Safety and benefit of modified mesohepatectomy in the treatment of bilobar involvement congenital biliary dilatation.

BACKGROUND: The diseased bile duct in bilobar congenital biliary dilatation is extensive and often requires major hepatectomy or liver transplantation associated with a higher risk. We aimed to evaluate the safety and benefit of modified mesohepatectomy, in comparison with trisectionectomy, to treat bilobar congenital biliary dilatation. METHODS: This study included 28 patients with type IV and V bilobar congenital biliary dilatation. An innovative mesohepatectomy comprising the hepatectomy technique beyond the P/U point and bile duct shaping was applied to 14 patients to address the extensively diseased bile duct and difficulty in hepaticojejunostomy. Another 14 patients received trisectionectomy. The perioperative and long-term outcomes of these patients were compared. RESULTS: The ratio of residual liver volume to standard liver volume in the mesohepatectomy group was higher (78.68% vs. 40.90%, p = 0.005), while the resection rate of the liver parenchyma was lower (28.25% vs. 63.97%, p = 0.000), than that in trisectionectomy group. The mesohepatectomy group had a lower severe complication (>Clavein III, 0% vs. 57.70%, p = 0.019) and incidence of posthepatectomy liver failure (7.14% vs. 42.86%, p = 0.038). No significant difference was observed in blood loss and bile leakage (p > 0.05). All the patients in the mesohepatectomy group achieved optimal results in the long-term follow-up. CONCLUSIONS: mesohepatectomy provides an efficient treatment option for bilobar congenital biliary dilatation and can achieve radical resection, retain more liver parenchyma, and reduce the difficulty of hepaticojejunostomy, especially for patients that are not eligible for major hepatectomy and liver transplantation.

Melittin analog p5RHH enhances recombinant adeno-associated virus transduction efficiency.

OBJECTIVE: Melittin and its derivative have been developed to support effective gene delivery systems. Their ability to facilitate endosomal release enhances the delivery of nanoparticle-based gene therapy. Nevertheless, its potential application in the context of viral vectors has not received much attention. Therefore, we would like to optimize the rAAV vector by Melittin analog to improve the transduction efficiency of rAAV in liver cancer cells and explore the mechanism of Melittin analog on rAAV. METHODS: Various melittin-derived peptides were inserted into loop VIII of the capsid protein in recombinant adeno-associated virus vectors. These vectors carrying either gfp or fluc genes were subjected to quantitative polymerase chain reaction assays and transduction assays in human embryonic kidney 293 (HEK293T) cells to investigate the efficiency of vector production and gene delivery. In addition, the ability of a specific p5RHH-rAAV vector to deliver genes was examined through in vitro transduction of different cultured cells and in vivo tail vein administration to C57BL/6 mice. Finally, the intricate details of the vector-mediated transduction mechanisms were explored by using pharmacological inhibitors of every stage of the rAAV2 intracellular life cycle. RESULTS: A total of 76 melittin-related peptides were identified from existing literature. Among them, CMA-3, p5RHH and aAR3 were found to significantly inhibit transduction of rAAV2 vector crude lysate. The p5RHH-rAAV2 vectors efficiently transduced not only rAAV-potent cell lines but also cell lines previously considered resistant to rAAV. Mechanistically, bafilomycin A1, a vacuolar endosome acidification inhibitor, completely inhibited the transgene expression mediated by the p5RHH-rAAV2 vectors. Most importantly, p5RHH-rAAV8 vectors also increased hepatic transduction in vivo in C57BL/6 mice. CONCLUSION: The incorporation of melittin analogs into the rAAV capsids results in a significant improvement in rAAV-mediated transgene expression. While further modifications remain an area of interest, our studies have substantially broadened the pharmacological prospects of melittin in the context of viral vector-mediated gene delivery. Please cite this article as: Meng J, He Y, Yang H, Zhou L, Wang S, Feng X, Al-shargi OY, Yu X, Zhu L, Ling, C. Melittin analog p5RHH enhances recombinant adeno-associated virus transduction efficiency. J Integr Med. 2024; 22(1): 72-82.

