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Colorectal cancer (CRC) is one of the most common malignant cancers worldwide and seriously threatens human health. The clustered regulatory interspaced short palindromic repeat/CRISPR-associate nuclease 9 (CRISPR/Cas9) system is an adaptive immune system of bacteria or archaea. Since its introduction, research into various aspects of treatment approaches for CRC has been accelerated, including investigation of the oncogenes, tumor suppressor genes (TSGs), drug resistance genes, target genes, mouse model construction, and especially in genome-wide library screening. Furthermore, the CRISPR/Cas9 system can be utilized for gene therapy for CRC, specifically involving in the molecular targeted drug delivery or targeted knockout in vivo. In this review, we elucidate the mechanism of the CRISPR/Cas9 system and its comprehensive applications in CRC. Additionally, we discussed the issue of off-target effects associated with CRISPR/Cas9, which serves to restrict its practical application. Future research on CRC should in-depth and systematically utilize the CRISPR/Cas9 system thereby achieving clinical practice.

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BACKGROUND AND AIMS: The quality of EGD is a prerequisite for a high detection rate of upper GI lesions, especially early gastric cancer. Our previous study showed that an artificial intelligence system, named intelligent detection endoscopic assistant (IDEA), could help to monitor blind spots and provide an operation score during EGD. Here, we verified the effectiveness of IDEA to help evaluate the quality of EGD in a large-scale multicenter trial. METHODS: Patients undergoing EGD in 12 hospitals were consecutively enrolled. All hospitals were equipped with IDEA developed using deep convolutional neural networks and long short-term memory. Patients were examined by EGD, and the results were recorded by IDEA. The primary outcome was the detection rate of upper GI cancer. Secondary outcomes were part scores, total scores, and endoscopic procedure time, which were analyzed by IDEA. RESULTS: A total of 17,787 patients were recruited. The total detection rate of cancer-positive cases was 1.50%, ranging from .60% to 3.94% in each hospital. The total detection rate of early cancer-positive cases was .36%, ranging from .00% to 1.58% in each hospital. The average total score analyzed by IDEA ranged from 64.87 ± 16.87 to 83.50 ± 9.57 in each hospital. The cancer detection rate in each hospital was positively correlated with total score (r = .775, P = .003). Similarly, the early cancer detection rate was positively correlated with total score (r = .756, P = .004). CONCLUSIONS: This multicenter trial confirmed that the quality of the EGD result is positively correlated with the detection rate of cancer, which can be monitored by IDEA. (Clinical trial registration number: ChiCTR2000029001.).

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Effects of scanning strategy during powder bed fusion electron beam additive manufacturing (PBF-EB AM) on microstructure, nano-mechanical properties, and creep behavior of Ti6Al4V alloys were compared. Results show that PBF-EB AM Ti6Al4V alloy with linear scanning without rotation strategy was composed of 96.9% α-Ti and 2.7% ß-Ti, and has a nanoindentation range of 4.11-6.31 GPa with the strain rate ranging from 0.001 to 1 s-1, and possesses a strain-rate sensitivity exponent of 0.053 ± 0.014. While PBF-EB AM Ti6Al4V alloy with linear and 90° rotate scanning strategy was composed of 98.1% α-Ti and 1.9% ß-Ti and has a nanoindentation range of 3.98-5.52 GPa with the strain rate ranging from 0.001 to 1 s-1, and possesses a strain-rate sensitivity exponent of 0.047 ± 0.009. The nanohardness increased with increasing strain rate, and creep displacement increased with the increasing maximum holding loads. The creep behavior was mainly dominated by dislocation motion during deformation induced by the indenter. The PBF-EB AM Ti6Al4V alloy with only the linear scanning strategy has a higher nanohardness and better creep resistance properties than the alloy with linear scanning and 90° rotation strategy. These results could contribute to understanding the creep behavior of Ti6Al4V alloy and are significant for PBF-EB AM of Ti6Al4V and other alloys.

