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Background Artificial intelligence (AI) assistance has been considered as a promising way to improve colonoscopic polyp detection, but there are limited prospective studies on real‐time use of AI systems. Methods We conducted a prospective, multicenter, randomized controlled trial of patients undergoing colonoscopy at six centers. Eligible patients were randomly assigned to conventional colonoscopy (control group) or AI‐assisted colonoscopy (AI group). AI assistance was our newly developed AI system for real‐time colonoscopic polyp detection. Primary outcome is polyp detection rate (PDR). Secondary outcomes include polyps per positive patient (PPP), polyps per colonoscopy (PPC), and non‐first polyps per colonoscopy (PPC‐Plus). Results A total of 2352 patients were included in the final analysis. Compared with the control, AI group did not show significant increment in PDR (38.8% vs. 36.2%, p = 0.183), but its PPC‐Plus was significantly higher (0.5 vs. 0.4, p, Artificial intelligence (AI) assistance plays a limited role in overall polyp detection. AI system increases detection of easily missed polyps, including non‐first polyps, diminutive and flat polyps. The impact is greater for male operators, longer withdrawal time, and elderly obese patients.

Circular RNAs (circRNAs) are an intriguing class of RNAs with covalently closed-loop structures. With characteristics of high stability and disease-specific expression, circRNAs are emerging as ideal targets for cancer therapy. However, the screening utility and clinical value of circRNAs in gastric cancer (GC) remain largely elusive. We detected levels of hsa_circ_0001020 in cell lines and tissue and plasma samples and investigated its clinicopathological correlations. Kaplan-Meier survival curves and regression analyses were used to analyze its prognostic value. Receiver operating characteristic curves and biomarker combinations were examined to verify its screening value. Bioinformatics analysis was also performed to predict potential biological functions. Our tests found that hsa_circ_0001020 was significantly upregulated in GC cell lines, GC tissue samples, and even in plasma. High hsa_circ_0001020 expression levels in GC tissues were significantly associated with distal metastasis and blood carbohydrate antigen 19-9 (CA19-9). GC patients with high hsa_circ_0001020 had a lower overall survival and disease-free survival time than the low levels. Regression analysis suggested that the level of hsa_circ_0001020 expression was an independent prognostic factor for survival time. As a biomarker for GC, hsa_circ_0001020 showed a superior AUC, sensitivity, and specificity than carcinoembryonic antigen and CA19-9, and was suitable for combination with clinical tumor biomarkers. Bioinformatics analysis provided valuable clues for the possible oncogenic pathways of GC, such as the FoxO and p53 signaling pathways. In conclusion, our study found that hsa_circ_0001020 in GC could be a reliable biomarker to screen for GC and predict prognosis.

Background Recently, tRNA-derived fragments (tRFs) have been shown to serve important biological functions. However, the role of tRFs in gastric cancer has not been fully elucidated. This study aimed to identify the tumor suppressor role of tRF-5026a (tRF-18-79MP9P04) in gastric cancer. Methods Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was first used to detect tRF-5026a expression levels in gastric cancer tissues and patient plasma. Next, the relationship between tRF-5026a levels and clinicopathological features in gastric cancer patients was assessed. Cell lines with varying tRF-5026a levels were assessed by measuring tRF-5026a using qRT-PCR. After transfecting cell lines with a tRF-5026a mimic or inhibitor, cell proliferation, colony formation, migration, apoptosis, and cell cycle were evaluated. The expression levels of related proteins in the PTEN/PI3K/AKT pathway were also analyzed by Western blotting. Finally, the effect of tRF-5026a on tumor growth was tested using subcutaneous tumor models in nude mice. Results tRF-5026a was downregulated in gastric cancer patient tissues and plasma samples. tRF-5026a levels were closely related to tumor size, had a certain diagnostic value, and could be used to predict overall survival. tRF-5026a was also downregulated in gastric cancer cell lines. tRF-5026a inhibited the proliferation, migration, and cell cycle progression of gastric cancer cells by regulating the PTEN/PI3K/AKT signaling pathway. Animal experiments showed that upregulation of tRF-5026a effectively inhibited tumor growth. Conclusions tRF-5026a (tRF-18-79MP9P04) is a promising biomarker for gastric cancer diagnostics and has tumor suppressor effects mediated through the PTEN/PI3K/AKT signaling pathway.

