Tumor cells undergo metabolic reprogramming to adapt to rapid proliferation and harsh microenvironments,as evidenced by aerobic glycolysis.Mitochondria serve as key coordinators of this process.Under internal and envi...Tumor cells undergo metabolic reprogramming to adapt to rapid proliferation and harsh microenvironments,as evidenced by aerobic glycolysis.Mitochondria serve as key coordinators of this process.Under internal and environmental stress in tumors,mitochondria reprogram metabolism by balancing energy dynamics,redirecting metabolic routes,communicating via metabolites,and preserving the quality of mitochondria,thus supporting tumor cell survival.Traditional Chinese medicine(TCM)has a key role in modulating mitochondrial reprogramming in tumor cells,possibly disrupting metabolic pathways that are necessary for survival and proliferation.However,the underlying molecular signaling and cellular biological mechanisms need to be elucidated.In this review,we focused on the Key functions of mitochondria in adapting to tumor metabolic reprogramming are the focus of this review and recent advances in and regulatory mechanisms of TCM and nano-pharmaceutical formulations in maintaining mitochondrial homeostasis are discussed.These insights may help understand the role of mitochondria in the pathogenesis of metabolic diseases,such as cancer,and identify therapeutic targets.展开更多
The presence or absence of adult neural stem cells in the mammalian forebrain ependyma has been debated for two decades.In this study,we performed single-cell RNA sequencing to investigate the cellular composition of ...The presence or absence of adult neural stem cells in the mammalian forebrain ependyma has been debated for two decades.In this study,we performed single-cell RNA sequencing to investigate the cellular composition of the ependymal surface of the adult mouse forebrain using whole mounts of lateral walls of lateral ventricles.We identified 12 different cell subtypes in the ependymal surface.Immunocytochemical analyses revealed that CD133^(+)multi-ciliated cells comprised 67.6%of ependymal cells,while the remaining 32.4%were CD133^(-).CD133^(+)ependymal cells can be further classified into FOXJ1^(+)/SOX2^(+)/ACTA2^(+)cells,FLT1^(+)/CD31^(+)/CLDN5^(+)endothelial-like cells,and PDGFRB^(+)/VTN^(+)/NG2^(+)pericyte-like cells,as well as endothelial-pericyte-like cells and Foxj1^(+)endothelial-like cells.CD133^(-)ependymal cells can be further divided into endothelial-like cells,Foxj1^(+)ependymal cells,Foxj1^(+)endothelial-like cells,pericyte-like cells,endothelial-pericyte-like cells,VIM^(+)cells,and cells negative for all of these markers.This comprehensive profiling confirms the heterogeneity of the ependymal surface in the adult mouse forebrain.Debate regarding whether adult ependymal cells contain neural stem cells has arisen because different researchers have examined different populations of ependymal cells.Our study provides a new perspective for investigation of clinical endogenous neural stem cells,ultimately paving the way for stem cell therapies in neurological diseases.展开更多
Objective:Traditional Chinese medicine(TCM)has been extensively used as one of popular alternative therapies for several cancers.However,it remains unclear whether TCM treatment is associated with longer survival in l...Objective:Traditional Chinese medicine(TCM)has been extensively used as one of popular alternative therapies for several cancers.However,it remains unclear whether TCM treatment is associated with longer survival in lung cancer patients.In this study,we explored the effect of long-term TCM treatment on patients with different stages of lung cancer.Methods:All information of lung cancer patients with stage I-III disease from January 2007 to September 2015 was collected for this retrospective cohort study.Those who were treated with TCM after surgery were divided into TCM group and the others were into the non-TCM group(control group).All patients were regularly followed up by clinic appointment or phone,and all survival data were collected from databases after the last follow-up in October 2017.Results:A total of 575 patients were included in this study,with 299 patients in the TCM group and 276 in the control group.For all patients,5-year disease-free survival(DFS)was 62.2% in TCM group and 42.1% in the control group,and 6-year DFSs were 51.8% and 35.4%,respectively(HR=0.51,95% CI:0.40 to 0.66,log-rank P≤0.001).For patients with stage I,5-year DFSs were 83.7%(TCM group)and 57.5%(control group)and 6-year DFSs were 73.7% and 51.9%,respectively(HR=0.30,95% CI:0.18 to 0.50,log-rank P≤0.001).For patients with stage II in the TCM group and the control group,5-year DFSs were 59.4% and 17.6% and 6-year DFSs were 44.7% and 17.6%,respectively(HR=0.31,95% CI:0.19 to 0.52,log-rank P≤0.001),and for patients with stage III,5-year and 6-year DFSs in the TCM group were 18.7% and 12.5% compared with 28.4% and 20.3% in the control group(HR=1.06,95% CI:0.72 to 1.56,log-rank P=0.76).Conclusions:This study demonstrated that long-term TCM treatment as an adjuvant therapy is able to improve the DFS of postoperative stage I-III lung cancer patients,especially in patients with stage I and II disease.However,these observational findings need being validated by large sample randomized controlled trials.展开更多
Next-generation sequencing(NGS) technology is capable of sequencing millions or billions of DNA molecules simultaneously.Therefore, it represents a promising tool for the analysis of molecular targets for the initial ...Next-generation sequencing(NGS) technology is capable of sequencing millions or billions of DNA molecules simultaneously.Therefore, it represents a promising tool for the analysis of molecular targets for the initial diagnosis of disease, monitoring of disease progression, and identifying the mechanism of drug resistance. On behalf of the Tumor Biomarker Committee of the Chinese Society of Clinical Oncology(CSCO) and the China Actionable Genome Consortium(CAGC), the present expert group hereby proposes advisory guidelines on clinical applications of NGS technology for the analysis of cancer driver genes for precision cancer therapy. This group comprises an assembly of laboratory cancer geneticists, clinical oncologists, bioinformaticians,pathologists, and other professionals. After multiple rounds of discussions and revisions, the expert group has reached a preliminary consensus on the need of NGS in clinical diagnosis, its regulation, and compliance standards in clinical sample collection. Moreover, it has prepared NGS criteria, the sequencing standard operation procedure(SOP), data analysis, report, and NGS platform certification and validation.展开更多
Rectal cancer ranks as the third most prevalent malignancy globally,with an estimated 1.9 million incident cases reported in 2020.The management of low rectal cancer presents significant therapeutic challenges due to ...Rectal cancer ranks as the third most prevalent malignancy globally,with an estimated 1.9 million incident cases reported in 2020.The management of low rectal cancer presents significant therapeutic challenges due to its anatomical complexity,and substantially impacts patients'quality of life.While abdominoperineal resection(Miles procedure)ensures oncological radicality,the morbidity associated with permanent colostomy has driven innovations in sphincter-preserving surgical techniques.This review synthesizes current evidence on sphincter-preserving surgical approaches for low rectal cancer.The implementation of total mesorectal excision(TME)principles and enhanced understanding of circumferential resection margin have facilitated the evolution of diverse sphincter-preserving surgical modalities.These include local excision,low anterior resection(Dixon procedure),intersphincteric resection,pull-through procedures,transanal TME,and conventional sphincter-preserving operation.Minimally invasive approaches,particularly laparoscopic and robotic platforms,alongside natural orifice transluminal endoscopic surgery,have demonstrated improved surgical precision and enhanced postoperative recovery outcomes.Novel functional perineal reconstruction techniques offer promising alternatives for patients requiring posterior pelvic exenteration.Nevertheless,the high incidence of low anterior resection syndrome(LARS)and its chronic sequelae remain clinically notable.Evidence indicates that long-course neoadjuvant radiotherapy and TME constitute significant risk factors for LARS development.Contemporary sphincter-preserving surgery for low rectal cancer is advancing toward minimally invasive,personalized,and precision-based approaches.The increasing incidence of early-onset rectal cancer necessitates individualized treatment strategies that balance oncological efficacy with functional preservation.Future directions should focus on standardizing surgical indications,optimizing postoperative rehabilitation protocols,and enhancing treatment outcomes through multidisciplinary integration and technological innovation.展开更多
