The efficacy and safety of snare traction-assisted endoscopic submucosal dissection for circumferential superficial esophageal cancer.

OBJECTIVE: This study aims to investigate the efficacy and safety of snare traction-assisted endoscopic submucosal dissection (ESD) for the management of circumferential superficial esophageal cancer. METHODS: A total of 68 patients who underwent ESD for circumferential superficial esophageal cancer were included in this study. All the patients were divided into two groups based on whether the snare traction was used or not; the snare traction group (S-ESD, group n = 35) and the control group (C-ESD, group n = 33). RESULTS: There was no significant difference in the size of the resected area between the groups [21.98 (18.30, 27.00) cm2 vs 24.00 (15.28, 30.72) cm2, P = 0.976]. The snare traction group had a shorter dissection time [92.00 (74.00, 121.00) min vs 110.00 (92.50, 137.00) min, P = 0.017] and a faster resection speed [0.28 ± 0.13 cm2/min vs 0.22 ± 0.11cm2/min, P = 0.040] compared to the control group. There were no statistically significant differences between the two groups in terms of hospital stay, cost, en bloc resection rate, R0 resection rate, curative resection rate, bleeding rate, perforation rate, stricture rate, and recurrence rate (P > 0.05). CONCLUSION: Snare traction-assisted ESD is a safe and efficient approach for the treatment of circumferential superficial esophageal cancer. Its advantages includes shorter procedure so the anesthesia requirement, clear operative filed view, improved mucosal dissection efficiency, simple, and easily accessible equipment.

Comparative Analysis of Enbloc or Piecemeal Removal After Enbloc Resection of Gastrointestinal Stromal Tumors.

OBJECTIVE: To investigate the safety and prognosis of enbloc or piecemeal removal after enbloc resection of a gastric GIST by comparing the clinical data of endoscopic en block resection and piecemeal removal (EP) and en block resection and complete removal (EC) of gastric GISTs. METHODS: A total of 111 (43 endoscopic piecemeal, and 68 complete removal) patients with gastric GIST's ≥ 2 cm in diameter who underwent endoscopic therapy from January 2016 to June 2020 at the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. In all cases, it was ensured that the tumor was intact during the resection, however, it was divided into EP group and EC group based on whether the tumor was completely removed or was cut into pieces which were then removed. The patients' recurrence-free survival rate and recurrence-free survival (RFS) were recorded. RESULTS: There was no statistically significant difference in RFS rates between the two groups (P = 0.197). The EP group had relatively high patient age, tumor diameter, risk classification, and operation time. However, there was no statistically significant difference in the number of nuclear fission images, postoperative hospitalization time, postoperative fasting time, complication rate and complication grading between the two groups (P > 0.05). CONCLUSION: Endoscopic piecemeal removal after en block resection of gastric GIST is safe and effective and achieves similar clinical outcomes as complete removal after en block resection.

Tip-Induced In-Plane Ferroelectric Superstructure in Zigzag-Wrinkled BaTiO3 Thin Films.

The complex micro-/nanoscale wrinkle morphology primarily fabricated by elastic polymers is usually designed to realize unique functionalities in physiological, biochemical, bioelectric, and optoelectronic systems. In this work, we fabricated inorganic freestanding BaTiO3 ferroelectric thin films with zigzag wrinkle morphology and successfully modulated the ferroelectric domains to form an in-plane (IP) superstructure with periodic surface charge distribution. Our piezoresponse force microscopy (PFM) measurements and phase-field simulation demonstrate that the self-organized strain/stress field in the zigzag-wrinkled BaTiO3 film generates a corresponding pristine domain structure. These domains can be switched by tip-induced strain gradient (flexoelectricity) and naturally form a robust and unique "braided" in-plane domain pattern, which enables us to offer an effective and convenient way to create a microscopic ferroelectric superstructure. The corresponding periodic surface potential distribution provides an extra degree of freedom in addition to the morphology that could regulate cells or polar molecules in physiological and bioelectric applications.

