LncRNA OIP5-AS1 Targets the miR-140-5p/UBR5 Cascade to Promote the Development of Gastric Cancer.

Gastric cancer (GC) is a malignant tumor with the highest incidence among all kinds of malignant tumors in China. Long noncoding RNAs (LncRNAs) have been reported to act as microRNA (miRNAs) sponges and thus play key roles in biological processes and pathogenesis. Thus, this study aimed to investigate the functional effects and the regulatory mechanism of lncRNA opa interacting protein 5-antisense 1 (OIP5-AS1) in gastric cancer cells. The expression of OIP5-AS1, miR-140-5p, Ubiquitin protein ligase E3 component n-recognin 5 (UBR5) was detected using quantitative real-time polymerase chain reaction (qRT-PCR). Cell proliferation, apoptosis, migration, and invasion were assessed using Cell-Counting Kit-8 (CCK-8), Flow cytometry, and Transwell assays. UBR5 protein level was detected by Western blot. Binding between miR-140-5p and OIP5-AS1 or UBR5 was predicted by Starbasev2.0 and TargetScan, and verified using Dual-luciferase reporter assays and RNA pull-down assay. A xenograft mice model was used to evaluate the effects of OIP5-AS1 on tumor growth in vivo. OIP5-AS1 was upregulated in GC cancer and cells. OIP5-AS1 knockdown inhibited cell proliferation, migration, invasion, but induced cell apoptosis in GC. In mechanism, OIP5-AS1 might serve as a sponge for miR-140-5p to enhance UBR5 expression. Moreover, overexpression of miR-140-5p or UBR5 partly reversed the effects of OIP5-AS1 depletion on the progression of GC cells. Furthermore, OIP5-AS1 depletion also suppressed tumor growth in vivo. OIP5-AS1 silencing might suppress proliferation, migration, invasion, and induced apoptosis in GC cells by regulating the miR-140-5p/UBR5 axis.

A Fast Soft Continuum Catheter Robot Manufacturing Strategy Based on Heterogeneous Modular Magnetic Units.

Developing small-scale continuum catheter robots with inherent soft bodies and high adaptability to different environments holds great promise for biomedical engineering applications. However, current reports indicate that these robots meet challenges when it comes to quick and flexible fabrication with simpler processing components. Herein, we report a millimeter-scale magnetic-polymer-based modular continuum catheter robot (MMCCR) that is capable of performing multifarious bending through a fast and general modular fabrication strategy. By preprogramming the magnetization directions of two types of simple magnetic units, the assembled MMCCR with three discrete magnetic sections could be transformed from a single curvature pose with a large tender angle to a multicurvature S shape in the applied magnetic field. Through static and dynamic deformation analyses for MMCCRs, high adaptability to varied confined spaces can be predicted. By employing a bronchial tree phantom, the proposed MMCCRs demonstrated their capability to adaptively access different channels, even those with challenging geometries that require large bending angles and unique S-shaped contours. The proposed MMCCRs and the fabrication strategy shine new light on the design and development of magnetic continuum robots with versatile deformation styles, which would further enrich broad potential applications in biomedical engineering.

Natural Cilia and Pine Needles Combinedly Inspired Asymmetric Pillar Actuators for All-Space Liquid Transport and Self-Regulated Robotic Locomotion.

Natural structures and motion behaviors open new avenues for effective small-scale transport, such as the plant-inspired energy-free liquid transport surfaces and cilia-inspired propulsion systems. However, they are restricted by either the fixed structure or nonself-regulating beating modes, making many complex tasks remain challenging, e.g., the controllable multidirectional liquid transport and flexible propulsion. Herein, inspired by pine needles and natural cilia, we report an asymmetric-structured intelligent magnetic pillar actuator (AI-MPA) with both the "passive" and "active" transport features. Under the control of the magnetic field, the AI-MPA shows an all-space liquid transport ability toward arbitrary directions. Moreover, benefiting from the material's magnetoelasticity and asymmetric-structured design, the AI-MPA enables self-regulation of two-dimensional (2D)/three-dimensional (3D) cilia-like beating modes and can be further developed for robotic crawling and self-rotatable motion. The AI-MPA integrates the superiority of static and dynamic systems in nature and exhibits intelligent self-regulation that could not be achieved before. Confirmed theoretically and demonstrated experimentally, this work provides insights into increasingly functional and intelligent miniature biomimetic systems, with applications from directional liquid transport to robotic locomotion.

Assessment of the Effect on Thromboprophylaxis with Multifaceted Quality Improvement Intervention based on Clinical Decision Support System in Hospitalized Patients: A Pilot Study.

