BACKGROUND:Ulcerative colitis (UC) is a long-term, recurrent inflammatory condition marked by bloody feces and mucosal damage. Its rising global incidence and socioeconomic burden necessitate safer long-term interventions. Edible and medicinal herbs (EMHs) are prospective alternatives due to their multi-target profiles and safety. Eleutheroside E (EE), a key component of the well-known EMH Eleutherococcus senticosus, exhibits robust inflammation-suppressing capacities. Nonetheless, its anti-inflammatory protective efficacy and associated mechanisms in acute colitis require further exploration. PURPOSE:This study endeavored to delineate the anti-inflammatory protective effects and associated molecular cascades of EE in DSS-induced acute colitis. METHODS:The anti-inflammatory protective properties of EE were evaluated in a dextran sulfate sodium (DSS)-induced colitis model under simultaneous administration conditions. The functional reliance and target engagement of the MAPK pathway were explored in vivo and in vitro using a specific inhibitor (SCH772984), an agonist (Ro 67-7476), small interfering RNA (siRNA) knockdown, and cellular thermal shift assay (CETSA). Protective efficacy, the inflammatory microenvironment, Th17 immune responses, and gut microbiota profiles were assessed via histopathological scoring, ELISA, RT-qPCR, Western blotting, flow cytometry, RNA-seq, and 16S rRNA sequencing. RESULTS:EE alleviated DSS-mediated body weight reduction, disease progression and colonic shortening, and relieved intestinal mucosal lesions. Secondary to the attenuation of local inflammation, EE maintained the intact intestinal barrier structure. Molecularly, CETSA supported cellular target engagement of EE with MEK1 and ERK2 and their thermal stabilization. In vitro, targeted siRNA silencing of MEK/ERK in LPS-stimulated RAW264.7 macrophages abolished the further inhibitory effects of EE on MAPK activation, while RO stimulation showed that EE reduced the generation of pro-inflammatory cytokines essential for Th17 polarization (IL-6, IL-1β, and IL-23). In vivo, this dampening of the pro-inflammatory microenvironment corresponded with a significant reduction in the proportion of Th17 cells (CD4⁺IL-17A⁺RORγt⁺) in the colonic lamina propria and decreased IL-17A levels. Furthermore, 16S rRNA sequencing indicated that EE treatment was accompanied by gut microbiota remodeling. CONCLUSION:EE, a bioactive molecule derived from a well-known EMH, exerts anti-inflammatory protective effects against acute UC. This protection is associated with the suppression of Th17 immune responses through modulation of the MAPK (MEK/ERK) signaling pathway and a blunted pro-inflammatory microenvironment. These protective effects are also accompanied by gut microbiota remodeling.

BACKGROUND:Artificial intelligence (AI)-assisted endoscopy facilitates upper gastrointestinal lesion detection. Whether Helicobacter pylori (H. pylori) infection influences its diagnostic performance remains unclear. This study evaluated the effect of H. pylori infection on an AI model's accuracy for diagnosing gastric neoplasms. METHODS:A deep convolutional neural network-based AI system was evaluated for gastric neoplasm detection (low-grade intraepithelial neoplasia (LGIN), high-grade intraepithelial neoplasia (HGIN), and early gastric cancer (EGC)) in a retrospective cohort study. White light endoscopy (WLE) images (n = 2347) were collected from 563 patients who underwent imaging from November 2019 to August 2024 at Taizhou Hospital of Zhejiang Province to assess H. pylori infection's impact on diagnostic performance. Additional WLE images (n = 447) from 117 patients (September 2024-June 2025) were used to compare the AI system's performance with that of expert and non-expert endoscopists. RESULTS:The AI system achieved 85.0% accuracy, 82.0% sensitivity, 87.6% specificity, 85.2% positive predictive value (PPV), and 84.8% negative predictive value (NPV). The accuracy (87.1% vs. 80.2%), specificity (89.9% vs. 76.6%), and NPV (89.7% vs. 65.4%) were significantly higher in the H. pylori-negative group than in the H. pylori-positive group (all P < 0.001), whereas the PPV was lower (82.7% vs. 88.5%, P = 0.008), with a comparable sensitivity (82.3% vs. 81.6%, P = 0.790). Within the H. pylori-negative cohort, further stratification into never-infected and eradicated subgroups showed that the eradicated group had significantly higher accuracy, sensitivity, and NPV than the H. pylori-positive group (all P < 0.05). It exhibited significantly higher accuracy for detecting non-neoplastic lesions and LGIN in the H. pylori-negative group (P < 0.05), but not for HGIN or EGC (P > 0.05). Its diagnostic accuracy was comparable to the expert endoscopists' (84.8% vs. 81.9%, P = 0.247) and significantly higher than the non-expert endoscopists' (84.8% vs. 72.1%, P < 0.001). CONCLUSION:This AI system exhibited excellent performance for gastric neoplasm detection, which was significantly affected by H. pylori infection (particularly for non-neoplastic lesions and LGIN). Eradication of H. pylori appeared to restore the diagnostic performance of the AI system. Its diagnostic accuracy in still image classification was comparable to expert endoscopists and superior to non-experts, supporting its potential as an adjunctive clinical endoscopy tool.

