Deficit of PKHD1L1 in the dentate gyrus increases seizure susceptibility in mice.

Epilepsy is a chronic neurological disorder featuring recurrent, unprovoked seizures, which affect more than 65 million people worldwide. Here, we discover that the PKHD1L1, which is encoded by polycystic kidney and hepatic disease1-like 1 (Pkhd1l1), wildly distributes in neurons in the central nervous system (CNS) of mice. Disruption of PKHD1L1 in the dentate gyrus region of the hippocampus leads to increased susceptibility to pentylenetetrazol-induced seizures in mice. The disturbance of PKHD1L1 leads to the overactivation of the mitogen-activated protein kinase (MAPK)/extracellular regulated kinase (ERK)-Calpain pathway, which is accompanied by remarkable degradation of cytoplasmic potassium chloride co-transporter 2 (KCC2) level together with the impaired expression and function of membrane KCC2. However, the reduction of membrane KCC2 is associated with the damaged inhibitory ability of the vital GABA receptors, which ultimately leads to the significantly increased susceptibility to epileptic seizures. Our data, thus, indicate for the first time that Pkhd1l1, a newly discovered polycystic kidney disease (PKD) association gene, is required in neurons to maintain neuronal excitability by regulation of KCC2 expression in CNS. A new mechanism of the clinical association between genetic PKD and seizures has been built, which could be a potential therapeutic target for treating PKD-related seizures.

Arsenite Antiporter PvACR3 Driven by Its Native Promoter Increases Leaf Arsenic Accumulation in Tobacco.

Pteris vittata is the first-reported arsenic (As) hyperaccumulator, which has been applied to phytoremediation of As-contaminated soil. PvACR3, a key arsenite (AsIII) antiporter, plays an important role in As hyperaccumulation in P. vittata. However, its functions in plants are not fully understood. In this study, the PvACR3 gene was heterologously expressed in tobacco, driven by its native promoter (ProPvACR3). After growing at 5 µM AsIII or 10 µM AsV in hydroponics for 1-5 days, PvACR3-expression enhanced the As levels in leaves by 66.4-113 and 51.8-101%, without impacting the As contents in the roots or stems. When cultivated in As-contaminated soil, PvACR3-expressed transgenic plants accumulated 47.9-85.5% greater As in the leaves than wild-type plants. In addition, PvACR3-expression increased the As resistance in transgenic tobacco, showing that enhanced leaf As levels are not detrimental to its overall As tolerance. PvACR3 was mainly expressed in tobacco leaf veins and was likely to unload AsIII from the vein xylem vessels to the mesophyll cells, thus elevating the leaf As levels. This work demonstrates that heterologously expressing PvACR3 under its native promoter specifically enhances leaf As accumulation in tobacco, which helps to reveal the As-hyperaccumulation mechanism in P. vittata and to enhance the As accumulation in plant leaves for phytoremediation.

Biodegradation of mixed litter-derived dissolved organic matter with varying evenness in a temperate freshwater wetland.

Litter-derived dissolved organic matter (DOM) plays an essential role in biogeochemical cycles. In wetlands, species relative abundance and its change have great influences on input features of litter-derived DOM, including chemical characteristics per se and functional diversity of chemical characteristics. Functional diversity is an important factor controlling organic matter biodegradation, but little is known in terms of the DOM. We mixed litter leachates of four macrophytes with a constant concentration (20 mg DOC L-1) but varying dominant species and volume ratios, i.e. 15:1:1:1 (low-evenness), 5:1:1:1 (mid-evenness), and 2:1:1:1 (high-evenness), generating a gradient of chemical characteristics and functional diversity (represented by functional dispersion index FDis). Based on a 42-d incubation, we measured degradation dynamics of these DOM mixtures, and analyzed potential determinants. After 42 days of incubation, the high-evenness treatments, along with mid-evenness treatments sometimes, had most degradation, while the low-evenness treatments always had least degradation. The degradation of mixtures related significantly to not only the volume-weighted mean chemical characteristics but also FDis. Furthermore, the FDis even explained more variation of degradation. The non-additive mixing effects, synergistic effects (faster degradation than predicted) in particular, on degradation of DOM mixtures were rather common, especially in the high- and mid-evenness treatments. Remarkably, the mixing effects increased linearly with the FDis values (r2adj. = 0.426). This study highlights the critical role of functional diversity in regulating degradation of mixed litter-derived DOM. Resulting changes in chemistry and composition of litter leachates due to plant community succession may exert substantial influences on biogeochemical cycling.

