Case report: Endoscopic full-thickness resection of gastric metastatic tumor from renal cell carcinoma.

Renal cell carcinoma (RCC) is a common malignant kidney tumor; however, gastric metastasis is rare. We report the case of an 82-year-old male patient who developed gastric metastasis 12 years after an initial diagnosis of RCC. The patient underwent endoscopic full-thickness resection (EFTR), and the gastric metastatic focus was successfully removed. Postoperative pathology and immunohistochemistry showed that the gastric metastasis originated from RCC. Although gastric metastasis of RCC is rare, it should be suspected in patients with a history of RCC or gastrointestinal symptoms. EFTR is associated with reduced trauma and greater retention of gastric tissue and function. It is a more appropriate choice than surgical resection; however, it requires more endoscopists.

Case report of a child with long QT syndrome type 14 caused by CALM1 gene mutation and literature review.

OBJECTIVE: To analyze the clinical and genetic characteristics of a patient with long QT syndrome type 14 (long QT syndrome-14, LQT14, OMIM # 616247) caused by a de novo CALM1 mutation. METHODS: The clinical data of the patient were collected, next-generation sequencing technology was used to determine the exome gene sequence of the patient, and the suspected pathogenic locus was verified by Sanger sequencing. RESULTS: A 5-year and 9-month-old girl was admitted to the hospital due to a syncopal episode. During the attack, the main symptoms were loss of consciousness, cyanosis of the face and lips, and weakness of limbs. The child had multiple seizures in the past, all of which occurred after emotional excitement and activity. She was diagnosed with epilepsy for more than 3 years, but the effect of antiepileptic treatment was not satisfactory. The electrocardiogram was normal in the past. A month ago, convulsions occurred again after exercise, and the electrocardiogram showed QTc 496 ms. The treadmill test showed a significant prolongation of QTc after exercise, and the genetic results suggested a new heterozygous variant of CALM1, c.395A>G; p. (Asp132Gly). Consequently, she was diagnosed with LQT14 and treated with propranolol. During a follow-up of 15 months, there were no seizures or syncope. CONCLUSIONS: This patient had multiple episodes of convulsions or syncope after emotional stimulation or activity, with intermittent prolongation of the QTc on routine ECG, marked prolongation of the QTc after exercise, and T-wave alternans, which differed from the LQT14 phenotype caused by the previous CALM1 mutation.

Hyaluronic acid coated nano-particles for H2O2-elevation augmented photo-/chemodynamic therapy.

In recent years, the association of chemodynamic therapy (CDT) with photodynamic therapy (PDT) has attracted much attention due to their mutually reinforced property. Nevertheless, how to further strengthen their performance is still a big challenge. Given the PDT/CDT therapeutic mechanism, the H2O2 amount might affect their final performance. Thus, in this paper, our synthesized pH-responsive Fenton agents (ferrocene-cinnamaldehyde conjugates, Fc-CA) were encapsulated in hyaluronic acid (HA) coated porphyrin-based MOF to obtain supramolecular nano-particles (Fc-CA-PCN-HA). After the CD44-receptor mediated internalization, the released Fc-CA could further dissociate in the acidic pH micro-environment. The released CA can activate the NADPH oxidase to elevate the H2O2 amount which could be preferable to produce more ·OH through Fenton reaction for cancer cells apoptosis. Additionally, O2 was also generated in the CDT which could alleviate tumor hypoxia condition and be provided as the reactant for PDT to produce more 1O2. Thus, given the excellent cascade reactions induced therapeutic performance of Fc-CA-PCN-HA in vitro and in vivo, the H2O2-elevation strategy might further enhance the PDT/CDT outcomes.

RE-doped (RE = La, Ce and Er) Ni2P porous nanostructures as promising electrocatalysts for hydrogen evolution reaction.