ETHNOPHARMACOLOGICAL RELEVANCE:Coicis Semen is a classic example of a resource used both as food and medicine. In traditional Chinese medicine, it is known for several functions: promoting diuresis, resolving dampness, strengthening the spleen, stopping diarrhea, draining pus, and removing toxins. For a long time, it has been widely used to relieve symptoms of gastrointestinal disorders. In particular, Coixol shows strong biological activity when it comes to regulating intestinal inflammation. However, its specific therapeutic potential and underlying mechanisms in ulcerative colitis (UC) have not been fully elucidated. AIM OF THE STUDY:This research aimed to define the therapeutic potential of Coixol in ulcerative colitis and clarify its regulatory influence on the Axin1-mediated Wnt signaling axis and the subsequent activation of group 3 innate lymphoid cells (ILC3). MATERIALS AND METHODS:We established a colitis model in mice using dextran sulfate sodium and utilized LPS-stimulated macrophages for in vitro assays. Therapeutic outcomes were measured through disease activity scores, tissue histology, and epithelial barrier assessment. We integrated bulk RNA sequencing and Olink proteomics to pinpoint core regulatory pathways. We then validated Axin1 as the direct molecular target of the drug using molecular docking, surface plasmon resonance, and cellular thermal shift assay. Mechanistic insights were further substantiated by Western blot, flow cytometry, and a pharmacological rescue experiment using a Wnt signaling activator. Finally, the functional necessity of this axis was confirmed via IL-22 neutralization assays, demonstrating the regulatory link between Axin1 and the observed phenotypic changes. RESULTS:Coixol intervention significantly lowered inflammatory markers and promoted the restoration of the intestinal wall. Coixol modulated macrophage polarization and increased Axin1 protein levels to trigger the degradation of β-catenin. Furthermore, flow cytometry demonstrated that Coixol expanded the colonic ILC3 population, a process essential for driving IL-22-dependent mucosal healing. This protective effect was reversed by an IL-22-neutralizing antibody. CONCLUSION:Coixol effectively mitigates experimental colitis by targeting the Axin1 and Wnt axis to promote ILC3 expansion and subsequent IL-22 production. These results provide a modern scientific foundation for the traditional medicinal use of Coicis Semen and highlight the Axin1 and ILC3 module as a viable target for treating UC.

INTRODUCTION: Accurate assessment of invasion depth in esophageal squamous cell carcinoma is essential for optimal treatment. Probe-based confocal laser endomicroscopy (pCLE) enables real-time in vivo imaging, but its interpretation depends heavily on endoscopist expertise. This study aimed to develop and validate an artificial intelligence-assisted pCLE (AI-pCLE) system for the differential diagnosis of low-grade intraepithelial neoplasia (LGIN) from high-grade intraepithelial neoplasia with submucosal invasion (HGIN-SM1). METHODS: In this retrospective single-center study, 1,234 pCLE images were used to develop and validate the AI model. Histopathology from resected specimens served as the reference standard. Six deep learning algorithms were evaluated using accuracy, sensitivity, specificity, area under the curve, positive predictive value (PPV), and negative predictive value (NPV). The best-performing model was selected and compared with 10 endoscopists. RESULTS: For the differentiation between LGIN and HGIN-SM1 lesions, the AI-pCLE system exhibited a sensitivity of 97.4%, specificity of 92.6%, accuracy of 95.3%, PPV of 94.17%, and NPV of 96.70%, respectively. In comparison, the mean sensitivity, specificity, accuracy, PPV, and NPV of the endoscopists were 83.79%, 85.26%, 84.46%, 88.14%, and 82.61%, respectively. With AI-pCLE assistance, the accuracy, sensitivity, and NPV of the endoscopists increased to 94.41% ( P = 0.001), 96.98% ( P = 0.006), and 96.24% ( P = 0.001), respectively. The diagnostic performance of the AI-assisted system was comparable with that of expert endoscopists. DISCUSSION: The AI-pCLE system demonstrated robust diagnostic performance in differentiating LGIN from HGIN-SM1 lesions, indicating its potential as a reliable tool for evaluating the invasion depth of esophageal squamous cell carcinoma.