Protonated and deprotonated vanadyl imidazole tartrates for the mimics of the vanadium coordination in the FeV-cofactor of V-nitrogenase.

Chiral imidazole-based oxidovanadium tartrates (H2im)2[Δ,Λ-VIV2O2(R,R-H2tart)(R,R-tart)(Him)2]·Him (1, H4tart = tartaric acid, Him = imidazole) and [Λ,Λ-VIV2O2(R,R-tart)(Him)6]·4H2O (2) and their corresponding enantiomers (H2im)2[Λ,Δ-VIV2O2(S,S-H2tart)(S,S-tart)(Him)2]·Him (3) and [Δ,Δ-VIV2O2(S,S-tart)(Him)6]·4H2O (4) were obtained in alkaline solutions. Interestingly, the tartrates chelate with vanadium bidentately through α-alkoxy/α-hydroxy and α-carboxy groups and imidazole coordinates monodentately through nitrogen atom. It is worth noting that complexes 1 and 3 contain both protonated α-hydroxy and deprotonated α-alkoxy groups simultaneously, which have short V-Oα-alkoxy distances [1.976(4)av Å in 1-4] and long V-Oα-hydroxy distances [2.237(3)av Å in 1 and 2.230(2)av Å in 3]. There is an interesting strong intramolecular hydrogen bond [O(11)⋯O(1) 2.731(5) Å] between the two parts in 1 and 3. The protonated V-O distances are closer to the average bond distance in reported FeV-cofactors (FeV-cos, V-Oα-alkoxy 2.156av Å) in VFe proteins, which corresponds to the feasible protonation of coordinated α-hydroxy in R-homocitrate in V-nitrogenase, showing the homocitrate in the mechanistic model for nitrogen reduction as a secondary proton donor. Furthermore, vibrational circular dichroism (VCD) and IR spectra of 1-4 pointed out the disparity between the characteristic vibrations of the C-O and C-OH groups clearly. EPR experiment and theoretical calculations support +4 oxidation states for vanadium in 1-4. Solution 13C {1H} NMR spectra and CV analyses exhibited the solution properties for 1 and 2, respectively, which indicates that there should be a rapid exchange equilibrium between the protonated and deprotonated species in solutions.

Predicting the outcomes of hepatocellular carcinoma downstaging with the use of clinical and radiomics features.

BACKGROUND: Downstaging of hepatocellular carcinoma (HCC) makes it possible for patients beyond the criteria to have the chance of liver transplantation (LT) and improved outcomes. Thus, a procedure to predict the prognosis of the treatment is an urgent requisite. The present study aimed to construct a comprehensive framework with clinical information and radiomics features to accurately predict the prognosis of downstaging treatment. METHODS: Specifically, three-dimensional (3D) tumor segmentation from contrast-enhanced computed tomography (CT) is employed to extract spatial information of the lesions. Then, the radiomics features within the segmented region are calculated. Combining radiomics features and clinical data prompts the development of feature selection to enhance the robustness and generalizability of the model. Finally, we adopt the support vector machine (SVM) algorithm to establish a classification model for predicting HCC downstaging outcomes. RESULTS: Herein, a comparative study was conducted on three different models: a radiomics features-based model (R model), a clinical features-based model (C model), and a joint radiomics clinical features-based model (R-C model). The average accuracy of the three models was 0.712, 0.792, and 0.844, and the average area under the receiver-operating characteristic (AUROC) of the three models was 0.775, 0.804, and 0.877, respectively. CONCLUSIONS: The novel and practical R-C model accurately predicted the downstaging outcomes, which could be utilized to guide the HCC downstaging toward LT treatment.

Macrophages facilitate tumor cell PD-L1 expression via an IL-1ß-centered loop to attenuate immune checkpoint blockade.

