ENDOANGEL versus water exchange for the detection of colorectal adenomas.

Background: Recently, the ENDOANGEL (EN) system, a computer-assisted detection technique, and water exchange (WE) assisted colonoscopy have both been shown to increase the colorectal adenoma detection rate (ADR). Objectives: The aim of this study was to compare the ADR between EN- and WE-assisted colonoscopy. Design: This was a retrospective study. Methods: Data from patients who underwent either EN- or WE-assisted colonoscopy between October 2021 and August 2022 were analysed consecutively. The primary outcome measure was the ADR. Results: The ADR was found to be similar between the EN and WE groups, with 80 out of 199 (40.2%) patients in the EN group compared to 78 out of 174 (44.8%) patients in the WE group [1.21; 95% confidence interval (CI), 0.80-1.83]. In the analysis using stabilized inverse probability treatment weighting after adjustment for confounding factors, both colonoscopy methods had similar performance in terms of ADR (1.41; 95% CI, 0.88-2.27). Conclusion: EN was found to be comparable to WE in terms of ADR during colonoscopy, and both methods may be effectively used in clinical practice.

How well did the consensus methods apply in the guideline development of traditional Chinese medicine: a web-based survey in China.

BACKGROUND AND OBJECTIVE: Consensus methods are crucial in developing clinical guidelines. Different methods, such as the Delphi and nominal group techniques, are commonly used, but there is a lack of detailed instructions on how to implement them effectively. The survey aims to explore the opinions and attitudes of the chair, panel and working group on the critical elements of the consensus methods during guideline development. METHODS: We used a cross-sectional design to conduct this study and sent a structured questionnaire to stakeholders, including the chair, panel members, and working group participants, through the popular mobile phone application WeChat.We selected participants using a combination of purposive and snowball sampling. The questionnaire gathered information on demographics, experiences, opinions, and concerns regarding consensus methods and guideline development. RESULTS: The sample comprised 290 participants representing 31 provinces or municipalities. Among them, the most significant number of respondents (n = 107, 36.9%) were from Beijing. Most participants, specifically 211 (72.76%), held senior professional titles, while 186 (64.14%) adhered to ongoing guidelines. The Delphi method was the most commonly used consensus method (n = 132, 42.31%), but the respondents had only a preliminary understanding of it (n = 147, 47.12%). The consensus process also revealed the insufficiency of involving pharmacoeconomists, patients, and nurses. CONCLUSIONS: Consensus methods have to be standardised and used consistently in the guideline development process. The findings of this study offer insights into diverse roles and more effective ways to apply the consensus process during guideline development.

MST4 promotes proliferation, invasion, and metastasis of gastric cancer by enhancing autophagy.

Background: Mammalian infertile-20-like kinase 4 (MST4) plays major roles in the progression of malignant tumor types, but its function in gastric cancer (GC) remains poorly understood. Objective: To investigate the regulatory mechanism of MST4 in GC. Methods: Immunohistochemistry was used to detect MST4 protein in GC tissue. Additionally, the correlation between MST4 expression and the clinicopathological characteristics and prognosis of GC was evaluated. The MST4 expression level in GC cells was measured by western blotting and quantitative real-time polymerase chain reaction. Moreover, the regulatory mechanism of MST4 was investigated in vitro and in vivo. Results: Overexpression of MST4 was found in GC tissue and cell lines, which correlated to the tumor size, histological type, invasion depth, ulcer, lymph node metastasis, lymphovascular invasion, perineural invasion and TNM stage (all P < 0.01). In terms of MST4 functions in vitro, its upregulation facilitated the proliferation, migration, and invasion of GC cells. Furthermore, MST4 promoted these processes by facilitating autophagy, whereas downregulation of MST4 significantly attenuated these processes. Downregulation of MST4 also attenuated tumor growth in vivo. Conclusion: High expression of MST4 indicates a poor prognosis and promotes GC cell proliferation, invasion, and metastasis by enhancing autophagy.

The Efficacy of Microfracture Combined with Extracorporeal Shock Wave Therapy for Treating Osteochondral Lesion of the Talus and the Quality of Regenerated Cartilage: A Retrospective Cohort Study and MRI Assessment.

