Flexible and antibacterial conductive hydrogels based on silk fibroin/polyaniline/AgNPs for motion sensing and wound healing promotion under electrical stimulation.

Flexible conductive hydrogel-based electronic skin (E-skin) for simultaneous biotherapeutics and sensing applications is one of the current research directions. In this study, conductive and homogeneous silk fibroin/polyaniline/AgNP complexes (SPAg complexes) were prepared with the assistance of silk fibroin, which greatly optimized the compatibility of PANI with the hydrogel matrix. Then, SPAg was introduced into the covalently crosslinked polymer network to prepare poly(acrylamide-co-sulfobetaine methacrylate) - SPAg hydrogels (labeled as PSPAg hydrogels). The PSPAg hydrogels exhibit good biocompatibility, excellent mechanical properties, superb adhesive performance, and fantastic sensing capabilities. Being connected to a smartphone via a Bluetooth system, the SPAg hydrogel-based E-skin was employed to accurately monitor human movements including vigorous joint movements and subtle facial micro-expressions. Finally, benefiting from the synergistic effect of antimicrobial and exogenous electrical stimulation, through promoting angiogenesis and accelerating collagen production in diabetic wounds, PSPAg E-skin successfully facilitates rapid diabetic wound healing. Therefore, the multifunctional PSPAg hydrogel-based E-skin shows great promise for applications in wearable devices and bioelectronics.

Deep nitrate accumulation in typical black soil critical zones of Northeast China.

Deep nitrate accumulation below 1 m has been observed in various soil regions, yet remains undocumented in the black soil (mainly Phaeozems and Chernozems) region. Climatic and edaphic factors likely influence deep nitrate accumulation on a large scale, although existing studies primarily focus on individual sites. In order to evaluate the distribution and controlling factors of deep nitrate in the black soil region, inorganic nitrogen forms and regolith properties of nine boreholes spanning humid, semi-humid, and semi-arid areas in Fujin, Hailun, and Lindian in northeast China were analyzed down to a depth of 10 m. The results revealed significant nitrate accumulation in Lindian, peaking at 11.03 mg N kg-1 at a depth of 3 m underground. Nitrate storage from the land surface to a depth of 10 m in Lindian ranged from 459.65 kg N ha-1 to 1072.88 kg N ha-1, with over 70 % of nitrate stored below 1 m. Nitrate accounted for 97.74 % of the total N stock in Lindian. Ammonium accumulation has been observed at a deeper depth in Hailun, with no nitrate accumulation detected in Hainlun and Fujin. Regolith properties such as clay, silt, sand, and pH playing a crucial role in reshaping the vertical pattern of nitrate. The presence of nitrate pools at greater depths in intensively managed black soil regions should be taken into account for the sustainable utilization of soil resources and the mitigation of groundwater pollution risks.

Chinese expert consensus on management of antifungal-resistant dermatophytoses (2024 edition).

Antifungal-resistant dermatophytes (ARD) infection is a hotspot issue in clinical microbiology and the dermatology field. Trichophyton indotineae as the dominant species of dermatophyte with terbinafine-resistance or multidrug resistance, is easy to be missed detection clinically, which brings severe challenges to diagnosis and treatment. ARD infection cases have emerged in China, and it predicts a risk of transmission among human. Based on the existing medical evidence and research data, the Mycology Group of Combination of Traditional and Western Medicine Dermatology and Chinese Antifungal⁃Resistant Dermatophytoses Expert Consensus Group organized experts to make consensus on the management of the infection. Here, the consensus formulated diagnosis and treatment recommendations, to raise attention to dermatophytes drug resistance problem, and expect to provide reference information for the clinical diagnosis, treatment, prevention and control.

Modified Chitosan-Based Coating/Packaging Composites with Enhanced Antibacterial, Antioxidant, and UV-Resistant Properties for Fresh Food Preservation.