The construction of an efficient non-noble-metal electrocatalyst towards alkaline hydrogen evolution is challenging but in great demand. The fabrication of a porous nanostructure and heteroatom doping are two productive strategies for developing effective electrocatalysts. In this contribution, we report the preparation of La, Ce and Er-doped Ni2P porous nanostructures through a facile water bath method and phosphorization strategy. The Er-doped Ni2P porous nanostructure exhibits superb hydrogen evolution reaction (HER) catalytic performance under alkaline conditions with a low cathodic overpotential of 87 mV (10 mA cm-2, glassy carbon) and a small Tafel slope of 65.4 mV dec-1. It also displays excellent electrochemical stability in alkaline electrolytes. First-principles density functional theory (DFT) calculations disclosed the mechanism of the alkaline HER catalysis. For pristine Ni2P, the P site acts as the optimal active site with the Gibbs free energy of H* absorption (ΔGH*) of 0.48 eV. After La, Ce and Er are doped, respectively, the P site is still the active center of the three doping systems. Notably, the ΔGH* value is reduced from 0.48 eV to 0.23 eV (P site in La-doped Ni2P), 0.20 eV (P site in Ce-doped Ni2P) and 0.18 eV (P site in Er-doped Ni2P), suggesting that doping with La, Ce and Er atoms plays a crucial role in decreasing the H* absorption energy on optimal P sites and the optimum active site with a smaller ΔGH* can expedite the charge transfer rate for H* midbody and H2 generation. This is particularly noticeable for Er doping, which is in accordance with the experimental result.

Status and associations of nursing practice environments in intensive care units: A cross-sectional study in China.

OBJECTIVE: The objective of this study is to investigate the status and associations of nursing practice environments in intensive care units of tertiary hospitals and provide suggestions for improvement. BACKGROUND: Nursing shortage is an urgent global problem and a concern in China. Intensive care unit nurses have been reported to have one of the highest rates of burnout; however, their comprehensive perceptions of nursing practice environments have not yet been examined. METHODS: The Nursing Practice Environment Scale was used to conduct a questionnaire-based survey of 1,523 intensive care unit nurses from 22 tertiary hospitals in China. The data collection was conducted in 2020. RESULTS: The overall score for the nursing practice environment was 77.042 ± 19.682 (where 100 was the highest possible score). The three highest scoring dimensions were quality management, clinical nursing professionalism and professional improvement, whereas the three lowest-scoring dimensions were hospital management participation, remuneration package and social status. Educational background, position, gender and hospital type were significantly associated with nurses' satisfaction with the working environment. CONCLUSION: Chinese nurses in the intensive care units of tertiary hospitals reported relatively satisfactory nursing practice environments, but the scale scores in dimensions such as hospital management participation, remuneration package and social status remained low. IMPLICATIONS FOR NURSING MANAGEMENT: Understanding the status and associations of the nursing practice environment in intensive care units provides evidence that new policies are needed. Furthermore, managers are responsible for supervising and ensuring that nursing practice environments meet the criteria necessary to improve job satisfaction.

Emerging roles of the aptasensors as superior bioaffinity sensors for monitoring shellfish toxins in marine food chain.

Shellfish toxins are derived from harmful algae and are easily accumulated in environment and marine food through the food chain, exposing high risks on human health. Preliminary rapid screening is one of the most effective monitoring ways to reduce the potential risks; however, the traditional methods encounter with many limitations, such as complicated procedures, low sensitivity and specificity, and ethical problems. Alternatively, bioaffinity sensors are proposed and draw particular attention. Among them, the aptasensors are springing up and emerging as superior alternatives in recent years, exhibiting high practicability to analyze shellfish toxins in real samples in the marine food chain. Herein, the latest research progresses of aptasensors towards shellfish toxins in the marine food chain in the past five years was reviewed for the first time, in terms of the aptamers applied in these aptasensors, construction principles, signal transduction techniques, response types, individual performance properties, practical applications, and advantages/disadvantages of these aptasensors. Synchronously, critical discussions were given and future perspectives were prospected. We hope this review can serve as a powerful reference to promote further development and application of aptasensors to monitor shellfish toxins, as well as other analytes with similar demands.