OBJECTIVE To investigate possible associations between physical function assessment scales,such as Short Physical Performance Battery(SPPB)and Berg Balance Scale(BBS),with all-cause mortality in acute decompensated he...OBJECTIVE To investigate possible associations between physical function assessment scales,such as Short Physical Performance Battery(SPPB)and Berg Balance Scale(BBS),with all-cause mortality in acute decompensated heart failure(ADHF)patients.METHODS A total of 108 ADHF patients were analyzed from October 2020 to October 2022,and followed up to May 2023.The association between baseline clinical characteristics and all-cause mortality was analyzed by univariate Cox regression analysis,while for SPPB and BBS,univariate Cox regression analysis was followed by receiver operating characteristic curves,in which the area under the curve represented their predictive accuracy for all-cause mortality.Incremental predictive values for both physical function assessments were measured by calculating net reclassification index and integrated discrimination improvement scores.Optimal cutoff value for BBS was then identified using restricted cubic spline plots,and survival differences below and above that cut-off were compared using Kaplan-Meier survival curves and the log-rank test.The clinical utility of BBS was measured using decision curve analysis.RESULTS For baseline characteristics,age,female,blood urea nitrogen,as well as statins,angiotensin-converting enzyme inhibitors,angiotensin II receptor blockers,or angiotensin receptor-neprilysin inhibitors,were predictive for all-cause mortality for ADHF patients.With respect to SPPB and BBS,higher scores were associated with lower all-cause mortality rates for both assessments;similar area under the curves were measured for both(0.774 for SPPB and 0.776 for BBS).Furthermore,BBS≤36.5 was associated with significantly higher mortality,which was still applicable even adjusting for confounding factors;BBS was also found to have great clinical utility under decision curve analysis.CONCLUSIONS BBS or SPPB could be used as tools to assess physical function in ageing ADHF patients,as well as prognosticate on all-cause mortality.Moreover,prioritizing the improvement of balance capabilities of ADHF patients in cardiac rehabilitation regimens could aid in lowering mortality risk.展开更多
Lung cancer-derived exosomes are a kind of valuable and clinically-predictable biomarkers for lung cancer, but they have the limitations in individual differences when being applied in liquid biopsy. To improve their ...Lung cancer-derived exosomes are a kind of valuable and clinically-predictable biomarkers for lung cancer, but they have the limitations in individual differences when being applied in liquid biopsy. To improve their application value and accuracy in clinical diagnosis, a dual-labelled electrochemical method is herein reported for precise assessment of lung cancer-derived exosomes. To do so, two probes are prepared for the dual labeling of exosome membrane to run DNA assembly reactions: One is modified with cholesterol and can insert into exosome membrane through hydrophobic interaction;another one is linked with programmed death ligand-1(PD-L1) antibody and can bind to exosome surface-expressing PD-L1 via specific immunoreaction. Quantum dots-tagged signal strands are used to collect respective DNA products, and produce stripping signals corresponding to the amounts of total exosome and surfaceexpressing PD-L1, respectively. A wide linear relationship is established for the quantitative determination of lung cancer-derived exosomes in the range from 103to 1010particles/m L, whereas the ratiometric value of the two stripping signals is proven to have a better diagnostic use in screening and staging of lung cancer when being applied to clinical samples. Therefore, our method might provide a new insight into precise diagnosis of lung cancer, and offer sufficient information to refiect the biomarker level and guide the personalized treatment level even at an early stage in clinic.展开更多
OBJECTIVE:To explore if Hewei Jiangni granule(和胃降逆颗粒,HWJNG)could regulate esophageal hypersensitivity via stromal interaction molecule 1(STIM1)/transient receptor potential vanilloid subfamily member 1(TRPV1)pat...OBJECTIVE:To explore if Hewei Jiangni granule(和胃降逆颗粒,HWJNG)could regulate esophageal hypersensitivity via stromal interaction molecule 1(STIM1)/transient receptor potential vanilloid subfamily member 1(TRPV1)pathway.METHODS:Qualitative analysis of HWJNG was analysis by high performance of liquid and gas chromatography.In vivo,animal model of non-erosive reflux disease(NERD)was established by fructose intake and restraint stress.HWJNG and Omeprazole were administered by gavage to the drug intervention group.Reflux and visceral hypersensitivity were analyzed by pathological changes,PH value test,mechanical paw withdrawal threshold,thermal withdrawal latency and mast cells(MCs)degranulation.In vitro,substance P(SP)-induced P815 cells and dorsal root ganglion(DRG)cells were cocultured.Expression in both mice and cells of STIM1,TRPV1,and esophageal visceral hypersensitivity-related gastrointestinal neurochemicals were validated by enzyme linked immunosorbent assays,quantitative realtime polymerase chain reaction(qRT-PCR)and Western blot.Moreover,overexpression and small interfering RNA against STIM1 were utilized to verify of the role of HWJNG in DRG cells.RESULTS:HWJNG significantly suppressed intercellular space widening,injury of mitochondrial,MCs degranulation,mechanical allodynia and heat neuropathic sensory and increased pH value of esophageal mucosa in NERD mice.HWJNG inhibited expression of visceral hypersensitivityrelated gastrointestinal neurochemicals in esophageal mucosa and activated P815 cells,and expression of the STIM1,TRPV1 and related neurotransmitters in DRG and DRG cells.STIM1 siRNA and HWJNG both reduced P815 cells adhesion to DRGs cells and Ca2+flow into the cytoplasmic space of DRG cells.Furthermore,HWJNG could reversed STIM1 overexpression induced upregulation of TRPV1.CONCLUSION:HWJNG suppressed intercellular space widening in NERD mice,stabilized MCs and restored neuronal hyperexcitability by regulating visceral hypersensitivity via STIM1/TRPV1 pathway.展开更多
General anesthesia,pivotal for surgical procedures,requires precise depth monitoring to mitigate risks ranging from intraoperative awareness to postoperative cognitive impairments.Traditional assessment methods,relyin...General anesthesia,pivotal for surgical procedures,requires precise depth monitoring to mitigate risks ranging from intraoperative awareness to postoperative cognitive impairments.Traditional assessment methods,relying on physiological indicators or behavioral responses,fall short of accurately capturing the nuanced states of unconsciousness.This study introduces a machine learning-based approach to decode anesthesia depth,leveraging EEG data across different anesthesia states induced by propofol and esketamine in rats.Our findings demonstrate the model’s robust predictive accuracy,underscored by a novel intrasubject dataset partitioning and a 5-fold cross-validation method.The research diverges from conventional monitoring by utilizing anesthetic infusion rates as objective indicators of anesthesia states,highlighting distinct EEG patterns and enhancing prediction accuracy.Moreover,the model’s ability to generalize across individuals suggests its potential for broad clinical application,distinguishing between anesthetic agents and their depths.Despite relying on rat EEG data,which poses questions about real-world applicability,our approach marks a significant advance in anesthesia monitoring.展开更多