Chitosan-based biomass packaging materials are a promising material for food preservation, but their limited solubility, antioxidant capacity, UV resistance, and mechanical properties severely restrict their application. In this study, we developed a novel chitosan-based coating/packaging composite (QCTO) using quaternary ammonium salt and tannic acid (TA)-modified chitosan (QCS-TA) and oxidized chitosan (OCS). The introduction of quaternary ammonium salt and TA effectively improves the water solubility and antibacterial, antioxidant, and UV-resistant properties of chitosan. The Schiff-base bond formed between OCS and QCS-TA, along with the TA-mediated multiple interactions, conferred the prepared composite film with good mechanical properties (69.9 MPa tensile strength) and gas barrier performance to water (14.3 g·h-1·m-2) and oxygen (3.5 g·mm·m-2·h-1). Meanwhile, the prepared QCTO composites demonstrate excellent biocompatibility and safety and are applied as coatings for strawberries and bananas as well as packaging films for mushrooms. These preservation experiments demonstrated that the prepared composites are able to effectively reduce weight loss, prevent microbial growth, maintain color, and significantly prolong the shelf life of fresh products (bananas, strawberries, and mushrooms extended shelf life by 6, 5, and 6 days, respectively). Therefore, the developed QCTO coating/packaging film shows great potential for applications in the field of food preservation and packaging.

Comparison of prognosis between oncocytic thyroid carcinoma and follicular thyroid carcinoma: a population-based propensity score matching analysis.

BACKGROUND: Oncocytic thyroid carcinoma (OTC) is a rare subtype of thyroid cancer known for its distinctive morphology and high likelihood of recurrence, setting it apart from follicular thyroid carcinoma (FTC). Despite this, there is limited research comparing the clinicopathological characteristics and outcomes of OTC and FTC. METHODS: We retrospectively searched through the Surveillance, Epidemiology, and End-Results (SEER) database (2004-2015) for histologically diagnosed OTC and FTC patients. Kaplan-Meier analysis, propensity score matching (PSM), univariate Cox proportional risk regression model, and subgroup analysis were employed to investigate the prognostic effect of clinicopathological features and treatment regimens on survival outcomes of OTC and FTC patients. RESULTS: 2329 OTC patients and 5679 FTC patients were included in the study. OTC patients were prone to older age, white race, lymph node metastasis, distal metastasis, extension and multiple primary tumors compared with FTC patients. After using a 1:1 PSM matching ratio, there were no significant differences in demographic and clinicopathological characteristics between the matched groups. Further Cox regression analysis showed that OTC patients had lower overall survival (OS) and cancer-specific survival (CSS) in contrast with FTC patients. Subgroup survival analysis suggested that the OTC patients were related to lower OS in subgroups including those over 55 years old, male sex, white ethnicity, extrathyroidal extension, single primary tumor, surgery and without chemotherapy compared with the FTC patients in these subgroups. In addition, the OTC patients were connected with lower CSS in subgroups including male sex, white ethnicity, married status, tumor size is less than 20 mm or more than 40 mm, N0 stage, localized stage, single primary tumor, surgery, radiotherapy, and without chemotherapy compared with the FTC patients in these subgroups. Meanwhile, the OTC patients had lower CSS compared to FTC patients regardless of age and extrathyroidal extension. CONCLUSIONS: The results suggested that OTC patients have unique clinical features and poorer prognoses compared to FTC patients. Surgical resection and radioactive iodine therapy are recommended for OTC patients and FTC patients. It is worth noting that the prognosis of OTC relies largely on the selection of treatment strategies. Therefore, our results highlighted the clinical significance of the early distinguishment and the correct choice of treatment in OTC patients.

Efficacy and long-term outcomes of single-balloon enteroscopy-assisted treatment for biliary obstruction after choledochojejunostomy.

