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The gut has been a focal point in the research of digestive system disorders. The internal microbiota generates metabolites that function as signaling molecules and substrates, interacting with the intestinal wall and influencing host physiology and pathology. Besides, the gut microbiota and metabolites owe highly diverse types and quantities, posing challenges for quantitative analysis, and monitoring frequent interactions between digestive tract metabolites and the intestinal wall remains a challenge. However, research targeting gut microbiota metabolites has elucidated their relevance to digestive diseases. By modulating metabolites such as short-chain fatty acids, bile acids, and lipopolysaccharides, it is possible to intervene in the progression of diseases such as inflammatory bowel disease and non-alcoholic fatty liver disease. Currently, research on gut microbiota is advancing, and more work is required to explore the interactions between host, microbes and underlying mechanisms. In this review, we have revisited the generation of gut microbiota-related metabolites, their impact on diseases, and modes of interaction, emphasizing the significant role of metabolites in digestive system disorders. It is believed that the linkage between gut microbiota and diseases in current research can be established through metabolites, providing a framework and foundation for research in the field of metabolomics and fundamental mechanisms.

Complexities of the intestine have brought enormous controversy and discussions to the research on the digestive diseases. The neglected gas environment is crucial in shaping the dynamic intestinal microenvironment. Many gases are involved in the biological activities within the intestinal anaerobic environment, including oxygen, hydrogen, carbon monoxide, ammonia, methane, hydrogen sulfide, carbon dioxide, and nitrogen. These gases participate in the regulation of systemic inflammation and metabolism via different pathways, thereby alleviating or promoting the development of intestinal disease. Meanwhile, the constitution and changes of gases reflect the intestinal environment, which could be utilized to monitor the variation in local metabolism and imply the progress of digestive disorders. However, individual gas has intrinsic functions in maintaining a healthy intestinal microenvironment or causing digestive diseases, and the underlying mechanisms are still unclear. Therefore, exploring the profile of gases in the digestive tract and their extraordinary impact on the intestinal microenvironment will be of great value in understanding the interplay between intestinal health and diseases. By reviewing the research progress of gases in the digestive tract, we anticipate that a better understanding of the roles of gases would promote the research and application transformation in this field as well as the diagnostics and treatment of clinical diseases.

Abstract Pancreatic ductal adenocarcinoma (PDAC) is a highly metastatic disease refractory to all targeted and immune therapies. However, our understanding of PDAC microenvironment especially the metastatic microenvironment is very limited partly due to the inaccessibility to metastatic tumor tissues. Here, we present the single-cell transcriptomic landscape of synchronously resected PDAC primary tumors and matched liver metastases. We perform comparative analysis on both cellular composition and functional phenotype between primary and metastatic tumors. Tumor cells exhibit distinct transcriptomic profile in liver metastasis with clearly defined evolutionary routes from cancer cells in primary tumor. We also identify specific subtypes of stromal and immune cells critical to the formation of the pro-tumor microenvironment in metastatic lesions, including RGS5+ cancer-associated fibroblasts, CCL18+ lipid-associated macrophages, S100A8+ neutrophils and FOXP3+ regulatory T cells. Cellular interactome analysis further reveals that the lack of tumor-immune cell interaction in metastatic tissues contributes to the formation of the immunosuppressive microenvironment. Our study provides a comprehensive characterization of the transcriptional landscape of PDAC liver metastasis.