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INTRODUCTION: One of the most common malignancies in women worldwide is breast cancer. Erector spinae plane block (ESPB) can reduce pain after modified radical mastectomy for breast cancer. The duration of nerve block analgesia is limited if local anesthetic agents are used alone. The purpose of this study was to evaluate the effect of dexmedetomidine on postoperative analgesia during a single injection of local anesthetics. METHODS: In this double-blind, randomized study, 60 female American Society of Anesthesiologists (ASA) I-II patients undergoing modified radical mastectomy were randomized into two groups: ultrasound (US)-guided ESPB with 30 mL of 0.33% ropivacaine (group R) and US-guided ESPB with 30 mL of dexmedetomidine plus 0.33% ropivacaine (group DR). US-guided ESPB at the T3 vertebral level was performed preoperatively in all patients. The indicators were 1-, 6-, 12-, 24-, and 48-h visual analog scale (VAS) pain scores after surgery in the resting state and at 90-degree shoulder abduction. Other measures were a comparison of intraoperative sufentanil and remifentanil, postoperative nausea and vomiting (PONV), flurbiprofen consumption, the lengths of post-anesthesia care unit (PACU) stay and hospital stay, postoperative bradycardia, and hypotension. RESULTS: The VAS pain score was lower in group DR than group R at any time in the resting state, except at 1 h after surgery. The VAS pain score was lower in group DR than group R at 12 and 24 h in an active state after surgery (P < 0.05 for each time interval). The intraoperative dosages of remifentanil and sufentanil in group DR were lower than that in group R. The postoperative dosage of flurbiprofen in group DR was lower than that in group R (P = 0.038). The lengths of PACU stay were longer in group DR than in group R. No significant difference was found in PONV and hospital stay between the two groups. No sinus bradycardia or hypotension after surgery occurred in the two groups. CONCLUSIONS: Dexmedetomidine as an adjunctive to ESPB can effectively relieve pain and significantly reduce the need for opioids during modified radical mastectomy for breast cancer. TRIAL REGISTRATION: The study was registered in the Chinese Clinical Trial Registry (ChiCTR2000031134, principal investigator: Yao Lu, date of registration: 2020-3-22).

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The photocatalytic efficiency is limited by poor charge separation efficiency and high carrier transport activation energy (CTAE) of photogenerated electron/hole pairs than traditional semiconductor. Hybridizing nanostructure with two staggered alignment band structure is proved as an effective strategy to mitigate these two challenges but still suffers a strong coulomb electrostatic repulsive force between two heterogeneous semiconductors. Here, we steer a friendly sulfurization process to construct BiVO4@Bi2S3 heterojunction with a scenario of cosharing Bi atoms. The intimate atomic-level contact between BiVO4 and Bi2S3 not only enhances the visible-light absorption and lowers CTAE, but also accelerate carrier's separation efficiency, which enables it to deliver the best photocatalytic performance toward reduction of Cr(VI). BiVO4@Bi2S3 only needs less than 40 min to completely reduce 50 ppm Cr(VI) solution. The type II heterojunction photocatalytic mechanism is systematically studied to decipher the carriers' transfer track between BiVO4 and Bi2S3. Our new finding of engineering inorganic heterojunction by cosharing atoms opens a new avenue to other similar materials for potential applications.

