Clinical characteristics of postoperative necrotizing enterocolitis in patients with congenital jejunoileal atresia and its risk factors.

Objective: To review postoperative necrotizing enterocolitis (NEC) in patients with jejunoileal atresia (JIA) and to explore the potential risk factors related to the concurrence of NEC. Methods: Patients diagnosed with JIA who received surgical treatment from January 2016 to June 2021 were enrolled. Demographics, viral infection of the fetus, transfusion within 48 hours before NEC, sepsis before JIA repair, pathological and anatomical classification of JIA, combined malformation, occurrence time of NEC after the operation, treatment, and prognosis of patients were analyzed. Patients were divided into NEC group and non-NEC group, and all patients were followed up for 3-6 months to observe for complications. Results: A total of 180 patients with JIA were included, of whom 12 were diagnosed with NEC after surgery and 1 patient with NEC died during follow-up. The average age, birth weight, gestational age, proportion of premature infants, proportion of preoperative infections, and pathological classification of JIA did not significantly differ between the two groups. The probability of patients with proximal jejunal atresia (PJA) in the NEC group (58.3%) was higher than that in the non-NEC group (22.6%) (p=0.011), and patients with PJA had longer parenteral nutrition time than patients without PJA (26.64±9.21 days vs 15.11±6.58 days, p<0.001). Conclusion: PJA was more likely to be associated with concurrent NEC after surgery, which is a highly NEC-related risk factor inherent in JIA.

Head-to-head comparison of 18F-FDG PET/CT and 18F-FDG PET/MRI for lymph node metastasis staging in non-small cell lung cancer: a meta-analysis.

PURPOSE: The current meta-analysis aimed to compare the diagnostic performance of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) with 18F-FDG PET/magnetic resonance imaging (MRI) in non-small cell lung cancer (NSCLC) lymph node metastasis staging. METHODS: We searched the PubMed, Web of Science, and Embase databases for relevant articles between November 1992 and September 2022. Studies evaluating the head-to-head comparison of 18F-FDG PET/CT and 18F-FDG PET/MRI for lymph node metastasis in patients with NSCLC were included. The quality of each study was assessed using the Quality Assessment of Diagnostic Performance Studies-2 tool. RESULTS: The analysis includes six studies with a total of 434 patients. The pooled sensitivity of 18F-FDG PET/CT and 18F-FDG PET/MRI was 0.78 [95% confidence interval (CI): 0.59-0.90] and 0.84 (95% CI: 0.68-0.93), and the pooled specificity was 0.87 (95% CI: 0.72-0.94) and 0.87 (95% CI: 0.80-0.92), respectively. The accuracy of 18F-FDG PET/CT and 18F-FDG PET/MRI was 0.81 (95% CI: 0.71-0.90) and 0.84 (95% CI: 0.75-0.92), respectively. When the pre-test probability was set at 50%, the post-test probability for 18F-FDG PET/CT could increase to 85%, and the post-test probability for 18F-FDG PET/MRI could increase to 87%. CONCLUSION: 18F-FDG PET/CT and 18F-FDG PET/MRI have similar diagnostic performance in detecting lymph node metastasis in NSCLC. However, the results of this study were from a small sample study, and further studies with larger sample sizes are needed.

Diagnostic potential of [18F]FDG PET/MRI in non-small cell lung cancer lymph node metastasis: a meta-analysis.

PURPOSE: This meta-analysis evaluated the diagnostic accuracy and diagnostic value of [18F]FDG PET/MRI for mediastinal lymph node staging of NSCLC. METHODS: Relevant articles in PubMed, Embase, Web of Science, and the Cochrane Library were searched until January 2023. Research evaluating [18F]FDG PET/MRI for mediastinal lymph node staging of NSCLC was included. Pooled estimates of sensitivity, specificity, PLR, and NLR were calculated by the "Stata" software. RESULTS: Nine researches were included, containing 618 patients. The pooled sensitivity of [18F]FDG PET/MRI for detecting mediastinal lymph node staging of NSCLC was 0.82 (0.70-0.90), and the pooled specificity was 0.88 (0.82-0.93). PLR and NLR were 7.38 (4.73-11.52) and 0.20 (0.11-0.36), respectively. The AUC value of this imaging modality was 0.92 (0.90-0.94). The post-test probability for [18F]FDG PET/MRI might rise to 88% when the pre-test probability was set at 50%. CONCLUSIONS: We considered [18F]FDG PET/MRI as an effective imaging tool with relatively high specificity and sensitivity. It has great potential to be used in the clinical management of patients in NSCLC who are amenable to early surgery. More studies with large sample sizes in the same direction are needed in future to obtain more reliable evidence-based support.