BACKGROUND: To evaluate the long-term efficacy of single-balloon enteroscopy endoscopic retrograde cholangiography (SBE-ERC) for the treatment of biliary obstruction and to analyze the factors affecting the recurrence of benign bilioenteric anastomotic stricture after SBE-ERC treatment. METHODS: The clinical data of patients with biliary diseases treated with SBE-ERC after choledochojejunostomy in our hospital from January 2015 to December 2021 were analyzed retrospectively for the success rates of diagnosis and treatment and the incidence of complications. Patients who were diagnosed with benign bilioenteric anastomotic stricture were followed up. The independent factors affecting recurrence were obtained by univariate and multivariate analyses using the Kaplan‒Meier method and Cox proportional hazard regression model. RESULTS: A total of 289 SBE-ERCs were performed in 165 patients. The overall success rate was 83.0% (240/289). The incidence of postoperative complications was 5.2% (15/289). The 108 successfully treated patients diagnosed with benign bilioenteric anastomotic stricture were followed up. Twenty-six percent (29/108) of patients had recurrent stricture after SBE-ERC. The biliary patency rates at 1 year, 2 years and 5 years after SBE-ERC were 90.1%, 69.3%, and 53.9%, respectively. Single-factor analysis revealed the absence of intrahepatic biliary gas imaging during endoscopy ( χ 2 =5.366, P = 0.021), a diameter of balloon dilatation during the last endoscopic treatment less than 0.8 cm ( χ 2 =4.552, P = 0.033), and the presence of a thread in the anastomosis ( χ 2 =8.921, P = 0.003) as risk factors for recurrence. A non-indwelling biliary plastic stent ( χ 2 =14.868, P < 0.001) and undergoing only one ERCP treatment ( χ 2 =13.313, P = 0.001) were risk factors for the recurrence of benign stricture after SBE-ERC resection. Multivariate analysis revealed that the absence of a stent (HR = 0.15, 95% CI 0.06-0.40, P = 0.001), absence of intrahepatic biliary gas imaging during endoscopy (HR = 0.39, 95% CI 0.17-0.91, P = 0.03) and the presence of a thread in the anastomosis (HR = 3.69, 95% CI 1.59-8.57, P = 0.002) were independent risk factors for stricture recurrence. CONCLUSIONS: Treating biliary disease after choledochojejunostomy with SBE-ERC is safe and effective, with a good immediate technical success rate and an acceptable incidence of complications. SBE-ERC has long-term efficacy in the treatment of benign bilioenteric anastomotic stricture. The absence of intrahepatic biliary gas imaging during endoscopy, non-indwelling biliary stents and the existence of anastomotic threads are independent risk factors for the recurrence of benign bilioenteric anastomotic stricture.

Clinical characteristics and biomarkers feature analysis using a proteomics platform in young patients with acute coronary syndrome.

Background: Acute coronary syndrome (ACS) is a leading cause of morbidity and mortality worldwide. In recent years, ACS has been reported to be associated with age, and the incidence has become more common in younger patients. Previous studies have identified various risk factors that contribute to the stratification of ACS patients. However, it remains unclear whether these risk factors, along with proteomic and clinical characteristics, are applicable to young ACS patients, as they are for middle-aged and elderly patients. This study aimed to investigate the proteomics, risk factors, and clinical characteristics of young ACS patients, as well as the differences between them and middle-aged and elderly ACS patients. By comparing these findings with those of middle-aged and elderly patients, we aimed to identify any discrepancies and these findings possibly may have implications for future management strategies of this specific population. Methods: This observational study included a total of 187 participants diagnosed with ACS and 17 young healthy individuals as the control group. ACS patients were divided into three age groups: <45 years old, 45-60 years old, and 61-75 years old. The control group consisted of healthy individuals under the age of 45 who underwent coronary angiography and were excluded from CAD. We collected clinical characteristics, laboratory data, and echocardiographic results from each participant. Additionally, blood samples were collected for further analysis of relevant proteomic and arteriosclerosis marker data using proteomics analysis. Results: Our findings revealed that the presence of certain key factors was associated with a significantly difference in patients with ACS aged younger than 45 years, and this association differed from that of traditional cardiovascular risk factors in patients older than 45 years. Specifically, a higher body mass index and hyperlipidemia were found to be associated with an increased risk of ACS morbidity in young adults (<45 years old) compared to middle-aged and elderly individuals. Furthermore, our findings indicated that the expression levels of growth differentiation factor 15, osteopontin, and NT-proBNP were significantly different among the groups. Conclusion: In summary, our study revealed that the main pathogenic factors of ACS patients under 45 years of age differed from those of middle-aged and elderly patients. These findings may contribute to the prevention and treatment strategies for young patients with ACS.

Research progress on the effect of pyroptosis on the occurrence, development, invasion and metastasis of colorectal cancer.

