Clinical study of electroacupuncture on the recovery of gastrointestinal dysfunction after laparoscopic surgery for gastrointestinal cancer - study protocol for a randomized controlled trial.

BACKGROUND: Gastrointestinal dysfunction is one of the common complaints for patient post-surgery. Acupuncture has been employed to improve gastrointestinal function and sleeping quality and has confirmed clinical efficacy for emotional problems. This study aims to evaluate the clinical effect of electroacupuncture for postoperative rapid recovery. METHODS: This study design is a two-arm, parallel, double-blinded randomized controlled trial. 104 subjects, aged from 40 to 89 years old, diagnosed with gastrointestinal cancer undergoing laparoscopic surgery, will be divided into Interventional Group and Control Group. Patients of both groups receive perioperative care under the guidance of ERAS guidance. The Interventional Group receives electroacupuncture treatment starting from the first day post-surgery for a consecutive 5 days, whereas the Control Group receives placebo electroacupuncture treatment. The primary outcome will be the first flatus time whereas the secondary outcomes will be the first sign of borborygmus, recovery of defecation, laboratory tests and questionnaires including Self-rating anxiety scale, Ford Insomnia Response to Stress Test, TCM rating scale of Gastrointestinal symptoms and Gastrointestinal Symptoms Rating Scales. DISCUSSION: This study aims to provide timely intervention for post-laparoscopic patients with gastrointestinal tumour using the ERAS concept combined with electroacupuncture, observe the efficacy of this therapy in treating PGID, and contribute reliable scientific evidence for postoperative rapid recovery. TRIAL REGISTRATION: Chictr.org.cn Identifier: ChiCTR2300078710. Registered on 15th December 2023.

Tumor cells-derived exosomal circVCP promoted the progression of colorectal cancer by regulating macrophage M1/M2 polarization.

BACKGROUND: Colorectal cancer (CRC) is among the most frequent tumors of the digestive tract and the second leading cause of cancer death worldwide. Tumor-associated macrophages (TAMs) are one of the most critical immune cells in the tumor microenvironment, which closely interact with tumor cells to promote tumor incidence and progression. However, the precise mechanism of action between CRC cells and TAMs polarization is still being investigated. METHODS: Transmission electronic microscopy (TEM), NanoSight and western blotting were used to characterize exosomes (Exo) isolated from the culture medium of CRC cells. The cellular uptake and internalization of Exo were detected by confocal laser scanning microscopy. M1/ M2 phenotype markers expression were examined by ELISA and flow cytometry. Cell migration, invasion and proliferation were determined by transwell and CCK-8 assay, respectively. A xenograft tumor model was established to explore the role of circVCP in vivo. The target genes of circVCP or miR-9-5p were predicted by StarBase2.0. The target association among miR-9-5p and circVCP or NRP1 was confirmed using the luciferase assay and RNA-pull down assay. RESULTS: circVCP was highly accumulated in exosomes derived from plasma of CRC patients and CRC cells. Additionally, exosomal circVCP derived from CRC cells promoted cell proliferation, migration and invasion by regulating the miR-9-5p/NRP1 axis, and induced macrophage M2 polarization and inhibited macrophage M1 polarization. CONCLUSIONS: Over-expressed exosomal circVCP promoted the progression of CRC by regulating macrophage M1/M2 polarization through miR-9-5p/NRP1 axis. CircVCP may be a diagnostic biomarker and potential target for CRC therapy.

Porous Amorphous Silicon Hollow Nanoboxes Coated with Reduced Graphene Oxide as Stable Anodes for Sodium-Ion Batteries.

Amorphous silicon (a-Si), due to its satisfactory theoretical capacity, moderate discharge potential, and abundant reserves, is treated as one of the most prospective materials for the anode of sodium-ion batteries (SIBs). However, the slow Na+ diffusion kinetics, poor electrical conductivity, and rupture-prone structures of a-Si restrict its further development. In this work, a composite (a-Si@rGO) consisting of porous amorphous silicon hollow nanoboxes (a-Si HNBs) and reduced graphene oxide (rGO) is prepared. The a-Si HNBs are synthesized through "sodiothermic reduction" of silica hollow nanoboxes at a relatively low temperature, and the rGO is covered on the surface of the a-Si HNBs by electrostatic interaction. The as-synthesized composite anode applying in SIBs exhibits a high initial discharge capacity of 681.6 mAh g-1 at 100 mA g-1, great stability over 2000 cycles at 800 mA g-1, and superior rate performance (261.2, 176.8, 130.3, 98.4, and 73.3 mAh g-1 at 100, 400, 800, 1500, and 3000 mA g-1, respectively). The excellent electrochemical properties are ascribed to synergistic action of the porous hollow nanostructure of a-Si and the rGO coating. This research not only offers an innovative synthetic means for the development of a-Si in various fields but also provides a practicable idea for the design of other alloy-type anodes.