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Background This study aimed to assess the efficacy, feasibility, and safety of robot-assisted pylorus- and vagus nerve-preserving gastroplasty (RA[PPG]), using the da Vinci Surgical System, compared with those of laparoscopy-assisted PPG (LAPPG). Methods Clinical and follow-up data of patients who underwent PPG were retrospectively analyzed, which included 14 RAPPG and 21 LAPPG cases. The histological data, surgical results, postoperative recovery, and complication rates were compared between the two groups; the surgical experience was also summarized. Results The operation time was slightly longer in the RAPPG group (309.3 ± 59.9 vs. 236.2 ± 36.5 min, P

Phialophora verrucosa (P. verrucosa) is a pathogen that can cause chromoblastomycosis and phaeohyphomycosis. Recent evidence suggests that neutrophils can produce neutrophil extracellular traps (NETs) that can protect against invasive pathogens. As such, we herein explored the in vitro functional importance of P. verrucosa-induced NET formation. By assessing the co-localization of neutrophil elastase and DNA, we were able to confirm the formation of classical NETs entrapping P. verrucosa specimens. Sytox Green was then used to stain these NETs following neutrophil infection with P. verrucosa in order to quantify the formation of these extracellular structures. NET formation was induced upon neutrophil exposure to both live, UV-inactivated, and dead P. verrucosa fungi. The ability of these NETs to kill fungal hyphae and conidia was demonstrated through MTT and pouring plate assays, respectively. Overall, our results confirmed that P. verrucosa was able to trigger the production of NETs, suggesting that these extracellular structures may represent an important innate immune effector mechanism controlling physiological responses to P. verrucosa infection, thereby aiding in pathogen control during the acute phases of infection.

Pollutants such as PM2.5 are polluting the environment seriously, causing numerous health problems. However, the skin toxicity caused by PM2.5 has been little reported so far. CCK-8 was used to test the effects of PM2.5 on melanin cell proliferation. The effect of PM2.5 on melanocyte apoptosis was detected by flow cytometry. ELISA was used to detect the expression of oxidative stress-related factors, including reactive oxygen species (ROS). The expression of autophagosomes was detected by MDC immunohistochemical staining, and Western blot was used to detect the expression of autophagy marker LC3II/I. With the increasing concentrations of PM2.5, the proliferation rate and apoptosis rate of melanocytes decreased significantly, meanwhile the expression of oxidative stress-related factors ROS, was obviously increased. The expression of LC3II/I induced by PM2.5 venom was higher than that of the control group in a concentration-dependent manner. However, there was no statistically significant difference between the water-soluble components of PM2.5 and the water-insoluble ones. PM2.5 can inhibit the proliferation of melanocytes and induce their apoptosis, which may be related to the oxidative damage of PM2.5. PM2.5 also induced autophagy in melanocytes, which is obviously correlated with its concentration. The mechanism may be a self-protective response of cells to oxidative stress injury and apoptosis.

Pylorus and vagus nerve-preserving gastrectomy (PPG) is a function-preserving surgery for early gastric cancer (GC) that has gained considerable interest in the recent years. The operative technique performed using the Da Vinci Xi robot system is considered ideal for open and laparoscopic surgery.To introduce Da Vinci Xi robot-assisted PPG (RAPPG)-based operative procedure and technical points as well as report the initial experience based on the clinical pathology data of eight cases of early GC.Da Vinci Xi robot-assisted pylorus and vagus nerve-preserving gastrectomy (RAPPG) was performed for 11 consecutive patients with middle GC from December 2020 to July 2021. Outcome measures were postoperative morbidity, operative time, blood loss, number of lymph nodes harvested, postoperative hospital stay, time to first flatus, time to diet, and resection margins.Eight of the 11 patients who were pathologically diagnosed with early GC were enrolled in a retrospective study to assess the feasibility and safety of RAPPG. The mean operative time, mean blood loss, mean number of lymph nodes harvested, length of preserved pylorus canal, distal margin, and proximal margin were 330.63 ± 47.24 min, 57.50 ± 37.70 mL, 18.63 ± 10.57, 3.63 ± 0.88 cm, 3.50 ± 1.31 cm, and 3.63 ± 1.19 cm, respectively. None of the cases required conversion to laparotomy. Postoperative complications occurred in two (25.0%) patients. Postoperative complications were hyperamylasemia and gastric stasis in one case and incision infection in the other. Time to first flatus was 3.75 ± 2.49 d after the operation, and postoperative hospital stay was 10.13 ± 4.55 d.The core technique in the Da Vinci Xi RAPPG is lymph node dissection and the anatomic method of the nerve. Robotic surgical procedures are feasible and safe. With the progress of surgical technology, optimization of medical insurance structure, and emergence of evidence-based medicine, automated surgery systems will have a broad application in clinical treatment.

