[Preliminary results of Chinese magnetic sphincter augmentation in treating gastroesophageal reflux disease]

Objective: To examine the preliminary clinical efficacy of Chinese magnetic sphincter augmentation (MSA) in the treatment of gastroesophageal reflux disease (GERD). Methods: According to the enrollment criteria for the MSA developed by ShengJieKang Co. and Shanghai Chest Hospital (SS-MSA) clinical trial, a total of 19 GERD patients were treated with SS-MSA from August 2018 to January 2020 at Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University. The majority of registered cases were male patients with age of (32.2±7.3) years (range: 22 to 50 years), height of (170.7±6.2) cm (range: 160 to 179 cm) and weight of (65.2±10.3) kg (range: 47.5 to 90.0 kg). SS-MSA was implanted via laparoscopy. The major evaluation indexs of postoperative efficacy were the total time of acid exposure within 24 hours and the total number of reflux. Secondary efficacy indicators included: (1) evaluation of the average daily dose of proton pump inhibitor medications; (2) the score of GERD health related quality of life questionnaire (GERD-Q) before and after MSA implantation. Paired design t-test was used to evaluate the efficacy of the SS-MSA. Results: A total of 19 patients underwent SS-MSA surgery successfully. The history of the GERD were 19 (54) months (M(Q(R))). The operation time was 63 (22) minutes and the in-hospital stay was 3 (2) days. No obvious surgical complications occurred. Postoperative adverse events included 14 cases with mild to moderate dysphagia exited after surgery, gradually eased within 1 to 3 months, 1 case with the removal of the device after 1 month of severe swallowing difficulties, 1 case of diarrhea. No corrosion, perforation, displacement occurred. The GERD-Q score (11.0(4.5) vs. 6(1.0), t=4.274, P=0.013), 24-hour acid exposure time (6.2(4.8)% vs. 0.1(0.9)%, t=5.814, P=0.004), and Demeester score (23.72(16.20) vs. 0.96(3.10), t=6.678, P=0.003) were significantly decreased 1 year after surgery(n=5). Proton pump inhibitor reuse rates were 6/18, 5/15, 3/10, and 1/5 in 1, 3, 6 and 12 months after the operation, respectively. Conclusions: SS-MSA implantation is feasible and safe with short hospital stay and rare perioperative complications. The preliminary results is good after 1 year follow-up. It could be expected to be an ideal substitutive for future GERD treatment.

[Clinicopathological features of indolent T-cell lymphoproliferative disorder of the gastrointestinal tract: a report of five cases]

Objective: To investigate the clinicopathological features of indolent T-cell lymphoproliferative disorder of the gastrointestinal tract. Methods: Five cases of indolent T-cell lymphoproliferative disorder of the gastrointestinal tract from the Affiliated Hospital of Qingdao University from 2016 to 2019 were retrospectively reviewed. The clinical and pathological parameters were analyzed by combining clinical data and reviewing the available literature of 35 cases (34 cases abroad and 1 case in China). Results: There were 4 males and 1 female with a median age of 47 years (18-66 years). All patients had abdominal pain and constitutional symptoms including diarrhea, emaciation, intermittent mucous stool or oral and epiglottic ulcers. Endoscopic manifestations included multiple punctate congestion, erosion and ulcer at the terminal ileum and colorectum. Two cases had congestion and erosion of antrum and angle of stomach, and the lesions did not fuse and form tumors. Histologically, the lamina propria was expanded by a dense, medium to small lymphocyte infiltration, which was monomorphic, with slightly irregular nuclei without prominent nucleolus or lymphoepithelial lesions. There were admixed small amount of plasma cells and eosinophils. In 4 cases, immunohistochemistry showed the lesional cells were positive for CD3, CD8, TIA1, and negative for CD4, CD56, granzyme B and Ki-67 index was ≤10%. In situ hybridization showed that EBER was negative and clonal TCR gene rearrangement was detected. One consultation case was CD3(+), CD5(-) and Ki-67 index of 10%, although other indicators were not done. All five patients were treated with symptomatic support. In follow-up observation for 2 to 25 months, all patients were alive with the disease. Conclusions: Indolent T-cell lymphoproliferative disorder of the gastrointestinal tract is a newly classified monoclonal T-cell proliferative disease, with low incidence, clinical inertia and long-term survival. It has unique clinicopathological features but pathologically it is easily misdiagnosed as inflammatory bowel disease or T-cell lymphoma. Correct diagnosis is of great important clinical significance.

