Transitional Care for Patients With Portal Hypertension: A Multicenter Study of Intervention for Post-TIPS Patients.

To explore the application effect of transitional nursing in patients with TIPS. A total of 368 patients were allocated to control group (conventional care) and intervention group (conventional care combined with transitional care). The Child-Pugh scores, blood ammonia levels, compliance behavior, medication compliance, and adverse event incidence rates were compared at 1, 3, 6, 9, and 12 months post-TIPS. There were significant differences in compliance behavior scores, Child-Pugh scores for group effects, time effects, and group × time interaction between the two groups at 1, 3, 6, 9, and 12 months post-TIPS, significant differences in blood ammonia levels at 9 months, and incidence of postoperative adverse events at 12 months after TIPS. Post-TIPS transitional care interventions increased patients' access to scientifically informed nursing, significantly improved patients' compliance behavior and health and decreased the incidence of postoperative adverse events.

Balloon-occluded retrograde transvenous obliteration with lauromacrogol sclerosant foam for gastric varices.

Objectives: To evaluate the safety and efficacy of balloon-occluded retrograde transvenous obliteration (BRTO) using lauromacrogol sclerosant foam for gastric varices (GVs) with gastrorenal venous shunts. Methods: Data of GV patients treated with BRTO using lauromacrogol sclerosant foam in 2016-2020 were retrospectively analyzed along with procedural success rate, complications, and follow-up efficacy. Results: A total of 31 patients were treated with BRTO. The sclerosant foam was prepared by mixing iodinated oil, lauromacrogol, and air at a 1:2:3 ratio. The BRTO procedure was successfully completed in 93.5% of patients. One patient was allergic to the lauromacrogol injection. A mild postoperative fever occurred in three patients. One patient experienced grand mal seizures after the procedure. There was no significant difference in the median Child-Turcotte-Pugh scores before versus after BRTO. Complete GV resolution was observed in 93.1% of patients. One patient underwent endoscopic treatment for the development of high-risk esophageal varices. Another patient underwent transjugular intrahepatic portosystemic shunt placement for the aggravation of ascites. Conclusions: Lauromacrogol sclerosant foam is safe and effective in patients undergoing BRTO for GV.

Chinese expert consensus on the nursing management of the totally implantable venous access device.

The totally implantable venous access device (TIVAD) has been widely used in clinical nursing work in China. The use of TIVAD has significantly improved the safety of venous access and reduced the pain caused by a repeated puncture; however, it may also bring with it varying degrees of complications associated with the long-term insertion of TIVAD and the maintenance quality of the venous access. Standard maintenance of the venous access for TIVAD is very important for reducing complications and improving the efficacy and patient's quality of life. This consensus briefly describes the fundamental knowledge and operating procedures of TIVAD while focusing on the evaluation and management of perioperative nursing, the observation and treatment of complications, the operation methods, and precautions for maintenance of venous access, as well as health education. This agreement seeks to standardize the nursing care of TIVAD patients in China.

Doubly Supervised Transfer Classifier for Computer-Aided Diagnosis With Imbalanced Modalities.

Transfer learning (TL) can effectively improve diagnosis accuracy of single-modal-imaging-based computer-aided diagnosis (CAD) by transferring knowledge from other related imaging modalities, which offers a way to alleviate the small-sample-size problem. However, medical imaging data generally have the following characteristics for the TL-based CAD: 1) The source domain generally has limited data, which increases the difficulty to explore transferable information for the target domain; 2) Samples in both domains often have been labeled for training the CAD model, but the existing TL methods cannot make full use of label information to improve knowledge transfer. In this work, we propose a novel doubly supervised transfer classifier (DSTC) algorithm. In particular, DSTC integrates the support vector machine plus (SVM+) classifier and the low-rank representation (LRR) into a unified framework. The former makes full use of the shared labels to guide the knowledge transfer between the paired data, while the latter adopts the block-diagonal low-rank (BLR) to perform supervised TL between the unpaired data. Furthermore, we introduce the Schatten-p norm for BLR to obtain a tighter approximation to the rank function. The proposed DSTC algorithm is evaluated on the Alzheimer's disease neuroimaging initiative (ADNI) dataset and the bimodal breast ultrasound image (BBUI) dataset. The experimental results verify the effectiveness of the proposed DSTC algorithm.

