Morphological and molecular response mechanisms of the root system of different Hemarthria compressa species to submergence stress.

Introduction: The severity of flood disasters is increasing due to climate change, resulting in a significant reduction in the yield and quality of forage crops worldwide. This poses a serious threat to the development of agriculture and livestock. Hemarthria compressa is an important high-quality forage grass in southern China. In recent years, frequent flooding has caused varying degrees of impacts on H. compressa and their ecological environment. Methods: In this study, we evaluated differences in flooding tolerance between the root systems of the experimental materials GY (Guang Yi, flood-tolerant) and N1291 (N201801291, flood-sensitive). We measured their morphological indexes after 7 d, 14 d, and 21 d of submergence stress and sequenced their transcriptomes at 8 h and 24 h, with 0 h as the control. Results: During submergence stress, the number of adventitious roots and root length of both GY and N1291 tended to increase, but the overall growth of GY was significantly higher than that of N1291. RNA-seq analysis revealed that 6046 and 7493 DEGs were identified in GY-8h and GY-24h, respectively, and 9198 and 4236 DEGs in N1291-8h and N1291-24h, respectively, compared with the control. The GO and KEGG enrichment analysis results indicated the GO terms mainly enriched among the DEGs were oxidation-reduction process, obsolete peroxidase reaction, and other antioxidant-related terms. The KEGG pathways that were most significantly enriched were phenylpropanoid biosynthesis, plant hormone signal transduction etc. The genes of transcription factor families, such as C2H2, bHLH and bZIP, were highly expressed in the H. compressa after submergence, which might be closely related to the submergence adaptive response mechanisms of H. compressa. Discussion: This study provides basic data for analyzing the molecular and morphological mechanisms of H. compressa in response to submergence stress, and also provides theoretical support for the subsequent improvement of submergence tolerance traits of H. compressa.

How outdoor horticultural activities affect elderly adults' thermal, physiological and psychological responses: a field study.

We recruited 162 healthy elderly adults to determine the thermal, physiological, and psychological effects of horticultural activities (flower arranging, transplanting, and rubble masonry) in outdoor open spaces. We linked these to local climate conditions, physiology, and comfort through a questionnaire survey. The results showed that: (1) the neutral physiological equivalent temperature (NPET) before the horticultural activities were 22.18 â„ƒ for flower arranging, 23.67 â„ƒ for transplanting, and 20.78 â„ƒ for rubble masonry, while the NPET decreased to 18.53 â„ƒ, 20.73 â„ƒ and 18.04 â„ƒ (respectively) after activities. (2) The heart rate and blood oxygen saturation changed significantly (p < 0.05) only after rubble masonry. (3) The average positive affect (PA) scores increased after flower arranging by 4.83, transplanting by 3.30, and rubble masonry by 4.00. (4) After activities, the thermal sensation vote was mainly influenced by globe temperature (41.36%), air temperature (33.47%), and wind speed (25.17%). Thermal comfort vote could be promoted because of 37.35% of an increasing positive and 21.20% of decreasing negative emotion.

DLP fabrication of HA scaffold with customized porous structures to regulate immune microenvironment and macrophage polarization for enhancing bone regeneration.

The immune microenvironment plays a pivotal role in osteoanagenesis. Biomaterials can modulate osteogenic efficacy by inducing specific local immune reactions. As 3D-printing technology advances, digital light projection printing has emerged as a promising method for creating large scale, high-precision biomaterial scaffolds. By adjusting the solid content and the sintering conditions during printing, the pore size of biomaterials can be meticulously controlled. Yet, the systematic influence of pore size on the immune microenvironment remains uncharted. We fabricated 3D-printed hydroxyapatite bioceramic scaffolds with three distinct pore sizes: 400 µm, 600 µm, and 800 µm. Our study revealed that scaffolds with a pore size of 600 µm promote macrophage M2 polarization, which is achieved by upregulating interferon-beta and HIF-1α production. When these materials were implanted subcutaneously in rats and within rabbit skulls, we observed that the 600 µm scaffolds notably improved the long-term inflammatory response, fostered vascular proliferation, and augmented new bone growth. This research paves the way for innovative therapeutic strategies for treating large segmental bone defects in clinical settings.

