Efficacy of different endoscopic treatments for gastroesophageal reflux disease: a systematic review and network meta-analysis.

BACKGROUND: There are no direct comparisons across different endoscopic therapies for gastroesophageal reflux disease (GERD). This study aimed to evaluate the relative effects of different endoscopic therapies in GERD. METHODS: Five databases were searched until August 2023 for randomized controlled trials (RCTs) that compared the efficacy of endoscopic band ligation (EBL), Stretta, endoscopic fundoplication (transoral incisionless fundoplication [TIF], endoscopic full-thickness plication [EFTP], and EndoCinch plication procedure [EndoCinch, CR BARD, Billerica, Mass., USA]), or proton pump inhibitors (PPIs)/sham procedure for GERD. Bayesian network meta-analysis was performed. RESULTS: A total of 19 trials comprising 1181 patients were included. EBL (mean difference [MD], -7.75; 95% credible interval [CrI], -13.90 to -1.44), Stretta (MD, -9.86; 95% CrI, -19.05 to -0.58), and TIF (MD, -12.58; 95% CrI, -20.23 to -4.91) all significantly improved patients' health-related quality of life score with equivalent efficacy compared with PPIs. TIF and EBL achieved equivalent efficacy in reducing PPIs utility (risk ratio [RR], 0.66; 95% CrI, 0.40-1.05) and both were significantly superior to other endoscopic interventions (Stretta, EFTP, and EndoCinch). Besides, EBL and TIF also could significantly decrease the esophagitis incidence compared with PPIs (EBL [RR, 0.34; 95% CrI, 0.22-0.48] and TIF [RR, 0.38; 95% CrI, 0.15-0.88]). In terms of lower esophageal sphincter (LES) pressure, only TIF could significantly increase the LES pressure (MD, 6.53; 95% CrI, 3.65-9.40) to PPIs. In contrast, TIF was inferior to PPIs in decreasing esophageal acid exposure (MD, 2.57; 95% CrI, 0.77-4.36). CONCLUSION: Combining the evidence, EBL and TIF may have comparable efficacy and both might be superior to Stretta, EFTP, or EndoCinch in GERD treatment.

Artificial intelligence-assisted system for the assessment of Forrest classification of peptic ulcer bleeding: a multicenter diagnostic study.

BACKGROUND: Inaccurate Forrest classification may significantly affect clinical outcomes, especially in high risk patients. Therefore, this study aimed to develop a real-time deep convolutional neural network (DCNN) system to assess the Forrest classification of peptic ulcer bleeding (PUB). METHODS: A training dataset (3868 endoscopic images) and an internal validation dataset (834 images) were retrospectively collected from the 900th Hospital, Fuzhou, China. In addition, 521 images collected from four other hospitals were used for external validation. Finally, 46 endoscopic videos were prospectively collected to assess the real-time diagnostic performance of the DCNN system, whose diagnostic performance was also prospectively compared with that of three senior and three junior endoscopists. RESULTS: The DCNN system had a satisfactory diagnostic performance in the assessment of Forrest classification, with an accuracy of 91.2% (95%CI 89.5%-92.6%) and a macro-average area under the receiver operating characteristic curve of 0.80 in the validation dataset. Moreover, the DCNN system could judge suspicious regions automatically using Forrest classification in real-time videos, with an accuracy of 92.0% (95%CI 80.8%-97.8%). The DCNN system showed more accurate and stable diagnostic performance than endoscopists in the prospective clinical comparison test. This system helped to slightly improve the diagnostic performance of senior endoscopists and considerably enhance that of junior endoscopists. CONCLUSION: The DCNN system for the assessment of the Forrest classification of PUB showed satisfactory diagnostic performance, which was slightly superior to that of senior endoscopists. It could therefore effectively assist junior endoscopists in making such diagnoses during gastroscopy.

Rational design of copper(I)-doped metal-organic frameworks as dual-functional nanocarriers for combined chemo-chemodynamic therapy.