Tumor-associated macrophages (TAMs) play critical roles in reprogramming other immune cells and orchestrating antitumor immunity. However, the interplay between TAMs and tumor cells responsible for enhancing immune evasion remains insufficiently understood. Here, we revealed that interleukin (IL)-1ß was among the most abundant cytokines within the in vitro tumor-macrophage coculture system, and enhanced IL-1ß expression was associated with impaired cytotoxicity of CD8+ T cells in human ovarian cancer, indicating the possibility that IL-1ß mediated immunosuppression during tumor-TAMs crosstalk. Mechanistically, we demonstrated that IL-1ß significantly boosted programmed death-ligand 1 (PD-L1) expression in tumor cells via the activation of the nuclear factor-κb signaling cascade. Specifically, IL-1ß released from TAMs was triggered by lactate, the anaerobic metabolite of tumor cells, in an inflammasome activation-dependent manner. IL-1ß sustained and intensified immunosuppression by promoting C-C motif chemokine ligand 2 secretion in tumor cells to fuel TAMs recruitment. Importantly, IL-1ß neutralizing antibody significantly curbed tumor growth and displayed synergistic antitumor efficacies with anti-PD-L1 antibody in tumor-bearing mouse models. Together, this study presents an IL-1ß-centered immunosuppressive loop between TAMs and tumor cells, highlighting IL-1ß as a candidate therapeutic target to reverse immunosuppression and potentiate immune checkpoint blockade.

A detection method of typical toxic mixed red tide algae in Qinhuangdao based on three-dimensional fluorescence spectroscopy.

Red tides occur every year in the Qinhuangdao sea area of China, including a variety of toxic algae and non-toxic algae. Toxic red tide algae have caused great damage to the marine aquaculture industry in China and seriously endangered human health, but most of non-toxic algae are important bait for marine plankton. Therefore, it is very important to identify the type of mixed red tide algae in Qinhuangdao sea area. In this paper, three-dimensional fluorescence spectroscopy and chemometrics were applied to the identification of typical toxic mixed red tide algae in Qinhuangdao. Firstly, the three-dimensional fluorescence spectrum data of typical mixed red tide algae in Qinhuangdao sea area were measured by f-7000 fluorescence spectrometer, and the contour map of algae samples was obtained. Secondly, the contour spectrum analysis is carried out to find the excitation wavelength of the peak position of the three-dimensional fluorescence spectrum and form the new three-dimensional fluorescence spectrum data selected by the feature interval. Then, the new three-dimensional fluorescence spectrum data are extracted by principal component analysis (PCA). Finally, the feature extraction data and the data without feature extraction are used as the input of the genetic optimization support vector machine (GA-SVM) and particle swarm optimization support vector machine (PSO-SVM) classification models, respectively, to obtain the classification model of mixed red tide algae, and the two feature extraction analysis methods and two classification algorithms are compared. The results show that the classification accuracy of the test set using the principal component feature extraction and GA-SVM classification method is 92.97 %, when the excitation wavelengths are 420 nm, 440 nm, 480 nm, 500 nm and 580 nm, and the emission wavelengths are 650-750 nm. Therefore, it is feasible and effective to apply the three-dimensional fluorescence spectrum characteristics and genetic optimization support vector machine classification method to the identification of toxic mixed red tide algae in Qinhuangdao sea area.

Bepotastine Sensitizes Ovarian Cancer to PARP Inhibitors through Suppressing NF-κB-Triggered SASP in Cancer-Associated Fibroblasts.

Therapy-induced senescence (TIS) is common in tumor cells treated with PARP inhibitors (PARPis) and can serve as a promising target for improving PARPi efficacy. However, whether stromal components within the tumor microenvironment undergo TIS caused by PARPis and contribute to consequential treatment failure remain unclear. We previously revealed that PARPis triggered a senescence-like secretory phenotype in stromal fibroblasts. Here, we further explored PARPi-induced senescence in the stroma, its contribution to PARPi resistance, and opportunities to leverage stromal TIS for improved PARPi sensitivity. In this study, we demonstrated that tumor tissues from patients treated with neoadjuvant PARPis showed a significant senescence-like phenotype in the stroma. Moreover, PARPi-induced senescent cancer-associated fibroblasts (CAFs) displayed a senescence-associated secretory phenotype (SASP) profile that was sufficient to induce tumor resistance to PARPis in both homologous recombination-deficient (HRD) and -proficient ovarian cancer cells. Using the GLAD4U database, we found that bepotastine, an approved H1-antihistamine, inhibited the SASP of PARPi-primed CAFs at clinical serum concentrations. We further demonstrated that bepotastine attenuated fibroblast-facilitated tumor resistance to PARPis in three-dimensional organotypic cultures and HRD-positive patient-derived xenograft models. Mechanistically, bepotastine suppressed PARPi-triggered SASP by inhibiting NF-κB signaling independent of the histamine H1 receptor. Taken together, our results highlight the importance of stromal TIS and SASP in PARPi resistance, and targeting SASP with bepotastine may be a promising therapeutic option for improving PARPi sensitivity in ovarian cancer.