The Use of Iron-Doped Anatase TiO2 Nanofibers for Enhanced Photocatalytic Fenton-like Reaction to Degrade Tylosin.

The removal of antibiotics from wastewater to prevent their environmental accumulation is significant for human health and ecosystems. Herein, iron (Fe)-atom-doped anatase TiO2 nanofibers (Fe-TNs) were manufactured for the photocatalytic Fenton-like decomposition of tylosin (TYL) under LED illumination. Compared with the pristine TiO2 nanofibers (TNs), the optimized Fe-TNs exhibited improved visible-light-driven photocatalytic Fenton-like activity with a TYL degradation efficiency of 98.5% within 4 h. The effective TYL degradation could be attributed to the expanded optical light absorption and accelerated separation and migration of photogenerated electrons and holes after the introduction of Fe. The photogenerated electrons were highly conducive to the generation of active SO4•- radicals as they facilitated Fe(III)/Fe(II) cycles, and to oxidizing TYL. Moreover, the holes could be involved in TYL degradation. Thus, a significant enhancement in TYL degradation could be achieved. This research verifies the use of iron-doped anatase nanofibers as an effective method to synthesize novel photocatalytic Fenton-like catalysts through surface engineering for wastewater remediation.

Synthesis of Ordered Pt Nanocube Arrays Directed by Block Copolymer Nanotemplate and Their Potential on Ethanol Oxidation Reaction.

In this work, well-ordered platinum (Pt) nanocubes (NCs), with precise control on the size and the spatial arrangement, are synthesized from a microemulsion overgrowth in a block copolymer (BC) nanotemplate. The nanovials on this self-assembled BC template serve as microreactors for the reduction of the HCl/H2PtCl6 precursor and direct the ordered periodic arrangement of the reduced Pt nanoparticles (NPs). As the content of HCl increases from 0% to 25%, the Pt NPs evolve from quasi-spheres to NCs, for which the density functional theory (DFT) computation reveals that the different adsorption energies of Cl and HCl dominate this morphology transition. For their potential application in fuel cells, the electrochemical catalysis of the Pt NCs demonstrates a 2.8-fold mass activity in contrast to the commercial JM 40% catalyst at the same Pt loading in ethanol oxidation reaction (EOR) and a good stability of 2.2% ECSA loss over 10 000 CV cycling.

Dual Specificity Phosphatase 12 Regulates Hepatic Lipid Metabolism Through Inhibition of the Lipogenesis and Apoptosis Signal-Regulating Kinase 1 Pathways.

Nonalcoholic fatty liver disease (NAFLD) has become the most common cause of chronic liver disease worldwide. Due to the growing economic burden of NAFLD on public health, it has become an emergent target for clinical intervention. DUSP12 is a member of the dual specificity phosphatase (DUSP) family, which plays important roles in brown adipocyte differentiation, microbial infection, and cardiac hypertrophy. However, the role of DUSP12 in NAFLD has yet to be clarified. Here, we reveal that DUSP12 protects against hepatic steatosis and inflammation in L02 cells after palmitic acid/oleic acid treatment. We demonstrate that hepatocyte specific DUSP12-deficient mice exhibit high-fat diet (HFD)-induced and high-fat high-cholesterol diet-induced hyperinsulinemia and liver steatosis and decreased insulin sensitivity. Consistently, DUSP12 overexpression in hepatocyte could reduce HFD-induced hepatic steatosis, insulin resistance, and inflammation. At the molecular level, steatosis in the absence of DUSP12 was characterized by elevated apoptosis signal-regulating kinase 1 (ASK1), which mediates the mitogen-activated protein kinase (MAPK) pathway and hepatic metabolism. DUSP12 physically binds to ASK1, promotes its dephosphorylation, and inhibits its action on ASK1-related proteins, JUN N-terminal kinase, and p38 MAPK in order to inhibit lipogenesis under high-fat conditions. Conclusion: DUSP12 acts as a positive regulator in hepatic steatosis and offers potential therapeutic opportunities for NAFLD.