Combination therapies are an increasingly important part of the antitumor medicine armamentarium. However, developing desirable nanomaterials for combination therapies is still a great challenge. Herein, a biocompatible Cu(I)-doped metal-organic framework (MOF) (denoted as CuZn-ZIF) is designed as a novel dual-functional nanocarrier. Doxorubicin molecules are covalently bound to the surface of the CuZn-ZIF and released by the cleavage of chemical bonds in an acidic environment, demonstrating the capacity of controlled drug release. More importantly, CuZn-ZIF nanocarriers can simultaneously play the role of nanocatalysts, capable of catalyzing H2O2 into a highly reactive intracellular toxic hydroxyl radical (˙OH). An in vivo study reveals that nanoparticles exhibit high antitumor efficacy through the combined performance of DOX and Cu(I), proving the great potential of this copper(I)-based MOF for combined chemo-chemotherapy to improve therapeutic efficacy.

Smart down/upconversion nanomachines integrated with "AND" logic computation and enzyme-free amplification for NIR-II fluorescence-assisted precise and enhanced photodynamic therapy.

Upconversion nanoparticles enable indirect activation of photodynamic therapy (PDT) using near-infrared (NIR) light, providing an excellent alternative for treating deep tumors. However, conventional NIR light-triggered PDT systems suffered from low spatiotemporal accuracy and restricted therapeutic efficiency in vivo. In this work, DNA logic circuits were functionally modified on down/upconversion nanoparticles (D/UCNPs) to construct smart down/upconversion nanomachines (D/UCNMs) for NIR light-triggered PDT toward target tumors. Upon dual inputs of tumor-associated GSH and TK1 mRNA, DNA logic circuits perform "AND" logic computation and initiate the toehold-mediated strand displacement reaction. Meanwhile, the quenched upconversion fluorescence was recovered and then the approaching photosensitizers were activated, leading to in situ output of singlet oxygen (1O2) for precise and enhanced PDT. Importantly, the biodistribution of the D/UCNMs in vivo could be visualized by second near-infrared (NIR-II) fluorescence imaging via the downconversion luminance of D/UCNPs, which further contributed to performing precise PDT. This work provides new insights into the development of precise and highly efficient PDT systems.

Engineered Cancer Cells as Signal Probes for Fluorescence-Assisted Digital Counting Analysis.

Fluorescence-assisted digital counting analysis allowed sensitive quantification of targets by measuring individual fluorescent labels. However, traditional fluorescent labels suffered from low brightness, small size, and sophisticated preparation procedures. Herein, engineering fluorescent dye-stained cancer cells with magnetic nanoparticles were proposed to construct single-cell probes for fluorescence-assisted digital counting analysis by quantifying the target-dependent binding or cleaving events. Various engineering strategies of cancer cells including biological recognition and chemical modification were developed for rationally designing single-cell probes. Introduction of suitable recognition elements into single-cell probes allowed digital quantification of each target-dependent event via counting the colored single-cell probes in the representative image taken using a confocal microscope. The reliability of the proposed digital counting strategy was corroborated by traditional optical microscopy- and flow cytometry-dependent counting technologies. The advantages of single-cell probes, including high brightness, big size, ease of preparation, and magnetic separation, contributed to the sensitive and selective analysis of targets of interest. As proof-to-concept assays, indirect analysis of exonuclease III (Exo III) activity, as well as direct quantitation of cancer cells, were investigated, and the potential in biological sample analysis was also assessed. This sensing strategy will open a new avenue for the development of biosensors.

Cd2(IO3)(PO4) and Cd1.62Mg0.38(IO3)(PO4): metal iodate-phosphates with large SHG responses and wide band gaps.

The first NLO-active metal iodate-phosphates, namely, Cd2(IO3)(PO4) and Cd1.62Mg0.38(IO3)(PO4) (1 and 2), with three types of NLO groups, have been reported. 1 and 2 are isostructural and the structure of 1 features a 3D network formed by the Cd4(IO3)8/4(PO4)6/3 groups. 1 and 2 with strong SHG signals of 4 × and 3.5 × KH2PO4 are promising SHG materials in the visible region.

α- and ß-Ag4P2S7: Two Semiconductors with Promising Photocatalytic Hydrogen Production Based on a Density Functional Theory Study.

Herein, a new chiral compound with short Ag-Ag distances, namely, ß-Ag4P2S7 (P3121), has been discovered by a solid-state method. Density functional theory (DFT) calculations show that both α and ß phases exhibit suitable band gaps, low reduction potentials, and large visible-light absorption coefficients, as well as excellent band edges for carrier separation, suggesting their promising application in photocatalytic hydrogen production.

Highly Efficient Encapsulation of Doxorubicin Hydrochloride in Metal-Organic Frameworks for Synergistic Chemotherapy and Chemodynamic Therapy.