An investigation into the HIF-dependent intestinal barrier protective mechanism of Qingchang Wenzhong decoction in ulcerative colitis management.

ETHNOPHARMACOLOGICAL RELEVANCE: Ulcerative colitis (UC) is a chronic, non-specific inflammatory disease affecting the colon and rectum with an etiology that remains elusive. Traditional Chinese medicine (TCM) has been widely used on long-term UC treatment to better maintain the efficacy than traditional aminosalicylic acid or glucocorticosteroids and to ease financial burden of patients. Qingchang Wenzhong Decoction (QCWZD) is a modern TCM decoction with established clinical efficacy but the mechanism of its protection on intestinal barrier function remains unclear. AIM OF THE STUDY: Current findings highlight that the activation of the hypoxia inducible factor (HIF) pathway can facilitate the repair of intestinal epithelium barrier. This study is to investigate the protective effects of QCWZD and its HIF-targeted ingredients on hypoxia-dependent intestinal barrier. METHODS: The mice model of UC was induced by dextran sulfate sodium (DSS). Disease activity index (DAI) and histopathology scores and colon length were used to measure the severity of colitis. The DAO activity in serum and protein expression of tight junction (TJ) proteins were detected to explore the function of intestinal barrier. The protein levels of HIF-1α and its downstream gene heme oxygenase-1 (HO-1) were measured as well. HIF-targeted active ingredients in QCWZD were selected by network pharmacology and molecular docking. Protective effects of six constituents on HIF-related anti-oxidative and barrier protective pathway were evaluated by lipopolysaccharide (LPS)-induced HT29 and RAW264.7 cells, through the measurement of the production of ROS and mRNA level of pro-inflammatory cytokines. HIF-1α knockdown was carried out to explore the correlation of protection effects with HIF-related pathway of the active ingredients. RESULTS: QCWZD effectively alleviated colitis induced by DSS and demonstrated a protective effect on intestinal barrier function by upregulating HIF-related pathways. Six specific ingredients in QCWZD, targeting HIF, successfully reduced the production of cellular ROS and proinflammatory cytokines in LPS-induced cells. It is noteworthy that the barrier protection provided by these molecules is intricately linked with the HIF-related pathway. CONCLUSIONS: This study elucidates the HIF-related molecular mechanism of QCWZD in protecting the function of the epithelial barrier. Six compounds targeting the activation of the HIF-dependent pathway were demonstrated to unveil a novel therapeutic approach for managing UC.

Bioinspired Hierarchical Self-Assembled Nanozyme for Efficient Antibacterial Treatment.

Along with the rapid development and ever-deepening understanding of nanoscience and nanotechnology, nanomaterials hold promise to mimic the highly evolved biological exquisite nanostructures and sophisticated functions. Here, inspired by the ubiquitous antibacterial nanostructures on the wing surfaces of some insects, a NiCo2 O4 nanozyme with self-adaptive hierarchical nanostructure is developed that can capture bacteria of various morphotypes via the physico-mechanical interaction between the nanostructure and bacteria. Moreover, the developed biomimetic nanostructure further exhibits superior peroxidase-like catalytic activity, which can catalytically generate highly toxic reactive oxygen species that disrupt bacterial membranes and induce bacterial apoptosis. Therefore, the mechano-catalytic coupling property of this NiCo2 O4 nanozyme allows for an extensive and efficient antibacterial application, with no concerns of antimicrobial resistance. This work suggests a promising strategy for the rational design of advanced antibacterial materials by mimicking biological antibiosis.

Establishment of an immortalized cell line derived from human adenomyosis ectopic lesions.