A major unmet need in gastric cancer prevention is the lack of biomarkers to predict precancerous lesion progression, and the potential of chromosomal instability (CIN) for this role, particularly regarding early cancer and recurrence, remains unclear. To assess the predictive role of CIN in lesion progression and postoperative recurrence following endoscopic submucosal dissection (ESD). We enrolled 106 patients from Taizhou Hospital Affiliated to Wenzhou Medical University (2011–2025) and collected 1,045 temporally continuous pathological samples. Copy number variations were profiled using low-coverage whole-genome sequencing (LC-WGS), and CIN scores were calculated. Associations between CIN and clinical outcomes were analyzed using survival analysis and ROC curves. CIN was detectable up to two years before gastric cancer diagnosis, with positivity rates increasing alongside lesion severity: 25.5% in intestinal metaplasia, 39.7% in low-grade dysplasia, and 83.0% in gastric cancer. CIN positivity independently predicted lesion progression (hazard ratio [HR] = 2.55, 95% CI: 1.19–5.47, p = 0.016), with the greatest risk for progression to carcinoma (HR = 16.61, p < 0.001). The predictive AUC was 0.81, improving to 0.88 when combined with age. Among 84 patients who underwent ESD, CIN positivity significantly increased recurrence risk (HR = 19.57, 95% CI: 2.59 – 147.61, p = 0.004; AUC = 0.80). Chromosomal arms 7p/q, 8p/q, and 20p/q showed high CIN frequencies, with MYC being the most frequently mutated oncogene. CIN represents a reliable biomarker for early prediction of lesion progression and postoperative recurrence, enabling proactive surveillance and precision management of gastric cancer. Chromosomal instability (CIN) acts as a reliable biomarker for predicting the progression of gastric precancerous lesions and postoperative recurrence.

A 63-year-old female was admitted for repeated hematochezia, red stool mainly, for one week. Physical examination showed anemic appearance without abdominal pain or rebound tenderness. Laboratory tests showed lower level of hemoglobin (76 g/L), and positive fecal occult blood test with abundant red blood cell. Emergency colonoscopy discovered a punctate bleeding in the left colon. Bleeding would be stopped after rinsing with water, but recovered after touching with the top of colonoscopy. Endoscopic resection was performed to remove the lesion (Video 1), and typical angioma was found in pathology. No bleeding occurred during the follow-up 2 years.

Introduction: ABAT, a key enzyme in GABA catabolism, modulates antitumor immune activity across various cancers. However, the molecular mechanisms by which the ABAT/GABA axis exerts immune regulation in the liver cancer microenvironment remain unclear. Methods: ABAT expression in liver cancer tissues was scrutinized via the TCGA-LIHC database, and the 5-year survival rates of liver cancer patients were appraised through Kaplan-Meier survival analyses. The mRNA levels of ABAT in liver cancer cell lines were quantified by qRT-PCR. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT), colony formation, and Transwell assays were employed to gauge the influence of ABAT overexpression on liver cancer cell growth, proliferation, migration, and invasion, respectively. Western blot evaluated epithelial-mesenchymal transition-related protein expression. ELISA quantified GABA, IL-10, TGF-beta 1, Granzyme B, and IFN-gamma in the culture medium. Flow cytometry was used to measure the frequency of CD25+FOXP3+ cells and the expression of CD25, CD69, and PD-1 on CD8(+)T cells in coculture. Carboxifluorescein diacetate succinimidyl ester dilution assays were performed to assess the proliferative activity of CD8(+)T cells. Results: ABAT was found to be underexpressed in liver cancer tissues and cells, and such underexpression is indicative of a poorer prognosis for patients, while its overexpression was shown to curb the malignancy of liver cancer cells. Upon overexpression of ABAT, there is a decrease in GABA levels in the cell supernatant, coupled with an increase in IL-10 and TGF-beta 1 cell number, and an upsurge in the CD25+FOXP3+ cell ratios, all of which were restored by the addition of exogenous GABA. Furthermore, the depletion of ABAT led to a reduction in the proliferation and tumor-killing ability of CD8(+)T cells, effects that were reversed by the application of GABAA receptor inhibitors. Conclusion: ABAT functions to inhibit Treg differentiation in liver cancer through downregulation of GABA, thus promoting the antitumor activity of CD8(+)T cells.