Small nucleolar RNA host gene 1 promotes development and progression of colorectal cancer through negative regulation of miR-137.

Small nucleolar RNA host gene 1 (SNHG1) is critical in the progression of cancers. However, the mechanism by which SNHG1 regulates the progression of colorectal cancer (CRC) remains unclear. Expressions of SNHG1 and miR-137 in CRC tissues and cell lines were evaluated by quantitative real-time polymerase chain reaction. A luciferase reporter gene assay was conducted to investigate miR-137 target. Additionally, RNA pull-down assay was performed to explore the physical association between miR-137, SNHG1, and RNA induced silencing complex (RISC). Cell cycling and invasion were examined by flow cytometry (FCM) and transwell assays. The in vivo carcinogenic activity of SNHG1 was examined using murine xenograft models. Expression of RICTOR, serine/threonine kinase 1 (AKT), serum and glucocorticoid-inducible kinase 1 (SGK1), p70S6K1, and LC3II/LC3I ratio was examined by Western blot analysis. SNHG1 upregulation was observed in CRC tissues and cell lines, which was associated with the lymph node metastasis, advanced TNM stage and poorer prognosis. SNHG1 increased RICTOR level in CRC via sponging miR-137. In addition, SNHG1 silencing inhibited CRC cell proliferation and migration in vitro and in vivo. SNHG1 regulated RICTOR expression by sponging miR-137 and promoted tumorgenesis in CRC.

[Effect of Small Knife Needle on ß-enorpin and Enkehalin Contents of Tansverse Process Syndrome of the Third Vertebra].

OBJECTIVE: To explore the analgesic mechanism of small knife needle for treating transverse process syndrome of the third vertebra (TPSTV) by observing peripheral and central changesof ß-endorphin (ß-EP) and enkephalin (ENK) contents. METHODS: Totally 30 Japanese white big-ear rabbits of clean grade were divided into 5 groups according to random digit table, i.e., the normal control group, the model group, the small knife needle group, the electroacupunture (EA) group, and the small knife needle plus EA group, 6 in each group. The TPSTV model was established by inserting a piece of gelatin sponge into the left transverse process of 3rd lumbar vertebrae. Rabbits in the small knife needlegroup were intervened by small knife needle. Those in the EA group were intervened by EA at bilateralWeizhong (BL40). Those in the small knife needle plus EA group were intervened by small knife needleand EA at bilateral Weizhong (BL40). Contents of ß-EP and ENK in plasma, muscle, spinal cord, and hypothalamus were determined after sample collection at day 28 after modeling. RESULTS: Compared with the normal control group, contents of ß-EP and ENK in plasma and muscle increased significantly, and contents of ß-EP and ENK in spinal cord and hypothalamus decreased significantly in the model group (P < 0.05, P < 0.01). Contents of ß-EP and ENK approximated normal levels in the three treatment groups after respective treatment. Compared with the model group, the content of ß-EP in muscle decreased, and contents of ß-EP and ENK in hypothalamus increased in the three treatment groups after respective treatment (P < 0.05). There were no significant difference among the three treatment groups (P > 0.05). CONCLUSIONS: Small knife needle treatment and EA had benign regulation on peripheral and central ß-EP and ENK in TPSTV rabbits. Small knife needle treatment showed better effect than that of EA.

Effect of electro-acupuncture on gene expression in heart of rats with stress-induced pre-hypertension based on gene chip technology.

OBJECTIVE: To explore electro-acupuncture's (EA's) effect on gene expression in heart of rats with stress-induced pre-hypertension and try to reveal its biological mechanism based on gene chip technology. METHODS: Twenty-seven Wistar male rats were randomly divided into 3 groups. The stress-induced hypertensive rat model was prepared by electric foot-shocks combined with generated noise. Molding cycle lasted for 14 days and EA intervene was applied,on rats in model + EA group during model preparation. Rat Gene 2.0 Sense Target Array technology was used for the determination of gene expression profiles and the screened key genes were verified by real-time quantitative polymerase chain reaction (RT-PCR) method. RESULTS: Compared with blank control group, 390 genes were changed in model group; compared with model control group, 330 genes were changed in model+EA group. Significance analysis of gene function showed that the differentially expressed genes are those involved in biological process, molecular function and cellular components. RT-PCR result of the screened key genes is consistent with that of gene chip test. CONCLUTION: EA could significantly lower blood pressure of stress-induced pre-hypertension rats and affect its gene expression profile in heart. Genes that related to the contraction of vascular smooth muscle may be involved in EA's anti-hypertensive mechanism.