Helichrysetin inhibits gastric cancer growth by targeting c-Myc/PDHK1 axis-mediated energy metabolism reprogramming.

Helichrysetin (HEL), a chalcone isolated from Alpinia katsumadai Hayata, has an antitumor activity in human lung and cervical cancers. However, the inhibitory effect and underlying mechanism of HEL in gastric cancer have not been elucidated. Here, HEL significantly inhibited the growth of gastric cancer MGC803 cells in vitro and in vivo. HEL decreased expression and transcriptional regulatory activity of c-Myc and mRNA expression of c-Myc target genes. HEL enhanced mitochondrial oxidative phosphorylation (OXPHOS) and reduced glycolysis as evidenced by increased mitochondrial adenosine triphosphate (ATP) production and excessive reactive oxygen species (ROS) accumulation, and decreased the pPDHA1/PDHA1 ratio and Glyco-ATP production. Pyruvate enhanced OXPHOS after HEL treatment. c-Myc overexpression abolished HEL-induced inhibition of cell viability, glycolysis, and protein expression of PDHK1 and LDHA. PDHK1 overexpression also counteracted inhibitory effect of HEL on cell viability. Conversely, c-Myc siRNA decreased cell viability, glycolysis, and PDHK1 expression. NAC rescued the decrease in viability of HEL-treated cells. Additionally, HEL inhibited the overactivated mTOR/p70S6K pathway in vitro and in vivo. HEL-induced cell viability inhibition was counteracted by an mTOR agonist. mTOR inhibitor also decreased cell viability. Similar results were obtained in SGC7901 cells. HEL repressed lactate production and efflux in MGC803 cells. These results revealed that HEL inhibits gastric cancer growth by targeting mTOR/p70S6K/c-Myc/PDHK1-mediated energy metabolism reprogramming in cancer cells. Therefore, HEL may be a potential agent for gastric cancer treatment by modulating cancer energy metabolism reprogramming.

[Application of multiple empirical kernel mapping ensemble classifier based on self-paced learning in ultrasound-based computer-aided diagnosis for breast cancer].

Both feature representation and classifier performance are important factors that determine the performance of computer-aided diagnosis (CAD) systems. In order to improve the performance of ultrasound-based CAD for breast cancers, a novel multiple empirical kernel mapping (MEKM) exclusivity regularized machine (ERM) ensemble classifier algorithm based on self-paced learning (SPL) is proposed, which simultaneously promotes the performance of both feature representation and the classifier. The proposed algorithm first generates multiple groups of features by MEKM to enhance the ability of feature representation, which also work as the kernel transform in multiple support vector machines embedded in ERM. The SPL strategy is then adopted to adaptively select samples from easy to hard so as to gradually train the ERM classifier model with improved performance. This algorithm is verified on a B-mode ultrasound dataset and an elastography ultrasound dataset, respectively. The results show that the classification accuracy, sensitivity and specificity on B-mode ultrasound are (86.36±6.45)%, (88.15±7.12)%, and (84.52±9.38)%, respectively, and the classification accuracy, sensitivity and specificity on elastography ultrasound are (85.97±3.75)%, (85.93±6.09)%, and (86.03±5.88)%, respectively. It indicates that the proposed algorithm can effectively improve the performance of ultrasound-based CAD for breast cancers with the potential for application.

Chronic atrophic gastritis and intestinal metaplasia induced by high-salt and N-methyl-N'-nitro-N-nitrosoguanidine intake in rats.