High-Performance and Highly Safe Solvate Ionic Liquid-Based Gel Polymer Electrolyte by Rapid UV-Curing for Lithium-Ion Batteries.

Utilizing ionic liquids (ILs) with low flammability as the precursor component for a gel polymer electrolyte is a smart strategy out of safety concerns. Solvate ionic liquids (SILs) consist of equimolar lithium bis(trifluoromethylsulfonyl)imide and tetraglyme, alleviating the main problems of high viscosity and low Li+ conductivity of conventional ILs. In this study, within a very short time of 30 s, a SIL turns immobile using efficient and controllable UV-curing with an ethoxylated trimethylolpropane triacrylate (ETPTA) network, forming a homogeneous SIL-based gel polymer electrolyte (SGPE) with enhanced thermal stability (216 °C), robust mechanical strength (compression modulus: 1.701 MPa), and high ionic conductivity (0.63 mS cm-1 at room temperature). A Li|SGPE|LiFePO4 cell demonstrates high charge/discharge reversibility and cycling stability with a capacity retention rate of 99.7% after 750 cycles and an average Coulombic efficiency of 99.7%, owing to its excellent electrochemical compatibility with Li-metal. A close-contact electrode/electrolyte interface is formed by in situ curing of the electrolyte on the electrode surface, which enables the pouch full cell to work stably under the conditions of cutting/bending. In view of the excellent mechanical, thermal, and electrochemical performances of SGPE, it is believed to be a promising gel polymer electrolyte for constructing high-safety lithium-ion batteries (LIBs).

The safety and effectiveness of Santulli enterostomy in neonatal intestinal conditions.

Background: As an end stoma, Santulli enterostomy provides early restoration of intestinal continuity without formal laparotomy. Short amputation of the common limb enables closure on a side to restore anatomic continuity without sacrificing valuable intestine; additionally, the procedure is simple and safe. Most newborns who require enterostomy might benefit from Santulli enterostomy; however, several pediatric surgeons lack information regarding this procedure. Therefore, we have reviewed our experience about Santulli enterostomy and explore the advantages and indications in neonatal intestinal conditions. Methods: The clinical data of 76 neonates who underwent enterostomywere obtained. The patients were divided into two groups: the Santulli group with 33 cases who underwent Santulli enterostomy, and the control group with 43 cases who underwent double- or single-lumen ostomy. The general data of the two groups were analyzed, and the perioperative/postoperative complications, clinical data and the long-term outcomes were compared. Results: There was no difference in the demographic informations, the level of enterostomy, the rate of high-sight stoma, the operative time and bleeding of enterostomy between the two groups. Compared to the control group, the operative time of ostomy closure was less in the Santulli group (53.00 vs. 152.47, P < 0.001). The duration of parenteral nutrition (27.45 vs. 44.56, P = 0.010), the mean interval of initial enterostomy to stomal closure (131.21 vs. 216.42, P < 0.001), and length of stay (46.00 vs. 67.60, P = 0.007) were shorter, while the incidence of postoperative complications and hospitalization costs (11.21 vs. 15.49, P = 0.006) were lower. The Santulli procedure can reduce the morbidity of high output ostomy (2 vs. 10, P = 0.042) and short bowel syndrome (3 vs. 132, P = 0.025), shorten the discrepancy of diameter between the proximal and distal segments, maximize the available intestine, and monitor the movement of the distal bowel. The length of incision was shorter, and the catch-up growth was significantly faster in the Santulli group. Conclusion: Santulli enterostomy is a superior procedure in the treatment of neonatal intestinal conditions, in terms of fewer complications, faster catch-up growth, shorter hospitalization time and treatment duration. It should be the procedure of choice in several newborns with intestinal conditions that require ostomy.

The Efficacy of Biofeedback Therapy for the Treatment of Fecal Incontinence After Soave Procedure in Children for Hirschsprung's Disease.

