Endoclip combined with colonic transendoscopic enteral tubing: a new approach for managing iatrogenic colonoscopy perforation.

BACKGROUND: Iatrogenic colonoscopy perforation (ICP) is a rare but most serious complication during colonoscopy investigation. However, endoscopic closure plays an important role in the dealing with ICP with the development of endoscopic techniques presently, there are still some portion of patients transferred to surgery. METHODS: Once a perforation was detected, endoclips were used to closed the defect of the colon. Then a colonic TET was planted inside the colon. The terminal end of the TET was put proximally to or near the location of the perforation. Then gas and fluid was sucked out through the TET with a syringe every 4 h. RESULTS: Three cases were treated with endoclip closure and colonic TET drainage. Case 1 was caused by urgent immediate perforation during routine colonoscopy, case 2 was delayed perforation after snare resection, and case 3 was ESD-related perforation. All patients got healed, no one transferred to surgery. CONCLUSIONS: A combination of endoclip closure and colonic TET drainage might be an easy and potential method in the dealing with different types of ICP. This study may offer a novel paradigm for addressing endoscopy-related intestinal perforations.

Parenteral nutrition effects of Omega-3 fatty acids on C-reactive protein, high-density lipoprotein, lymphocyte characteristics and the treatment of critically ill patients.

To study the effects of omega-3 fatty acid parenteral nutrition on the nutrition, inflammatory responses, immunity and prognoses of critically ill cancer patients. A total of 80 critically ill cancer patients were randomly divided into an observation group and a control group, 40 cases in each group. Both groups of patients received equal-nitrogen and equal-calorie enteral and parenteral nutrition. The observation group, on this basis, was added with omega-3 fatty acid parenteral nutrition. The weekly nutritional status measures, inflammatory response measures, immune function measures and prognosis measures (ICU mortality, ICU stay, infectious complications) of the two groups were observed. The nutrition, inflammatory response and immune measures of the observation group were improved compared with the control group. The ICU stay in the observation group was shorter than the control group. Compared with the control group, the ICU mortality rate and infectious complication rate were lower in the observation group, but the differences were not significant (P mortality = 0.13, P infection rate = 0.165). Omega-3 fatty acid parenteral nutrition could improve patients' nutritional status and immune function, reduce the body's inflammatory responses and shorten the length of hospital stay, but couldn't significantly improve ICU mortality and reduce the incidence of infectious complications.

Synthesis and antifouling evaluation of indole derivatives.

Indole derivatives derived from the secondary metabolites of marine organisms possess the excellent antifouling property to inhibit the biofouling. These compounds and their analogues are simple in structure and have been proven to have low toxicity and bioaccumulation. Therefore, the active indole antifoulants are expected to replace the potentially toxic antifoulants which are widely used in current antifouling coatings. Seven indole derivatives were synthesized via the Friedel-Crafts alkylation reaction and were characterized by IR spectra, 1H NMR, 13C NMR and elemental analysis. Inhibition experiments against marine algae and bacteria were conducted, and the partial inhibition rates of algae and bacteria were more than 90%. This outcome indicates that indole derivatives possess excellent properties suitable for use as targeting anti-fouling compound for algae and bacteria. Non-invasive Micro-test Technology (NMT) reveals that the Ca2+ efflux of Platymonas subcordiformis dramatically increased in the presence of indole derivatives, which is inferred to be the molecular mechanism for inhibiting the growth of marine algae. The antifouling coatings containing indole derivatives were prepared and subjected to an antifouling test in a marine environment, and the results show that N-(1-H-5-bromo-indole-3-ylmethyl) benzamide and N-(1-H-2-phenyl-indole-3-ylmethyl) benzamide possess better antifouling performance compared to copper pyrithione (CuPT). According to these results, indole derivatives in this study might become novel and promising antifoulants.

Preparation and antifouling performance of tin-free self-polishing antifouling coatings based on side-chain suspended indole derivative structural resins.

Tin-free self-polishing antifouling coatings have the highest market share since organotin self-polishing antifouling coatings have been banned. However, its high dependence on cuprous oxide was found to have caused potential harm to the environment, making it necessary to improve the functionality of the resin. In this paper, a zinc acrylate resin with side chain hanging indole derivative structure was prepared by using N-(1H-5-bromoindole-3-methylene) (BIAM) with good biological activity as functional monomer. The functional resin with good antifouling performance was selected by antibacterial and algae inhibition experiments. The results showed that when the BIAM content was 9 %, the inhibition rates of the resin on E. coli and Prymnesium parvum reached 98 % and 90 %, respectively. Tin-free self-polishing antifouling coatings were prepared using the above resins as film-forming materials. The anti-protein adsorption performance and antifouling performance of the coating were tested by anti-protein adsorption experiment and real sea hanging plate experiment. The results showed that the coating containing indole derivative structure had good anti-protein adsorption performance and antifouling performance, and the higher the BIAM content, the better the anti-protein adsorption performance and marine antifouling performance.

KMT2C mutation as a predictor of immunotherapeutic efficacy in colorectal cancer.

