The coping experiences in patients with hepatocellular carcinoma and their spouses following postoperative recurrence: A dyadic qualitative study

Objective

Dyadic coping practices can vary depending on cultural contexts, socioeconomic factors, and the stages of the cancer journey. This study aimed to explore the dyadic coping experiences of hepatocellular carcinoma (HCC) patients and their spouses following postoperative recurrence in the Chinese cultural context, where cancer recurrence is frequently seen as a death sentence, and family-centered care is prioritized.

Methods

A descriptive qualitative research design was used, involving face-to-face, in-depth semi-structured interviews with 13 pairs of hepatocellular carcinoma patients and their spouses at a tertiary cancer hospital from July to October 2023. The interview guide was designed based on the Actor-Partner Interdependence Model (APIM) framework. Data were analyzed using thematic analysis, and the study adhered to the COnsolidated criteria for REporting Qualitative research (COREQ) checklist.

Results

Three themes were identified: (1) active coping strategies, (2) negative coping tendencies, and (3) the need for systematic coping support. The majority of couples perceived hepatocellular carcinoma recurrence as a death sentence, which prompted them-especially the spouses-to adopt proactive strategies, such as striving to seek advanced treatments and concealing unfavorable information. In contrast, patients, particularly those with a hereditary hepatocellular carcinoma background, often exhibited passivity, withdrawal, and contemplation of treatment abandonment. Spouses frequently felt overwhelmed and unable to alleviate their partners' anxiety about recurrence and death, particularly in the absence of support from health care professionals. They expressed a strong need for professional guidance and targeted interventions to address end-of-life concerns, emphasizing the need for increased financial support, empowerment through knowledge, and access to peer support networks.

Conclusions

This research emphasizes the importance of recognizing the interdependent coping experiences of recurrent HCC patients and their spouses. Health care professionals are encouraged to implement culturally sensitive, dyadic interventions that foster collaborative coping, address death-related anxiety, and empower couples in managing recurrence together, thereby enhancing their coping strategies and confidence.

Light-triggered nanocarriers for nucleic acid delivery

Gene therapy has evolved into a clinically viable strategy, with several approved products demonstrating its therapeutic potential for genetic disorders, cancer, and infectious diseases, and it has ample applications in regenerative medicine. Its success depends on the ability to efficiently and specifically deliver therapeutic nucleic acids (NAs) into target cells. Although viral or chemical carriers have been used in pioneering applications, safety concerns, and variable delivery efficiencies have prompted the search for alternative delivery vehicles. Light-mediated strategies have gained particular interest due to their biocompatibility and ability to improve the intracellular delivery efficiency. In this review, we focus on recent advancements in the development of light-triggered NA delivery carriers and discuss how they can be designed to overcome specific intracellular barriers. Additionally, we discuss notable therapeutic applications and highlight challenges and opportunities for translating this technology to a clinical setting.

A cascade nanoreactor based on metal azolate framework integrated natural enzyme for α-glucosidase activity assay and inhibitor screening

Enzyme cascades have attracted widespread attention owing to the exceptional specificity and efficient signals transduction, however, constrained by the high cost and limited stability of bio-enzymes. In this study, a novel mimic multienzyme nanoreactor (GOx@MAF-7(Fe), i.e. GMF) was developed through a one-step encapsulation of glucose oxidase (GOx) into a metal azolate framework, MAF-7(Fe). Benefiting from the synergistic effect of GOx and the exceptional peroxidase-like (POD) activity of MAF-7(Fe), GMF enabled a robust cascade catalytic reaction for colorimetric sensing. The unique structural and functional properties of MAF-7(Fe) not only facilitated efficient enzyme immobilization but also enhanced the stability of GOx, outperforming free enzymes in terms of storage and thermal tolerance. The GMF-based platform demonstrated high sensitivity and selectivity in glucose response. More importantly, by integrating α-glucosidase (α-Glu) into a three-enzyme cascade system, a colorimetric assay was successfully developed for α-Glu activity with a detection limit of 0.25 mU/mL, surpassing most existing methods. This platform was further applied for α-Glu inhibitor screening, with acarbose as a model inhibitor, and achieved precise quantification of inhibition efficiency (IC50 = 60.06 nM). This work not only establishes a versatile and efficient sensing platform for diabetes-related biomolecule detection but also pioneers a novel strategy for enzyme immobilization and multienzyme cascade construction, opening new avenues for multifunctional material design in biomedical research.

Deformation-resistant coaxial fiber photoelectrochemical sensor with vertical anchoring of graphene nanosheets for ultrasensitive glucose detection

Endowing microelectrode architecture with eminent light-absorbing, analyte-trapping and mechanical robustness is pivotal but challenging for state-of-the-art photoelectrochemical monitoring. Herein, an effective tactic to tackle these issues was proposed for building coaxial fiber-shaped photoelectrochemical sensor, with multiscale vertically oriented channels created by highly ordered arrangement of molecule-recognized graphene (G) nanosheets serving as photoexcitation initiator along the direction perpendicular to the core-layer carbon nanotube (CNT) fiber acting as supporting and conductive matrix. The unique architectural features enabled rapid analyte diffusion and ready light spreading to photoactive and specific recognition sites situated at all channel walls, and meanwhile rendered the device with robust structural integrity, thereby showcasing impressive glucose-assaying capability with rapid response (0.3 s), low detection limit (0.7 μM), wide linear range (4-180 μM), good long-time stability (more than 60 days), superior selectivity and deformation endurance. This work opens up a promising route for processing advanced microelectrode architectures toward highly sensitive and selective photoelectrochemical monitoring even under harsh deformations.

Nanozyme mediated Raman-NLISA dual-modal immunosensor for accurate and sensitive detection of microcystin-LR

A Raman scattering and nanozyme-linked immunosorbent assay (NLISA) dual modal immunosensor, was constructed by mesoporous SiO2/Au-Pt nanozymes (m-SAP) and nanobodies (A2.3-SBP). Oxidized TMB served as Raman and ELISA signals in a competitive binding assay. Under optimized conditions, an inverse correlation was established between the Microcystin-LR (MC-LR) concentration and the signals, spanning Raman and ELISA ranges of 0.1-100 μg L-1 and 1.0-500 μg L-1, with limit of detections (LODs, 3σ/S) of 0.015 μg L-1 and 0.12 μg L-1, respectively. The LODs showed over 90 times and 11 times higher sensitivity than that of traditional ELISA (t-ELISA, LOD, 1.36 μg L-1). The immunosensor exhibited excellent accuracy in practical samples, can be integrated together for the detection of MC-LR within 45 min, which greatly short the detection time of t-ELISA (>2 h). This method displayed potential for detecting other toxins by simply changing the nanobodies.

Nanostrategies synergize with locoregional interventional therapies for boosting antitumor immunity

Compared with traditional surgical resection, systemic chemotherapy, or radiotherapy, locoregional interventional therapies (LITs) possess their own advantages of minimally invasive procedure and immunomodulatory effects in cancer treatment. Local ablation and intravascular interventional therapy represent excellent LIT candidate to combine with immunotherapy. Diverse nanomaterials with excellent biocompatibility show promises in modulating antitumor immunity. In this review, we summarized several immune-LIT combinations, discussed the following immunomodulatory effects, and presented the novel nanostrategies for synergizing with the combination therapy. With continuous optimization, further promotion of clinical translation will ultimately benefit patients with personalized and tailored cancer strategy.

Bifunctional S-doping-mediated interfacial gradient electric field for in-situ amplified photoelectrochemical immunoassay

Ultrasensitive chemical reactions at the photoanode interface provide new ideas for the development of novel photoelectrochemical (PEC) immunoassays. Herein, we reported an in situ-promoted all-inorganic semiconductor reaction realizing an ultrasensitive PEC analysis of carcinoembryonic antigen (CEA). Uniform In2O3 nanocubes were synthesized through one-step in situ growth, and composite In2OxS3-x was obtained by one-step post-modification sulfurization, achieving ultra-high light-to-dark current switching ratios (169 times). S doping, on the one hand, lowered the band gap of In2O3 and established a gradient electric field to enhance charge separation, resulting in a substantial enhancement of the photocurrent; on the other hand, it reacted with Cu2+ released from the detection probes during the detection process to further amplify the photocurrent signal. The presence of a built-in gradient electric field of In2OxS3-x was determined by in situ X-ray photoelectron spectroscopy (XPS) and density functional theory (DFT). In the presence of CEA, CuO modified on the detection probe formed Cu2+ by exogenous acidification and therefore caused a sudden crossing of the photocurrent by forming a robust Cu-S bond with the vulcanized photoanode. Under optimized conditions, the developed PEC immunosensing system based on photoanodic interfacial reaction exhibited an ultra-wide operating range (0.05-100 ng mL-1), and an ultra-low limit of detection (13.5 pg mL-1). In conclusion, this work provides a promising in situ ultrasensitive monitoring strategy for efficient PEC bio-immunosensor, expanding the range of potential applications in early cancer analysis and bedside diagnostics.