Pyroptosis is a type of programmed cell death mediated by gasdermines (GSDMs). The N-terminal domain of GSDMs forms pores in the plasma membrane, causing cell membrane rupture and the release of cell contents, leading to an inflammatory response and mediating pyrodeath. Pyroptosis plays an important role in inflammatory diseases and malignant tumors. With the further study of pyroptosis, an increasing number of studies have shown that the pyroptosis pathway can regulate the tumor microenvironment and antitumor immunity of colorectal cancer and is closely related to the occurrence, development, treatment and prognosis of colorectal cancer. This review aimed to explore the molecular mechanism of pyroptosis and the role of pyroptosis in the occurrence, development, treatment and prognosis of colorectal cancer (CRC) and to provide ideas for the clinical diagnosis and treatment of CRC.

Boosting-Crystal Graph Convolutional Neural Network for Predicting Highly Imbalanced Data: A Case Study for Metal-Insulator Transition Materials.

Applying machine-learning techniques for imbalanced data sets presents a significant challenge in materials science since the underrepresented characteristics of minority classes are often buried by the abundance of unrelated characteristics in majority of classes. Existing approaches to address this focus on balancing the counts of each class using oversampling or synthetic data generation techniques. However, these methods can lead to loss of valuable information or overfitting. Here, we introduce a deep learning framework to predict minority-class materials, specifically within the realm of metal-insulator transition (MIT) materials. The proposed approach, termed boosting-CGCNN, combines the crystal graph convolutional neural network (CGCNN) model with a gradient-boosting algorithm. The model effectively handled extreme class imbalances in MIT material data by sequentially building a deeper neural network. The comparative evaluations demonstrated the superior performance of the proposed model compared to other approaches. Our approach is a promising solution for handling imbalanced data sets in materials science.

Corrigendum: Paclitaxel-incorporated nanoparticles improve functional recovery after spinal cord injury.

[This corrects the article DOI: 10.3389/fphar.2022.957433.].

Formononetin attenuates hepatic injury in diabetic mice by regulating macrophage polarization through the PTP1B/STAT6 axis.

BACKGROUND: Formononetin (FNT) is an isoflavone known for its anti-inflammatory properties and has been shown to reduce insulin resistance in Type 2 Diabetes Mellitus (T2DM). However, its effects and the underlying mechanisms in diabetic liver injury remain largely unexplored. METHODS: We established a T2DM-induced liver injury mouse model by feeding high-fat diet, followed by injecting streptozotocin. The mice were then treated with FNT and the liver function in these mice was assessed. Macrophage markers in FNT-treated T2DM mice or human THP-1 cells were evaluated using flow cytometry, RT-qPCR, and Western blotting. The expression of PTP1B and STAT6 in mouse liver tissues and THP-1 cells was analyzed. Molecular docking predicted the interaction between PTP1B and STAT6, which was validated via co-immunoprecipitation (Co-IP) and phos-tag analysis. Microscale thermophoresis (MST) assessed the binding affinity of FNT to PTP1B. RESULTS: FNT treatment significantly ameliorated blood glucose levels, hepatocyte apoptosis, inflammatory response, and liver dysfunction in T2DM mice. Moreover, FNT facilitated M2 macrophage polarization in both T2DM mice and high glucose (HG)-induced THP-1-derived macrophages. The PTP1B/STAT6 axis, deregulated in T2DM mice, was normalized by FNT treatment, which counteracted the T2DM-induced upregulation of PTP1B and downregulation of phosphorylated STAT6. Molecular docking and subsequent analyses revealed that PTP1B binds to and dephosphorylates STAT6 at the S325A site. In contrast, FNT strongly binds to PTP1B and influences its expression at the K116A site, promoting M2 polarization of THP-1 cells via downregulation of PTP1B. CONCLUSION: Formononetin mitigates diabetic hepatic injury by fostering M2 macrophage polarization via the PTP1B/STAT6 axis.

Cryoablation combined with dual immune checkpoint blockade enhances antitumor efficacy in hepatocellular carcinoma model mice.