The preventive and relieving effects of ginger on postoperative nausea and vomiting: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Postoperative nausea and vomiting are common uncomfortable symptoms experienced by patients. Besides drugs, non-pharmaceutical therapies such as herbal medicine therapy are available. Ginger has played a therapeutic role in patients undergoing chemotherapy and pregnant women, but results from postoperative patients are inconsistent. OBJECTIVES: The aim of this study was to examine and evaluate the preventive effect of ginger on postoperative nausea and vomiting. DESIGN: A systematic review and meta-analysis of randomized controlled trials METHODS: Two independent researchers searched Chinese and English databases from their inception dates to November 2020. The Chinese databases used were CNKI and SinoMed, and the English databases used were PubMed, Embase, and the Cochrane Library. We only included randomized controlled trials. The primary outcomes were nausea score, presented as standard mean difference, and the number of vomiting episodes, presented as risk ratio. The secondary outcomes were side effects and antiemetic drug use, presented as risk ratios. We used the random-effects model. RESULTS: Fourteen randomized trials with a total of 1,506 patients were pooled. At the different time points, the control group had higher postoperative nausea scores than the experimental group, and the differences were significant between the ginger and placebo groups at 2, 6, and 12 h after operation, with standard mean differences and 95% confidence intervals of -1.10 and -1.95 to -0.25, -1.54 and -3.05 to -0.03, and -2.04 and -3.67 to -0.41, respectively. Except in the recovery room, no statistically significant correlation was found between ginger intake and postoperative vomiting, postoperative nausea and vomiting, or antiemetic drug use. CONCLUSION: The results of this meta-analysis demonstrate that ginger can reduce postoperative nausea but showed no significant difference in the incidence rates of postoperative vomiting, postoperative nausea and vomiting, and antiemetic drug use. More high-quality and rigorous trials are needed to elucidate the relationship between ginger intake and the reduction in the incidence of postoperative nausea and vomiting. PROTOCOL REGISTRATION: CRD42020220916.

A label-free colorimetric aptasensor based on split aptamers-chitosan oligosaccharide-AuNPs nanocomposites for sensitive and selective detection of kanamycin.

Herein, the split aptamers, chitosan oligosaccharide, and AuNPs were combined as nanocomposites that present different formations to develop a label-free colorimetric aptasensor for rapid detection of small molecules. Kanamycin was chosen as a model target. Computational studies were performed to assist in the design of orientated immobilization of the split aptamers onto the AuNPs surface. Chitosan oligosaccharide was initially applied as an aggregation inducer of AuNPs, and chitopentaose was screened as the optimal. Under optimized conditions, the proposed aptasensor showed high sensitivity and selectivity, with a limit of detection of 20.58 nM, a linear range of 25-800 nM, and good recoveries of 98.49-104.9% and 85.69-107.0% when employed to detect kanamycin in tap water and milk samples, respectively. Only 55 min was needed for the whole assay. More importantly, this study can serve as a novel and robust reference for the aptasensing detection of other small molecules.

P2Y12 receptor as a new target for electroacupuncture relieving comorbidity of visceral pain and depression of inflammatory bowel disease.

BACKGROUND: The P2Y12 receptor is a kind of purinoceptor that is engaged in platelet aggregation, and P2Y12 inhibitors have been used in clinical antithrombotic therapy. The P2Y12 receptor in microglia induces interleukin-1ß (IL-1ß) expression, which is a key mediator of depression in the brain. Although peripheral P2Y12 is involved in neuropathic pain, whether P2Y12 expression in the medial prefrontal cortex (mPFC) is associated with comorbidities of visceral pain and depression remains unclear. Accumulating evidence suggests that electroacupuncture (EA) is effective in treating inflammatory bowel disease (IBD), but its mechanism is unknown. This study aimed to determine whether P2Y12 expression in the mPFC is associated with comorbidities of visceral pain and depression in IBD and whether EA treats IBD by targeting the P2Y12 receptor. METHODS: We used 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced IBD mice. P2Y12 short hairpin RNA (shRNA) was stereotaxically injected into the bilateral mPFC. EA was performed on bilateral "Dachangshu" (BL25) acupoints once a day for 7 days. Von Frey filaments and colorectal distension were used to detect the mechanical pain threshold and visceral pain sensitivity. The sucrose preference test, tail suspension test and forced swimming test were used to evaluate depression in mice. Western blotting was used to test the expression of P2Y12 and IL-1ß. Immunofluorescence staining was used to assess microglial activity. RESULTS: We found that IBD mice presented visceral pain and depression associated with increased P2Y12 expression in the mPFC. P2Y12 shRNA significantly attenuated visceral pain and depression in IBD mice. P2Y12 shRNA significantly downregulated IL-1ß expression and inhibited the activation of microglia in the mPFC of IBD mice. Meanwhile, EA played a similar role of P2Y12 shRNA. EA significantly downregulated P2Y12 expression, weakened the activation of microglia, and then inhibited IL-1ß expression in the mPFC, thus relieving visceral pain and depression in IBD mice. CONCLUSION: The present study provided new ideas that the P2Y12 receptor in the mPFC could be a new target for the treatment of comorbid visceral pain and depression by EA. This may not only deepen our understanding of the analgesic and antidepressant mechanisms of EA but also promote the application of EA to treat IBD.