Serum total bilirubin and long-term outcome in patients undergoing percutaneous coronary intervention.

PURPOSE: The purpose of this study was to investigate the associated between serum total bilirubin (STB) levels and long-term outcomes in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). METHODS: A total of 1,273 consecutive patients were enrolled. Patients were grouped according to their baseline STB levels: Group 1 (STB < 3.4 µmol/L), Group 2 (3.4 µmol/L ≤ STB ≤ 10.3 µmol/L), Group 3 (10.3 µmol/L < STB ≤ 17.1 µmol/L), and Group 4 (STB < 17.1 µmol/L) and the rate of major adverse cardiovascular events (MACE) was determined RESULTS: A total of 1,152 patients were successfully followed up (90.5%) for a mean period of 30 ± 5 months, including 187 patients experiencing a major adverse cardiovascular event (MACE: death from any cause, myocardial infarction, repeat revascularization or readmission). The MACE rate in Groups 3 and 4 was lower than in Groups 1 and 2 (P < 0.01). After adjusted the confounding factors with Cox regression analysis, the MACE rates in Groups 2-4 were still lower than in Group 1 (Group 2, RR=0.293, 95% CI 0.167-0.517, P < 0.01; Group 3, RR=0.142, 95% CI 0.065-0.312, P < 0.01; Group 4, RR=0.134, 95% CI 0.071-0.252, P < 0.01). The cumulative survival rates of Groups 3 and 4 were higher than that of Groups 1and 2 (P < 0.01). CONCLUSIONS: High STB concentration is associated with lower MACE in patients with ACS after PCI.

Effect of acupotomy on nitric oxide synthase and beta-endorphin in third lumbar vertebrae transverse process syndrome model rats.

OBJECTIVE: To explore the long-term effects and pain relief mechanism of acupotomy by observing changes in nitric oxide synthase (NOS) and beta-endorphin (beta-EP) in the hypothalamus, spinal cord, and peripheral blood of rats with third lumbar vertebrae (L3) transverse process syndrome. METHODS: Twenty-eight SD rats were randomly assigned to normal, model, electroacupuncture (EA), and acupotomy group. The last three groups were put through an operation to emulate L3 transverse process syndrome. Fourteen days after the simulation operation, EA and acupotomy treatments were applied to the respective groups. Fifty-six days after the simulation operation, biochemistry tests and enzyme-linked immunosorbent assay were used to measure NOS and beta-EP in the hypothalamus, spinal cord, and peripheral blood. RESULTS: Rats with the simulation operation showed significantly higher levels of NOS and beta-EP in the hypothalamus, spinal cord, and peripheral blood than those in the normal group. The EA and acupotomy groups had significantly lower levels of NOS and beta-EP than those in the model group. There was no statistical difference between the EA and acupotomy groups. CONCLUSION: EA and acupotomy treatments significantly lowered NOS and beta-EP levels in the hypothalamus, spinal cord, and peripheral blood and alleviated L3 transverse process syndrome.

Surface Effect of Thickness-Dependent Polarization and Domain Evolution in BiFeO3 Epitaxial Ultrathin Films.