Reproductive hormones associated with the hypothalamic-pituitary-gonadal(HPG)axis are closely linked to bone homeostasis.In this study,we demonstrate that Gonadotropin inhibitory hormone(GnIH,one of the key reproducti...Reproductive hormones associated with the hypothalamic-pituitary-gonadal(HPG)axis are closely linked to bone homeostasis.In this study,we demonstrate that Gonadotropin inhibitory hormone(GnIH,one of the key reproductive hormones upstream of the HPG axis)plays an indispensable role in regulating bone homeostasis and maintaining bone mass.We find that deficiency of GnIH or its receptor Gpr147 leads to a significant reduction in bone mineral density(BMD)in mice primarily by enhancement of osteoclast activation in vivo and in vitro.Mechanistically,GnIH/Gpr147 inhibits osteoclastogenesis by the PI3K/AKT,MAPK,NF-κB and Nfatc1 signaling pathways.Furthermore,GnIH treatment was able to alleviate bone loss in aging,ovariectomy(OVX)or LPS-induced mice.Moreover,the therapy using green light promotes the release of GnIH and rescues OVX-induced bone loss.In humans,serum GnIH increases and bone resorption markers decrease after green light exposure.Therefore,our study elucidates that GnIH plays an important role in maintaining bone homeostasis via modulating osteoclast differentiation and demonstrates the potential of GnIH therapy or green light therapy in preventing osteoporosis.展开更多
Prevalence of gastroesophageal reflux disease(GERD)has shown an upward trend over the years.Even though patients with GERD have a poor quality of life,the current treatment options are highly limited.In recent years,h...Prevalence of gastroesophageal reflux disease(GERD)has shown an upward trend over the years.Even though patients with GERD have a poor quality of life,the current treatment options are highly limited.In recent years,however,the development of anti-reflux mucosal intervention(ARMI),a novel strategy for treating GERD,has provided hope to such patients.ARMI comprises three main steps:Anti-reflux mucosectomy,anti-reflux mucosal ablation,and peroral endoscopic cardial constriction.ARMI involves the constriction of the pericardial mucosa through endoscopic surgery so as to reduce the damage caused by the reflux of gastric contents.This study compares different ARMI techniques,their therapeutic efficacy in treating GERD,indications and contraindications,endoscopic operational procedures,perioperative management,and adverse events,in an attempt to provide clinical guidance.展开更多
Biliary stent placement and removal are common medical procedures,but they carry risks of chyme regurgitation and residual common bile duct stones(CBDS),highlighting the necessity of intra-biliary cleansing during sec...Biliary stent placement and removal are common medical procedures,but they carry risks of chyme regurgitation and residual common bile duct stones(CBDS),highlighting the necessity of intra-biliary cleansing during secondary endoscopic stent removal.AIM To compare the incidence of chyme reflux into the common bile duct and residual or recurrent CBDS,and the safety of intra-biliary cleansing during secondary duodenoscopic removal of duodenal bend vs single pigtail biliary stents.METHODS We included 554 patients undergoing secondary duodenoscopy for biliary stent removal and intra-biliary cleansing from March 2019 to September 2024.Patients were divided into a single pigtail biliary stent group and a duodenal bend biliary stent group(DBBSG).Chyme reflux and CBDS occurrences were compared using the Cox proportional hazards model.RESULTS The median age of the patients included was 62 years(interquartile range:51-70),with 53.11%being female.During stent removal,DBBSG showed higher rates of chyme reflux(23.27%vs 9.65%,P<0.001)and CBDS(42.77%vs 21.05%,P<0.001)compared to the single pigtail biliary stent group.No significant differences were found in the incidence of adverse reactions between the two groups(P>0.05),and no serious events or deaths occurred.DBBSG patients had increased risks of chyme reflux(hazard ratio=2.793;95%confidence interval:1.695-4.603;P<0.001)and CBDS(hazard ratio:2.475;95%confidence interval:1.732-3.536;P<0.001).CONCLUSION Duodenal bend biliary stents increase the risk of chyme reflux into the common bile duct and CBDS.The safety of intra-biliary cleaning during stent removal has been validated,and as a result,it is recommended that endoscopists perform intra-biliary cleaning during duodenoscopic removal of duodenal bend biliary stents.展开更多
BACKGROUND Indolent T-cell lymphoma of the gastrointestinal tract(iTCL-GI)is a rare mature T-cell lymphoma that has been formally recognized as a distinct entity in the 5th Edition World Health Organization Classifica...BACKGROUND Indolent T-cell lymphoma of the gastrointestinal tract(iTCL-GI)is a rare mature T-cell lymphoma that has been formally recognized as a distinct entity in the 5th Edition World Health Organization Classification of Tumours of Haematolymphoid Tumours.However,the coexistence of iTCL-GI with epithelial malignancies is rare in clinical practice.This study reports a case of iTCL-GI with gastric signet-ring cell carcinoma(SRCC).We aim to increase diagnostic awareness among clinicians and pathologists regarding multiple primary tumors.CASE SUMMARY A 65-year-old female presented with a 5-month history of lower abdominal pain,bloating,and vomiting.An abdominal computed tomography scan revealed irregular thickening of the gastric wall.Endoscopy revealed diffuse mucosal edema and rigid mucosa along the lesser curvature of the gastric body.There was a 1.5 cm mucosal protrusion on the greater curvature.Biopsy revealed that the lamina propria was expanded by a dense,nondestructive infiltrate of small lymphocytes in the greater curvature,which were characterized by a CD3+/CD8+/TIA-1+immunophenotype with a low Ki-67 index.Clonal T-cell receptor rearrangement was detected,but the Epstein-Barr virus encoded RNA's was negative.Lesions on the lesser curvature of the gastric body were confirmed to be SRCCs.After three months of follow-up,the patient completed four cycles of chemotherapy targeting the SRCC.While her abdominal pain improved,she experienced a weight loss of 5 kg.CONCLUSION Clinicians and pathologists must integrate assessment of these rare cases to prevent misdiagnosis and guide clinical practice.展开更多
BACKGROUND Recently,the identification of cell apoptosis induced by natural products has become research hotspot and frontier in the biopharmaceutical and food industries under the umbrella of global green development...BACKGROUND Recently,the identification of cell apoptosis induced by natural products has become research hotspot and frontier in the biopharmaceutical and food industries under the umbrella of global green development worldwide.Traditionally,cell apoptosis is identified using morphological,biochemical,and cell cycle experiments,which is time consuming,and experimental materials are not from the same group,and it is very hard to ensure the identity and veracity of results of former and latter experiments.AIM To establish a selective,instant,and practical protocol to identify cell apoptosis induced by natural products.METHODS A one transient cell processing procedure(OTCPP)was used to detect human colorectal cancer LoVo cell apoptosis after treatment with Pinus massoniana bark extract(PMBE)at the morphological,biochemical,and cell cycle levels.The methods used included treatment with DNA gel electrophoresis,fluorescence microscopy,and flow cytometry.RESULTS In PMBE-treated LoVo cells,we observed a DNA ladder on gel electrophoresis and fluorescence microscopy revealed"nuclear shrinkage,chromatin condensation or fragmentation".In addition,flow cytometry showed an"obvious apoptosis curve".Thus OTCPP achieved synchronous detection of the morphology,biochemistry,cell cycle,and the DNA content of the cells.CONCLUSION OTCPP can quickly identify apoptosis and measure the apoptosis rate,thereby unifying qualitative and quantitative analysis.展开更多
BACKGROUND Diabetic peripheral neuropathy(DPN)is the most prevalent complication of type 2 diabetes mellitus(T2DM).Due to a lack of specific biomarkers,the early diagnosis of this disorder is limited.AIM To identify a...BACKGROUND Diabetic peripheral neuropathy(DPN)is the most prevalent complication of type 2 diabetes mellitus(T2DM).Due to a lack of specific biomarkers,the early diagnosis of this disorder is limited.AIM To identify and validate serum amino acids that could discriminate T2DM patients with DPN from those without DPN.METHODS T2DM patients with DPN,T2DM patients without DPN,and healthy controls were recruited for this study.The participants comprised two nonoverlapping cohorts:A training cohort(DPN=84 participants,T2DM=82 participants,normal=50 participants)and a validation cohort(DPN=112 participants,T2DM=93 participants,normal=58 participants).A prediction model of the ability of serum amino acids to distinguish DPN from T2DM was established using a logistic regression model,and area under the curve(AUC)analysis was used to evaluate the diagnostic ability of the model.In addition,the serum amino acid levels of 13 DPN patients were also detected before treatment and after 3 months of treatment.RESULTS A clinical detection method for the diagnosis of DPN based on a biomarker panel of three serum amino acids and diabetes duration was developed.The diagnostic model demonstrated AUC values of 0.805(95%CI:0.739-0.871)and 0.810(95%CI:0.750-0.870)in the training and verification cohorts,respectively.In the identification of T2DM patients and normal controls,the AUC values were 0.891(95%CI:0.836-0.945)and 0.883(95%CI:0.832-0.934)in the training and validation cohorts,respectively.Arginine and tyrosine levels were increased after treatment,whereas aspartic acid levels were decreased after treatment.CONCLUSION This study successfully identified and validated the metabolomic significance of arginine,tyrosine,and glutamic acid as potential biomarkers for diagnosing DPN.These findings are particularly valuable,as they establish a foundational step toward developing the first routine laboratory test for DPN.Moreover,the diagnostic model that was constructed in this study effectively distinguishes DPN patients from those with T2DM without neuropathy,thereby potentially facilitating early diagnosis and intervention.展开更多