BACKGROUND: osteochondral lesion of the talus (OLT) is a common disease in the physically active population, and extracorporeal shock wave therapy (ESWT) is a noninvasive treatment. We hypothesized that microfracture (MF) combined with ESWT may have great potential to become a novel combination treatment of OLT. METHODS: the OLT patients who received MF + ESWT or MF + platelet-rich plasma (PRP) injection were retrospectively included, with a minimal follow up of 2y. The daily activating VAS, exercising VAS, and American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score (AOFAS) were used to assess the efficacy and functional outcome, and ankle MRI T2 mapping was used to evaluate the quality of regenerated cartilage in the OLT patients. RESULTS: only transient synovium-stimulated complications were found during the treatment sessions; the complication rate and daily activating VAS did not have differences between groups. MF + ESWT had a higher AOFAS and a lower T2 mapping value than MF + PRP at the 2y follow up. CONCLUSIONS: the MF + ESWT had superior efficacy for treating OLT, which resulted in better ankle function and more hyaline-like regenerated cartilage, superior to the traditional MF + PRP.

miRNA-223-3p regulates ECT2 to promote proliferation, invasion, and metastasis of gastric cancer through the Wnt/ß-catenin signaling pathway.

PURPOSE: Expression of the guanine nucleotide exchange factor epithelial cell transforming 2 (ECT2) is elevated in gastric cancer (GC) but its biological function in GC is poorly understood. MicroRNAs (miRNAs) have great potential as therapeutic targets for GC through their ability to modulate gene expression. In the present study, we sought to identify potential miRNA-mRNA-protein regulatory pathways that might control ECT2 expression and function in GC. METHODS: ECT2 expression was examined in clinical GC specimens by immunohistochemical staining, and protein levels were correlated with clinicopathological features and prognosis. TargetScan was used to identify potential ECT2 mRNA-complementary miRNAs, and the roles of ECT2 and miRNA-223-3p (miR-223-3p) in GC cell biology and signaling pathway activation were examined by targeted knockdown (KD) or overexpression (OE) of ECT2 and miR-223-3p in GC cell lines. A murine GC xenograft model was developed to explore the impact of ECT2 OE on tumor growth in vivo. RESULTS: ECT2 expression was significantly elevated in GC specimens compared with normal gastric tissues and the level correlated positively with depth of invasion, ulceration, vascular tumor thrombus, neural invasion, and lymph node metastasis (p < 0.05). ECT2 was an independent prognostic factor for overall survival of GC patients (high ECT2 expression v.s. low ECT2 expression: χ2 = 29.831, p < 0.001). ECT2 KD or miR-223-3p OE markedly suppressed the proliferation, migration, and invasion of GC cells in vitro, whereas ECT2 OE had the opposite effects. ECT2 OE also promoted the growth of GC tumors in vivo. Tumor expression of Wnt2, ß-catenin, and several downstream target proteins in GC cells were decreased by ECT2 KD or miR-223-3p OE but increased by ECT2 OE. CONCLUSIONS: miR-223-3p regulates ECT2 expression to promote tumorigenic behavior of GC via activation of the Wnt/ß-catenin signaling pathway, suggesting that ECT2 and miR-223-3p as potential therapeutic targets for GC.

A Nano Refractive Index Sensing Structure for Monitoring Hemoglobin Concentration in Human Body.

This paper proposes a nanosensor structure consisting of a metal-insulator-metal (MIM) waveguide with a rectangular root and a double-ring (SRRDR) with a rectangular cavity. In this paper, the cause and internal mechanism of Fano resonance are investigated by the finite element method (FEM), and the transport characteristics are optimized by changing various parameters of the structure. The results show that the structure can achieve double Fano resonance. Due to the destructive disturbance between the wideband mode of the inverted rectangle on the bus waveguide and the narrowband mode of the SRRDR, the output spectrum of the system shows an obvious asymmetric Fano diagram, and the structural parameters of the sensor have a great influence on the Fano resonance. By changing the sensitive parameters, the optimal sensitivity of the refractive index nanosensor is 2280 nm/RIU, and the coefficient of excellence (FOM) is 76.7. In addition, the proposed high-sensitivity nanosensor will be used to detect hemoglobin concentration in blood, which has positive applications for biosensors and has great potential for future nanosensing and optical integration systems.

