Unique immunohistochemical profiles of MUC5AC, MUC6, P53, and Ki67 in gastric atypical hyperplasia and dysplasia.

OBJECTIVES: Differentiating gastric atypical hyperplasia (AH) from dysplasia, including low-grade dysplasia (LGD) and high-grade dysplasia (HGD), poses significant challenges in small biopsies and specimens with technical artifacts. This study aims to establish objective diagnostic criteria for these conditions through combined morphologic and immunohistochemical (IHC) analyses. METHODS: Between January 2018 and September 2020, a total of 123 gastric mucosa biopsy specimens were collected at Anyang Tumor Hospital. According to the WHO Classification of Digestive System Tumors (5th edition), specimens were categorized into three groups: AH (n=48), LGD (n=30), and HGD (n=45). Morphologic characteristics were assessed, and IHC staining for MUC5AC, MUC6, MUC2, CD10, P53, and Ki67 was performed, followed by statistical analysis. RESULTS: Histologically, AH was predominantly marked by a pronounced inflammatory background (60.42%), intestinal metaplasia (64.58%), indistinct boundaries (83.33%), and a distinct maturation gradient (97.72%). AH nuclei were typically circular (97.92%), with a high nucleus-to-cytoplasm ratio (64.58%), prominent nucleoli (47.92%), and preserved polarity (89.58%). In contrast, LGD and HGD typically exhibited well-defined boundaries with an absent maturation gradient. LGD nuclei were rod-shaped (96.67%), with a low nucleus-to-cytoplasm ratio (96.67%) and preserved polarity (100%), whereas HGD demonstrated a loss of cellular polarity (77.78%). IHC findings revealed a consistent maturation gradient in AH, with polarized MUC5AC and MUC6 expression, significantly reduced in LGD (86.67%), and absent in HGD. P53 expression in HGD showed a predominant 'mutation-type pattern' (66.67%), contrasting with 'wild-type pattern' expression in AH and LGD (100%, 93.33%). Ki67 expression patterns varied from a 'pit neck pattern' in AH (95.83%) to a 'polarity pattern' in LGD (76.67%) and a 'diffuse pattern' in HGD (57.78%). The expression patterns of MUC5AC, MUC6, CD10, P53, and Ki67 varied significantly across the three groups (P<0.001). CONCLUSIONS: The integration of histomorphological features and expression profiles of MUC5AC, MUC6, P53, and Ki67 is instrumental in diagnosing gastric atypical hyperplasia and dysplasia.

Combination of Fushengong decoction with Western medicine on patients with chronic renal failure: An observational study.

Chronic renal failure (CRF) causes a reduction in glomerular filtration rate and damage to renal parenchyma. Fushengong decoction (FSGD) showed improvement in renal function in CRF rats. This study aims to analyze the differentially expressed proteins in CRF patients treated with Western medicine alone or in combination with FSGD. Sixty patients with CRF recruited from Yongchuan Traditional Chinese Medicine Hospital affiliated to Chongqing Medical University were randomly assigned into control (treated with Western medicine alone) and observation groups (received additional FSGD treatment thrice daily for 8 weeks). The clinical efficacy and changes in serum Bun, serum creatinine, Cystatin C, and transforming growth factor beta 1 (TGF-ß1) before and after treatment were observed. We employed isotope relative labeling absolute quantification labeling and liquid chromatography-mass spectrometry to identify differentially expressed proteins and carried out bioinformatics Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses. Patients in the observation group showed greater clinical improvement and lower levels of serum Bun, serum creatinine, Cyc-c, and TGF-ß1 than the control group. We identified 32 differentially up-regulated and 52 down-regulated proteins in the observation group. These proteins are involved in the blood coagulation system, protein serine/threonine kinase activity, and TGF-ß, which are closely related to the pathogenesis of CRF. Protein-protein-interaction network analysis indicated that candidate proteins fibronectin 1, fibrinogen alpha chain, vitronectin, and Serpin Family C Member 1 were in the key nodes. This study provided an experimental basis suggesting that FSGD combined with Western medicine could significantly improve renal function and renal fibrosis of CRF patients, which may be through the regulation of fibronectin 1, fibrinogen alpha chain, vitronectin, Serpin Family C Member 1, TGF-ß, and the complement coagulation pathway (see Graphical abstract S1, Supplemental Digital Content, http://links.lww.com/MD/L947).