Background. Distal malignant biliary obstruction (DMBO) can result in obstructive jaundice. Endoscopic ultrasound- (EUS-) guided biliary drainage (EUS-BD) has been an alternative for DMBO after failed ERCP. Aim. To compare the efficacy and safety between antegrade and transluminal approaches in patients with unresectable DMBO when ERCP failed. Methods. Patients with DMBO leading to obstructive jaundice after failed ERCP were enrolled in this study. We retrospectively evaluated the safety and efficacy between EUS-guided transluminal stenting (TLS group) and antegrade stenting (AGS group). Results. 82 patients were enrolled, of which 45 patients were in TLS group and 37 in AGS group. There were no statistical differences in the malignancy type, baseline common bile duct diameter, total bilirubin level, reason for EUS-BD, and history of biliary drainage between TLS and AGS groups. The technical success rate was statistically higher in TLS group than in AGS group (97.8 vs. 81.1%, P=0.031). There were no statistical differences in clinical success rate, procedure-related adverse events, stent migration rate, stent dysfunction rate, reintervention rate, and overall patient survival time between TLS and AGS groups. The median time to stent dysfunction or patient death in TLS and AGS groups was 53 and 81 days, respectively (P=0.017). Conclusions. Although AGS had a lower technical success rate than TLS, it was superior to TLS in stent patency in patients with DMBO.

Lithium compounds, a classic class of metal complex medicine that target GSK 3β and are widely known as mood-stabilizer, have recently been reported as potential anti-tumor drugs. The objective of this investigation was to explore the anticancer potential of lithium chloride (LiCl) and elucidate its mode of action in pancreatic cancer cells. The MTT, colony formation, and Edu assay were used to evaluate the impact of LiCl on pancreatic cancer cell proliferation. Various methods were employed to investigate the anti-tumor activity of LiCl and its underlying mechanisms. Cell cycle analysis and apoptosis detection assays were utilized for in vitro experiments, while the orthotopic pancreatic cancer mouse model was employed to evaluate the effectiveness of LiCl treatment in vivo. Furthermore, the impact of LiCl on the proliferation of patient-derived organoids was also studied. The results demonstrated that LiCl inhibited the proliferation of pancreatic cancer (PC) cells, induced G2/M phase arrest, and activated apoptosis. Notably, the triggering of endoplasmic reticulum (ER) stress by LiCl was observed, leading to the activation of the PERK/CHOP/GADD34 pathway, which subsequently promoted apoptosis in PC cells. In the future, Lithium compounds could become an essential adjunct in the treatment of human pancreatic cancer.

Background: Readmission shortly after discharge is indicative of an increased disease severity for patients with ulcerative colitis (UC) and ineffectiveness to medical therapy, which may contribute to a dismal prognosis. Objectives: This study aimed to explore prognostic variables with a nomogram to predict unplanned UC-related readmission within 1 year after discharge. Design: A retrospective cohort study. Methods: Electronic medical records of all UC patients treated at our center between 1 January 2014 and 31 June 2021 were reviewed. A comprehensive analysis of various characteristics, such as demographics, comorbidities, medical history, follow-up appointments, admission endoscopy, histopathologic features, etc., was used to determine the primary end point, which was unplanned UC-related calendar year readmission. Results: We found that the unplanned UC-related readmission rate within 1 year was 20.8%. In multivariable cox analysis, the predictors of the Elixhauser comorbidity index [Hazard ratio (HR): 3.50, 95% confidence interval (CI): 1.93–6.37], regular follow-up (HR: 0.29, 95% CI: 0.16–0.53), any history of corticosteroid use (HR: 3.38, 95% CI: 1.83–6.27), seral level of C-reactive protein (HR: 1.01, 95% CI: 1.00–1.02), and the UC endoscopic index of severity (HR: 1.29, 95% CI: 1.05–1.57) independently predicted calendar year readmission after discharge. The established nomogram had a consistently high accuracy in predicting calendar year readmission in the training cohort, with a concordance index of 0.784, 0.825, and 0.837 at 13, 26, and 52 weeks, respectively, which was validated in both the internal and external validation cohorts. Therefore, UC patients were divided into clinically low-, high-, and extremely high-risk groups for readmission, based on the calculated score of 272.5 and 378. Conclusion: The established nomogram showed good discrimination and calibration powers in predicting calendar year readmission in high-risk UC patients, who may need intensive treatment and regular outpatient visits.

