Rui Li’s research while affiliated with Nanjing Medical University and other places

Gastric cancer (GC) occupies the first few places in the world among tumors in terms of incidence and mortality, causing serious harm to human health, and at the same time, its treatment greatly consumes the health care resources of all countries in the world. The diagnosis of GC is usually based on histopathologic examination, and it is very important to be able to detect and identify cancerous lesions at an early stage, but some endoscopists’ lack of diagnostic experience and fatigue at work lead to a certain rate of under diagnosis. The rapid and striking development of Artificial intelligence (AI) has helped to enhance the ability to extract abnormal information from endoscopic images to some extent, and more and more researchers are applying AI technology to the diagnosis of GC. This initiative has not only improved the detection rate of early gastric cancer (EGC), but also significantly improved the survival rate of patients after treatment. This article reviews the results of various AI-assisted diagnoses of EGC in recent years, including the identification of EGC, the determination of differentiation type and invasion depth, and the identification of borders. Although AI has a better application prospect in the early diagnosis of ECG, there are still major challenges, and the prospects and limitations of AI application need to be further discussed.

Exosomes served as “communicators” to exchange information among different cells in the nervous system. Our previous study demonstrated that the enhanced spinal synaptic transmission contributed to chronic visceral pain in irritable bowel syndrome. However, the underlying mechanism of primary sensory neuron (PSN)-derived exosomes on spinal transmission remains unclear. In this study, an exosome visualization method was established to specifically track exosomes derived from PSNs in CD63-GFP f/+ (green fluorescent protein) mice. Neonatal maternal deprivation (NMD) was adopted to induce chronic visceral pain in CD63-GFP f/+ male mice. The exosome visualization technology demonstrated that NMD increased visible PSN-derived exosomes in the spinal dorsal horn, enhanced spinal synaptic transmission, and led to visceral pain in CD63-GFP f/+ male mice. The PSN-derived exosomal miR-1306-3p sorted from spinal dorsal horn activated P2X3R, enhanced spinal synaptic transmission, and led to visceral pain in NMD mice. Moreover, upregulation of Rab27a in dorsal root ganglia mediated the increased release of PSN-derived exosomes, and intrathecal injection of siR-Rab27a reduced visible PSN-derived exosomes in spinal cord, suppressed spinal synaptic transmission, and alleviated visceral pain in NMD mice. This and future studies would reveal the detailed mechanisms of PSN-derived exosomes and provide a potential target for clinical treatment of chronic visceral pain in patients with irritable bowel syndrome.

Purpose This study aims to validate and revise the Spot Vision Screener referral criteria for detecting amblyopia risk factors (ARFs), visually significant refractive error (VSRE), and amblyopia. Methods In clinics, we gathered data from children aged 12 months to 7 years. The validity of the cut-off values was assessed using receiver operating characteristic (ROC) curves, with cycloplegic retinoscopy serving as a reference. These results were compared to the age-based 2021 AAPOS diagnostic thresholds. Additionally, this study validated previously reported referral criteria within its population. Results The study involved 1103 children (347 below four years; 756 aged four years and above). We established optimal cut-off points for hyperopia, myopia, astigmatism, and anisometropia: +2.13D, −2.88D, −2.88D, and 0.88D for children under four years; +1.88D, −1.88D, −2.13D, and 0.88D for those four years and older, forming the “Nanjing Referral Criteria”. The Youden index for several existing referral criteria ranged from 0.08 to 0.53 in detecting ARFs & VSRE and from 0.08 to 0.48 for ARFs, VSRE, and amblyopia. Conclusion The study proposes the “Nanjing Referral Criteria” and its modified version with enhanced specificity for the Spot Vision Screener to optimize vision screening in children. Vision screening programs can utilize this validated data to select referral criteria best suited to their local context.