[Experiences of esophageal replacement with ileocolon graft: a series of 34 cases]

Objective: To evaluate the safety and effectiveness of esophageal replacement with ileocolon graft. Methods: Totally 34 cases of esophageal replacement with ileocolon graft from July 2015 to November 2017 at Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University were analyzed retrospectively, including 24 male and 10 female, aging from 7 to 72 years old. Esophageal replacement with ileocolon graft by right and/or middle colic artery as a blood supply using retrosternal route except one subcutaneous route. The primary esophageal disease, postoperative complication rate and quality of life were analyzed. Results: The overall postoperative complication rate was 23.5% (8/34), cervical anastomotic leakage rate of 5.9% (2/34), necrosis of colon graft of 5.9% (2/34). There were 3 patients experienced re-operation including 2 patients with colon graft necrosis and 1 patient with intestinal obstruction after ERC. One patient with colon graft necrosis died of septic shock after reoperation. Six cases of cervical esophago-jejunal anastomosis stenosis and 1 case of diarrhea occurred in the later time. All patients were followed up for a median time of 9 months (range: 1 to 28 months), 32 cases survived but 1 patient died until last follow-up by the end of December 2017. Conclusion: Esophageal replacement with ileocolon graft by right and/or middle colic artery as a blood supply using retrosternal route was safe and effective.

Extracorporeal magnetic approach to reduce the unwanted side-effects and improve antibacterial activity of Ag/Fe3 O4 nanocomposites in rat

While Ag nanoparticles hold great promise for broad spectrum antibacterial activity, the potential risks of Ag nanoparticles (NPs) on human health remain a challenge. In this study, Ag/Fe₃ O₄ composites have been successfully prepared and characterized by transmission electron microscopy, X-ray powder diffraction, and Fourier-transform infrared spectroscopy, and their magnetic and antibacterial properties have been assessed. In vivo results show that the antibacterial effect of 500 μg/mL Ag/Fe₃ O₄ nanocomposites was significantly higher than that of 1000 μg/mL AgNPs after 72 h of treatment (p < 0.01). Hematoxylin and eosin (HE) staining showed that squamous epithelium and dermis collagen fibers formed in the Ag/Fe₃ O₄ group after 8 days treatment. Wound closure was significantly better for the Ag/Fe₃ O₄ group than for the AgNPs group. On the other hand, there was less Ag in blood, liver, and kidney in the Ag/Fe₃ O₄ group, as more Ag was retained in the wound. According to lactate dehydrogenase, γ-glutamyl transpeptidase, and reactive oxygen species results, Ag/Fe₃ O₄ nanocomposites caused less unwanted side-effects. This work presents a new paradigm to reduce the unwanted side-effects of AgNPs and improve their antibacterial activity, providing a new avenue for wound healing. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2029-2036, 2018.

Oxygen backed silicon hydride in correlation with the photoluminescence of silicon nano-crystals

Converting silicon hydride (–SiH) to oxygen backed silicon hydride (–OSiH) on porous silicon leads to a shift in the wavelength of photoluminescence (PL) maximum from 670 to 605 nm, corresponding to an increase of 0.2 eV on emission energy.

[Current status of Chinese herbal preparations included in LiverTox database]

Objective: To investigate the contents and features of drug-induced liver injury (DILI) database called LiverTox, as well as 37 herbal preparations included in this database. Methods: Firstly, the source and contents of LiverTox were briefly introduced, including the clinical features, types, severity, and causality assessment scale of DILI. Secondly, detailed information of 37 herbal preparations included in the class of "Herbals and Dietary Supplements" were extracted, including drug name, origin, efficacy, constituents, type of liver injury, and manifestations, to perform a preliminary statistical analysis. Finally, a comparative analysis was performed between such information and current knowledge of Chinese herbal medicine-induced liver injury in China. Results: LiverTox was a DILI database with open access and rich information and provided practical information on treatment, typing, causality assessment, and treatment. Among the 37 herbal preparations, 28 had the risk of liver injury. The most common indication was weight loss, followed by arthritis and constipation. The latency of hepatotoxicity ranged from 4 weeks to 6 months. Compared with the current knowledge in China, there were differences in the varieties and indications for herbal preparations with hepatotoxicity included in LiverTox, and many herbals with acknowledged hepatotoxicity in China were not included. Conclusion: LiverTox database is concise and practical, but there are certain differences between the herbal preparations included in this database and current knowledge in China.

Molecular mechanism of chronic HBV infection based on miroRNA regulation

AIM: To reveal the molecular mechanism of chronic HBV infection from the perspective of microRNA (miRNA) regulation.

METHODS: Patients with chronic hepatitis B virus infection (including chronic hepatitis B and chronic HBV carrier) and normal controls were included. Agilent Human miRNA8 × 60k microarray chip was used to profile the expression of miRNAs in plasma, to obtain differentially expressed miRNAs between the groups (P < 0.05). miRNA bioinformatics analysis software was used to predict the target genes, and conduct GO functional enrichment analysis and pathway analysis of target genes.