Background: Obesity, which is associated with excessive accumulation of body fat, is emerging as a new public health problem. Bioelectrical impedance analysis (BIA) is a non-invasive and straightforward method to analyze body composition, providing a more accurate estimate of obesity than the commonly used body mass index. The primary objective of this study was to examine the potential impact of Helicobacter pylori (H. pylori) infection on body fat percentage in a population using cross-sectional and cohort studies. Methods: A population of people who underwent physical examinations at Taizhou Hospital between 2017 and 2022 was included. The participants underwent various tests, including urea breath test, hematological examination, and anthropometric measurement, in addition, their body fat percentage was determined through the use of BIA. Univariate and multifactorial regression analyses were conducted to identify factors associated with excess body fat. Results: There was a difference in body fat percentage between H. pylori positive and negative populations. The population was divided into young and middle-aged and elderly according to age, and H. pylori infection was found to differ only in the middle-aged and elderly population. Multifactorial logistic regression showed that H. pylori infection remained associated with excess body fat in the middle-aged and elderly population. A subsequent cohort study confirmed the association of persistent H. pylori infection with excess body fat in the population. Conclusion: H. pylori was negatively associated with excess body fat in middle-aged and elderly populations, and long-term H. pylori infection has a negative effect on body fat in people.

Diabetic cardiomyopathy is the complication of diabetes and a serious health risk for diabetics. Pyrroloquinoline quinone, is a food-derived vitamin. The aim of this study was to investigate whether pyrroloquinoline quinone has a protective effect on the myocardium of patients with diabetic cardiomyopathy. We designed five groups of mice; control, diabetic cardiomyopathy, diabetic cardiomyopathy+pyrroloquinoline quinone-L, diabetic cardiomyopathy+pyrroloquinoline quinone-M, and diabetic cardiomyopathy+pyrroloquinoline quinone-H, and determined the changes of diabetic cardiomyopathy in each group based on the echocardiographic results of the mice. In addition, we also observed the myocardial tissue specimens of mice and found myocardial fibrosis was lower in pyrroloquinoline quinone group mice. To further explore the mechanism of pyrroloquinoline quinone affecting myocardial fibrosis, we used reverse transcriptase-polymerase chain reaction to measure the long noncoding RNA associated with myocardial fibrosis in mice, and found the expression of metastasis associated lung adenocarcinoma transcript 1, growth arrestspecific 5, and KCNQ1OT1 were higher in the groups of pyrroloquinoline quinone. This also indicated that pyrroloquinoline quinone improved myocardial fibrosis by affecting metastasis associated lung adenocarcinoma transcript 1, growth arrestspecific 5, and KCNQ1OT1 expressions.

BACKGROUND Endoscopic resection (ER) and laparoscopic resection (LR) have been widely used for the treatment of non-metastatic gastric gastrointestinal stromal tumors (gGISTs) (2-5 cm), but there are no selection criteria for their application. AIM To provide a reference for the development of standardized treatment strategies for gGISTs. METHODS Clinical baseline characteristics, histopathological results, and short-term and long-term outcomes of patients who treated with ER or LR for gGISTs of 2-5 cm in Taizhou Hospital of Zhejiang Province from January 2014 to August 2022 were retrospectively reviewed. Propensity score matching (PSM) was employed to achieve balance in baseline characteristics of the two groups. RESULTS Among 206 patients, 135 were in the ER group and 71 in the LR group. The ER group had significantly smaller tumors [3.5 cm (3.0-4.0 cm) vs 4.2 cm (3.3-5.0 cm), P < 0.001] and different tumor locations (P = 0.048). After PSM, 59 pairs of patients were balanced. After matching, the baseline characteristics of the ER and LR groups did not differ significantly from each other. Compared with LR, ER had faster recovery of diet (P = 0.046) and fewer postoperative symptoms (P = 0.040). LR achieved a higher complete resection rate (P < 0.001) and shorter operation time (P < 0.001). No significant differences were observed in postoperative hospital stay (P = 0.478), hospital costs (P = 0.469), complication rates (P > 0.999), pathological features (mitosis, P = 0.262; National Institutes of Health risk classification, P = 0.145), recurrence rates (P = 0.476), or mortality rates (P = 0.611). CONCLUSION Both ER and LR are safe and effective treatments for gGISTs. ER has less postoperative pain and faster recovery, while LR has a higher rate of complete resection.