Purpose: To evaluate the refractive differences among school-aged children with macular or peripapillary fundus tessellation (FT) distribution patterns, using fundus tessellation density (FTD) quantified by deep learning (DL) technology. Methods: The cross-sectional study included 1942 school children aged six to 15 years, undergoing ocular biometric parameters, cycloplegic refraction, and fundus photography. FTD was quantified for both the macular (6 mm) and peripapillary (4 mm) regions, using DL-based image processing applied to 45° color fundus photographs. Eyes exhibiting tessellation were classified into two groups: the macular distribution group had greater FTD in the macular area, while the peripapillary distribution group had higher FTD in the peripapillary area, allowing for a comparative analysis of axial length (AL), corneal radius, and refraction. Results: Participants had a median age of 13 years and a median spherical equivalent (SE) of -0.75 D. The macular distribution group exhibited significantly larger AL (24.13 mm vs. 23.93 mm, P < 0.001) and more myopic refraction (-1.13 D vs. -0.75 D, P < 0.001) compared to the peripapillary group. A higher prevalence of macular-distributed FT was noted in the myopic groups (χ2 = 131.675, P < 0.001). SE negatively correlated with macular (r = -0.238) and peripapillary FTD (r = -0.195), while AL positively correlated with FTD in both regions (r = 0.308; r = 0.265) (all P < 0.001). Conclusions: The macular FT distribution pattern is significantly associated with larger AL and greater myopic refraction in school-aged children, suggesting its potential as a marker for identifying children at risk of progressing myopia. Translational relevance: DL analysis precisely identifies FT distribution patterns, potentially enhancing early detection of high-risk myopia in populations.

Resilience was a core factor for mitigating the risks of adverse impacts of workplace violence (WPV) and may be determined by perceived organizational support (POS) and coping styles. The aim of this study was to examine the potential mediation effects of coping styles between POS and resilience in emergency nurses exposed to WPV. Participants were 670 emergency nurses (84.0% female; mean age 30.94 [SD 6.13]) reporting WPV exposure in the past 3 months. Potential mediation effects of coping styles were explored using structural equation modeling. Results showed that POS, negative coping style, and positive coping style were associated with resilience in emergency nurses exposed to WPV. Coping styles mediated the association of POS with resilience. Two indirect pathways explained 21.8% and 22.4% of the variance in nurse resilience, respectively. The findings underscore the importance of POS and coping skills in promoting resilience of emergency nurses exposed to WPV. Nurse management programs are warranted to improve the resilience of emergency nurses at the organizational and individual levels.

Introduction α-Calcium sulfate hemihydrate (α-CSH) is a widely used artificial bone graft material, but it suffers from rapid deterioration and limited osteoinductivity. This study aims to develop composite cements by combining treated dentin matrix (TDM) with α-CSH to enhance osteogenic properties for the healing of bone deformities. Methods The composite cements were prepared by mixing treated dentin matrix (TDM) with α-calcium sulfate hemihydrate (α-CSH) and characterized for their mechanical, morphological, and chemical properties using a universal mechanical testing machine, scanning electron microscopy (SEM), X-ray diffraction (XRD), and Fourier-transform infrared (FTIR) spectroscopy. The biological performance was assessed by measuring osteoblast proliferation using the CCK-8 test and evaluating new bone formation in a calvarial bone defect model in rats. Results The compressive strength of the TDM/α-CSH cements decreased with increasing TDM mass ratio, while SEM analysis revealed a distinct three-dimensional porous network structure and increased surface roughness upon thorough mixing. XRD and FTIR studies confirmed the physical mixture of the two materials without phase changes. The TDM/α-CSH composites significantly stimulated osteoblast proliferation, which was dependent on the TDM content, and demonstrated superior enhancement in new bone formation as confirmed by X-ray examination and micro-CT analysis. Discussion The findings suggest that TDM/α-CSH composite cements have promising potential as an alternative for repairing bone defects due to their improved mechanical properties, osteoblast proliferation, and enhanced new bone formation in vivo. Conclusion TDM/α-CSH composite cements show potential as a novel bone graft material, offering advantages in terms of mechanical strength, osteoconductivity, and osteoinductivity, making them a viable option for bone repair applications.