The aim of the present study was to induce chronic atrophic gastritis (CAG) with intestinal metaplasia (IM) in rats by administering saturated salt and methyl-N'-nitro-N-nitrosoguanidine (MNNG) via oral gavage. Changes in gastric mucosal blood microcirculation and activation of the cyclo-oxygenase-2 (COX-2)/hypoxia inducible factor-1α (HIF-1α)/vascular endothelial growth factor (VEGF) signaling pathway during CAG and IM development were investigated. After administering saturated salt and MNNG for 25 weeks, mild atrophy was detected in the stomach of model rats using hematoxylin and eosin staining. CAG with IM was successfully induced in the gastric mucosa of the model rats after 35 weeks. Gastric mucosal blood flow was decreased in comparison with controls as early as 15 weeks after treatment to induce CAG and the mRNA expression levels of COX-2, HIF-1α, vascular endothelial growth factor receptor (VEGFR)1 and VEGFR2 were increased in comparison with untreated rats as early as 25 weeks after treatment. HIF-1α, COX-2 and VEGFR2 expression levels were increased as early as 25 weeks after CAG induction treatment when compared to controls and HIF-1α, COX-2, VEGFR1 and VEGFR2 expression levels were significantly increased after 35 weeks. These findings indicated that administering saturated salt and MNNG by gavage for 35 weeks successfully induced CAG and IM in rats. Furthermore, the microcirculation was disturbed before activation of the COX-2/HIF-1α/VEGF signaling pathway.

Weiqi Decoction Attenuated Chronic Atrophic Gastritis with Precancerous Lesion through Regulating Microcirculation Disturbance and HIF-1α Signaling Pathway.

AIM: Chronic atrophic gastritis (CAG), the precancerous lesions of gastric cancer, plays an important role in the stepwise process of gastric cancer. The ancient Chinese medicine believes in that Qi deficiency and blood stasis are involved in the pathogenesis of CAG. Weiqi decoction, a classical formula from Longhua Hospital, could supplement Qi and activate blood circulation of human beings and has been used for treating CAG in clinic over twenty years. The study aims to clarify the effect and underlying molecular mechanism of Weiqi decoction on CAG rats. METHODS: Forty-eight male Wistar rats were divided randomly into six groups: control group, model group, folic acid group, and WQD-treated groups at doses of 4 g/kg, 2 g/kg, and 1 g/kg, with eight rats in each group. MNNG and saturated NaCl were used to induce CAG rat with precancerous lesion (intestinal metaplasia and dysplasia). After 40 weeks, gastric mucosal blood flow was measured using Laser Doppler Flowmetry. The pathological changes of the gastric mucosa were identified by H&E staining and AB-PAS staining. The protein expression of COX-2, HIF-1α, VEGFR1, VEGFR2, Ki67, and cleaved caspase 3 in the gastric tissues was measured by western blotting approach. Gene expression of COX-2, HIF-1α, VEGF, VEGFR1, VEGFR2, Ang-1, and Ang-2 was detected by using Quantitative PCR method. The PGE2 concentrations in serum were detected by ELISA method. The protein expression of Ki67 in gastric mucosa was also detected by immunohistochemistry. RESULTS: Compared with control rats, atrophy and intestinal metaplasia as well as the microcirculation disturbance of gastric mucosa were induced in the stomach of CAG rats identified by the H&E and AB-PAS staining as well as microcirculation measurement, which could be significantly attenuated by WQD treatment. Moreover, compared with the control group, the protein and gene expression of COX-2, HIF-1α, VEGFR1, and VEGFR2 in gastric tissues of pylorus was obviously increased and the serum PGE2 level was significantly deceased in CAG rats, which could be significantly counteracted by WQD administration. However, the gene expression of Ang-1 and Ang-2 was not significant difference between control rats and CAG rats, and WQD also had no significant effect on the gene expression of Ang-1 and Ang-2. Furthermore, the increased cell proliferation marked by upregulated protein expression of Ki67 and decreased cell apoptosis marked by downregulated protein expression of cleaved caspase 3 in stomach of pylorus in CAG rats were obviously reversed by WQD treatment. CONCLUSION: WQD attenuated CAG with precancerous lesion through regulating gastric mucosal blood flow disturbance and HIF-1α signaling pathway.

miR-140-3p functions as a tumor suppressor in squamous cell lung cancer by regulating BRD9.