Introduction: Hirschsprung's disease is a common digestive tract malformation in children, and the Soave procedure is one of the classic surgical methods for Hirschsprung's disease (HD). Fecal incontinence is one of the most common postoperative complications that can cause significant distress to the patients and their family, the incidence of which is 20% in a recent series. Biofeedback therapy (BFT) can be an effective treatment for managing anorectal disorders, but there has been little report of the efficacy of BFT for the treatment of fecal incontinence after the Soave procedure, and the main objective of this study is to evaluate it. Methods: We retrospectively analyzed postoperative fecal incontinence in 46 children who received the Soave procedure for HD and who received BFT at our institution from March 2016 to February 2020, which included 38 males and 8 females (mean age 8.1 years, from 3.7 to 14 years). Anal sphincter contraction training was performed using BFT for 10 days per session in the hospital, one time each day, and 20 min each time. BFT was performed by employing visual and verbal feedback techniques using the biofeedback instrument. Long-term functional outcomes were objectively assessed using the Rintala Bowel Function Score (RBFS), and the patients were scored according to the sum total as excellent (18-20 points, 0 case), good (11-16 points, 0 case), fair (9-11 points, 9 cases), or poor (6-9 points, 37 cases). Defecation questionnaires and anorectal manometry were completed pretreatment and after three, six, or nine sessions, and primary outcome measures of anorectal manometry were anal maximal contraction pressure (AMCP), anal longest contraction time (ALCT), rectal rest pressure (RRP), and anal rest pressure (ARP). Results: Followed up from 6 months to 4 years, the symptoms of fecal incontinence disappeared completely in 39 (84.78%) patients. Among them, 14 (30.43%) had complete disappearance of symptoms after 3 sessions of treatment, 25 (54.34%) patients had improved symptoms after 6 sessions of treatment, symptoms completely disappeared after 6 sessions of treatment, and 7 (15.22%) cases still suffered fecal incontinence mildly. The AMCP after three and six sessions in the poor group was significantly increased compared with that before treatment [(85.87 ± 31.75) mmHg vs. (135.33 ± 37.69) mmHg vs. (128.41 ± 33.45) mmHg, P < 0.05]. The ALCT and ARP showed the same trend, while the RRP after three and six sessions were not significant (P > 0.05). The mean (±SD) score of the RBFS increased from 9 to 17.40 ± 0.84 in the fair group, while it increased from 7.22 ± 0.76 to 16.58 ± 1.66 in the poor group after six sessions (P < 0.05). Conclusion: Biofeedback therapy is a safe and effective treatment of fecal incontinence after the Soave procedure of children for Hirschsprung's disease. It is beneficial to design the individualized treatment programs for the children with varying degrees of fecal incontinence.

Recyclable laccase by coprecipitation with aciduric Cu-based MOFs for bisphenol A degradation in an aqueous environment.

Copper-based MOF (Cu-PABA) was selected to immobilize laccase (Lac) at optimum pH because of its favorable acid resistance. Cu-PABA@Lac biocomposites were synthesized in situ by the one-step method under moderate conditions (water environment and normal temperature and pressure). Cu-PABA@Lac had great potential to maintain stability due to the protection of the Cu-PABA shell and reasonable conformational changes. In addition, Cu-PABA@Lac could be used repeatedly by centrifugation, as confirmed in the degradation experiment of bisphenol A (BPA). Because of the synergistic effect of copper ions between laccase and Cu-PABA, the Km value decreased (from 0.0024 to 0.0014 mM); therefore, the affinity between laccase and guaiacol was enhanced. In conclusion, the system provides a choice for immobilized acid-resistant enzymes and a solution for environmental BPA degradation.

Green and facile fabrication of porous titanium dioxide as efficient sulfur host for advanced lithium-sulfur batteries: An air oxidation strategy.

Lithium-sulfur (Li-S) battery has been considered a promising next-generation electrochemical energy storage device due to its high theoretical capacity and high energy density. However, the dissolution and shuttling problems of lithium polysulfides (LiPSs) are major obstacles hindering the performance and application of Li-S batteries. To address these issues, we report the rapid preparation of porous TiO2 nanoparticles (p-TiO2-NPs) as an effective sulfur host for Li-S batteries using a facile, scalable, and green one-step air oxidation strategy. Experimental results reveal that the p-TiO2-NPs have a mesopores-rich structure and strong chemical adsorption capability against LiPSs, which effectively mitigates the dissolution and shuttling of LiPSs by way of physical and chemical adsorptions. Incorporating highly conductive multi-wall carbon nanotubes to interconnect with the active materials, the p-TiO2-NPs-based cathode delivers a high discharge capacity of 1276 mAh g-1 at 0.2 C and stable cycling performance with an ultralow capacity decay rate of 0.0526% per cycle at 1 C over 1200 cycles. This green and facile fabrication strategy can also be extended to other metal carbides to endow an environmentally friendly route for the sustainable development of high-performance Li-S batteries.

