these new compounds (1-8) were determined by spectroscopic analyses, X-ray diffraction, and comparison of ECD spectra to calculations. Compounds 2, 10, and 15 inhibited lipopolysaccharide (LPS)-induced nuclear factor kappa-B (NF-κB) with IC50 values of 10.4, 18.6, and 15.2 µM, respectively. Compound 2 could suppress the receptor activator of NF-κB ligand (RANKL)-induced osteoclast differentiation in bone marrow macrophage cells (BMMCs). To the best of our knowledge, this is the first report of osteoclastogenesis inhibitory activity for tanzawaic acid derivatives.

Structurally various p-terphenyls with neuraminidase inhibitory from a sponge derived fungus Aspergillus sp. SCSIO41315.

Guided by Global Natural Products Social molecular networking, 14 new p-terphenyl derivatives, asperterphenyls A-N (1-14), together with 20 known p-terphenyl derivatives (15-34), were obtained from a sponge derived fungus Aspergillus sp. SCSIO41315. Among them, new compounds 2-8 and 15-17 were ten pairs of enantiomers. Comprehensive methods such as chiral-phase HPLC analysis, ECD calculations and X-ray diffraction analysis were applied to determine the absolute configurations. Asperterphenyls B (2) and C (3) represented the first reported natural p-terphenyl derivatives possessing a dicarboxylic acid system. Asperterphenyl A (1) displayed neuraminidase inhibitory activity with an IC50 value of 1.77 ± 0.53 µM and could efficiently inhibit infection of multiple strains of H1N1 with IC50 values from 0.67 ± 0.28 to 1.48 ± 0.60 µM through decreasing viral plaque formation in a dose-dependent manner, which suggested that asperterphenyl A (1) might be exploited as a potential antiviral compound in the pharmaceutical fields.

New Meroterpenoids and Anti-Osteoclastogenic Polyketides from the Mangrove-Derived fungus Arthrinium sp. SCSIO 41306.

Two new meroterpenoids, arthrinones A and B (1 and 2), along with six known compounds (3-8), were obtained from the fungus Arthrinium sp. SCSIO 41306. Comprehensive methods such as chiral-phase HPLC analysis and ECD calculations were applied to determine the absolute configurations. Griseofulvin (5), kojic acid (6), and 1H-indole-3-carboxaldehyde (8) showed inhibition of NF-κB in RAW 264.7 macrophages induced by lipopolysaccharide (LPS) with IC50 values of 22.21, 13.87 and 19.31 µM, respectively. In addition, griseofulvin (5) inhibited receptor activator of NF-κB ligand (RANKL)-induced osteoclast differentiation in a dose-dependent manner without visible evidence of cytotoxicity in bone marrow macrophages (BMMs). This is the first report on the activity of griseofulvin (5) to inhibit osteoclast formation (IC50 10.09±0.21 µM).

Estimation of Lower Limb Joint Angles and Joint Moments during Different Locomotive Activities Using the Inertial Measurement Units and a Hybrid Deep Learning Model.

Using inertial measurement units (IMUs) to estimate lower limb joint kinematics and kinetics can provide valuable information for disease diagnosis and rehabilitation assessment. To estimate gait parameters using IMUs, model-based filtering approaches have been proposed, such as the Kalman filter and complementary filter. However, these methods require special calibration and alignment of IMUs. The development of deep learning algorithms has facilitated the application of IMUs in biomechanics as it does not require particular calibration and alignment procedures of IMUs in use. To estimate hip/knee/ankle joint angles and moments in the sagittal plane, a subject-independent temporal convolutional neural network-bidirectional long short-term memory network (TCN-BiLSTM) model was proposed using three IMUs. A public benchmark dataset containing the most representative locomotive activities in daily life was used to train and evaluate the TCN-BiLSTM model. The mean Pearson correlation coefficient of joint angles and moments estimated by the proposed model reached 0.92 and 0.87, respectively. This indicates that the TCN-BiLSTM model can effectively estimate joint angles and moments in multiple scenarios, demonstrating its potential for application in clinical and daily life scenarios.

VDVM: An automatic vertebrae detection and vertebral segment matching framework for C-arm X-ray image identification.