A competitive colorimetric aptasensor transduced by hybridization chain reaction-facilitated catalysis of AuNPs nanozyme for highly sensitive detection of saxitoxin.

Saxitoxin (STX) is a small molecule toxin (Mw. ca. 299 g/mol) with high acute toxicity, and it has urgent need of facile analytical methods. Herein, a competitive colorimetric aptasensor was developed for highly sensitive detection of STX. An anti-STX aptamer was hybridized with a complementary strand on the magnetic beads and was competitively bound by STX. The supernatant containing the aptamer binding to STX was obtained by magnetic separation, which could trigger hybridization chain reaction (HCR) to generate rigid double stranded DNAs (dsDNAs) with sticky end and variable length. These HCR-dsDNAs were found to be able to facilitate significant enhancement on the peroxidase-like catalytic capability of AuNPs nanozyme towards 3,3,5,5-tetramethylbenzidine (TMB). The concentration of STX was responded in a "turn on" mode, based on the amplified colorimetric transduction thereof. The aptasensor realized high sensitivity, with a limit of detection (LOD) as low as 42.46 pM. Moreover, a wide linear detection range of 78.13-2500 pM, good selectivity, as well as good recovery rates of 106.2-113.5% when analyzing STX in real shellfish samples were obtained. This strategy could be referred to develop robust aptasensors for simple and highly sensitive detection of other small molecules and toxins.

Advances and perspectives of aptasensors for the detection of tetracyclines: A class of model compounds of food analysis.

The residual tetracyclines in food are frequently applied as the model compounds to develop aptasensors. Until now, more than 100 advanced aptasensors towards tetracyclines have been developed and published in English. This review summarizes and discusses comprehensively these advanced aptasensors, in terms of the principle designs, applied frontier transducers/materials, working performance, and advantages/disadvantages. The aptasensors are classified according to the inherent transduction techniques, i.e., optics, optics-electricity, optics-mass, and electricity-mass. Moreover, the present challenges such as the limited specificity and limited affinity of the aptamers, the future prospects and trends such as further combination with other advanced materials and technologies, and the urgent need of expanding the practical application were discussed and prospected. We hope this review can serve as a powerful tool for both tracing the development progresses of aptasensors and providing adequate references for further development of aptasensing methods for food-related analytes.

Effect of painting intervention based on Mandala-self theory on mood and physiological state in patients in preoperative waiting room. / 基于曼陀罗-è‡ªæ€§ç†è®ºçš„ç»˜ç”»å¹²é¢„å¯¹æœ¯å‰ç­‰å€™å®¤æ‚£è€ æƒ ç»ªåŠç”Ÿç†çŠ¶æ€çš„å½±å“.