Refractive Index and Alcohol-Concentration Sensor Based on Fano Phenomenon.

A novel nano-refractive index sensor based on the Fano resonance phenomenon is proposed in this paper. The sensor consists of the metal-insulator-metal (MIM) waveguide and a V-ring cavity with a groove (VRCG). We analyzed the performance of the nanoscale sensor using the finite element method. The simulation results show that the asymmetry of the geometric structure itself is the main factor leading to Fano resonance splitting. In Fano splitting mode, the Fano bandwidth of the system can be significantly reduced when the sensor sensitivity is slightly reduced, so that the figure of merit (FOM) of the sensor can be substantially improved. Based on the above advantages, the sensor's sensitivity in this paper is as high as 2765 nm/RIU, FOM = 50.28. In addition, we further applied the sensor to alcohol concentration detection. The effect is good, and the sensitivity achieves about 150. This type of sensor has a bright future in the precision measurement of solution concentrations.

Interstitial Lung Disease as an Extraintestinal Manifestation of Crohn's Disease in the Time of COVID-19: A Rare Case Report and Review of the Literature.

Introduction: Recently, the extraintestinal manifestations of Crohn's disease (CD) have attracted more and more attention, among which interstitial lung disease (ILD) is a rare extraintestinal manifestation. Clinical presentation is polymorphic and pathogenesis remains unclear. The purpose of this article is to elaborate on these rare extraintestinal manifestations of CD, and the importance of short-term chest computed tomography (CT) for differential diagnosis is emphasized. Case Presentation: A 27-year-old male patient, who is a student, presented with chief complaints of "loose stools for 4 months, intermittent low-grade fever for 1 month". The next day, he developed a high fever with a body temperature of 39.8°C. A chest CT scan revealed multiple patellar ground glass shadows which suggested ILD. In the time of Corona virus disease (COVID-19), novel coronavirus pneumonia was first suspected according to the patient's history and symptoms, but laboratory examinations did not confirm. Colonoscopy showed multiple ulcers between the sigmoid colon to the terminal ileum, and pathology found epithelioid granuloma in submucosa. Moreover, a total gastrointestinal CT angiography showed that segmental leaping thickening of the bowel. Based on the above results, we ultimately made a diagnosis of CD. After using systemic steroid therapy, his fever was quickly relieved, and a follow-up chest CT showed that multiple patellar ground glass shadows were almost completely absorbed. Then, infliximab was used, and a repeat colonoscopy showed that intestinal ulcers were significantly improved. Conclusion: ILD is a rare extraintestinal manifestation of CD and reveals the excellent response to systemic steroid therapy. Manifestations of pulmonary disease associated with IBD are polymorphic; therefore; clinicians should be more vigilant regarding IBD-related ILD, especially when infectious causes have been excluded in the time of COVID-19. For those with ILD related to IBD, a short-term follow-up CT would be crucial.

Refractive index sensor based on a ring with a disk-shaped cavity for temperature detection applications.

In this study, we proposed a novel refractive index sensor structure, comprising a metal-insulator-metal (MIM) waveguide and a circular ring containing a disk-shaped cavity (CRDC). The finite element method was used to theoretically analyze the sensor characteristics. The simulation results showed that the disk-shaped cavity is the key to the asymmetric Fano resonance, and the radius of the CRDC has a significant influence on the performance of the sensor. A maximum sensitivity and figure of merit (FOM) of 2240 nm/RIU and 62.5, respectively, were realized. Additionally, the refractive index sensor exhibits the potential of aiding in temperature detection owing to its simple structure and high sensitivity of 1.186 nm/ºC.

A Nanoscale Sensor Based on a Toroidal Cavity with a Built-In Elliptical Ring Structure for Temperature Sensing Application.