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BACKGROUND: The application of bedside ultrasound to evaluate gastric content and volume can assist in determining aspiration risk. Applying positive pressure ventilation via supraglottic airway devices (SAD) can result in a degree of gastric insufflation. This study assessed and compared the antral cross-sectional area (CSA) in patients undergoing laparoscopic gynecological surgery when managed with different SAD. METHODS: One hundred American Society of Anesthesiologists I or II female patients were assessed for inclusion in this study and divided into three groups of different ventilation devices. Patients were randomly allocated into three groups to receive LMA-Supreme (Group S), I-gel (Group I) or tracheal tube (Group T). The primary outcome was the antral cross-sectional area and secondary outcomes included haemodynamic parameters and postoperative morbidity such as sore throat, hoarseness, dry throat, nausea and vomiting. RESULTS: The antral CSA was not significantly different among three groups before induction (P = 0.451), after induction (P = 0.456) and at the end of surgery (P = 0.195). The haemodynamic variables were significantly higher in the tracheal tube group than in the LMA-Supreme and I-gel groups after insertion (P < 0.0001) and after removal (P < 0.01). Sore throat was detected in none in the I-gel group compare to two patients (6.7%) in the LMA-Supreme group and fifteen patients (50%) in the tracheal tube group. Hoareness was detected in one (3.3%) in the I-gel group compare to two patients (6.7%) in the LMA-Supreme group and eleven patients (36.7%) in the tracheal tube group. CONCLUSIONS: The SADs do not cause obvious gastric insufflation. Thus, LMA-Supreme and I-gel can be widely used as alternative to endotracheal intubation for the short laparoscopic gynecological surgery. TRIAL REGISTRATION: This trial was registered at the Chinese Clinical Trial Registry (ChiCTR1800018212, data of registration, September 2018).

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Electrochemical conversion of CO2 into valuable products by utilizing renewable electricity is a thriving research field. For electrochemical reduction of CO2 to CO, uniform sponge-like porous Ag nanocubes (SPC-Ag) integrated on carbon paper are prepared by using an electrochemically driven method. The SPC-Ag has a 3 D porous structure and a large specific surface area, which affords abundant active sites for the CO2 reduction reaction (CO2 RR), as well as reducing impedance to accelerate the CO2 RR kinetics. This distinctive organization affords SPC-Ag with outstanding electrocatalytic performance for CO2 reduction to CO. High faradaic efficiency (>90 %) and large partial current density for CO with excellent durability are observed in a wide potential window, with a maximum value of 93 % at -0.9 V versus reversible hydrogen electrode.

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BACKGROUND The ultrasonography-guided technique is superior to the traditional palpation technique for artery cannulation. However, considering the complexity of assembling the ultrasonography machine, this technique has not been extensively used. Here, we compared the ultrasonography-guided technique with the traditional palpation technique in adult patients in the pre-anesthesia room. MATERIAL AND METHODS A total of 66 patients were enrolled and divided into 2 groups: the ultrasonography group and the palpation group. Anesthesiologists then cannulated the radial artery via either method. The primary outcomes included the first-attempt success and total success rates, as well as the cannulation duration and total procedure duration. The secondary outcome was the rate of complications attributable to cannulation. RESULTS Overall, 60 patients were analyzed in the present study. The first-attempt success rate in the ultrasonography group (96.6%) was significantly higher than that in the palpation group (73.3%; P=0.03). There was no significant difference in the cannulation duration and the total procedure duration between the 2 groups. The rate of complications caused by cannulation in 2 groups was similar. CONCLUSIONS The ultrasonography-guided radial artery cannulation technique is more efficient for arterial cannulation in the pre-anesthesia room compared with the traditional palpation method.

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Abiotic stresses such as water deficit, salt, and heat are major environmental factors that negatively affect plant growth, development, and productivity. Previous studies showed that overexpression of the Arabidopsis vacuolar H+-pyrophosphatase gene AVP1 increases salt and water deficit stress tolerance and overexpression of the rice SUMO E3 ligase gene OsSIZ1 improves heat and water deficit stress tolerance in transgenic plants. In this report, the effects of co-overexpression of AVP1 and OsSIZ1 in Arabidopsis on abiotic stress tolerance were studied. It was found that AVP1/OsSIZ1 co-overexpressing plants performed significantly better than AVP1-overexpressing plants and OsSIZ1-overexpressing plants, and produced 100% more seed than wild-type plants under single stress or multiple stress conditions. The increased stress tolerance in AVP1/OsSIZ1 co-overexpressing plants was substantially larger than the increased stress tolerance in AVP1-overexpressing plants and OsSIZ1-overexpressing plants under every abiotic stress condition tested. This research provides the proof-of-concept that crop yields might be substantially improved using this approach.