With the trend of device miniaturization, ultrathin ferroelectric films are gaining more and more attention. However, understanding ferroelectricity in this nanoscale context remains a formidable challenge, primarily due to the heightened relevance of surface effects, which often leads to the loss of net polarization. Here, the influence of surface effects on the polarization as a function of thickness in ultrathin BiFeO3 films is investigated using phase-field simulations. The findings reveal a notable increase in ferroelectric polarization with increasing thickness, with a particularly discernible change occurring below the 10 nm threshold. Upon accounting for surface effects, the polarization is marginally lower than the case without such considerations, with the disparity becoming more pronounced at smaller thicknesses. Moreover, the hysteresis loop and butterfly loop of the ultrathin film were simulated, demonstrating that the ferroelectric properties of films remain robust even down to a thickness of 5 nm. Our investigations provide valuable insights into the significance of ferroelectric thin films in device miniaturization.

TGF-ß-driven LIF expression influences neutrophil extracellular traps (NETs) and contributes to peritoneal metastasis in gastric cancer.

Gastric cancer (GC), notorious for its poor prognosis, often advances to peritoneal dissemination, a crucial determinant of detrimental outcomes. This study intricately explores the role of the TGFß-Smad-LIF axis within the tumor microenvironment in propagating peritoneal metastasis, with a specific emphasis on its molecular mechanism in instigating Neutrophil Extracellular Traps (NETs) formation and encouraging GC cellular functions. Through a blend of bioinformatics analyses, utilizing TCGA and GEO databases, and meticulous in vivo and in vitro experiments, LIF was identified as pivotally associated with GC metastasis, notably, enhancing the NETs formation through neutrophil stimulation. Mechanistically, TGF-ß was substantiated to elevate LIF expression via the activation of the Smad2/3 complex, culminating in NETs formation and consequently, propelling peritoneal metastasis of GC. This revelation uncovers a novel potential therapeutic target, promising a new avenue in managing GC and mitigating its metastatic propensities.

Electrically and mechanically driven rotation of polar spirals in a relaxor ferroelectric polymer.

Topology created by quasi-continuous spatial variations of a local polarization direction represents an exotic state of matter, but field-driven manipulation has been hitherto limited to creation and destruction. Here we report that relatively small electric or mechanical fields can drive the non-volatile rotation of polar spirals in discretized microregions of the relaxor ferroelectric polymer poly(vinylidene fluoride-ran-trifluoroethylene). These polar spirals arise from the asymmetric Coulomb interaction between vertically aligned helical polymer chains, and can be rotated in-plane through various angles with robust retention. Given also that our manipulation of topological order can be detected via infrared absorption, our work suggests a new direction for the application of complex materials.

Endoscopic resection of extra-luminal gastric gastrointestinal stromal tumors using a snare assisted external traction technique (with video).

OBJECTIVE: The primary purpose of the study was to explore the clinical efficacy of the novel snare assisted endoscopic resection of extraluminal growing gastric gastrointestinal stromal tumors (gastric GISTs) using external traction, and the secondary purpose was to compare the novel snare assisted endoscopic resection of extraluminal GISTs with the standard laparoscopic procedure. METHODS: We retrospectively analyzed the patients who underwent novel external traction assisted endoscopic resection or laparoscopic resection for their extraluminal gastric GIST ≤5 cm in diameter. RESULTS: A total of 111 patients (27 in the endoscopic group and 84 in the laparoscopic group) were included in this study. There was no significant difference in tumor diameter and complication rate between the two groups. The overall procedure time was slightly higher in the endoscopic group compared to the laparoscopic group (P = 0.034). However, postoperative hospitalization time (P < 0.001) and postoperative fasting time (P = 0.005) were shorter in the endoscopic group compared to the laparoscopic group. CONCLUSION: Snare external traction-assisted endoscopic resection of extraluminal growing gastric GISTs is safe and effective, and it provides a new adjunctive method for endoscopic resection of GIST.

Electroacupuncture Exerts Chondroprotective Effect in Knee Osteoarthritis of Rabbits Through the Mitophagy Pathway.