Endoscopic submucosal dissection (ESD) is a safe and effective technique for the treatment of gastrointestinal tumors, including rectal neuroendocrine tumors (r-NETs). However, the relative advantages of traction-assisted ESD for the treatment of small rectal lesions are still debated. We conducted a study to compare the efficacy and safety of rubber band traction-assisted ESD (RBT-ESD) to conventional ESD (C-ESD). This study retrospectively analyzed consecutive patients with r-NET treated with ESD between October 2021 and October 2023. Our study assessed differences between the groups in the complete resection rate of lesions, muscular layer injury, surgical complications, operation time, resection speed, time to liquid diet, postoperative hospital stay, hospital cost, and recurrence rate. A total of 119 patients with r-NETs participated in this study (RBT-ESD group, n = 27; C-ESD group, n = 92). The operation time in RBT-ESD group was shorter than in C-ESD group, but the difference was not statistically significant (16.0 min [9.0–22.0 min] vs. 18.0 min [13.3–27.0 min], P = 0.056). However, the resection speed was significantly faster in the RBT-ESD group (6.7 vs. 4.1 mm2/min, P = 0.005). Furthermore, the RBT-ESD group showed significantly less muscular layer injury (P = 0.047) and faster diet recovery (P = 0.035). No significant differences were observed in the complete resection rate, surgical complications, postoperative hospital stay, hospital cost, or recurrence rate between the two groups. For r-NETs of < 2 cm in size, the RBT method did not significantly shorten the operation time but resulted in faster resection speed, less muscular layer injury, and earlier postoperative recovery to a liquid diet.

Endoscopy is the primary modality for detecting asymptomatic esophageal squamous cell carcinoma (ESCC) and precancerous lesions. Improving detection rate remains challenging. We developed a system based on deep convolutional neural networks (CNNs) for detecting esophageal cancer and precancerous lesions [high-risk esophageal lesions (HrELs)] and validated its efficacy in improving HrEL detection rate in clinical practice (trial registration ChiCTR2100044126 at www.chictr.org.cn ). Between April 2021 and March 2022, 3117 patients ≥50 years old were consecutively recruited from Taizhou Hospital, Zhejiang Province, and randomly assigned 1:1 to an experimental group (CNN-assisted endoscopy) or a control group (unassisted endoscopy) based on block randomization. The primary endpoint was the HrEL detection rate. In the intention-to-treat population, the HrEL detection rate [28 of 1556 (1.8%)] was significantly higher in the experimental group than in the control group [14 of 1561 (0.9%), P = 0.029], and the experimental group detection rate was twice that of the control group. Similar findings were observed between the experimental and control groups [28 of 1524 (1.9%) versus 13 of 1534 (0.9%), respectively; P = 0.021]. The system’s sensitivity, specificity, and accuracy for detecting HrELs were 89.7, 98.5, and 98.2%, respectively. No adverse events occurred. The proposed system thus improved HrEL detection rate during endoscopy and was safe. Deep learning assistance may enhance early diagnosis and treatment of esophageal cancer and may become a useful tool for esophageal cancer screening.