This study highlights the significance of considering pituitary neuroendocrine tumor volume when determining the appropriate line of therapy for patients with acromegaly.The findings suggest that,although tumor volume...This study highlights the significance of considering pituitary neuroendocrine tumor volume when determining the appropriate line of therapy for patients with acromegaly.The findings suggest that,although tumor volume may assist in predicting the need for more aggressive treatment strategies,it is not a reliable indicator of disease persistence following surgical intervention.Further research is warranted to investigate additional factors influencing acromegaly treatment outcomes to enhance patient care.展开更多
In this editorial we comment on the article published in the recent issue of World Journal of Gastrointestinal Oncology.This study aims to explore the relationship be-tween preoperative inflammation markers and the re...In this editorial we comment on the article published in the recent issue of World Journal of Gastrointestinal Oncology.This study aims to explore the relationship be-tween preoperative inflammation markers and the recurrence of gastrointestinal stromal tumors(GIST)after surgery.It is well known that the best-documented prognostic parameters for GIST are mitotic activity,tumor size and anatomical site.Besides,mutation status represents a prognostic as well as predictive factor.This study provides a new tool for postoperative recurrence risk assessment of GIST patients by establishing a line chart prediction model,which is certificated by previous research that high platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio correlated with increased tumour sizes,more advanced tumour stages and mitotic index.However,as a retrospective study,inevitable bias exists in the results;furthermore,the sample size of this study is relatively small,in-fluencing the universality of the results.Moreover,when assessing risk rating and prognosis of GIST,some novel inflammatory makers could be taken into consi-deration,such as proenkephalin and SLITRK3.Overall,this study can offer an additional model for GIST prognosis and recurrence risk assessment,indepen-dent of the traditional prognostic factors of GIST.展开更多
BACKGROUND Occult pancreaticobiliary reflux(OPBR)is characterized by the absence of congenital anomalies at the pancreaticobiliary junction yet leads to altered bile composition and an increased incidence of gallbladd...BACKGROUND Occult pancreaticobiliary reflux(OPBR)is characterized by the absence of congenital anomalies at the pancreaticobiliary junction yet leads to altered bile composition and an increased incidence of gallbladder stones.AIM To explore the computed tomography(CT)imaging characteristics of gallbladder stones in patients diagnosed with OPBR.METHODS We analyzed 362 patients undergoing cholecystectomy(November 2020 to January 2022).Intraoperative bile samples were assayed for amylase(>110 U/L indicated OPBR).CT features,including stone density and visibility,were compared between 54 OPBR and 308 controls.Stone attenuation(HU)was measured under standardized conditions(uCT-780,120 kVp,160 mAs).Logistic regression and receiver operating characteristic curve analysis identified independent OPBR predictors,forming a validated nomogram.RESULTS OPBR patients exhibited significantly higher rates of CT-invisible stones(35.2%vs 12.3%)and uniform stones(87%vs 73.1%)along with lower overall stone density(P=0.01).Logistic regression identified stone visibility,uniformity,and density as independent predictors.A nomogram integrating these features with patient age achieved high diagnostic accuracy(area under the curve=0.71).CONCLUSION CT imaging distinctly identifies gallbladder stone density,indicating a heightened risk of OPBR in patients with uniform and CT-invisible stones.Such imaging is crucial for preoperative assessments to evaluate potential recurrent biliary pathologies post-cholecystectomy.展开更多
BACKGROUND Metabolic dysregulation is considered a significant hallmark of hepatocellular carcinoma(HCC).SAC3 domain containing 1(SAC3D1)functions in the cell cycle,and its expression is upregulated in various cancers...BACKGROUND Metabolic dysregulation is considered a significant hallmark of hepatocellular carcinoma(HCC).SAC3 domain containing 1(SAC3D1)functions in the cell cycle,and its expression is upregulated in various cancers.It is known that metabolic changes occur at different stages of the cell cycle to maintain the biosynthesis and replication of both normal and cancer cells.Based on the role of SAC3D1 in mitosis,we hypothesize that abnormal expression of SAC3D1 may affect cellular metabolism.However,it remains unclear whether SAC3D1 mediates the progression of HCC by regulating metabolic reprogramming.AIM To comprehensively elucidate the impact and molecular mechanism of SAC3D1 on the progression of HCC by regulating the metabolic reprogramming.METHODS The constructed SAC3D1 overexpression and knockdown HCC cell lines were used for detecting cell proliferation,migration capabilities,as well as glycolysis and adenosine triphosphate(ATP)production rate assays.They were also employed for examining molecular markers associated with cell migration and glycolysis.The transcriptome sequencing data of cells have revealed the pathways potentially influenced by SAC3D1.The tail vein metastasis model and xenograft tumor experiments were utilized to demonstrate SAC3D1’s tumor-promoting effects in vivo.RESULTS SAC3D1 expression was upregulated and associated with poor prognosis in HCC patients.SAC3D1 enhanced the proliferation and migration abilities and reduced the population dependence of HCC cells in vitro and in vivo.The upregulation of SAC3D1 enhanced cellular glycolysis and ATP production.The cell transcriptome sequencing data revealed that SAC3D1 activated Wnt signaling pathway.SAC3D1 did not modulate the transcription ofβ-Catenin,while might inhibit its degradation.Further investigations indicated that the increase of SAC3D1 leads to moreβ-Catenin accumulating in the nucleus,facilitating the expression of c-Myc,one of the upstream regulatory factors of glycolysis.The iCRT3,an antagonist ofβ-Catenin,could counteract the increase of c-Myc induced by SAC3D1,while also downregulating the expression of glycolysis-related proteins.CONCLUSION This study found that SAC3D1 enhances HCC cell glycolysis and ATP production via theβ-Catenin/c-Myc signaling axis,thereby promoting the progression of HCC.展开更多
Amphiphiles,including surfactants,have emerged as indispensable elements in materials science and pharmaceutical science,and their functions are highly relying on the critical micelle concentration(CMC)[1,2].Numerous ...Amphiphiles,including surfactants,have emerged as indispensable elements in materials science and pharmaceutical science,and their functions are highly relying on the critical micelle concentration(CMC)[1,2].Numerous fluorimetry-based probes have been developed to measure CMCs[3](Fig.S1).However,CMC measurements using these probes suffer from a time-consuming and laborious procedure and large uncertainties,primarily due to their poor photo-stabilities and highly fluctuating fluorescence backgrounds.展开更多
基金supported by the National Natural Science Foundation of China(Grant no.81922030)International Cooperation Project of the Belt and Road(Grant no.20400750600)+1 种基金Construction Project of Shanghai TCM-Integrated Innovative Flagship Hospital[Grant nos.ZY(2021-2023)-0205-05 and ZXXT-202203]Shanghai Municipal Commission of Health and Family Plan(Grant no.201840056).