BACKGROUND: C-arm fluoroscopy, as an effective diagnosis and treatment method for spine surgery, can help doctors perform surgery procedures more precisely. In clinical surgery, the surgeon often determines the specific surgical location by comparing C-arm X-ray images with digital radiography (DR) images. However, this heavily relies on the doctor's experience. OBJECTIVE: In this study, we design a framework for automatic vertebrae detection as well as vertebral segment matching (VDVM) for the identification of vertebrae in C-arm X-ray images. METHODS: The proposed VDVM framework is mainly divided into two parts: vertebra detection and vertebra matching. In the first part, a data preprocessing method is used to improve the image quality of C-arm X-ray images and DR images. The YOLOv3 model is then used to detect the vertebrae, and the vertebral regions are extracted based on their position. In the second part, the Mobile-Unet model is first used to segment the vertebrae contour of the C-arm X-ray image and DR image based on vertebral regions respectively. The inclination angle of the contour is then calculated using the minimum bounding rectangle and corrected accordingly. Finally, a multi-vertebra strategy is applied to measure the visual information fidelity for the vertebral region, and the vertebrae are matched based on the measured results. RESULTS: We use 382 C-arm X-ray images and 203 full length X-ray images to train the vertebra detection model, and achieve a mAP of 0.87 in the test dataset of 31 C-arm X-ray images and 0.96 in the test dataset of 31 lumbar DR images. Finally, we achieve a vertebral segment matching accuracy of 0.733 on 31 C-arm X-ray images. CONCLUSIONS: A VDVM framework is proposed, which performs well for the detection of vertebrae and achieves good results in vertebral segment matching.

Therapeutic targeting RORγ with natural product N-hydroxyapiosporamide for small cell lung cancer by reprogramming neuroendocrine fate.

Small cell lung cancer (SCLC) is an aggressive and exceptionally fatal disease. Unlike non- small cell lung cancer (NSCLC), no targetable genetic driver events have been identified in SCLC to date. Here, we investigate the function of RAR-related orphan receptor gamma (RORγ) and identified the anti-cancer activity of its natural inhibitor against SCLC and illustrate the underlying mechanism. We show that RORγ depletion affected cell growth both in 2-D cell proliferation and 3-D organoids formation. Natural marine product N-hydroxyapiosporamide (N-hydap) directly bound to RORγ and inhibited its transcriptional activity, leading to the blocking of transmission process of RORγ signaling. Gene expression profiling analysis revealed that N-hydap reprograms neuroendocrine fate via inhibiting RORγ activity in SCLC. Chromatin immunoprecipitation analysis showed that N-hydap strongly reduced RORγ occupancy and transcriptional activation-linked histone marks H3K27ac on the promoter and/or enhancer sites of neurogenesis markers gene including aurora kinase a (AURKA), delta like canonical Notch ligand 3 (DLL3) and tubulin beta 3 class III (TUBB3). Therapeutically, N-hydap exhibited a strong inhibitory effect on tumor growth and did not show significant toxicity in SCLC mice xenograft models. Taken together, RORγ could be an attractive target for SCLC and thus N-hydap can be a promising therapeutic drug candidate for SCLC by inhibiting the RORγ activation.

Citrinin and α-pyrone derivatives with pancreatic lipase inhibitory activities from Penicillium sp. SCSIO 41302.

One new citrinin monomer derivative (1), and two new natural products α-pyrone analogues (2a and 2b), were isolated from the sponge derived fungus Penicillium sp. SCSIO 41302. Their structures were determined by extensive spectroscopic analysis, chiral-phase HPLC analysis, modified Mosher's method, ECD calculations, and X-ray single-crystal diffraction. Bioactivity screening showed that compounds 2b and 8 exhibited obvious inhibitory activities against pancreatic lipase and acetyl cholinesterase with IC50 values of 48.5 and 4.8 µM, respectively, which indicated that different chiral center between enantiomers (2a and 2b) might result in different biological activities (IC50 value against PL for 2a >100 µg/ml).

Human placental mesenchymal stem cell derived exosomes exhibit anti-inflammatory effects via TLR4-mediated NF-κB/MAPK and PI3K signaling pathways.

Exosomes are a type of nanoparticles in 40-200 nm extracellular vesicles secreted from living cells, containing a plurality of biologically active substances, which can be used as carriers of intercellular delivery signals. Among them, mesenchymal stem cell (MSC)-derived exosomes have been reported to play important roles in injury repair, alleviating inflammation; thus, MSC-derived exosomes have become hot spot in noncellular therapies. The role of human placental MSC-derived exosomes (hplMSC-Exos) in inflammation and their potential mechanisms are unclear. Therefore, we investigated the anti-inflammatory effects of hplMSC-Exos in lipopolysaccharide (LPS)-induced RAW264.7 cells and their intrinsic mechanisms. Our data demonstrated that hplMSCs-Exos can adjust inflammation by regulating TLR4-mediated NF-κB/MAPK and PI3K signaling pathways, indicating that hplMSCs-Exos can act as a new strategy for inflammatory treatment.