A water-stable dual-responsive Cd-CP for fluorometric recognition of hypochlorite and acetylacetone in aqueous media.

One novel cadmium(II)-coordination polymer [Cd3L2(datrz)(H2O)3] (CP 1) is controllably synthesized by surmising the astute combination of semi-rigid tricarboxylate acid 4-(2',3'-dicarboxylphenoxy) benzoic acid (H3L) and auxiliary ligand 3,5-diamino-1,2,4-triazole (datrz). Structure analysis shows that CP 1 has a two-dimensional (2D) layer structure with a 5-nodal (43) (44·62) (45·64·8) (45·6) (47·66·82) topology. Further investigations reveal that CP 1 shows superordinary water stability and good thermal stability. The fluorescent explorations suggest that the as-synthesized CP 1 could emit blue light centered at 485 nm, attributing to ligand-based emission. In terms of sensing investigations, CP 1 could act as a fluorescent sensor for detecting hypochlorite (ClO-) and acetylacetone (acac) through fluorescence turn-off process in aqueous solution, and the detection limit could reach 0.18 µM and 0.056 µM, respectively. Further research reveals that it is more likely the N-H···O-Cl hydrogen bonds between -NH2 groups of the triazole ligands and O atoms of ClO- plays the key role in the system, which may serve as a bridge for the energy transfer, leading to fluorescence quenching of the chemosensor. While the photoinduced electron transfer (PET) combined with inner filter effect (IFT) should be responsible for the turn-off fluorescence of CP 1 triggered by acac.

Progress on application of PD⁃1／PD⁃L1 monoclonal antibodies in oncotherapy / 中国生物制品学杂志

@#Abstract：Programmed death receptor⁃ 1（PD⁃1）belongs to the family of immunoglobulin B7⁃CD28，which plays an important role in regulating immune response in human body. Since the first PD⁃1／PD⁃ligand 1（PD⁃L1）monoclonal antibody was approved for marketing in China in 2018，the value of PD⁃1／PD⁃L1 immunotherapy in oncotherapy has attracted wide attention. Based on the introduction of the action mechanism of PD⁃1／PD⁃L1 mAbs，this paper reviews the application progress of 8 on ⁃ market PD ⁃ 1／PD ⁃ L1 mAbs in China in oncotherapy from the perspectives of approved indications，clinical trials，usage and dosage，and adverse reactions，in order to provide reference for the rational appli⁃ cation of PD⁃1／PD⁃L1 monoclonal antibodies in clinic.

Intelligent air defense task assignment based on hierarchical reinforcement learning.

Modern air defense battlefield situations are complex and varied, requiring high-speed computing capabilities and real-time situational processing for task assignment. Current methods struggle to balance the quality and speed of assignment strategies. This paper proposes a hierarchical reinforcement learning architecture for ground-to-air confrontation (HRL-GC) and an algorithm combining model predictive control with proximal policy optimization (MPC-PPO), which effectively combines the advantages of centralized and distributed approaches. To improve training efficiency while ensuring the quality of the final decision. In a large-scale area air defense scenario, this paper validates the effectiveness and superiority of the HRL-GC architecture and MPC-PPO algorithm, proving that the method can meet the needs of large-scale air defense task assignment in terms of quality and speed.