Background:Animal organ meat (offal) is a food with high nutrient density that is popular in different parts of the world, but its relationship with nonalcoholic steatohepatitis (NASH) is unclear. We aimed to examine whether daily animal organ meat consumption is associated with the presence of NASH in individuals with nonalcoholic fatty liver disease (NAFLD).Methods:A total of 136 Chinese adults with biopsy-proven NAFLD were included. Definite NASH was defined as NAFLD activity score ≥4 and at least one point for steatosis, ballooning, and lobular inflammation. Daily animal organ meat consumption was estimated using a self-administered validated food frequency questionnaire. Logistic regression analysis was performed to assess the association between animal organ meat intake and liver disease severity.Results:The 136 participants (80.9% men) of the study had a mean ± standard deviation (SD) age of 39.0±12.5 years and body mass index of 27.4±3.6 kg/m2. Prevalence of definite NASH was 65.4%. Daily median organ meat consumption was 1.30 g/1,000 kcal. Animal organ meat consumption was inversely associated with the presence of NASH even after adjustment of demographics, lifestyle variables, metabolic and dietary factors, as well as liver fibrosis stage; adjusted-odds ratios (95% confidence intervals) for NASH were 0.15 (0.03, 0.69) for the highest tertile and 0.18 (0.05, 0.70) for the medium tertile, compared to the lowest (reference) tertile of animal organ meat intake (P value for trend =0.024).Conclusions:Our results suggest for the first time that higher animal organ meat consumption is associated with a lower prevalence of NASH in Chinese individuals with biopsy-proven NAFLD.

BACKGROUND:The Haptoglobin (Hp) genotypes have been linked to immune diseases and play a significant role in metabolic diseases. This study aimed to analyze the correlation between Hp gene polymorphism and the severity of hepatitis B accompanied by liver steatosis. METHODS:A total of 182 with Hepatitis B and concurrent hepatic steatosis were included in the study. Clinical biochemical indices for each participant were recorded. DNA was extracted from peripheral blood leukocytes for globin genotyping. Of these participants, 128 underwent biopsy from which histological data were collected. RESULTS:Subjects with hepatitis B and hepatic steatosis carrying the Hp 2-2 genotype exhibited elevated alanine transaminase (ALT), c-glutamyl transferase (GGT), and aspartate amino transferase (AST) levels. In contrast, high-density lipoprotein (HDL) levels and the copy number of Hepatitis B Virus (HBV)-DNA were significantly reduced in those with the Hp 2-2 genotype (p < 0.05). Furthermore, individuals processing the Hp 2-2 genotype demonstrated a heightened hepatitis score and advanced fibrosis stage (p < 0.05). Notably, the Hp 2-2 genotype was independently associated with increased inflammation (odds ratio (OR) = 7.059, p < 0.001) and progressive fibrosis (OR = 3.05, p < 0.022). CONCLUSIONS:The Hp 2-2 genotype is significantly associated with increased severity in cases of hepatitis B with coexisting hepatic steatosis.

Background and AimThe relationship between Helicobacter pylori (H. pylori) and fast plasma glucose (FPG) on nondiabetes populations is still inconclusive. Nowadays, not only the high infection rate of H. pylori but also the high FPG level is threatening the Chinese people. MethodsA retrospective cohort study has been established to analyze the relationship between H. pylori infection and FPG level, 18 164 individuals performed healthy examination in Taizhou Hospital Health Examination Center from 2017 to 2022 were included, and hematological indicators, body parameters, and H. pylori detection by C-13-urea breath test were collected from patients. The follow-up intervals were greater than 12 months. ResultsH. pylori infection was regarded as an independent risk factor for elevated FPG after multivariate logistic regression. Additionally, the average interval time were 33.6 & PLUSMN; 13.3 months. Mean changed FPG values in the persistent infection group were higher than in the subgroup of persistent negative (P = 0.029) as well as eradication infection (P = 0.007). The aforementioned changes began to appear after 2 years of follow-up. Similarly, when compared with the subgroup of persistent infection, mean changed triglyceride/high density lipoprotein (TG/HDL) values were much lower in the subgroup of persistent negative (P = 0.008) and eradication infection (P = 0.018), but the differences appeared after 3 years of follow-up. ConclusionsH. pylori infection is an independent risk factor for elevated FPG in non-diabetes mellitus (DM) individuals. Persistent H. pylori infection causes an increase in FPG level and TG/HDL, which may be a risk factor for diabetes mellitus.