Effects of mind-body exercise on knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: To evaluate the effect of mind-body exercise on improving knee osteoarthritis (KOA) and thereby informing osteoarthritis exercise rehabilitation. METHODS: The China National Knowledge Infrastructure (CNKI), Wanfang, PubMed/Medline, Cochrane Library, Web of Science, EBSCO, Embase, Scopus, and ProQuest databases were searched to identify randomized controlled trials (RCTs) that involved tai chi, yoga, and baduanjin interventions for KOA. The search period ranged from inception to October 25, 2022. The methodological quality of the included studies was evaluated by the Cochrane risk of bias assessment tool, and the included data were statistically analyzed and plotted using Review Manager 5.3 and Stata 14.0 software. RESULTS: We included 17 articles with a total of 1122 patients. Compared with the control group, mind-body exercise significantly improved patient pain (standardized mean difference (SMD) = -0.65, 95% confidence interval (CI) [-0.87, -0.42], p < 0.00001), stiffness (SMD = -0.75, 95% CI [-1.05, -0.45], p < 0.00001), physical function (SMD = -0.82, 95% CI [-1.03, -0.62], p < 0.00001), mental health (SMD = 0.31, 95% CI [0.11, 0.51], p = 0.002), and depression (SMD = -0.32, 95% CI [-0.50, -0.15], p = 0.0003). In terms of motor ability, mind-body exercise significantly increased the 6-min walking distance (SMD = 18.45, 95% CI [5.80, 31.10], p = 0.004) and decreased timed up and go test time (SMD = -1.15, 95% CI [-1.71, -0.59], p < 0.0001). CONCLUSIONS: The current study showed that mind-body exercise is safe and effective for KOA patients. However, given the methodological limitations of the included studies, additional high-quality evidence is needed to support the conclusions of this study.

Combining dredging with modified zeolite thin-layer capping to control nitrogen release from eutrophic lake sediment.

Dredging is widely used to control internal sediment nitrogen (N) pollution during eutrophic lake restoration. However, the effectiveness of dredging cannot be maintained for long periods during seasonal temperature variations. This study used modified zeolite (MZ) as a thin-layer capping material to enhance dredging efficiency during a year-long field sediment core incubation period. Our results showed that dredging alone more effectively reduced pore water N, N flux, and sediment N content than MZ capping but showed more dramatic changes during the warm seasons. The N flux in dredged sediment in summer was 1.8 and 2.5 times that in spring and autumn, respectively, indicating a drastic N regeneration process in the short term. In contrast, the combination method reduced the extra 10% pore water N, 22% N flux, and 8% sediment organic N content compared with dredging alone and maintained high stability during seasonal changes. The results indicated that the addition of MZ to the surface of dredged sediment not only enhanced the control effect of dredging by its adsorption capacity but may also smooth the N regeneration process via successive accumulation (in the channel of the material) and activation of bacteria for months, which was evidenced by the variation in microbial diversity in the MZ treatment. As a result, the combination of dredging with modified zeolite simultaneously enhanced the efficiency and stability of the single dredging method in controlling sediment N content and its release, exhibiting great prospects for long-term application in eutrophic lakes with severe pollution from internal N loading.

Instability in a carbon pool driven by multiple dissolved organic matter sources in a eutrophic lake basin: Potential factors for increased greenhouse gas emissions.