Patterns of Caudate Lobe Invasion of Hilar Cholangiocarcinoma: A Panoramic Histologic Study of Liver.

BACKGROUND: At present, caudate lobectomy (CL) in hilar cholangiocarcinoma (HCCA) was controversial. Our study was designed to investigate the features of caudate lobe invasion (CLI) by whole-mount histologic large sections (WHLS). METHODS: A total of 46 HCCA patients underwent hemihepatectomy or trisectionectomy combined with CL were included. Serial WHLS (120 mm × 100 mm) were collected, and the relationship between caudate lobe and tumor was retained to determine the incidence of CLI. Hematoxylin and eosin (HE) and immunohistochemical (IHC) staining were completed to further explore the pathway of CLI. RESULTS: The whole region of the Glisson system in caudate lobe and hilar area can be clearly displayed by WHLS, and 32 (32/46 69.6%) patients were identified with CLI. There were three different pathways of CLI with panoramic IHC staining. The most common pathway is through the fibrous connective tissue along Glisson system (20/32 62.5%, without carcinoma in bile ducts). The Bismuth type, tumor size, vascular invasion, pathological type, and hepatic invasion were related to the CLI (p < 0.05). CONCLUSIONS: The incidence and distribution of CLI provided histologic evidence for CL in HCCA. Based on the invasion pathway, it is necessary to assess the fibrous connective tissue in Glisson system of caudate lobe in pathological research and practice.

Immune checkpoint inhibitor-based therapy for advanced clear cell renal cell carcinoma: A narrative review.

The prognosis for advanced clear cell renal cell carcinoma (ccRCC) is not satisfactory, even though its treatment has evolved rapidly over the past 20 years. Systemic ccRCC treatment options mainly involve antiangiogenic therapy, immune checkpoint blockade, or a combination of these therapies, and as more clinical evidence becomes available, immune checkpoint inhibitors (ICIs) are increasingly dominant. Conventional ICIs lead to the restoration of T-cell activation and a reduction in T-cell depletion by specifically blocking programmed cell death 1 (PD-1), programmed cell death 1 ligand 1 (PD-L1) or cytotoxic T lymphocyte antigen 4 (CTLA-4), ultimately enhancing the antitumor immune response. There is no doubt that these therapies have achieved some clinical efficacy in the overall ccRCC population, but response rates and durability remain a great challenge. Therefore, novel immune checkpoints or new combination therapeutic strategies based on ICIs continue to be sought and developed. This review will provide a comprehensive overview of ICI-based therapeutic strategies in advanced ccRCC, including their mechanisms of action and the latest clinical evidence.

"RESET" Effect: Random Extending Sequences Enhance the Trans-Cleavage Activity of CRISPR/Cas12a.

The trans-cleavage activity of CRISPR/Cas12a has been widely used in biosensing applications. However, the lack of exploration on the fundamental properties of CRISPR/Cas12a not only discourages further in-depth studies of the CRISPR/Cas12a system but also limits the design space of CRISPR/Cas12a-based applications. Herein, a "RESET" effect (random extending sequences enhance trans-cleavage activity) is discovered for the activation of CRISPR/Cas12a trans-cleavage activity. That is, a single-stranded DNA, which is too short to work as the activator, can efficiently activate CRISPR/Cas12a after being extended a random sequence from its 3'-end, even when the random sequence folds into secondary structures. The finding of the "RESET" effect enriches the CRISPR/Cas12a-based sensing strategies. Based on this effect, two CRISPR/Cas12a-based biosensors are designed for the sensitive and specific detection of two biologically important enzymes.

Characteristic of Perineural Invasion in Hilar Cholangiocarcinoma Based on Whole-Mount Histologic Large Sections of Liver.