In this article, a refractive index sensor based on Fano resonance, which is generated by the coupling of a metal-insulator-metal (MIM) waveguide structure and a toroidal cavity with a built-in elliptical ring (TCER) structure, is presented. The finite element method (FEM) was employed to analyze the propagation characteristics of the integral structure. The effects of refractive index and different geometric parameters of the structure on the sensing characteristics were evaluated. The maximum sensitivity was 2220 nm/RIU with a figure of merit (FOM) of 58.7, which is the best performance level that the designed structure could achieve. Moreover, due to its high sensitivity and simple structure, the refractive index sensor can be applied in the field of temperature detection, and its sensitivity is calculated to be 1.187 nm/℃.

Multiwalled Carbon Nanotube/Graphite Powder Film for Wearable Pressure Sensors with High Sensing Performance.

With the continuous progress of artificial intelligence and other manufacturing technologies, there is promising potential for wearable piezoresistive sensors in human physiological signal detection and bionic robots. Here, we present a facile solution-mixing process to fabricate a multiwalled carbon nanotube/graphite powder (MWCNT@Gp) film, which has high sensitivity and great linearity and is more oriented to flexible piezoresistive sensors. The sensor consists of two parts: a spinosum microstructure shaped by a sandpaper template and polydimethylsiloxane (PDMS) as the top substrate and interdigital electrodes as the bottom substrate. The experiments we have conducted show that these two parts provide good protection to the MWCNTs@Gp film and improve sensor sensitivity. Additionally, the sensitivity of the optimal ratio of multiwalled carbon nanotubes and graphite powder is analyzed. The 5%MWCNT@5%Gp composites were found to have relatively good conductivity, which is convenient for the fabrication of conductive films of piezoresistive sensors. Finally, we conducted application experiments and found that the flexible piezoresistive sensor can detect minute signals of human motion and different pressure points. This indicates the feasibility of portable sensors in electronic skin and smart devices.

High-Property Refractive Index and Bio-Sensing Dual-Purpose Sensor Based on SPPs.

A high-property plasma resonance-sensor structure consisting of two metal-insulator-metal (MIM) waveguides coupled with a transverse ladder-shaped nano-cavity (TLSNC) is designed based on surface plasmon polaritons. Its transmission characteristics are analyzed using multimode interference coupling mode theory (MICMT), and are simulated using finite element analysis (FEA). Meanwhile, the influence of different structural arguments on the performance of the structure is investigated. This study shows that the system presents four high-quality formants in the transmission spectrum. The highest sensitivity is 3000 nm/RIU with a high FOM* of 9.7 × 105. In addition, the proposed structure could act as a biosensor to detect the concentrations of sodium ions (Na+), potassium ions (K+), and the glucose solution with maximum sensitivities of 0.45, 0.625 and 5.5 nm/mgdL-1, respectively. Compared with other structures, the designed system has the advantages of a simple construction, a wide working band range, high reliability and easy nano-scale integration, providing a high-performance cavity choice for refractive index sensing and biosensing devices based on surface plasmons.

Multi-input convolutional network for ultrafast simulation of field evolvement.

There is a compelling need for the regression capability of mapping the initial field and applied conditions to the evolved field, e.g., given current flow field and fluid properties predicting next-step flow field. Such a capability can provide a maximum to full substitute of a physics-based model, enabling fast simulation of various field evolvements. We propose a conceptually simple, lightweight, but powerful multi-input convolutional network (ConvNet), yNet, that merges multi-input signals by manipulating high-level encodings of field/image input. yNet can significantly reduce the model size compared with its ConvNet counterpart (e.g., to only one-tenth for main architecture of 38-layer depth) and is as much as six orders of magnitude faster than a physics-based model. yNet is applied for data-driven modeling of fluid dynamics, porosity evolution in sintering, stress field development, and grain growth. It consistently shows great extrapolative prediction beyond training datasets in terms of temporal ranges, spatial domains, and geometrical shapes.

A Nanoscale Structure Based on an MIM Waveguide Coupled with a Q Resonator for Monitoring Trace Element Concentration in the Human Body.