Lakes serve as vital reservoirs of dissolved organic matter (DOM) and play pivotal roles in biogeochemical carbon cycles. However, the sources and compositions of DOM in freshwater lakes and their potential effects on lake sediment carbon pools remain unclear. In this study, seven inflowing rivers in the Lake Taihu basin were selected to explore the potential effects of multi-source DOM inputs on the stability of the lake sediment carbon pool. The results showed the high concentrations of dissolved organic carbon in the Lake Taihu basin, accompanied by a high complexity level. Lignins constituted the majority of DOM compounds, surpassing 40% of the total, while the organic carbon content was predominantly composed of humic acids (1.02-3.01 g kg-1). The high amounts of lignin oxidative cleavage led to CHO being the main molecular structure in the DOM of the seven rivers. The carbon constituents within the sediment carbon reservoir exhibited a positive correlation with dissolved CH4 and CO2, with a notable emphasis on humic acid and dissolved CH4 (R2 = 0.86). The elevated concentration of DOM, coupled with its intricate composition, contributed to the increases in dissolved greenhouse gases (GHGs). Experiments showed that the mixing of multi-source DOM can accelerate the organic carbon mineralization processes. The unit carbon emission efficiency was highest in the mixed group, reaching reached 160.9 µmol∙Cg-1, which also exhibited a significantly different carbon pool. The mixed decomposition of DOM from different sources influenced the roles of the lake carbon pool as source and sink, indicating that the multi-source DOM of this lake basin was a potential driving factor for increased carbon emissions. These findings have improved our understanding of the sources and compositions of DOM in lake basins and revealed their impacts on carbon emissions, thereby providing a theoretical basis for improving assessments of lake carbon emissions.

[Effects of humic acid water-soluble fertilizer on growth and physiological characteristics of Bupleurum chinense seedlings].

The effects of humic acid water-soluble fertilizer on the growth and physiological characteristics of Bupleurum chinense seedlings(Zhongchai No.1) were studied by using a single factor experiment design. When the seedling age was 60 days, the humic acid water-soluble fertilizer was diluted 1 200 times(T1), 1 500 times(T2), 1 800 times(T3), and 2 100 times(T4) for seedling treatment, respectively, and water was used as the control(CK). The effects of different treatments on growth indexes, biomass accumulation, root activity, antioxidant enzyme activity, membrane lipid peroxidation, and photosynthetic characteristics of B. chinense seedlings were analyzed after 30 days. The results showed that compared with CK, stem height, leaf number, root diameter, and root length of the B. chinense seedlings under T3 treatment were significantly increased by 36.82%, 37.03%, 42.78%, and 22.38%, respectively. Root fresh weight, leaf fresh weight, root dry weight, and leaf dry weight under T3 treatment were significantly increased by 90.36%, 98.68%, 123.84%, and 104.38%, respectively. In addition, humic acid water-soluble fertilizer also enhanced TTC reducing activity of the root of B. chinense seedlings, inhibited malonaldehyde(MDA) content, increased superoxide dismutase(SOD), peroxidase(POD), and catalase(CAT) enzyme activities, improved chlorophyll content, and enhanced P_n, G_s, T_r, and other photosynthetic parameters. In conclusion, the application of humic acid water-soluble fertilizer diluted 1 800 times can significantly promote the growth of B. chinense seedlings, enhance root vitality, improve seedling stress resistance, and enhance photosynthesis. The results of this study can provide a theoretical basis for fertilization of B. chinense seedlings.

BDNF-TrkB signaling pathway-mediated microglial activation induces neuronal KCC2 downregulation contributing to dynamic allodynia following spared nerve injury.