Because adenomyosis (AM) ectopic primary cells are hard to come by, have a short lifespan, and the characteristics that alter over time, their utility in AM research is constrained. This study aimed to establish a line of immortalized human adenomyosis ectopic cell (ihAMEC) to change this situation. Primary cells were obtained from AM ectopic lesion tissue and then infected with Simian Vacuolating Virus 40 Tag (SV40 T) lentivirus and screened to establish immortalized cells. We verified the main features and found that the ihAMEC could be cultured for more than 50 generations and the proliferation ability of ihAMEC was more active than that of primary cells. The cytoskeleton and cell types of ihAMEC were similar to primary cells and maintained a normal karyotype. The expression of epithelial-mesenchymal transition (EMT) markers, estrogen-metabolizing proteins, and estrogen/progesterone receptors in ihAMEC was similar to the expression seen in primary cells. In addition, the response of ihAMEC under estrogen treatment and Lipopolysaccharide intervention is similar to primary cells. The clonogenic ability of ihAMEC was lower than tumor cells and did not form tumors in tumorigenicity assays. Thus, ihAMEC can be used as in vitro cellular model for pathogenesis and drug development studies regarding AM.

WLP3 Encodes the Ribosomal Protein L18 and Regulates Chloroplast Development in Rice.

Plastid ribosomal proteins play a crucial role in the growth and development of plants, mainly in the gene expression and translation of key genes in chloroplasts. While some information is known about the regulatory processes of plastid ribosomal proteins in various plant species, there is limited knowledge about the underlying mechanisms in rice. In this study, ethyl methanesulfonate (EMS) mutagenesis was used to generate a new mutant called wlp3 (white leaf and panicle3), characterized by white or albino leaves and panicles, which exhibited this phenotype from the second leaf stage until tillering. Furthermore, after a certain period, the newly emerging leaves developed the same phenotype as the rice variety ZH11, while the albino leaves of wlp3 showed an incomplete chloroplast structure and significantly low chlorophyll content. A transition mutation (T to C) at position 380 was identified in the coding region of the LOC_Os03g61260 gene, resulting in the substitution of isoleucine by threonine during translation. WLP3 encodes the ribosomal L18 subunit, which is localized in the chloroplast. Complementation experiments confirmed that LOC_Os03g61260 was responsible for the albino phenotype in rice. WLP3 has high expression in the coleoptile, leaves at the three-leaf stage, and panicles at the heading stage. Compared to the wild-type (WT), wlp3 exhibited reduced chlorophyll synthesis and significantly decreased expression levels of genes associated with plastid development. Yeast two-hybrid (Y2H) analysis revealed that WLP3 interacts with other ribosomal subunits, to influence chloroplast development. These results contribute to a better understanding of the underlying molecular mechanisms of chloroplast development and plastid gene translation.

Gait Domains May Be Used as an Auxiliary Diagnostic Index for Alzheimer's Disease.

BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disorder with cognitive dysfunction and behavioral impairment. We aimed to use principal components factor analysis to explore the association between gait domains and AD under single and dual-task gait assessments. METHODS: A total of 41 AD participants and 41 healthy control (HC) participants were enrolled in our study. Gait parameters were measured using the JiBuEn® gait analysis system. The principal component method was used to conduct an orthogonal maximum variance rotation factor analysis of quantitative gait parameters. Multiple logistic regression was used to adjust for potential confounding or risk factors. RESULTS: Based on the factor analysis, three domains of gait performance were identified both in the free walk and counting backward assessments: "rhythm" domain, "pace" domain and "variability" domain. Compared with HC, we found that the pace factor was independently associated with AD in two gait assessments; the variability factor was independently associated with AD only in the counting backwards assessment; and a statistical difference still remained after adjusting for age, sex and education levels. CONCLUSIONS: Our findings indicate that gait domains may be used as an auxiliary diagnostic index for Alzheimer's disease.

Integrated Design of a Dual-Mode Colorimetric Sensor Driven by Enzyme-like Activity Regulation Strategy for Ultratrace and Portable Detection of Hg2.