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To solve the intrinsic deficiency inherited from the large band gap of ZnSn(OH)6 (ZSH), a gradual sulfur doping strategy is first proposed here to expand the optical absorption range, improve the separation efficiency of photogenerated electron-hole pairs, and thus enhance the photocatalytic activity. It is demonstrated that the distribution of sulfur in the flower-like ZSH (the sulfur doped sample is denoted as S-ZSH) tends to be largest on the outer most surface and becomes smaller towards the interior. The S-ZSH therefore has a gradual bandgap structure that is beneficial for transferring photogenerated charge carriers from the interior to the surface, which will greatly enhance the utilization of photoelectrons. As a result, the visible light photocurrent density of S-ZSH and the photocatalytic degradation rate of rhodamine (RhB) are about 5 and 10 times higher than with pristine ZSH, respectively.

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Recent results have evidenced that carbon plays an important role in stabilizing the structure of the active phase in catalysts. In this work, carbon-coated alumina was prepared by applying polydopamine (PDA) as a sacrificial carbon source to modify the surface properties of γ-alumina, which then was used as a support to prepare supported NiMo catalysts for hydrodesulfurization (HDS) of dibenzothiophene (DBT). NiMo/Al2O3 catalysts exhibited limited hydrodesulfurization performances due to their strong metal-support interaction. Herein, we report an unexpected phenomenon that sacrificial carbon layers can be constructed on the surface of the Al2O3 support from the carbonization of polydopamine (PDA) and mediated the interaction between the active site and support. Through the removal of carbon layers and sulfidation, the resulting NiMo catalysts exhibit excellent performance for HDS reaction of dibenzothiophene (DBT), which is associated with adequate loading of residual carbon species, leading to an enhanced amount of active species under sulfidation conditions. Moreover, the facile synthetic strategy can be extended to the stabilization of the active phase on a broad range of supports, providing a general approach for improving the metal-support interaction supported nanocatalysts.

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To find satisfactory treatment strategies for neuropathic pain syndromes, the cellular mechanisms should be illuminated. Central sensitization is a generator of pain hypersensitivity, and is mainly reflected in neuronal hyperexcitability in pain pathway. Neuronal excitability depends on two components, the synaptic inputs and the intrinsic excitability. Previous studies have focused on the synaptic plasticity in different forms of pain. But little is known about the changes of neuronal intrinsic excitability in neuropathic pain. To address this question, whole-cell patch clamp recordings were performed to study the synaptic transmission and neuronal intrinsic excitability 1 week after spared nerve injury (SNI) or sham operation in male C57BL/6J mice. We found increased spontaneous excitatory postsynaptic currents (sEPSC) frequency in layer II/III pyramidal neurons of anterior cingulate cortex (ACC) from mice with neuropathic pain. Elevated intrinsic excitability of these neurons after nerve injury was also picked up, which was reflected in gain of input-output curve, inter-spike interval (ISI), spike threshold and Refractory period (RP). Besides firing rate related to neuronal intrinsic excitability, spike timing also plays an important role in neural information processing. The precision of spike timing measured by standard deviation of spike timing (SDST) was decreased in neuropathic pain state. The electrophysiological studies revealed the elevated intrinsic excitation in layer II/III pyramidal neurons of ACC in mice with neuropathic pain, which might contribute to central excitation.

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BACKGROUND: We sought to evaluate the safety, efficacy, and cost-effectiveness of intraoperative blood salvage (IBS) in off-pump coronary artery bypass grafting (OPCABG) surgery with different amount of bleeding. METHODS: We retrospectively reviewed the medical records of 321 patients who underwent OPCABG between December 2012 and December 2016 at our hospital. Patients treated with IBS or allogeneic blood (AB) transfusions were divided into three groups depending on the amount of bleeding respectively: IBS1 or AB1 group (400-600 ml); IBS2 or AB2 group (600-1000 ml); IBS3 or AB3 group (1000-1500 ml). The intraoperative and postoperative conditions, blood transfusion volume, clinical and hematological outcomes, and total blood transfusion cost were examined. RESULTS: The amount of allogeneic red blood cell (RBC) transfusion in the IBSs groups were significantly lower than that in the ABs groups (P < 0.01). Furthermore, drainage volume 24 h post-surgery (P < 0.05) and white blood cell count (WBC) 2 day post-surgery (P < 0.01) in IBS3 group were significantly higher compared with the AB3 group. Additionally, when IBS cost was 230 USD per set, the total blood transfusion cost in the IBSs groups was significantly higher than that in the ABs groups (P < 0.01); however, when 199 or 184 USD, only the IBS1 group, rather than IBS2 or IBS3, showed significantly higher cost of the total blood transfusion compared with the AB1 group (P < 0.05). CONCLUSIONS: When the amount of bleeding was 600-1000 ml, IBS can significantly reduce the demand for allogeneic blood, and has no direct adverse effects on coagulation function and recuperation, and is cost-effective in OPCABG.