Mechanical allodynia can be evoked by punctate pressure contact with the skin (punctate mechanical allodynia) and dynamic contact stimulation induced by gentle touching of the skin (dynamic mechanical allodynia). Dynamic allodynia is insensitive to morphine treatment and is transmitted through the spinal dorsal horn by a specific neuronal pathway, which is different from that for punctate allodynia, leading to difficulties in clinical treatment. K+-Cl- cotransporter-2 (KCC2) is one of the major determinants of inhibitory efficiency, and the inhibitory system in the spinal cord is important in the regulation of neuropathic pain. The aim of the current study was to determine whether neuronal KCC2 is involved in the induction of dynamic allodynia and to identify underlying spinal mechanisms involved in this process. Dynamic and punctate allodynia were assessed using either von Frey filaments or a paint brush in a spared nerve injury (SNI) mouse model. Our study discovered that the downregulated neuronal membrane KCC2 (mKCC2) in the spinal dorsal horn of SNI mice is closely associated with SNI-induced dynamic allodynia, as the prevention of KCC2 downregulation significantly suppressed the induction of dynamic allodynia. The over activation of microglia in the spinal dorsal horn after SNI was at least one of the triggers in SNI-induced mKCC2 reduction and dynamic allodynia, as these effects were blocked by the inhibition of microglial activation. Finally, the BDNF-TrkB pathway mediated by activated microglial affected SNI-induced dynamic allodynia through neuronal KCC2 downregulation. Overall, our findings revealed that activation of microglia through the BDNF-TrkB pathway affected neuronal KCC2 downregulation, contributing to dynamic allodynia induction in an SNI mouse model.

Stabilizing oil-oil interfaces with mixed-shell polymeric nanoparticles prepared via PISA and the grafting combination.

The preparation of mixed-shell polymeric nanoparticles (MSPNs) and their stabilized non-aqueous Pickering emulsions was described in this study. Poly(methyl methacrylate)-poly(4-vinylpyridine) (PMMA-P4VP) diblock copolymer nanoparticles with different morphologies including spheres, worms and vesicles were first prepared via reversible addition-fragmentation chain transfer-based polymerization induced self-assembly in toluene. C18 alkyl chains were subsequently grafted onto the surfaces of the as-prepared PMMA-P4VP nanoparticles, affording C18/PMMA-P4VP MSPNs with P4VP blocks as the core and C18/PMMA chains as the mixed shells. MSPNs were utilized as Pickering emulsifiers to prepare non-aqueous Pickering emulsions, where [Bmim][PF6] and toluene oils were selected. Two kinds of different Pickering emulsions, [Bmim][PF6]-in-toluene and toluene-in-[Bmim][PF6], could be formed, depending on the initial location of MSPNs. However, neither of them could be generated when PMMA-P4VP diblock copolymer nanoparticles were adopted as Pickering emulsifiers, indicating MSPNs were better than diblock copolymer nanoparticle precursors in the aspect of stabilizing oil-oil interfaces. The formation mechanisms of different kinds of Pickering emulsions were unraveled in this study.

Space-for-time substitution leads to carbon emission overestimation in eutrophic lakes.

Lacustrine eutrophication is generally considered as an important contributor of carbon emissions to the atmosphere; however, there is still a huge challenge in accuracy estimating carbon emissions from lakes. To test the effect of widely used space-for-time substitution on lake carbon emissions, this study monitored different processes of carbon emissions, including the carbon production potential, dissolved carbon concentrations, and carbon release fluxes in eight lakes along the trophic gradients on a spatial scale and the typical eutrophic Lake Taihu for one year on a temporal scale. Eutrophication promoted carbon production potential, dissolved carbon concentrations, and carbon release fluxes, especially for CH4. Trophic lake index (TLI) showed positive correlations with the CH4 production potential, dissolved CH4 concentrations, and CH4 release fluxes, and also positive correlations with the CO2 production potential, dissolved CO2 concentrations, and CO2 release fluxes. The space-for-time substitution led to an overestimation for the influence of eutrophication on carbon emissions, especially the further intensification of lake eutrophication. On the spatial scale, the average CH4 production potential, dissolved CH4 concentrations and CH4 release fluxes in eutrophic lakes were 268.6, 0.96 µmol/L, and 587.6 µmol m-2·h-1, respectively, while they were 215.8, 0.79 µmol/L, and 548.6 µmol m-2·h-1 on the temporal scale. Obviously, CH4 and CO2 emissions on the spatial scale were significantly higher than those on the temporal scale in eutrophic lakes. The primary influencing factors were the seasonal changes in the physicochemical environments of lake water, including dissolved oxygen (DO) and temperature. The CH4 and CO2 release fluxes showed negative correlations with DO, while temperature displayed positive correlations, respectively. These results suggest that the effects of DO and temperature on lake carbon emissions should be considered, which may be ignored during the accurate assessment of lake carbon budget via space-for-time substitution in eutrophic lakes.