Colorimetric analysis for mercury detection has great application potential in the prevention of health damage caused by mercury in the environment. Sensitivity, selectivity, and portability are core competencies of sensors, and concentrating these properties in a single sensor for efficient mercury detection remains a great challenge. Herein, a hollow structure CuS@CuSe@PVP (CCP) was prepared in which the enzyme-like activities could be activated by Hg2+ due to the antagonism between Hg and Se, inspiring the establishment of a colorimetric method for Hg2+ detection. As for Hg2+ detection performance, the linear range (LR) and limit of detection (LOD) were 1-900 and 0.81 nM in the POD-like activity system, respectively. Also, 5-550 nM of LR and 2.34 nM of LOD were achieved in the OD-like activity system. Further, a smartphone-mediated portable RGB nanosensor was fabricated, with a LOD down to 6.65 nM in the POD-like system and 7.97 nM in the OD-like system. Moreover, the excellent self-calibration and satisfactory recovery of 94.77%-106.16% were shown in the application of real water samples analysis. This study represented advanced progress toward emerging applications of nanozymes with multiple enzyme-like activities in heavy metal detection and will accelerate the development of efficient and portable heavy metal sensors.

A spectrally discretized wide-angle parabolic equation model for simulating acoustic propagation in laterally inhomogeneous oceans.

Sound waves can be used to carry out underwater activities. Rapidly and accurately simulating sound propagation is the basis for underwater detection. The wide-angle parabolic model has a good computational speed and accuracy and is currently the main numerical model for mid- and low-frequency sound propagation. The classical wide-angle parabolic equation model is discretized by the finite difference method and a low-order difference scheme is generally adopted. In this paper, a wide-angle parabolic equation model based on a spectral method is proposed. The depth operators of each layer are discretized via the Chebyshev spectral method and then assembled into a global matrix for the forward step. Lateral inhomogeneity is addressed by updating the global depth matrix while stepping forward. In the proposed spectral algorithm, both soft and hard seabeds can be accurately simulated by imposing boundary conditions, and the perfectly matched layer technique is used to truncate the unbounded acoustic half-space. Several representative numerical experiments prove the accuracy and efficiency of the proposed algorithm. However, the spectral method requires that the thickness of the layers does not change during the forward step. Thus, the current spectral algorithm cannot simulate waveguides with terrain undulation, which is its main limitation.

Wafer-Scale 1T' MoTe2 for Fast Response Self-Powered Wide-Range Photodetectors.

The semimetal-based photodetector possesses the intrinsic advantage of high response speed, low power consumption, and wide-range photoresponse. Here, we report the synthesis and application of 1 inch wafer-scale polycrystalline few layer 1T'-MoTe2 on the SiO2/Si substrate by employing a modified chemical vapor deposition method of predeposition of precursors. A continuous film with seamlessly stitched micrometer scale grains has been realized, and the pure 1T' phase was confirmed by Raman spectroscopy. An asymmetric metal electrode photodetector device of Pd-MoTe2-Au was designed and fabricated by using shadow mask-assisted UHV deposition. By measuring the self-powered photocurrent under the illumination of Xe lamp, we show that the device is sensitive to a wide spectra range (λ = 320-1200 nm) while maintaining high performance of the ON/OFF ratio (∼103), responsivity (1.2 A/W), and specific detectivity (7.68 × 1012 Jones). Under 450, 648, and 850 nm pulsed laser illumination, the response time achieves tens of microsecond scale. The device shows polarized photoresponse as well. Our work may promote the potential application of a self-powered high-performance photodetector based on 1T'-MoTe2.

The counterbalance of endothelial glycocalyx and high wall shear stress to low-density lipoprotein concentration polarization in mouse ear skin arterioles.