Efficient fluorescence and electrochemiluminescence dual-signal au nanoclusters-based portable antibiotic testing platform with super-wide detection range

The convenient detection of tetracycline (TC) residues has attracted considerable attention because irrational use of TC causes food pollution damaging the human health. Herein, a point-of-care testing (POCT) platform is established for the sensitive and specific determination of TC in a polydopamine-functionalised Eppendorf tube. In particular, TC can be efficiently recognised by an aptamer-antibody chimera to trigger visual fluorescence (FL) and electrochemiluminescence (ECL) 'dual-signal' response of gold nanoclusters. Consequently, the biosensor exhibits a wide detection range spanning from 5 fM to 1 μM, with low detection limits of 73 fM (visual FL) and 2.3 fM (ECL). Hence, it can be said that the POCT platform is superior to the enzyme-linked immunosorbent assay. The strategy utilises the strength of FL, i.e. visualisation, and that of ECL, i.e. high sensitivity, providing a guiding approach for the development of POCT in food security and environmental monitoring.

Protein-inorganic hybrid flowers with a two-stage accelerated strategy for stimulated activation of CRISPR/Cas12a enhance polynucleotide kinase biosensing

Polynucleotide kinases (PNK) play a crucial role in DNA damage repair and are closely associated with specific diseases, making them promising targets for therapeutic intervention. In this study, we propose a two-stage accelerated strategy that utilizes protein-inorganic hybrid flowers (PHFs) to enhance the performance of the terminal deoxynucleotidyl transferase (TdT)-combined CRISPR/Cas12a system (TCS) for efficient detection of PNK activity. In TCS, the participation of PHFs confines the substrate probes (SPs) to a limited space, thereby significantly enhancing the local concentration of phosphorylated 3' termini of SPs and effectively promoting the enzymatic reaction kinetics as the first step in the accelerated strategy. Upon encountering the target PNK, the phosphorylated 3' termini were promptly recognized and dephosphorylated to 3'-OH termini. Subsequently, TdT catalyzed the assembly of deoxyadenosine triphosphates (dATPs) without a template, rapidly activating the CRISPR/Cas12a system by forming multiple polyadenine (poly-A) chains. PHF-fixed poly-A chains then substantially boosted the localized concentration of CRISPR/Cas12a systems and vastly enhanced their efficacy in cleaving reporter nucleic acids. Our findings indicated that the spatial confinement effect facilitated by PHFs promoted frequent molecular collisions and accelerated multiple enzymatic reactions. The developed sensing strategy allows for the detection of PNK activity within a linear range of 0.001-1 U/mL, with a detection limit of 1.82 × 10-4 U/mL. Additionally, this strategy has been successfully applied to detect PNK activity in cell extracts and to screen for PNK inhibitors. Owing to these advantages, PNK can be rapidly and accurately detected with a high sensitivity, specificity, and biostability.

A turn on fluorescent probe for nitroreductase activity and its application in real-time imaging of tumor hypoxia

Nitroreductase (NTR) is an endogenous reductase overexpressed in hypoxic tumors, with its levels closely correlated to the degree of hypoxia. This correlation has significant clinical implications for the analysis of tumor hypoxia, as it allows for the indirect detection of nitroreductases. Due to their simplicity, noninvasive nature, and excellent spatiotemporal resolution, various fluorescence methods have been developed for the analysis of nitroreductase and tumor hypoxia. In this study, we present the design, synthesis, in vitro evaluation, and biological application of an NTR-activated fluorescent probe, F-NTR. Utilizing an oxanthrene fluorophore as the core component, F-NTR incorporates a 4-nitrobenzene recognition group. This innovative probe, which introduces a nitro group, demonstrates high selectivity and reactivity towards nitroreductase (NTR) due to its reducing properties. Furthermore, probe F-NTR is capable of accurately identifying hypoxic environments, which provides a basis for precise detection and localization of tumors. This work lays the groundwork for future investigations into cell metabolism, tumor metabolism, and the surgical management of solid tumors under hypoxic conditions.

Square-shaped Cu2MoS4 loaded on three-dimensional flower-like AgBiS2 to form S-scheme heterojunction as a light-driven photoelectrochemical sensor for efficient detection of serotonin in biological samples

Serotonin (5-HT) is a crucial neurotransmitter in the body, with its levels being particularly significant for life safety. Here, we designed the AgBiS2/Cu2MoS4 S-scheme heterojunction by uniformly immobilizing lamellar Cu2MoS4 on the surface of three-dimensional (3D) flower-like AgBiS2 using a simple physical mixing technique. In this case, AgBiS2 and Cu2MoS4 are bonded together by electrostatic attraction to form an active surface with a large specific surface area. Subsequently, the detector 5-HT bound to AgBiS2/Cu2MoS4/GCE undergoes hole oxidation and the photocurrent signal increases significantly. Meanwhile, the reaction mechanism of AgBiS2/Cu2MoS4 composite material was investigated through density functional theory calculations. The AgBiS2/Cu2MoS4/GCE sensor demonstrates a low detection limit of 0.046 nM and a wide linear range (0.0001-8 μM). Furthermore, by comparing UV-Vis spectrophotometry and fluorescence spectroscopy for the detection of 5-HT in human serum, it was proved that the sensor has an impressive recovery rate.

Embryonic exposure to GenX causes reproductive toxicity by disrupting the formation of the blood-testis barrier in mouse offspring

As a replacement for perfluorooctanoic acid, hexafluoropropylene oxide dimer acid, commercially referred to as "GenX", has attracted significant attention. However, a comprehensive understanding of the reproductive systems of male offspring exposed to GenX is lacking. This study aimed to investigate how embryonic exposure to GenX affects the reproductive development of male offspring and the underlying mechanisms. We administered GenX daily via gavage (2 mg/kg body weight/day) to the mice from day 12.5 of pregnancy until delivery. Our results suggested that embryonic exposure to GenX led to delayed onset of puberty in male offspring, with destruction of the testicular structure, disruption of the blood-testis barrier, decreased serum testosterone levels, decreased sperm count, impaired sperm motility, and increased rates of sperm abnormalities. We investigated the mechanism of blood-testis barrier breakdown in vitro by treating Sertoli cells (TM4) with GenX. GenX exposure caused the accumulation of senescent TM4 cells, decreased their glutathione (GSH) levels, and increased their oxidized glutathione levels. GenX inhibited glutaminase activity in TM4 cells, leading to decreased GSH synthesis, increased intracellular oxidative stress, and subsequent TM4 cell senescence, ultimately compromising the blood-testis barrier. Our findings indicated that embryonic exposure to GenX may cause Sertoli cell senescence by altering glutamine metabolism, disrupting the blood-testis barrier, and resulting in abnormal reproductive development in male offspring.

Jianpi Huayu decoction enhances the antitumor effect of doxorubicin via piezo1-mediated autophagy in hepatocellular carcinoma

BACKGROUND

Hepatocellular carcinoma (HCC) carries a poor prognosis, especially in advanced stages. Although Piezo1, a mechanosensitive ion channel, is linked to HCC progression, its underlying mechanisms and therapeutic potential remain poorly understood.

METHODS

Piezo1 expression in HCC and its correlation with prognosis were assessed using TCGA and GEO datasets, along with clinical tissue samples. The role of Piezo1 in HCC malignancy and autophagy was investigated in MHCC97H cells via siRNA-mediated silencing. A DEN-induced Piezo1-knockout mouse model and an shPiezo1-transfected MHCC97H xenograft nude mouse model were also used to evaluate the role of Piezo1 in tumor development and growth. The effects of Jianpi Huayu decoction (JPHY), doxorubicin (DOX), and combined treatment on malignant phenotypes and autophagy were examined in MHCC97H cells as well as an allogeneic transplantation model. Shared pathways between JPHY and DOX were identified by network pharmacology analysis and validated by molecular biology experiments. Molecular docking studies analyzed interactions between JPHY active components and Piezo1.

RESULTS

Piezo1 was overexpressed in HCC tissues and correlated with poor prognosis. Piezo1 knockdown suppressed malignancy and enhanced autophagy in MHCC97H cells. In Piezo1+/- mice, the size and number of DEN-induced liver tumors were reduced by approximately 60 % and 45 %, respectively. Tumor growth was also suppressed in nude mice transplanted with shPiezo1-transfected MHCC97H cells. JPHY combined with DOX enhanced the antitumor effect and increased treatment sensitivity. Network pharmacology analysis revealed common targets of JPHY and DOX, enriched in the PI3K/AKT pathway. Both JPHY and DOX downregulated Piezo1 expression and inhibited the PI3K/AKT/mTOR pathway, while the combination demonstrated an even greater efficacy. The combination of JPHY and DOX reduced xenograft tumor size by approximately 40 % compared to DOX alone, without apparent hepatic or renal toxicity.