OBJECTIVES: The waiting room for surgery is an area set up to improve the surgical turnover rate, but the waiting time for surgery is uncertain. Patients are prone to negative emotions that affect their physiological state during waiting time. This study aims to explore the effect of Mandala painting intervention based on Mandala-self theory on the emotion and physiological state of patients waiting before operation. METHODS: The patients in the control group (n=30) were given routine nursing before operation in the waiting room, and the patients in the intervention group (n=30) were given Mandala painting intervention on the basis of routine nursing. Repeated measurement analysis of variance was used to compare patients' mood, pressure, heart rate, and waiting time of perception after intervention via SPSS 21.0. RESULTS: Diastolic pressure, heart rate, and happiness and excitement showed no statistical significance in the time effect, intervention effect, and interaction between the 2 factors (all P>0.05). Systolic pressure, fidgety, and pain and sadness showed interaction between the time effect and intervention effect (P<0.05 or P<0.01). The waiting time of perception in the intervention group was significantly shorter than that in the control group (P<0.01). CONCLUSIONS: The application of Mandala painting in the operation waiting room is feasible and can effectively regulate the patients' negative mood and systolic pressure, as well as shorten the waiting time of perception.

Potential HIV transmission risk among spouses: marriage intention and expected extramarital male-to-male sex among single men who have sex with men in Hunan, China.

OBJECTIVE: The HIV epidemic in China is shifting from the high-risk groups of men who have sex with men (MSM), injection drug users and sex workers to the general population, and sexual contact among spouses is assumed to be one route of transmission. Our objective was to determine the intention to marry and the expected extramarital male-to-male sex among single Chinese MSM, in order to estimate the potential HIV transmission risk among MSM living with HIV and their female spouses. METHODS: We conducted a web-based, cross-sectional survey between May 2016 and May 2017. A questionnaire covering sociodemographic characteristics, sexual behaviours, HIV-related and homosexuality-related stigma, marriage intention, and expected extramarital sexual behaviours was completed by 556 single MSM in Hunan, China. Descriptive statistics, χ2 test, two-sample t-test and multivariate logistic regression analysis were performed. RESULTS: Currently 48.9% of the participants intended to marry a woman in their lifetime, and 91% of them reported that they would continue to have sex with men after getting married. Those who were living with parents (OR=2.26), self-identified as bisexual (OR=2.57), had at least one heterosexual partner in the previous 6 months (OR=0.33) and perceived a higher level of self-homosexual stigma (OR=1.78) had greater intention to marry a woman. CONCLUSION: Nearly half of Chinese MSM intend to marry women, which has significantly dropped from the estimated percentage more than 10 years ago for Chinese MSM. However, the expectation of extramarital homosexual behaviours was common in these men. Sexual and gender minority stresses especially from family members, homosexual identity assertiveness and related stigma were the main factors for marriage intention, which should be addressed in future studies and practices.

Nanotetrahedron-assisted electrochemical aptasensor with cooperatively-folding aptamer chimera for sensitive and selective detection of lysozyme in red wines.

Although aptamers show great potential in the field of analytical chemistry, their intrinsic shortcomings of relatively weak affinity and selectivity in complex working environment limit their applicability to real analysis, because the flexibility of aptamers makes the specific aptatopes (i.e., binding sites for targets) in the conformational structure unstable and deficient. Herein, an anti-lysozyme aptamer and lysozyme were chosen as models. An aptamer chimera which could cooperatively fold to provide stable aptatopes for lysozyme was designed for improvement of the anti-lysozyme aptamers' recognition ability, and an electrochemical aptasensor was then developed based on the aptamer chimera, with assistance of a rigid DNA nanotetrahedron as a spacer to orientate the aptamer chimera on the electrodes. The nanotetrahedron-aptamer chimera-based aptasensor presented highly sensitive and selective detection towards lysozyme in red wines, furnishing a 42-fold lower LOD (17.9 pmol L-1) and better selectivity than that of the aptasensor with the original aptamer. Moreover, the developed aptasensor was characterized by good recovery (91.3-109.0%), good accuracy, repeatability and stability, indicating the excellent practical applicability of the cooperatively-folding aptamer chimera in real world. This proof-of-concept study can be referred for any other aptamers, analytes, and samples.

Engineering Aptamer with Enhanced Affinity by Triple Helix-Based Terminal Fixation.