Four Ti53−xZr20Nb10Cu5Be12Agx (x = 0, 1, 3 and 5 at.%) bulk metallic glass composites (BMGCs) with various size, volume fraction and morphology of in-situ crystal phase were prepared by the arc-melting method. The shear bands extensions under strain of 5% and 20% were observed to explore the contributions of in-situ crystal phase on the deformation behaviors. The results showed that addition of Ag element significantly increased the glass forming ability. When Ag addition increased from 0 to 5 at.%, the volume fraction of in-situ crystal phase decreased from 74.5% to 38.3%, the morphology transformed from the dense cluster to the spotted shape, resulting in the decrease of dendrites span length (L) and the increase of dendritic arm spacing (DAS). The size, volume fraction and morphology of in-situ crystal phase had great influence on the initiation and extensions of shear bands. In the in-situ BMGCs, the crystal phases with the appropriate size, volume fraction and morphology were conducive to the initiation of multiple shear bands and could effectively restrain the expansion of single shear band, improving the plasticity, and the in-situ BMGCs with Ag element of 3 at.% exhibited the highest plasticity of 17.9%.

Background and Aims. Currently sedation is a common practice in colonoscopy to reduce pain of patients and improve the operator satisfaction, whereas its impact on examination quality, especially adenoma detection rate (ADR) is still controversial. Thus, we aimed to investigate the association of sedation with ADR. Methods. Consecutive patients receiving colonoscopy between January 2017 and January 2020 at the Nanjing Drum Tower Hospital, Nanjing, China, were collected. Univariate and multivariate logistic regression models were performed to investigate the association between sedation and ADR. Subgroup analysis and propensity score matching (PSM) analysis, as sensitivity analysis, were performed to validate the independent effect. Results. The ADR was significantly higher in cases with sedation (ADR: 36.9% vs. 29.1%, odds ratio [OR]: 1.42, 95% confidence interval [CI]: 1.31–1.55, P0.05) and PSM analysis (ADR: 37.6% vs. 29.1%, OR: 1.47, 95% CI: 1.33–1.63, P

The effects of adhesive layer on the multi-hit ballistic performance of ceramic/metal composite armors are studied by the experimental and numerical methods. The types (epoxy and polyurethane), bonding performance (bonding strength and failure displacement) and thickness, ranging from 0.2 to 3.0 mm, of adhesive layer are systematically investigated for exploring the responses on the projectile, the ceramic and the backing plate. The results show that the epoxy targets exhibit slightly better single-hit ballistic performance than the polyurethane targets. The polyurethane targets display superior multi-hit ballistic performance. However, the residual penetration depth of the backing plate in the second penetration becomes larger owing the extensive damage in the surrounding ceramic tiles. The detached ceramic area decreases sharply with the increase of bonding strength and failure displacement. In addition, compared with the bonding strength, the failure displacement is more sensitive to the detachment of ceramic. The results show that with the increase of adhesive layer thickness, the time of ceramic unsupported by the backing plate becomes longer, making the ballistic performance of the ceramic poor. The adhesive layer thickness has contrary effects on the ballistic resistance and the damage area of ceramic. The optimal adhesive layer thickness with the better multi-hit ballistic performance is 2.0 mm.

Abstract Background Endoscopic transpapillary cannulation of the gallbladder is useful but challenging. This study aimed to investigate cystic duct anatomy patterns, which may guide cystic duct cannulation. Methods A total of 226 patients who underwent endoscopic transpapillary cannulation of the gallbladder were analyzed retrospectively. Results According to the cystic duct take-off, 226 cystic duct patterns were divided into 3 patterns: Type I (193, 85.4%), located on the right and angled up; Type II (7, 3.1%), located on the right and angled down; and Type III (26, 11.5%), located on the left and angled up. Type I was further divided into three subtypes: Line type, S type (S1, not surrounding the common bile duct; S2, surrounding the common bile duct), and α type (α1, forward α; α2, reverse α). Types I and III cystic ducts were easier to be cannulated with a higher success rate (85.1 and 86.4%, respectively) compared with Type II cystic duct (75%) despite no statistically significant difference. The reasons for the failure of gallbladder cannulation included invisible cyst duct take-off, severe cyst duct stenosis, impacted stones in cyst duct or neck of the gallbladder, sharply angled cyst duct, and markedly dilated cyst duct with the tortuous valves of Heister. Conclusion Classification of cystic duct patterns was helpful in guiding endoscopic transpapillary gallbladder cannulation.