Response of aquatic plant decomposition to invasive algal organic matter mediated by the co-metabolism effect in eutrophic lakes.

The decomposition of aquatic plant residues changes by the invasive algal organic matter in eutrophic lakes, however, the driving mechanisms of these biogeochemistry processes are still far from clear. In this study, a series of microcosms was constructed to simulate the mixed decomposition processes of aquatic plant residues with invasive algae as long as 205 days. Three aquatic plants (Potamogeton malaianus, Nymphoides peltatum, and Phragmites australis) and algae were collected from a typical eutrophic lake. The addition of algae promoted the decomposition of three plant residues based on the mass loss, and the positive co-metabolism effect was produced. The co-metabolism intensity was 8%-25% on the water surface and 19%-45% on the water-sediment interface, respectively. In addition, the response of three aquatic plant residues to the algal organic matter was different with their co-metabolism intensities in the order of P. australis > P. malaianus > N. peltatum on both the water surface and water-sediment interface. The phylum number of bacteria attached to the surface of plant residues increased from 27 to 52. The abundance of Bacteroidetes, which had the function of decomposing refractory organic matter, increased most significantly at the final incubation. At present, shallow lakes are under the double pressure of eutrophication and global warming, and the intensity and duration of algal blooms are increasing. Therefore, the co-metabolism effect of the residue decomposition process described here may change the carbon cycle strength and increase the greenhouse gas emissions of lakes and need to be taken into account in future lake management.

The contradictory roles of tightly bound and loosely bound extracellular polymeric substances of activated sludge in trimethoprim adsorption process.

Extracellular polymeric substances (EPS) of activated sludge are a mixture of high molecular weight polymers secreted by microorganisms, which have the double structure of tightly-bound EPS (TB-EPS) in inner layer and loosely-bound EPS (LB-EPS) in outer layer. The characteristic of LB- and TB-EPS were different, which would affect their adsorption of antibiotics. However, the adsorption process of antibiotics on LB- and TB-EPS was still unclear yet. Therefore, in this work, the roles of LB-EPS and TB-EPS in adsorption of a typical antibiotic-trimethoprim (TMP) at environmentally relevant concentration (25.0 µg/L) were investigated. The results showed the content of TB-EPS was higher than that of LB-EPS, which was 17.08 and 10.36 mg/g VSS, respectively. The adsorption capacity of raw, LB-EPS extracted and both LB- and TB-EPS extracted activated sludges for TMP were 5.31, 4.65 and 9.51 µg/g VSS, respectively, which indicated LB-EPS had positive effect on TMP removal, while TB-EPS had negative effect. The adsorption process can be well described by a pseudo-second-order kinetic model (R2 > 0.980). The ratio of different functional groups was calculated and the CO and C-O bond might be responsible for the adsorption capacity difference between LB- and TB-EPS. The fluorescence quenching results indicated that tryptophan protein-like substances in LB-EPS provided more binding sites (n = 0.36) than that of tryptophan amino acid in TB-EPS (n = 0.1). Furthermore, the extend DLVO results also demonstrated that LB-EPS promoted the adsorption of TMP, while TB-EPS inhibited the process. We hope the results of this study were helpful for understanding the fate of antibiotics in wastewater treatment systems.