BACKGROUND AND AIMS: Atherosclerosis preferentially occurs at regions in arterial branching, curvature, and stenosis, which may be explained by the geometric predilection of low-density lipoprotein (LDL) concentration polarization that has been investigated in major arteries in previous studies. Whether this also happens in arterioles remains unknown. METHODS: Herein, a radially non-uniform distribution of LDL particles and a heterogeneous endothelial glycocalyx layer in the mouse ear arterioles, as shown by fluorescein isothiocyanate labeled wheat germ agglutinin (WGA-FITC), were successfully observed by a non-invasive two-photon laser-scanning microscopy (TPLSM) technique. The stagnant film theory was applied as the fitting function to evaluate LDL concentration polarization in arterioles. RESULTS: The concentration polarization rate (CPR, the ratio of the number of polarized cases to that of total cases) in the inner walls of curved and branched arterioles was 22% and 31% higher than the outer counterparts, respectively. Results from the binary logistic regression and multiple linear regression analysis showed that endothelial glycocalyx thickness increases CPR and the thickness of the concentration polarization layer (CPL). Flow field computation indicates no obvious disturbances or vortex in modeled arterioles with different geometries and the mean wall shear stress is about 7.7-9.0 Pa. CONCLUSIONS: These findings suggest a geometric predilection of LDL concentration polarization in arterioles for the first time, and the existence of an endothelial glycocalyx, acting together with a relatively high wall shear stress in arterioles, may explain to some extent why atherosclerosis rarely occurs in these regions.

Engineered Collaborative Size Regulation and Shape Engineering of Tremella-Like Au-MnOx for Highly Sensitive Bimodal-Type Lateral Flow Immunoassays.

Engineered collaborative size regulation and shape engineering of multi-functional nanomaterials (NPs) offer extraordinary opportunities for improving the analysis performance. It is anticipated to address the difficulty in distinguishing color changes caused by subtle variations in target concentrations, thereby facilitating the highly sensitive analysis of lateral flow immunoassays (LFIAs). Herein, tremella-like gold-manganese oxide (Au-MnOx ) nanoparticles with precise MnCl2 regulation are synthesized as immuno signal tracers via a facile one-step redox reaction in alkaline condition at ambient temperature. Avail of the tunable elemental composition and anisotropy in morphology, black-colored tremella-like Au-MnOx exhibits superb colorimetric signal brightness, enhanced antibody coupling efficiency, marvelous photothermal performance, and unrestricted immunological recognition affinity, all of which facilitate highly sensitive multi-signal transduction patterns. In conjunction with the handheld thermal reader device, a bimodal-type LFIA that combines size-regulation- and shape-engineering-mediated colorimetric-photothermal dual-response assay (coined as the SSCPD assay) with a limit of detection of 0.012 ng mL-1 for ractopamine (RAC) monitoring is achieved by integrating Au-MnOx with the competitive-type immunoreaction. This work illustrates the effectiveness of this strategy for establishing high-performance sensing, and the SSCPD assay may be extended to a wide spectrum of future point-of-care (POC) diagnostic applications.

Novel Biomass-Based Polymeric Dyes: Preparation and Performance Assessment in the Dyeing of Biomass-Derived Aldehyde-Tanned Leather.

High-performance chrome-free leather production is currently one of the most concerning needs to warrant the sustainable development of the leather industry due to the serious chrome pollution. Driven by these research challenges, this work explores using biobased polymeric dyes (BPDs) based on dialdehyde starch and reactive small-molecule dye (reactive red 180, RD-180) as novel dyeing agents for leather tanned using a chrome-free, biomass-derived aldehyde tanning agent (BAT). FTIR, 1H NMR, XPS, and UV-visible spectrometry analyses indicated that a Schiff base structure was generated between the aldehyde group of dialdehyde starch (DST) and the amino group of RD-180, resulting in the successful load of RD-180 on DST to produce BPD. The BPD could first penetrate the BAT-tanned leather efficiently and then be deposited on the leather matrix, thus exhibiting a high uptake ratio. Compared with the crust leathers prepared using a conventional anionic dye (CAD), dyeing, and RD-180 dyeing, the BPD-dyed crust leather not only had better coloring uniformity and fastness but it also showed a higher tensile strength, elongation at break, and fullness. These data suggest that BPD has the potential to be used as a novel sustainable polymeric dye for the high-performance dyeing of organically tanned chrome-free leather, which is paramount to ensuring and promoting the sustainable development of the leather industry.

Single-Cell Profiling Uncovers the Roles of Endometrial Fibrosis and Microenvironmental Changes in Adenomyosis.