Iron-based metal-organic frameworks (MOFs) have been reported to have great potential for encapsulating doxorubicin hydrochloride (DOX), which is a frequently used anthracycline anticancer drug. However, developing a facile approach to realize high loading capacity and efficiency as well as controlled release of DOX in MOFs remains a huge challenge. Herein, we synthesized water-stable MIL-101(Fe)-C4H4 through a microwave-assisted method. It was found the nano-MOFs acted as nanosponges when soaked in a DOX alkaline aqueous solution with a loading capacity experimentally up to 24.5 wt %, while maintaininga loading efficiency as high as 98%. The mechanism of the interaction between DOX and nanoMOFs was investigated by absorption spectra and density functional theory (DFT) calculations, which revealed that the deprotonated DOX was electrostatically adsorbed to the unsaturated Fe3OCl(COO)6·H2O (named Fe3 trimers). In addition, the as-designed poly(ethylene glycol-co-propylene glycol) (F127) modified nanoparticles (F127-DOX-MIL) could be decomposed under the stimulation of glutathione (GSH) and ATP. As a result, DOX and Fe(III) ions were released, and they could undergo a Fenton-like reaction with the endogenous H2O2 to generate the highly toxic hydroxyl radical (·OH). The in vitro experiments indicated that F127-DOX-MIL could cause remarkable Hela cells inhibition through chemotherapy and chemodynamic therapy. Our study provides a new strategy to design a GSH/ATP-responsive drug-delivery nanosystem for chemo/chemodynamic therapy.

One-dimensional In2O3nanorods as sensing material for ppb-level n-butanol detection.

Effectively and quantificationally detecting hazardous gas n-butanol is very significant in daily life, which can bring about a safe living condition for humans. In this study, the one-dimensional In2O3nanorods were successfully synthesized via hydrothermal route and post-heat treatment. Noticeably, one-dimensional nanorods structures were obtained and the products presented a superior growth orientation along with (222) plane. Additionally, systematical gas-sensing measurements of the sensor made from In2O3nanorods towards hazardous n-butanol gas were conducted. Results exhibited that the fabricated sensor showed excellent n-butanol sensing properties, with aspects to a superior response value of 342.20 with concentration 100 ppm at 240 °C, remarkable selectivity, fast response/recovery times (77.5/34.2 s) and good stability. More interestingly, the detection limit of sensor as low as 500 ppb and a good linearity relationship between response values and n-butanol concentrations was presented. Gas-sensitive properties of this sensor are better than previously reported in n-butanol detection. All results demonstrate that one-dimensional In2O3nanorod is a promising sensor material to practical applications in effectively detecting n-butanol gas.

Boosting Ethylene/Ethane Separation within Copper(I)-Chelated Metal-Organic Frameworks through Tailor-Made Aperture and Specific π-Complexation.

The development of new materials for separating ethylene (C2H4) from ethane (C2H6) by adsorption is of great importance in the petrochemical industry, but remains very challenging owing to their close molecular sizes and physical properties. Using isoreticular chemistry in metal-organic frameworks (MOFs) enables the precise design and construction of target materials with suitable aperture sizes and functional sites for gas separations. Herein, it is described that fine-tuning of pore size and π-complexation simultaneously in microporous copper(I)-chelated MOFs can remarkably boost the C2H4/C2H6 adsorption selectivity. The judicious choice of organic linkers with a different number of carboxyl groups in the UiO-66 framework not only allows the fine tuning of the pore size but also immobilizes copper(I) ions onto the framework. The tailor-made adsorbent, CuI@UiO-66-(COOH)2, thus possesses the optimal pore window size and chelated Cu(I) ions to form π-complexation with C2H4 molecules. It can rapidly adsorb C2H4 driven by the strong π-complexation interactions, while effectively reducing C2H6 uptake due to the selective size-sieving. Therefore, this material exhibits an ultrahigh C2H4/C2H6 selectivity (80.8), outperforming most previously described benchmark materials. The exceptional separation performance of CuI@UiO-66-(COOH)2 is validated by breakthrough experiments for 50/50 v/v C2H4/C2H6 mixtures under ambient conditions.

Isorhamnetin alleviates esophageal mucosal injury in a chronic model of reflux esophagitis.