Squamous cell lung cancer (SqCLC) is among the most malignant lung cancers worldwide, lacking biomarkers for diagnostic and targets for treatment. In this study, we observed that miR-140-3p was expressed at low levels both in SqCLC cell lines and patient samples, while overexpression of miR-140-3p dramatically reduced the cell proliferation and invasion in SqCLC cells and Patient derived xenograft (PDX) models. Our further investigation indicated miR-140-3p negatively affected the tumorigenesis of SqCLC by down-regulating the expression of BRD9, an oncogene in SqCLC. Inhibition of BRD9 repressed SqCLC tumorigenesis by regulating c-myc expression. Meanwhile, BRD9 expression is up-regulated and negatively correlated with miR-140-3p in clinical samples; a meta-analysis of survival data indicates that SqCLC patients with high levels of BRD9 in their tumors have a worse prognosis. Collectively, our study suggests the prognostic and therapeutic roles of miR-140-3p and BRD9 axis in squamous cell lung cancer.

Ultrasound-Based Diagnosis of Breast Tumor with Parameter Transfer Multilayer Kernel Extreme Learning Machine.

B-mode ultrasound (BUS) imaging is widely used for diagnosis of breast tumors. In recent years, another ultrasound modality, namely ultrasound elastography (UE), has also been successfully applied in clinical practice. Although the combination of bimodal ultrasound imaging can improve the diagnosis accuracy for breast tumors, the single-modal ultrasound-based diagnosis is more popular in clinical practice, especially in the rural areas. Since transfer learning (TL) can transfer knowledge from a source domain to a target domain to help train more effective model, we propose to develop a single-modal ultrasound-based computer-aided diagnosis (CAD) with the transferred information from an additional modality in this work. We propose a projective model (PM) based multilayer kernel extreme learning machine (ML-KELM-PM) algorithm, which performs the parameter transfer approach in classifier to perform TL in CAD. The experimental results on a bimodal ultrasound image dataset show that the proposed ML-KELM-PM algorithm outperforms all the compared algorithms for the single-modal ultrasound-based CAD for breast tumors.

miR-342-3p suppresses cell proliferation and migration by targeting AGR2 in non-small cell lung cancer.

AGR2 is a well-studied secreted protein that is involved in multiple biological processes including cell proliferation and migration. The mechanism by which AGR2 increases the growth and migration of non-small cell lung cancer cells (NSCLC) is still unknown. In this study, we report that AGR2 is directly targeted by miR-342-3p. Functional studies suggest that overexpression of miR-342-3p inhibits the proliferation and migration of non-small cell lung cancer cells. Overexpression of AGR2 counteracts the phenotypes induced by miR-342-3p. Moreover, AGR2 expression is up-regulated and negatively correlated with miR-342-3p levels in NSCLC cells and tissues. A meta-analysis of survival data indicates that NSCLC patients with high levels of AGR2 in their tumors have a worse prognosis. Collectively, the identification of miR-342-3p and AGR2 might facilitate the development of biomarkers and therapeutic targets for this devastating disease.

Modulation of glucose metabolism by a natural compound from Chloranthus japonicus via activation of AMP-activated protein kinase.