CONCLUSION

This study uncovers a novel mechanism by which JPHY enhances DOX sensitivity in HCC, acting through modulation of Piezo1-mediated autophagy via the PI3K/AKT/mTOR pathway.

Porous platinum nanozyme-amplified capacitance immunoassay for alpha-fetoprotein with hepatocellular carcinoma on an interdigitated gold micro-comb array

BACKGROUND

Hepatocellular carcinoma, one of the most common malignancies, is the worldwide three cause leading the mortality of cancers. Alpha-fetoprotein (AFP) is a typical tumor marker for the recurrences of HCC, and can be utilized potentially during routine follow-up after HCC resection. Therefore, sensitive and accuracy detection of AFP is very critical at the early stage of hepatocellular carcinoma.

RESULTS

In this work, an in-situ amplified capacitance immunoassay was designed for highly sensitive determination of AFP in biological fluids. The capacitance immunosensor was fabricated by means of immobilizing anti-AFP capture antibodies on an interdigitated gold micro-comb array through a carbodiimide coupling method. Porous platinum nanoparticles (PtNPs) were used for the labeling of anti-AFP detection antibody. The presence of target analyte induced the formation of the sandwiched immunocomplex between capture antibody and detection antibody. The carried porous PtNPs with peroxidase-like activity catalyzed 4-chloro-1-naphethol oxidation to produce an insoluble benzo-4-chlorohexadienone precipitation in the presence of hydrogen peroxide. The precipitation was coated on the micro-comb electrode, thus causing the capacitance change. Two labeling protocols including porous PtNPs and solid PtNPs were investigated for determination of AFP, and improved analytical features were acquired with porous PtNPs. Under optimal conditions, porous PtNP-based capacitance immunoassay gave a good linear response from 0.01 ng mL-1 to 300 ng mL-1 AFP with a detection limit of 7.4 pg mL-1. Good reproducibility, high specificity and long-term stability were also achieved. In addition, 15 human serum specimens were determined through our method, and the results were in accordance with those obtained from commercial AFP enzyme-linked immunosorbent assay.

SIGNIFICANCE

This capacitance immunoassay offers promise for sensitive and cost-effective detection of cancer biomarkers without the requirement of natural enzymes. Importantly, porous PtNP-based labeling strategy opens a new horizon for advanced development of capacitance immunoassays.

Multifunctional nanozymes: Promising applications in clinical diagnosis and cancer treatment

Cancer remains one of the greatest challenges in modern medicine. Traditional chemotherapy drugs often cause severe side effects, including nausea, vomiting, diarrhea, neurotoxicity, liver damage, and nephrotoxicity. In addition to these adverse effects, high recurrence and metastasis rates following treatment pose significant challenges for clinicians. There is an urgent need for novel therapeutic strategies to improve cancer treatment outcomes. In this context, nanozymes-artificial enzyme mimetics-have attracted considerable attention due to their unique advantages, including potent tumor-killing effects, enhanced biocompatibility, and reduced toxicity. Notably, nanozymes can dynamically monitor tumors through imaging and tracing. The multifunctional nanozyme (MN) is a promising research focus, integrating multiple catalytic activities, signal enhancement, sensing capabilities, and diverse modifications within a single nanozyme system. MNs can selectively target tumor regions, facilitating synergistic effects with other cancer therapies while enabling real-time imaging and tumor tracking. In this review, we first categorize MNs based on their composition and structural characteristics. We then discuss the primary mechanisms by which MNs exert their anticancer effects. Additionally, we review three types of MN biosensors and four MN-based therapeutic approaches applied in cancer treatment. Finally, we highlight the current challenges in MN research and provide an outlook on future developments in this field.

Biomimetic nanocrystals co-deliver paclitaxel and small-molecule LF3 for ferroptosis-combined chemotherapy for gastric cancer

Combination chemotherapy is considered more effective than monotherapy in enhancing clinical outcomes. Ferroptosis, a unique form of regulated cell death, has been demonstrated to inhibit tumor growth and progression. Consequently, combining ferroptosis with chemotherapy represents a promising and innovative approach to antitumor therapy. In this study, we developed a novel TMTP1-modified biomimetic nanocrystal (TRNC@P + L) for the co-delivery of PTX and LF3, aiming to achieve ferroptosis-combined chemotherapy in gastric cancer. TRNC@P + L, which incorporates a tumor-homing peptide-modified red blood cell membrane, demonstrated efficient tumor targeting, prolonged circulation, enhanced drug bioavailability, and reduced non-specific toxicities of free PTX and LF3. By utilizing the synergistic effects of PTX and LF3, TRNC@P + L combination therapy significantly inhibited tumor growth, as demonstrated by both in vitro and in vivo studies. Mechanistically, TRNC@P + L triggers ferroptosis in tumor cells by downregulating GPX4 expression, the promotion of ROS accumulation, and the enhancement of lipid peroxidation. These processes synergistically enhance the anticancer efficacy of PTX.

MRI-based microvascular invasion prediction in mass-forming intrahepatic cholangiocarcinoma: survival and therapeutic benefit

OBJECTIVES

To establish an MRI-based model for microvascular invasion (MVI) prediction in mass-forming intrahepatic cholangiocarcinoma (MF-iCCA) and further evaluate its potential survival and therapeutic benefit.

METHODS

One hundred and fifty-six pathologically confirmed MF-iCCAs with traditional surgery (121 in training and 35 in validation cohorts), 33 with neoadjuvant treatment and 57 with first-line systemic therapy were retrospectively included. Univariate and multivariate regression analyses were performed to identify the independent predictors for MVI in the traditional surgery group, and an MVI-predictive model was constructed. Survival analyses were conducted and compared between MRI-predicted MVI-positive and MVI-negative MF-iCCAs in different treatment groups.

RESULTS

Tumor multinodularity (odds ratio = 4.498, p < 0.001) and peri-tumor diffusion-weighted hyperintensity (odds ratio = 4.163, p < 0.001) were independently significant variables associated with MVI. AUC values for the predictive model were 0.760 [95% CI 0.674, 0.833] in the training cohort and 0.757 [95% CI 0.583, 0.885] in the validation cohort. Recurrence-free survival or progression-free survival of the MRI-predicted MVI-positive patients was significantly shorter than the MVI-negative patients in all three treatment groups (log-rank p < 0.001 to 0.046). The use of neoadjuvant therapy was not associated with improved postoperative recurrence-free survival for high-risk MF-iCCA patients in both MRI-predicted MVI-positive and MVI-negative groups (log-rank p = 0.79 and 0.27). Advanced MF-iCCA patients of the MRI-predicted MVI-positive group had significantly worse objective response rate than the MVI-negative group with systemic therapy (40.91% vs 76.92%, χ2 = 5.208, p = 0.022).

CONCLUSION

The MRI-based MVI-predictive model could be a potential biomarker for personalized risk stratification and survival prediction in MF-iCCA patients with varied therapies and may aid in candidate selection for systemic therapy.

KEY POINTS

Question Identifying intrahepatic cholangiocarcinoma (iCCA) patients at high risk for microvascular invasion (MVI) may inform prognostic risk stratification and guide clinical treatment decision. Findings We established an MRI-based predictive model for MVI in mass-forming-iCCA, integrating imaging features of tumor multinodularity and peri-tumor diffusion-weighted hyperintensity. Clinical relevance The MRI-based MVI-predictive model could be a potential biomarker for personalized risk stratification and survival prediction across varied therapies and may aid in therapeutic candidate selection for systemic therapy.

Target-induced oxygen vacancy on the etching WO3 photoanode for in-situ amplified photoelectrochemical immunoassay

Sluggish charge transfer and rapid electron-hole recombination severely limit the analytical performance of photoelectrochemical (PEC) immunoassays. This work presented a PEC immunosensing strategy that employed a target-induced enzyme-catalyzed reaction to in-situ generate oxygen vacancy (Ov) for amplifying the photocurrent detection of carcinoembryonic antigen (CEA). Concretely, ascorbic acid-2-phosphate (AAP) was catalyzed to produce ascorbic acid (AA) by alkaline phosphatase (ALP) in the presence of CEA. The generated AA could serve as a reducing agent to introduce oxygen vacancy (Ov) into the etching tungsten trioxide (E-WO3) photoanode, resulting in an Ov-enriched E-WO3 (E-WO3-Ov) photoanode. The formation of Ov allowed efficient introduction of defect levels into the energy band structure of E-WO3-Ov photoanode, resulting in high charge transfer and electron-hole separation efficiency for photocurrent amplification. Later, it was applied to fabricate a PEC immunosensor, thus enabling a wide linear range from 0.02 to 80 ng/mL and a low detection limit of 12.9 pg/mL. Overall, this work presented a promising sensing strategy for PEC immunosensors, expanding the scope of potential applications in bioassays and clinical diagnostics.