BACKGROUND: Cryoablation (Cryo) is a minimally invasive treatment for tumors. Cryo can activate the body's immune response, although it is typically weak. The immune response induced by Cryo in hepatocellular carcinoma (HCC) is poorly understood. PD-1 and CTLA-4 monoclonal antibodies are immune checkpoint inhibitors used in immunotherapy for tumors. The combined use of these antibodies with Cryo may enhance the immune effect. METHODS: A Balb/c mouse model of HCC was established and treated with Cryo, immune checkpoint blockade (ICB), or Cryo + ICB (combination therapy). The growth trend of right untreated tumors and survival time of mice were determined. The expression of apoptosis-related proteins was detected by Western blot (WB) assay. The percentages of immune cells and immunosuppressive cells were analyzed by flow cytometry. The numbers of infiltrating T lymphocytes were checked by immunohistochemistry, and the levels of T-cell-associated cytokines were detected by Quantitative real-time Polymerase Chain Reaction (qRT-PCR) assays and Enzyme-Linked Immunosorbent Assays (ELISA) assays. RESULTS: Cryo + ICB inhibited the growth of right untreated tumors, promoted tumor cell apoptosis, and prolonged the survival time of mice. Local T-cell infiltration in right tumor tissues increased after the combination therapy, while the number of immunosuppressive cells was significantly reduced. In addition, the combination therapy may induce the production of multiple Th1-type cytokines but reduce the production of Th2-type cytokines. CONCLUSIONS: Cryo can activate CD8+ and CD4+ T-cell immune responses. Cryo + ICB can relieve the immunosuppressive tumor microenvironment and shift the Th1/Th2 balance toward Th1 dominance, further enhancing the Cryo-induced T-cell immune response and resulting in a stronger antitumor immune response.

TFAP2A is involved in neuropathic pain by regulating Grin1 expression in glial cells of the dorsal root ganglion.

Neuropathic pain is a highly prevalent and refractory condition, yet its mechanism remains poorly understood. While NR1, the essential subunit of NMDA receptors, has long been recognized for its pivotal role in nociceptive transmission, its involvement in presynaptic stimulation is incompletely elucidated. Transcription factors can regulate the expression of both pro-nociceptive and analgesic factors. Our study shows that transcription factor TFAP2A was up-regulated in the dorsal root ganglion (DRG) neurons, satellite glial cells (SGCs), and Schwann cells following spinal nerve ligation (SNL). Intrathecal injection of siRNA targeting Tfap2a immediately or 7 days after SNL effectively alleviated SNL-induced pain hypersensitivity and reduced Tfap2a expression levels. Bioinformatics analysis revealed that TFAP2A may regulate the expression of the Grin1 gene, which encodes NR1. Dual-luciferase reporter assays confirmed TFAP2A's positive regulation of Grin1 expression. Notably, both Tfap2a and Grin1 were expressed in the primary SGCs and upregulated by lipopolysaccharides. The expression of Grin1 was also down-regulated in the DRG following Tfap2a knockdown. Furthermore, intrathecal injection of siRNA targeting Grin1 immediately or 7 days post-SNL effectively alleviated SNL-induced mechanical allodynia and thermal hyperalgesia. Finally, intrathecal Tfap2a siRNA alleviated SNL-induced neuronal hypersensitivity, and incubation of primary SGCs with Tfap2a siRNA decreased NMDA-induced upregulation of proinflammatory cytokines. Collectively, our study reveals the role of TFAP2A-Grin1 in regulating neuropathic pain in peripheral glia, offering a new strategy for the development of novel analgesics.

Synthesis and Luminescence Studies of a Tethered, Trigonal, Silver(I) Tris(alkyne) Complex.

The synthesis and characterization of a tris(alkyne) ligand, tris[2-(trimethylsilyl)ethynyl-4-tert-butylbenzyl]amine (1), and its silver(I) hexafluorophosphate complex, 1-Ag, are reported. The solid-state structure and luminescence properties of 1-Ag indicate relatively strong silver(I)-alkyne interactions between the metal cation and 1. No significant changes in the bond angles or lengths were observed upon metalation of 1 with Ag+, indicating a relatively unstrained ligand-metal motif. The luminescence properties of 1 and 1-Ag are also disclosed, showing attenuation in the luminescence intensity upon Ag+ metalation, with Stokes shifts of ∼3700 and ∼3200 cm-1 for 1 and 1-Ag, respectively. The lifetimes of 1-Ag (τ1 = 8.383 ± 0.053 ns and τ2 = 4.665 ± 0.061 ns) were longer than those of 1 (τ1 = 6.708 ± 0.085 ns and τ2 = 3.689 ± 0.025 ns), possibly indicating multiple conformers of 1-Ag in solution. This new silver alkyne platform has potential applications in studies of catalysis, luminescent compounds, and sensing.

Comprehensive analysis of adverse events associated with pimavanserin using the FAERS database.