Antifouling and Antioxidant Properties of PVDF Membrane Modified with Polyethylene Glycol Methacrylate and Propyl Gallate.

In this study, molecules of propyl gallate (PG) and polyethylene glycol methacrylate (PEGMA) were covalently bonded via a transesterification reaction and subsequently grafted onto polyvinylidene fluoride substrates using a homogeneous radiation grafting technique. The enhancement of the membranes' hydrophilicity with the increment of the grafting rate was corroborated by scanning electron microscopy imaging and measurements of the water contact angle. At a grafting degree of 10.1% and after a duration of 4 min, the water contact angle could decrease to as low as 40.1°. Cyclic flux testing demonstrated that the membranes modified in this manner consistently achieved a flux recovery rate exceeding 90% across varying degrees of grafting, indicating robust anti-fouling capabilities. Furthermore, these modified membranes exhibited significant antioxidant ability while maintaining antifouling performance over 30 days. The ability of the modified membranes to scavenge 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt (ABTS+) free radicals remained nearly unchanged after being stored in pure water for 30 days, and the flux recovery rate remained above 95% after immersion in sodium hypochlorite solution for 30 days. Among the tested membranes, the PVDF-g-PEGMAG modified membrane with a grafting degree of 7.2% showed the best antioxidant effect.

Effectiveness of Endoscopic Screening on Esophageal Cancer Incidence and Mortality: A 9-Year Report of the Endoscopic Screening for Esophageal Cancer in China (ESECC) Randomized Trial.

PURPOSE: To evaluate the effectiveness of endoscopic screening against incidence of and mortality from esophageal squamous cell carcinoma (ESCC). METHODS: From January 2012 to September 2016, we conducted a community-based cluster randomized controlled trial involving permanent residents age 45-69 years in a high-risk region for ESCC in northern China. A total of 668 targeted villages were randomly assigned in a 1:1 ratio to the screening group (offered Lugol's chromoendoscopy) or control group (no screening). Intention-to-treat and per-protocol analyses were performed to compare esophageal cancer (EC) incidence and mortality between the two groups. The per-protocol analysis adjusted for nonadherence to the screening procedure. RESULTS: A total of 33,847 participants were included in the analysis: 17,104 in the screening group, 15,165 (88.7%) of whom underwent screening, and 16,743 in the control group. During a maximum follow-up of 9 years, EC incidence in the screening and control groups were 60.9 and 72.5 per 100,000 person-years, respectively; mortality in the screening and control groups were 29.7 and 32.4 per 100,000 person-years, respectively. Compared with the control group, the incidence and mortality of the screening group reduced by 19% (adjusted hazard ratio [aHR], 0.81 [95% CI, 0.60 to 1.09]) and 18% (aHR, 0.82 [95% CI, 0.53 to 1.26]), respectively, in the intention-to-treat analysis; and by 22% (aHR, 0.78 [95% CI, 0.56 to 1.10]) and 21% (aHR, 0.79 [95% CI, 0.49 to 1.30]), respectively, in the per-protocol analysis. CONCLUSION: With a 9-year follow-up, our trial suggests that chromoendoscopic screening induces modest reductions in EC incidence and mortality. A more efficient strategy for EC screening and subsequent patient management should be established to guarantee the effectiveness of endoscopic screening.

The role of mountains in shaping the global meridional overturning circulation.

The meridional overturning circulation (MOC) in the ocean is a key player in the global climate system, while continental topography provides an essential backdrop to the system. In this study, we design a series of coupled model sensitivity experiments to investigate the influence of various mountain ranges on the global thermohaline circulation. The results highlight the influence of the Tibetan Plateau (TP) on the global thermohaline circulation. It emerges as a requisite for establishing the Atlantic MOC (AMOC) and a determining factor for the cessation of the Pacific MOC (PMOC). Additionally, the Antarctic continent plays a vital role in facilitating the TP to form the AMOC. While the formation of the AMOC cannot be attributed to any single mountain range, the TP alone can inhibit the PMOC's development. By modifying the global hydrological cycle, the TP is likely to have been crucial in molding the global thermohaline circulation.

