Explore the vast range of titles available.

BackgroundHybrid endoscopic submucosal dissection (ESD) incorporates snare-assisted resection to reduce technical difficulty and perforation risk in anatomically complex colon lesions. The All In OneTM (AIO) snare probe, which integrates an ESD knife, needle injector, snare, and argon gas spray - facilitates complete lesion removal using a single instrument during hybrid ESD. This study aims to evaluate the efficacy and safety of the AIOTM snare probe for large colorectal polyp during hybrid ESD.MethodsThis prospective single-arm multicenter trial enrolled patients from five clinical centers between November 2021 and November 2022, who presented with sessile, sub-pedunculated, or broad-based polyp measured 1–3 cm in diameter. All patients underwent hybrid ESD assisted by the AIOTM device. The primary outcome was the en bloc resection rate. The secondary outcomes were complete resection rate, hemostasis success rate, device-related adverse events, intraoperative/postoperative bleeding and perforation occurrences.ResultsA total of 161 patients ultimately enrolled in the study, with 173 target polyps removed by AIOTM (IDDF2025-ABS-0051 figure 1). The average polyp diameter was 1.42 ± 0.47 cm (range 1–3 cm). The en bloc resection rate was 94.8% (164/173) (95% CI: 90.4% - 97.6%). The complete resection rate was 95.4% (165/173) (95% CI: 91.1% - 98.0%), and the hemostasis success rate was 94.2% (163/173) (95% CI: 89.6% - 97.2%). Device-related adverse events occurred in 1.2% (2/161) of patients, both cases involving delayed bleeding. No intraoperative perforation or delayed perforation was reported.Abstract IDDF2025-ABS-0051 Figure 1ConclusionsIn this study, we demonstrated that the AIOTM device achieved favorable efficacy and safety during hybrid ESD procedures. Further large-scale studies are needed.

Background Chronic kidney disease (CKD) is a severe public health problem associated with a disordered gut microbiome. However, the functional alterations of microbiota and their cross talk with metabolism pathways based on disease severity remain unclear. Results We performed metagenomics and untargeted metabolomics in a cohort of 68 patients with CKD of differing severities and 20 healthy controls to characterize the complex interplay between the gut microbiome and fecal and serum metabolites during CKD progression. We identified 26 microbial species that significantly changed in patients with CKD; 18 species changed as the disease progressed, and eight species changed only in a specific CKD group. These distinct changes in gut microbiota were accompanied by functional alterations in arginine and proline, arachidonic acid, and glutathione metabolism and ubiquinone and other terpenoid-quinone biosynthesis pathways during CKD progression. Further metabolomic analyses revealed that the distributions of toxic and pro-oxidant metabolites from these four essential metabolic pathways varied in the feces and serum as CKD progressed. Furthermore, we observed a complex co-occurrence between CKD severity-related bacteria and the characterized metabolites from the four essential metabolic pathways. Notably, Ruminococcus bromii , fecal hydroquinone, and serum creatinine were identified as the main contributors to the integrated network, indicating their key roles in CKD progression. Moreover, a noninvasive model including R. bromii and fecal hydroquinone, L-cystine, and 12-keto-tetrahydro-LTB4 levels classified the CKD severity (area under the curve [AUC]: > 0.9) and had better performance than the serum creatinine level for mild CKD ( AUC : 0.972 vs. 0.896). Conclusions Perturbed CKD severity-related gut microbiota may contribute to unbalanced toxic and pro-oxidant metabolism in the gut and host, accelerating CKD progression, which may be an early diagnostic and therapeutic target for CKD. 5fQUC17u92h1vMeJ2rz_WV Video Abstract

Aim： To study the effects of LY294002, an inhibitor of class I phosphatidylinositol 3-kinase （PI3K）, on proliferation and apoptosis of SGC7901 gastric cancer cells. Methods： The MTT assay was used to determine the cytotoxic effects of LY294002. Cell cycle distribution was analyzed using flow cytometry and apoptosis was assessed using flow cytometry analysis after staining DNA with propidium iodide. Mitochondrial membrane potential was measured using the fluorescent probe JC- 1. Expression of p53 and PUMA was determined using real-time RT-PCR and Western blotting analysis. Results： The viability of SGC7901 cells was significantly reduced by LY294002 treatment. Expression of p53 and PUMA was induced, and mitochondrial membrane potential collapsed after treatment with LY294002. LY294002 induced apoptotic cell death. Conclusion： Activation of the p53 pathway is involved in LY294002-induced SGC7901 cell death.