In this study, a nano-refractive index sensor is designed that consists of a metal-insulator-metal (MIM) waveguide with a stub-1 and an orthogon ring resonator (ORR) with a stub-2. The finite element method (FEM) was used to analyze the transmission characteristics of the system. We studied the cause and internal mechanism of Fano resonance, and optimized the transmission characteristics by changing various parameters of the structure. In our experimental data, the suitable sensitivity could reach 2260 nm/RIU with a figure of merit of 211.42. Furthermore, we studied the detection of the concentration of trace elements (such as Na+) of the structure in the human body, and its sensitivity reached 0.505 nm/mgdL-1. The structure may have other potential applications in sensors.

The PdeK-PdeR two-component system promotes unipolar localization of FimX and pilus extension in Xanthomonas oryzae pv. oryzicola.

Bacterial type IV pili (T4P) contribute to virulence and can be rapidly extended and retracted to mediate twitching motility. T4P biogenesis, which is normally limited to the cell poles, is regulated by extracellular stimuli and internal signals such as cyclic di-GMP (c-di-GMP). The c-di-GMP­binding protein FimX interacts with the T4P assembly complex and, when intracellular c-di-GMP concentrations are low, assumes a unipolar localization and promotes T4P biogenesis. Here, we demonstrated that FimX formed a complex with the two-component system consisting of the histidine kinase PdeK and its downstream response regulator PdeR. This complex promoted T4P assembly in the phytopathogen Xanthomonas oryzae pv. oryzicola and virulence in rice. PdeK and the c-di-GMP phosphodiesterase activity of PdeR were required for the unipolar localization of FimX, leading to T4P extension. High amounts of c-di-GMP reduced the affinity of FimX for PdeR in vitro, consistent with FimX promoting T4P extension only under conditions of low c-di-GMP. We propose that low intracellular amounts of c-di-GMP created by PdeR facilitate the recruitment of FimX to the leading pole of motile cells. Our findings indicate that the PdeK-PdeR two-component system connects environmental cues to second messenger turnover, resulting in a change in the intracellular concentration of c-di-GMP that promotes T4P biogenesis and virulence.

Lymph node metastasis risk factors and applicability of endoscopic submucosal dissection in mixed-type early gastric cancer in Chinese patients.

BACKGROUND: To analyze the risk factors of lymph node metastasis (LNM) of mixed-type early gastric cancer (EGC), and to explore whether endoscopic submucosal dissection (ESD) is applicable to mixed-type EGC in Chinese patients. METHODS: A total of 812 EGC patients were included. We classified the lesions into four types: pure moderately differentiated (PMD) adenocarcinoma, mixed predominantly moderately differentiated (MMD) type, mixed predominantly poorly differentiated (MPD) type, and pure poorly differentiated (PPD) adenocarcinoma. LNM risk factors in EGC were evaluated by univariate and multivariate analyses, and the feasibility of ESD in mixed-type EGC was estimated. RESULTS: The LNM rate in mixed-type EGC was 24.7% (68/275). Tumor size [odds ratio (OR) =1.419, P=0.008], MPD (OR =3.278, P=0.002), submucosal invasion ≥500 µm (OR =5.059, P=0.002), and lymphovascular invasion (LVI) (OR =5.836, P<0.001) were independent predictors of LNM in mixed-type EGC. LNM was more common in MMD patients than in PMD patients who met the expanded indications for ESD of differentiated EGC (0.0% vs. 7.84%, P=0.005). CONCLUSIONS: Tumor size, histology, invasion depth, and LVI are independent risk factors for LNM in mixed-type EGC. The absolute indications for ESD are applicable to MMD, and the feasibility of the expanded indications for ESD in MMD and MPD requires further investigation in Chinese patients.

Clinicopathologic Characteristics and Risk Factors of Lymph Node Metastasis in Patients with Early Gastric Cancer in the Wannan Region.