Near-infrared II theranostic agents for the diagnosis and treatment of Alzheimer's disease.

BACKGROUND: Near-infrared II theranostic agents have gained great momentum in the research field of AD owing to the appealing advantages. Recently, an array of activatable NIR-II fluorescence probes has been developed to specifically monitor pathological targets of AD. Furthermore, various NIR-II-mediated nanomaterials with desirable photothermal and photodynamic properties have demonstrated favorable outcomes in the management of AD. METHODS: We summerized amounts of references and focused on small-molecule probes, nanomaterials, photothermal therapy, and photodynamic therapy based on NIR-II fluorescent imaging for the diagnosis and treatment in AD. In addition, design strategies for NIR-II-triggered theranostics targeting AD are presented, and some prospects are also addressed. RESULTS: NIR-II theranostic agents including small molecular probes and nanoparticles have received the increasing attention for biomedical applications. Meanwhile, most of the theranostic agents exhibited the promising results in animal studies. To our surprise, the multifunctional nanoplatforms also show a great potential in the diagnosis and treatment of AD. CONCLUSIONS: Although NIR-II theranostic agents showed the great potential in diagnosis and treatment of AD, there are still many challenges: 1) Faborable NIR-II fluorohpores are still lacking; 2) Biocompatibility, bioseurity and dosage of NIR-II theranostic agents should be further revealed; 3) New equipment and software associated with NIR-II imaging system should be explored.

A PEGylated PVDF Antifouling Membrane Prepared by Grafting of Methoxypolyethylene Glycol Acrylate in Gama-Irradiated Homogeneous Solution.

In this study, methoxypolyethylene glycol acrylate (mPEGA) served as a PEGylated monomer and was grafted onto polyvinylidene fluoride (PVDF) through homogeneous solution gamma irradiation. The grafting process was confirmed using several techniques, including infrared spectroscopy (FTIR), thermodynamic stability assessments, and rotational viscosity measurements. The degree of grafting (DG) was determined via the gravimetric method. By varying the monomer concentration, a range of DGs was achieved in the PVDF-g-mPEGA copolymers. Investigations into water contact angles and scanning electron microscopy (SEM) images indicated a direct correlation between increased hydrophilicity, membrane porosity, and higher DG levels in the PVDF-g-mPEGA membrane. Filtration tests demonstrated that enhanced DGs resulted in more permeable PVDF-g-mPEGA membranes, eliminating the need for pore-forming agents. Antifouling tests revealed that membranes with a lower DG maintained a high flux recovery rate, indicating that the innate properties of PVDF could be largely preserved.

Transcriptome Analysis Reveals Novel Insights into the Hyperaccumulator Phytolacca acinosa Roxb. Responses to Cadmium Stress.

Cadmium (Cd) is a highly toxic heavy metal that causes serious damage to plant and human health. Phytolacca acinosa Roxb. has a large amount of aboveground biomass and a rapid growth rate, and it has been identified as a novel type of Cd hyperaccumulator that can be harnessed for phytoremediation. However, the molecular mechanisms underlying the response of P. acinosa to Cd2+ stress remain largely unclear. In this study, the phenotype, biochemical, and physiological traits of P. acinosa seeds and seedlings were analyzed under different concentrations of Cd2+ treatments. The results showed higher Cd2+ tolerance of P. acinosa compared to common plants. Meanwhile, the Cd2+ content in shoots reached 449 mg/kg under 10 mg/L Cd2+ treatment, which was obviously higher than the threshold for Cd hyperaccumulators. To investigate the molecular mechanism underlying the adaptability of P. acinosa to Cd stress, RNA-Seq was used to examine transcriptional responses of P. acinosa to Cd stress. Transcriptome analysis found that 61 genes encoding TFs, 48 cell wall-related genes, 35 secondary metabolism-related genes, 133 membrane proteins and ion transporters, and 96 defense system-related genes were differentially expressed under Cd2+ stress, indicating that a series of genes were involved in Cd2+ stress, forming a complex signaling regulatory mechanism. These results provide new scientific evidence for elucidating the regulatory mechanisms of P. acinosa response to Cd2+ stress and new clues for the molecular breeding of heavy metal phytoremediation.