An electrode-assisted plasma electrolysis is developed to synthesize the reduced graphene oxide@NiO (rGO@NiO) composites as supercapacitor electrode materials. The method is fast and efficient, realizing one-step synthesis for the rGO@NiO composites. The composition, morphologies, electrochemical properties, and deposition dynamics of rGO@NiO composites are systematically investigated in current work. The results of X-ray diffraction (XRD) and Raman spectra show that NiO is synthesized on the rGO. The weight ratio of NiO in the rGO@NiO composites is about 50.2% by thermo gravimetric analysis (TGA). Transmission electron microscope (TEM) exhibits that lots of nanoparticles distribute uniformly relatively on the rGO, and the diameter of nanoparticles is mostly in 30–80 nm. The as-prepared rGO@NiO composite displays a specific capacitance of 1093 F·g−1 at 1 A·g−1 current density. In addition, it exhibits an excellent cycle stability, and still keeps ~87% of the original capacitance and 90.6% coulombic efficiency after 5000 cycles. Based on the electrochemical theory, the electrode-assisted plasma electrolysis process is dominated by the electrochemical polarization, shortening the deposition process and realizing a fast synthesis for the rGO@NiO composites. The synthesis method, electrode-assisted plasma electrolysis, presents a promising route for the efficient and rapid preparation of rGO-metal oxide composites as energy storage materials.

Background and study aims Gastric outlet obstruction (GOO) is common in the late stage of many malignant tumors of the digestive system. Endoscopic ultrasound (EUS)-guided gastroenterostomy (EUS-GE) is commonly used for palliative treatment of malignant GOO. The objective of this study was to investigate the safety, efficacy, and prognosis of EUS-GE in treatment of malignant GOO in Chinese patients. Patients and methods This was a retrospective, single-center study with 36 consecutive patients with malignant GOO who were treated with EUS-GE. The main outcome measures were technical success rate, clinical success rate, incidence of adverse events (AEs), and median survival time. Results A total of 36 patients with malignant GOO underwent double-balloon-assisted EUS-GE between March 2017 and June 2019 in our hospital. GOO occurred mainly in elderly men (mean age 69.0 years, M:F 0.89). The most common etiology of GOO was pancreatic cancer (41.7 %). The most common obstruction site was the second part of the duodenum (63.9 %). The technical success rate was 100 % (36/36). The clinical success rate was 94.4 % (34/36). Median time for the total procedure was 52 minutes (range 34 – 156 min). Median time for determination of puncture site was 20 minutes (range 15 – 28 min). Median time between puncture and successful delivery of the stent was 38 minutes (range 19 – 128 min). The GOOSS score was 0.2 before EUS-GE. The GOO Scoring System (GOOSS) score was 2.2 at 15 days after the EUS-GE (P = 0.001). The GOOSS score was still higher than 2 during a median follow-up period of 89 days. AEs were observed in nine patients (25.0 %) and 13 total AEs occurred. One patient died as a result of delayed stent migration and bleeding. Mean length of hospital stay was 5.8 ± 4.7 days. The median survival period was 103 days. The rate of GOO recurrence was 2.7 % (1/36). Conclusion EUS-GE was associated with increased safety and efficacy for treatment of malignant GOO in Chinese Mainland.