343 Background: Conversion therapy can improve the survival of patients with locally advanced unresectable or potentially resectable metastatic gastric adenocarcinoma. This study was conducted to evaluate the efficacy and safety of nab-paclitaxel combined with oxaliplatin and S-1 as a conversion therapy in gastric cancer. Methods: This was a single-arm, multicenter, open-label trial of patients with locally advanced unresectable or potentially resectable metastatic gastric adenocarcinoma. Eligible patients were administered nab-paclitaxel (150 mg/m2, day 1), oxaliplatin (85 mg/m2, day 1), and S-1 (80–120 mg/day, days 1–14) every 21 days for two or four cycles. Radiographic assessments were performed after two cycles of treatment. Subsequent treatment or surgery was decided by the investigator according to assessment results and patient's condition. The primary endpoint was R0 resection rate. Secondary endpoints included progression-free survival (PFS), overall survival (OS), and safety. Results: From January 2020 to September 2022, 62 patients (49 males/13 females) with a median age of 58.9 years (range: 36–73) were enrolled in this study. Sixteen (25.8%) of the 62 patients had distant metastasis. The overall response rate and disease control rate of 54 patients who underwent at least one assessment were 61.1% (33/54, 95% CI: 46.9–74.1%) and 94.4% (51/54, 95% CI: 84.6–98.8%), respectively. Of the 39 patients who underwent surgery, 33 (84.6%, 95% CI: 69.5–94.1%) patients had an R0 resection, two had an R1 resection, and four had exploratory laparotomies. The pathological complete response rate was 15.4% (6/39, 95% CI: 6.4–31.2%). After a median follow-up time of 8.4 months, the 1-year PFS rate was 68.6% (95% CI: 53.4–83.8%), whereas the median PFS and OS were not reached. Seven patients died because of disease progression (5 patients who did not undergo surgery), myocardial infarction (1 patient), and electrolyte disturbance (1 patient). Treatment-related adverse events occurred in 82.3% (51/62) patients, although most events were grade 1–2. Common hematological toxicities were leukopenia (61.3%), neutropenia (54.8%), anemia (41.9%), and thrombocytopenia (30.6%). Common non-hematological treatment-related adverse events were nausea (53.2%), fatigue (43.5%), hepatic function abnormal (33.9%), neurotoxicity (29.0%), and diarrhea (24.2%). Conclusions: Nab-paclitaxel combined with oxaliplatin and S-1 showed promising efficacy and acceptable toxicity in patients with locally advanced unresectable or potentially resectable metastatic gastric cancer. Clinical trial information: NCT04047953 .