Background: To explore the feasibility and effectiveness of multifaceted quality improvement intervention based on the clinical decision support system (CDSS) in VTE prophylaxis in hospitalized patients. Methods: A randomized, department-based clinical trial was conducted in the department of respiratory and critical care medicine, orthopedic, and general surgery wards. Patients aged ≥18 years, without VTE in admission, were allocated to the intervention group and received regular care combined with multifaceted quality improvement intervention based on CDSS during hospitalization. VTE prophylaxis rate and the occurrence of hospital-associated VTE events were analyzed as primary and secondary outcomes. Results: A total of 3644 eligible residents were enrolled in this trial. With the implementation of the multifaceted quality improvement intervention based on the CDSS, the VTE prophylaxis rate of the intervention group increased from 22.93% to 34.56% (p < 0.001), and the incidence of HA-VTE events increased from 0.49% to 1.00% (p = 0.366). In the nonintervention group, the VTE prophylaxis rate increased from 24.49% to 27.90% (p = 0.091), and the incidence of HA-VTE events increased from 0.47% to 2.02% (p = 0.001). Conclusions: Multifaceted quality improvement intervention based on the CDSS strategy is feasible and expected to facilitate implementation of the recommended VTE prophylaxis strategies and reduce the incidence of HA-VTE in hospital. However, it is necessary to conduct more multicenter clinical trials in the future to provide more reliable real-world evidence.

Clinical Observation of CT-Guided Intervertebral Foramen Puncture and Radiofrequency Thermocoagulation for the Treatment of Refractory PHN in the Superior Thoracic Segment.

BACKGROUND: Post-herpetic neuralgia (PHN) is a typical neuropathic pain. Conventional oral analgesics and nerve block therapy can only obtain temporary analgesia in many cases. This study summarized the clinical effect of CT-Guided intervertebral foramen puncture and radiofrequency thermocoagulation through the superior margin of costotransverse joint for the treatment of refractory PHN in the superior thoracic segment. OBJECTIVES: To observe the efficacy of CT-Guided intervertebral foramen puncture and radiofrequency thermocoagulation (RFT) treatment of refractory PHN in the T1 ~ T3 spinal innervation area. STUDY DESIGN: A retrospective, observational study. SETTING: Pain department, Jiaxing and Hangzhou, China. METHODS: Thirty-six patients with intractable superior thoracic PHN were admitted to the Pain Department. After the positioning image of CT was taken by prone, the upper thoracic segment was scanned in axial position with the layer thickness of 3 mm of spinal model.The puncture path was designed by selecting the slice of the foramen and costotransverse joint from the obtained images. The needle was inserted to the corresponding foramen. After confirmation by high and low frequency current stimulation tests, the RFT was performed at 90°C for 180s. A numeric rating scale (NRS) for pain was recorded before surgery, 2 hours, 1 week, 4 weeks and 8 weeks after surgery and the mental state was assessed with the SF-36 clinical questionnaire before surgery, 4 weeks and 8 weeks after surgery. RESULTS: Following RFT intervention the measured pain NRS significantly decreased after 2 hours, 1 week, 4 weeks and 8 weeks (P < 0.01). SF-36 scores in all categories increased 4 and 8 weeks after the operation (P < 0.01). No serious adverse effects were reported during the study period and no hypoxemia was found under intraoperative nasal catheter oxygen inhalation. LIMITATIONS: Limitations of this study include the small sample size, and nonrandomized retrospective design. CONCLUSION: CT-Guided intervertebral foramen puncture and RFT through the superior margin of the costotransverse joint can effectively improve refractory PHN in the superior thoracic segment with good safety.

Functionalized Spiral-Rolling Millirobot for Upstream Swimming in Blood Vessel.

Untethered small robots with multiple functions show considerable potential as next-generation catheter-free systems for biomedical applications. However, owing to dynamic blood flow, even effective upstream swimming in blood vessels remains a challenge for the robot, let alone performing medical tasks. This paper presents an untethered millirobot with a streamlined shape that integrates the engine, delivery, and biopsy modules. Based on the proposed spiral-rolling strategy, this robot can move upstream at a record-breaking speed of ≈14 mm s-1 against a blood phantom flow of 136 mm s-1 . Moreover, benefiting from the bioinspired self-sealing orifice and easy-open auto-closed biopsy needle sheath, this robot facilitates several biomedical tasks in blood vessels, such as in vivo drug delivery, tissue and liquid biopsy, and cell transportation in rabbit arteries. This study will benefit the development of wireless millirobots for controllable, minimally invasive, highly integrated, and multifunctional endovascular interventions and will inspire new designs of miniature devices for biomedical applications.

[Influence of hemoglobin level(Hb) on survival and prognosis of elderly hip fracture at admission].