Purpose: Adenomyosis (AM) is a common benign uterine disorder that has deleterious effects on women's health. However, the pathogenesis of AM is not clearly understood. We aimed to investigate the pathophysiological changes and molecular mechanism in AM. Methods: Single-cell RNA sequencing (scRNA-seq) was employed to construct a transcriptomic atlas of various cell subsets from the ectopic endometrium (EC) and eutopic endometrium (EM) of one AM patient and evaluate differential expression. The Cell Ranger software pipeline (version 4.0.0) was applied to conduct sample demultiplexing, barcode processing and mapping reads to the reference genome (human GRCh38). Different cell types were classified with markers with the "FindAllMarkers" function, and differential gene expression analysis was performed with Seurat software in R. The findings were confirmed by Reverse Transcription Real-Time PCR using samples from three AM patients. Results: We identified nine cell types: endothelial cells, epithelial cells, myoepithelial cells, smooth muscle cells, fibroblasts, lymphocytes, mast cells, macrophages and unknown cells. A number of differentially expressed genes, including CLO4A1, MMP1, TPM2 and CXCL8, were identified from all cell types. Functional enrichment showed that aberrant gene expression in fibroblasts and immune cells was related to fibrosis-associated terms, such as extracellular matrix dysregulation, focal adhesion and the PI3K-Akt signaling pathway. We also identified fibroblast subtypes and determined a potential developmental trajectory related to AM. In addition, we identified increased cell-cell communication patterns in EC, highlighting the imbalanced microenvironment in AM progression. Conclusion: Our results support the theory of endometrial-myometrial interface disruption for AM, and repeated tissue injury and repair could lead to increased fibrosis in the endometrium. Therefore, the present study reveals the association between fibrosis, the microenvironment, and AM pathogenesis. This study provides insight into the molecular mechanisms regulating AM progression.

ExosomePurity: tumour purity deconvolution in serum exosomes based on miRNA signatures.

Exosomes cargo tumour-characterized biomolecules secreted from cancer cells and play a pivotal role in tumorigenesis and cancer progression, thus providing their potential for non-invasive cancer monitoring. Since cancer cell-derived exosomes are often mixed with those from healthy cells in liquid biopsy of tumour patients, accurately measuring the purity of tumour cell-derived exosomes is not only critical for the early detection but also essential for unbiased identification of diagnosis biomarkers. Here, we propose 'ExosomePurity', a tumour purity deconvolution model to estimate tumour purity in serum exosomes of cancer patients based on microribonucleic acid (miRNA)-Seq data. We first identify the differently expressed miRNAs as signature to distinguish cancer cell- from healthy cell-derived exosomes. Then, the deconvolution model was developed to estimate the proportions of cancer exosomes and normal exosomes in serum. The purity predicted by the model shows high correlation with actual purity in simulated data and actual data. Moreover, the model is robust under the different levels of noise background. The tumour purity was also used to correct differential expressed gene analysis. ExosomePurity empowers the research community to study non-invasive early diagnosis and to track cancer progression in cancers more efficiently. It is implemented in R and is freely available from GitHub (https://github.com/WangHYLab/ExosomePurity).

Photochemical Method for Laser Absorption.

During the laser application process, laser energy is usually converted into heat energy, causing high temperature, which affects the (high-speed) aircraft in routine flight. A completely novel photochemical method was investigated to potentially minimize the energy effect of the laser beam. Ag nanoparticles/C3N4 were synthesized by an ultra-low temperature reduced deposit method with Ag mean diameters of 5-25 nm for photofixation of N2. The absorption performance of laser can be improved by using appropriate charge density and small size Ag metal particles. The energy absorption rate was 7.1% over Ag/C3N4 (-40) at 5 mJ/cm2 of laser energy.

Highly Sensitive and Selective Detection of Formaldehyde via Bio-Electrocatalysis over Aldehyde Dehydrogenase.