A three-stage amplified pressure bioassay for sensitive detection of cardiac troponin

Cardiac troponin I (cTnI) level in human blood is a key biomarker associated with acute myocardial infarction (AMI). Rapid, convenient, inexpensive and highly sensitive point-of-care (POC) bioassays for cTnI in home and community are of great importance in saving the lives of AMI patients. Herein, we present a three-stage amplified pressure-sensing bioassay system for highly sensitive detection of cTnI. Specifically, the magnetic bead-cTnI-Pt nanoclusters protein complex formed by the immunoconjugation of antigen and antibody can be conveniently subjected to magnetic separation to reduce background interference and achieve first-stage amplification. Then, the Pt nanoclusters in the complex can effectively catalyze the decomposition of H2O2 into O2, thus achieving the secondary amplification of the pressure signal. Finally, the biotin and streptavidin cross-linked Pt nanoclusters significantly increase the amount of catalyst, enabling the tertiary amplification of the bioassay. The method has good linearity in the range of 10 to 1 × 104 pg/mL for quantitative detection, and the detection limit of the method was calculated to be 3.8 pg/mL (in water), which is 30 times more sensitive than the original secondary amplification detection system. In addition, the results of clinical samples tested with the developed method were consistent with those tested with commercial kits. Given the automation, rapid response and miniaturization of pressure-based sensors, our bioassay is expected to be a powerful tool for home and community-based POC diagnosis of patients with various acute diseases in the future.

Low prealbumin level is a poor prognostic biomarker for surgically treated pancreatic cancer

The present study aimed to evaluate the clinicopathological and prognostic significance of preoperative prealbumin levels in patients with surgically treated pancreatic cancer. The present retrospective study included 95 patients with pancreatic cancer who underwent radical surgery between January 2011 and December 2021. Of the patients, 49 were male and 46 were female, with a median age of 73 years. According to the median preoperative prealbumin level of 21.1 mg/dl, the patients were divided into low (<21.1 mg/dl) and high (≥21.1 mg/dl) prealbumin groups. Univariate and multivariate analyses were performed to evaluate the prognostic significance of prealbumin levels. Notably, no clinicopathological factors were associated with low prealbumin levels. Overall (P=0.008) and recurrence-free (P=0.004) survival were significantly lower in the low prealbumin group than those in the high prealbumin group. In addition, multivariate analysis showed that low prealbumin levels were an independent risk factor for poor overall (P=0.024) and recurrence-free (P=0.013) survival. Furthermore, the liver (P=0.038) and peritoneal recurrence (P=0.012) rates were higher in the low prealbumin group than those in the high prealbumin group. In conclusion, low preoperative prealbumin levels may be a poor prognostic biomarker in patients with surgically treated pancreatic cancer.

Biosensing of single-nucleotide polymorphism: Technological advances and their transformative applications on health

Single nucleotide polymorphisms (SNPs) are important genetic changes related to many diseases such as breast cancer, Alzheimer's disease, and β-thalassemia. Because of the increased interest in biosensor technologies, there has been a notable surge in the creation of new techniques to identify these changes in recent years. These new methods are highly accurate and sensitive, cost-effective and fast, making them ideal for use in clinical analysis. The non-invasive nature of biosensing techniques further enhances their integration into clinical protocols and point-of-care diagnostics. Several electrochemical, optical, and mass-based biosensors are carefully examined in this extensive review; each is distinguished by unique sensing platforms and techniques. This review presents in-depth discussions of linear dynamic ranges, detection limits, and real-world applications of contemporary research in the diagnosis of biological substrate disorders.

The role and application of Coronin family in human tumorigenesis and immunomodulation

The Coronin family, a class of actin-binding proteins involved in the formation and maintenance of cytoskeleton structural stability, is aberrantly expressed in various tumors, including lung, gastric and head and neck cancers. They can regulate tumor cell metabolism and proliferation through RAC-1 and Wnt/β-Catenin signaling pathways and regulate invasion by influencing the PI3K, PAK4, and MT1-MMP signaling pathways and impacting the actin-network dynamics. In recent years, an increasing number of studies have highlighted the crucial roles of the cytoskeleton and immune modulation in the occurrence and development of tumors. The article delves into the Coronin family's pivotal role in tumor immune evasion, highlighting its modulation of neutrophil, T cell, and vesicular transport functions, as well as its interactions with tumorigenesis related organelles such as the endoplasmic reticulum, Golgi apparatus, mitochondria, and lysosomes. It also summarizes the potential therapeutic applications of the Coronin family in oncology. This review provides valuable insights into the mechanisms through which the Coronin family is implicated in the onset and progression of tumors. It also provides more theoretical foundation for tumor immunotherapy and combination drug therapy.

A colorimetric and photocurrent-polarity-switching photoelectrochemical dual-mode biosensor for the ultrasensitive detection of DNA damage biomarker and rapid screening of genotoxic chemicals

Phosphorylated histone H2AX (γH2AX), an early sensitive biomarker for DNA damage and a key indicator of genotoxicity, has been reliably used to screen for genotoxic chemicals. However, developing a sensitive and visual method for detecting γH2AX in cells, especially through a switchable dual-mode detection system using a multifunctional sensing material, remains a significant challenge. Herein, a dual-mode sensing platform was constructed for γH2AX detection, utilizing a novel multifunctional Bi-doped Bi2MoO6 (Bi/Bi2MoO6)-powered colorimetric (CL) and photocurrent-polarity-switching photoelectrochemical (PEC) system. Thanks to Bi doping, Bi/Bi2MoO6 exhibited excellent peroxidase-like activity and photocatalytic properties, allowing it to simultaneously satisfy H2O2-mediated CL-PEC dual-mode sensing. Based on the γH2AX-associated sandwich immunoreaction and glucose oxidase catalysis reaction in the microplates, the signaling factor H2O2 was obtained. Afterward, H2O2 was transferred to the catalytic system containing Bi/Bi2MoO6 and TMB to obtain visual γH2AX detection, with a low detection limit of 70.8 fg/mL. Meanwhile, H2O2 effectively switched the photocurrent polarity of the ITO/Bi/Bi2MoO6 from anode to cathode due to their well-matched potentials, thus leading to the highly sensitive and selective PEC assay of γH2AX, with an ultralow detection limit of 0.32 fg/mL. This is 20,000 times lower than the reported best detection performance (6.78 pg/mL), significantly ensuring the ultrasensitive detection of low-abundance γH2AX and accurate chemical toxicity screening. Additionally, this sensor showed good practicability in cells exposed to known genotoxic chemicals. Finally, using our constructed sensor, four emerging pollutants, including PFOA, PFOS, OBS, and PFAN, were quickly screened to identify potential genotoxicity. Surprisingly, PFOA exhibited the strongest toxic effects, which is a significant finding that enables us to anchor PFOA for further toxicity mechanism studies. In short, this work provides a convenient, rapid, reliable and accurate genotoxicity screening tool for chemicals.

Inhibition effect-involved colorimetric sensor array based on PtBi aerogel nanozymes for discrimination of antioxidants

Nanozymes, as superior alternatives to natural enzymes, frequently employ the inhibition effect in turn-off sensors for analyte detection. However, limited attention has been paid to the inhibition mechanisms between analytes and nanozymes, limiting advancements in nanozyme-based sensing. Benefiting from the synergistic effects between three-dimensional network structure of aerogel and ligand effect triggered electronic regulation, Pt100Bi2 aerogel nanozymes (Pt100Bi2 ANs) exhibit superior peroxidase-like activity (293.48 U/mg). We found that antioxidants are able to inhibit the peroxidase-like activity of Pt100Bi2 ANs. The inhibition type (gallic acid as model) is reversible mixed-inhibition with the inhibition constants (Ki and Ki') of 0.213 mM and 0.108 mM. The inhibition effect-involved colorimetric sensor arrays were developed to overcome the "lock-key" limitation of traditional sensors, enabling distinguish five antioxidants via principal component analysis, with detection limit below 2 μM. This work provides new perspective on the inhibition mechanisms of nanozymes and optimization strategies for high-performance nanozyme-based sensors.

Preoperative model for predicting early recurrence in hepatocellular carcinoma patients using radiomics and deep learning: A multicenter study

BACKGROUND

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. Ablation therapy is one of the first-line treatments for early HCC. Accurately predicting early recurrence (ER) is crucial for making precise treatment plans and improving patient prognosis.