Distribution pattern of dissolved organic matter in pore water of sediments from three typical areas of western Lake Taihu and its environmental implications.

The migration, transformation, and accumulation of dissolved organic matter (DOM) in pore water of sediment cores play a pivotal role in lacustrine carbon cycling. In order to understand the dynamics of DOM in the sediments of large shallow eutrophic lakes, we examined the vertical profiles of DOM and the benthic fluxes of dissolved organic carbon (DOC) in sediment cores located in algae accumulated, dredged, and central areas of eutrophic Lake Taihu, China. Optical properties showed the significant influence of terrestrial inputs on the DOM components of pore water in the algae accumulated area but an abundant accumulation of autochthonous DOM in the central area. The benthic fluxes of DOC ranging from -458.2 to -139.4 mg·m-2·d-1 in the algae accumulated area displayed an opposite diffusion direction to the other two areas. The flux ranges of 9.5-31.2 mg·m-2·d-1 in the dredged area and 14.6-48.0 mg·m-2·d-1 in the central area were relatively smaller than those in the previously reported lake ecosystems with low trophic levels. Dredging engineering disturbed the pre-dredging distribution patterns of DOM in sediment cores. The deposition, accumulation, and transformation of massive algae scums in eutrophic lakes probably promoted the humification degree of sediments.

Revealing How Polyvinyl Chloride Microplastic Physicochemically Affect the Anaerobic Digestion of Waste Activated Sludge.

Recent studies have shown that the microplastics in waste activated sludge (WAS) can directly reduce the microbial activity and influence the performance of anaerobic digestion. Unfortunately, few studies paid attention on the interactions between WAS and MPs, since MPs could impact the contact between sludge flocs and microorganisms. We found that PVC-MP changed the interfacial energy properties of the WAS surface and affected methane production. Low concentration (40 mg/L) of PVC-MP changed the water affinity and greatly reduced the energy barrier of interfacial reaction. Simultaneously, WAS surface charge characteristics changed with increasing MPs concentration, which made the sludge difficult to contact with microorganisms. The change process of WAS surface functional groups also indicated that PVC-MP first cover the sludge surface to prevent from being utilized by microorganisms, and then affect the surface protein structure before toxic substances leaching. Our study provides new insights into how MPs affect anaerobic digestion.

Boosting the Quantum Yield of Oxygen-Doped g-C3N4 via a Metal-Azolate Framework-Enhanced Electron-Donating Strategy for Highly Sensitive Sulfadimethoxine Tracing.

Two of the most persistent challenges for the sensing applications of luminescent carbon nitride-based materials are poor quantum yields and aggregation-induced luminescence quenching in aqueous environments. Herein, a highly emissive oxygen-doped carbon nitride composite (OCNP@M7) was synthesized, with a metal-azolate framework (MAF-7) serving as a luminous booster. Both experimental studies and theoretical calculations suggest that the MAF-enhanced electron-donating effect dramatically promoted the electron density on the π-structure of oxygen-doped carbon nitride. In addition, the structural rigidity of MAF-7 effectively inhibits both aggregation and nonradiative energy dissipation. Consequently, OCNP@M7 exhibits strong and stable blue emission under UV light irradiation and an absolute quantum yield up to 95.2%, which is, as far as we know, the highest value among fluorescent carbon nitride materials in solution ever reported. OCNP@M7 could further function as a high-efficiency fluorescent probe for the sensitive detection of sulfadimethoxine residues in complex environments. It is anticipated that this strategy can be extended to fabricate various carbon nitride-based antibiotic monitoring systems with tailor-made functions.

Compact nonvolatile 2×2 photonic switch based on two-mode interference.