Immobilizing Polysulfide by In Situ Topochemical Oxidation Derivative TiC@Carbon-Included TiO2 Core-Shell Sulfur Hosts for Advanced Lithium-Sulfur Batteries.

The performance of lithium-sulfur (Li-S) batteries is greatly hindered by the notorious shuttle effect of lithium polysulfides (LiPSs). To address this issue, in situ topochemical oxidation derivative TiC@carbon-included TiO2 (TiC@C-TiO2 ) core-shell composite is designed and proposed as a multifunctional sulfur host, which integrates the merits of conductive TiC core to facilitate the redox reaction kinetics of sulfur species, and porous C-TiO2 shell to suppress the dissolution and shuttling of LiPSs through chemisorption. A unique dual chemical mediation mechanism is demonstrated for the proposed TiC@C-TiO2 composite that synergistically entraps LiPSs through thiosulfate/polythionate conversion coupled with strong polar-polar interaction. The morphological characterization reveals that the TiC@C-TiO2 -based cathode can well regulate the distribution of electrode materials to retard their accumulation inside the electrode, ensuring effective contact between the active materials and electrolyte. Based on its unique function and structure, the cathode delivers an improved capacity of 1256 mAh g-1 at 0.2C, a remarkable rate capability of 643 mAh g-1 , and an ultralow capacity decay rate of 0.065% per cycle at 2C over 900 cycles. This work not only demonstrates a dual chemical mediation mechanism to immobilize LiPSs, but also provides a universal strategy to construct multifunctional sulfur hosts for advanced Li-S batteries.

Silicon-nanoparticle-based composites for advanced lithium-ion battery anodes.

Lithium-ion batteries (LIBs) play an important role in modern society. The low capacity of graphite cannot meet the demands of LIBs calling for high power and energy densities. Silicon (Si) is one of the most promising materials instead of graphite, because of its high theoretical capacity, low discharge voltage, low cost, etc. However, Si shows low conductivity of both ions and electrons and exhibits a severe volume change during cycles. Fabricating nano-sized Si and Si-based composites is an effective method to enhance the electrochemical performance of LIB anodes. Using a small size of Si nanoparticles (SiNPs) is likely to avoid the cracking of this material. One critical issue is to disclose different types and electrochemical effects of various coupled materials in the Si-based composites for anode fabrication and optimization. Hence, this paper reviews diverse SiNP-based composites for advanced LIBs from the perspective of composition and electrochemical effects. Almost all kinds of materials that have been coupled with SiNPs for LIB applications are summarized, along with their electrochemical influences on the composites. The integrated materials, including carbon materials, metals, metal oxides, polymers, Si-based materials, transition metal nitrides, carbides, dichalcogenides, alloys, and metal-organic frameworks (MOFs), are comprehensively presented.

TNF-α induces autophagy through ERK1/2 pathway to regulate apoptosis in neonatal necrotizing enterocolitis model cells IEC-6.

Necrotizing enterocolitis (NEC) is a potentially fatal illness in premature neonates. Tumor necrosis factor-α (TNF-α) and autophagy are associated with the pathogenesis of NEC. This study aimed to explore whether TNF-α might regulate apoptosis in neonatal NEC model cells IEC-6 via regulation of autophagy. NEC rat model was induced by hand feeding and exposure to asphyxia/cold-stress for histologic examination. The NEC in vitro model (IEC-6/NEC cells) was established by stimulating the intestinal epithelial cell line IEC-6 with lipopolysaccharide (LPS, 100 µg/mL) for 3 h to investigate the effects of TNF-α on IEC-6 proliferation and apoptosis. In this study, NEC rats showed decreased proliferating cell nuclear antigen (PCNA) expression, increased TUNEL-positive cells, higher expression of TNF-α, p-ERK1/2, and autophagy-related proteins in rat small intestine compared with their controls. Additionally, the LPS-stimulated IEC-6/NEC cells showed a significantly decreased proliferation and increased apoptosis compared with the control cells. Furthermore, the LPS-stimulated IEC-6/NEC cells exhibited enhanced autophagy level, as evidenced by a dose-dependent increase in Beclin-1 protein expression, LC3II/LC3I ratio and accumulation of MDC-positive autophagic vacuoles. Moreover, inhibition of autophagy by wortmannin or LY294002 significantly abolished the LPS-mediated decreased proliferation and increased apoptosis of IEC-6/NEC cells. Results also showed that inhibition of ERK1/2 pathway using U0126 significantly inhibited TNF-α-induced autophagy. Furthermore, the TNF-α-mediated inhibition of IEC-6 proliferation and promotion of IEC-6 apoptosis was abolished by U0126. Our findings demonstrated that TNF-α might induce autophagy through ERK1/2 pathway to regulate apoptosis in neonatal NEC cells IEC-6. Our study enhances our understanding of neonatal NEC pathogenesis.