AIM

To establish an intratumoral and peritumoral model for predicting ER in HCC patients following curative ablation.

METHODS

This study included a total of 288 patients from three Centers. The patients were divided into a primary cohort (n = 222) and an external cohort (n = 66). Radiomics and deep learning methods were combined for feature extraction, and models were constructed following a three-step feature selection process. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), while calibration curves and decision curve analysis (DCA) were used to assess calibration and clinical utility. Finally, Kaplan-Meier (K-M) analysis was used to stratify patients according to progression-free survival (PFS) and overall survival (OS).

RESULTS

The combined model, which utilizes the light gradient boosting machine learning algorithm and incorporates both intratumoral and peritumoral regions (5 mm and 10 mm), demonstrated the best predictive performance for ER following HCC ablation, achieving AUCs of 0.924 in the training set, 0.899 in the internal validation set, and 0.839 in the external validation set. Calibration and DCA curves confirmed strong calibration and clinical utility, whereas K-M curves provided risk stratification for PFS and OS in HCC patients.

CONCLUSION

The most efficient model integrated the tumor region with the peritumoral 5 mm and 10 mm regions. This model provides a noninvasive, effective, and reliable method for predicting ER after curative ablation of HCC.

ID-CRISPR: A CRISPR/Cas12a platform for label-free and sensitive detection of rare mutant alleles using self-interference DNA hydrogel reporter

Accurate and sensitive detection of single nucleotide variants (SNVs) is paramount for cancer diagnosis and treatment. The CRISPR/Cas12a system shows promise for SNV detection due to its high sensitivity and single-base specificity. However, most CRISPR/Cas12a-based methods rely on F/Q-labeled single-stranded DNA (ssDNA) reporters, which are susceptible to fluorescence fluctuations, thereby reducing accuracy. To address these limitations, researchers have proposed using DNA hydrogels as signal transducers in CRISPR/Cas12a systems. Yet, the encapsulation of indicators into DNA hydrogels introduces additional instability, which could compromise both detection sensitivity and linearity. In this study, we integrated hyperspectral interferometry into a DNA hydrogel-based CRISPR/Cas12a detection platform (ID-CRISPR) to achieve sensitive label-free SNV detection. Using EGFR L858R SNV as a model target, we demonstrated that ID-CRISPR can detect mutant allele frequencies (MAFs) as low as 0.1% with a limit of detection (LOD) of 5 aM, while also showing its potential for quantifying SNV abundance. Its clinical utility was confirmed through analysis of lung tumor samples, with results consistent with sequencing data. Therefore, ID-CRISPR provides a sensitive, label-free, and user-friendly platform for SNV detection, offering new insights into combining optical sensing with DNA hydrogel technology in CRISPR/Cas assays.

Harnessing bifunctional nanozyme with potent catalytic and signal amplification for innovating electrochemical immunoassay

Nanozyme-based electrochemical biosensors have emerged as an alternative to enzyme-based biosensors for next-generation bioanalysis. However, potential antibody modifications limit the catalytic sites of the nanozyme, thereby reducing sensor sensitivity. Here, a sensitive method for determining carcinoembryonic antigen (CEA) was developed. It involved coupling a cascade enzyme - enzyme - like catalytic reaction using Fe - Co Prussian blue analog nanozymes with high peroxidase - like activity (79.42 U mg-1). Briefly, the transduction of biological signals to chemical signals was achieved through the strategy centered on catalytic electroactive probes. Thereafter, with the assistance of the microelectrochemical workstation, the output of signals was realized. The platform exhibited an ultra-wide range of 0.020-100 ng mL-1 and a detection limit of 0.013 ng mL-1 CEA, which was mainly attributed to the excellent peroxidase activity, good conductivity, and synergistic amplification of current signals of synthesized nanozymes. In addition, the modification-free features greatly reduced the complexity of the bioassay and significantly improves its portability and cost-effectiveness. Overall, this study advances the development of nanozymes and their electrochemical biosensing applications and is expected to extend to the development of miniaturized devices in direct detection environments.

Evaluating and improving the accuracy of pediatric infusion dose using PDCA combined with HPLC: a quality improvement study from China

BACKGROUND

Accurate formulation of an intravenous infusion is critical in ensuring its smooth implementation. However, in clinical practice, owing to the diverse reasons for drug preparation, some patients cannot obtain safe and accurate medications, especially in pediatric infusion rooms. Pediatric patients often experience adverse reactions as the dosage administered does not meet the requirements or exceeds the recommended dose.

METHODS

Finished product infusion of potassium sodium dehydroandrographolide succinate (PSDS) was used as the study drug. Drug residue samples from the finished product infusion bags were collected randomly in the pediatric infusion room and clinical wards before (from October 2022 to December 2022) and after (from May 2023 to July 2023) the plan-do-check-action (PDCA) cycle intervention. High-performance liquid chromatography (HPLC) was used to determine the drug content. Comparisons of the changes in the proportion of the drug in the infusion were made based on the monitoring results.

RESULTS

After PDCA cycle intervention, the qualified rates of whole, non-whole, and overall infusions increased from 92.95%, 82.68%, and 86.59% to 97.56%, 95.12%, and 96.10% (P < 0.05), respectively. The accuracy and uniformity of the infusion preparations significantly improved.

CONCLUSIONS

The combination of HPLC and PDCA cycle management can effectively improve the quality of pediatric infusion preparations and enhance their effectiveness.

Bidirectional roles of nanoenzymes in enhancing GPC3-CAR T cell infiltration and cancer immunotherapy

BACKGROUND

Vascular abnormalities and hypoxia in solid tumors limit the efficacy of chimeric antigen receptor (CAR) T-cell therapy. This study proposes a biomimic nanoenzyme, Lenv@BSA-PtNPs, combining platinum nanoparticles (PtNPs) and lenvatinib, to address these challenges in a hepatocellular carcinoma (HCC) nonobese diabetic (NOD) mice model.

METHODS

Lenv@BSA-PtNPs were designed using albumin as a solubilizer, embedding lenvatinib via hydrophobic interactions and facilitating in situ PtNPs generation. The nanoenzyme functions as a catalase, converting H2O2 to O2, downregulating hypoxia-inducible factor (HIF-1), and normalizing tumor vasculature. Its efficacy was evaluated in a glypican-3 (GPC3)-CAR T-cell therapy model for HCC.

RESULTS

Lenv@BSA-PtNPs significantly improved tumor oxygenation, normalized vasculature, and enhanced GPC3-CAR T-cell infiltration into tumors. This led to potent antitumor effects and prolonged survival in the HCC mouse model.

CONCLUSIONS

Lenv@BSA-PtNPs provide a simple and effective strategy to enhance CAR-T cell accumulation and efficacy by ameliorating hypoxia and normalizing tumor vasculature, offering a promising approach for improving CAR-T therapy in solid tumors.

Anticancer potential of eugenol in hepatocellular carcinoma through modulation of oxidative stress, inflammation, apoptosis, and proliferation mechanisms

This investigation explored the chemopreventive effects of eugenol on diethylnitrosamine (DENA) and acetylaminofluorene (AAF)-induced hepatocellular carcinoma (HCC) in Wistar rats. To induce HCC, DENA was administered intraperitoneally once per week for two weeks at a concentration of 150 mg/kg body weight (b.w.), followed by oral AAF administration for 3 weeks, four times a week, at a dosage of 20 mg/kg b.w. After these three weeks, the rats were treated with eugenol every other day for 17 weeks at a dosage of 20 mg/kg b.w. In vitro, eugenol reduced cell viability (IC50 of 189.29 µg/mL) and inhibited cell migration in the HCC cell line HepG2. Moreover, eugenol treatment in DENA/AAF-induced rats significantly improved cancerous histopathological changes and reduced inflammatory cell infiltration in the liver. Eugenol treatment significantly reduced the activity levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP), along with the levels of total bilirubin (TBIL), alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA 19-9), lipid peroxides (LPO), tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β). Additionally, the expressions of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), interleukin-8, C-X-C Motif Chemokine Receptor 3 (CXCR3), B-cell lymphoma 2 (Bcl-2), IQ Motif Containing GTPase Activating Protein 1 (IQGAP1), IQ Motif Containing GTPase Activating Protein 3 (IQGAP3), Harvey rat sarcoma viral oncogene homolog (HRAS), Kirsten rat sarcoma viral oncogene homolog (KRAS), and Ki-67 were downregulated following eugenol administration in DENA/AAF-induced HCC. Conversely, eugenol supplementation significantly enhanced glutathione (GSH) content, as well as the activities of glutathione peroxidase (GPx) and superoxide dismutase (SOD), and the levels of nuclear factor erythroid 2-related factor 2 (Nrf2). Furthermore, the expressions of tumor suppressor gene p53, Bcl-2-associated X protein (BAX), death receptor 4 (DR4), death receptor 5 (DR5), decoy receptor 1 (DcR1), programmed cell death 5 (PDCD5), and IQ Motif Containing GTPase Activating Protein 2 (IQGAP2) were markedly upregulated compared to the DENA/AAF-administered group. These findings indicate that the potent anticancer effects of eugenol are primarily driven by its ability to reduce oxidative stress, suppress inflammation, and inhibit cell proliferation while promoting apoptosis. This study underscores the potential of eugenol as a promising therapeutic agent for the prevention and management of HCC, offering a novel approach to HCC treatment.