On-chip nonvolatile photonic switches enabled by phase change materials (PCMs) are promising building blocks for power-efficient programmable photonic integrated circuits. However, large absorption loss in conventional PCMs (such as Ge2Sb2Te5) interacting with weak evanescent waves in silicon waveguides usually leads to high insertion loss and a large device footprint. In this paper, we propose a 2×2 photonic switch based on two-mode interference in a multimode slot waveguide (MSW) with ultralow loss Sb2S3 integrated inside the slot region. The MSW supports two lowest order TE modes, i.e., symmetric TE00 and antisymmetric TE01 modes, and the phase of Sb2S3 could actively tune two-mode interference behavior. Owing to the enhanced electric field in the slot, the interaction strength between modal field and Sb2S3 could be boosted, and a photonic switch containing a ∼9.4 µm-long Sb2S3-MSW hybrid section could effectively alter the light transmission between bar and cross ports upon the phase change of Sb2S3 with a cross talk (CT) less than -13.6 dB and an insertion loss (IL) less than 0.26 dB in the telecommunication C-band. Especially at 1550 nm, the CT in the amorphous (crystalline) Sb2S3 is -36.1 dB (-31.1 dB) with a corresponding IL of 0.073 dB (0.055 dB). The proposed 2×2 photonic switch is compact in size and compatible with on-chip microheaters, which may find promising applications in reconfigurable photonic devices.

The application of endoscopic loop ligation in defect repair following endoscopic full-thickness resection of gastric submucosal tumors originating from the muscularis propria layer.

OBJECTIVE: We sought to investigate the clinical efficacy and safety of a novel endoscopic closure technique in repairing gastric wall defects after endoscopic full-thickness resection (EFTR) of gastric submucosal tumors (SMTs) originating from the muscularis propria layer. METHODS: From December 2016 to December 2019, patients with gastric submucosal tumors were enrolled and clinicopathological data were collected. All SMTs were resected by EFTR and gastric wall defects were closed using a novel endoscopic closure technique. The feasibility, efficacy, and safety were evaluated. RESULTS: A total of 21 patients with gastric SMTs were included in this study. Among the included SMTs, 15 tumors were located in the fundus of the stomach, and 6 were located in the upper body of the stomach. The average size of the lesions was 2.3 cm (range: 1.9-2.5 cm). All patients underwent EFTR and the gastric wall defect was closed by endoscopic closure. The average endoscopic closure time was 9 min (range: 7-15 min) and the average hospitalization stay length was five days (range: 4-6 days). One patient developed abdominal pain on the first day after the procedure and their body temperature increased; he received treatments such as anti-infection, antacid, and gastrointestinal decompression and was cured and discharged after 4 days. No instance of delayed bleeding, postoperative gastrointestinal fistula, or abdominal infection occurred. No case was transferred to surgery. The postoperative pathology profile included 18 stromal tumors and 3 leiomyomas. During the follow-up period (6-24 months), no case of residual or recurrence was recorded. CONCLUSION: The described endoscopic loop ligation technique is feasible, effective, and safe for repairing gastric wall defects after EFTR for gastric submucosal tumors originating from the muscularis propria layer.

Pulmonary Artery Catheter in Patients with Severe Acute Pancreatitis: A Single-Center Retrospective Study.