The affinity of aptamers relies on their adaptive folding, but the excessive flexibility of the aptamer backbone usually hampers the folding process. Thus, there is an urgent need to engineer aptamers with more stable and defined structures. Herein, we report a postselection strategy for stabilizing aptamer structures, by fixing both termini of the aptamer with a length-optimized triple helix structure. An anti-lysozyme aptamer was engineered in this way, and its affinity was enhanced by almost 10-fold. An electrochemical aptasensor was designed based on this engineered aptamer, assisted by a DNA tetrahedron as a spacer to orient the aptamer. The aptasensor achieved a 180-fold lower limit of detection than that achieved by the aptasensor without termini-fixed aptamer and exhibited high sensitivity and selectivity toward lysozyme in real red wine samples. This work sheds light on engineering aptamers to achieve enhanced affinity and on the application of aptasensors in complex matrices.

Inhibition of histone acetylation by curcumin reduces alcohol-induced fetal cardiac apoptosis.

BACKGROUND: Prenatal alcohol exposure may cause cardiac development defects, however, the underlying mechanisms are not yet clear. In the present study we have investigated the roles of histone modification by curcumin on alcohol induced fetal cardiac abnormalities during the development. METHODS AND RESULTS: Q-PCR and Western blot results showed that alcohol exposure increased gene and active forms of caspase-3 and caspase-8, while decreased gene and protein of bcl-2. ChIP assay results showed that, alcohol exposure increased the acetylation of histone H3K9 near the promoter region of caspase-3 and caspase-8, and decreased the acetylation of histone H3K9 near the promoter region of bcl-2. TUNEL assay data revealed that alcohol exposure increased the apoptosis levels in the embryonic hearts. In vitro experiments demonstrated that curcumin treatment could reverse the up-regulation of active forms of caspase-3 and caspase-8, and down-regulation of bcl-2 induced by alcohol treatment. In addition, curcumin also corrected the high level of histone H3K9 acetylation induced by alcohol. Moreover, the high apoptosis level induced by alcohol was reversed after curcumin treatment in cardiac cells. CONCLUSIONS: These findings indicate that histone modification may play an important role in mediating alcohol induced fetal cardiac apoptosis, possibly through the up-regulation of H3K9 acetylation near the promoter regions of apoptotic genes. Curcumin treatment may correct alcohol-mediated fetal cardiac apoptosis, suggesting that curcumin may play a protective role against alcohol abuse caused cardiac damage during pregnancy.

Triptolide protects rat heart against pressure overload-induced cardiac fibrosis.

BACKGROUND: Emerging evidence underlines the role of inflammation activation in the process of cardiac fibrosis. Triptolide has potent anti-inflammatory and anti-proliferative properties, and extensively used in the treatment of chronic inflammatory disorders. In the current study, we test the hypothesis that triptolide treatment facilitates to attenuate chronic pressure overload-induced cardiac fibrosis in a model of rat. METHODS: Adult male Sprague-Dawley rats were subjected to a suprarenal abdominal aorta constriction (AC) or sham (as control) to induce sustained pressure overload. Eight weeks later, rats were randomly assigned to receive triptolide (9 µg/kg.d, i.p) or vehicle (0.1% dimethyl sulfoxide, 0.2 ml/d, i.p) treatment for an additional 8 weeks. RESULTS: AC caused significant pathological hypertrophy, cardiac fibrosis and reduced cardiac diastolic function. Triptolide treatment markedly inhibited AC-induced increases in myocardial collagen volume fraction, collagen type I/III deposition, left ventricular end-diastolic pressure, expressions of pro-fibrogenic factors (transforming growth factor-ß and angiotensin II) and pro-inflammatory cytokines (IL-1ß and IL-6), NF-κB activation and inflammatory cell infiltration in left ventricles compared with vehicle, without affecting cardiac hypertrophy. However, triptolide had no effects on systemic blood pressure and circulating angiotensin II level. CONCLUSIONS: Collectively, the findings suggested that triptolide treatment elicits favorable anti-fibrogenic effect in a blood pressure-independent manner, at least in part, through inhibiting myocardial pro-fibrogenic factor production and inflammatory activation in the pressure overloaded heart.