Immunotherapy had shown good antitumor activity in a variety of solid tumors, but low benefit in CRC, so there was an urgent need to explore new biomarkers. We evaluated the role of KMT2C using publicly available data from the Cancer Genome Atlas (TCGA) and Memorial Sloan Kettering Cancer Center (MSKCC). In addition, further analysis was performed in an internal cohort. Moreover, the mutant profiles of KMT2C was analyzed in a large CRC cohort. The relationship between clinical pathologic features and KMT2C were analyzed with using the two-sided chi-squared test or the Fisher exact test. Clinicopathologic characteristics associated with overall survival using Cox regression and the Kaplan-Meier method. We found that KMT2C-mutated CRC patients in the immunotherapy cohort had significantly improved OS compared with KMT2C WT patients (P = 0.013). However, this phenomenon did not exist in non-immunotherapy cohort. Our cohort validated the value of KMT2C mutations in predicting better clinical outcomes, including ORR (P < 0.0001) and OS (P = 0.010). Meanwhile, KMT2C mutation was associated with higher tumor mutation burden, MSI score, higher levels of immune-associated T cells, neutrophil, and M1-type macrophages. Our study suggested that KMT2C mutation might be a potential positive predictor for CRC immunotherapy.

Clinical value of bedside ultrasound measurements of inferior vena cava diameter and its rate of change in early fluid resuscitation in patients with severe traumatic brain injury.

OBJECTIVE: To explore the clinical value of inferior vena cava diameter (IVCD) detection in guiding early fluid resuscitation in patients with severe traumatic brain injury (sTBI). METHODS: Eighty patients with sTBI admitted to our hospital from October 2018 to October 2021 were retrospectively enrolled and divided into an observation group (n=40) and control group (n=40) according to the different monitoring methods used for treatment. The cerebrospinal fluid (CSF) lactate level, coagulation function, neurological function, and functional impairment, organ, cognitive, living ability and physical condition, Glasgow score, and adverse reactions in two groups were compared. RESULTS: The differences in CSF lactate level and serum levels of PT, APTT and TT between both groups before resuscitation were not significant (all P>0.05). After resuscitation, all these indexes decreased in both groups, so that patients in the observation group had significantly lower CSF lactate level and serum levels of PT, APTT and TT than those in the control group (all P<0.05). Differences in the levels of neurological function factors such as GFAP, NSE, MBP, and S-100B and the scores of NIHSS, SOFA, MMSE, APACHE II and Barthel were not significant between both groups before treatment (all P>0.05). The levels of neurological function factors, NIHSS, SOFA and APACHE II scores decreased in both groups after treatment (all P<0.05) with lower scores in the observation group than the control group (all P<0.05). The MMSE and Barthel scores increased after treatment, and the scores were significantly higher in the observation group than those in the control group (all P<0.05). The GOS scores of patients in the observation group were higher than those in the control group at 1 month after treatment. The incidence of adverse reactions in the observation group (10%) was significantly lower than in the control group (30%). CONCLUSION: Monitoring IVCD to guide fluid resuscitation in patients with sTBI can reduce cerebrospinal fluid lactate levels, better protect patients' vital organs and neurological function, reduce the occurrence of adverse effects, improve patients' quality of life, and improve prognostic outcome.

Enterobacterial LPS-inducible LINC00152 is regulated by histone lactylation and promotes cancer cells invasion and migration.

Gut microbes participate in pathogenesis by interacting with the host genome through epigenetic mechanisms, such as long non-coding RNAs. However, the mechanisms by which the microbiota induce expression alteration of long non-coding RNAs remains unclear. Here, we quantified the transcriptome alteration of human colon cell lines after being infected by a common enteric pathogen Salmonella typhimurium SL1344. We observed a widespread lncRNAs expression alteration. Among them, the elevated expression of LINC00152 was verified and proved to be induced by enteric bacteria-derived lipopolysaccharide (LPS). The inducible LINC00152 were found to inhibit Salmonella invasion and inflammation response. LINC00152 was overexpressed in tumors of the clinical CRC samples compared with adjacent normal tissues. Accordingly, we also demonstrated that overexpression of LINC00152 promoted the migration and invasion of colorectal cancer cells. Consistently, we observed an increased abundance of gram-negative bacteria and LPS in tumors tissue. Taken together, the above data implicated that enriched gram-negative bacteria in tumor tissue might promote tumor growth through modulating the expression of LINC00152. Furthermore, we demonstrated that LPS upregulated the expression of LINC00152 by introducing histone lactylation on its promoter and decreasing the binding efficiency of the repressor, YY1, to it. Our results provide new insights into how enterobacteria affect host epigenetics in human disease.

Synthesis and evaluation of acrylate resins suspending indole derivative structure in the side chain for marine antifouling.

A novel indole derivative (N-(1H-2-phenyl-indole-3-ylmethyl) acrylamide, NPI) synthesized by a Friedel-Crafts alkylation reaction was identified using IR spectroscopy, 1H NMR, 13C NMR and elemental analysis. The inhibitory effect of this novel indole derivative on bacteria and marine algae was studied. The results showed that the inhibition ratios of the indole derivative against Escherichia coli and Staphylococcus aureus were 95.93% and 94.91%, respectively, and the indole derivative possessed prominent inhibitory activity against Phaeodactylum tricornutum, Nitzschia Closterium and Skeletonema costatum. These findings indicate that the indole derivative has high biological activity. Subsequently, the indole derivative was introduced to acrylate resins by free-radical polymerization. The resulting acrylate resins were subjected to self-polishing, anti-algal and antifouling test, the results of which indicated that acrylate resins containing the synthesized indole derivative could exhibit significant antifouling properties because of the combination of the biofouling resistance of the indole derivative and the self-polishing properties of acrylate. This work provides an academic foundation for studying environmentally friendly and highly efficient antifouling coatings.