Background & Objective: Perineural invasion is an important biological feature of hilar cholangiocarcinoma (HCCA). We developed a whole-mount histologic large sections (WHLS) of the liver to evaluate peripheral nerve invasion (PNI) of HCCA. Methods: Using sampling, fixation, dehydration, embedding, sectioning, hematoxylin and eosin (H&E) and immunohistochemical (IHC) staining, and scanning, the characteristics of intrahepatic and extrahepatic PNI in 20 patients with Bismuth type III and type IV HCCA were analyzed with WHLS. Correlation between the characteristics of nerve invasion and tumor size, vascular invasion (artery, portal vein), degree of differentiation, microvascular invasion (MVI), carbohydrate antigen19-9 (CA19-9), and differentiation degree of HCCA was statistically evaluated. Results: The WHLS of the liver was successfully established, which enabled us to observe intrahepatic and extrahepatic distribution of HCCA and whether surrounding tissues including nervous, blood, and lymph vessels were infiltrated. Extrahepatic and intrahepatic PNI were identified in 20 (100%) patients and 1 (5.0%) patient, respectively. Vessel density decreased in most invaded nerves presented by CD-34, which correlated with 100% of poorly differentiated and 83% of moderately differentiated tumors (P<0.008). Conclusion: This study established a WHLS of the liver that can be used for clinical diagnosis and research, and confirmed that extrahepatic PNI is prevalent, but intrahepatic nerve invasion is rare and does not accompany the invasion scope of bile ducts in types III and IV HCCA. In addition, moderately and poorly differentiated malignant tumors are more prone to PNI, independent of blood supply.

[Temporal and Spatial Variation in O3 Concentration Near the Surface of Shandong Peninsula and Analysis of Potential Source Areas].

The purpose of this study was to explore the temporal and spatial distribution characteristics and potential sources of ozone (O3) in the Shandong Peninsula over a long period of time based on the analysis of the temporal and spatial changes in O3 concentration in Shandong Peninsula from 2005 to 2020. We used wavelet analysis, the entropy weight method, and correlation analysis to discuss O3 and its influencing factors and researched the potential sources of O3 in Shandong Peninsula. The results showed that:① in terms of the time pattern, the near-surface O3 in Shandong Peninsula showed a "triple peak" trend from 2005 to 2020, reaching the maximum value of[(40.48±7.64) µg·m-3] in 2010 and a minimum value of[(36.63±5.61) µg·m-3] in 2013. The season was expressed as:summer[(42.49±1.7) µg·m-3]>spring[(40.65±0.6) µg·m-3]>autumn[(36.47±0.7) µg·m-3]>winter[(36.46±0.3) µg·m-3]. ② In terms of the spatial pattern, the O3 concentration of Shandong Peninsula gradually increased with the increase in latitude from 2005 to 2020, showing the characteristics of high concentrations in the east and west and low in the middle region. During the 16-year evolution of the O3 concentration, there was a 1.5 a main oscillation period. ③The analysis of meteorological conditions revealed that O3 concentration was positively correlated with temperature, precipitation, relative humidity, and sunshine hours, whereas pressure and wind speed were negatively correlated. In the analysis of social factors, soot (dust) emissions were the most obvious factor affecting the third indicator, with a weight of 0.25. ④ Through simulating the trajectory of airflow from different regions (Ji'nan and Qingdao), it was found that the ocean airflow contributed 10.69% to Jinan and 48.94% to Qingdao. There was 64.04% of the long-distance air mass transmission path coming from the northwest, and 43.69% of the short-distance air mass transmission path was from the Bohai Sea and the Yellow Sea, followed by Shandong Province with 21.01%. ⑤ The analysis of potential sources of O3 showed that the potential sources of Ji'nan were mainly distributed in Jinzhou, Liaoning Province, northern Jiangsu Province, Hubei Province, and Anhui Province, with a WPSCF value >0.6, and Qingdao's WPSCF value of >0.6 was mainly distributed in the Yellow Sea area. The O3 contribution of Jining City, Linyi City, Xuzhou City, Huaibei City, and Lianyungang City was >40 µg·m-3. The area with >45 µg·m-3 in Qingdao was mainly in the Yellow Sea. Through the analysis of potential sources in the Shandong Peninsula, particular attention should be paid to the supply of industrial sources in the surrounding areas and the marine sources provided by marine air pollution.