Insight into melting point differences of dinitroimidazoles and dinitropyrazoles from the perspective of intermolecular interactions.

Dinitroimidazole (DNI) and dinitropyrazole (DNP), along with their congeners, possess similar molecular structures but exhibit distinct melting points. To analyse and elucidate the fundamental reasons for property differences from the perspective of intermolecular interactions, we proposed a simplified approach named binding energy in clusters (BEC) in computing weak interactions within complex crystal systems. Based on the results of the symmetry-adapted perturbation theory (SAPT) calculations, an approximate estimation of the melting point range can be derived by taking into account the cumulative effect (energy of electrostatic, dispersion and induction terms) and repulsive effect (energy of exchange term) values. We have also proposed a formula for calculating the specific melting point, which indicates that stronger intermolecular interactions have a major impact on the melting point, while the distribution of weak interactions also affects the melting point. This work would provide an effective reference for molecular design and structure-performance analysis.

Novel dual-responsive hydrogel composed of polyacrylamide/Fe-MOF/zinc finger peptide for construction of electrochemical sensing platform.

Responsive hydrogels have received much attention for improving the detection performance of electrochemical sensors because of their special responsiveness. However, current responsive hydrogels generally suffer from long response times, ranging from tens of minutes to several hours. This situation severely limits the detection performance and practical application of electrochemical sensors. Here, an electrochemical sensing platform was constructed by employing dual-responsive polyacrylamide/zinc finger peptide/Fe-MOF hydrogel (PZFH) as the silent layer, sodium alginate-Ni2+-graphene oxide hydrogel as the signal layer. GOx@ZIF-8, as the immunoprobe, catalyzed glucose to H2O2 and gluconic acid, resulting in the cleavage of immunoprobe as the pH decreased and subsequent release of Zn2+ ions. During the process of Fe-MOF converting from Fe3+ to Fe2+, free radicals were generated and used to destroy the structure of the PZFH. Cysteine and histidine in the zinc finger peptide can specifically bind to Zn2+ to create many pores in PZFH, exposing the signal layer. These synergistic effects rapidly decreased the impedance of PZFH and increased the electrochemical signal of Ni2+. The electrochemical sensing platform was used to detect pro-gastrin-releasing peptide with response times as short as 7 min of PZFH, a wide linear range from 100 ng mL-1 to 100 fg mL-1, and an ultra-low limit of detection of 14.24 fg mL-1 (S/N = 3). This strategy will provide a paradigm for designing electrochemical sensors.

A Novel Strategy for the Characterization of Self-Assembled Structures Using the Static Solid-State Phosphorus Nuclear Magnetic Resonance Technique.

Structural characterization of assemblies in solutions is essential for understanding the relationship between the structure and material properties. In this study, we introduce a novel approach to investigate amphiphilic self-assemblies in solutions using the phospholipid molecule 1-palmitoyl-2-hydroxy-sn-glycero-3-phosphocholine (Lyso PC) as a 31P NMR probe. The high natural abundance and gyromagnetic ratio of 31P make it one of the most sensitive nuclei in the low-frequency region, enabling efficient detection even in dilute solutions. Lyso PC can readily co-assemble with amphiphilic molecules and ions in aqueous solutions, forming various structures, such as hexagonal, lamellar, and micellar assemblies. The characteristic line shapes of these assemblies reflect the chemical environment around the probe and provide insights into the different phase states of the assemblies. This strategy offers a simple, cost-effective, and static method for obtaining structural information about various assemblies. Our work not only introduces a sensitive probe for characterizing assemblies in a solvent environment but also inspires new ideas for the development of similar spectroscopic probes.

Diagnosis of Esophageal Squamous Cell Carcinoma by High-Performance Serum Metabolic Fingerprints: A Retrospective Study.