Formaldehyde (HCHO), as one of the prominent indoor pollutants, causes many health-related problems. Although the detection of HCHO is a widespread concern and a variety of detection methods have been continuously developed, the volatile organic chemical (VOC) interference remains to be solved. Here, we report a highly sensitive and selective method for HCHO detection, relying on the selective electrochemical oxidation of formaldehyde catalyzed by aldehyde dehydrogenases (ALDHs) on a Cu electrode. The detection signal exhibits a standard power law relationship against the analytes with a broad detection range of 10-5-10-15 M and a limit of detection (LOD) of 1.46 × 10-15 M, far below the indoor safe exposure limit (about 10-9 M) for formaldehyde. In comparison to the standard spectrophotometry method, the ALDH-based electrochemical method shows a much high specificity to formaldehyde among common VOCs, such as benzene, toluene, and xylene. This simple yet effective detection technique opens up a new path for developing advanced formaldehyde sensors with high sensitivity and selectivity.

Remission from the 5-Fu-Based Chemotherapy to Gemcitabine-Based Chemotherapy-Based on the Pathological Classification of Periampullary Carcinoma: A Case Report and Literature Review.

Background: Periampullary carcinoma, which includes ampullary carcinoma, pancreatic head cancer, distal common bile duct cancer, and duodenal papillary cancer, is a relatively rare malignancy with uncertain therapeutic options. Although several studies have investigated the efficacy of multiple adjuvant chemotherapy regimens for periampullary carcinoma treatment, the optimal regimen remains to be determined. The inherent heterogeneity of the mucosal origin divides periampullary carcinoma into intestinal and pancreaticobiliary types. Therefore, the selection of chemotherapy regimens based on pathological type may have potential therapeutic significance. Case Presentation: A 72-year-old woman with moderately differentiated periampullary adenocarcinoma experienced disease progression after receiving FOLFOX regimen. Subsequently, the sample was subtyped first by H&E evaluation and then by the evaluation of an IHC panel composed of CK20, CDX2, MUC1, MUC2, and MUC5AC. The pathologists concluded that the patient's sample was of the pancreaticobiliary (PB) subtype. The subsequent change to gemcitabine plus S-1 adjuvant therapy achieved remission of liver metastases based on the pathological classification of the cancer. Conclusion: Based on the pathological classification, adjuvant chemotherapy with gemcitabine may be beneficial for patients with PB subtype periampullary carcinoma. 5-Fu-based adjuvant chemotherapy may be beneficial for patients with intestinal subtype periampullary carcinoma.

Defects of endoscopic biopsy in the diagnosis of periampullary carcinoma and recommendations for diagnosis and treatment: a retrospective study before and after surgery.

Background: Pancreaticoduodenectomy (PD) is the main curative treatment for periampullary carcinoma (PAC), but the high risk of complications in PD means an accurate preoperative diagnosis is essential, because benign lesions can be treated without PD. Despite as the preferred diagnosis method, preoperative endoscopic biopsy is characterized with high false-negative rate, which disturbs the making of surgical plans. We explored the degree of matching between preoperative and postoperative pathological diagnoses, analyzed the shortcomings of endoscopic biopsy, and provide recommendations for the diagnosis and treatment of periampullary tumors. Methods: We retrospectively analyzed 198 patients with periampullary tumors who underwent endoscopic biopsy and PD between June 2013 and February 2021. Data on disease characteristics, such as sex, age, total bilirubin (TBIL), direct bilirubin (DBIL), tumor markers, imaging features, preoperative and postoperative pathology were collected and reviewed. The measurement data with normal distribution were expressed by mean ± standard deviation, and the categorical data were expressed by the number of cases. Results: In our cohort, 196 patients (98.99%) were diagnosed with PAC based on postoperative pathology. Preoperative pathological biopsy was performed in 198 patients with dysplasia (n=76), inflammation (n=7), and PAC (n=115), among whom 111 were diagnosed with PAC at the first biopsy and 4/7 at the second biopsy. The false-negative rate for one preoperative biopsy was 85/196 (43.37%); 74/76 (97.37%) patients in the dysplasia subgroup and 7/7 (100%) patients in the inflammation subgroup showed malignant results after surgery. Conclusions: Preoperative endoscopic biopsy has a high false-negative rate. Multiple sites, greater depth, and more biopsies may increase accuracy. Patients preoperatively diagnosed with dysplasia have a high risk for cancer and are recommended to undergo PD directly.