Gastric cancer (GC) is a relevant public health issue as its incidence and mortality rates are growing worldwide. There are recognized carcinogen agents, such as obesity, tobacco, meat, alcohol consumption and some dietary protective factors. Strategies of early diagnosis through population-based surveillance programs have been demonstrated to be effective in lowering the morbidity and mortality related to GC in some countries. Indeed, the detection of early lesions is very important in order to offer minimally invasive treatments. Endoscopic resection is the gold standard for lesions with a low risk of lymph node metastasis, whereas surgical mini-invasive approaches can be considered in early lesions when endoscopy is not curative. This review outlines the role of lifestyle and prevention strategies for GC, in order to reduce the patients’ risk factors, implement the surveillance of precancerous conditions and, therefore, improve the diagnosis of early lesions. Furthermore, we summarize the available treatments for early gastric cancer.

https://www.mdpi.com/1660-4601/20/3/2149/pdf?version=1675741708

Early Gastric Cancer: Update on Prevention, Diagnosis and Treatment

Chitosan is a promising naturally derived polysaccharide to be used in hydrogel forms for pharmaceutical and biomedical applications. The multifunctional chitosan-based hydrogels have attractive properties such as the ability to encapsulate, carry, and release the drug, biocompatibility, biodegradability, and non-immunogenicity. In this review, the advanced functions of the chitosan-based hydrogels are summarized, with emphasis on fabrications and resultant properties reported in literature from the recent decade. The recent progress in the applications of drug delivery, tissue engineering, disease treatments, and biosensors are reviewed. Current challenges and future development direction of the chitosan-based hydrogels for pharmaceutical and biomedical applications are prospected.

/pdf/recent-development-of-functional-chitosan-based-hydrogels-3nfrk5st.pdf

Recent Development of Functional Chitosan-Based Hydrogels for Pharmaceutical and Biomedical Applications

Abstract Microbial infections based on drug‐resistant pathogenic organisms following surgery or trauma and uncontrolled bleeding are the main causes of increased mortality from trauma worldwide. The prevalence of drug‐resistant pathogens has led to a significant increase in medical costs and poses a great threat to the normal life of people. This is an important issue in the field of biomedicine, and the emergence of new antimicrobial materials hydrogels holds great promise for solving this problem. Hydrogel is an important material with good biocompatibility, water absorption, oxygen permeability, adhesion, degradation, self‐healing, corrosion resistance, and controlled release of drugs as well as structural diversity. Bacteria‐disturbing hydrogels have important applications in the direction of surgical treatment, wound dressing, medical device coating, and tissue engineering. This paper reviews the classification of antimicrobial hydrogels, the current status of research, and the potential of antimicrobial hydrogels for one application in biomedicine, and analyzes the current research of hydrogels in biomedical applications from five aspects: metal‐loaded hydrogels, drug‐loaded hydrogels, carbon‐material‐loaded hydrogels, hydrogels with fixed antimicrobial activity and biological antimicrobial hydrogels, and provides an outlook on the high antimicrobial activity, biodegradability, biocompatibility, injectability, clinical applicability and future development prospects of hydrogels in this field. 

Antimicrobial Hydrogels: Potential Materials for Medical Application.

Different types of clinical wounds are difficult to treat while infected by bacteria. Wound repair involves multiple cellular and molecular interactions, which is a complicated process. However, wound repair often suffers from abnormal cellular functions or pathways that result in unavoidable side effects, so there is an urgent need for a material that can heal wounds quickly and with few side effects. Based on these needs, hydrogels with injectable properties have been confirmed to be able to undergo self-healing, which provides favorable conditions for wound healing. Notably, as a biopolymer with excellent easy-to-modify properties from a wide range of natural sources, chitosan can be used to prepare injectable hydrogel with multifunction for wound healing because of its outstanding flowability and injectability. Especially, chitosan-based hydrogels with marked biocompatibility, non-toxicity, and bio-adhesion properties are ideal for facilitating wound healing. In this review, the characteristics and healing mechanisms of different wounds are briefly summarized. In addition, the preparation and characterization of injectable chitosan hydrogels in recent years are classified. Additionally, the bioactive properties of this type of hydrogel in vitro and in vivo are demonstrated, and future trend in wound healing is prospected.

Chitosan-based injectable hydrogel with multifunction for wound healing: A critical review

Over the years, polysaccharides such as chitosan, alginate, hyaluronic acid, k-carrageenan, xanthan gum, carboxymethyl cellulose, pectin, and starch, alone or in combination with proteins and/or synthetic polymers, have been used to engineer an extensive portfolio of hydrogels with remarkable features. The application of polysaccharide-based hydrogels has the potential to alleviate challenges related to bioavailability, solubility, stability, and targeted delivery of phytocompounds, contributing to the development of innovative and efficient drug delivery systems and functional food formulations. This review highlights the current knowledge acquired on the preparation, features and applications of polysaccharide/phytocompounds hydrogel-based hybrid systems in wound management, drug delivery, functional foods, and food industry. The structural, functional, and biological requirements of polysaccharides and phytocompounds on the overall performance of such hybrid systems, and their impact on the application domains are also discussed. 

Trends in polysaccharide-based hydrogels and their role in enhancing the bioavailability and bioactivity of phytocompounds

Injectable carboxymethyl chitosan-genipin hydrogels encapsulating tea tree oil for wound healing.