Gastro-esophageal reflux disease is one of the most common disorders in gastroenterology. The aim of this work was to investigate the protection of isorhamnetin against esophageal mucosal injury in rats with chronic reflux esophagitis (RE). Chronic RE model was established through fundus ligation and partial obstruction of the pylorus in rats. Then, the rats were treated with isorhamnetin (5 mg/kg) daily for a period of 14 days. Through histological and gross assessment, it was found that administration of isorhamnetin alleviated esophageal mucosal injury in RE rats. Treatment of RE rats with isorhamnetin improved esophageal barrier function, through upregulating proteins expression of occludin and zonula occludens-1 (ZO-1) and downregulating proteins expression of matrix matalloproteinases-3 (MMP3) and -9. Administration of isorhamnetin decreased CD68-positive cells and mRNA levels of IL-6, TNF-α, and IL-1ß in the esophagus of RE rats. Administration of isorhamnetin downregulated inducible nitric oxide synthase (iNOS) protein expression and decreased production of nitric oxide (NO) and 3-nitrotyrosin in the esophagus of RE rats. Administration of isorhamnetin enhanced heme oxygenase-1 (HO-1) activities and reduced malondialdehyde (MDA) levels in esophagus of RE rats. Additionally, treatment with isorhamnetin inhibited p38 MAPK and NFκB activation in RE esophagus. In conclusion, isorhamnetin attenuated esophageal mucosal injury in rats with chronic RE, possibly by suppressing formation of cytokines and infiltration of inflammatory cells, inhibiting p38 and NFκB pathways, and enhancing HO-1 activity.

Confinement of Perovskite-QDs within a Single MOF Crystal for Significantly Enhanced Multiphoton Excited Luminescence.

The development of the photostable higher-order multiphoton-excited (MPE) upconversion single microcrystalline material is fundamentally and technologically important, but very challenging. Here, up to five-photon excited luminescence in a host-guest metal-organic framework (MOF) and perovskite quantum dot (QD) hybrid single crystal ZJU-28⊃MAPbBr3 is shown via an in situ growth approach. Such a MOF strategy not only results in a high QD loading concentration, but also significantly diminishes the aggregation-caused quenching (ACQ) effect, provides effective surface passivation, and greatly reduces the contact of the QDs with the external bad atmosphere due to the confinement effect and protection of the framework. These advantages make the resulting ZJU-28⊃MAPbBr3 single crystals possess high PLQY of ≈51.1%, a high multiphoton action cross-sections that can rival the current highest record (measured in toluene solution), and excellent photostability. These findings liberate the excellent luminescence and nonlinear optical properties of perovskite QDs from the solution system to the solid single-crystal system, which provide a new avenue for the exploitation of high-performance multiphoton excited hybrid single microcrystal for future optoelectronic and micro-nano photonic integration applications.

FOXA2 alleviates CCl4-induced liver fibrosis by protecting hepatocytes in mice.

The liver-enriched transcription factor Forkhead Box A2 (FOXA2) has been reported to be involved in bile acid homeostasis and bile duct development. However, the role of FOXA2 in liver fibrogenesis remains undefined. In this study, we found that the abundance of FOXA2 was significantly lower in fibrotic livers of patients and mice treated with CCl4 than in controls. Interestingly, the expression level of FOXA2 decreased in hepatocytes, whereas FOXA2 was elevated in hepatic stellate cells (HSCs) of mouse fibrotic livers. Hepatocyte-specific ablation of FOXA2 in adult mice exacerbated liver fibrosis induced by CCl4. Either lentivirus LV-CMV-FOXA2 mediated FOXA2 overexpression in the liver or adeno-associated virus AAV8-TBG-FOXA2-mediated hepatocyte-specific upregulation of FOXA2 alleviated hepatic fibrosis. Overexpression of FOXA2 in HSCs did not obviously affect hepatic fibrogenesis. Additionally, FOXA2 knockout in hepatocytes resulted in aberrant transcription of metabolic genes. Furthermore, hepatocyte-specific knockout of FOXA2 enhanced endoplasmic reticulum stress (ER stress) and the apoptosis of hepatocytes, whereas FOXA2 overexpression in hepatocytes suppressed ER stress and hepatocyte apoptosis in mouse fibrotic livers. In conclusion, our findings suggested that FOXA2-mediated hepatocyte protection has a therapeutic role in hepatic fibrosis, and thus may be a new, promising anti-fibrotic option for treating chronic liver diseases.