Comparative analysis of kinetics and mechanisms for Pb(II) sorption onto three kinds of microplastics.

Microplastics (MPs), a kind of novel contaminant, have potential to concentrate and transport heavy metals in the aquatic environment. This feature may affect the distribution and bioavailability of heavy metals. In order to determine the sorption behaviors of heavy metals onto the MPs, the sorption kinetics and mechanisms were investigated between the MPs (polyvinylchloride PVC, polyethylene PE, polystyrene PS) and Pb(II). The results suggested that the Pb(II) sorption onto the MPs were pH- and ionic strength-dependent. The sorption processes were best fitted by the pseudo-second-order model, and the rate-limiting steps were the intraparticle diffusion and final equilibrium process. The maximum sorption capacities of PVC, PE and PS were 483.1 µg/g, 416.7 µg/g and 128.5 µg/g under the condition of 0.01 M NaCl, pH 6.0, T = 298 K. The sorption rate constants were in the following order: PVC

Di-tert-butyl Ethynylimidodicarbonate as a General Synthon for the ß-Aminoethylation of Organic Electrophiles: Application to the Formal Synthesis of Pyrrolidinoindoline Alkaloids (±)-CPC-1 and (±)-Alline.

The reagent di-tert-butyl ethynylimidodicarbonate is demonstrated as a ß-aminoethyl anion synthetic equivalent. It can be used to install ethyleneamine groups by exploiting its terminal alkyne reactivity with common organic electrophiles. Reactions exemplified with this terminal ynimide reagent include additions to imines, aldehydes, ketones, pyridinium salts, Michael acceptors, epoxides, and Pd-catalyzed Sonogashira couplings. Subsequent regioselective [3 + 2] cycloadditions of the alkynyl-imides (ynimides) generate N,N-di-Boc imide-functionalized triazole and isoxazole heterocycles. Reduction of the ynimides with Pd-catalyzed hydrogenation generates ethyleneimides with easily removable N,N-di-Boc-carbamate protecting groups, allowing for a flexible ynimide-based approach to ethyleneamine installation. The utility of this two-step aminoethylation strategy was demonstrated in the short formal syntheses of pyrrolidinoindoline alkaloids (±)-CPC-1 and (±)-alline. Analogously, the reagent (N,N,N')-tri-Boc 2-ethynylhydrazine serves as a ß-hydrazinoethyl anion synthetic equivalent.

The efficacy of immersive virtual reality surgical simulator training for pedicle screw placement: a randomized double-blind controlled trial.

OBJECTIVE: To verify whether the pedicle screw placement (PSP) skills of young surgeons receiving immersive virtual reality surgical simulator (IVRSS) training could be improved effectively and whether the IVRSS-PSP training mode could produce a real clinical value in clinical surgery. METHODS: Twenty-four young surgeons were equally randomized to a VR group and a NON-VR group. Participants in VR group received IVRSS-PSP training, and those in NON-VR group used the conventional model of observing a spinal model first and then watching a teaching video of spinal surgery for 40 minutes x five. The nailing outcome of the participants before and after training was evaluated by statistical analysis in both groups. RESULTS: Post-training data analysis showed that the success rate and accuracy rate of screw placement in VR group and NON-VR group were 82.9% and 69.6% vs. 74.2% and 55.4%, respectively, showing statistically significant differences between the two groups by chi-square test (P < 0.05). CONCLUSION: The present study demonstrated that IVRSS-PSP was helpful to improve the success rate of PSP for young surgeons, and may provide valuable reference for PSP training of young surgeons. In addition, our study also showed a promising potential of the VR technology in surgical simulation training.

ILKAP Binding to and Dephosphorylating HIF-1α is Essential for Apoptosis Induced by Severe Hypoxia.

BACKGROUND/AIMS: Integrin-linked kinase-associated phosphatase (ILKAP), a serine/threonine phosphatase that belongs to the protein phosphatase 2C family, has a role in cell survival and apoptosis. Hypoxia-inducible factor 1α (HIF-1α) is the key transcription factor in the response to oxygen deficiency in mammals. Direct phosphorylation and dephosphorylation of HIF-1α affect its function. The present study investigated the role of ILKAP on HIF-1α dephosphorylation and cell behavior. METHODS: HIF-1α was induced by hypoxia. Physical binding between ILKAP and HIF-1α was demonstrated by a co-immunoprecipitation assay. HIF-1α transcriptional activity was investigated using a hypoxia-response element-containing luciferase reporter plasmid. Cell viability was evaluated by a trypan blue dye exclusion assay. ILKAP function was explored by a gain and loss assay with an overexpression plasmid and shRNA infection. RESULTS: ILKAP physically interacted with HIF-1α and induced its dephosphorylation. Both the HIF-1α-p53 interaction and apoptosis relied on ILKAP. CONCLUSION: The results indicated that the ILKAP directly binds and dephosphorylates HIF-1α and responsible for severe hypoxia-induced cell apoptosis.