RESULTS: There were 69 differentially expressed miRNAs between the two groups (P < 0.05), including 28 up-regulated and 41 down-regulated ones. By GO enrichment analysis and pathway analysis, the target genes are mainly involved in bioadhesive, positive/negative regulation of transcription, positive/negative regulation of biosynthesis, positive/negative regulation of metabolism of nitrogen compounds, protein localization, phosphorylation of protein amino acids. Notch signaling pathway, apoptosis, Wnt signal pathway, Hedgehog signaling pathway, T cell receptor signaling pathway, MAPK signaling pathway, TGF-β signaling pathways, B cell receptor signaling pathway, ErbB signaling pathway, and p53signaling pathway.

CONCLUSION: Chronic HBV infection is regulated by specific miRNAs, and the regulation involves a number of life processes and signaling pathways.

Effect of "phase change" complex on postoperative adhesion prevention

BACKGROUND

Postsurgical peritoneal adhesion is a major clinical problem. Numerous anti-adhesion products have been studied, but none could be easily used to provide a physical barrier. In this study, we developed a "phase change" anti-adhesion barrier for reducing peritoneal adhesion by cross-linked copolymerization of O-carboxymethyl chitosan (CMC) and CaCl2 and addition of cyclosporin A (CsA).

MATERIALS AND METHODS

The CMC-CaCl2-CsA compound was characterized by equilibrium swelling rate, weight loss, releasing effect, and coagulation test, and its biosafety was characterized by acute oral toxicity, hemolysis, and cytotoxicity. Intestinal adhesion model was applied on 64 Sprague-Dawley rats, which received CMC, CMC-CaCl2, or CMC-CaCl2-CsA treatment. At postoperative days 7 and 14, the rats were euthanized, and adhesions were graded by an investigator blinded to the treatment groups, using a predetermined adhesion scoring system. The cecum and adhesion tissue were stained with hematoxylin and eosin and antibodies for matrix metalloproteinase-9 and TIMP-1 for further histopathologic examination.

RESULTS

The phase change anti-adhesive material exhibited effective blood clotting and were nontoxic in clotting experiments and acute toxicity test. The degradation rate could be adjusted using phosphate-buffered solution with varying pH. Adhesions were significantly reduced in the CMC-CaCl2-CsA treatment group compared with the control group (P < 0.001). Expression of matrix metalloproteinase-9 was stronger in CMC-CaCl2-CsA treatment group at 7 days after surgery.

CONCLUSIONS

"Phase-change" adhesive can undergo changes after application, and it inhibits the formation of abdominal adhesions after surgery. The material is convenient for using by surgeons and provides an effective tool for intestinal adhesion prevention.

Influence of reducing agents on biosafety and biocompatibility of gold nanoparticles

Extensive biomedical applications of nanoparticles are mainly determined by their safety and compatibility in biological systems. The aim of this study was to compare the biosafety and biocompatibility of gold nanoparticles (GNPs) prepared with HEPES buffer, which is popular for cell culture, and sodium citrate, a frequent reducing agent. From experimental results on the body weight and organ coefficients of acute oral toxicity tests, it could be observed that HEPES-prepared GNPs are biologically safer than citric-prepared GNPs at the same dose of 500 μg/kg. The in vitro cell viability was higher for HEPES-prepared GNPs than citric-prepared GNPs at 5.0- and 10.0-ug/mL concentrations. More reactive oxygen species (ROS) were generated in the cell suspension when supplemented with citric-prepared GNPs than HEPES-prepared GNPs when their concentrations were higher than 20 μg/mL. The results stated that HEPES-prepared GNPs had better biosafety and biocompatibility than citric-prepared GNPs. This study not only revealed the influence of reducing agent on biosafety and biocompatibility of nanomaterials but also provided accumulative evidence for nanomaterials in biomedical applications.

Graphical Abstract

Role of magnetic resonance imaging in the detection of local prostate cancer recurrence after external beam radiotherapy and radical prostatectomy

AIMS

To carry out a meta-analysis to assess the effectiveness of magnetic resonance imaging (MRI) during the follow-up of patients with prostate cancer after undergoing external beam radiotherapy (EBRT) or radical prostatectomy.

MATERIALS AND METHODS

MEDLINE, EMBASE and other databases were searched for relevant original articles published from January 1995 to October 2011. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Pooled estimation and subgroup analysis data were obtained by statistical analysis.