Background Multi-target stool DNA (MT-sDNA) test can reduce colorectal cancer (CRC) incidence and mortality as a simple, noninvasive screening method. It is crucial to understand people's willingness to accept and willingness to pay for MT-sDNA test for CRC screening. Methods A hospital-based study was conducted in the affiliated hospital of medical school of Ningbo University in southeastern China between June 2021 to March 2022. Individuals aged ≥ 40 years from outpatient department, endoscopy center and inpatient department were included. All participants completed a questionnaire to collect detailed information by a face-to-face interview. Characteristics of individuals were described using frequency and percentage. Group comparisons were performed with chi-square test for categorical variable. Multivariate logistic regression analyses were performed to estimate the associations of social-demographic characteristics, lifestyle factors, CRC risk and medical history with screening intention. Results Of the 977 participants who completed the interview, 85.06% were willing to accept MTs-DNA test for CRC screening, 82.29% were willing to pay for it. Individuals came from non outpatient source (OR = 3.16, 95% CI: 2.14, 4.68), with moderate risk of CRC (OR = 1.66, 95% CI: 1.10, 2.52) were more likely to accept MTs-DNA test for CRC screening. Those came from non outpatient source (OR = 2.56, 95% CI: 1.79, 3.67), with moderate risk of CRC (OR = 1.98, 95% CI: 1.34, 2.91), with history of polypectomy (OR = 2.20, 95% CI: 1.31, 3.68) and with middle/high school education and graduated from college or above (OR = 1.62, 95% CI: 1.07, 2.46, OR = 2.67, 95% CI: 1.27, 5.60, respectively) were more willing to pay for MTs-DNA test for CRC screening. Conclusion The present study found that individuals from non outpatient source, with moderate risk of CRC, with higher education and history of polypectomy were more likely to accept MTs-DNA test or pay for it. It is worth noting that individuals with high risk of CRC were less likely to accept MTs-DNA test and pay for it. Health education interventions should be developed to emphasise the significance of screening and introduce the simple, noninvasive MT-sDNA test to the public, especially those with above characteristics.

Resistance of Helicobacter pylori (H. pylori) to antibiotics is an evolving and dynamic process. Presence of antibiotic resistance impacts the success rate of initial eradication strategies in the clinic.To improve the success rate of initial eradication therapy and explore new antibiotic regimens, a large sample-based study utilizing antimicrobial susceptibility testing was performed. A total of 2508 H. pylori strains from patients subjected to initial eradication therapy were isolated, cultured, and tested for drug susceptibility from 2017 to 2021. The minimal inhibitory concentration (MIC) was recorded. H. pylori susceptibility profiles and its change trends from initial eradication patients were analyzed. The relationships between drug resistance, year of sample collection, age, and sex of patients were analyzed.The overall resistance rates were as follows: amoxicillin (9.25%), clarithromycin (38.48%), levofloxacin (42.86%), furazolidone (11.28%), doxycycline (8.56%), rifampicin (10.81%), tinidazole (74.32%), gatifloxacin (61.71%), tetracycline (0%), metronidazole (78.71%), ornidazole (97.87%), and fosfomycin (31.67%). Only 38.04% of the strains were pansusceptible to amoxicillin, clarithromycin, levofloxacin, and furazolidone, followed by those of mono resistance (29.90%), double resistance (24.96%), triple resistance (6.34%), and quadruple resistance (0.76%). Significant differences in the resistance rate and MIC were also observed in different age and sex groups. Time of collection and patient age and sex were associated with the distribution of antibiotic resistance.With the increasing resistance rate and multiple resistance of H. pylori to commonly used antibiotics, drug susceptibility testing is imperative to permit individualized therapy, and a regimen containing the combination of amoxicillin, furazolidone, tetracycline, doxycycline, or rifampicin is reasonable for initial empirical eradication therapy.

Worldwide, gastric cancer (GC) is a common lethal solid malignancy with a poor prognosis. Cuproptosis is a novel kind of cell death mediated by protein lipoylation and the relationship between cuprotosis and GC prognosis. We estimated the expression level and prognostic values of pyroptosis-related genes (CRGs) in GC samples and related mechanisms using public databases and bioinformatics. Our results revealed that FDX1, LIAS, and MTF1 were differentially expressed in GC samples and exhibited important prognostic significance in the TCGA cohort. We constructed a nomogram model for overall survival and disease-specific survival prediction and validated it via calibration plots. Mechanistically, immune cell infiltration prominently affected the survival time of GC patients. Moreover, protein‒protein interaction network, KEGG pathway and gene ontology enrichment analyses demonstrated that FDX1, LIAS, MTF1 and related proteins played key roles in the tricarboxylic acid cycle and cuprotosis. GEO database validation showed that the expression levels of FDX1, LIAS, and MTF1 were consistent with those in the TCGA cohort. In conclusion, FDX1, LIAS, and MTF1 could serve as potential prognostic biomarkers for GC patients and provide novel targets for immunotarget therapy.