Esophageal squamous cell carcinoma (ESCC) is a highly prevalent and aggressive malignancy, and timely diagnosis of ESCC contributes to an increased cancer survival rate. However, current detection methods for ESCC mainly rely on endoscopic examination, limited by a relatively low participation rate. Herein, ferric-particle-enhanced laser desorption/ionization mass spectrometry (FPELDI MS) is utilized to record the serum metabolic fingerprints (SMFs) from a retrospective cohort (523 non-ESCC participants and 462 ESCC patients) to build diagnostic models toward ESCC. The PFELDI MS achieved high speed (≈30 s per sample), desirable reproducibility (coefficients of variation < 15%), and high throughput (985 samples with ≈124 200 data points for each spectrum). Desirable diagnostic performance with area-under-the-curves (AUCs) of 0.925-0.966 is obtained through machine learning of SMFs. Further, a metabolic biomarker panel is constructed, exhibiting superior diagnostic sensitivity (72.2-79.4%, p < 0.05) as compared with clinical protein biomarker tests (4.3-22.9%). Notably, the biomarker panel afforded an AUC of 0.844 (95% confidence interval [CI]: 0.806-0.880) toward early ESCC diagnosis. This work highlighted the potential of metabolic analysis for accurate screening and early detection of ESCC and offered insights into the metabolic characterization of diseases including but not limited to ESCC.

Co-application of concentrated biogas slurry and pyroligneous liquor mitigates ammonia emission and sustainably releases ammonium from paddy soil.

Biogas production causes vast amounts of biogas slurry (BS). Application of BS to croplands can substitute chemical fertilizers while result in higher ammonia emissions. Tremendous variation of ammonium concentration in different BSs induces imprecise substitution, while concentrated BS holds higher and more stable ammonium. Pyroligneous liquor, an acidic aqueous liquid from biochar production, can be used with concentrated BS to reduce ammonia emission. However, the effects of combining concentrated BS with pyroligneous liquor on ammonia emission and soil (nitrogen) N transformation have been poorly reported. In this study, a field experiment applying concentrated BS only, or combining with 5 %, 10 %, and 20 % pyroligneous liquor (v/v) for substituting 60 % N of single rice cultivation was conducted by contrast with chemical fertilization. The results showed that substituting chemical N fertilizers with concentrated BS increased 24.6 % ammonia emission. In comparison, applying 5 %, 10 %, and 20 % pyroligneous liquor with concentrated BS reduced 4.9 %, 20.3 %, and 24.4 % ammonia emissions, respectively. Applying concentrated BS with more pyroligneous liquor preserved higher ammonium and dissolved organic carbon in floodwater, and induced higher nitrate concentration after fertilization. Whereas soil ammonium and nitrate contents were decreased along with more pyroligneous liquor application before and after the topdressing and exhibited sustainable release until rice harvest. In comparison, the soil N mineralization and nitrification rates were occasionally elevated, while the activities of soil urease, protease, nitrate reductase, and nitrite reductase had multiple responses. Applying concentrated BS only, or combining with 5 %, 10, and 20 % pyroligneous liquor, have little effect on soil basic properties but inorganic N. In summary, applying concentrated BS with >10 % pyroligneous liquor could preserve more N with sustainable release and potentially lower N loss to the atmosphere, and we proposed that applying 13.5 % pyroligneous liquor in concentrated BS could achieve maximum soil fertility and minimum ammonia emission.

Simultaneously Suppressing the Coffee Ring Effect of Solutes with Different Sizes.

Suppressing the coffee ring effect (CRE), which improves the uniformity of deposition, has attracted great attention. Usually, a realistic system contains solutes of various sizes. Large particles preferentially settle onto the substrate under gravity, separated from small particles even when CRE is suppressed, which generates nonuniformity in another way. This hinders small particles from filling the gaps at the deposition-substrate interface, leaving a frail deposition. Here, the CRE of polydispersed solutes is simultaneously suppressed, and a more uniform deposition is achieved by suspending the drop together with adding trace amounts of cations. The gaps tend to be filled, which makes the deposition bind more tightly. Analysis shows that gravity coordinates with the interactions that mediate the attraction between particles and the substrate, resulting in the coinstantaneous adsorption of all particles. This work adds another dimension to the suppression of CRE, improving the uniformity of deposition in complex systems and paving the way for the development of techniques in diverse manufacturing industries.