文摘Tumor cells undergo metabolic reprogramming to adapt to rapid proliferation and harsh microenvironments,as evidenced by aerobic glycolysis.Mitochondria serve as key coordinators of this process.Under internal and environmental stress in tumors,mitochondria reprogram metabolism by balancing energy dynamics,redirecting metabolic routes,communicating via metabolites,and preserving the quality of mitochondria,thus supporting tumor cell survival.Traditional Chinese medicine(TCM)has a key role in modulating mitochondrial reprogramming in tumor cells,possibly disrupting metabolic pathways that are necessary for survival and proliferation.However,the underlying molecular signaling and cellular biological mechanisms need to be elucidated.In this review,we focused on the Key functions of mitochondria in adapting to tumor metabolic reprogramming are the focus of this review and recent advances in and regulatory mechanisms of TCM and nano-pharmaceutical formulations in maintaining mitochondrial homeostasis are discussed.These insights may help understand the role of mitochondria in the pathogenesis of metabolic diseases,such as cancer,and identify therapeutic targets.
基金supported by the State Key Program of the National Natural Science Foundation of China,No.82030035(to YES)Peak Disciplines(Type IV)of Institutions of Higher Learning in Shanghai(to LZ).
文摘The presence or absence of adult neural stem cells in the mammalian forebrain ependyma has been debated for two decades.In this study,we performed single-cell RNA sequencing to investigate the cellular composition of the ependymal surface of the adult mouse forebrain using whole mounts of lateral walls of lateral ventricles.We identified 12 different cell subtypes in the ependymal surface.Immunocytochemical analyses revealed that CD133^(+)multi-ciliated cells comprised 67.6%of ependymal cells,while the remaining 32.4%were CD133^(-).CD133^(+)ependymal cells can be further classified into FOXJ1^(+)/SOX2^(+)/ACTA2^(+)cells,FLT1^(+)/CD31^(+)/CLDN5^(+)endothelial-like cells,and PDGFRB^(+)/VTN^(+)/NG2^(+)pericyte-like cells,as well as endothelial-pericyte-like cells and Foxj1^(+)endothelial-like cells.CD133^(-)ependymal cells can be further divided into endothelial-like cells,Foxj1^(+)ependymal cells,Foxj1^(+)endothelial-like cells,pericyte-like cells,endothelial-pericyte-like cells,VIM^(+)cells,and cells negative for all of these markers.This comprehensive profiling confirms the heterogeneity of the ependymal surface in the adult mouse forebrain.Debate regarding whether adult ependymal cells contain neural stem cells has arisen because different researchers have examined different populations of ependymal cells.Our study provides a new perspective for investigation of clinical endogenous neural stem cells,ultimately paving the way for stem cell therapies in neurological diseases.
基金the Nation Natural Science Foundation of China (No.814737627, No.81673947)the Science and Technology Commission of Shanghai Municipality (No.17401933500)the Shanghai Municipal Population and Family Planning Commission (No.201740059).
文摘Objective:Traditional Chinese medicine(TCM)has been extensively used as one of popular alternative therapies for several cancers.However,it remains unclear whether TCM treatment is associated with longer survival in lung cancer patients.In this study,we explored the effect of long-term TCM treatment on patients with different stages of lung cancer.Methods:All information of lung cancer patients with stage I-III disease from January 2007 to September 2015 was collected for this retrospective cohort study.Those who were treated with TCM after surgery were divided into TCM group and the others were into the non-TCM group(control group).All patients were regularly followed up by clinic appointment or phone,and all survival data were collected from databases after the last follow-up in October 2017.Results:A total of 575 patients were included in this study,with 299 patients in the TCM group and 276 in the control group.For all patients,5-year disease-free survival(DFS)was 62.2% in TCM group and 42.1% in the control group,and 6-year DFSs were 51.8% and 35.4%,respectively(HR=0.51,95% CI:0.40 to 0.66,log-rank P≤0.001).For patients with stage I,5-year DFSs were 83.7%(TCM group)and 57.5%(control group)and 6-year DFSs were 73.7% and 51.9%,respectively(HR=0.30,95% CI:0.18 to 0.50,log-rank P≤0.001).For patients with stage II in the TCM group and the control group,5-year DFSs were 59.4% and 17.6% and 6-year DFSs were 44.7% and 17.6%,respectively(HR=0.31,95% CI:0.19 to 0.52,log-rank P≤0.001),and for patients with stage III,5-year and 6-year DFSs in the TCM group were 18.7% and 12.5% compared with 28.4% and 20.3% in the control group(HR=1.06,95% CI:0.72 to 1.56,log-rank P=0.76).Conclusions:This study demonstrated that long-term TCM treatment as an adjuvant therapy is able to improve the DFS of postoperative stage I-III lung cancer patients,especially in patients with stage I and II disease.However,these observational findings need being validated by large sample randomized controlled trials.
基金supported by grants from Guangdong Provincial Key Lab of Translational Medicine in Lung Cancer (Grant No. 2017B030314120)General Research Project of Guangzhou Science and Technology Bureau (Grant No. 201607010391)+1 种基金National Key Research and Development Program of China (Grant No. 2016YFC1303800)Guangdong Provincial Applied S&T R&D Program (Grant No. 2016B020237006)
文摘Next-generation sequencing(NGS) technology is capable of sequencing millions or billions of DNA molecules simultaneously.Therefore, it represents a promising tool for the analysis of molecular targets for the initial diagnosis of disease, monitoring of disease progression, and identifying the mechanism of drug resistance. On behalf of the Tumor Biomarker Committee of the Chinese Society of Clinical Oncology(CSCO) and the China Actionable Genome Consortium(CAGC), the present expert group hereby proposes advisory guidelines on clinical applications of NGS technology for the analysis of cancer driver genes for precision cancer therapy. This group comprises an assembly of laboratory cancer geneticists, clinical oncologists, bioinformaticians,pathologists, and other professionals. After multiple rounds of discussions and revisions, the expert group has reached a preliminary consensus on the need of NGS in clinical diagnosis, its regulation, and compliance standards in clinical sample collection. Moreover, it has prepared NGS criteria, the sequencing standard operation procedure(SOP), data analysis, report, and NGS platform certification and validation.
文摘Rectal cancer ranks as the third most prevalent malignancy globally,with an estimated 1.9 million incident cases reported in 2020.The management of low rectal cancer presents significant therapeutic challenges due to its anatomical complexity,and substantially impacts patients'quality of life.While abdominoperineal resection(Miles procedure)ensures oncological radicality,the morbidity associated with permanent colostomy has driven innovations in sphincter-preserving surgical techniques.This review synthesizes current evidence on sphincter-preserving surgical approaches for low rectal cancer.The implementation of total mesorectal excision(TME)principles and enhanced understanding of circumferential resection margin have facilitated the evolution of diverse sphincter-preserving surgical modalities.These include local excision,low anterior resection(Dixon procedure),intersphincteric resection,pull-through procedures,transanal TME,and conventional sphincter-preserving operation.Minimally invasive approaches,particularly laparoscopic and robotic platforms,alongside natural orifice transluminal endoscopic surgery,have demonstrated improved surgical precision and enhanced postoperative recovery outcomes.Novel functional perineal reconstruction techniques offer promising alternatives for patients requiring posterior pelvic exenteration.Nevertheless,the high incidence of low anterior resection syndrome(LARS)and its chronic sequelae remain clinically notable.Evidence indicates that long-course neoadjuvant radiotherapy and TME constitute significant risk factors for LARS development.Contemporary sphincter-preserving surgery for low rectal cancer is advancing toward minimally invasive,personalized,and precision-based approaches.The increasing incidence of early-onset rectal cancer necessitates individualized treatment strategies that balance oncological efficacy with functional preservation.Future directions should focus on standardizing surgical indications,optimizing postoperative rehabilitation protocols,and enhancing treatment outcomes through multidisciplinary integration and technological innovation.