OBJECTIVE: To analyze the relationship between hemoglobin(Hb) level on admission and survival prognosis of patients with hip fracture. METHODS: From February 2016 to October 2018, 249 elderly patients with hip fracture were surgically treated including 62 males and 187 females;the age ranged from 60 to 91(73.67±10.52) years;the time from injury to operation was (6.79±2.27) d. The clinical and laboratory examination results were collected. The Hb level at admission and the mortality at 30, 90, 180 and 360 days after operation were observed. According to the Hb level at admission, the patients were divided into Hb<120 g/L and Hb≥120 g/L groups. The survival conditions of the two groups at 30, 90, 180 and 360 days after operation were compared and analyzed. Logistic regression was used to analyze the effect of Hb level on death 30, 90, 180 and 360 days after operation. RESULTS: The mortality rates at 30, 90, 180 and 360 days after operation were 5.22%, 9.24%, 16.87% and 20.48% respectively. The level of Hb at admission was a risk factor for prognosis and death 30, 90, 180 and 360 days after operation(P<0.05). The OR(95% CI) were 2.431(1.475-4.006), 2.625(1.468-4.695), 2.276(1.320-3.925) and 2.082(1.221-3.551) respectively. CONCLUSION: The level of Hb at admission can affect the survival and prognosis of elderly patients with hip fracture. We should further study how to manage the level of Hb before operation.

Millimeter-Scale Soft Continuum Robots for Large-Angle and High-Precision Manipulation by Hybrid Actuation.

Developing small-scale soft continuum robots with large-angle steering capacity and high-precision manipulation offers broad opportunities in various biomedical settings. However, existing continuum robots reach the bottleneck in actuation on account of the contradiction among small size, compliance actuation, large tender range, high precision, and small dynamic error. Herein, a 3D-printed millimeter-scale soft continuum robot with an ultrathin hollow skeleton wall (300 µm) and a large inner-to-outer ratio (0.8) is reported. After coating a thin ferromagnetic elastomer layer (≈100-150 µm), the proposed soft continuum robot equipped with hybrid actuation (tendon- and magnetic-driven mode) achieves large-angle (up to 100°) steering and high-precision (low to 2 µm for static positioning) micromanipulation simultaneously. Specifically, the robot implements an ultralow dynamic tracking error of ≈10 µm, which is ≈30-fold improved than the state of art. Combined with a microneedle/knife or nasopharyngeal swab, the robot reveals the potential for versatile biomedical applications, such as drug injection on the target tissue, diseased tissue ablation, and COVID-19 nasopharyngeal sampling. The proposed millimeter-scale soft continuum robot presents remarkable advances in large-range and high-precise actuation, which provides a new method for miniature continuum robot design and finds broad applications in biomedical engineering.

Effect on thromboprophylaxis among hospitalized patients using a system-wide multifaceted quality improvement intervention: Rationale and design for a multicenter cluster randomized clinical trial in China.

BACKGROUND: Venous thromboembolism (VTE) is a life-threatening disease that can affect each hospitalized patient. But the current in-hospital thromboprophylaxis remains suboptimal and there exists a large gap between clinical practice and guideline-recommended care in China. METHODS: To facilitate implementation of guideline recommendations, we conduct a multicenter, adjudicator-blinded, cluster-randomized clinical trial, aiming to assess the effectiveness of a system-wide multifaceted quality improvement (QI) strategy on VTE prophylaxis improvement and thromboembolism reduction in clinical setting. Hospitals are randomized into intervention or control group. In intervention group, hospitals receive the concept of appropriate in-hospital thromboprophylaxis plus a multifaceted QI which encompasses four components: (1) an electronic alert combining computer-based clinical decision support system and electronic reminders, (2) appropriate prophylaxis based on dynamic VTE and bleeding risk assessments, (3) periodical audit and interactive feedback on performance, (4) strengthened training and patient education. In control, hospitals receive the concept of recommended prophylaxis alone without QI. Thromboprophylaxis will be at the discretion of hospitals and conducted as usual. With a final sample size of 5760 hospitalized patients in 32 hospitals on mainland China, this trial will examine the effect of QI on improvement in thromboprophylaxis and patient-centered outcomes. This is an open-label trial that patients and healthcare professionals will know group allocation after enrollment, but endpoint adjudicators and statisticians will be blinded. RCT# NCT04211181 CONCLUSIONS: The system-wide multifaceted QI intervention is expected to facilitate implementation of recommended VTE prophylaxis in hospital, thereafter reducing VTE incidence and relevant adverse events among hospitalized patients in China.

Correlations between anterior wall motion velocity of ascending aorta measured by quantitative tissue velocity image and left ventricular geometry as well as left heart function in hypertension patients.