Investigation of joint torque constraint compliance is of significance for robot manipulators especially working in complex environments. A lot of which is attributed to that, on the one hand, it is beneficial to the improvement of both safety and reliability of the mission execution. On the other hand, the energy consumption required by the robot to complete the desired mission can be reduced. Most existing schemes do not take the joint torque limit and other inherent physical structure limits in a manipulator into account at the same time. In addition, many unavoidable uncertainties such as the external environmental disturbance and/or electromagnetism interferences in the circuit system may influence the accuracy and effectiveness of the task execution for a robot. In this study, we cast light on the acceleration level control of redundant robot manipulators considering both four physical constraint limits and interference rejection. A robust unified quadratic-programming-based hybrid control scheme is proposed, where the joint torque constraints are converted as two inequality constraints based on the robots’ dynamics equation. A recurrent-neural-network-based controller is designed for solving the control variable. Numerical experiments performing in PUMA 560 manipulator and planer manipulator illustrate that a rational torque distribution is obtained among the joints and the considered physical structural vectors are all restricted to the respective constraint range. In addition, even disturbed by the noise, the manipulator still successfully tracks the desired trajectory under the proposed control scheme.

Circular RNAs (circRNAs) are thought to be vital participants in carcinogenesis and have the characteristics of being stable, specific, and well conserved. However, their clinical significance and application value in gastric cancer (GC) are still poorly understood. Hsa_circ_0086720 was found to be a dysregulated circRNA in GC by microarray screening and was further explored for its clinical significance and application.Hsa_circ_0086720 was detected in GC cell lines, tissues, and plasma, and the clinicopathological correlations were investigated. The existence, stability, origin, and change in the plasma hsa_circ_0086720 level were verified in early GC patients. Moreover, receiver operating characteristic and Kaplan-Meier survival curves were constructed to analyze the diagnostic and prognostic values, and bioinformatics analysis was used to identify the potential functions. Finally, risk factors and nomogram predicting were established.Hsa_circ_0086720 was found to be downregulated in gastric carcinogenesis, and tissue hsa_circ_0086720 was negatively associated with perineural invasion, Borrmann type, disease-free survival, and overall survival. Hsa_circ_0086720 was stable in circulating plasma and was actively secreted by cells in gastric carcinogenesis. As a biomarker for early GC screening, plasma hsa_circ_0086720 had good sensitivity and specificity, and its stability met the clinical application requirements. Bioinformatics analysis suggested that dysregulated hsa_circ_0086720 has important functions in gastric carcinogenesis. Univariate Cox regression analysis identified factors associated with overall survival time and disease-free survival time. The nomograms showed good accuracy of predicting survival time.Hsa_circ_0086720 is a novel biomarker for screening early GC and predicting the prognosis of advanced-stage patients.

Uterine corpus endometrial carcinoma (UCEC) tightly correlates with dysregulated iron homeostasis. MGST1 (microsomal glutathione S-transferase 1) involves in the regulation of oxidative stress and plays a key role in inhibiting iron-mediated cell death in cancer cells. Hence, we aimed to illuminate the characteristics of MGST1 expression and prognosis in UCEC using bioinformatics prediction to provide novel perspectives for theoretical supplementation and ferroptosis-based immunotherapy.We retrieved MGST1 expression data via several public data portals. The relationships between MGST1 expression and clinicopathologic characteristics as well as survival time were evaluated via multivariate methods and Kaplan-Meier survival curves. The MGST1-interacting protein-protein interaction was also established by the STRING website. The TIMER and GEPIA databases were used to illustrate the association between MGST1 expression and infiltrated immune cells. We used the MethSurv website and the UALCAN website to determine the relationship between MGST1 expression and DNA methylation.MGST1 overexpression in UCEC compared with normal tissues correlates with different histological types, a lack of hormone therapy and poor survival time. MGST1 interacts with several ferroptosis-related proteins. Overexpression of MGST1 was accompanied by lower levels of NK cell and CD8Elevated MGST1 expression is related to tumour development and poor prognosis, as well as dysregulated infiltration of immune cells in UCEC, which can be a potential prognostic indicator and ferroptosis-based immunotherapy target.