Chronic visceral pain stems from internal organs and is frequently associated with functional gastrointestinal disorders, like irritable bowel syndrome (IBS). Since the underlying mechanisms of visceral pain remain largely unclear, clinical management is often limited and ineffective. Comprehensive research into the pathogenesis of visceral pain, along with the development of personalized therapeutic strategies, is crucial for advancing treatment options. Studies suggest that imbalances in purinergic receptors and neural circuit function are closely linked to the onset of visceral pain. In this review, we will explore the etiology and pathological mechanisms underlying visceral pain, with a focus on ion channels, epigenetic factors, and neural circuits, using functional gastrointestinal disorders as case studies. Finally, we will summarize and evaluate emerging treatments and potential initiatives aimed at managing visceral pain.

Gastric pain has limited treatment options and the mechanisms within the central circuitry remain largely unclear. This study investigates the central circuitry in gastric pain induced by noxious gastric distension (GD) in mice. Here, we identified that the nucleus tractus solitarius (NTS) serves as the first-level center of gastric pain, primarily via the vagus nerve. The prelimbic cortex (PL) is engaged in the perception of gastric pain. The lateral parabrachial nucleus (LPB) and the paraventricular thalamic nucleus (PVT) are crucial regions for synaptic transmission from the NTS to the PL. The glutamatergic tetra-synaptic NTS–LPB–PVT–PL circuitry is necessary and sufficient for the processing of gastric pain. Overall, our finding reveals a glutamatergic tetra-synaptic NTS–LPB–PVT–PL circuitry that transmits gastric nociceptive signaling by the vagus nerve in mice. It provides an insight into the gastric pain ascending pathway and offers potential therapeutic targets for relieving visceral pain.

Perovskite nanocrystals (PeNCs)-based light-emitting diodes (PeLEDs) are emerging as promising candidates for next-generation electroluminescent devices. However, their practical application is limited due to the poor stability of PeNCs. Here, we demonstrate an efficient and stable PeLED enabled by entropy-driven CsCd _0.1 Pb _0.8 Sr _0.1 Br ₃ PeNCs as emitter. Based on density functional theory (DFT) calculations with the Compound Energy Formalism (CEF) model, the simultaneous incorporation of multiple elements increases the entropy (S) of PeNCs, thereby enhancing their stability and suppressing lattice defects. The optimized PeLED achieves a maximum external quantum efficiency (EQE) of 22.2%, dramatically surpassing that (14.1%) of the control CsPbBr ₃ -based device. More importantly, the device operating lifetime reaches 10 h, 14-fold higher than that of the control LED.

Immune checkpoint inhibitors (ICIs) have significantly transformed the treatment of gastroesophageal cancer (GEC). However, the lack of reliable prognostic biomarkers hinders the ability to predict patient response to ICI therapy. In this study, we engineered and validated a genomic mutation signature (GMS) utilizing an innovative artificial intelligence (AI) algorithm to forecast ICI therapy outcomes in GEC patients. We further explored immune profiles across subtypes through comprehensive multiomics analysis. Our investigation of drug sensitivity data from the Genomics of Drug Sensitivity in Cancer (GDSC) database led to the identification of trametinib as a potential therapeutic agent. We subsequently evaluated trametinib’s efficacy in AGS and MKN45 cell lines using Cell Counting Kit-8 (CCK8) assays and clonogenic experiments. We developed a GMS by integrating 297 algorithms, enabling autonomous prognosis prediction for GEC patients. The GMS demonstrated consistent performance across three public cohorts, exhibiting high sensitivity and specificity for overall survival (OS) at 6, 12, and 18 months, as shown by Receiver Operator Characteristic Curve (ROC) analysis. Notably, the GMS surpassed traditional clinical and molecular features, including tumor mutational burden (TMB), programmed death-ligand 1 (PD-L1) expression, and microsatellite instability (MSI), in predictive accuracy. Low-risk samples exhibited elevated levels of cytolytic immune cells and heightened immunogenic potential compared to high-risk samples. Our investigation identified trametinib as a potential therapeutic agent. An inverse correlation was observed between GMS and trametinib IC50. Moreover, the high-risk-derived AGS cell line showed increased sensitivity to trametinib compared to the low-risk-derived MKN45 cell line. The GMS utilized in this study successfully demonstrated the ability to reliably predict the survival advantage for patients with GECs undergoing ICI therapy.