AMP-activated protein kinase (AMPK) is a key sensor and regulator of glucose metabolism. Here, we demonstrated that shizukaol F, a natural compound isolated from Chloranthus japonicus, can activate AMPK and modulate glucose metabolism both in vitro and in vivo. Shizukaol F increased glucose uptake in differentiated C2C12 myotubes by stimulating glucose transporter-4 (GLUT-4) membraned translocation. Treatment of primary mouse hepatocytes with shizukaol F decreased the expression of phosphoenolpyruvate carboxykinase 2 (PEPCK), glucose-6-phosphatase (G6Pase) and suppressed hepatic gluconeogenesis. Meanwhile, a single oral dose of shizukaol F reduced gluconeogenesis in C57BL/6 J mice. Further studies indicated that shizukaol F modulates glucose metabolism mainly by AMPKa phosphorylation activity. In addition, we also found that shizukaol F depolarizes the mitochondrial membrane and inhibits respiratory complex I, which may result in AMPK activation. Our results highlight the potential value of shizukaol F as a possible treatment of metabolic syndrome.

Alterations in serotonin, transient receptor potential channels and protease-activated receptors in rats with irritable bowel syndrome attenuated by Shugan decoction.

AIM: To determine the molecular mechanisms of Shugan decoction (SGD) in the regulation of colonic motility and visceral hyperalgesia (VHL) in irritable bowel syndrome (IBS). METHODS: The chemical compounds contained in SGD were measured by high-performance liquid chromatography. A rat model of IBS was induced by chronic water avoidance stress (WAS). The number of fecal pellets was counted after WAS and the pain pressure threshold was measured by colorectal distension. Morphological changes in colonic mucosa were detected by hematoxylin-eosin staining. The contents of tumor necrosis factor (TNF)-α in colonic tissue and calcitonin-gene-related peptide (CGRP) in serum were measured by ELISA. The protein expression of serotonin [5-hydroxytryptamide (5-HT)], serotonin transporter (SERT), chromogranin A (CgA) and CGRP in colon tissue was measured by immunohistochemistry. RESULTS: SGD inhibited colonic motility dysfunction and VHL in rats with IBS. Blockers of transient receptor potential (TRP) vanilloid 1 (TRPV1) (Ruthenium Red) and TRP ankyrin-1 (TRPA1) (HC-030031) and activator of protease-activated receptor (PAR)4 increased the pain pressure threshold, whereas activators of PAR2 and TRPV4 decreased the pain pressure threshold in rats with IBS. The effect of SGD on pain pressure threshold in these rats was abolished by activators of TRPV1 (capsaicin), TRPV4 (RN1747), TRPA1 (Polygodial) and PAR2 (AC55541). In addition, CGRP levels in serum and colonic tissue were both increased in these rats. TNF-α level in colonic tissue was also significantly upregulated. However, the levels of 5-HT, SERT and CgA in colonic tissue were decreased. All these pathological changes in rats with IBS were attenuated by SGD. CONCLUSION: SGD alleviated VHL and attenuated colon motility in IBS, partly by regulating TRPV1, TRPV4, TRPA1, PAR2, 5-HT, CgA and SERT, and reducing CGRP and TNF-α level.

[Tongxie Yaofang inhibits the contraction of colonic smooth muscle isolated from rats through a mechanism related to calcium mobilization].

OBJECTIVE: To study the relationship between the inhibitory effects of Tongxie Yaofang, a compound traditional Chinese herbal medicine, on the contraction of the colonic smooth muscle isolated from rats and calcium mobilization. METHODS: By measuring the tension of the isolated colonic smooth muscle strips, the inhibitory effects of Tongxie Yaofang on the contraction induced by acetylcholine (ACh), KCl and exhausting Ca(2+) of internal calcium store were assessed respectively. RESULTS: Tongxie Yaofang could concentration-dependently inhibit the contraction of isolated rat colonic smooth muscle strips induced by KCl and exhausting the Ca(2+) of internal calcium store. Tongxie Yaofang could also inhibit the tension of the second contractile phase induced by ACh (P<0.01, vs control), but had no influence on the first contractile phase. CONCLUSION: Tongxie Yaofang can inhibit the contraction of isolated rat colonic smooth muscle strips mainly by preventing the influx of extracellular Ca(2+), which may be associated with blocking voltage-dependent channel, store-operated channel and receptor-operated channel, but not by preventing the release of internal Ca(2+) from calcium store.