The medical literature contains a wealth of valuable medical knowledge. At present, the research on extraction of entity relationship in medical literature has made great progress, but with the exponential increase in the number of medical literature, the annotation of medical text has become a big problem. In order to solve the problem of manual annotation time such as consuming and heavy workload, a remote monitoring annotation method is proposed, but this method will introduce a lot of noise. In this paper, a novel neural network structure based on convolutional neural network is proposed, which can solve a large number of noise problems. The model can use the multi-window convolutional neural network to automatically extract sentence features. After the sentence vectors are obtained, the sentences that are effective to the real relationship are selected through the attention mechanism. In particular, an entity type (ET) embedding method is proposed for relationship classification by adding entity type characteristics. The attention mechanism at sentence level is proposed for relation extraction in allusion to the unavoidable labeling errors in training texts. We conducted an experiment using 968 medical references on diabetes, and the results showed that compared with the baseline model, the present model achieved good results in the medical literature, and F1-score reached 93.15%. Finally, the extracted 11 types of relationships were stored as triples, and these triples were used to create a medical map of complex relationships with 33 347 nodes and 43 686 relationship edges. Experimental results show that the algorithm used in this paper is superior to the optimal reference system for relationship extraction.医学文献含有丰富的有价值的医学知识。目前，在医学文献上的实体关系提取研究已经得到了很大的进步，但是随着医学文献数量以指数形式增加，医学文本的标注工作成为一个很大的问题。为解决人工标注耗时长、工作量大的问题，研究者提出了远程监督标注的方法，但这种方法会引入大量噪声。本文提出了一种基于卷积神经网络的新型神经网络结构，可以解决大量噪声问题。该模型可以利用多窗口卷积神经网络自动提取句子特征，在得到句子向量后，通过注意力机制选择对真实关系有效的句子。特别地，提出实体类型（ET）嵌入方法，通过加入实体类型特征用于关系分类。我们针对训练文本存在不可避免的标注错误问题，提出句子级别的注意力机制用于关系提取。使用 968 份糖尿病医学文献进行实验，结果表明，与基线模型相比，本文模型在医学文献中得到了较好的效果，F1 分数达到 93.15%。最后，我们将提取的 11 类关系以三元组的形式存储，并利用这些三元组制成具有 33 347 个节点、43 686 条关系边的复杂关系医学知识图谱。实验结果证明，本文所使用的算法明显优于用于关系提取的最佳基准系统。.

Hypersensitivity to mosquito bites (HMB) refers to skin reactions such as bullae and necrosis, which occurs after being bitten by mosquitoes and can present with multiple systemic reactions such as fever, lymphadenopathy, hepatosplenomegaly simultaneously or subsequently. A 48-year-old male patient presented with recurrent erythema, nodules, papules, vesicles and bullae over upper body and bilateral limbs with itching over the sites of mosquito bite for more than 1 year with low-grade fever and superficial lymph nodes enlargement. The patient's symptoms failed to improve from conventional anti allergic treatment although skin biopsy showed changes of HMB reaction. Subsequently, the lymph node was biopsied and was reported to be nodal marginal zone lymphoma (NMZL), and then the patient was eventually diagnosed with nodal marginal zone lymphoma with HMB. To date only one case of nodal marginal zone lymphoma with HMB has been reported from Korea, and this is the first case to be reported in China.

Background: Atypical chemokine receptors (ACKRs), including DARC, D6 and CCX-CKR, hold very critical roles in cancer invasion and metastasis. The objective of the present study was to determine preliminarily the predictive value of ACKRs in colorectal cancer (CRC). Methods: From 2012 to 2019 in the First Affiliated Hospital of Dalian Medical University, 44 CRC patients were followed up. We performed immunohistochemical analysis, Western blot and RT-PCR analysis on CRC and adjacent normal tissues for investigating the expression of ACKRs and their relationships to clinicopathologic features and survival rate. Results: The expression of three ACKRs, CCX-CKR, DARC and D6, in normal colon tissues is higher than that in colorectal cancer tissues. Meanwhile, the expression of corresponding ligands CCL21, CCL2 and CCL22 shows the opposite. Low expression of ACKRs in colon cancer tissues was closely related to the potential of lymph node metastasis (P= 0.001). When compared with triple-negative ACKR expression, co-expression of the ACKRs predicted better outcomes of colorectal cancer patients with statistical significance (P=0.011). Conclusions: The loss of ACKRs may play important roles in lymph node metastasis of CRC. ACKR expression may be considered as prognostic markers in CRC patients.