Qiuyan Weng,1 Zhe Li,2,3 Yaoyao Xie,4 Junming Guo,2– 4 Yong Zhang,5 Guoliang Ye2,3 1Department of Neurology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, Zhejiang, People’s Republic of China; 2Department of Gastroenterology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, Zhejiang, People’s Republic of China; 3Institute of Digestive Diseases, Ningbo University, Ningbo, Zhejiang, People’s Republic of China; 4Department of Biochemistry and Molecular Biology and Zhejiang Key Laboratory of Pathophysiology, Ningbo University School of Medicine, Ningbo, Zhejiang, People’s Republic of China; 5Department of Trauma Orthopedics, Ningbo No. 6 Hospital, Ningbo, Zhejiang, People’s Republic of ChinaCorrespondence: Guoliang Ye, Department of Gastroenterology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, 315020, People’s Republic of China, Tel +86-574-87035171, Fax +86-574-87380487, Email ndfyygl@126.com Yong Zhang, Department of Trauma Orthopedics, Ningbo No. 6 Hospital, Ningbo, 315000, Zhejiang, People’s Republic of China, Email yongzhang2018@hotmail.comObjective: Gastric signet ring cell carcinoma (SRCC) is a distinct entity with a relatively poor prognosis. This study analyzed the clinicopathological characteristics of long-time survivors (LTSs) and identified independent predictors of long-term survival (LTS) in non-metastatic gastric SRCC.Methods: Data from 3906 patients with non-metastatic gastric SRCC were retrieved from Surveillance, Epidemiology and End Results according to the inclusion and exclusion criteria. Patients were randomly divided into training and validation cohorts. Predictors of LTS in the training cohort were identified by multivariate logistic regression. A nomogram-based predictive model for LTS was constructed in non-metastatic gastric SRCC.Results: There were 800 patients who survived for > 5 years and were defined as TLSs. Young age, other race (not black or white population), female gender, married status, small tumor size, low tumor infiltration, and negative lymph node involvement were independent predictors of LTS in non-metastatic gastric SRCC. These seven variables were incorporated into a nomogram model for predicting LTS. The calibration curve showed good consistency between observed and predicted probability of LTS, and the receiver operating characteristic curve showed acceptable discriminative capacity in the training and validation cohorts.Conclusion: This study provides an overview of the features of patients with non-metastatic gastric SRCC. Age, race, sex, marital status, tumor size, tumor infiltration, and lymph node involvement were identified as independent predictors of LTS.Keywords: gastric cancer, signet ring cell carcinoma, long-time survivor, nomogram

Transfer RNAs (tRNAs) are essential for protein synthesis. Mature or pre-tRNAs may be cleaved to produce tRNA-derived small RNAs (tsRNAs). tsRNAs, divided into tRNA-derived stress-induced RNA (tiRNAs) and tRNA-derived fragments (tRFs), play versatile roles in a number of fundamental biological processes. tsRNAs not only play regulatory roles in gene silencing, RNA stability, reverse transcription, and translation, but are also closely related to cell proliferation, migration, cell cycle, and apoptosis. Their abnormal expression is associated with the occurrence and development of various human diseases, especially cancer. This paper reviews the classification, biogenesis, and mechanism of action of tsRNAs, and the research progress to date on tsRNAs in cancers. These findings provide new opportunities for diagnostic biomarkers and treatment targets of several types of cancers including gastric cancer, colorectal cancer, hepatocellular carcinomas, pancreatic cancer, breast cancer, prostate cancer, renal cell carcinoma, ovarian cancer, lung cancer, bladder cancer, thyroid cancer, oral cancer, and leukemia.