基金supported by the Key Research and Development Special Project of the Autonomous Region(No.2022B03023-3)the Key Supported Discipline of Health System in Shanghai(No.2023ZDFC0302)。
文摘OBJECTIVE To investigate possible associations between physical function assessment scales,such as Short Physical Performance Battery(SPPB)and Berg Balance Scale(BBS),with all-cause mortality in acute decompensated heart failure(ADHF)patients.METHODS A total of 108 ADHF patients were analyzed from October 2020 to October 2022,and followed up to May 2023.The association between baseline clinical characteristics and all-cause mortality was analyzed by univariate Cox regression analysis,while for SPPB and BBS,univariate Cox regression analysis was followed by receiver operating characteristic curves,in which the area under the curve represented their predictive accuracy for all-cause mortality.Incremental predictive values for both physical function assessments were measured by calculating net reclassification index and integrated discrimination improvement scores.Optimal cutoff value for BBS was then identified using restricted cubic spline plots,and survival differences below and above that cut-off were compared using Kaplan-Meier survival curves and the log-rank test.The clinical utility of BBS was measured using decision curve analysis.RESULTS For baseline characteristics,age,female,blood urea nitrogen,as well as statins,angiotensin-converting enzyme inhibitors,angiotensin II receptor blockers,or angiotensin receptor-neprilysin inhibitors,were predictive for all-cause mortality for ADHF patients.With respect to SPPB and BBS,higher scores were associated with lower all-cause mortality rates for both assessments;similar area under the curves were measured for both(0.774 for SPPB and 0.776 for BBS).Furthermore,BBS≤36.5 was associated with significantly higher mortality,which was still applicable even adjusting for confounding factors;BBS was also found to have great clinical utility under decision curve analysis.CONCLUSIONS BBS or SPPB could be used as tools to assess physical function in ageing ADHF patients,as well as prognosticate on all-cause mortality.Moreover,prioritizing the improvement of balance capabilities of ADHF patients in cardiac rehabilitation regimens could aid in lowering mortality risk.
基金supported by the National Natural Science Foundation of China (Nos. 81972799, 82202834, and 81871449)。
文摘Lung cancer-derived exosomes are a kind of valuable and clinically-predictable biomarkers for lung cancer, but they have the limitations in individual differences when being applied in liquid biopsy. To improve their application value and accuracy in clinical diagnosis, a dual-labelled electrochemical method is herein reported for precise assessment of lung cancer-derived exosomes. To do so, two probes are prepared for the dual labeling of exosome membrane to run DNA assembly reactions: One is modified with cholesterol and can insert into exosome membrane through hydrophobic interaction;another one is linked with programmed death ligand-1(PD-L1) antibody and can bind to exosome surface-expressing PD-L1 via specific immunoreaction. Quantum dots-tagged signal strands are used to collect respective DNA products, and produce stripping signals corresponding to the amounts of total exosome and surfaceexpressing PD-L1, respectively. A wide linear relationship is established for the quantitative determination of lung cancer-derived exosomes in the range from 103to 1010particles/m L, whereas the ratiometric value of the two stripping signals is proven to have a better diagnostic use in screening and staging of lung cancer when being applied to clinical samples. Therefore, our method might provide a new insight into precise diagnosis of lung cancer, and offer sufficient information to refiect the biomarker level and guide the personalized treatment level even at an early stage in clinic.
基金National Natural Science Foundation of China:Study on the Molecular Mechanism of the Regulation of Crypt Goblet Cell Pyroptosis and Exocytosis to Repair Ulcerative Colitis Mucus Barrier by the Method of Clearing and Opening the Xuanfu from the Perspective of"Xuanfu-Crypt"(No.82305143),and National Natural Science Foundation of China:Exploring the Molecular Mechanism of"Hewei Jiangni Fang"Intervention in Non-erosive Reflux Disease Esophageal Hypersensitivity from the Perspective of Mas-related Gene X2/Stromal Interaction Molecule 1/Cell Adhesion Molecule 1 Pathway Regulation of Mast Cell/Dorsal Root Ganglion Communication based on the"Xinkai-Kujiang"Method(No.82374401)。
文摘OBJECTIVE:To explore if Hewei Jiangni granule(和胃降逆颗粒,HWJNG)could regulate esophageal hypersensitivity via stromal interaction molecule 1(STIM1)/transient receptor potential vanilloid subfamily member 1(TRPV1)pathway.METHODS:Qualitative analysis of HWJNG was analysis by high performance of liquid and gas chromatography.In vivo,animal model of non-erosive reflux disease(NERD)was established by fructose intake and restraint stress.HWJNG and Omeprazole were administered by gavage to the drug intervention group.Reflux and visceral hypersensitivity were analyzed by pathological changes,PH value test,mechanical paw withdrawal threshold,thermal withdrawal latency and mast cells(MCs)degranulation.In vitro,substance P(SP)-induced P815 cells and dorsal root ganglion(DRG)cells were cocultured.Expression in both mice and cells of STIM1,TRPV1,and esophageal visceral hypersensitivity-related gastrointestinal neurochemicals were validated by enzyme linked immunosorbent assays,quantitative realtime polymerase chain reaction(qRT-PCR)and Western blot.Moreover,overexpression and small interfering RNA against STIM1 were utilized to verify of the role of HWJNG in DRG cells.RESULTS:HWJNG significantly suppressed intercellular space widening,injury of mitochondrial,MCs degranulation,mechanical allodynia and heat neuropathic sensory and increased pH value of esophageal mucosa in NERD mice.HWJNG inhibited expression of visceral hypersensitivityrelated gastrointestinal neurochemicals in esophageal mucosa and activated P815 cells,and expression of the STIM1,TRPV1 and related neurotransmitters in DRG and DRG cells.STIM1 siRNA and HWJNG both reduced P815 cells adhesion to DRGs cells and Ca2+flow into the cytoplasmic space of DRG cells.Furthermore,HWJNG could reversed STIM1 overexpression induced upregulation of TRPV1.CONCLUSION:HWJNG suppressed intercellular space widening in NERD mice,stabilized MCs and restored neuronal hyperexcitability by regulating visceral hypersensitivity via STIM1/TRPV1 pathway.
基金supported by grants from the Shanghai Municipal Health Commission(2023ZDFC0203)the National Natural Science Foundation of China(32171044).
文摘General anesthesia,pivotal for surgical procedures,requires precise depth monitoring to mitigate risks ranging from intraoperative awareness to postoperative cognitive impairments.Traditional assessment methods,relying on physiological indicators or behavioral responses,fall short of accurately capturing the nuanced states of unconsciousness.This study introduces a machine learning-based approach to decode anesthesia depth,leveraging EEG data across different anesthesia states induced by propofol and esketamine in rats.Our findings demonstrate the model’s robust predictive accuracy,underscored by a novel intrasubject dataset partitioning and a 5-fold cross-validation method.The research diverges from conventional monitoring by utilizing anesthetic infusion rates as objective indicators of anesthesia states,highlighting distinct EEG patterns and enhancing prediction accuracy.Moreover,the model’s ability to generalize across individuals suggests its potential for broad clinical application,distinguishing between anesthetic agents and their depths.Despite relying on rat EEG data,which poses questions about real-world applicability,our approach marks a significant advance in anesthesia monitoring.
基金National Key Research and Development Program of China(2023YFB3810200 to J.L.)National Natural Science Foundation of China(92168204,82225030 to J.L.)Fundamental Research Funds for the Central Universities(22120210586 to J.L.)。
文摘Reproductive hormones associated with the hypothalamic-pituitary-gonadal(HPG)axis are closely linked to bone homeostasis.In this study,we demonstrate that Gonadotropin inhibitory hormone(GnIH,one of the key reproductive hormones upstream of the HPG axis)plays an indispensable role in regulating bone homeostasis and maintaining bone mass.We find that deficiency of GnIH or its receptor Gpr147 leads to a significant reduction in bone mineral density(BMD)in mice primarily by enhancement of osteoclast activation in vivo and in vitro.Mechanistically,GnIH/Gpr147 inhibits osteoclastogenesis by the PI3K/AKT,MAPK,NF-κB and Nfatc1 signaling pathways.Furthermore,GnIH treatment was able to alleviate bone loss in aging,ovariectomy(OVX)or LPS-induced mice.Moreover,the therapy using green light promotes the release of GnIH and rescues OVX-induced bone loss.In humans,serum GnIH increases and bone resorption markers decrease after green light exposure.Therefore,our study elucidates that GnIH plays an important role in maintaining bone homeostasis via modulating osteoclast differentiation and demonstrates the potential of GnIH therapy or green light therapy in preventing osteoporosis.