Background Curing locally advanced gastric cancer through surgery alone is difficult. Adjuvant and neoadjuvant chemotherapy bring potential benefits to more patients with gastric cancer based on several clinical trials. According to phase II studies and guidelines, SOX regimen as neoadjuvant chemotherapy is efficient. However, the optimal duration of neoadjuvant chemotherapy has not been established. In this study, we will evaluate the efficacy and safety of different cycles of SOX as neoadjuvant chemotherapy for patients with locally advanced gastric cancer. Methods RESONANCE-II trial is a prospective, multicenter, randomized, controlled phase III study which will enroll 524 patients in total. Eligible patients will be registered, pre-enrolled and receive three cycles of SOX, after which tumor response evaluations will be carried out. Those who show stable disease or progressive disease will be excluded. Patients showing complete response or partial response will be enrolled and assigned into either group A for another three cycles of SOX (six cycles in total) followed by D2 surgery; or group B for D2 surgery (three cycles in total). The primary endpoint is the rate of pathological complete response and the secondary endpoints are R0 resection rate, three-year disease-free survival, five-year overall survival, and safety. Discussion This study is the first phase III randomized trial to compare the cycles of neoadjuvant chemotherapy using SOX for resectable locally advanced cancer. Based on a total of six to eight cycles of perioperative chemotherapy usually applied in locally advanced gastric cancer, patients in group A can be considered to have completed all perioperative chemotherapy, the results of which may suggest the feasibility of using chemotherapy only before surgery in gastric cancer. Trial registration Registered prospectively in the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) with registration number ChiCTR1900023293 on May 21st, 2019.

Background: Fusarium species are environmentally ubiquitous fungi capable of causing diverse superficial, locally invasive, or disseminated infections, making them important pathogens. Compared with antibacterial drugs, the types of antifungal drugs are still limited, and the adverse reactions are significant. Therefore, novel treatments against Fusarium spp. are an urgent need.Results: Here we investigated the interaction of amorolfine combined with voriconazole on Fusarium spp. Our study demonstrated that amorolfine in combination with voriconazole could inhibited the Fusarium spp. significantly. Galleria mellonella was also used as a model to show the interaction of the two-drug combination in vivo against Fusarium spp.; larval survival rates were significantly higher after treatment with the amorolfine-voriconazole combination compared to the monotherapy group.Conclusions: This study is the first to demonstrate that voriconazole combined with amorolfine has a synergistic effect against Fusarium spp. infection and may be an effective method for antifungal therapy.

Bullous pemphigoid (BP) is an acute or chronic autoimmune skin disease. It is reported that poor conditions of general health and increased mortality rates are observed in BP patients, although there is a paucity of studies on the pathophysiologic reasons for the phenomena. In the study, we applied various time series data mining techniques to validate the effect of environmental factors on BP. Several statistical methods were used to explore the seasonal incidence patterns of BP, and validate the significance of the obtained patterns. The correlation measure was employed to evaluate the relationship between meteorological variables and BP incidence. The Fourier–Gaussian Decomposition (FGD) algorithm developed by our research group is a significant contribution. The FGD was also adopted to recognize the seasonal incidence distributions of BP. The study indicated that the monthly incident counts for BP significantly increased in August. The correlation measure verified strong correlation of BP inci...

Synthetic molecular machines have received increasing attention because of their great ability to mimic natural biological motors and create novel modes of motion. However, very few examples have been implemented with real autonomous movement inside living cells, due to the challenges of the driving force and highly integrated system design. In this work, we report an elegant, highly integrated DNA nanomachine that can be powered by endogenous ATP molecules and autonomously operated inside living cells without any auxiliary additives. It assembles all components on a single gold nanoparticle (AuNP) including a hairpin-locked swing arm encoding a start triggered by an intracellular target molecule and a two-stranded DNA track responding to the motion of the swing arm. When the intracellular target activates the nanomachine via the unlocking swing arm, the machine autonomously and progressively operates on the established DNA track via intramolecular toehold-mediated strand migration and internal ATP binding. This paper also demonstrates the machine's bioanalytical application for specific microRNA (miRNA) imaging in living cells.

Coronary arteries are covered by a layer of endothelial cells (ECs) that have a thickness of approximately 1 μm. Impairment of ECs is at the origin of coronary atherosclerosis and its clinical manifestations. The current gold standard, scanning electron microscopy (SEM), has demonstrated that ECs