Circular RNAs (circRNAs) are an endogenous RNAs with a covalently closed cyclic structure. They have emerged recently as key regulators in the development and progression of human cancers. However, the clinical values of most circRNAs in gastric cancer (GC) are unknown. Hsa_circ_0065149, one of the dysregulated circRNAs in gastric carcinogenesis detected by circRNA microarray, was chose as a targeted circRNA in this study. We firstly enlarged sample size and identified the level changes of hsa_circ_0065149 among four stages of gastric tumorigenesis from healthy gastric mucosa, gastritis, intestinal metaplasia to GC. Then, the potential relationship between hsa_circ_0065149 expression levels and GC patients' clinicopathological factors was investigated. Moreover, the clinical significance of hsa_circ_0065149 in plasma exosomes and gastric juice were explored. Receiver operating characteristic (ROC) curve and Kaplan-Meier survival curve were constructed to evaluate diagnostic and prognostic values. Finally, bioinformatics analysis was performed to excavate the potential functions of hsa_circ_0065149. Hsa_circ_0065149 expression was only significantly down-regulated in gastric cancer, not changed among healthy gastric mucosa and gastritis intestinal metaplasia. Low hsa_circ_0065149 expression levels in GC tissues were significantly associated with tumor diameter (P = 0.034) and perineural invasion (P = 0.037). GC patients with low hsa_circ_0065149 levels had a much longer overall survival than those in high group (P = 0.020). More important, hsa_circ_0065149 levels were significantly decreased in plasma exosomes of early GC patients. As a screening biomarker for early GC, hsa_circ_0065149 in plasma exosomes has higher sensitivity and specificity than traditional clinical biomarkers. Bioinformatics analysis suggest that the abnormal expression of hsa_circ_0065149 may play an important role during gastric carcinogenesis. Those results indicate that hsa_circ_0065149 in exosmoes is an indicator for early GC screening and prognosis prediction.

Malignant pulmonary nodules are one of the main manifestations of lung cancer in early CT image screening. Since lung cancer may have no early obvious symptoms, it is important to develop a computer-aided detection (CAD) system to assist doctors to detect the malignant pulmonary nodules in the early stage of lung cancer CT diagnosis. Due to the recent successful applications of deep learning in image processing, more and more researchers have been trying to apply it to the diagnosis of pulmonary nodules. However, due to the ratio of nodules and non-nodules samples used in the training and testing datasets usually being different from the practical ratio of lung cancer, the CAD classification systems may easily produce higher false-positives while using this imbalanced dataset. This work introduces a filtering step to remove the irrelevant images from the dataset, and the results show that the false-positives can be reduced and the accuracy can be above 98%. There are two steps in nodule detection. Firstly, the images with pulmonary nodules are screened from the whole lung CT images of the patients. Secondly, the exact locations of pulmonary nodules will be detected using Faster R-CNN. Final results show that this method can effectively detect the pulmonary nodules in the CT images and hence potentially assist doctors in the early diagnosis of lung cancer.

Background Recent studies have indicated that circular RNAs (circRNAs) are novel endogenous RNAs whose 5′ and 3′ ends are covalently linked and play critical roles in gastric carcinogenesis. However, the significance of circRNA hsa_circ_0001874 in gastric cancer (GC) is still unclear. Methods Therefore, we first detected hsa_circ_0001874 levels in GC cell lines and tissues and analyzed their potential correlation with clinicopathological factors. Then, a receiver operating characteristic (ROC) curve was established to evaluate its clinical value. Finally, we further predicted the biological functions of this molecule by bioinformatics analysis. Results Our data showed that as an indicator, hsa_circ_0001874 expression was significantly decreased in 78.02% (71/91) of the GC patients. Combined with clinicopathological factors, the hsa_circ_0001874 level was strongly associated with cell differentiation (p, Prediction for hsa_circ_0001874‐miRNAs‐target genes axis. (A) The interaction between hsa_circ_0001874 and miRNAs based on TargetScan and miRanda. (B) Venn diagram reveled the number of common downstream targets of hsa‐miR‐593‐5p, hsa‐miR‐103a‐3p and hsa‐miR‐107. (C) The interaction network map of hsa_circ_0001874‐miRNAs‐target genes axis.