Dual-metal CuFe/Fe cube nanozyme with Prussian blue analogue for highly efficient colorimetric immunoassay

Due to unique framework structures, Prussian blue analogs (PBAs) have long been of considerable interest in biosensing. However, the predominantly cubic morphology of most PBAs, along with their inherent elemental and structural limitations, restricts their catalytic performance as the nanozymes. Herein, we designed a dual-metal CuFe/Fe PBA nanozyme composite (CuFe/Fe DMPBA) exhibiting excellent peroxidase (POD)-like activity. The synthesized FePBA was prismatically loaded along the inner core CuFe PBA to build an epitaxially deposited structure. This unique architecture resulted in a substantial enhancement of the POD-like activity of the composite nanozyme compared to its individual components, FePBA and CuFe PBA. Leveraging the superior catalytic performance of the synthesized CuFe/Fe DMPBA, we further developed a highly sensitive and selective colorimetric immunoassay platform for the detection of human epidermal growth factor receptor 2 (HER2), a crucial biomarker of cancer. Under optimized conditions, this nanozyme-based immunoassay platform achieved a limit of detection (LOD) of 0.007 ng mL-1 and a linear range from 0.01 to 10 ng mL-1 for HER2 detection. This work not only presents a novel strategy for synthesizing high-performance PBA-based nanozymes, but also provides insights for the rational design and application of PBA materials in bioanalytical sensing.

Reconfiguration/Immobilization "Dual-Free" Self-Powered Multiplex Photoelectrochemical Strategy for Dual Magnetic Bead-Mediated Dimension Differentiate Type Complex Sample Assay

Despite significant advances in single-interface multiplex photoelectrochemical (PEC) sensors, their potential in high-throughput complex sample analysis is still limited by time-consuming immobilization and cumbersome surface reconfiguration procedures. Particularly for the rapidly growing demand for point-of-care testing, there is an urgent need to explore fast, low-consumption, and sustainable multisignal differentiation approaches ready for implantation into a portable sensor. Herein, a dual magnetic bead-mediated reconfiguration/immobilization "dual-free" strategy is proposed for self-powered PEC sensing of multiple targets on a single electrode. The dual magnetic bead-mediated dimension-differentiated system is formed by two size-differentiated magnetic beads (MBs) and methylene blue-loaded liposomes (MLLs). A large MB is involved in obtaining the MLL signal label via magnetic separation, which modulates the electron transfer mechanism and generates a detection signal. After physically controlled release, the small MB (second signal label) magnetically anchors at the electrode interface to produce another detection signal. By circumventing chemical immobilization and interface reconfiguration, the "dual-free" strategy realizes the rapid, low-cost, sequential, and nondestructive detection of coexisting antibiotics (kanamycin and tobramycin). To further reduce the dimensions and power consumption of the sensing device, a self-powered dual-photoelectrode system is established and instrumented. The reconfiguration/immobilization "dual-free" self-powered sensor eliminates cross-interference, preserves electrode integrity, and avoids external power requirements, thereby pioneering a universal approach for developing miniaturized PEC sensors with great promise for point-of-care testing.

Point-of-care analysis for foodborne pathogens in food samples based on a fully enclosed microfluidic chip cartridge

Foodborne pathogens endanger public health and rapid, sensitive, and accurate detection of them is vital. Portable, highly integrated detection devices have great application prospects in the screening and analysis of foodborne pathogens. In this study, a fully automated detection device based on a fully enclosed microfluidic chip cartridge was successfully designed. This device integrates multiple functions, including nucleic acid extraction, reagent preparation, LAMP reaction, and signal detection. By simply adding a sample, it can simultaneously detect four types of foodborne pathogens, making it advantageous for the analysis of complex samples and improving detection accuracy. Additionally, freeze-dried reagents are integrated into the fully enclosed microfluidic chip cartridge, which allows the reagents to be transported and stored at room temperature, greatly reducing the cost of detection. It has been successfully applied in actual samples contaminated with multiple foodborne pathogens and has excellent stability. The entire detection process can be completed in 45 minutes, with a sensitivity of approximately 500 CFU mL-1. Therefore, the automated microfluidic device would be adequate for point-of-care testing (POCT) with high simplicity and high speed, providing an advanced genetic analysis microsystem for foodborne pathogen detection.

Dual-Mode Photoelectrochemical/ColoriMetric Biosensor with a Broad Linear Range for the Sensitive Detection of Enrofloxacin in Aquatic Products

In this study, an integrated dual-mode biosensor combining photoelectrochemical (PEC) and colorimetric (CL) methods was proposed to broaden the linear detection range of enrofloxacin (ENR), thus enabling sensitive detection of ENR in aquatic products. Compared to traditional PEC/CL dual-mode biosensors that rely on the same sensitizer for both PEC and CL signals, this biosensor expanded the linear range and enhanced sensitivity by separating the sensitizer of PEC and the signal label of CL. Specifically, the PEC detection platform employed a Z-type heterojunction of iron indium sulfide (FeIn2S4) and cadmium sulfide (CdS) to significantly improve the photoelectric conversion efficiency for the sensitivity of PEC detection. Furthermore, based on an entropy-driven catalytic nucleic acid circuit (ETSD) strategy mediated by aptamers, ENR was converted into a mass of output DNA. Subsequently, the output DNA triggered a strand displacement reaction mediated by a palindrome-catalyzed DNA assembly (NEPA) to form a three-dimensional gold nanoparticle-DNA nanocomposite for the adsorption of methylene blue (3D Au-DNA NC-MB). The resulting 3D Au-DNA NC-MB biomolecular nanocarrier was then used in PEC detection for trace ENR with a linear detection range of 10-5-102 ng·mL-1. Concurrently, the unadsorbed MB solution was used in CL detection for a high level of ENR with a linear detection range from 10-1 to 104 ng·mL-1. Finally, the method was successfully applied to detect ENR in aquatic products with higher sensitivity and a wider linear range than most reported detection methods, which is anticipated for use in food safety and environmental surveillance.

Intraoperative Blood Transfusion has a Distinct Impact on the Long-Term Prognosis of Hepatocellular Carcinoma Patients With Different Alpha-Fetoprotein-Tumor Burden Scores After Liver Resection: A Large-Scale Multicenter Study

BACKGROUND

To identify the influence of intraoperative blood transfusion (IBT) on the long-term prognosis of patients with hepatocellular carcinoma (HCC) in patients with low/medium alpha-fetoprotein-tumor burden scores (ATSs) and high ATSs.

METHODS

Data from HCC patients (n = 3374) who underwent liver resection between 2014 and 2022 from a multicenter database were reviewed. The impact of IBT on overall survival (OS) and recurrence-free survival (RFS) in the whole cohort, low/medium ATS group, and high ATS group was evaluated via multivariate analyses, respectively.

RESULTS

Before propensity score matching (PSM), patients who underwent IBT had poorer RFS (5-year RFS: 37.7% vs. 49.6%, p < 0.001) and OS (5-year OS: 52.8% vs. 68.2%, p < 0.001) than those who did not undergo IBT. After PSM, both RFS (5-year RFS: 37.9%, vs. 45.8%, p = 0.207) and OS (5-year OS: 52.5% vs. 59.5%, p = 0.125) were similar between patients who did and did not receive IBT. Multivariate analysis revealed that the IBT was not associated with RFS or OS in the whole cohort or in patients with high ATSs. However, the IBT was independently related to both RFS (HR = 1.407, 95% CI = 1.089-1.818; p = 0.009) and OS (HR = 1.522, 95% CI = 1.114-2.080, p = 0.008) in patients with low/moderate ATSs.

CONCLUSION

Our study confirmed that the IBT had different effects on the prognosis of HCC patients with different ATSs after liver resection. The IBT negatively impacts on the prognosis of patients with low/medium ATSs patients, but not those with high ATSs.