Identification of ichthyotoxic red tide algae based on three-dimensional fluorescence spectra and particle swarm optimization support vector machine.

Acccurate identification whether red tide has ithyotoxicity is very significant for microalgae monitoring. In order to realize the rapid and non-destructive detection of ichthyotoxic red tide algae, a detection method combining three-dimensional (3D) fluorescence spectrum and particle swarm optimization support vector machine (PSO-SVM) was developed to monitor the ichthyotoxic red tide algae with cell concentrations from 104 cells/mL to 106 cells/mL. The contour maps contracted form three-dimensional fluorescence spectra of six common species of ichthyotoxic algae and eight common species of non-ichthyotoxic algae,which are analyzed to select the optimal emission and excitation wavelength span. The new feature data are acquired by using the emission spectrum data at 480 nm and 510 nm excitation wavelengths. The new feature data are used as the input of particle swarm optimization support vector machine to establish the optimal classification model of ichthyotoxic algae, which achieves an classification accuracy of 100% for the test set. The optimal classification model is successfully applied to identify the ichthyotoxicity of different algae including Heterosigma akashiwo, Chattonella marina, Phaeocystis globosa, Prorocentrum donghaiense, Karenia dunnii, Isoscelina galbana, Isosceles globosa and Skeletonema costatum.

A controlled clinical study of a two-trocar mini-laparoscopic technique versus the standard laparoscopic technique in treatment of adult renal cysts.

INTRODUCTION: Laparoscopic renal cyst decortication is currently the best choice for the treatment of simple renal cysts and is widely used in clinical practice. AIM: To investigate the safety and clinical efficacy of two-trocar mini-laparoscopic decortication of adult renal cysts. MATERIAL AND METHODS: A total of 90 patients were enrolled in the study and randomly divided into two groups: a two-trocar mini-laparoscopic treatment group (M group) and a three-trocar standard laparoscopic treatment group (S group), with 45 patients in each group. RESULTS: The average length of hospital stay was shorter, and the demand for postoperative analgesics was less in the M group than in the S group (p < 0.05). The proportion of "very satisfied" patients in the patient physical recovery satisfaction survey was significantly higher in the M group than in the S group (p < 0.05). Of the 45 patients in the M group, 40 successfully underwent surgery. In 3 patients, the two-trocar procedure was converted to a three-trocar procedure due to difficulty in separating perirenal adhesion for visualization. Mini-laparoscopic surgery was converted to classic laparoscopic surgery in 2 patients. In the S group, 44 patients successfully underwent the renal cyst decortication procedure. One patient underwent partial renal resection due to an intraoperative diagnosis of multilocular cystic renal cell carcinoma. Postoperative urine leakage was reported in 3 patients in the M group and two in the S group. CONCLUSIONS: Two-trocar mini-laparoscopic treatment of renal cysts is as safe and effective as traditional laparoscopy but is associated with less cosmetic damage, leading to a better physical appearance.

Signal amplification and output of CRISPR/Cas-based biosensing systems: A review.

CRISPR (clustered regularly interspaced short palindromic repeats)/Cas (CRISPR-associated) proteins are powerful gene-editing tools because of their ability to accurately recognize and manipulate nucleic acids. Besides gene-editing function, they also show great promise in biosensing applications due to the superiority of easy design and precise targeting. To improve the performance of CRISPR/Cas-based biosensing systems, various nucleic acid-based signal amplification techniques are elaborately incorporated. The incorporation of these amplification techniques not only greatly increases the detection sensitivity and specificity, but also extends the detectable target range, as well as makes the use of various signal output modes possible. Therefore, summarizing the use of signal amplification techniques in sensing systems and elucidating their roles in improving sensing performance are very necessary for the development of more superior CRISPR/Cas-based biosensors for various applications. In this review, CRISPR/Cas-based biosensors are summarized from two aspects: the incorporation of signal amplification techniques in three kinds of CRISPR/Cas-based biosensing systems (Cas9, Cas12 and Cas13-based ones) and the signal output modes used by these biosensors. The challenges and prospects for the future development of CRISPR/Cas-based biosensors are also discussed.