Purpose: Mitochondrial dysfunction of chondrocytes has become an area of focus in Knee Osteoarthritis (KOA) in recent years. Activation of mitophagy could promote the survival of chondrocytes and alleviate cartilage degeneration. The aim of this study was to explore whether mitophagy was involved in the cartilage protection of KOA rabbits after electroacupuncture (EA) intervention. Methods: The rabbits were divided into 3 groups, Control group, KOA group, EA group, with 6 rabbits in each group. KOA model rabbits were established by modified Videman's extended immobilization method for 6 weeks and randomly divided into KOA group and EA group. The rabbits in EA group were treated every other day for 3 weeks. The degree of cartilage degeneration was detected by Safranine O-Fast Green staining and immunofluorescence. The morphological changes of chondrocytes mitochondria were detected by transmission electron microscope. ATP concentration in cartilage was measured by ATP Assay Kit. The changes of Pink1-Parkin signal pathway were detected by immunofluorescence, Western blot, and Real-time PCR. Results: The morphology showed that EA could reduce the degeneration of KOA cartilage and increase the distribution of collagen II. We also found that EA could activate mitophagy in KOA rabbit chondrocytes to remove damaged mitochondria and restore mitochondrial homeostasis, which was manifested as increasing the expression of LC3 II/I, promoting the colocalization of TOM20 and LC3B, reducing the accumulation of mitochondrial markers outer mitochondrial membrane 20 (TOM20) and inner mitochondrial membrane 23 (TIM23), and increasing ATP production in chondrocytes. This regulation might be achieved by upregulating the Pink1-Parkin signal pathway. Conclusion: EA may play a role in protecting KOA cartilage by activating mitophagy mediated through Pink1-Parkin pathway.

Efficacy analysis of endoscopic treatment of giant gastric gastrointestinal stromal tumors (≥5 cm).

OBJECTIVE: To investigate the safety, feasibility and prognosis of endoscopic treatment of giant (≥5 cm) gastric gastrointestinal stromal tumors (gastric GISTs). METHODS: Data from patients who underwent surgical resection of nonmetastatic gastric GISTs in our hospital from January 2016 to February 2022 were collected. The patients were divided into an endoscopic group and a laparoscopic group according to the surgical method. The clinical data and tumor recurrence information were compared between the two groups. RESULTS: Eighteen cases were collected in the endoscopic group and sixty-three cases in the laparoscopic group. There were no significant differences in age, gender, tumor diameter, tumor growth site, tumor growth mode, clinical manifestations, risk classification or complication rate between the two groups (P > 0.05). The hospitalization cost, length of postoperative hospital stay and postoperative fasting time of the endoscopic group were less than those of the laparoscopic group, while the operation time was greater than that of the laparoscopic group (P < 0.05). In the endoscopic group, the follow-up was 33.50 ± 19.410 months, and no patients were lost to follow-up. The laparoscopic group was followed up for 59.07 ± 12.964 months, and eleven patients were lost to follow-up. There was no recurrence or metastasis in the two groups during the follow-up. CONCLUSION: Endoscopic resection of gastric GIST with a diameter ≥5 cm is technically feasible. And it not only achieves a short-term prognosis similar to laparoscopic resection but also has the advantages of rapid postoperative recovery and low cost.

Bioinspired Underwater Superoleophilic Two-Dimensional Surface with Asymmetric Oleophobic Barriers for Unidirectional and Long-Distance Oil Transport.

Unidirectional and long-distance liquid transport is critically important to a range of practical applications, e.g., water harvesting, microfluidics, and chemical reactions. Great efforts have been made on liquid manipulation; most of which, however, are limited in the air environment. It is still a great challenge to achieve unidirectional and long-distance oil transport in an aqueous environment. Herein, we have successfully fabricated an underwater superoleophilic two-dimensional surface (USTS) with asymmetric oleophobic barriers to arbitrarily manipulate oil in aqueous medium. The behavior of oil on USTS was carefully investigated, of which the unidirectional spreading capability was originated from the anisotropic spreading resistance resulted from the asymmetric oleophobic barriers. Accordingly, an underwater oil/water separation device has been developed, which can achieve continuous and efficient oil/water separation and further prevent the secondary pollution caused by oil volatilization.