Artificial intelligence in gastrointestinal surgery: A minireview of predictive models and clinical applications

BACKGROUND

Artificial intelligence (AI) is playing an increasingly significant role in predicting outcomes of gastrointestinal (GI) surgeries, improving preoperative risk assessment and post-surgical decision-making. AI models, particularly those based on machine learning, have demonstrated potential in predicting surgical complications and recovery trajectories.

AIM

To evaluate the role of AI in predicting outcomes for GI surgeries, focusing on its efficacy in enhancing surgical planning, predicting complications, and optimizing post-operative care.

METHODS

A systematic review of studies published up to March 2025 was conducted across databases such as PubMed, Scopus, and Web of Science. Studies were included if they utilized AI models for predicting surgical outcomes, including morbidity, mortality, and recovery. Data were extracted on the AI techniques, performance metrics, and clinical applicability.

RESULTS

Machine learning models demonstrated significantly better performance than logistic regression models, with an area under the curve difference of 0.07 (95%CI: 0.04–0.09; P < 0.001). Models focusing on variables such as patient demographics, nutritional status, and surgical specifics have shown improved accuracy. AI’s ability to integrate multifaceted data sources, such as imaging and genomics, contributes to its superior predictive power. AI has improved the early detection of gastric cancer, achieving 95% sensitivity in real-world settings.

CONCLUSION

AI has the potential to transform GI surgical practices by offering more accurate and personalized predictions of surgical outcomes. However, challenges related to data quality, model transparency, and clinical integration remain.

Outcome prediction for cholangiocarcinoma prognosis: Embracing the machine learning era

We read with great interest the study by Huang et al. Cholangiocarcinoma (CC) is the second most common type of primary liver tumor worldwide. Although surgical resection remains the primary treatment for this disease, almost 50% of patients experience relapse within 2 years after surgery, which negatively affects their prognosis. Key predictors can be used to identify several factors (e.g., tumor size, tumor location, tumor stage, nerve invasion, the presence of intravascular emboli) and their correlations with long-term survival and the risk of postoperative morbidity. In recent years, artificial intelligence (AI) has become a new tool for prognostic assessment through the integration of multiple clinical, surgical, and imaging parameters. However, a crucial question has arisen: Are we ready to trust AI with respect to clinical decisions? The study by Huang et al demonstrated that AI can predict preoperative textbook outcomes in patients with CC and highlighted the precision of machine learning algorithms using useful prognostic factors. This letter to the editor aimed to explore the challenges and potential impact of AI and machine learning in the prognostic assessment of patients with CC.

Dual Z-scheme In2S3/Bi2S3/ZnS heterojunction with broad-spectrum response as a photoactive material for ultrasensitive detection of environmental Pollutant tetracycline

Herein, a novel dual Z-scheme heterojunction In2S3/Bi2S3/ZnS (IBZS) with core-shell structure was prepared to establish a photoelectrochemical (PEC) biosensor for ultrasensitive detection of tetracycline (TC) referred to environmental pollution. Compared with the traditional single Z-scheme heterojunction with low PEC response, the dual Z-scheme heterojunction exhibited a strong PEC response due to its broad-spectrum response and highly efficient carrier migration. Furthermore, a redesigned target-triggered entropy-driven DNA reaction (TEDR) was implemented to mitigate spontaneous transient strand dissociation (breathing effect) in DNA duplexes, thereby effectively suppressing nonspecific background noise and enhancing the detection sensitivity of the biosensor. Hence, the PEC biosensor achieved an ultrasensitive detection of TC from 1.0 fM to 10 nM with a detection limit of 0.54 fM, which was far beyond the current TC detection methods. This strategy provided a new avenue for designing high-performance PEC photoactive materials, which was expected to be used to analyze antibiotics in environmental pollution monitoring and food quality control.

Unraveling biochemical differences in the membrane of functional RBCs and elliptocytes using vortex beam-based micro-Raman spectroscopy

Understanding the complexity of membrane biochemical changes in in-vitro-induced elliptocytosis can be interesting as it may mimic those in hereditary elliptocytosis. Studying the membrane biochemical changes in metabolically active elliptocytes can be crucial, but most modern methods, such as ektacytometry and EMA binding tests, fail to do so. This study employs single-cell Raman spectroscopy, a proven technique to study biochemical changes in individual functional cells to investigate biochemical modifications in the membrane and cytoskeleton of elliptocytes. This was possible by applying a vortex beam, which can probe the RBC membrane with a reduced contribution from hemoglobin, which otherwise dominates the cell spectrum. Raman spectral variations in elliptocytes indicated changes in proteins, lipids, and lipid-protein interactions. The study also presented an incidental observation of diversity in membrane components and membrane-hemoglobin interaction among tested individuals.

A two-step machine learning approach for predictive maintenance and anomaly detection in environmental sensor systems

Environmental sensor systems are essential for monitoring infrastructure and environmental quality but are prone to unreliability caused by sensor faults and environmental anomalies. Using Environmental Sensor Telemetry Data, this study introduces a novel methodology that combines unsupervised and supervised machine learning approaches to detect anomalies and predict sensor failures. The dataset consisted of sensor readings such as temperature, humidity, CO, LPG, and smoke, with no class labels available. This research is novel in seamlessly blending unsupervised anomaly detection using Isolation Forest to create labels for data points that were previously unlabeled. Finally, these generated labels were used to train the supervised learning models such as Random Forest, Neural Network (MLP Classifier), and AdaBoost to predict anomalies in new sensor data as soon as it gets recorded. The models confirmed the proposed framework's accuracy, whereas Random Forest 99.93 %, Neural Network 99.05 %, and AdaBoost 98.04 % validated the effectiveness of the suggested framework. Such an approach addresses a critical gap, transforming raw, unlabeled IoT sensor data into actionable insights for predictive maintenance. This methodology provides a scalable and robust real-time anomaly detection and sensor fault prediction methodology that greatly enhances the reliability of the environmental monitoring systems and advances the intelligent infrastructure management.•Combines Isolation Forest for anomaly labeling and supervised models for anomaly prediction.•Scalable and adaptable for diverse IoT applications for environmental monitoring.•Provides actionable insights through anomaly visualization, revealing patterns in sensor performance.

Non-radiomics imaging (US-CEUS) features and clinical text features: correlation with microvascular invasion and tumor grading in hepatocellular carcinoma

OBJECTIVES

To predict microvascular invasion (MVI) status and tumor grading of hepatocellular carcinoma (HCC) by evaluating preoperative non-radiomics ultrasound and contrast-enhanced ultrasound (US-CEUS) features and determine the influences of MVI/tumor grading on the category of CEUS LI-RADS for HCC.

METHODS

A total of 506 HCC patients who underwent preoperative US-CEUS examinations from 8 hospitals between July 2020 and June 2023 were enrolled. According to the MVI status, all the patients were classified, and HCC differentiation was assessed by using Edmondson-Steiner (ES) grading: MVI-negative (M0) and low-grade ES (GI/II) (MN-L, n = 297) and MVI-positive (M1/M2) and/or high-grade ES (GIII/IV) (MP-H, n = 209). Stratified analysis was performed based on fibrosis stage and tumor size.

RESULTS

The results proved that MN-L HCC was more frequently classified into the LR-5 category (p = 0.034), while MP-H HCC was more frequently classified into the LR-TIV (p = 0.010). The heterogeneously arterial phase hyperenhancement (APHE) is significantly correlated with MVI(+)/high grade-ES (p = 0.003). Compared with MN-L HCC, the onset of washout was earlier, washout rate was higher, and tumor-invasion border was larger (all p < 0.01) in MP-H HCC. In addition, fibrosis stage and tumor size significantly influenced the onset of washout and washout rate of HCC (all p < 0.01). The tumor-invasion border was only positively correlated with tumor size (p < 0.001) rather than fibrosis stage (p > 0.05).

CONCLUSIONS

MVI status and tumor grading influence the classification of LR-5 and LR-TIV. Heterogeneous APHE, higher washout rate, earlier onset of washout (≤65 s), larger tumor-invasion border (≥3 mm) and higher alpha fetoprotein level indicate the presence of MVI and/or high-grade ES.

Statistical Cure After Hepatectomy for Hepatitis B Virus-Associated Hepatocellular Carcinoma: A Risk-Stratification Model

BACKGROUND

Statistical cure, defined as achieving life expectancy comparable with that of disease-free individuals, has not been specifically investigated in hepatitis B virus-associated hepatocellular carcinoma (HBV-HCC), which accounts for more than 50% of the global HCC burden. This study aimed to develop a cure model for HBV-HCC after hepatectomy using matched HBV carriers and the general population as reference groups.

METHODS

From a Chinese multicenter database, HBV-HCC patients who underwent curative-intent hepatectomy were retrospectively reviewed. Independent prognostic factors were identified through Cox regression. A spline-based cure model was applied using two reference populations: matched Chinese HBV carriers (from Shanghai Center for Disease Control and Prevention) and the general population (from the National Bureau of Statistics).