Traditionally, transfer RNAs (tRNAs) specifically decoded messenger RNA (mRNA) and participated in protein translation. tRNA-derived fragments (tRFs), also known as tRNA-derived small RNAs (tsRNAs), are generated by the specific cleavage of pre- and mature tRNAs and are a class of newly defined functional small non-coding RNAs (sncRNAs). Following the different cleavage positions of precursor or mature tRNA, tRFs are classified into seven types, 5′-tRNA half, 3′-tRNA half, tRF-1, 5′U-tRF, 3′-tRF, 5′-tRF, and i-tRF. It has been demonstrated that tRFs have a diverse range of biological functions in cellular processes, which include inhibiting protein translation, modulating stress response, regulating gene expression, and involvement in cell cycles and epigenetic inheritance. Emerging evidences have indicated that tRFs in extracellular vesicles (EVs) seem to act as regulatory molecules in various cellular processes and play essential roles in cell-to-cell communication. Furthermore, the dysregulation of EV-associated tRFs has been associated with the occurrence and progression of a variety of cancers and they can serve as novel potential biomarkers for cancer diagnosis. In this review, the biogenesis and classification of tRFs are summarized, and the biological functions of EV-associated tRFs and their roles as potential biomarkers in human diseases are discussed.

Laser ultrasonic non-destructive inspection may be difficult to detect small defects inside additive manufactured components due to weak longitudinal waves propagation. This paper proposes a defect detection method of using laser ultrasonic transverse waves in transmission mode. This method uses a scanning procedure of synchronously moving the laser ultrasound generator and the ultrasound detector on the opposite side of the sample. The cross-correlation algorithm is used to calculate the time delay of the transmitted transverse wave at each scanning point. Finally, the location of the internal defect can be estimated by considering the thickness of the sample and the distance between the two maximum signal delay points in the left scanning and the right scanning. The numerical simulation using finite elements method and the experimental results show that this method can successfully identify the internal defect of 1 mm diameter inside the additive manufactured 316L stainless steel components.

Additional file 1: Appendix 1. Stability of mixed solution contained simethicone and different doses of 5% sodium bicarbonate solution when added to artificial gastric acid (10mL). Appendix 2. Stability of mixed solution contained simethicone and different doses of 5% sodium bicarbonate solution when added to artificial gastric acid (20mL).

Introduction Patients with atrophic gastritis (AG) or gastric intestinal metaplasia (GIM) have elevated risk of gastric adenocarcinoma. Endoscopic screening and surveillance have been implemented in high incidence countries. The study aimed to evaluate the accuracy of a deep convolutional neural network (CNN) for simultaneous recognition of AG and GIM. Methods Archived endoscopic white light images with corresponding gastric biopsies were collected from 14 hospitals located in different regions of China. Corresponding images by anatomic sites containing AG, GIM, and chronic non-AG were categorized using pathology reports. The participants were randomly assigned (8:1:1) to the training cohort for developing the CNN model (TResNet), the validation cohort for fine-tuning, and the test cohort for evaluating the diagnostic accuracy. The area under the curve (AUC), sensitivity, specificity, and accuracy with 95% confidence interval (CI) were calculated. Results A total of 7,037 endoscopic images from 2,741 participants were used to develop the CNN for recognition of AG and/or GIM. The AUC for recognizing AG was 0.98 (95% CI 0.97-0.99) with sensitivity, specificity, and accuracy of 96.2% (95% CI 94.2%-97.6%), 96.4% (95% CI 94.8%-97.9%), and 96.4% (95% CI 94.4%-97.8%), respectively. The AUC for recognizing GIM was 0.99 (95% CI 0.98-1.00) with sensitivity, specificity, and accuracy of 97.9% (95% CI 96.2%-98.9%), 97.5% (95% CI 95.8%-98.6%), and 97.6% (95% CI 95.8%-98.6%), respectively. Discussion CNN using endoscopic white light images achieved high diagnostic accuracy in recognizing AG and GIM.

Background: The reformulated simethicone emulsion from Berlin Chemical AG might develop white flocculate precipitation covering gastric mucosa when used before esophagogastroduodenoscopy (EGD). We aim to investigate whether combining reformulated simethicone emulsion with 5% NaHCO3 solution could prevent the development of white precipitation and improve visibility during EGD. Methods: Our study involved 523 patients. They were randomly assigned to two groups: In Group A patients received a warm mixed solution containing 30 ml 5% NaHCO3 solution and 15 ml reformulated simethicone emulsion. In Group B patients received 45 ml 40℃ lukewarm water. Visibility scores were recorded and analyzed. In addition, flush times, volume of flush water, overall time taken for EGD and complications during or after procedure were also recorded. Results: We found that no white precipitation was observed during EGD in Group A. Moreover, visibility scores in Group A were significantly lower (P < 0.01). Patients in Group A had fewer flush times (P < 0.01) and smaller volumes of flush water (P < 0.01). In addition, overall time taken for EGD procedure was significantly shorter in Group A (P < 0.01). The percentage of patients who had no adverse response is significantly higher in patients in Group A compared to Group B (P < 0.01). Conclusions: Premedication with mixed solution of 15ml reformulated simethicone emulsion and 30ml 5% NaHCO3 solution can prevent the development of white precipitation, substantially enhance mucosal visibility safely.Trial registration: The registered name of the trial is “Efficacy of using premedication with reformulated simethicone emulsion during upper gastrointestinal endoscopy examination”. Current Controlled Trials ChiCTR1900021689, as well as the date of registration is 11 September 2019. Retrospectively registered, http://www.medresman.org.cn/uc/sindex.aspx.