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BACKGROUND: During regional anesthesia, including combined spinal and epidural anesthesia (CSEA), patients may develop a perceptual alteration of limb position known as phantom limb syndrome (PLS). We aimed to identify factors that influence the PLS onset, to explore whether PLS predisposes to other postoperative symptoms, and to document the relationship between PLS and sensorimotor impairment during recovery. METHODS: Psychological questionnaires for anxiety and depression were completed beforehand, then multimodal tests of sensory and motor function, especially tests of proprioception, were performed regularly afterward. Two hundred participants undergoing elective gynecological surgery under CSEA reported their experiences of PLS and other symptoms using Likert rating scales. RESULTS: Prolonged preoperative fasting (odds ratio (OR) 2.34; 95% confidence intervals (CI) 1.21-4.52), and surgical history (OR 2.56; 95% CI 1.16-5.62) predisposed to PLS, but patients with more extensive anesthetic histories may be at lower risk (OR 0.57; 95% CI 0.31-1.08). Furthermore, significant correlations were observed between the recovery from PLS and the perception of joint movement within the deafferented area (R = 0.82, P < .01) and motor functions (R = 0.68). PLS increases the chance of experiencing postoperative fatigue, physical discomfort, and emotional upset. CONCLUSION: This study is the first to have identified the risk factors for PLS, assessed the relationship between PLS and postoperative sensorimotor impairment, and its influence on postoperative complications.

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During partial oxidation of methane (POM), the greatest challenge is to maintain the thermal stability of the catalyst at high temperatures. One of the most effective ways to improve thermal stability is to construct core-shell structure. Herein, using a microemulsion method, we synthesized a core-shell Ni/nanorod-CeO2@SiO2 catalyst, in which the Ni nanoparticles were supported on the CeO2 nanorods and encapsulated by SiO2 shells. Based on a series of characterizations, we found that the Ni particles are of nanosize (2.2 nm) and the thickness of the SiO2 shell is about 8 nm in the core-shell catalyst. Moreover, the Ni/nanorod-CeO2@SiO2 catalyst can perfectly maintain rod-like structures of the CeO2 support and enhance interaction between the metal Ni and CeO2, significantly reducing the sintering of metal Ni particles at high temperatures. Therefore, the as-prepared Ni/nanorod-CeO2@SiO2 catalyst shows high catalytic activity and good thermal stability during the POM reaction.

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A 25-days experiment was conducted to evaluate the effect of dietary Haematococcus pluvialis on growth, survival, immune response and stress tolerance ability of post-larval Litopenaeus vannamei. Post-larval white shrimp (mean initial weight 2.1 mg) were fed five isoenergic and isonitrogenous diets containing grade levels of Haematococcus pluvialis (0, 1.7, 3.3, 6.7 and 13.3 g kg-1 diet, respectively). Results indicated that 3.3 g Haematococcus pluvialis kg-1 diet increased the survival rate of post-larval white shrimp. Specific growth rate (SGR) and weight gain (WG) showed no difference among each groups. After the acute salinity stress (salinity decreased rapidly from 28‰ to 5‰), survival of shrimp fed 6.7 g Haematococcus pluvialis kg-1 diet significant higher than the control (P < 0.05), and the total antioxidant capacity (T-AOC) was increased with the increasing dietary Haematococcus pluvialis levels. The malonaldehyde (MDA) contents in whole body decreased with the increasing dietary Haematococcus pluvialis levels before and after the salinity stress. Before the salinity stress, relative mRNA levels of Caspase 3, Rho and Janus kinase (JAK) decreased in shrimp fed diets contain Haematococcus pluvialis. After the salinity stress, relative mRNA levels of anti-oxidative related genes and immune related genes decreased with the dietary Haematococcus pluvialis level increased to 3.3 g kg-1. Based on the effect of Haematococcus pluvialis on survival, salinity stress tolerance ability and the immune response of post-larval L. vannamei, the optimal level of Haematococcus pluvialis was 3.3-6.7 g kg-1 diet (100-200 mg astaxanthin kg-1 diet).