A Digitalized Gyroscope System Based on a Modified Adaptive Control Method.

In this work we investigate the possibility of applying the adaptive control algorithm to Micro-Electro-Mechanical System (MEMS) gyroscopes. Through comparing the gyroscope working conditions with the reference model, the adaptive control method can provide online estimation of the key parameters and the proper control strategy for the system. The digital second-order oscillators in the reference model are substituted for two phase locked loops (PLLs) to achieve a more steady amplitude and frequency control. The adaptive law is modified to satisfy the condition of unequal coupling stiffness and coupling damping coefficient. The rotation mode of the gyroscope system is considered in our work and a rotation elimination section is added to the digitalized system. Before implementing the algorithm in the hardware platform, different simulations are conducted to ensure the algorithm can meet the requirement of the angular rate sensor, and some of the key adaptive law coefficients are optimized. The coupling components are detected and suppressed respectively and Lyapunov criterion is applied to prove the stability of the system. The modified adaptive control algorithm is verified in a set of digitalized gyroscope system, the control system is realized in digital domain, with the application of Field Programmable Gate Array (FPGA). Key structure parameters are measured and compared with the estimation results, which validated that the algorithm is feasible in the setup. Extra gyroscopes are used in repeated experiments to prove the commonality of the algorithm.

Antitumor aspochalasin and antiviral benzofuran derivatives from a marine-derived fungus Aspergillus sp. SCSIO41032.

Chemical investigation of the EtOAc extract of a deep-sea derived fungus Aspergillus sp. SCSIO41032 resulted in the isolation of ten known compounds, including eight aspochalasins. Their structures were elucidated by using extensive NMR spectroscopic, mass spectrometric and single crystal X-ray diffraction analysis. The detailed crystallographic data for structures 1, 2, and 4, along with the relative configurations of aspochalasin E (3) determined by its acetonide derivative were reported for the first time. The results of antitumor and antiviral activities showed that 3 displayed moderate antitumor activities against 22Rv1, PC-3, A549, and HCT-15 cell lines with IC50 values ranged from 5.9 ± 0.8 to 19.0 ± 7.7 µM, and 9 exhibited moderate antiviral activities against HSV-1/2 with EC50 values of 9.5 ± 0.5 and 5.4 ± 0.6 µM, respectively. Plate clone formation assays results indicated that 3 inhibited the 22Rv1, PC-3 cells growth in a dose-dependent manner.

Estimation of electrical muscle activity during gait using inertial measurement units with convolution attention neural network and small-scale dataset.

In general, muscle activity can be directly measured using Electromyography (EMG) or calculated with musculoskeletal models. However, both methods are not suitable for non-technical users and unstructured environments. It is desired to establish more portable and easy-to-use muscle activity estimation methods. Deep learning (DL) models combined with inertial measurement units (IMUs) have shown great potential to estimate muscle activity. However, it frequently occurs in clinical scenarios that a very small amount of data is available and leads to limited performance of the DL models, while the augmentation techniques to efficiently expand a small sample size for DL model training are rarely used. The primary aim of the present study was to develop a novel DL model to estimate the EMG envelope during gait using IMUs with high accuracy. A secondary aim was to develop a novel model-based data augmentation method to improve the performance of the estimation model with small-scale dataset. Therefore, in the present study, a time convolutional network-based generative adversarial network, namely MuscleGAN, was proposed for data augmentation. Moreover, a subject-independent regression DL model was developed to estimate EMG envelope. Results suggested that the proposed two-stage method has better generalization and estimation performance than the commonly used existing methods. Pearson correlation coefficient and normalized root-mean-square errors derived from the proposed method reached up to 0.72 and 0.13, respectively. It was indicated that the MuscleGAN indeed improved the estimation accuracy of lower limb EMG envelope from 70% to 72%. Thus, even using only two IMUs and a very small-scale dataset, the proposed model is still capable of accurately estimating lower limb EMG envelope, demonstrating considerable potential for its application in clinical and daily life scenarios.