OBJECTIVE: It is still uncertain what effects pulmonary artery catheter (PAC)-guided resuscitation has on outcomes for patients with severe acute pancreatitis (SAP). Therefore, we aimed to investigate the effect of PAC on hospital mortality in patients with SAP. METHODS: We collected the data of patients with a diagnosis of SAP from January 10, 2017, to July 30, 2019. Patients were divided into a PAC group and a control group. The primary outcome measured was the day-28 mortality. Secondary outcomes included day-90 mortality, duration of ICU and hospital stay, ventilation days, usage of renal support and vasoactive agents, incidences of acute abdominal compartment syndrome, infusion volumes, and fluid balance and hemodynamic characteristics measured by the PAC. Kaplan-Meier analysis was applied to estimate survival outcomes. Complications related to PAC were also analyzed. RESULTS: There was no significant difference between the PAC group and the control group for day-28 mortality (22.7% vs. 30%, odds ratio, 0.69; 95% CI 0.31-1.52; P = 0.35). The duration of ICU stay in the PAC group was shorter (P = 0.00), and the rate of dependence on renal support treatment was lower in the PAC group than in the control group (P = 0.03). There was no difference in other secondary outcomes and no significant difference in the survival curve between the two groups (log-rank P = 0.72, X2 = 0.13). However, SAP patients inserted PAC within 24 h ICU admission showed that duration of renal support therapy in PAC patients within 24 h ICU admission (mean days, 1.60; standard deviation, 0.14) was shorter than those with 24-72 h ICU admission (mean days, 2.94; standard deviation, 0.73; P = 0.03). The organ failure rates (1 organ, 2 organs and 3 organs) were all lower in PAC patients within 24 h ICU admission than with 24-72 h ICU admission (P = 0.02, P = 0.02, P = 0.048, respectively). CONCLUSION: In patients with severe acute pancreatitis, PAC-guided fluid resuscitation shortened the duration of ICU stay, and patients in the PAC group had a lower rate of dependence on renal support, while no benefit in terms of mortality was observed. However, SAP patients inserted PAC within 24 h ICU admission showed shorter duration of renal support therapy and lower organ failure rates than those with 24-72 h ICU admission, indicating that early use of PAC, especially within 24 h, might be better for SAP patients.

Prognostic Value of HLA Class I in Patients with Hepatocellular Carcinoma.

BACKGROUND: Downregulation of HLA class I molecules is a major tumor escape mechanism from immune attack. However, its prognostic impact for patients with hepatocellular carcinoma is still unclear. This study aimed to investigate whether HLA class I has prognostic significance in patients with hepatocellular carcinoma. METHODS: A cohort of 132 patients with hepatocellular carcinoma was enrolled. HLA class I expression was detected by immunohistochemistry. Levels of HLA class I expression were dichotomized as low and high according to staining intensity or staining percentage of positive tumor cells, respectively. Association of HLA class I expression with clinical characteristics and survival was analyzed. RESULTS: None of the clinical characteristics, including gender, age, virus infection, cirrhosis, AFP, vascular invasion, tumor size and number, was significantly associated with staining percentage of HLA class I or staining intensity (p > 0.05). Low staining percentage of HLA class I was significantly associated with a worse survival (p = 0.011), which was further confirmed by Cox regression hazards model in multivariate analysis (HR 0.416, 95% CI 0.204 - 0.849, p = 0.016). Staining intensity of HLA class I was not significantly associated with survival (p > 0.05). CONCLUSIONS: Expression of HLA class I might be a significant prognostic factor in hepatocellular carcinoma, and downregulation of HLA class I was significantly associated with a worse survival in terms of expression percentage of HLA class I.

Reconfigurable hybrid silicon waveguide Bragg filter using ultralow-loss phase-change material.

Reconfigurable silicon photonic devices attract much research attention, and hybrid integration with tunable phase-change materials (PCMs) exhibiting large refractive index contrast between amorphous (Am) and crystalline (Cr) states is a promising way to achieve this goal. Here, we propose and numerically investigate a Sb2Se3-Si hybrid waveguide Bragg filter operating in the telecom C-band on the silicon-on-insulator (SOI) platform. The proposed device consists of a Bragg grating (BG) with a thin top layer of ultralow-loss Sb2Se3 PCM interacting with evanescent field of the silicon waveguide mode. By harnessing the ultralow-loss and reversible index change of Sb2Se3 film, the spectral response of the hybrid BGs could be dynamically tuned. We also theoretically investigate the reversible phase transitions between Am and Cr states of Sb2Se3 film that could be attained by applying voltage pulses on the indium-tin-oxide (ITO) strip heater covered on Sb2Se3 film. Thermal simulations show that a 2 V (4.5 V) pulse with a duration of 400 ns (55 ns) applied to electric contacts would produce crystallization (or amorphization). The proposed structure may find great potential for on-chip phase tunable devices on a silicon platform.