基金Supported by National Natural Science Foundation of China,No.82200613Shanghai“Rising Stars of Medical Talents”Youth Development Program,No.SHWSRS(2025)_071+3 种基金The Healthcare Talents Youth Program of Shanghai Pudong New Area,No.2025PDWSYCQN-03Shanghai Municipal Health Commission,No.2024ZDXK0001the Medical Discipline Construction Project of Pudong Health Committee of Shanghai,No.PWZxq2022-6,No.2024-PWXZ-07,and No.2025PDWSYCBJ-01Shanghai East Hospital's Key Clinical Disciplines and Specialty Departments,No.2024-DFZD-005.
文摘Prevalence of gastroesophageal reflux disease(GERD)has shown an upward trend over the years.Even though patients with GERD have a poor quality of life,the current treatment options are highly limited.In recent years,however,the development of anti-reflux mucosal intervention(ARMI),a novel strategy for treating GERD,has provided hope to such patients.ARMI comprises three main steps:Anti-reflux mucosectomy,anti-reflux mucosal ablation,and peroral endoscopic cardial constriction.ARMI involves the constriction of the pericardial mucosa through endoscopic surgery so as to reduce the damage caused by the reflux of gastric contents.This study compares different ARMI techniques,their therapeutic efficacy in treating GERD,indications and contraindications,endoscopic operational procedures,perioperative management,and adverse events,in an attempt to provide clinical guidance.
基金Supported by the Key Specialty Construction Project of Shanghai Pudong New Area Health Commission,No.PWZzk2022-17the Featured Clinical Discipline Project of Shanghai Pudong,No.PWYts2021-06+1 种基金Clinical Research Project of Shanghai East Hospital,No.DFLC2022019Shanghai Dongfang Hospital Key Discipline Department of Gallstone Disease,No.2024-DFZD-005DS.
文摘Biliary stent placement and removal are common medical procedures,but they carry risks of chyme regurgitation and residual common bile duct stones(CBDS),highlighting the necessity of intra-biliary cleansing during secondary endoscopic stent removal.AIM To compare the incidence of chyme reflux into the common bile duct and residual or recurrent CBDS,and the safety of intra-biliary cleansing during secondary duodenoscopic removal of duodenal bend vs single pigtail biliary stents.METHODS We included 554 patients undergoing secondary duodenoscopy for biliary stent removal and intra-biliary cleansing from March 2019 to September 2024.Patients were divided into a single pigtail biliary stent group and a duodenal bend biliary stent group(DBBSG).Chyme reflux and CBDS occurrences were compared using the Cox proportional hazards model.RESULTS The median age of the patients included was 62 years(interquartile range:51-70),with 53.11%being female.During stent removal,DBBSG showed higher rates of chyme reflux(23.27%vs 9.65%,P<0.001)and CBDS(42.77%vs 21.05%,P<0.001)compared to the single pigtail biliary stent group.No significant differences were found in the incidence of adverse reactions between the two groups(P>0.05),and no serious events or deaths occurred.DBBSG patients had increased risks of chyme reflux(hazard ratio=2.793;95%confidence interval:1.695-4.603;P<0.001)and CBDS(hazard ratio:2.475;95%confidence interval:1.732-3.536;P<0.001).CONCLUSION Duodenal bend biliary stents increase the risk of chyme reflux into the common bile duct and CBDS.The safety of intra-biliary cleaning during stent removal has been validated,and as a result,it is recommended that endoscopists perform intra-biliary cleaning during duodenoscopic removal of duodenal bend biliary stents.
基金Supported by Key Disciplines of The Sixth Cycle of Tongji Hospital,No.ZDTS24-BLShanghai Municipal Science and Technology Commission 2021"Science and Technology Innovation Action Plan"Medical Innovation Research Project,No.21Y11908800Clinical Research Project of Tongji Hospital of Tongji University,No.ITJ(ZD)2206.
文摘BACKGROUND Indolent T-cell lymphoma of the gastrointestinal tract(iTCL-GI)is a rare mature T-cell lymphoma that has been formally recognized as a distinct entity in the 5th Edition World Health Organization Classification of Tumours of Haematolymphoid Tumours.However,the coexistence of iTCL-GI with epithelial malignancies is rare in clinical practice.This study reports a case of iTCL-GI with gastric signet-ring cell carcinoma(SRCC).We aim to increase diagnostic awareness among clinicians and pathologists regarding multiple primary tumors.CASE SUMMARY A 65-year-old female presented with a 5-month history of lower abdominal pain,bloating,and vomiting.An abdominal computed tomography scan revealed irregular thickening of the gastric wall.Endoscopy revealed diffuse mucosal edema and rigid mucosa along the lesser curvature of the gastric body.There was a 1.5 cm mucosal protrusion on the greater curvature.Biopsy revealed that the lamina propria was expanded by a dense,nondestructive infiltrate of small lymphocytes in the greater curvature,which were characterized by a CD3+/CD8+/TIA-1+immunophenotype with a low Ki-67 index.Clonal T-cell receptor rearrangement was detected,but the Epstein-Barr virus encoded RNA's was negative.Lesions on the lesser curvature of the gastric body were confirmed to be SRCCs.After three months of follow-up,the patient completed four cycles of chemotherapy targeting the SRCC.While her abdominal pain improved,she experienced a weight loss of 5 kg.CONCLUSION Clinicians and pathologists must integrate assessment of these rare cases to prevent misdiagnosis and guide clinical practice.
基金Supported by 2023 Key R&D Projects of Tongji University,No.150029607160-24323Industrial Key Program Foundation of Guangdong Province:R&D of Natural Novel Anticancer Drugs,No.2004B10401033。
文摘BACKGROUND Recently,the identification of cell apoptosis induced by natural products has become research hotspot and frontier in the biopharmaceutical and food industries under the umbrella of global green development worldwide.Traditionally,cell apoptosis is identified using morphological,biochemical,and cell cycle experiments,which is time consuming,and experimental materials are not from the same group,and it is very hard to ensure the identity and veracity of results of former and latter experiments.AIM To establish a selective,instant,and practical protocol to identify cell apoptosis induced by natural products.METHODS A one transient cell processing procedure(OTCPP)was used to detect human colorectal cancer LoVo cell apoptosis after treatment with Pinus massoniana bark extract(PMBE)at the morphological,biochemical,and cell cycle levels.The methods used included treatment with DNA gel electrophoresis,fluorescence microscopy,and flow cytometry.RESULTS In PMBE-treated LoVo cells,we observed a DNA ladder on gel electrophoresis and fluorescence microscopy revealed"nuclear shrinkage,chromatin condensation or fragmentation".In addition,flow cytometry showed an"obvious apoptosis curve".Thus OTCPP achieved synchronous detection of the morphology,biochemistry,cell cycle,and the DNA content of the cells.CONCLUSION OTCPP can quickly identify apoptosis and measure the apoptosis rate,thereby unifying qualitative and quantitative analysis.
基金Supported by the Youth Fund for Specialized Clinical Research of the Health Commission,No.20214Y0149.