ARL9 is a newly identified member of the ARF family, and the clinical significance of ARL9 in colon adenocarcinoma is unknown. In this study, we aimed to explore the expression of ARL9 mRNA in colon adenocarcinoma, and its effect on the prognosis of patients with colon adenocarcinoma. We investigated the differential expression of ARL9 between colon adenocarcinoma tissue and adjacent tissues through a bioinformatics analysis using The Cancer Genome Atlas (TCGA) database. The correlation between clinical characteristics and the mRNA expression level of ARL9 were analyzed. A survival analysis and a Cox regression analysis were used to determine the prognostic significance of ARL9. Finally, we conducted a gene set enrichment analysis (GSEA) to explore the ARL9 signaling pathways involved in the development of colon adenocarcinoma. The effect of the expression of ARL9 on the proliferation and migration of colon adenocarcinoma was analyzed by the CCK8 method and a cell scratch test, respectively. The mRNA expression of ARL9 in colon adenocarcinoma tissues was higher in comparison to the level in normal adjacent tissues (P < 0.05). The mRNA expression of ARL9 was not related to sex, tumor stage, T stage, N stage, M stage, but to age. The 5-year survival rate of colon adenocarcinoma patients with high ARL9 mRNA expression levels was significantly lower than that of patients with low ARL9 mRNA expression levels (P < 0.05). Age and the high mRNA expression of ARL9 were independent risk factors for a poor prognosis in patients with colon adenocarcinoma. The GSEA suggested that ARL9 may be able to upregulate cell adhesion, extracellular matrix receptor interactions, tumor-associated pathways, and downregulate the citrate cycle and tricarboxylic acid cycle pathway, which are involved in the development of colon adenocarcinoma. After knocking down ARL9, the proliferation and migration abilities of colon adenocarcinoma cells were decreased (P < 0.01). The mRNA expression of ARL9 is upregulated in colon adenocarcinoma, and higher mRNA expression levels are associated with a poor prognosis. Knocking down ARL9 can reduce the proliferation and migration of colon adenocarcinoma cells. ARL9 mRNA can be used as a prognostic biomarker in patients with colon adenocarcinoma.

目的 探讨基于时机理论模式的失代偿期肝硬化患者在疾病不同阶段主要照顾者的照护体验,为照顾者提供有效的干预和支持,提高其照护质量及生活质量.方法 选取浙江省台州医院消化内科2020年11月至2021年4月收治的失代偿期肝硬化患者的主要照顾者41名为受访对象,采用现象学研究方法,基于时机理论的五个不同时期对其进行非结构访谈,并采用Colaizzi七步分析法处理数据.结果 诊断期:害怕面对现实;内镜治疗期:缺乏疾病和手术相关知识;出院准备期:焦虑和无助;调整期:积极面对,希望提高居家照顾能力;适应期:接受现实,积极的回应.结论 失代偿期肝硬化患者照顾者的照护体验是复杂的动态过程,根据患者疾病的不同阶段会发生变化,应对照顾者在各个阶段给予针对性的指导,促进出院后治疗和护理的连续性,帮助他们建立重新开始的信心.

Chronic gastritis mainly includes chronic non-atrophic gastritis (CNAG), autoimmune gastritis (AIG), and type B gastritis. Early detection of AIG and type B gastritis will help identify high-risk groups for gastric cancer and prevent the development of irreversible peripheral neuropathy. We aim to develop a computer-assisted diagnosis (CADx) system by presenting a novel Convolution and Relative Self-Attention Parallel Network (CRSAPNet). We collected 3576 endoscopic images of chronic gastritis from 205 patients. MBConv and Relative Self-Attention Parallel Block (CRSAPB) was proposed to concatenate local features (such as mucosal folds and mucosal vessels extracted by MBConv) and global features (such as atrophied area extracted by Relative Self-Attention) in parallel in the last two stages of CRSAPNet. The CADx system distinguished AIG from type B gastritis and CNAG. The CRSAPNet achieved the highest overall accuracy of 95.44% (94.65% precision, 93.51% recall, 94.08% F1-score for AIG) with the fewest parameters. We used Grad-CAM to visually analyze the heat maps. We only replaced the original blocks of the third stage of ResNet50 and ConvNeXt-T with CRSAPB, resulting in an overall accuracy improvement of 0.37%, and 4.19%, respectively. Furthermore, the CADx system classified the three types of chronic gastritis for the first time. The CRSAPNet achieved an overall accuracy of 91.62%, and the overall accuracies in the location of the gastric body and gastric fundus were 93.43% and 92.51%, respectively. A new state-of-the-art deep learning network is introduced to distinguish AIG from type B gastritis and CNAG, and a classification for three types of chronic gastritis is reported for the first time.