Formulation and application of the "hospital-to-home + online-to-offline" treatment scheme in caring for and supporting vulnerable patients with chronic heart failure.

BACKGROUND: Chronic heart failure (CHF) is the terminal stage of cardiovascular disease. OBJECTIVE: In this study, the "hospital-to-home + online-to-offline" (H2H + O2O) care scheme was implemented for patients with CHF during vulnerable periods, and its effect was evaluated. METHODS: Patients with CHF in the cardiovascular department of a Class III/Grade A hospital in Jiangxi Province from January to December 2020 were selected using a convenience sampling method and randomly divided into a control and intervention group (n= 100 each). The patients in the control group received routine in-hospital treatment and out-of-hospital follow-up, while in the intervention group, a multi-disciplinary cooperation team with CHF specialist nurses evaluated and stratified the patients before discharge and formulated individualized prescriptions and care plans. Based on the "Health & Happiness" chronic disease follow-up application designed for this study, the specialist nurses provided patients with one-to-one guidance. After three months, the cardiac function, heart failure knowledge, self-care behavior, and re-hospitalization rate of the patients were compared between the two groups. Cardiac function was evaluated by the serum B-type natriuretic peptide (BNP), the left ventricular ejection fraction (LVEF), and a six-minute walking test (6MWT). Heart failure knowledge and self-care behavior was assessed using specific questionaries. RESULTS: The level of cardiac function in the intervention group was significantly higher than that in the control group, and the difference was statistically significant (P< 0.001). The mastery of heart failure knowledge and self-care behavior in the intervention group were significantly higher than those in the control group, and the differences were statistically significant (P< 0.05). The re-hospitalization rate due to CHF in the intervention group was 21.0%, which was lower than that in the control group (35.0%), and the difference was statistically significant (P< 0.05). CONCLUSION: The H2H + O2O care scheme can be used for the transition of vulnerable patients with CHF from the hospital to family care to improve the patients' level of cardiac function, elevate their knowledge level and self-care abilities, and improve their overall health outcomes.

Metabolism characterization and toxicity of N-hydap, a marine candidate drug for lung cancer therapy by LC-MS method.

N-Hydroxyapiosporamide (N-hydap), a marine product derived from a sponge-associated fungus, has shown promising inhibitory effects on small cell lung cancer (SCLC). However, there is limited understanding of its metabolic pathways and characteristics. This study explored the in vitro metabolic profiles of N-hydap in human recombinant cytochrome P450s (CYPs) and UDP-glucuronosyltransferases (UGTs), as well as human/rat/mice microsomes, and also the pharmacokinetic properties by HPLC-MS/MS. Additionally, the cocktail probe method was used to investigate the potential to create drug-drug interactions (DDIs). N-Hydap was metabolically unstable in various microsomes after 1 h, with about 50% and 70% of it being eliminated by CYPs and UGTs, respectively. UGT1A3 was the main enzyme involved in glucuronidation (over 80%), making glucuronide the primary metabolite. Despite low bioavailability (0.024%), N-hydap exhibited a higher distribution in the lungs (26.26%), accounting for its efficacy against SCLC. Administering N-hydap to mice at normal doses via gavage did not result in significant toxicity. Furthermore, N-hydap was found to affect the catalytic activity of drug metabolic enzymes (DMEs), particularly increasing the activity of UGT1A3, suggesting potential for DDIs. Understanding the metabolic pathways and properties of N-hydap should improve our knowledge of its drug efficacy, toxicity, and potential for DDIs.

Improvement of antibacterial activity of polysaccharides via chemical modification: A review.

Antibiotic residue and bacterial resistance induced by antibiotic abuse have seriously threatened food safety and human healthiness. Thus, the development and application of safe, high-efficiency, and environmentally friendly antibiotic alternatives are urgently necessary. Apart from antitumor, antivirus, anti-inflammatory, gut microbiota regulation, immunity improvement, and growth promotion activities, polysaccharides also have antibacterial activity, but such activity is relatively low, which cannot satisfy the requirements of food preservation, clinical sterilization, livestock feeding, and agricultural cultivation. Chemical modification not only provides polysaccharides with better antibacterial activity, but also promotes easy operation and large-scale production. Herein, the enhancement of the antibacterial activity of polysaccharides via acetylation, sulfation, phosphorylation, carboxymethylation, selenation, amination, acid graft, and other chemical modifications is reviewed. Meanwhile, a new trend on the application of loading chemically modified polysaccharides into nanostructures is discussed. Furthermore, possible limitations and future recommendations for the development and application of chemically modified polysaccharides with better antibacterial activity are suggested.