Mediating effect of self-concealment between non-suicidal self-injury and internet addiction in college students: a cross-sectional study.

BACKGROUND: Internet addiction, defined as uncontrolled behaviour resulting from the use of the Internet without the influence of addictive substances, which can seriously impair academic, occupational and social functioning. Non-suicidal self-injury, defined as self-injurious behaviour without the intent to die, and its addictive characteristics are similar to those of Internet addiction. Currently, there is a lack of research on the relationship between non-suicidal self-injury and Internet addiction. The purpose of this study was to examine the relationship between non-suicidal self-injury and internet addiction among college students and the role of self-concealment in this relationship. METHODS: In this study, data were collected online between December 2022 and January 2023 from 600 university students in Chengdu, Sichuan Province, China, using purposive sampling. The questionnaires included the Non-Suicidal Self-Injury Inventory (NSSI), the Self-Concealment Scale (SCS) and the Internet Addiction Test (IAT). RESULTS: A total of 573 valid questionnaires were recovered, with a valid recovery rate of 95.50%. CONCLUTION: The results suggest that self-concealment plays a partial mediating role between non-suicidal self-injury and internet addiction among college students. The authors emphasized the importance of internet addiction. In order to reduce the occurrence of internet addiction, schools should provide targeted interventions to promote the psychological health of college students' internet addictive behaviours.

Clinicopathological characteristics of well-differentiated gastric cancer missed by endoscopy.

The objective was to explore the clinicopathological features of moderately well-differentiated gastric cancer missed by endoscopy. The clinicopathological data of 88 patients who were diagnosed as moderately well-differentiated gastric cancer by biopsy and pathology from January 2019 to December 2020 in Anyang Tumor Hospital were analyzed retrospectively. The clinicopathological features and immunophenotypic characteristics of these gastric cancers were analyzed together with the literature review. Seventy males and 18 females were included in this study. There were 59 cases of gastritis, 14 cases of ulcer and 15 cases of polyp under endoscope. Based on mucous phenotype, there were 27 gastric cases, 18 intestinal cases, 39 gastrointestinal cases and 4 untyping cases. 54 cases expressed mutant p53 and 34 cases had wild type p53. None of the indicators could yield reliablediagnosis, which requires comprehensive morphological and immunohistochemical analysis by the pathologist. Meanwhile, the clinician should give the patient a systematic treatment plan incuding endoscopy, magnifying endoscopy, NBI, linear endoscopic ultrasound and other examinations. Regardless of the diagnostic criteria, once the pathology suggests a tumor lesion, local resection should be performed first. Additional surgery can be performed if there is submucosal invasion.

Terahertz label-free detection of nicotine-induced neural cell changes and the underlying mechanisms.

Nicotine exposure can lead to neurological impairments and brain tumors, and a label-free and nondestructive detection technique is urgently required by the scientific community to assess the effects of nicotine on neural cells. Herein, a terahertz (THz) time-domain attenuated total reflection (TD-ATR) spectroscopy approach is reported, by which the effects of nicotine on normal and cancerous neural cells, i.e., HEB and U87 cells, are successfully investigated in a label/stain-free and nondestructive manner. The obtained THz absorption coefficients of HEB cells exposed to low-dose nicotine and high-dose nicotine are smaller and larger, respectively, than the untreated cells. In contrast, the THz absorption coefficients of U87 cells treated by nicotine are always smaller than the untreated cells. The THz absorption coefficients can be well related to the proliferation properties (cell number and compositional changes) and morphological changes of neural cells, by which different types of neural cells are differentiated and the viabilities of neural cells treated by nicotine are reliably assessed. Collectively, this work sheds new insights on the effects of nicotine on neural cells, and provides a useful tool (THz TD-ATR spectroscopy) for the study of chemical-cell interactions.

How should extra-large Lugol-unstained lesions of the esophagus be treated? Results from a population-based cohort study.