Introduction Natural orifice specimen extraction surgery (NOSES) has been widely regarded as a new technology in minimally invasive surgery. Meanwhile, carbon nanoparticles have been increasingly used for lymph node tracing in colorectal cancer surgery. Aim To evaluate the effectiveness and feasibility of carbon nanoparticle-assisted natural orifice specimen extraction surgery with left colic artery preservation for total laparoscopic colorectal resection. Material and methods We retrospectively reviewed the medical records of 83 patients diagnosed with sigmoid colon cancer or mid- and upper-rectal cancer from October 2017 to June 2020. These patients were divided into the NOSES group who underwent left colic artery preservation NOSES, being injected with a carbon nanoparticle suspension under colonoscopy the day before surgery, and the LA group, who underwent left colic artery preservation laparoscopic surgery. Surgical outcomes were retrospectively analyzed. Results The mean number of harvested lymph nodes (p < 0.001) in the NOSES group was higher than in the LA group. Conversely, as regards pain score (p < 0.001) and postoperative hospital stay (p = 0.035), the LA group has higher mean values. The incidence of perioperative complications (p = 0.385) was 5.3% for the NOSES group compared to 13.3% for the LA group. Conclusions Preoperative colonoscopic injection of a carbon nanoparticle suspension is a feasible and practical solution to dissect lymph nodes surrounding the inferior mesenteric artery without affecting the left colic artery in patients with colorectal cancer and about to receive NOSES. Moreover, NOSES combined with this approach leads to less postoperative pain and shorter hospital stays.

/pdf/carbon-nanoparticle-assisted-natural-orifice-specimen-e42iivoo.pdf

Carbon nanoparticle-assisted natural orifice specimen extraction surgery with left colic artery preservation: a retrospective study

Simple Summary Conventional gastrectomy combined with regional lymph node dissection has been the standard treatment for early gastric cancer (EGC). This retrospective case–control study aimed to compare the clinical outcomes of endoscopic submucosal dissection (ESD) and surgical resection for EGC in China. After propensity score-matching, there were no significant differences between the two groups for OS, RFS, and DSS. Additionally, with similar R0 resection and recurrence rates, the ESD group showed less blood loss, fewer adverse events, lower hospital cost, and a shorter operative time and hospital duration than the surgery group. Therefore, ESD can be a first-line treatment of EGC in addition to surgery. Abstract Background: Endoscopic submucosal dissection (ESD) has become a preferred treatment option for early gastric cancer (EGC). This study aimed to compare the clinical outcomes of ESD and surgical resection for EGC. Methods: This was a retrospective case–control study. Patients with a diagnosis of EGC who underwent ESD or surgery in our hospital from 2011 to 2020 were enrolled. We compared the clinical characteristics and treatment outcomes of these two groups according to propensity score-matching. The primary outcome comparison was overall survival (OS). Secondary outcomes were disease-specific survival (DSS), recurrence-free survival (RFS), and treatment-related events. Results: In the matched cohort, the ESD group showed comparable OS, RFS, and DSS with the surgery group. Statistical differences were shown in blood loss and adverse events. Furthermore, the ESD group showed lower hospital cost, as well as a shorter operative time and hospital duration than the surgery group. The R0 resection and recurrence rates were similar between the two groups. In Cox regression analysis, age, tumor size, poor differentiation, and lymphovascular invasion were regarded as independent factors of OS. Conclusions: With sufficient safety and advantages, ESD can be a first-line treatment of EGC. Preoperative evaluation is vital to the appropriate treatment and prognosis.

/pdf/comparison-between-endoscopic-submucosal-dissection-and-3eawn3he.pdf

Comparison between Endoscopic Submucosal Dissection and Surgery in Patients with Early Gastric Cancer

Introduction Previous observational studies have demonstrated the relationship between leisure sedentary behavior, physical activity, and nonalcoholic liver disease (NAFLD). However, whether these associations are causal or confounding factors remains unclear. Methods Pooled genetic data from the UK Biobank and other large genome-wide association studies (GWAS) were used to extract instrumental variables representing sedentary television watching, computer use, driving, vigorous physical activity (VPA), and moderate-to-vigorous physical activity (MVPA). The two-sample Mendelian randomization (MR) method was used to explain the causal relationship between them and NAFLD. The inverse variance of the weighted method was used as the main analysis method, and MR-Egger, weighted median, MR-PRESSO, and other supplementary methods were also used. A sensitivity analysis was also performed. Simultaneously, the common risk factors for NAFLD were further analyzed for potential mediating associations. Results We observed that sedentary television viewing (odds ratio (OR): 1.84; 95% confidence interval (CI): 1.09–3.10; p = 0.021) and genetically predicted VPA duration (OR: 0.0033; 95% CI: 0.000015–0.70; p = 0.036) were suggestively associated with the risk of NAFLD. Using a computer (OR: 1.51; 95% CI: 0.47–4.81; p = 0.484), driving (OR: 0.78; 95% CI: 0.05–11.94; p = 0.858), and MVPA time (OR: 0.168; 95% CI: 0.01–2.81; p = 0.214) were not significantly associated with NAFLD. The role of heterogeneity versus pleiotropy was limited in all the analyses. Discussion This study supports the association between sedentary television watching and an increased risk of NAFLD, along with vigorous physical activity as a possible protective factor for NAFLD.

/pdf/association-of-leisure-sedentary-behavior-and-physical-1nc0zf7k.pdf

Association of leisure sedentary behavior and physical activity with the risk of nonalcoholic fatty liver disease: a two-sample Mendelian randomization study

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Injectable carboxymethyl chitosan-genipin hydrogels encapsulating tea tree oil for wound healing.

Carbon nanoparticle-assisted natural orifice specimen extraction surgery with left colic artery preservation: a retrospective study

Comparison between Endoscopic Submucosal Dissection and Surgery in Patients with Early Gastric Cancer

Association of leisure sedentary behavior and physical activity with the risk of nonalcoholic fatty liver disease: a two-sample Mendelian randomization study