OBJECTIVE: Pimavanserin, a novel 5-HT2A receptor antagonist, has been approved for the treatment of Parkinson's disease psychosis (PDP). This study aims to conduct a comprehensive analysis of the adverse events (AEs) of pimavanserin by analyzing the FDA's Adverse Event Reporting System (FAERS) database. METHODS: AE reports related to pimavanserin in the FAERS database from the second quarter of 2016 to the fourth quarter of 2023 were mined. Signal detection methods, including the Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Empirical Bayesian Geometric Mean (EBGM), were employed to identify and classify AEs. RESULTS: The study collected 12,839,687 AE reports, with 30,997 reports primarily suspecting pimavanserin, identifying 166 Preferred Terms (PTs) across 27 System Organ Classes (SOCs). The data showed that males reported more frequently than females, with the highest reporting in patients aged 75 and above. Reports increased over time, with a significant rise in 2023 compared to 2016. Major categories of AEs included hallucination, death, product dose omission issue, and confusional state, with death being notably the second most reported issue. Strong and new potential AEs were identified, including sleep-related issues like somnolence, insomnia, and sleep talking; cognitive and behavioral issues such as alexithymia, belligerence, and aggression; dose-related issues like prescribed underdose and underdose; and other AEs like nonspecific reactions. CONCLUSION: This study reveals potential AEs of pimavanserin, including sleep disorders and cognitive changes, underscoring the importance of careful monitoring and personalized treatment in managing PDP.

Factors associated with blood donation among college and university students in Wuhan, China: structural equation model.

BACKGROUND: College and university students were an important population group of blood donors, especially in the current situation of tight blood supply. This study aimed to investigate the current status and determinants of blood donation among this population group in Wuhan using a structural equation model. METHODS: We conducted a cross-sectional study involving 12 colleges and universities in Wuhan, China, including 5168 students. Sociodemographic characteristics, health status, knowledge about blood donation, and attitude toward blood donation were treated as latent variables, with blood donation as the observed variable. Confirmatory factor analysis was conducted using the Mplus 8.0 statistical software application, followed by the establishment of a structural equation model to assess the relationships that exist between these variables. RESULTS: The overall blood donation rate among college and university students was 24.71%. The established model indicated that sociodemographic characteristics, health status, knowledge about blood donation, and attitude toward blood donation showed significant positive effects (0.135, 0.056, 0.321, and 0.389, respectively) on blood donation, among them, the direct effects were 0.076, -0.110, 0.143, and 0.389, respectively (P < 0.01). Additionally, sociodemographic characteristics, health status, and knowledge about blood donation had indirectly affected blood donation through the mediating effect of attitude towards blood donation. Their effects on attitude towards blood donation were 0.099, 0.243, and 0.468, respectively. (P < 0.01). The model could explain explained 22.22% of the variance in blood donation behavior among college and university students in Wuhan. CONCLUSION: Blood donation among college and university students in Wuhan was associated with sociodemographic characteristics, health status, knowledge about blood donation, and attitude towards blood donation, with attitude being the primary influencing factor. Tailored recruitment strategies for blood donation among students should prioritize initiatives aimed at enhancing knowledge about blood donation and fostering positive attitudes toward it.

Cation-π Interaction-Enhanced Self-Healing Injectable Hydrogels for Gastric Perforation Repair.

Surgical operations are the preferred treatment for gastric perforation (GP) but incur postoperative complications such as gastrointestinal adhesions and bacterial infections, leading to inefficient wound healing and serious complications that may even threaten the life of the patient. Developing hydrogel dressings capable of adapting to the gastric environment (acid) and decreasing visceral adhesions and bacterial infections after GP treatment is crucial. In this article, we developed an injectable, self-healing hydrogel using cation-π interactions between protonated amines and aromatic rings under acidic conditions and explored it for GP repair. The hydrogels demonstrate exceptional self-healing capabilities under acidic conditions and can be effectively tailored for the gastric environment. In addition, the hydrogel demonstrated significant efficacy in preventing gastrointestinal adhesion, reducing inflammation, promoting angiogenesis, and effectively facilitating wound healing in a rat GP model. This novel hydrogel demonstrates adaptability to the gastric environment, rendering it highly promising for potential applications in gastric trauma healing.