BACKGROUND: Current guidelines recommend only severe dysplasia and above (SDA) lesions of the esophageal squamous epithelium for clinical intervention. However, the histopathologic diagnosis derived from tissue biopsies may be subject to underestimation of severity. METHODS: 1073 participants from whom biopsies were taken at baseline chromoendoscopic examination in a population-based screening trial were enrolled in this study. The size of the Lugol-unstained lesions (LULs) was mainly analyzed. The outcome was defined as SDA lesions either identified at baseline screening, or during follow-up, collectively referred to as the cumulative risk of SDA. Multivariable logistic regression models were used to evaluate the cumulative risk of SDA. RESULTS: One hundred and forty-six SDA cases were identified in the study period. Participants with large LULs had a high cumulative incidence of SDA (cumulative incidence16-20mm : 55.88%; cumulative incidence>20mm : 76.92%) in the median of 7-year duration. LULs of large size were significantly associated with a higher cumulative risk of SDA, regardless of the pathologic diagnosis (adjusted OR16-20mmvs.≤5mm = 21.02, 95% CI: 7.56-58.47; adjusted OR>20mmvs.≤5mm = 33.62, 95% CI: 11.79-95.87). CONCLUSIONS: Results from this study suggest physician-patient shared decision-making regarding clinical treatment or intensive surveillance should be carried out for LULs >20 mm in the esophagus, regardless of the histologic diagnosis. For those with LULs of 16-20 mm, intensive surveillance would also best be considered.

Clinical Significance of Porphyromonas gingivalis Enriching Cancer Stem Cells by Inhibiting Programmed Cell Death Factor 4 in Esophageal Squamous Cell Carcinoma.

Studies have confirmed that the colonization of Porphyromonas gingivalis (Pg) could promote the malignant evolution of esophageal squamous cell carcinoma (ESCC). Since pathogenic microorganisms can promote malignant tumor proliferation by inhibiting programmed cell death factor 4 (PDCD4) and the decrease of PDCD4 activity can enhance the stemness of cancer cells, we here investigated the functional mechanism by which Pg promoted ESCC chemoresistance and malignancy through inhibiting PDCD4 and enriching cancer stem cells (CSCs). The effects of Pg and PDCD4 on CSCs, chemoresistance and malignancy of ESCC cells were evaluated by in vitro studies. The expression of Pg, PDCD4, and ALDH1 in ESCC tissues were detected by IHC, and the correlations between each index and postoperative survival of ESCC patients were analyzed. The results showed that Pg could inhibit PDCD4 expression and lead to CSCs enrichment in ESCC cells. After eliminating Pg, the expression of PDCD4 was upregulated, the percentage of CSCs, chemoresistance and malignancy were decreased. ESCC patients with Pg-positive, PDCD4-negative, and ALDH1-positive have a significant shorter survival. This study proved that eliminating Pg and blocking CSCs enrichment caused by decreasing PDCD4 activity may provide a new strategy for ESCC treatment.

Lugol-unstained lesions location in the esophagus affects the detection rate of malignancy: a population-based study.

INTRODUCTION: This study aimed to evaluate the impact of Lugol-unstained lesion (LUL) location on the detection yield, which may help the endoscopist select targets for biopsy. METHODS: We enrolled 1064 subjects who had LULs at the baseline screening of a population-based randomized controlled trial. There were 1166 LULs with recorded location and pathologic diagnosis, and these were used for analysis. The detection rate of severe dysplasia and above (SDA) was calculated as the number of LULs identified as SDA divided by the number of LULs biopsied. Logistic regression with a generalized estimating equation was applied to evaluate the association between the location of a given LUL and the risk of the LUL being SDA. RESULTS: The detection rate of SDA for LULs located in the lower, middle, and upper esophagus increased from 5.9% and 10.9% to 16.7%. LUL location was significantly associated with having SDA (adjusted odds ratio (OR)upper vs. lower  = 2.88, 95% confidential interval (CI) = 1.48-5.60; adjusted ORmiddle vs. lower  = 1.63, 95% CI = 0.96-2.76), and the association was stronger in subgroups with a family history of esophageal squamous cell carcinoma (ESCC) (adjusted ORupper vs. lower  = 9.72, 95% CI = 2.57-36.69; adjusted ORmiddle vs. lower  = 3.76, 95% CI = 0.93-15.21). CONCLUSIONS: Our results suggest that more attention should be paid by endoscopists to LULs in the upper and middle esophagus, particularly for individuals with a family history of ESCC.