Purpose. Patients with inflammatory bowel disease (IBD) frequently suffer from venous thromboembolic events, and the risk of thromboembolism increases along with disease activity. This study was conducted to discover novel thrombophilic markers using thromboelastography (TEG) and to evaluate the relation between the predisposing factors and the activity of disease in Chinese patients with Crohn’s disease (CD) and ulcerative colitis (UC). Methods. Thirty-four patients with CD, 29 patients with UC, and 53 healthy volunteers were enrolled into this study. Blood levels of R, K, α Angle, G, maximal amplitude (MA), and LY30 with TEG were determined. Results. Mean values of R, K, α Angle, G, and MA were significantly different in patients with CD and UC compared with the healthy individuals. Patients with active CD had different K, α Angle, G, and MA levels compared with patients in remission (P

In this study, a novel assisted liquid−phase plasma electrolysis was developed to realize one−step synthesis of popcorn biomass−derived porous carbon/cobalt tetroxide (popcorn−carbon/Co3O4) composites, effectively improving the structural stability and conductivity of Co3O4. The phase structure, morphologies, chemical composition, and weight ratio of the as−prepared popcorn−carbon/Co3O4 composites were systematically analyzed. The results of X−ray diffraction (XRD), Raman spectrometer, Fourier infrared spectrometer (FTIR), X−ray photoelectron spectrometer (XPS), and thermogravimetry analyzer (TG) proved the synthesis of the popcorn−carbon/Co3O4 composites. Co3O4 nanoparticles were distributed relatively uniformly on the popcorn−carbon surface. The electrochemical properties of the popcorn−carbon/Co3O4 composite electrode materials were analyzed for exploring the influence of different Co/C ratios on the electrochemical properties of composites. The results showed that the popcorn−carbon/Co3O4 composite electrode materials prepared under 200:1 mass ratio of Co(NO3)2·6H2O and popcorn−carbon possessed a specific capacitance and specific capacity of almost 1264 F/g (594 C/g) at a current density of 1 A/g, exhibiting a better electrochemical property. The efficient, fast, and novel assisted liquid−phase plasma electrolysis provides a new method for the preparation of composite electrode materials on the supercapacitors.

Abstract Background The risk factors for post-ERCP cholecystitis (PEC) have not been characterized. Hence, this study aimed to identify the potential risk factors for PEC. Methods The medical records of 4238 patients undergoing the first ERCP in a single center from January 2012 to December 2016 were analyzed in this study. A multivariate analysis was used to identify the risk factors. Results This study included 2672 patients who met the enrollment criteria. Of these, 36 patients (incidence rate of 1.35%) developed PEC within 2 weeks of the procedure. Univariate and multivariate analyses identified the following factors associated with PEC: history of acute pancreatitis [odds ratio (OR) = 2.60; 95% confidence interval (CI): 1.29–5.23], history of chronic cholecystitis (OR = 8.47; 95% CI: 2.54–28.24), gallbladder opacification (OR = 2.79; 95% CI: 1.37–5.70), biliary duct metallic stent placement (OR = 3.66; 95% CI: 1.78–7.54), and high leukocyte count before ERCP (OR = 1.10; 95% CI: 1.04–1.17). The prediction model incorporating these factors demonstrated an area under the receiver operating characteristic curve of 0.85 (95% CI, 0.80–0.91). A prognostic nomogram was developed using the aforementioned variables to estimate the probability of PEC. Conclusions The risk factors, including the history of acute pancreatitis, history of chronic cholecystitis, gallbladder opacification, biliary duct metallic stent placement, and high leucocyte counts before ERCP, increased the occurrence of PEC and were positive predictors for PEC. The constructed nomogram was used to estimate the risk of PEC, guiding the implementation of prophylactic measures to prevent PEC in clinical practice.