文摘BACKGROUND Diabetic peripheral neuropathy(DPN)is the most prevalent complication of type 2 diabetes mellitus(T2DM).Due to a lack of specific biomarkers,the early diagnosis of this disorder is limited.AIM To identify and validate serum amino acids that could discriminate T2DM patients with DPN from those without DPN.METHODS T2DM patients with DPN,T2DM patients without DPN,and healthy controls were recruited for this study.The participants comprised two nonoverlapping cohorts:A training cohort(DPN=84 participants,T2DM=82 participants,normal=50 participants)and a validation cohort(DPN=112 participants,T2DM=93 participants,normal=58 participants).A prediction model of the ability of serum amino acids to distinguish DPN from T2DM was established using a logistic regression model,and area under the curve(AUC)analysis was used to evaluate the diagnostic ability of the model.In addition,the serum amino acid levels of 13 DPN patients were also detected before treatment and after 3 months of treatment.RESULTS A clinical detection method for the diagnosis of DPN based on a biomarker panel of three serum amino acids and diabetes duration was developed.The diagnostic model demonstrated AUC values of 0.805(95%CI:0.739-0.871)and 0.810(95%CI:0.750-0.870)in the training and verification cohorts,respectively.In the identification of T2DM patients and normal controls,the AUC values were 0.891(95%CI:0.836-0.945)and 0.883(95%CI:0.832-0.934)in the training and validation cohorts,respectively.Arginine and tyrosine levels were increased after treatment,whereas aspartic acid levels were decreased after treatment.CONCLUSION This study successfully identified and validated the metabolomic significance of arginine,tyrosine,and glutamic acid as potential biomarkers for diagnosing DPN.These findings are particularly valuable,as they establish a foundational step toward developing the first routine laboratory test for DPN.Moreover,the diagnostic model that was constructed in this study effectively distinguishes DPN patients from those with T2DM without neuropathy,thereby potentially facilitating early diagnosis and intervention.
文摘This study highlights the significance of considering pituitary neuroendocrine tumor volume when determining the appropriate line of therapy for patients with acromegaly.The findings suggest that,although tumor volume may assist in predicting the need for more aggressive treatment strategies,it is not a reliable indicator of disease persistence following surgical intervention.Further research is warranted to investigate additional factors influencing acromegaly treatment outcomes to enhance patient care.
文摘In this editorial we comment on the article published in the recent issue of World Journal of Gastrointestinal Oncology.This study aims to explore the relationship be-tween preoperative inflammation markers and the recurrence of gastrointestinal stromal tumors(GIST)after surgery.It is well known that the best-documented prognostic parameters for GIST are mitotic activity,tumor size and anatomical site.Besides,mutation status represents a prognostic as well as predictive factor.This study provides a new tool for postoperative recurrence risk assessment of GIST patients by establishing a line chart prediction model,which is certificated by previous research that high platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio correlated with increased tumour sizes,more advanced tumour stages and mitotic index.However,as a retrospective study,inevitable bias exists in the results;furthermore,the sample size of this study is relatively small,in-fluencing the universality of the results.Moreover,when assessing risk rating and prognosis of GIST,some novel inflammatory makers could be taken into consi-deration,such as proenkephalin and SLITRK3.Overall,this study can offer an additional model for GIST prognosis and recurrence risk assessment,indepen-dent of the traditional prognostic factors of GIST.
基金Supported by Key Specialty Construction Project of Shanghai Pudong New Area Health Commission,No.PWZzk2022-17Shanghai East Hospital Clinical Research Project,No.DFLC2022019the Featured Clinical Discipline Project of Shanghai Pudong District,No.PWYts2021-06.
文摘BACKGROUND Occult pancreaticobiliary reflux(OPBR)is characterized by the absence of congenital anomalies at the pancreaticobiliary junction yet leads to altered bile composition and an increased incidence of gallbladder stones.AIM To explore the computed tomography(CT)imaging characteristics of gallbladder stones in patients diagnosed with OPBR.METHODS We analyzed 362 patients undergoing cholecystectomy(November 2020 to January 2022).Intraoperative bile samples were assayed for amylase(>110 U/L indicated OPBR).CT features,including stone density and visibility,were compared between 54 OPBR and 308 controls.Stone attenuation(HU)was measured under standardized conditions(uCT-780,120 kVp,160 mAs).Logistic regression and receiver operating characteristic curve analysis identified independent OPBR predictors,forming a validated nomogram.RESULTS OPBR patients exhibited significantly higher rates of CT-invisible stones(35.2%vs 12.3%)and uniform stones(87%vs 73.1%)along with lower overall stone density(P=0.01).Logistic regression identified stone visibility,uniformity,and density as independent predictors.A nomogram integrating these features with patient age achieved high diagnostic accuracy(area under the curve=0.71).CONCLUSION CT imaging distinctly identifies gallbladder stone density,indicating a heightened risk of OPBR in patients with uniform and CT-invisible stones.Such imaging is crucial for preoperative assessments to evaluate potential recurrent biliary pathologies post-cholecystectomy.
基金Supported by the Shanghai Yangpu District Science and Technology Commission,No.YPQ202303Shanghai Municipal Health Commission Clinical Research Special Project,No.202240122Shanghai Medical Innovation Research Special Project,No.22Y11908600.
文摘BACKGROUND Metabolic dysregulation is considered a significant hallmark of hepatocellular carcinoma(HCC).SAC3 domain containing 1(SAC3D1)functions in the cell cycle,and its expression is upregulated in various cancers.It is known that metabolic changes occur at different stages of the cell cycle to maintain the biosynthesis and replication of both normal and cancer cells.Based on the role of SAC3D1 in mitosis,we hypothesize that abnormal expression of SAC3D1 may affect cellular metabolism.However,it remains unclear whether SAC3D1 mediates the progression of HCC by regulating metabolic reprogramming.AIM To comprehensively elucidate the impact and molecular mechanism of SAC3D1 on the progression of HCC by regulating the metabolic reprogramming.METHODS The constructed SAC3D1 overexpression and knockdown HCC cell lines were used for detecting cell proliferation,migration capabilities,as well as glycolysis and adenosine triphosphate(ATP)production rate assays.They were also employed for examining molecular markers associated with cell migration and glycolysis.The transcriptome sequencing data of cells have revealed the pathways potentially influenced by SAC3D1.The tail vein metastasis model and xenograft tumor experiments were utilized to demonstrate SAC3D1’s tumor-promoting effects in vivo.RESULTS SAC3D1 expression was upregulated and associated with poor prognosis in HCC patients.SAC3D1 enhanced the proliferation and migration abilities and reduced the population dependence of HCC cells in vitro and in vivo.The upregulation of SAC3D1 enhanced cellular glycolysis and ATP production.The cell transcriptome sequencing data revealed that SAC3D1 activated Wnt signaling pathway.SAC3D1 did not modulate the transcription ofβ-Catenin,while might inhibit its degradation.Further investigations indicated that the increase of SAC3D1 leads to moreβ-Catenin accumulating in the nucleus,facilitating the expression of c-Myc,one of the upstream regulatory factors of glycolysis.The iCRT3,an antagonist ofβ-Catenin,could counteract the increase of c-Myc induced by SAC3D1,while also downregulating the expression of glycolysis-related proteins.CONCLUSION This study found that SAC3D1 enhances HCC cell glycolysis and ATP production via theβ-Catenin/c-Myc signaling axis,thereby promoting the progression of HCC.
基金supported by Shanghai Municipal Commission of Science and Technology,China(Grant No.:19XD1400300)the National Natural Science Foundation of China(Grant Nos.:821040821,82273867,and 82030107).
文摘Amphiphiles,including surfactants,have emerged as indispensable elements in materials science and pharmaceutical science,and their functions are highly relying on the critical micelle concentration(CMC)[1,2].Numerous fluorimetry-based probes have been developed to measure CMCs[3](Fig.S1).However,CMC measurements using these probes suffer from a time-consuming and laborious procedure and large uncertainties,primarily due to their poor photo-stabilities and highly fluctuating fluorescence backgrounds.