BACKGROUND To date, there has been no agreement on the risk factors of lymph node metastasis (LNM) for early gastric cancer (EGC). The objective of this article was to investigate the risk factors of LNM in EGC in the Wannan region of Anhui Province and then to develop a regional practice guideline to manage EGC cases in this population. MATERIAL AND METHODS This retrospective analysis was performed from July 1, 2014 to June 30, 2017, at First Affiliated Hospital of Wannan Medical College. We explored the independent risk factors of LNM by using univariate analysis and multivariate analysis. RESULTS In total, 381 patients were selected for analysis. The LNM rate of EGC was 13.65% (52 out of 381 patients). Submucosal invasion, ulcer presence, undifferentiated tumor, vascular tumor thrombus, and neural invasion were significantly associated with LNM in EGC patients. Multivariate analysis suggested that depth of invasion (odds ratio [OR], 3.50; 95% confidence interval [CI], 1.45-8.42; P=0.005), vascular tumor thrombus (OR, 6.33; 95%CI, 2.31-17.31; P=0.001), and neural invasion (OR, 10.95; 95%CI, 3.29-36.41; P=0.001) were independent predictors of LNM in EGC patients CONCLUSIONS In the Wannan region of Anhui Province in China, depth of invasion, vascular tumor thrombus, and neural invasion were independent predictive risk factors for LNM in EGC patients. EGC patients with these risk factors for LNM are more likely to have LNM, and radical surgical procedure was more likely to be considered. With respective to EGC with submucosal invasion, the flat type pattern had a lower risk of LNM.

Mina53, a novel molecular marker for the diagnosis and prognosis of gastric adenocarcinoma.

Mina53 is a direct novel target protein of Myc. The present study investigated the expression of mina53 and c-myc in gastric carcinoma and the relationship between Mina53 expression and clinicopathological features. The expression levels of mina53 and c-myc mRNA and protein in gastric cancers and the adjacent normal tissues from 12 patients were assessed by laser-capture microdissection (LCM) combined with quantitative polymerase chain reaction (qPCR) and western blotting, respectively. Immunohistochemical analysis was used to evaluate the expression of the Mina53 protein in normal gastric tissues (n=30), chronic atrophic gastritis without intestinal metaplasia (n=44), intestinal metaplasia (n=34), gastric dysplasia (n=36), intestinal-type gastric carcinoma (IGC) (n=30) and diffuse-type gastric carcinoma (DGC) (n=34). The correlation between expression of mina53 and patient survival time was also investigated. The expression levels of mina53 and c-myc mRNA in the gastric carcinomas were found to be higher when compared to these levels in the adjacent normal tissues. In addition, the expression levels of Mina53 and c-Myc protein in gastric carcinomas were higher when compared with levels in the adjacent normal epithelium. mina53 expression was significantly increased during gastric carcinogenesis and was correlated with different clinicopathological factors in IGC and DGC. The prognosis of patients with low expression of Mina53 was more favorable when compared to the prognosis of patients with high expression of Mina53. mina53 expression was gradually elevated during gastric carcinogenesis, and the overexpression of mina53 was correlated with different clinicopathological features between DGC and IGC cases. Furthermore, the prognosis of gastric carcinoma patients was significantly correlated with the expression of Mina53.

Determination of cnidilin and its two metabolites in rat plasma by high-performance liquid chromatography-electrospray ionization tandem mass spectrometry.

Simple, fast, and sensitive HPLC coupled with an electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS) method for the simultaneous determination of cnidilin and its two metabolites, 3",8-methoxy-isoimperatorin (M1) and 5"-hydroxyl-8-methoxy-isoimperatorin (M2), in rat plasma has been developed. Pimpinellin was used as the internal standard and the total analysis time was 7 min. Methanol was the only reagent during the process of sample handling used as a protein precipitant. The analytes were separated on a reversed-phase C18 column with gradient elution consisting of 0.5% aqueous formic acid and methanol (containing 0.5% formic acid) in the multiple-reaction monitoring mode. Cnidilin, M1, M2, and the internal standard could be well ionized under positive electrospray ionization conditions. Full validation of the method (linearity, precision, accuracy, limit of detection, and limit of quantification) was carried out and the method was successfully employed in a metabolism study of cnidilin administered to rats at a dose of 24 mg/kg. The pharmacokinetic parameters of cnidilin determined after orally administrating the single coumarin to the rat were obtained and the mass fragmentation pathways for analysis are proposed in this article.