Chewing areca nuts is popular in China. Areca alkaloids are the major toxic compounds in areca nuts. In this study, the levels of four areca alkaloids (i.e. arecoline, arecaidine, guvacoline and guvacine) in 119 areca nut samples were analyzed and 3030 areca nut consumption questionnaires were collected to investigate the exposure to areca alkaloids in the Chinese populations through areca nut chewing. The levels of arecoline, arecaidine, guvacoline and guvacine in different areca nut products were 0.46–4.97 mg/g, 0.57–7.51 mg/g, 0.08–1.44 mg/g and 0.03–8.48 mg/g, respectively. Chewing fresh areca fruits was the main source of arecoline and the total areca alkaloids exposure. The estimated daily intake (EDI) of arecoline and the total areca alkaloids for the Chinese populations were 1.126 and 2.625 mg/kg BW/day for average exposure, 4.411 and 9.739 mg/kg BW/day for high exposure (P95th). The EDI varied with age and gender. The young male population (≤ 34 years) had the highest EDI than other populations. Concentrated and focused efforts are required to educate the general public, especially the young male population, about the risks of areca nut chewing to reduce exposure to areca alkaloids of the Chinese population.

Lymphocytes and their subsets are implicated in both the onset and remission of gout. However, the specific roles in gout recurrence and complete remission remain unclear. This study aimed to characterize lymphocyte immunophenotypes across different stages of gout and developed a predictive model for remission and recurrence of gout. Plasma levels of 75 lymphocyte immunophenotypes were determined using multiplex flow cytometry in patients with acute gout flare (AG, n=78), gout remission (RG, n=63), and healthy controls (NC, n=66). Lymphocyte immunophenotyping candidates and significant clinical parameters were subjected to LASSO regression for conducting a predictive model. Significant variations in lymphocyte profiles were identified among the groups. A combination of T peripheral helper cells, virus-specific cytotoxic natural killer (NK) cells, inhibition of Vδ1 and Vδ2 cells, along with BMI, eGFR, hemoglobin, uric acid, distinguished RG from NC (AUC=0.934). Similarly, inhibition of Vδ2 cells, virus-specific cytotoxic NK cells, inactive and terminally differentiated virus-specific CD8 T cells, plus hematological parameters, classified RG from AG (AUC = 0.814) and predicted gout recurrence in a one-year follow-up validation cohort (AUC = 0.724). Inhibition of Vδ2 cells and virus-infected specific cytotoxic NK cells are strongly associated with gout recurrence and complete remission. Significant alterations in lymphocyte immunophenotypes, notably the inhibition of Vδ2 cells and virus-infected specific cytotoxic NK cells during the transition from gout recurrence to complete remission, provide compelling evidence to enhance the clinical delineation of gout stages and propel mechanistic investigations into the progression of gout.

We aimed to establish a discriminative gene-expression-based classifier to predict survival outcomes of T-cell lymphoblastic lymphoma (T-LBL) patients. After exploring global gene-expression profiles of progressive (n = 22) vs. progression-free (n = 28) T-LBL patients, 43 differentially expressed mRNAs were identified. Then an eleven-gene-based classifier was established using LASSO Cox regression based on NanoString quantification. In the training cohort (n = 169), high-risk patients stratified using the classifier had significantly lower progression-free survival (PFS: hazards ratio 4.123, 95% CI 2.565–6.628; p < 0.001), disease-free survival (DFS: HR 3.148, 95% CI 1.857–5.339; p < 0.001), and overall survival (OS: HR 3.790, 95% CI 2.237–6.423; p < 0.001) compared with low-risk patients. The prognostic accuracy of the classifier was validated in the internal testing (n = 84) and independent validation cohorts (n = 360). A prognostic nomogram consisting of five independent variables including the classifier, lactate dehydrogenase levels, ECOG-PS, central nervous system involvement, and NOTCH1/FBXW7 status showed significantly greater prognostic accuracy than each single variable alone. The addition of a five-miRNA-based signature further enhanced the accuracy of this nomogram. Furthermore, patients with a nomogram score ≥154.2 significantly benefited from the BFM protocol. In conclusion, our nomogram comprising the 11-gene-based classifier may make contributions to individual prognosis prediction and treatment decision-making.