Background The reformulated simethicone emulsion from Berlin Chemical AG might develop white flocculate precipitate covering the gastric mucosa when used before esophagogastroduodenoscopy (EGD). We aim to investigate whether combining the reformulated simethicone emulsion with 5% sodium bicarbonate solution could prevent the development of white precipitate and improve visibility during EGD. Methods Our clinical study involved 523 patients. They were randomly assigned to two groups. In Group A, patients received a warm solution containing 30 ml 5% sodium bicarbonate solution and 15 ml reformulated simethicone emulsion. In Group B, patients received 45 ml 40 °C lukewarm water. Visibility scores were recorded and analyzed. Flushes, volume of flush water, overall time taken for EGD and complications during or after the procedure were also recorded. Results We found that no white precipitate was observed during EGD in Group A. Moreover, visibility scores in Group A were significantly lower (P P P P P Conclusions Premedication with a mixed solution of 15 ml reformulated simethicone emulsion and 30 ml 5% sodium bicarbonate solution can prevent the development of white precipitate, substantially enhancing mucosal visibility safely. Trial registration: The registered name of the trial is “Efficacy of using premedication with reformulated simethicone emulsion during upper gastrointestinal endoscopy examination”. Its Current Controlled Trials number is ChiCTR1900021689. Its date of registration is 11 September 2019. Retrospectively registered, http://www.medresman.org.cn/uc/sindex.aspx.

Background and aim: Medicine has made great progress, but gastric cancer is still one of the most common malignant tumors worldwide. tRNA-derived fragments (tRFs), a type of small non-coding RNA, have been found to play important roles in cancers. Due to an abundance of modifications, tRFs have the potential to serve as cancer biomarkers. However, the relationship between tRFs and gastric cancer is still largely unclear. We have identified a new tRF, tRF-19-3L7L73JD, found to be expressed at a lower level in gastric cancer patients than healthy controls. Our study aims to explore the diagnostic value of tRF-19-3L7L73JD screening in gastric cancer and to investigate its effects on the growth of gastric cancer cells. Methods: Using quantitative reverse transcription-polymerase chain reaction, we identified tRF-3L7L73JD as differentially expressed in plasma from gastric cancer patients compared to healthy controls. We measured tRF-3L7L73JD levels in plasma from 40 gastric cancer patients and healthy controls. Furthermore, we tested another cohort containing 89 gastric cancer patients and 98 healthy controls to validate our findings. Next, we analyzed the relationship between levels of tRF-19-3L7L73JD in plasma and clinicopathological data of gastric cancer patients, and then evaluated the effects of tRF-19-3L7L73JD on gastric cancer cell growth. Cell proliferation was measured by the Cell Counting Kit-8 and clone formation experiments after transfer with tRF-19-3L7L73JD mimics. The changes in cell migration ability were explored through the scratch and Transwell experiments. Finally, we explored changes in apoptosis and cell cycle by flow cytometry. Results: tRF-19-3L7L73JD showed lower expression in the tested gastric cancer patients. In the validation cohort tRF-19-3L7L73JD was also expressed at low levels in the pre-operative plasma group compared with healthy plasma and post-operative plasma groups. Additionally, a comparison of gastric cancer cell lines with normal gastric epithelial cell lines produced the same result. We found that tRF-19-3L7L73JD expression in patients was related to tumor size. The area under the curve (AUC) was 0.6230, with sensitivity and specificity of 0.4045 and 0.7959, respectively. Cellular function studies revealed that tRF-19-3L7L73JD inhibited cell proliferation and migration, induced apoptosis, and arrested cells at G0/G1 phases, suggesting it may suppress the development of gastric cancer. Conclusion: The results suggest that tRF-19-3L7L73JD may be useful as a biomarker of gastric cancer.