RESULTS

Fourteen of 768 initially identified studies were included in the meta-analysis. Seven studies examining patient after radical prostatectomy had a pooled sensitivity and specificity on the patient level of 82% (95% confidence interval 78-86%) and 87% (95% confidence interval 81-92%), respectively. In the subgroup analysis, compared with T2-weighted imaging (T2WI), dynamic contrast-enhanced (DCE) MRI showed higher pooled sensitivity (85%, 95% confidence interval 78-90%) and specificity (95%, 95% confidence interval 88-99%). DCE MRI combined with magnetic resonance spectroscopic imaging (1H-MRSI) had the highest pooled sensitivity (92%, 95% confidence interval 83-97%). Nine studies examining men after EBRT had a pooled sensitivity and specificity on the patient level of 82% (95% confidence interval 75-88%) and 74% (95% confidence interval 64-82%), respectively. Compared with T2WI, DCE MRI showed higher pooled sensitivity (90%, 95% confidence interval 77-97%) and specificity (81%, 95% confidence interval 64-93%). DCE combined with 1H-MRSI had the highest pooled specificity (90%, 95% confidence interval 56-100%). The pooled sensitivity and specificity on sextant analysis was 58% (95% confidence interval 53-64%) and 85% (95% confidence interval 82-88%), respectively. DCE MRI showed the highest pooled sensitivity: 71% (95% confidence interval 60-80%).

CONCLUSION

A limited number of small studies suggest that MRI can accurately detect local recurrences after EBRT and radical prostatectomy. DCE MRI is particularly accurate. The addition of MRSI to DCE MRI can significantly improve the diagnostic accuracy of local prostate cancer recurrence. The eventual role of 1H-MRSI alone remains controversial and needs to be defined further.

Biological effects of protons targeted to different ranges in Arabidopsis seeds

PURPOSE

To investigate the biological effects of radiation damage induced at different depths of a plant seed and to investigate the difference in radiation response between dry seeds and water-imbibed seeds to the same type of radiation.

MATERIALS AND METHODS

Arabidopsis seeds of the wild-type Columbia ecotype were used in our experiments. Dry or water-imbibed Arabidopsis seeds were irradiated with 1.1 MeV, 2.6 MeV or 6.5 MeV protons (H+). For comparison, 30 keV nitrogen ions (N+) were also used to irradiate dry Arabidopsis seeds. The germination and survival rates of the seeds were measured after each irradiation.

RESULTS

After irradiation with 2.6 MeV H+ and 6.5 MeV H+, the fluence-response curves for germination and survival had distinct shoulders and then survival was reduced rapidly with increasing fluence. 2.6 MeV H+ was more effective than 6.5 MeV H+ in inhibiting germination and survival and water-imbibed seeds were more sensitive to the 6.5 MeV H+ irradiation than dry seeds. For 1.1 MeV H+ the germination and survival rates were reduced gradually and an intermediate plateau emerged for germination, which was similar to that observed for survival following 30 keV N+ irradiation. One of the key morphologic malformations, the multi-SAM (shoot apical meristem), was observed both for dry and water-imbibed seeds after all proton irradiations and for the dry seeds after 30 keV N+ irradiation.

CONCLUSIONS

Radiation-induced damage produced at different ranges in Arabidopsis seeds results in different fluence-response curves with water-imbibed seeds being more sensitive to proton irradiation than dry seeds. As well as the shoot apical meristem (SAM) being the primary target for irradiation, there exists a secondary target around the SAM that also contributes to the radiation response.

The immobilization of hepatocytes on 24 nm-sized gold colloid for enhanced hepatocytes proliferation

Bioartificial liver and hepatocyte transplantation is anticipated to supply a temporary metabolic support for candidates of liver transplantation or for patients with fulminant liver failure. An essential restriction of this form is the inability to acquire an enough amount of hepatocytes. Enhancement of the proliferation and differentiated function of hepatocytes is becoming a pursued target. Here, porcine hepatocytes were successfully immobilized on nano-sized gold colloid particles to construct a "hepatocyte/gold colloid" interface at which hepatocytes can be quickly proliferated. The properties of this resulting interface were characterized and confirmed by scanning electron microscopy and atomic force microscopy. The proliferative mechanism of hepatocytes was also discussed. The proliferated hepatocytes could be applied to the clinic based on their excellent functions for the synthesis of protein, glucose and urea as well as lower lactate dehydrogenase release.

[Polarographic behavior of latamoxef sodium and its trace determination]

In the medium of HCl-KCl (pH 1-2) by means of cyclic voltammetry and differential pulse polarography (DPP), the mechanism of the electrode reaction for latamoxef sodium (Shiomarin) at static mercury drop electrode (SMDE) and hanging mercury drop electrode (HMDE) has been proposed. A sensitive method for the determination of nanomolar concentration of latamoxef sodium by DPP was developed. The peak potential was -0.62 V (vs Ag/AgCl). The linear range was from 1 x 10(-8) to 8 x 10(-4) mol.L-1, the detection limit was ca. 4 x 10(-9) mol.L-1(tac = 90 s). The method was applied to the determination of latamoxef sodium in injection with satisfactory results. The possibility for the direct determination of latamoxef sodium in mimic urine sample was also studied.