BACKGROUD: This study aimed to analyze the correlations between anterior wall motion velocity of ascending aorta measured by quantitative tissue velocity image (QTVI) technique and left ventricular geometry as well as left heart function to evaluate its value of clinical application. METHODS: One hundred ten hypertension patients and 35 healthy controls were included, divided into left ventricular concentric remodeling group and left ventricular hypertrophy group. The QTVI technique was used to obtain the velocity curve of anterior wall of ascending aorta, the peak systolic velocity (Vs), peak velocity of early diastolic motion (Ve) and peak velocity of late diastolic motion (Va). The single-plane Simpson method was utilized to measure the left ventricular ejection fraction (EF). The QTVI method was used to obtain the index of left ventricular diastolic function (Em/Am). RESULTS: Compared to control group, both Vs and Ve values significantly reduced in hypertension group (P<0.05). Both Vs and Ve values were significantly negatively correlated with LVMI and RWT (P<0.01). The Va value was negatively correlated with LVMI (P<0.05). The Vs value was significantly positively correlated with EF value (P<0.01). The Ve value was significantly positively correlated with both EF and Em/Am (P<0.01). The Va value was positive correlated with Em/Am (P<0.05). CONCLUSIONS: The QTVI anterior wall velocity of ascending aorta could be indicator for the geometric patterns and function of left ventricle, which may provide a simple and comprehensive method for clinical assessment of hypertensive heart disease.

[DORSALIS PEDIS FLAP SERIES-PARALLEL BIG TOE NAIL COMPOSITE TISSUE FLAP TO REPAIR HAND SKIN OF DEGLOVING INJURY WITH THUMB DEFECT].

OBJECTIVE: To investigate the effectiveness of dorsalis pedis flap series-parallel big toe nail composite tissue flap in the repairment of hand skin of degloving injury with tumb defect. METHODS: Between March 2009 and June 2013, 8 cases of hand degloving injury with thumb defect caused by machine twisting were treated. There were 7 males and 1 female with the mean age of 36 years (range, 26-48 years). Injury located at the left hand in 3 cases and at the right hand in 5 cases. The time from injury to hospitalization was 1.5-4.0 hours (mean, 2.5 hours). The defect area was 8 cm x 6 cm to 15 cm x 1 cm. The thumb defect was rated as degree I in 5 cases and as degree II in 3 cases. The contralateral dorsal skin flap (9 cm x 7 cm to 10 cm x 8 cm) combined with ipsilateral big toe nail composite tissue flap (2.5 cm x 1.8 cm to 3.0 cm x 2.0 cm) was used, including 3 parallel anastomosis flaps and 5 series anastomosis flaps. The donor site of the dorsal flap was repaired with thick skin grafts, the stumps wound was covered with tongue flap at the shank side of big toe. RESULTS: Vascular crisis occurred in 1 big toe nail composite tissue flap, margin necrosis occurred in 2 dorsalis pedis flap; the other flaps survived, and primary healing of wound was obtained. The grafted skin at dorsal donor site all survived, skin of hallux toe stump had no necrosis. Eight cases were followed up 4-20 months (mean, 15.5 months). All flaps had soft texture and satisfactory appearance; the cutaneous sensory recovery time was 4-7 months (mean, 5 months). At 4 months after operation, the two-point discrimination of the thumb pulp was 8-10 mm (mean, 9 mm), and the two-point discrimination of dorsal skin flap was 7-9 mm (mean, 8.5 mm). According to Society of Hand Surgery standard for the evaluation of upper part of the function, the results were excellent in 4 cases, good in 3 cases, and fair in 1 case. The donor foot had normal function. CONCLUSION: Dorsalis pedis flap series-parallel big toe nail composite tissue flap is an ideal way to repair hand skin defect, and reconstructs the thumb, which has many advantages, including simple surgical procedure, no limitation to recipient site, soft texture, satisfactory appearance and function of reconstructing thumb, and small donor foot loss.

[A study of hemodynamic changes in the arteries of rabbit's eye caused by acute high intraocular pressure].

OBJECTIVE: Using the color Doppler flow imaging (CDFI) to measure and to study the hemodynamic changes of rabbit's retrobulbar artery caused by changes of intraocular pressure (IOP). To provide information for screening of drugs that improves the blood circulation and decrease the IOP. METHODS: This is a self-contrast research performed at the left eye: high IOP was induced, then the hemodynamic changes of rabbit's retrobulbar artery at different IOP stages were observed. RESULTS: Rabbit's ophthalmic artery (OA), ciliary artery (CA), short posterior ciliary artery (SPCA), central retinal artery (CRA) are low resistant artery. When the IOP raised rapidly, the velocity of blood flow became slower and resistance force index became higher. The hemodynamic changes could not return to normal even after the IOP decreased to the normal level. CONCLUSION: A short-term high IOP can influence the hemodynamic pattern of retro-bulbar arteries. Color Doppler flow imaging is a valuable method for monitoring these changes.