Background Gout is a common and complex form of immunoreactive arthritis based on hyperuricemia, while the symptoms would turn to remission or even got worse. So, it is hard to early identify whether an asymptomatic hyperuricemia (AHU) patient will be susceptible to get acute gout attack and it is also hard to predict the process of gout remission to flare. Here, we report that the plasma proteins profile can distinguish among acute gout (AG), remission of gout (RG), AHU patients, and healthy controls. Methods We established an isobaric tags for relative and absolute quantification (iTRAQ) and parallel reaction monitoring (PRM) based method to measure the plasma proteins for AG group ( n  = 8), RG group ( n  = 7), AHU group ( n  = 7) and healthy controls ( n  = 8). Results Eleven differentially expressed proteins such as Histone H2A, Histone H2B, Thrombospondin-1 (THBS1), Myeloperoxidase (MPO), Complement C2, Complement component C8 beta chain (C8B), Alpha-1-acid glycoprotein 1 (ORM1), Inter-alpha-trypsin inhibitor heavy chain H4 (ITIH4), Carbonic anhydrase 1 (CA1), Serum albumin (ALB) and Multimerin-1 (MMRN1) were identified. Histone H2A, Histone H2B and THBS1 might be the strongest influential regulator to maintain the balance and stability of the gout process. The complement and coagulation cascades is one of the main functional pathways in the mechanism of gout process. Conclusions Histone H2A, Histone H2B and THBS1 are potential candidate genes for novel biomarkers in discriminating gout attack from AHU or RG, providing new theoretical insights for the prognosis, treatment, and management of gout process. Trial registration This study is not a clinical trial.

Hipposponlachnins A ( 1 ) and B ( 2 ), possessing an unprecedented tetracyclo [9.3.0.0 2,8 .0 3,7 ] tetradecane ring system, and the probable biogenetic precursor [ 3 , (1 R *,2 E ,4 R *,7 E ,10 S *,11 S *,12 R *)-10, 18-diacetoxydolabella-2,7-dien-6-one] of 1 ‒ 2 were isolated from the South China Sea marine sponge Hippospongia lachne . The structures of the novel compounds were determined using integrated spectroscopic methods in combination with single-crystal X-ray diffraction analysis. Compounds 1 ‒ 2 showed potent inhibitory activity on the release of β -hexosaminidase, a biomarker for degranulation, as well as the production of pro-inflammatory cytokine IL-4 and lipid mediator LTB 4 in DNP-IgE-stimulated RBL-2H3 cells.

BackgroundTo compare the safety and efficacy of benzbromarone and febuxostat in hyperuricemia patients with estimated glomerular filtration rate (eGFR) 20–60 mL/min/1.73 m2.MethodsThis study was a single-centered, parallel-grouped, randomized clinical trial (RCT). We randomly assigned hyperuricemia participants with eGFR 20–60 mL/min/1.73 m2 into benzbromarone and febuxostat treatment group. Drugs were adjusted by titration from small doses.ResultsSeventy-three eligible participants enrolled, 66 subjects (33 in each group) were included finally for analysis. When compared to baseline, serum uric acid (SUA) decreased significantly after treatment in both groups, but no differences were detected among all the follow-up points. After 12-month treatment, eGFR did not have significant change in both groups. In the benzbromarone group, kidney stones in one case increased in quantity. In the febuxostat group, kidney stones in one case became smaller in size and in two cases vanished completely. Both drugs did not increase myocardial enzymes significantly after the treatment. In addition, hemoglobin increased significantly in the two groups (p < 0.05).ConclusionsBenzbromarone and febuxostat could reduce SUA and maintain renal function in chronic kidney disease (CKD) patients with eGFR 20–60 mL/min/1.73 m2. Urate-lowering therapy with benzbromarone or febuxostat could increase serum hemoglobin level and potentially improve anemia.

Background and Aims. Magnifying chromoendoscopy (ME-CE) through the observation of pit patterns is a productive way to distinguish between neoplastic and nonneoplastic polyps. Magnifying optical enhancement technology (ME-OE) is an emerging virtual chromoendoscopy imaging technology and appeared to be a promising approach. However, this information is currently not available. This study is aimed at comparing the differential diagnostic value of ME-CE and OE for neoplastic and nonneoplastic polyps. Patients and Methods. Consecutive patients undergoing colonoscopy were randomized (1 : 1) into examination by ME-OE or ME-CE. Histopathological findings were utilized as the reference standard. Accuracy, sensitivity, specificity, and positive and negative predictive values of two endoscopy methods were compared using ME-OE (were classified according to the JNET classification) and ME-CE (were classified according to the Kudo pit pattern classification), respectively, and the time to predict the histological polyp type was compared. And the agreements between the pathological and clinical diagnosis by ME-OE or ME-CE were analyzed. Results. A total of 365 polyps were found in the 220 patients included (ME-OE: 185; ME-CE: 180.202 had nonneoplastic polyps, 163 had neoplastic polyps). The diagnostic accuracy of ME-OE was higher than that of ME-CE (93% vs. 92%, p>0.05). The average diagnosis time was lower in ME-OE than ME-CE (83±26.4 s vs. 194±17.7 s, p<0.001). The agreements between the pathological and clinical diagnosis were at least substantial in both groups. Conclusion. ME-OE was superlative to ME-CE in predicting the histology of polyps. OE devoted classification would possibly similarly enhance the endoscopist performance. The trial is registered with ChiCT2000032075.