RESULTS

The study analyzed 740 HBV-HCC patients. The following eight independent risk factors were identified: preoperative high viral load (hazard ratio [HR] 1.27), Child-Pugh grade (HR 1.21 and 1.43), multiple tumors (HR 1.70), tumor size greater than 5.0 cm (HR 1.47), macrovascular invasion (HR 3.33), microvascular invasion (HR 1.25), intraoperative blood transfusion (HR 1.21), and postoperative HBV reactivation (HR 1.89). The overall cure probability was 21.2% versus that for HBV carriers and 11.1% versus that for the general population. Risk stratification identified distinct groups relative to HBV carriers. Low risk (64.2%) showed an initial cure rate of 30.3% and achieved a 95% cure probability by 8.6 years, whereas high risk (10.5%) showed negligible cure probability.

CONCLUSIONS

This first HBV-HCC-specific cure model demonstrated that statistical cure is achievable for a subset of patients after hepatectomy. Risk stratification identifies patients with varying cure probabilities, providing valuable guidance for personalized treatment strategies and surveillance protocols.

Advanced cortisol detection: A cMWCNTs-enhanced MB@Zr-MOF ratiometric electrochemical aptasensor

A ratiometric electrochemical aptasensor was developed for ultra-sensitive detection of cortisol using aptamer (Apt) as recognition element, methylene blue (MB) as signal probe, and zirconium metal-organic framework (Zr-MOF) as carrier loaded with abundant MB for signal amplification. The carboxylated multi-walled carbon nanotubes (cMWCNTs)-modified Au electrode showed excellent electrochemical performance to immobilize complementary DNA (cDNA) for hybridizing with MB@Zr-MOF-Apt via amide bonds. In the presence of cortisol, it would compete with cDNA for binding the Apt, resulting in the detachment of MB@Zr-MOF-Apt complex from the electrode surface, and the electrochemical signal of MB was decreased, while that of [Fe(CN)6]3-/4- was basically unchanged. The ratio of the electrochemical signals of [Fe(CN)6]3-/4- to MB was proportional to the cortisol concentration. Due to the greatly enhanced conductivity of the cMWCNTs-decorated Au electrode and the largely improved EC signals of Zr-MOF encapsulated MB probes, this ratiometric electrochemical aptasensor offered high sensitivity with an ultra-low detection limit of 0.0046 nM and a wide linearity of 0.01-1000 nM, as well as satisfactory accuracy with recoveries of 93.79-106.76 % in artificial sweat samples, providing a potential strategy for the detection of more trace hormones in different clinical samples by simply replacing the corresponding aptamers.

Hypoxia-responsive theranostic nanoplatform with intensified chemo-photothermal/photodynamic ternary therapy and fluorescence tracing in colorectal cancer ablation

Photothermal therapy (PTT) is an emerging cancer therapeutic modality displaying the great potential to clinical patients. However, the conventional PTT is suffering from restrictions of heat resistance of tumor cells (e.g. the overexpression of heat shock proteins, HSPs) and adverse effects to normal cells. To break the shackles, herein, a hypoxia-responsive theranostic nanoplatform (GA/BN LIP) was designed for achieving synergistic chemotherapy, photothermal therapy (PTT), and photodynamic therapy (PDT) through overcoming heat-shock response, while enabling fluorescence tracing. The GA/BN LIP consisted of a hypoxia-responsive liposomal material (DSPE-AZO-PEG) as the shell, surface-functionalized with cRGD peptides targeted binding to integrin αVβ3 receptor expressed in tumors. The GA/BN LIP co-delivered gambogic acid (GA) as HSP90 inhibitor and hypoxia-responsive photosensitizer Bcy-NO2. After GA/BN LIP entering tumor cells by integrin αVβ3 receptor-mediated endocytosis, drugs were specifically released in response to hypoxic conditions due to lysis of liposomes. GA not only directly killed tumor cells to realize chemotherapy, but also sensitized tumor cells to PTT by downregulating HSP90 protein expression, meantime Bcy-NO2 targeted mitochondria for combined PTT and PDT. Intriguingly, the reduction of Bcy-NO2 by nitroreductase (NTR) resulted in the restoration of fluorescence, achieving real-time monitoring of the theranostic process in live cells. In conclusion, this theranostic system, designed to target the hypoxic tumor microenvironment, utilized a sensitization mechanism to enhance the synergistic effects of chemo/PTT/PDT therapy, resulting in improved antitumor efficacy in both in vitro and in vivo studies.

Strategies for neoantigen screening and immunogenicity validation in cancer immunotherapy (Review)

Cancer immunotherapy stimulates and enhances antitumor immune responses to eliminate cancer cells. Neoantigens, which originate from specific mutations within tumor cells, are key targets in cancer immunotherapy. Neoantigens manifest as abnormal peptide fragments or protein segments that are uniquely expressed in tumor cells, making them highly immunogenic. As a result, they activate the immune system, particularly T cell‑mediated immune responses, effectively identifying and eliminating tumor cells. Certain tumor‑associated antigens that are abnormally expressed in normal host proteins in cancer cells are promising targets for immunotherapy. Neoantigens derived from mutated proteins in cancer cells offer true cancer specificity and are often highly immunogenic. Furthermore, most neoantigens are unique to each patient, highlighting the need for personalized treatment strategies. The precise identification and screening of neoantigens are key for improving treatment efficacy and developing individualized therapeutic plans. The neoantigen prediction process involves somatic mutation identification, human leukocyte antigen (HLA) typing, peptide processing and peptide‑HLA binding prediction. The present review summarizes the major current methods used for neoantigen screening, available computational tools and the advantages and limitations of various techniques. Additionally, the present review aimed to summarize experimental strategies for validating the immunogenicity of the predicted neoantigens, which will determine whether these neoantigens can effectively trigger immune responses, as well as challenges encountered during neoantigen screening, providing relevant recommendations for the optimization of neoantigen‑based immunotherapy.

Comparative analysis of hepatectomy for HCC with PVTT: Insights from a 30-year single-center experience: Hepatectomy for HCC with PVTT

BACKGROUND AND AIM

Portal vein tumor thrombosis (PVTT) is frequent in hepatocellular carcinoma (HCC). Although hepatectomy is the primary treatment for HCC, no consensus exists on its role in PVTT between Eastern and Western clinicians. This study aims to assess the efficacy of hepatectomy in HCC patients with PVTT by analyzing perioperative outcomes and prognosis.

METHODS

This retrospective, single-center study reviewed HCC patient data from Queen Mary Hospital, Hong Kong (1989-2020). Propensity score matching (PSM) was applied to match patients with and without PVTT undergoing hepatectomy, comparing perioperative and survival outcomes between groups.

RESULTS

Among 3981 HCC patients, 1842 had PVTT and were not operated (not-operated group), while 2139 underwent hepatectomy. Of the operated patients, 156 had PVTT (PVTT group) and 1983 did not (no-PVTT group). Median overall survival (mOS) in the not-operated group was 2.7 months, compared to 13.0 months in the PVTT group. After 1:3 PSM, the no-PVTT group (n = 468) had longer mOS (47.0 vs. 13.0 months, p < 0.001) and disease-free survival (10.6 vs. 4.2 months, p < 0.001). The PVTT group had longer operative times (449 vs. 390 min, p < 0.001), higher complication rates (37.8 % vs. 28.2 %, p = 0.024), and closer surgical margins (0.6 vs. 1.0 cm, p = 0.036), but similar hospital mortality (p = 0.898). mOS for low-AFP (<17400 ng/ml) and high-AFP (≥17400 ng/ml) patients was 16.2 vs. 8.2 months, respectively (p < 0.001).

CONCLUSION

Aggressive treatment of PVTT is necessary. For certain PVTT patients, hepatectomy may be potentially effective, with acceptable perioperative safety and seemingly no technical barriers.

Hepatectomy in a young patient with advanced hepatocellular carcinoma and poor prognostic imaging features: A case of recurrence-free survival

A 45-year-old male with chronic hepatitis B presented with an advanced hepatocellular carcinoma (HCC) occupying the entire left liver and invading the left portal vein. Despite multiple poor prognostic imaging features, including vascular invasion, corona enhancement, an incomplete capsule, intratumoral necrosis, intratumoral arteries, and irregular tumor borders, the patient elected to undergo a left hepatectomy. Although Barcelona Clinic Liver Cancer (BCLC) staging classified the case as stage C, a resection was successfully performed. Remarkably, 6 years postsurgery, the patient remains recurrence-free. This report highlights a rare, fortunate outcome in a high-risk HCC case and underscores the potential of surgical intervention even in advanced HCC.