Gene expression profile of TLR7 signaling pathway in the liver of rhesus rotavirus-induced murine biliary atresia.

PURPOSE: To identify genes potentially involved in the pathogenesis of bile duct obstruction in biliary atresia (BA). METHODS: We used rhesus rotavirus (RRV) Balb/c mouse BA model to study BA. Liver and serum samples were harvested from BA and normal control (NC) groups at 1, 3, 5, 7, 10 and 14 days postinoculation. Serum total bilirubin (STB) and conjugated bilirubin (CB) were measured. Livers of each group at day 7 were used for a genome-wide expression analysis. Expression of TLR7 signaling pathway in liver was measured by immunohistochemical staining and western blotting, including expression of TLR7, activation of phosphorylated IRF7 and secretion of IFN-ß, IL-1α and IL-6. Cell viability and survival rate after RRV infection were measured by using TLR7 knockdown human cholangiocarcinoma cell RBE. RESULTS: STB was significantly elevated from day 5 postinoculation and CB was from day 7 postinoculation, while CK19 (the biomarker of biliary epithelial cells) expression by western blotting was decreased. By microarray analysis of liver tissues at day 7 postinoculation, TLR7 signaling pathway was up-regulated in BA mice. Based on the results of microarray analysis, the protein expression of TLR7 in the liver tissues of BA groups were found to be up-regulated from day 5 comparing to respective NC groups, although it was increased as pups aged in NC groups. And the level of p-IRF7 and secretion of cytokines were also statistically significant in BA groups. In vitro, TLR7 knockdown cell line showed less cellular proliferation and more susceptible to RRV infection. CONCLUSION: By in vivo study, TLR7 signal pathway was up-regulated in BA group; by additional in vitro study, intact TLR7 signal pathway might have some protective abilities in BA pathogenesis.

Wetting transition of the caterpillar-like superhydrophobic Cu/Ni-Co hierarchical structure by heat treatment.

Caterpillar-like hierarchical structured Cu/Ni-Co coatings were fabricated by a simple two-step method of combined electroless and electrodeposition. Both contact angles and sliding angles were measured to investigate the hydrophobicity after stearic acid modification. The results revealed the contact angle was as high as 165.5°(superhydrophobic), while the sliding angle was only 3.5°, which makes it very promising as self-cleaning material. Wetting transition from slippery hydrophobicity to sticky hydrophobicity happened upon heat treatment. The scanning electron microscopy (SEM) analysis disclosed the morphology change of the hierarchical structure during the heat treatment leading to the wetting state transition. Different models of wetting states were raised and calculated to provide further confirmation of the transition. The contact angle remained larger than 156° when the pH value ranged from 1 to 14 and the heat-treatment temperature was from 100 to 250 °C. Such hierarchical micronanostructure and its special hydrophobicity are expected to have practical application in industry.

Anorectal malformation associated with a mutation in the P63 gene in a family with split hand-foot malformation.

PURPOSE: The aims of this study were to identify the mutation gene of a Chinese family with anorectal malformation (ARM) associated with split hand-foot malformation and to determine the spatiotemporal expression of the mutated gene during hindgut and anorectum development in human embryos. METHOD: A Chinese family with intrafamilial clinically variable manifestation was analyzed and primers were designed for exons 3-14 of P63, DLX5, DLX6, DAC, and HOXD13 as candidate genes and direct sequence analysis of the exons was performed. Immunohistochemical study of mutated gene in the hindgut and anorectum of human embryos of 4th-10th weeks was performed. RESULT: Affected individuals were found to have an Arg227Gln P63 gene mutation. From the 4th-10th weeks of gestation of the human embryo, the P63-positive cells were mainly located on the epithelium of the apical urorectal septum, hindgut, and cloacal membrane. After the anorectum ruptured during the 8th week, the P63 remained strongly immunoreactive on the epithelium of the anal canal and urethra, but the mucous membrane of the rectum exhibited no reaction. CONCLUSIONS: The mutation identified strongly suggests a causal relationship between the ARM phenotype and P63. The expression of P63 was persistently active during the dynamic and incessant septation of the cloaca and hindgut, suggesting that P63 may play a pivotal role in the morphogenesis of the hindgut and anorectum.