The effect of projectile nose shape on the ballistic performance of the ultra-high molecular weight polyethylene (UHMWPE) composite was studied through experiments and simulations. Eight projectiles such as conical, flat, hemispherical, and ogival nose projectiles were used in this study. The deformation process, failure mechanisms, and the specific energy absorption (SEA) ability were systematically investigated for analyzing the ballistic responses on the projectile and the UHMWPE composite. The results showed that the projectile nose shape could invoke different penetration mechanisms on the composite. The sharper nose projectile tended to shear through the laminate, causing localized damage zone on the composite. For the blunt nose projectile penetration, the primary deformation features were the combination of shear plugging, tensile deformation, and large area delamination. The maximum value of specific energy absorption (SEA) was 290 J/(kg/m2) for the flat nose projectile penetration, about 3.8 times higher than that for the 30° conical nose projectile. Furthermore, a ballistic resistance analytical model was built based on the cavity expansion theory to predict the energy absorption ability of the UHMWPE composite. The model exhibited a good match between the ballistic resistance curves in simulations with the SEA ability of the UHMWPE composite in experiments.

Chlorogenic acid (ChA)--one of the most abundant polyphenol compounds in the human diet--exerts anti-inflammatory activities. The aim of this study was to investigate the effect of ChA on gut microbiota in ulcerative colitis (UC). Colitis was induced by 2.5% dextran sulfate sodium (DSS) in C57BL/6 mice, which were on a control diet or diet with ChA (1 mM). The histopathological changes and inflammation were evaluated. Fecal samples were analyzed by 16S rRNA gene sequencing. ChA attenuated several effects of DSS-induced colitis, including weight loss, increased disease activity index, and improved mucosal damage. Moreover, ChA could significantly suppress the secretion of IFNγ, TNFα, and IL-6 and the colonic infiltration of F4/80+ macrophages, CD3+ T cells, and CD177+ neutrophils via inhibition of the active NF-B signaling pathway. In addition, ChA decreased the proportion of Firmicutes and Bacteroidetes. ChA also enhanced a reduction in fecal microbiota diversity in DSS treated mice. Interestingly, ChA treatment markedly increased the proportion of themucin-degrading bacterium Akkermansia in colitismice. ChA acted as the intestine-modifying gutmicrobial community structure, resulting in a lower intestinal and systemic inflammation and also improving the course of the DSS-induced colitis, which is associated with a proportional increase in Akkermansia. [ABSTRACT FROM AUTHOR]

The Warburg effect is important in tumor growth. The human M2 isoform of pyruvate kinase (PKM2) is a key enzyme that regulates aerobic glycolysis in tumor cells. Recent studies have demonstrated that PKM2 is a potential target for cancer therapy. The present study investigated the effects of pantoprazole (PPZ) treatment and PKM2 transfection on human gastric adenocarcinoma SGC-7901 cells in vitro. The present study revealed that PPZ inhibited the proliferation of tumor cells, induced apoptosis and downregulated the expression of PKM2, which contributes to the current understanding of the functional association between PPZ and PKM2. In summary, PPZ may suppress tumor growth as a PKM2 protein inhibitor. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 44-year-old woman diagnosed with gastric syphilis mimicking lymphoma. Topics discussed include the medical history of the patient, her medical examination through serologic tests and gastrointestinal endoscopy, and her treatment. Information about the disease such as its symptoms and causes is also provided.

Allergic rhinitis (AR) is an allergic disease induced by the T helper 2 (TH2) lymphocyte immune response, where its mediators are the primary cause of clinical symptoms. Environmental factors are the primary determinants of the allergic response in genetically susceptible individuals. This study investigates the effects of climate conditions (warm, cold, humid, and dry) on allergic rhinitis. AR models were created in mice under 4 different conditions. We investigated AR-related behavior (sneezing and nose rubbing), as well as total immunoglobulin E (IgE), histamine, interleukin-4 (IL-4), leukotriene (LT) B4 and LTC4 levels, and gene expression of CysLT1R, HRH1, and MUC5a. Nose rubbing, histamine levels, and the expression of MUC5a and HRH1 were increased in AR models in cold conditions, and sneezing was increased in AR models kept in dry conditions. LTB4 and LTC4 levels and the expression of CysLT1R in AR models kept in a wet environment also significantly increased compared with the control group. The levels of total IgE and IL-4 showed no significant changes. Air temperature and humidity affect AR pathophysiology, and weather conditions can be essential in controlling AR.