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Hybrid vigor contributes in a large way to the yield and quality of cotton (Gossypium hirsutum) fiber. Although microRNAs play essential regulatory roles in flower induction and development, it is still unclear if microRNAs are involved in male sterility, as the regulatory molecular mechanisms of male sterility in cotton need to be better defined. In this study, two independent small RNA libraries were constructed and sequenced from the young buds collected from the sporogenous cell formation to the meiosis stage of the male sterile line Yu98-8A and the near-isogenic line. Sequencing revealed 1588 and 1536 known microRNAs and 347 and 351 novel miRNAs from male sterile and male fertile libraries, respectively. MicroRNA expression profiles revealed that 49 conserved and 51 novel miRNAs were differentially expressed. Bioinformatic and degradome analysis indicated the regulatory complexity of microRNAs during flower induction and development. Further RT-qPCR and physiological analysis indicated that, among the different Kyoto Encyclopedia Gene and Genomes pathways, indole-3-acetic acid and gibberellic acid signaling transduction pathways may play pivotal regulatory functions in male sterility.

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Uniform 3D NiMoS nanoflowers with self-assembled nanosheets were successfully synthesized via a simple hydrothermal growth method using cheap and nontoxic elemental sulfur as sulfur sources. The structure and morphology of the nanomaterials were characterized by SEM, TEM, XRD, Raman and XPS analyses, revealing that the NiMoS nanoflowers were composed of ultrathin nanosheets with a thickness of approximately 6-12 nm. The HRTEM results indicate that the curve/short MoS2 slabs on the nanosheets possess the characteristics of dislocations, distortions and discontinuity, which suggests a defect-rich structure, resulting in the exposure of additional Ni-Mo-S edge sites. The obtained NiMoS nanoflowers exhibited an excellent activity for thiophene hydrodesulfurization (HDS) and 4,6-dimethyldibenzothiophene deep HDS due to their high density of active sites. The outstanding HDS performance suggests that these NiMoS composites with a unique flower-like nanostructure could be useful as promising catalysts for deep desulfurization of fuel oils.

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Verticillium wilt is threatening cotton productivity globally. This disease is caused by soil-borne Verticillium dahliae which directly infects cotton roots, and exclusively colonizes and occludes xylem vessels, finally resulting in necrosis, defoliation, and most severely, plant death. For the first time, iTRAQ (isobaric tags for relative and absolute quantification) was applied to screen the differentially expressed proteins of Gossypium thurberi inoculated with V. dahliae. A total of 6533 proteins were identified from the roots of G. thurberi after inoculation with V. dahliae, and 396 showed up- and 279 down-regulated in comparison to a mock-inoculated roots. Of these identified proteins, the main functional groups were those involved in cell wall organization and reinforcement, disease-resistant chemicals of secondary metabolism, phytohormone signaling, pathogenesis-related proteins, and disease-resistant proteins. Physiological and biochemical analysis showed that peroxidase activity, which promotes the biosynthesis and accumulation of lignin, was induced early in the hypocotyl after inoculation with V. dahliae. Similarly, salicylic acid also accumulated significantly in hypocotyl of the seedlings after inoculation. These findings provide an important knowledge of the molecular events and regulatory networks occurring during G. thurberi-V. dahliae interaction, which may provide a foundation for breeding disease-resistance in cotton.

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